April 22, 2021. Some coronavirus stuff.

April 22, 2021

An informed guide to the pandemic, with the latest developments and expert advice about prevention and treatment.

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The New York Times

By Jonathan Wolfe and Amelia Nierenberg

A preliminary study found no evidence that the Pfizer or Moderna vaccines are unsafe during pregnancy. Germany approved a law expected to bring stricter lockdowns. U.S. regulators found more flaws at the plant where Johnson & Johnson doses were ruined. Get the latest updates here, as well as maps and vaccines in development.

How India’s outbreak became the worst in the world

India recorded 312,731 new infections on Thursday, making the current outbreak there the worst measured in the world over the last year. Previously, the U.S. had the highest one-day record, of 300,669 coronavirus cases, on Jan. 8.

Over the last two months the situation in India has spiraled out of control — and could get much worse. To understand the steps that got us here, I spoke to Jeffrey Gettleman, The Times’s South Asia bureau chief, who is based in New Delhi.

“Chapter No. 1 is false confidence,” Jeffrey said. In the spring of 2020, as Italy and other Western countries were being pummeled, India was doing comparatively well, with only a few deaths. That led to the mistaken belief that the country might have natural resistance to the virus and could possibly avoid a serious outbreak. As cases started ticking up, Jeffrey said, “India went into a harsh lockdown, with more people under restrictions than anywhere else.”

Two: An urban exodus. A turbulent migration of poor people who couldn’t afford to live under the lockdown followed. Workers in the informal sector — rickshaw drivers, construction workers, street vendors — moved by the tens of millions to the countryside. “It was the greatest mass movement of people across the Indian continent since 1947,” Jeffrey said. “These migrants left the cities, and they went everywhere, and they brought the virus with them because the cities were the hot spots.”

Daily new cases in India.The New York Times

Three: A lockdown lifts, and a spike follows. Some restrictions were rolled back in the summer, although schools and many public spaces remained closed. Last fall, cases soared to nearly 100,000 per day. “But the decision from leaders was we just have to move on,” Jeffrey said. The country didn’t want to ruin its economy with more restrictions.

Four: The long lull. The winter of 2020 and early spring of 2021 saw a drastic drop in cases and a long period of low case rates. “There was this idea again that India somehow was going to evade what had affected the rest of the world,” Jeffrey said. “People here thought it was over.”

Five: The second wave. It arrived last month. Cases skyrocketed, partly because restrictions were relaxed, and in some places, Jeffrey said, “nobody was wearing masks — like nobody.” Experts also think a “double mutant” variant, which has multiple mutations that make it more contagious and better able to reinfect people, may be to blame.

Hospitals are now overwhelmed, and the vaccination rollout has been slow — only around 9 percent of the population has had at least one shot. “There’s a sense of panic, and it’s really widespread,” Jeffrey said. “Just from my own personal experience, I had a couple of friends that got Covid during the last surge. And now, like half the people I’m friends with have it. Neighbors, colleagues, fellow journalists, people at our school. So many people we know.”

Six: The weeks ahead. Experts and modeling projections suggest that things are going to get worse for another couple of weeks, but that cases will then drop pretty fast, Jeffrey said. “The question is, will they be able to handle the surge?”

He added: “Can they keep up with the demand for oxygen, medicine and hospital beds? If they can hang on, we hope, for the next few weeks, the power of the virus may dissipate.”

Masks off outside?

As most people get vaccinated and spring weather beckons, we can, in some circumstances, safely remove our masks outdoors.

A growing body of research shows that transmission of the virus is far less likely outdoors because viral particles quickly disperse, Linsey Marr, a professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission, told The Times. The risk of inhaling aerosolized virus from a jogger, biker or someone walking by you is negligible, and will get even lower as more people get vaccinated.

One way to calibrate your risk is to use the “two out of three” rule, which Dr. Marr employs. In situations where she doesn’t know everyone’s vaccination status, she makes sure she’s meeting two out of three conditions: outdoors, distanced and masked.

You should still mask up if you need to have an extended conversation with someone who isn’t vaccinated. Masks are still advised in outdoor crowds, as standing shoulder to shoulder with strangers could increase risk, particularly for the unvaccinated.

“If you’re outdoors, you either need to be distanced or masked,” Dr. Marr said. “If you’re not outdoors, you need to be distanced and masked. This is how I’ve been living for the past year.”

Vaccination rollout

The European Union will not order an extra 100 million vaccines from AstraZeneca foreseen in its contract, a European Commission spokesman said. The European Commission, the bloc’s executive body, is preparing legal proceedings against AstraZeneca, accusing it of failing to deliver the number of vaccine doses it promised, Politico reports. With all Americans over 16 now eligible for a vaccine, high schools are opening pop-up sites to inoculate teenagers, NBC reports.

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What else we’re following

A large new study found that the health effects of Covid-19 appear to increase the risk of death and chronic medical conditions even in people who were never sick enough to be hospitalized. As the Biden administration seeks to get most adults vaccinated by summer, men are holding back. California’s virus case rate is now the lowest in the contiguous U.S., The Los Angeles Times reports. A new study of a Nebraska school district has found that infection rates may be higher in schools than previously thought, ABC reports. Fully vaccinated baseball fans will have their own section at the Los Angeles Dodgers game this weekend against the San Diego Padres. The Burning Man festival, which draws around 80,000 people to the Nevada desert, is considering mandatory Covid vaccines for this year’s festivities in August, The Associated Press reports.