The New York Times. More stuff about the coronavirus thing.

June 21, 2021

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

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By Amelia Nierenberg Writer, Briefings

Medicaid enrollment jumped during the pandemic, with nearly 10 million Americans joining the health program for the poor. Some Japanese residents will be allowed to attend the Tokyo Olympics as spectators, indicating a growing certainty the event will go forward. The U.S. sent 2.5 million Moderna doses to Taiwan, prompting criticism from China. Get the latest updates here, as well as maps and a vaccine tracker.

A look into Southeast Asia

The countries of Southeast Asia largely escaped the worst of the coronavirus pandemic during its first year. But now, as more infectious variants take hold, the region is suffering from new outbreaks and lockdowns and lags the rest of the world in vaccinations.

“As the West is coming out if it, we’re probably looking at months and months of more deaths and spiraling outbreaks,” Hannah Beech, the Southeast Asia bureau chief for The Times, told me.

As the Delta variant rolls across the globe, Indonesia, Myanmar and the Philippines in particular are facing frightening waves.

“Hospital wards in Jakarta, Indonesia’s capital, are again full,” Hannah said. “There are not enough ventilators. People who were involved in the fight against Covid — frontline medical workers and others — are dying again.”

And they are not vaccinating fast enough to combat the spread. The region’s middle-income countries “kind of fell through the cracks,” Hannah said. “It wasn’t necessarily easy or economically advantageous for them to join Covax, the global vaccine-sharing initiative. But they weren’t rich enough to secure vaccines from Western countries.”

Last year, AstraZeneca designated Thailand as the regional hub for its vaccine and awarded a manufacturing contract to Siam Bioscience, a pharmaceutical firm controlled by the king of Thailand, which had no experience making vaccines.

Then, earlier this month, many hospitals in Thailand canceled vaccine appointments and the governments of Malaysia, the Philippines and Taiwan scaled back their vaccine programs because of what they said were lower-than-expected shipments from Thailand. (Thailand disputed the claims.)

Governments have also “used the pandemic to tighten political control and tamp down on dissent,” Hannah said. “States of emergency that are ostensibly about the pandemic are being used to stop dissidents from speaking their minds.”

Today’s outbreaks are a far cry from the early months of the pandemic, when theories abounded to explain the region’s relative success. Was it because people were used to masks? Or just luck?

One possible answer, researchers say, may come from bats: Thailand, Laos and parts of Southwestern China are home to a species that scientists think may have carried the coronavirus that causes Covid-19. Earlier forms of the coronavirus may have been circulating in the region for years.

“It is possible that people within this region were exposed to an earlier version of the coronavirus that could have, while not totally inoculating them, made them less prone to suffering as severely from the initial outbreak,” Hannah said.

Antibody tests and vaccines

Some of our readers have recently shared stories about getting antibody tests after receiving their coronavirus vaccines, only to be devastated when the tests came back negative. In fact, experts say most people don’t need a test to confirm their vaccine’s efficacy. The test results can be misleading or useless.

Extensive clinical trials have already shown that vaccines authorized in the United States trigger a strong antibody response for just about everyone. The exceptions are people with weakened immune systems or those who take certain medications.

To get a reliable answer from testing, vaccinated people would have to get a specific kind of test at the right time. Take the test too soon, or rely on one that looks for the wrong antibodies — all too easy to do, given the befuddling array of tests now available — and you may believe yourself to still be vulnerable when you are not.

Our colleague Apoorva Mandavilli has these takeaways.

Many tests look for a type of antibody that vaccines don’t produce. Many tests seek out antibodies to a protein called the nucleocapsid, or just “N,” which are often plentiful right after an infection. But U.S.-authorized vaccines create antibodies for a different protein, called the spike. Timing is everything. If you got a vaccine made by Pfizer-BioNTech or Moderna, you need to wait at least two weeks after your second dose. If you got the Johnson & Johnson vaccine, you may need to wait as long as four weeks.

Antibodies are just one aspect of immunity. The body also maintains so-called cellular immunity, a complex network of defenders that also responds to invaders.

The advice is still evolving, in part because the F.D.A. has been slow to wade in.

In May, the agency recommended against the use of antibody tests for assessing immunity — a decision that has drawn criticism from some scientists — and provided only bare-bones information about testing to health care providers. As a result, many doctors are still unaware of the differences between antibody tests.

Vaccine rollout

In 11 states, the rate of vaccination for people older than 65 is lower than the national level. Singapore will permit shots from Sinovac, a Chinese company, but top health officials doubt their effectiveness. Fully vaccinated citizens and permanent residents of Canada can now forgo a 14-day quarantine when arriving in the country.

See how the vaccine rollout is going in your county and state.

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What else we’re following

U.S. workers are quitting in record numbers as coronavirus restrictions end. Populist leaders in Slovenia, Hungary and Poland face growing opposition over their pandemic responses. Brazil has passed 500,000 Covid-19 fatalities, a death toll behind only the U.S. and India. The upcoming fire and drought season will most likely only complicate the fight. Doctors in India attribute an epidemic of “black fungus” among Covid survivors to crowded hospitals and oxygen shortages. Dr. Anthony Fauci talked to Kara Swisher about the controversy over the content of his leaked emails and his early dismissal of the lab leak theory.

What you’re doing

As a force of habit, I put out my fist to greet an 82-year-old patient: “So catch me up on your last year.” He put out both his hands, held my fist and shook it like it was a battle rope. “I got both shots, Doc, nothing else matters. Let’s shake on it.” — Dr. Raghav Gupta, Edmond, Okla.