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The White House, worried that coronavirus vaccination rates among young people are lagging as the new school year approaches, unveiled on Thursday a new push to get students their shots, including enlisting pediatricians to incorporate vaccination into back-to-school sports physicals and encouraging schools to host their own vaccination clinics.
The initiative, announced by Secretary of Education Miguel Cardona, comes as the school year is beginning in many parts of the country. It will include a “week of action” starting on Saturday, with text chains and phone banks aimed at encouraging vaccination.
Experts and school superintendents said in interviews that increasing vaccination among students may be a slow and uphill battle.
The Pfizer-BioNTech vaccine was authorized for people aged 12 and older in May, but young people remain far less likely than older adults to have gotten their shots. Though the nation passed President Biden’s goal of having at least 70 percent of adults at least partially vaccinated, only 40.2 percent of 12- to 15-year-olds and 50.6 percent of 16- to 17- year olds have received at least one dose, according to data collected by the Centers for Disease Control and Prevention.
Last week the C.D.C. said it wanted in-person schooling to resume across the country, and updated its mask guidance to call for universal mask use by students, staff and visitors in schools, regardless of their vaccination status or the rate of community transmission of the virus.
“Children should return to full-time, in-person learning in the fall, with proper prevention strategies in place,” Dr. Rochelle P. Walensky, director of the C.D.C., said at a news briefing.
A White House official, speaking on condition of anonymity to preview Mr. Cardona’s announcement, said the administration is focusing on school athletics as an important path to vaccination. Millions of American students play organized sports, and some school officials are making the case that if student athletes get vaccinated, they will be able to avoid quarantining — and forfeiting their games — if they are exposed to an infected person.
To that end, the White House official said, the administration has enlisted the help of various groups, including the American Academy of Pediatrics and the American Medical Society for Sports Medicine, to put out guidance for doctors and to update the forms required for school physicals. Mr. Cardona and Doug Emhoff, husband of Vice President Kamala Harris, are expected to visit a school vaccination clinic in Kansas next week.
In remarks to the nation last week, Mr. Biden called for every school district in the country to host at least one pop-up vaccination clinic, and many schools and school districts — particularly those in urban areas — are already doing so. The Covid Collaborative, a bipartisan group of politicians and policymakers, has also been working with the White House to promote school-based clinics.
But some school officials are finding that persuading parents to get their students vaccinated is a difficult task.
The school district in Anchorage, Alaska, has been a national leader in encouraging vaccination; a clinic it hosted last year at the district headquarters drew 29,000 people between January and April, many of them older adults eager for their shots, the district superintendent, Deena Bishop, said in an interview. But when Anchorage set up clinics in schools over the summer, the demand was much lower; those clinics vaccinated only about 30 students a day, Dr. Bishop said.
Other superintendents said school-based vaccine clinics, which typically partner with local pharmacies or county health departments, may be a hard sell in areas of the country where there is already resistance to vaccination.
“For people who are for it, it’s an easy one — they support vaccination as a strong strategy to fight Covid, and they don’t see any issue with the use of public space,” said Kristi Wilson, the superintendent of the Buckeye Elementary School District, just outside Phoenix, and who recently completed a term as president of AASA: The School Superintendents Association, which represents 13,000 school superintendents across the country.
“But the other side I’m hearing is that, ‘Where do you draw the line? Who’s going to administer it? Even if public health does it, is it an appropriate use of space?’ If you have a community that is very anti-vaccination, how do you manage that?” she said.
The powerful protection offered by Moderna’s Covid vaccine does not wane in the first six months after the second dose, according to a statement released by the company on Thursday morning in advance of its earnings call.
But during the call, Moderna executives said they anticipated that boosters would be necessary this fall to contend with the Delta variant, which became common in the United States after the results were collected.
“We believe a dose three of a booster will likely be necessary to keep us as safe as possible through the winter season in the Northern Hemisphere,” said Dr. Stephen Hoge, the president of Moderna.
Germany, Israel and France have all decided to administer boosters to potentially vulnerable populations — such as older people or people with compromised immune systems or both — to bolster their immunity in the face of a Delta-driven surge in cases. The Biden administration is considering a similar strategy.
Scientists, though, have not reached a consensus on whether booster shots are needed to boost immunity in fully vaccinated people. On Wednesday, the World Health Organization called for a moratorium on boosters till the end of September. The group urged health leaders to focus instead on vaccinating 10 percent of people in all countries.
Dr. Paul A. Offit, a member of the Food and Drug Administration’s vaccine advisory committee, said that the data presented by Moderna and other vaccine manufacturers so far did not justify rolling out boosters in the next few months. That wouldn’t be needed, he said, unless there was evidence that the vaccines are no longer protecting people against severe disease.
“You want this vaccine to protect against the kind of illness to cause you to seek medical attention, or be hospitalized,” he said. “And until you see any evidence that that isn’t true, then you don’t need a booster dose.”
Moderna’s data came from a new analysis of its clinical trial, which started in late July 2020 and recruited a total of 30,000 volunteers in the United States. In November, the company announced that the vaccine had an impressive efficacy of 94.1 percent. That number didn’t change much after six months, the company reported.
“We are pleased that our Covid-19 vaccine is showing durable efficacy of 93 percent through six months, but recognize that the Delta variant is a significant new threat so we must remain vigilant,” Stéphane Bancel, the chief executive officer of Moderna, said in the statement.
The trial found that the vaccine’s efficacy against severe Covid-19 was 98.2 percent. While three of the volunteers who received a placebo died of Covid-19, none of the vaccinated volunteers did.
“The conclusion we take from these data, is that our efficacy has remained consistently high and durable throughout the period of follow-up,” Dr. Jaqueline Miller, a senior vice president at Moderna, said during in the earnings call.
Last week, Pfizer and BioNTech released a detailed report of their own mRNA vaccine’s durability after six months. The companies estimated that the vaccine’s efficacy started off at 96.2 percent for the first two months after the second dose. It then declined after that, to 83.7 percent by six months.
But experts cautioned that the calculated decline in the Pfizer-BioNTech study could have been a statistical artifact. Chance alone could lead to a different efficacy estimate at different times. “I would not assume waning immunity based on this study alone,” said Maria Deloria Knoll, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
The F.D.A. is expected to give full approval to the Pfizer-BioNTech vaccine next month. Moderna filed for final approval of its vaccine on June 1, and expects to complete its submission in August. Pfizer is also expected to ask the F.D.A. to authorize a booster dose this month.
To estimate the efficacy of their vaccine, Moderna researchers looked at data from the trial up until late March. The Delta variant did not become common in the United States until weeks later. As a result, they cannot determine how well the vaccine protects people against Delta based on the clinical trial.
In June, Moderna released details on an experiment in which its researchers tested antibodies from people who received their vaccine against the Delta variant. They found that the antibodies were moderately less effective at blocking the variant from infecting cells.
In the earnings call on Thursday, the company presented details from additional studies. They found that the strength of the antibodies against variants waned substantially by six months after the second dose.
Moderna has been developing a range of boosters and testing them in clinical trials. On Thursday the company reported that a booster containing half a dose of the original formulation strengthened the antibodies against the Delta variant substantially above the levels seen shortly after volunteers received their two original doses.
The waning antibodies combined with the recent surge of infections would call for a booster, Dr. Hoge said in the earnings call. “We believe a booster dose is likely to be necessary this fall, particularly in the face of the Delta variant,” he said.
Rebecca Kahn, a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health, disagreed.
“These Phase 3 results underscore that the vaccines are highly effective,” she said. “While it’s important to continue evaluating their effectiveness against new variants, the priority needs to be increasing global access to first and second doses.”
In an earnings call last week, Pfizer also said that its booster raised antibodies above their original level. The booster studies from both companies have yet to be published in a scientific journal.
The Biden administration is developing plans to require all foreign travelers to the United States to be vaccinated against Covid-19, with limited exceptions, according to an administration official with knowledge of the developing policy.
The plan, first reported by Reuters, will be part of a new system to be put in place after the current restrictions on travel into the country are lifted, but officials have yet to determine when that might be done.
President Biden has been under pressure for months to ease restrictions on people wishing to travel to the United States, particularly as other countries including England, Scotland and Canada relax their own measures.
Ursula Von der Leyen, the president of the European Commission, the European Union’s executive arm, urged U.S. authorities on Wednesday to lift travel restrictions for E.U. residents, arguing that the epidemiological situation was similar on both sides of the Atlantic.
“This must not drag on for weeks,” Ms. Von der Leyen told the German news organization RND.
But White House officials have said in recent days that there is no plan to lift current restrictions any time soon, in light of the spread of the highly contagious Delta variant.
“Given where we are today,” Jen Psaki, the White House press secretary, told reporters last week, “with the Delta variant, we will maintain existing travel restrictions at this point.”
That stance was reiterated on Wednesday evening by White House officials who said that there was no timetable yet for requiring foreign travelers to be inoculated.
“The interagency working groups are working to develop a plan for a consistent and safe international travel policy, in order to have a new system ready for when we can reopen travel,” the administration official, who was not authorized to publicly detail the plan, wrote in an email. “This includes a phased approach that over time will mean, with limited exceptions, that foreign nationals traveling to the United States (from all countries) need to be fully vaccinated.”
Travelers from Brazil, Britain, China, India, Ireland, Iran, South Africa and Europe’s Schengen area — which spans 29 countries, city-states and micro-states — are barred from entering the United States, according to the Centers for Disease Control, unless they are U.S. citizens or they spend 14 days before arrival in a country that is not on that list.
The United States began restricting travel by foreigners in January 2020, when former President Donald Trump cut off some travel from China in the hope of preventing the spread of the virus. That effort largely failed.
But health officials pressed the Trump administration to expand travel bans to much of Europe during the first surge of the pandemic in spring last year, and more countries have been added to the ban as the original virus and several variants have spread.
This week, the Biden administration said that it would keep in place Title 42, a public health rule that allows the government to turn back people attempting to enter the United States from its southern border.
The decision, confirmed by the Centers for Disease Control and Prevention on Monday, amounted to a shift by the administration, which had been working on plans to begin lifting the rule this summer, more than a year after it was imposed by the Trump administration.
At the troubled beginning of Europe’s vaccine rollout, the Republic of San Marino found itself short on promised doses and turned to Russia for help. The tiny city-state, surrounded on all sides by Italy, quickly vaccinated most of its population with the Sputnik V vaccine, reaching levels of immunity that were the envy of larger European nations.
But in a reversal of fortune, the same Sputnik vaccines that liberated San Marino’s residents from the virus may now trap them within its narrow borders. Italy is set to introduce a vaccine passport for many social activities that will only recognize vaccines approved by the European health authorities. With Sputnik V not on the list, San Marino is out of luck.
“We are stuck here,” said Donata Bucci, 57, a shop assistant in a bridal shop in San Marino, who received the Sputnik V vaccine and has held off booking a vacation in a Tuscan farmhouse because of the new requirements. “We feel discriminated against.”
San Marino’s isolation has become a vivid preview of the potential tensions that new vaccine passports and requirements could create in Europe, as millions of travelers who received vaccines that haven’t been approved by European regulators may be barred from engaging in social activities.
Starting on Friday, Italy will require a proof of inoculation with the vaccines manufactured by Pfizer, Moderna, AstraZeneca or Johnson & Johnson to dine indoors in restaurants and bars, or go to concerts and museums. Those who have recovered from Covid or taken a recent negative swab will also be allowed in. The authorities have said they might extend the requisite to an even wider range of activities.
San Marino, 140 miles north of Rome, isn’t part of the European Union, but the lives of its 30,000 residents have always been closely intertwined with Italy — before the pandemic made this porous border palpable.
Its inhabitants and those of the neighboring northern region of Emilia Romagna speak the same Italian dialect, eat the same tagliatelle, and share workplaces, schools and beach days on the Riviera. Its medieval battlements, picturesque alleys and duty-free shops also attract scores of foreign tourists visiting the Italian coast.
San Marino’s health minister, Roberto Ciavatta, said he feared that as the health pass becomes an increasingly essential part of Italy’s social activities, life would be much harder for many Sammarinese who regularly cross the border.
On Wednesday, Mr. Ciavatta drove to Rome as he hoped to convince Italian officials to free up the Sammarinese through a bilateral agreement. In a telephone interview from his car, Mr. Ciavatta said he did not see why the largely vaccinated San Marino — 70 percent of the population has received two shots — should be treated like a “no vax-land” with its residents required to take a swab before every cappuccino.
“It’s humiliating,” he said.
A peer-reviewed article in The Lancet rated the efficacy of the Sputnik vaccine at 91.6 percent, but Russia has repeatedly failed to provide data requested by foreign drug regulators to approve the shot.
So far, Italy has not recognized Sputnik V vaccinations as meeting the requirement to obtain its health pass, known as a “green pass,” meaning those who have received the shot would still need to show proof of a negative test.
Diplomatic tensions emerged last year when San Marino offered evening dining as Italians faced stringent lockdown restrictions. Then, as the independent nation received the Sputnik vaccines and reached higher vaccination rates than Italy’s, they turned away Italian interlopers who also wanted a shot.
Italy had promised that it would include San Marino in the delivery of doses that was negotiated at European Union level, but Mr. Ciavatta said that San Marino did not receive any doses during the first two months of Italy’s vaccination campaign as Europe struggled with shortages.
As Covid patients filled hospital beds in San Marino, which once had one of the world’s highest Covid death rates, the tiny state decided to find a solution on its own, and bought doses from Russia, which it has close ties with.
“We did not want to fall into geopolitical struggles,” Mr. Ciavatta said. “We just did not want to die.”
Carlotta Porcellini, a 30-year-old owner of an ice cream shop in San Marino, said she would grudgingly spend the summer among the city-state’s quiet stone streets instead of enduring testing to go to the picturesque beach town of Rimini.
“It’s absurd — we are all vaccinated,” Ms. Porcellini said, “but we have to stay put in our tiny reality.”
The known total of global coronavirus infections has surpassed 200 million on Wednesday, according to a New York Times database, a daunting figure that also fails to capture how deeply the virus has embedded itself within humanity.
The official tally stands at more than 614,000 deaths in the United States. More than 550,000 in Brazil. More than 425,000 in India. Mexico has recorded more than 240,000 fatalities, and Peru nearly 200,000. Britain, Colombia, France, Italy, and Russia have all recorded well north of 100,000 deaths. The global toll as of Wednesday was 4.2 million, itself a rough estimate given the discrepancies in the way nations record Covid-19 deaths.
As the coronavirus continues to find new hosts across the planet, the emergence of the Delta variant — thought to be twice as infectious as the initial form of the virus — is adding fuel to a fire that has never stopped raging. Fully vaccinated people are protected against the worst outcomes of Covid-19 caused by the Delta variant.
Some countries, such as Australia, once had success keeping case counts low thanks to geographic isolation and strict lockdown measures. But that may not be possible with the Delta variant; Australia’s largest city, Sydney, is scheduled to be under lockdown until at least Aug. 28 as it tackles a continuing Delta outbreak. And governments have faced increasingly angry protests while enforcing lockdowns on weary populations and struggling businesses, and imposing new vaccine requirements.
Over the last six months — as the world raced to 200 million cases in half the time it took to reach 100 million — the calculus for measuring the danger of the moment has become more nuanced.
In Spain and Britain, where vaccine supplies are ample, cases have begun declining after the Delta variant drove numbers to concerning heights. But in other countries like Malaysia and Thailand, where doses are more scarce, that climb is continuing.
In the United States, with about 93 million people eligible for shots who have chosen not to get them, experts say that a rise in cases this winter is inevitable.
Public health officials are confident that there is little evidence to suggest that the virus has found a way to escape the main goal of vaccines: preventing serious sickness and death.
But there is also agreement that hundreds of millions of cases are now an inescapable part of our world of seven billion people. And with dramatic gaps in vaccination between wealthier and poorer nations, there is the extra challenge of funneling doses to those who remain unprotected. The W.H.O. on Wednesday called for a moratorium on booster shots until the end of September in an effort to help all countries inoculate 10 percent of their populations.
“We have to understand that this virus is now endemic,” said Robert West, a professor emeritus of health psychology at University College London, “and that we have to be thinking about our long-term strategies for dealing with it as a global phenomenon.”.
After almost 18 months of relying on expensive emergency aid programs to support their economies through the pandemic, governments across Europe are scaling back some of these measures, counting on returning economic growth and the power of vaccines to carry the load from here.
But the spread of the Delta variant of the coronavirus has thrown a new variable into that calculation, prompting concerns about whether this is the time for scheduled rollbacks in financial assistance.
The tension can be seen in France, where the number of new virus cases has increased more than 200 percent from the average two weeks ago, prompting President Emmanuel Macron to try to push the French into getting vaccinated by threatening to make it harder to shop, dine or work if they don’t.
At the same time, some pandemic aid in France — including generous state funding that prevented mass layoffs by subsidizing wages, and relief for some businesses struggling to pay their bills — is being reduced.
A government panel recently urged “the greatest caution” about winding down emergency aid even further at the end of the summer.
The eurozone economy has finally exited a double-dip recession, data last week showed, reversing the region’s worst downturn since World War II. European Union governments, which have spent nearly 2 trillion euros in pandemic aid and stimulus, have released nearly all businesses from lockdown restrictions, and the bloc is on target to fully vaccinate 70 percent of adults by autumn to help cement the rebound.
But the obstacles to a full recovery in Europe remain large, prompting worries about terminating aid that has been extended repeatedly to limit unemployment and bankruptcies.
“Governments have provided very generous support through the pandemic with positive results,” said Bert Colijn, a senior eurozone economist at ING. “Cutting the aid short too quickly could create an aftershock that would have negative economic effects after they’ve done so much.”
In Britain, the government has halted grants for businesses reopening after Covid-19 lockdowns, and will end a special unemployment benefit top-up by October. At least half of the 19 countries that use the euro have already sharply curtailed pandemic aid, and governments from Spain to Sweden plan to phase out billions of euros’ worth of subsidies more aggressively in autumn and through the end of the year.
Jack Ewing contributed reporting from Frankfurt, Eshe Nelson from London, and Léontine Gallois from Paris.
Demand for coronavirus vaccines has nearly quadrupled in recent weeks in Louisiana, providing a promising glimmer that the deadly reality of the virus might be breaking through a logjam of misunderstanding and misinformation.
But the new rush for vaccinations has been driven by an explosion in new coronavirus cases — the state is averaging more than 4,300 a day, according to New York Times data. It takes time for vaccines to bolster immune systems, and the state — which now leads the country in new cases per capita — could still be weeks away from relief.
Hospitals are overflowing with more Covid-19 patients than ever before. Even children’s hospitals have packed intensive care units. And the Delta variant has alarmed doctors, who described seeing patients in their 20s and 30s rapidly declining and dying.
“These are the darkest days of our pandemic,” said Catherine O’Neal, the chief medical officer at Our Lady of the Lake Regional Medical Center in Baton Rouge.
The Delta variant has unleashed a rush of diagnoses across the United States, but Louisiana has emerged as a troublesome hot spot, with the highest per capita rate of cases in the country and a beleaguered health care system straining to keep up.
“That’s a miserable place to be, I know it,” Gov. John Bel Edwards said, describing the swirl of frustration and shame expressed by government officials, epidemiologists and frontline medical workers as their state suffers the catastrophic consequences of a failure to vaccinate more people.
Resources have been taxed — especially in the state’s southeastern corner — as cases have surged from the Gulf Coast into the northern reaches of the state. In Baton Rouge, one hospital called in the kind of federal emergency support staff usually reserved for the aftermath of a hurricane. In Hammond, a city of some 21,000 people in the toe of Louisiana’s boot, nurses were ordered to pick up extra shifts.
France and Germany on Thursday reiterated plans to administer booster doses of Covid-19 vaccines to older and more vulnerable people, despite calls from the World Health Organization to halt such shots and send more doses to poorer nations instead.
President Emmanuel Macron of France, speaking in an Instagram video, said on Thursday that “in all likelihood a third dose will be necessary, not for everyone immediately, but in any case for the most vulnerable and the most elderly.” He said his government was preparing to administer those shots starting in September.
Mr. Macron, who has used social media over the past few days to promote vaccines and address resistance to his government’s health pass strategy, said that the French government was following scientific findings that the level of antibodies in those populations declined more rapidly.
Germany had made a similar announcement earlier this week, as Western countries try to ramp up their vaccination campaigns to keep infections in check and avoid the return of lockdown measures.
But there is no consensus among scientists on the need for booster shots, and some officials have said that administering a new round of doses in richer nations will only widen the gap with poorer countries.
Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said on Wednesday that while he understood richer nations’ concerns that they needed to protect their citizens, the world could not “accept countries that have already used most of the global supply of vaccines using even more of it.”
German authorities rejected those accusations on Thursday.
“We want to provide the vulnerable groups in Germany with a preventative third vaccination and at the same time support the vaccination of as many people in the world as possible,” Germany’s health ministry said in a statement.
The ministry said those eligible for boosters would include patients with weakened immune systems, older peopley, and nursing home residents, adding that Germany was also donating at least 30 million doses to countries where vaccination campaigns have been lagging.
While the European Union has bought vaccine doses in bulk for all its members, national governments plan their own vaccination strategies.
Emer Cooke, the head of the European Medicines Agency, told Politico Europe on Tuesday that there was not enough data to prove that a booster shot was necessary, and that approved coronavirus vaccines remained effective against the Delta variant.
Some populations might require an extra dose of the coronavirus vaccine, she said, but that “does not mean that there’s a need universally across the population.” Although member nations might have “very legitimate reasons” to divert from the agency’s guidance, Ms. Cooke said, doing so would “create confusion.”
Still, the European Commission, the E.U. administrative arm that has taken on the task of vaccine ordering, is already gearing up for a change in approach. In May, it signed a third contract with Pfizer-BioNTech for 1.8 billion doses, and ordered an additional 150 million doses of Moderna’s vaccine in June.
On Thursday, Moderna said that while its vaccine remained effective six months after the second dose, a third one would likely be needed because of the Delta variant.
Monika Pronczuk and Katrin Bennhold contributed reporting.
Just a week after emerging from its fifth coronavirus lockdown, the Australian state of Victoria reimposed restrictions on Thursday as officials tried to avert a prolonged outbreak of the Delta variant like the one seen in the country’s largest city, Sydney.
The authorities in Victoria — which includes Melbourne, the second largest city — said that they had detected eight new cases of the virus on Thursday, including five that they could not immediately link to known infections. The discovery prompted state officials to declare a new seven-day lockdown beginning Thursday evening.
“None of us want to be in a situation where we have to lock down again, but this Delta variant moves so fast,” the state’s premier, Daniel Andrews, said at a news conference. With even a handful of unlinked cases, he added, “there is no alternative for us but to listen to our public health experts.”
The crisis that Victoria is trying to avoid is unfolding in neighboring New South Wales, where the authorities on Thursday reported a record 262 new infections, and five deaths, in an outbreak that began in the Sydney suburbs and has spread to outlying areas of the state despite a seven-week lockdown in many areas.
Health officials said that the virus was infecting younger people who were less likely to be vaccinated. Only 16 percent of Australians have been fully vaccinated, and only people 40 and older are universally eligible for shots. One of the new clusters in New South Wales involves a beach party in the northern part of the state that was attended by young people from the Sydney area, officials said.
The governor of New Jersey, where 59 percent of people are fully vaccinated and confirmed cases have increased in the last two weeks, had a blunt rebuke for anti-vaccination demonstrators who showed up to his bill signing ceremony on Wednesday.
“You’ve lost your minds,” Gov. Phil Murphy said. “You are the ultimate knuckleheads. And because of what you are saying and standing for, people are losing their life.”
Mr. Murphy made the comment at an event in Union City where he signed legislation to extend New Jersey’s eviction moratorium. He joined a growing list of exasperated chief executives around the country speaking out in candid terms against people who resist being vaccinated.
Gov. Kay Ivey of Alabama, a Republican, told reporters in Birmingham two weeks ago that “it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.”
As of Tuesday, New Jersey has seen its seven-day average of new Covid-19 cases rise to 1,064 cases from 465 cases over the last two weeks, according to a New York Times database.
Anti-vaccination groups in the state have received support from key conservative political figures. In July, the Republican candidate for governor, Jack Ciattarelli, said he would expand exemptions for public school parents who do not want to vaccinate their children.
Last year, vaccine skeptics successfully blocked a bill that would have made New Jersey a national leader in banning religious exemptions on childhood vaccines.
When the Milwaukee Bucks defeated the Phoenix Suns in Game 6 of the N.B.A. finals last month, thousands of fans watching the victory in person in the arena yelled and cheered.
Tens of thousands more fans gathered to watch the game on giant, open-air screens erected outside the arena in the area known as the Deer District. Afterward, there was a huge parade.
Now, those gatherings are raising concerns among Wisconsin health officials. Milwaukee County has seen a steep rise in cases since the Bucks won, and health officials say they believe the game and surrounding events may have contributed to the increase.
Among people who tested positive for Covid-19 in Wisconsin, 491 said they had been in the Deer District in the two weeks before their positive test result, Elizabeth Goodsitt, a spokeswoman for the Wisconsin Department of Health Services said in a statement on Wednesday.
Around 52 percent of people in Wisconsin are fully vaccinated, according to a New York Times database.
The combination of unvaccinated people in the state, the presence of the highly contagious Delta variant and crowded Bucks events where less than half the attendees wore masks, could lead to a further rise in cases, Julie Willems Van Dijk, deputy secretary of the state health department, told reporters on Wednesday.
In the county of Milwaukee, the seven-day average of new cases rose to 315 on Tuesday, up from 67 on the day of the championship game, July 20, according to the Times database.
Statewide, the one-week average of new Covid-19 cases each day in Wisconsin has shot up in the last two weeks, to 962 on Tuesday, from 223 on July 20, according to the database. The victory parade took place on July 22.
“We know people wanted to be jubilant and celebrate” at those events, Ms. Willems Van Dijk said on a conference call, but “I didn’t see half of the participants wearing a mask, which would be the recommended behavior for someone who is not vaccinated.”
Some people, she said, “were really boisterous and yelling loud, which is a great way to spread infection.” She added: “I anticipate we’ll see additional cases as a result of those gatherings.”
Countries across the Americas must do more to help Indigenous communities prevent and treat Covid-19 infections — and that starts with collecting far more extensive and reliable data, a leading World Health Organization official said on Wednesday.
“While each group is unique, no matter where you look, our Indigenous communities are more vulnerable to Covid infections,” said Dr. Carissa Etienne, the director of the Pan American Health Organization, which is part of the W.H.O.
Nearly half of the more than 62 million Indigenous people in the Americas live and work in urban centers and travel home to visit their communities, a pattern that increases the chance of viral transmission. Many also hail from communal societies, which makes social distancing a challenge.
“This frequent movement and gathering creates opportunities for Covid to spread,” Dr. Etienne said. And even in urban centers, Indigenous people face “invisible barriers” to care, including language and poverty, she said.
Yet reliable data on Covid’s impact on Indigenous people is itself in short supply. Most countries in the region collect no figures at all on Covid’s effect on Indigenous people. Based on the limited information reported to the W.H.O. by a few countries, including Brazil, Colombia, Ecuador and Peru, at least 617,000 Indigenous people have been infected with Covid-19 in the Americas and nearly 15,000 have died.
“It is likely that many more have been infected and many more have died, but we may not know it because they have struggled to get the Covid care that they deserve,” Dr. Etienne said. “For many of our Indigenous people, the right to health remains a promise unfulfilled.”
The call for increased attention to Indigenous people comes as more than 1.2 million Covid-19 cases and 20,000 deaths were reported in the Americas over the past week.
Covid infections are rising in North America, primarily because of an increase in cases in the southern and eastern United States as well as in central Mexico. Infections are climbing in Guatemala, too, particularly among people younger than 50.
When New York City announced on Tuesday that it would soon require people to show proof of at least one coronavirus vaccine shot to enter businesses, Mayor Bill de Blasio said the system was “simple — just show it and you’re in.”
Less simple was the privacy debate that the city reignited.
Vaccine passports, which show proof of vaccination, often in electronic form such as an app, are the bedrock of Mr. de Blasio’s plan. Alongside a paper option, there are two official apps, the Excelsior Pass and NYC Covid Safe. For months, these records — also known as health passes or digital health certificates — have been under discussion around the world as a tool to allow vaccinated people, who are less at risk from the virus, to gather safely. New York will be the first U.S. city to include these passes in a vaccine mandate, potentially setting off similar actions elsewhere.
But the mainstreaming of these credentials could also usher in an era of increased digital surveillance, privacy researchers said. That’s because vaccine passes may enable location tracking, even as there are few rules about how people’s digital vaccine data should be stored and how it can be shared. While privacy laws limit the sharing of information among medical providers, there is no such rule for when people upload their own data onto an app.
The moment is reminiscent of the months after the Sept. 11, 2001, attacks, privacy advocates said. Changes made then in the name of national security led to lasting effects, including taking off shoes in airports and data collection enabled by the Patriot Act.
Without safeguards now, presenting a digital vaccination passport every time people enter a public place could lead to a “global map of where people are going,” said Allie Bohm, a policy counsel at the New York Civil Liberties Union. The information could be used by third parties for profit or be handed over to law enforcement or immigration authorities, she said.
“How do we make sure that in 20 years we’re not saying, ‘Well, there was Covid, so now I’ve got this passport on my phone that is also my driver’s license and also has every health record I’ve ever had and every time I go into a store I have to swipe it?’” Ms. Bohm said.
Tokyo 2020 organizers reported 31 new coronavirus cases on Thursday among people credentialed for the Olympics, setting a new high for a second day.
Among the new cases is a synchronized swimmer from Greece, who became the latest member of the team to test positive. The entire team has withdrawn from competition after at least seven athletes and staff members were found to be infected.
A total of at least 358 people connected to the Games have tested positive in Tokyo since July 1, including 32 athletes, according to organizers. Most of the infections have occurred among Japanese nationals, including contractors and others working at Olympic venues.
While a tightly controlled bubble has kept the virus from derailing the Games, infections are spiraling across Japan, which is recording more than 10,000 new cases every day, the highest rate since the start of the pandemic. Despite restrictions on alcohol sales and other measures in Tokyo and much of the country, average daily cases have risen by 219 percent over the past two weeks, according to New York Times data.
On Thursday, the Japanese government expanded emergency measures to several other prefectures as experts warned that the highly contagious Delta variant was placing a growing strain on the medical system. Health officials reported 5,042 new cases in Tokyo and 14,211 nationwide, both daily records.
Earlier, Yasutoshi Nishimura, the minister in charge of Japan’s coronavirus response, told a meeting of experts that many parts of the country were seeing infections rise at “an unprecedented and phenomenal speed.”
Though the famed dance clubs in the Spanish island resort of Ibiza are officially shuttered as a pandemic precaution, that has not stopped the music. Revelers have been crowding into illegal dance parties in private residences and villas away from the island’s main thoroughfare.
But with coronavirus cases rising on the island, worried Spanish officials say they have a plan: using foreign undercover detectives to pose as partygoers out for a good time.
“We are looking for all possible ways to fight against this serious problem that has been accentuated by legal nightlife closing and a pandemic situation,” Mariano Juan, an Ibiza Council official, told reporters last week.
He said it wasn’t feasible to use the island’s own health inspectors or the police to infiltrate the parties, because they lacked the training, or were overwhelmed by other tasks. So officials turned to an external agency to recruit a team of foreigners aged between 30 and 40, who would hang out in bars in the hours before the island’s 1 a.m. curfew to try score invitations to the illegal late-night parties, gather evidence of breaches of pandemic regulations, and turn it over to the police, Mr. Juan said to La Cadena SER, a Spanish radio network.
Critics of the plan have called for more serious proposals to combat the problem.
The underground parties would not be hard for the undercover agents to find. On a recent July evening, tourists and residents in one of Ibiza’s busiest streets swapped gossip in bars and at taxi stands about the gatherings, some of which were said to charge admission fees of up to 50 euros (about $59).
Clubs on the tourism-dependent Mediterranean island, which is known for its vibrant nightlife, have largely remained closed, and bars and restaurants have been limited to table service. The authorities say the illegal dance parties that have taken the clubs’ place are to blame for spreading Covid-19 cases among tourists, residents and seasonal workers, and have reimposed a curfew that bans gatherings of people from more than one household between 1 a.m. and 6 a.m. Organizers of illegal parties can face hefty fines.
Many of the illegal gatherings are held in secluded residences in rural areas, away from the main roads, Mr. Juan said. Of the 33 illegal parties that have recently been discovered by the authorities, he said, only three were hosted at the homes of tourists.
In Spain, the police generally do not have the authority to search private residences without a warrant, but have broken up illegal parties under the pandemic health regulations, a practice that has drawn criticism. Mr. Juan said that the goal now is to use the undercover agents to find out about the gatherings early enough to head them off.
“The idea is not to blow up the party from within but to notify the police, so that they can set up a control outside and prevent more people from going,” he said.
Mr. Juan told Periodico de Ibiza on Sunday that the undercover agents were a “necessity to safeguard the health situation in Ibiza.”
Over the past week, the Balearic Islands, which include Ibiza, reported an average of 843 new coronavirus cases a day, or 71 for every 100,000 residents, the most of any region in Spain, according to a New York Times database.
Cruise lines are imposing more stringent coronavirus measures as a precaution against the highly contagious Delta variant, which now accounts for more than 93 percent of cases in the United States.
Royal Caribbean announced last week that all guests aged 2 and older will be required to present a negative virus test before embarkation, after six guests tested positive on board its Adventure of the Seas cruise ship.
Four vaccinated adults and two unvaccinated minors tested positive during a routine end-of-trip screening last Thursday. No additional cases have been identified, the company said.
Most cruise lines are operating ships with at least 95 percent of passengers and crew vaccinated, but some cruises sailing out of Florida are accepting unvaccinated passengers after a recently enacted state law banned businesses from requiring proof of immunization from people seeking to use their services. Fully vaccinated people are protected against the worst outcomes of Covid-19, including those caused by the Delta variant.
The new guidance will apply to all passengers sailing on cruises for five nights or longer, regardless of their vaccination status. Unvaccinated guests will be required to take further tests at the terminal and onboard the ship, at their own expense.
Carnival Cruise Lines went a step further on Tuesday, requiring guests to wear masks in certain indoor areas of its ships as well as requiring pre-cruise testing. Norwegian Cruise Line also has a testing requirement for all passengers boarding its ships.
The new rules come after the Centers for Disease Control and Prevention urged fully vaccinated Americans to wear masks indoors in places with high coronavirus transmission.
While most cruise lines have reduced the capacity of sailings, some areas such as elevators, casinos and entertainment spaces can get crowded, which led to Carnival’s mask mandate.
“These new requirements are being implemented to protect our guests and crew while on board and to continue to provide confidence to our homeports and destinations that we are doing our part to support their efforts to protect public health and safety,” said Christine Duffy, president of Carnival Cruise Line.
“We expect these requirements will be temporary and appreciate the cooperation of our guests,” she added.
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