Covid Updates: Duterte Accuses Rich Nations of Hoarding Covid Vaccines

An extra dose of the Johnson & Johnson vaccine raises protection, the company says.

Duterte accuses rich countries of hoarding Covid vaccines while the poor ‘wait for trickles.’

ImagePhilippines President Rodrigo Duterte speaks via a video link during the 76th session of the United Nations General Assembly.
Credit...Spencer Platt/Getty Images

With his country badly lagging in Covid vaccinations, President Rodrigo Duterte of the Philippines railed against the world’s affluent countries at the United Nations on Tuesday, accusing them of hoarding vaccines while the poor “wait for trickles.”

Reinforcing his reputation as blunt speaker, Mr. Duterte described the rich-poor divide over vaccination rates as scandalous. His remarks, delivered via prerecorded video to the 193-member General Assembly, were among the most forceful criticisms of the inequities that have been laid bare by the pandemic.

Just 10 rich countries account for most of the 5.86 billion vaccine doses administered so far.

“There is a man-made drought of vaccines ravaging poor countries,” Mr. Duterte said. “Rich countries hoard lifesaving vaccines while poor nations wait for trickles. They now talk of booster shots, while developing countries consider half-doses just to get by.”

The disparity, he said, “is shocking beyond belief and must be condemned for what it is — a selfish act that can neither be justified rationally nor morally.”

The Philippines has one of the lowest Covid vaccination rates in Asia, with just 16 percent of its population fully inoculated, and Delta variant infections have surged in recent months. The country also is among only a handful that have kept schools closed throughout the pandemic, which has put its 27 million school-age children at an increased disadvantage.

Mr. Duterte has justified keeping elementary schools and high schools closed by arguing that students and their families need to be protected from contagion. But his policy has spawned a backlash among parents and students in a sprawling nation with endemic poverty. Many people, particularly in remote and rural areas, lack access to online learning.

Tracking the Coronavirus ›

An extra J. & J. shot substantially boosts protection against Covid, the company reports.

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Credit...Tobias Schwarz/Agence France-Presse — Getty Images

A second dose of Johnson & Johnson’s vaccine substantially increased its protection against Covid-19, the company announced Tuesday morning.

In a clinical trial, researchers found that two doses of the vaccine delivered 94 percent efficacy against mild to severe Covid-19 in the United States, up from 74 percent conferred with a single shot, the company reported. And two shots showed 100 percent efficacy against severe disease, although that estimate had a wide range of uncertainty.

The data, presented in a news release, has been submitted to the Food and Drug Administration, Johnson & Johnson said. Since the company received emergency authorization in February, 14.6 million people in the United States have received its one-shot vaccine.

On Friday, an F.D.A. advisory committee recommended that the agency authorize Pfizer-BioNTech booster shots for recipients of the vaccine who are at least 65 or at high risk of Covid. That vaccine, like Moderna’s, offers high levels of initial protection after two doses, which then seem to diminish slightly over several months.

By contrast, Johnson & Johnson’s vaccine has shown little sign of waning. Researchers released a study last week comparing 390,517 vaccinated people to 1,524,153 unvaccinated ones. Up to five months after vaccination, the effectiveness of the Johnson & Johnson vaccine against hospitalization remained steady at around 81 percent.

As the pandemic has unfolded, people who received the Johnson & Johnson vaccine have waited for guidance about whether they’ll need a booster. The new clinical trial, which recruited 32,000 volunteers around the world, compared people who received one dose of Johnson & Johnson to those who received two doses eight weeks apart.

The researchers found that the second shot lifted the level of antibodies in the blood of volunteers four times as high as the level produced by the first shot. That improvement translated into stronger protection.

Many people got their Johnson & Johnson shot far more than eight weeks ago. Other research suggests that the extra time between doses could mean even better protection.

In a separate study announced last month, Johnson & Johnson gave boosters to clinical trial volunteers six months after their first dose, and then measured their antibody levels.

Initially, the researchers reported that the antibodies rose nine times as high as after the first dose. But in Tuesday’s news release, the company announced the level had continued to rise, reaching 12 times as high as the initial levels.

Some preliminary studies suggest that higher levels of antibodies against the coronavirus produce higher levels of protection against Covid. If that’s true, then a second Johnson & Johnson shot given after a wait of several months may prove even more effective than after just eight weeks.

One Covid case prompts closures across a Chinese city of 10 million.

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Credit...Alex Plavevski/EPA, via Shutterstock

Harbin, a city in far northern China, ordered gyms, cinemas, bathhouses, mahjong parlors and other leisure venues to close on Tuesday after a single resident in the city of 10 million was confirmed to have Covid.

The closures in Harbin were part of a raft of measures that kicked in, enforcing the Chinese government’s “zero tolerance” approach that seeks to extinguish even small outbursts of infections with sweeping measures.

China had heavily limited inward travel in an effort to avoid surges of infection, but scattered outbreaks across the country have continued to dog the authorities, prompting them to limit activities in infection-hit cities. The actions taken in Harbin, the capital of Heilongjiang Province, typified how far the government is willing to go to curb outbreaks.

A city government announcement said that residents should not leave Harbin “unless necessary.” Temples, churches and other religious venues were ordered closed, and visitors to scenic spots must book ahead to ensure that numbers are limited.

Harbin, which grew from a railway town near the frontier with Russia, is already entering cooler weather, and the authorities may worry that crowded indoor venues could help spread the coronavirus.

The patient found with the virus had ranged around in the two weeks before confirmation, the authorities said. The patient had returned from a trip to southern China two weeks ago, and then visited hotels, a hotpot restaurant, a bathhouse and a bookstore, as well as making three visits to a gaming den to play a popular murder-mystery board game.

Pfizer says its vaccine is safe for children 5 to 11. Will parents buy in?

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Credit...Tamir Kalifa for The New York Times

With Pfizer-BioNTech’s announcement on Monday that its coronavirus vaccine had been shown to be safe and effective in low doses in children ages 5 to 11, a question looms: How many parents will have it given to their children?

If authorized by the Food and Drug Administration, the vaccine could be a game changer for millions of American families and could help bolster the U.S. response to the highly contagious Delta variant. There are about 28 million children of ages 5 to 11 in the United States, far more than the 17 million of ages 12 to 15 who became eligible for Pfizer’s vaccine in May.

But it remains to be seen how much of the younger group will be vaccinated. Uptake among older children has lagged, and polling indicates reservations among a significant number of parents.

Lorena Tule-Romain was up early Monday morning, getting ready to ferry her 7-year-old son to school in Dallas, when she turned on the television and heard the news.

“I was like, ‘Oh my gosh, this is exciting,’” said Ms. Tule-Romain, 32, who said she felt a surge of hope and relief. She has spent months in limbo, declining birthday party invitations, holding off registering her son for orchestra in school and even canceling a trip to see her son’s grandparents in Atlanta.

Ms. Tule-Romain will be among those eagerly waiting to learn whether federal officials authorize the vaccine for the younger group, a step that is expected to come first on an emergency-use basis, perhaps as soon as around Halloween.

However the F.D.A. rules, Michelle Goebel, 36, of Carlsbad, Calif., said she was nowhere near ready to vaccinate her children, who are 8, 6 and 3, against Covid-19.

Though Ms. Goebel said she had been vaccinated herself, she expressed worry about the risks for her children, in part because of the relatively small size of children’s trials and the lack of long-term safety data so far. She said the potential risk from a new vaccine seemed to her to outweigh the benefit, because young children have been far less likely than adults to become seriously sick.

Only about 40 percent of children ages 12 to 15 have been fully vaccinated so far, compared with 66 percent of adults, according to federal data. Polling indicates that parental openness to vaccination decreases with a child’s age.

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Credit...Allison Zaucha for The New York Times

About 20 percent of parents of 12- to 17-year-olds said they definitely did not plan to get their child vaccinated, according to polling by the Kaiser Family Foundation published last month. The “definitely not” group grew to about 25 percent in parents of children ages 5 to 11, and 30 percent among parents of under-5s.

René LaBerge, 53, of Katy, Texas, said she planned to vaccinate her 11-year-old son when he became eligible. “But I’m not impatient. I want them to do the work,” she said.

She said she had heard about some rare, but serious, side effects in children, and she was eager for federal officials to thoroughly review the data.

“I don’t want my son to take something that is unsafe,” she said, but added, “I believe Covid is dangerous. There aren’t any good easy answers here.”

Among the side effects scientists have been studying is myocarditis, an inflammation of the heart. In rare cases, the vaccine has led to myocarditis in young people. But a large Israeli study, based on electronic health records of two million people aged 16 and older, also found that Covid was far more likely to cause these heart problems.

The Pfizer trial results were greeted enthusiastically by many school administrators and teachers’ organizations, but are unlikely to lead to immediate policy changes.

“This is one huge step toward beating Covid and returning to normalcy. I don’t think it changes the conversation around vaccine requirements for kids,” said Randi Weingarten, president of the American Federation of Teachers, a national union.

Ms. Weingarten predicted that there would not be widespread student vaccine mandates until the 2022-2023 school year. She noted that parents and educators were still awaiting full F.D.A. approval of vaccines for children aged 12 to 15, and that mandates for adults did not come until months after the shots first became available.

A significant barrier to child vaccination, she said, were widespread conspiracy theories about the shots affecting fertility.

“When people have these conversations prematurely about requirements, it adds to the distrust,” she said.

Eric Adams, N.Y.C.’s likely next mayor, wants to turn shuttered hotels into permanent housing for the homeless.

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Credit...James Estrin/The New York Times

Hotels in New York City that have been left empty by the pandemic would be converted into “supportive housing” that provides assistance to people struggling with mental illness or substance abuse and to people leaving the prison system, under a plan proposed on Monday by Eric Adams, who is likely to be the city’s next mayor.

More than 20 percent of the city’s hotels are now closed, a trade association says. At the same time, the city faces a homelessness crisis, growing sentiment against warehousing homeless people in barrackslike shelters and a lot of severely mentally ill people living in the streets.

“The combination of Covid-19, the economic downturn and the problems we’re having with housing is presenting us with a once-in-a-lifetime opportunity,” Mr. Adams, who won the June Democratic primary for mayor, said as he stood outside a boarded-up hotel in Brooklyn’s Sunset Park. “Use these hotels not to be an eyesore, but a place where people can lay their eyes on good, affordable, quality housing.”

Details of the plan were thin. Mr. Adams mentioned the possibility of 25,000 converted hotel rooms, but he said that he would focus on boroughs outside Manhattan, where the number of rooms in closed hotels is much smaller than that.

He was not clear about whether there was any overlap between his plan and those that the current mayor, Bill de Blasio, and the former governor of New York, Andrew M. Cuomo, have already begun to build 25,000 supportive housing units in the city by about 2030. A spokesman for Mr. Adams’s campaign said that Mr. Adams was also considering converting rooms in former hotels that have already become homeless shelters into permanent supportive-housing apartments, something that Mr. de Blasio has also discussed.

Mr. Adams said that creating studio apartments in existing hotels would be far cheaper and faster than building affordable housing from scratch.

During the mayoral primary, he was one of several candidates who called for creating housing in updated versions of single room occupancy hotels, or S.R.O.s, a form of housing once synonymous with seediness and crime that were torn down en masse in the late 20th century, but that has been making a comeback in other cities.

“I’m a big ‘modernized S.R.O.’ person,” Mr. Adams said. “We can create safe spaces particularly for single adults, which is an increased population.”

The nexus of hotels and homelessness has been a contested one during the pandemic. Early in the lockdown imposed to stem the spread of the coronavirus, thousands of people who had been living in dorm-style shelters were moved to hotel rooms, mostly in Manhattan where their presence led to complaints from some residents about harassment and sometimes violence. The city has since moved most of those people back to group shelters.

Several advocates for homeless people and for supportive housing endorsed Mr. Adams’s plan and stood with him at the news conference. “Adams can be the mayor who uses this inflection moment to change the trajectory on homelessness,” Laura Mascuch, executive director of the Supportive Housing Network of New York, said in an interview. “We look forward to working with Adams to implement the strongest supportive housing program in the nation.”

Another advocate who Mr. Adams invited to speak was the formerly homeless man who goes by the name Shams Da Baron and who came to prominence last year as a de facto spokesman for the homeless people who were being put up in a Manhattan hotel. In New York’s primary, Mr. Da Baron had favored more progressive candidates over Mr. Adams, a former police captain. But on Monday he offered the candidate a warm hug and exhorted him to follow through on his plan.

“We are in crisis,” Mr. Da Baron said. “Do what is necessary to get people housed.”

For families in Europe, the end of the U.S. travel ban brings relief.

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Credit...Joe Raedle/Getty Images

LONDON — For Katie Wait, the coronavirus pandemic has been more than just a year and a half of uncertainty. It has also meant months separated from her parents, brother and extended family in Florida.

Birthdays missed. Milestones celebrated apart. Time together lost.

“It’s just been mentally and emotionally the most challenging year, when you really want your family around,” Ms. Wait said, suddenly overcome by tears. “It’s been hard.”

So on Monday, she was one of many across Europe and the world who rejoiced when the Biden administration announced that an 18-month ban on travel from 33 countries, including Britain, member states of the European Union, Brazil, China, India, Iran and South Africa, would be lifted.

The travel ban had not been a mere inconvenience, for Ms. Wait and countless others: It crushed jobs and dashed opportunities and put an immovable wall between them and families or partners.

As the months wore on, thousands who had been separated from family members and partners gathered online to share their experiences with the hashtag #LoveIsNotTourism to call attention to their plight.

Ms. Wait, who had to cancel a trip to catch up with family in March last year and hasn’t seen her parents since 2019, found the support there vital. She, her husband and her 9-year-old daughter are British, but Ms. Wait’s parents and brother have lived in St. Augustine, Fla., for the last 17 years and are U.S. citizens.

“You never expected that if they went to live in America, you wouldn’t be able to get to them,” she said. “You never think in a million years things like this will happen, that the border would be closed.”

Greece benefits from an early opening to tourists.

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Credit...Maria Mavropoulou for The New York Times

Greece, which was among the first countries to ease coronavirus restrictions for travelers, saw a surge in foreign visitors this summer, according to official data released on Tuesday by the country’s central bank.

Greece drew 4.5 million foreign visitors in the first seven months of the year, an increase of 51.4 percent over 2020 for the same period, when the pandemic battered the country’s crucial tourism sector, figures from the Bank of Greece showed. For the same period in 2019, the country attracted 15 million people, and more than 34 million over the whole year.

For summer travelers, Greece, which opened its borders in May, touted its relatively low infection rate, especially on its islands, and its enforcement of coronavirus hygiene rules, like social distancing at hotels and limited-capacity restaurants.

July was a strong month with 2.8 million foreign visitors choosing Greece for their summer holidays, a 240 percent increase from last year.

Arrivals from European Union countries were up 81 percent in the first seven months of 2021 over 2020. In July, almost 100,000 travelers came from the United States. During the same period last year, American travelers were barred from Greece.

At the end of last month, the European Union proposed new travel restrictions for unvaccinated travelers from the United States in response to a sharp surge in coronavirus infections and hospitalizations. But the suggested action is not mandatory and Greece has not indicated that it will reintroduce restrictions.

Greece’s tourism minister, Vassilis Kikilias, on Tuesday welcomed the U.S. decision to lift pandemic travel restrictions on foreign nationals who are fully vaccinated against coronavirus. “This means flights will come back full,” he said.

The improvement drew much-needed revenue for Greece’s tourism sector, a key pillar of the economy, accounting for around 20 percent of gross domestic product and one in five jobs. Income from tourism increased by 139.7 percent in the first seven months of the year, to 3.38 billion euros, or $3.9 billion, according to the central bank figures.

Yes, a mask will help protect you even if no one else is wearing one.

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Credit...Brittainy Newman for The New York Times

It’s true that masks work best when everyone in the room is wearing one. That’s because when an infected person wears a mask, a large percentage of their exhaled infectious particles are trapped, stopping viral spread at the source. And when fewer viral particles are floating around the room, the masks that others are wearing would be more likely to block them.

But there is also plenty of evidence showing that masks protect the wearer even when others around them are mask-free.

The amount of protection depends on the quality of the mask and how well it fits. During a hotel outbreak in Switzerland, for instance, several employees and a guest who tested positive for the coronavirus were wearing only face shields (with no masks); those who wore masks were not infected. And a Tennessee study found that communities with mask mandates had lower hospitalization rates than areas where masks weren’t required.

There are also a number of laboratory studies documenting that a mask protects the person who is wearing it, though the extent of the protection varied with the type of mask and the circumstances studied.

“Health care workers, scientists who work with nasty pathogens, and workers who may be exposed to hazardous airborne particles on the job rely on specialized masks like N95s for protection, so we know that properly-fitted, high-efficiency masks work,” said Linsey Marr, a Virginia Tech engineering professor and one of the world’s leading experts on viral transmission.

A gas station attendant is killed in Germany after telling a customer to mask up.

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Credit...Michael Probst/Associated Press

BERLIN — A 20-year-old student working at a gas station in southwestern Germany was shot and killed after refusing to sell beer to an unmasked customer, the local prosecutor said.

When an unmasked 49-year-old man entered the gas station on Saturday night and placed two six-packs of beer on the counter in the town of Idar-Oberstein, near the French border, the cashier insisted that he wear a mask, said Kai Fuhrmann, the district attorney in charge of the case, in a telephone interview.

Masks have been mandatory in shops in Germany since shortly after the pandemic started.

The man then left the store only to return an hour later, still unmasked but with a gun — one not licensed under Germany’s strict weapons laws. When the clerk asked him a second time to put on a mask, Mr. Fuhrmann said, he killed him with a single shot to the head.

The authorities are withholding names of both the victim and the suspect in accordance with German privacy laws.

Although Germany has seen protests, sometimes including violence, over its mask and hygiene rules, this is believed to be the first death in the country directly linked to the restrictions.

The suspect, who has no previous police record, told the authorities that he saw the cashier as “responsible for the situation because he was enforcing the rules,” Mr. Fuhrmann said.

The police and district attorney’s office are now evaluating the suspect’s electronic devices to ascertain whether the killing was somehow planned. Mr. Fuhrmann said it would take several weeks to determine what charges might be brought.

Until then, the man remains in custody on suspicion of murder.

Construction workers in Melbourne protest mandatory vaccinations.

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Melbourne Construction Workers Protest Vaccine Mandate

Up to 2,000 protesters took to the streets in Melbourne, Australia, for the second day in a row, angry over new workplace vaccination requirements.

We have seen throughout the day variously a journalist attacked numerous times. We’ve seen three police officers injured. That’s totally unacceptable. No person, be a police officer, be a journalist, anyone, no one should come to work and be suffered injuries at the expense of people who claim to be protesting for freedom.

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Up to 2,000 protesters took to the streets in Melbourne, Australia, for the second day in a row, angry over new workplace vaccination requirements.CreditCredit...Darrian Traynor/Getty Images

Construction workers in Melbourne, Australia, clashed violently with the police for the second day in a row on Tuesday in a dispute over mandatory vaccinations.

Up to 2,000 protesters descended into the city’s central business district, the police said. Videos posted to social media showed workers hurling bottles at the police and setting off flares, while officers in riot gear fired rubber bullets and used pepper spray. One TV journalist said he had urine thrown in his face.

The protests began after the state government in Victoria, where Melbourne is the largest city, mandated vaccinations for workers as it struggles to contain a quickly growing outbreak of the Delta variant. The demonstrators have promised to keep protesting, chanting “every day” as they marched.

The union representing construction workers has not supported mandatory vaccinations but has distanced itself from the protests, saying they were “heavily infiltrated by neo-Nazis and other right-wing extremist groups.”

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Credit...William West/Agence France-Presse — Getty Images

Construction has been among the few industries that have largely stayed open throughout the pandemic in Victoria but the authorities have become increasingly concerned that it may be a hotbed for coronavirus transmission.

After media reports last week that three out of four construction sites were breaching virus safety rules, the state government mandated vaccinations for workers in the industry.

Australian authorities have been reluctant to mandate vaccinations beyond high-risk sectors like health care.

In response, construction workers staged sit-ins on Friday, before escalating to protests this week. On Monday, a small number of workers gathered in front of the offices of the construction union and threw projectiles at the building.

Hours later, Victoria’s premier, Daniel Andrews, ordered a two-week halt on all construction work in the state, citing “continued concern about case numbers, transmission risk and reduced compliance.”

On Tuesday afternoon, the police said they had made 44 arrests, with the number expected to grow, and that three officers had been injured and police cars attacked and damaged.

In his U.N. debut, Biden calls for global unity against common threats.

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Biden Urges Unity Against Common Threats in an ‘Interconnected’ World

President Biden called for an era of international cooperation in tackling global threats in his first address to the United Nations General Assembly as president.

We stand, in my view, at an inflection point in history. And I’m here today to share with you how the United States intends to work with partners and allies to answer these questions, and the commitment of my new administration help lead the world toward a more peaceful, prosperous future for all people. Instead of continuing to fight the wars of the past, we are fixing our eyes on devoting our resources to the challenges that hold the keys to our collective future. Ending this pandemic, addressing the climate crisis, managing the shifts in global power dynamics, shaping the rules of the world on vital issues like trade, cyber and emerging technologies, and facing the threat of terrorism as it stands today. We’ve ended 20 years of conflict in Afghanistan. And as we close this period of relentless war, we’re opening a new era of relentless diplomacy, of using the power of our development aid, to invest in new ways of lifting people up around the world, of renewing and defending democracy, of proving that no matter how challenging or how complex the problems you’re going to face government by and for the people is still the best way to deliver for all of our people. And as the United States turns our focus to the priorities and the regions of the world like the Indo-Pacific that are most consequential today and tomorrow, we’ll do so with our allies and partners through cooperation and multilateral institutions like the United Nations to amplify our collective strength and speed, our progress toward dealing with these global challenges. Our security, our prosperity and our very freedoms are interconnected, in my view, as never before, and so I believe we must work together as never before.

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President Biden called for an era of international cooperation in tackling global threats in his first address to the United Nations General Assembly as president.CreditCredit...Doug Mills/The New York Times

President Biden delivered his debut address to the annual gathering of world leaders at the United Nations on Tuesday amid strong new doubts about his ability to vault the United States back into a position of global leadership after his predecessor’s promotion of “America First” isolationism.

Speaking to a smaller than usual audience of his peers because of the still-raging Covid-19 pandemic, Mr. Biden called for a new era of global unity against the coronavirus, climate change, emerging technological threats and the expanding influence of autocratic nations such as China and Russia.

“No matter how challenging or how complex the problems we’re going to face, government by and for the people is still the best way to deliver for all of our people,” he said, insisting that the United States and its Western allies would remain vital partners.

“Our security, our prosperity and our very freedoms are interconnected, in my view as never before,” Mr. Biden said.

Calling for the world to make the use of force “our tool of last resort, not our first,” he defended his decision to end the U.S. war in Afghanistan, a chaotic withdrawal of American troops that left allies blindsided.

“Today, many of our greatest concerns cannot be solved or even addressed by the force of arms,” he said. “Bombs and bullets cannot defend against Covid-19 or its future variants.”

But Mr. Biden’s efforts to move America past President Donald J. Trump’s more confrontational policies come amid growing frustration among allies with his administration’s diplomatic approach.

His familiar refrain that the world must choose between democracy and autocracy looks different now that the Taliban are once again in control of Kabul, reversing many of the democratic gains of the past 20 years. Covid is resurging in much of the world. And the French just recalled their ambassador in outrage — not just over losing a $60 billion-plus submarine contract, but because it was made clear they are not in the inner circle of allies.

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Credit...Doug Mills/The New York Times

Mr. Biden and other leaders are gathering against a backdrop of disastrous climate change, polarized superpower relations and a devastating pandemic that has worsened the global rich-poor divide.

The event is a major test of credibility for Mr. Biden, who was among the first to address the 193-member General Assembly. The last to speak in the morning session was President Xi Jinping of China, via prerecorded video, bookending with the competing views of the two most powerful countries in the world.

Both leaders announced potentially significant steps to address climate change, a rare moment of common purpose: Mr. Biden said he intended to double the American financial contribution to developing countries’ efforts to tackle the climate crisis, and Mr. Xi said China would stop financing coal-fired power projects abroad, a major source of heat-trapping gases.

Secretary General António Guterres, who has openly fretted about the bitter rivalry between China and the United States, said he was encouraged by “the leaders of the world’s two largest economies regarding their commitment to climate action.”

Still, a dominant theme of Mr. Biden’s speech was what he described as the choice faced by the world between the democratic values espoused by the West and the disregard for them by China and other authoritarian governments.

“The future belongs to those who give their people the ability to breathe free, not those who seek to suffocate their people with an iron hand authoritarianism,” he said. “The authoritarians of the world, they seek to proclaim the end of the age of democracy, but they’re wrong.”

But the president vowed not to pursue a new era of sustained conflict with countries like China, saying that the United States would “compete vigorously and lead with our values and our strength to stand up for our allies and our friends.”

“We’re not seeking — say it again, we are not seeking — a new Cold War or a world divided into rigid blocs,” he said.

Climate change and the pandemic are also expected to dominate the week, and Mr. Biden planned to host a Covid summit on the sidelines to push other countries to increase capacity to manufacture vaccines for poor countries.

“This year has also brought widespread death and devastation from the borderless climate crisis,” Mr. Biden said. “Extreme weather events that we’ve seen in every part of the world — and you all know it and feel it — represent what the secretary general has rightly called Code Red for humanity.”

On Covid, Mr. Biden urged leaders to move more quickly to rein in a pandemic that has killed millions.

“We need a collective act of science and political will,” he said. “We need to act now to get shots in arms as fast as possible, and expand access to oxygen, tests, treatments, to save lives around the world.”

Unvaccinated and defiant, Bolsonaro pushes back against criticism in his U.N. speech.

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Brazilian President Says He Is Not Vaccinated

During a meeting with Prime Minister Boris Johnson of Britain, who hailed the AstraZeneca vaccine, Brazil’s president, Jair Bolsonaro, said he had not been inoculated against Covid-19.

“Boris.” “Mr. President, how are you? Very nice to see you. Well, welcome, welcome, welcome. [unclear] Here we go. Here we go. Here we go. How’s that? How are you doing?” “OK.” “Very good.” “Thank you.” “Come here.” “AstraZeneca —” it’s a great vaccine. I had AstraZeneca. Thanks, everybody. Get AstraZeneca vaccine. I had it twice.” “Not yet.” [laughter]

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During a meeting with Prime Minister Boris Johnson of Britain, who hailed the AstraZeneca vaccine, Brazil’s president, Jair Bolsonaro, said he had not been inoculated against Covid-19.CreditCredit...Stefan Jeremiah/Reuters

President Jair Bolsonaro of Brazil kicked off the United Nations General Assembly on Tuesday by defending the use of ineffective drugs to treat the coronavirus and by pushing back on criticism of his government’s environmental record.

Brazil’s far-right president said doctors should have had more leeway in administering untested medications for Covid-19, adding that he had been among those who recovered after “off label” treatment with an anti-malaria pill that studies have found ineffective to treat the disease.

“History and science will hold everyone accountable,” said Mr. Bolsonaro, whose handling of the pandemic in South America’s largest country has been widely criticized.

Mr. Bolsonaro’s decision to not get vaccinated against the coronavirus has loomed large over his first couple of days in New York. It made for an awkward moment during a meeting on Monday with Prime Minister Boris Johnson of Britain, who hailed the AstraZeneca vaccine, which was developed at Oxford University.

“Get AstraZeneca vaccines,” Mr. Johnson said during his meeting with the Brazilian president. “I’ve had it twice.”

Mr. Bolsonaro pointed to himself and said: “Not yet.”

Brazil’s president has led one of the world’s most criticized responses to the pandemic. Mr. Bolsonaro repeatedly downplayed the threat the virus posed, railed against quarantine measures and was fined for refusing to wear a mask in the capital.

His government was slow to secure access to coronavirus vaccines even as the virus overwhelmed hospitals across the country. Covid-19 has killed more than 590,000 people in Brazil.

Mr. Bolsonaro, who had a mild case of Covid-19 in July of last year, has said he is in no hurry to get a shot. Earlier this year, the president said he was undecided about getting a vaccine.

“After the last Brazilian gets vaccinated, if there’s a spare shot, I will decide whether or not I get vaccinated,” he said in a televised video, adding, “that’s the example the boss must provide.”

His unvaccinated status has caused logistical problems when it comes to finding a place to eat in New York, where restaurants require that patrons show proof of inoculation for indoor seating. Mr. Bolsonaro and his traveling party have been taking the rule in stride. On Sunday, one of his ministers posted a photo on Twitter of the president and several top aides eating pizza standing up on the street.

“A luxurious dinner in NYC,” joked the minister, Luiz Ramos.

On Tuesday, Mr. Bolsonaro started his speech by telling the assembly that his nation was unfairly portrayed in the press.

“I came here to show a Brazil that is different from what is shown in the newspapers and on television,” he said. “Brazil has changed, and a lot, since we assumed office in January 2019.”

Mr. Bolsonaro’s government has weakened enforcement of environmental laws and hollowed out the agencies responsible for enforcing them. Yet on Tuesday he argued that Brazil should be applauded for how much of its forests remain intact and said the country could sustainably develop land in environmentally critical regions like the Amazon.

“The future of green jobs is in Brazil,” he said.

The U.N. secretary general urges nations to address a ‘cascade of crises.’

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‘We Are on the Edge of an Abyss,’ U.N. Secretary General Says

António Guterres, the United Nations secretary general, pressed for increased cooperation in facing a global “cascade of crises,” including wars, the pandemic, climate change and a polarization of world powers during a speech at the General Assembly.

I’m here to sound the alarm. The world must wake up. We are on the edge of an abyss, and moving in the wrong direction. Our world has never been more threatened or more divided. We face the greatest cascade of crises in our lifetimes. The Covid-19 pandemic has supersized glaring inequalities. The climate crisis is pummeling the planet, upheaval from Afghanistan to Ethiopia to Yemen and beyond. A thwarted peace. A surge of mistrust and misinformation is polarizing people and paralyzing societies. Human rights are in the fires and science is under assault, and the economic lifelines for the most vulnerable are coming too little and too late, if they come at all. Solidarity is missing in action just when we need it most. Excellencies, we face a moment of truth. Now is the time to deliver. Now is the time to restore trust, and now is the time to inspire hope. And I do have hope — the problems we have created are problems we can solve. Humanity has shown that we are capable of great things when we work together, and that is the raison d’être of our United Nations.

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António Guterres, the United Nations secretary general, pressed for increased cooperation in facing a global “cascade of crises,” including wars, the pandemic, climate change and a polarization of world powers during a speech at the General Assembly.CreditCredit...Pool photo by Eduardo Munoz Alvarez

Threatened by wars, climate change and a continuing pandemic, the world is becoming increasingly divided, the United Nations secretary general, António Guterres, warned on Tuesday in a sobering speech that called on nations to act.

“I am here to sound the alarm: The world must wake up,” Mr. Guterres said in the opening address of the U.N. General Assembly in New York, adding that the world faced “the greatest cascade of crises in our lifetimes.”

Covid-19 has exposed glaring inequalities, he said, pointing to a surplus of vaccines in wealthier nations while poorer countries remain largely unvaccinated. A window for combating climate change, which has already been blamed for driving scorching temperatures and other disasters, was “rapidly closing,” he said.

Peace remained “a distant dream” in places like Afghanistan, Ethiopia and Myanmar, Mr. Guterres noted, adding that misinformation and mistrust in institutions had polarized people.

And although he did not refer to the countries by name, he vocalized fears that a deepening competition between China and the United States, the world’s two largest economies, would further divide the world geopolitically — calling it “far less predictable than the Cold War.”

“Instead of the path of solidarity,” Mr. Guterres said, “we are on a dead end to destruction.”

The remarks were an indictment of the state of world affairs at the opening of a meeting meant to foster multilateralism and to demonstrate solidarity against global challenges. Mr. Guterres called on nations to create an agenda of peace and to institute climate-friendly fiscal and political overhauls.

Countries, he added, also needed to protect rights for women, who have been disproportionately affected by the pandemic, and address power imbalances between genders.

Nonetheless, hinting at hope for the future, Mr. Guterres, a Portuguese statesman who is serving his second term as secretary general, said: “The problems we have created are problems we can solve.”

Covid requirements add another number to define small businesses.

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Credit...Tom Grillo

When the Biden administration announced a mandate that employees be vaccinated or tested regularly at companies with 100 or more employees, business leaders responded with a barrage of questions. Among smaller companies, one loomed especially large: Why 100?

It’s an appealingly round, easy-to-remember number, and it captures a broad section of the American work force. President Biden estimated that his order would apply to 80 million employees and cover two-thirds of all workers.

But as a dividing line between a “big” business and a “small” one, it’s a threshold not found in any other major federal or state law. There was no explanation for how or why the number was chosen. And for entrepreneurs who employ a smattering of workers, that’s an increasingly common challenge: Every time lawmakers invent a new regulation, they also make up a new definition of which businesses count as small.

The Affordable Care Act set 50 as the number of workers after which employers would be required to offer health insurance. That edict, which took full effect in 2016, led to an intense, vocal backlash from owners who feared that the requirement would bankrupt them, with some even paring back their business to keep their employee roster under the limit.

The mandate’s actual costs turned out to be fairly muted for most — the law helped stabilize insurance prices in the notoriously erratic market for small-group plans — and, after surviving many legal and political efforts to dismantle it, the health care law has become a bedrock piece of federal policy. So why not use 50 employees as the boundary for the vaccination mandate?

The White House isn’t saying; officials did not respond to repeated questions about the 100-person criterion. The Labor Department’s Occupational Safety and Health Administration, which is responsible for drawing up the rules, has not yet explained how and when the mandate will be enforced.

The pandemic has worsened a shortage of child care workers.

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Credit...Kathleen Flynn/Reuters

Schools have largely reopened this fall, but life is far from normal for parents of young children. One reason is that child care — for children too young for school, and for the hours before and after school — is operating at 88 percent of its prepandemic capacity. Even before the pandemic, child care did not cover everyone who needed it.

The shortage is partly because of the pandemic. Some centers went out of business after lockdowns early on. Because children under 12 are not yet eligible for vaccines, many programs are enrolling fewer children to limit potential exposure.

But the biggest reason for the shortages, child care providers across the country said, is that they can’t find people to hire.

Eight in 10 providers said they were experiencing a staffing problem, and half said hiring was harder than before the pandemic, according to a survey over the summer of 7,500 of them by the National Association for the Education of Young Children.

Half said they were serving fewer children as a result of hiring problems, and a quarter had reduced their hours. The lack of child care is also contributing to other labor shortages, because many parents who can’t find reliable child care can’t return to work.

Child care providers face challenges like those in many other service industries that are unable to find enough workers: low pay and little job stability. The median hourly pay is $12, and 98 percent of occupations pay more, according to data from the Center for the Study of Child Care Employment at the University of California, Berkeley.

Turnover is high in early childhood education, and jobs caring for school-aged children are only a few hours a day and often end in the summer.

Child care has additional challenges. Some people are hesitant to work with unvaccinated children. The job requires more qualifications, including background checks, certifications and even college degrees in some areas, than the stores and restaurants that are paying more.

Yet child care centers have not responded the way some other industries have — by significantly raising wages and expanding benefits.

Uneven vaccination threatens the world’s economic recovery, an international body warns.

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Credit...Manish Swarup/Associated Press

The Organization for Economic Cooperation and Development said on Tuesday that a global economic recovery from the pandemic was finally taking hold, but it inched back its forecast for worldwide economic growth and warned that the rebound was benefiting wealthier countries more than the developing world as vaccine distribution occurs at an uneven pace.

Countries that have made big strides toward vaccinating most of their populations are bouncing back much more quickly than those that are still struggling to obtain shots, the organization said, raising a host of related economic problems that are affecting global supply chains and pose a risk for the future.

“The global shock that pushed the world to the worst recession in a century is now fading, and we’re now projecting the recovery will bring growth back to its pre-crisis trend,” Laurence Boone, the organization’s chief economist, said in a news briefing.

But vaccination rates remain varied, and many low-income countries and emerging markets, with the exception of China, are still far behind, Ms. Boone added. “A failure to vaccinate globally puts all of us at risk,” she said.

The warnings came as the O.E.C.D. released its semiannual economic forecast, in which it lowered its outlook for global growth, the U.S. economy and emerging markets, but raised its outlook for Europe.

The global growth outlook for 2021 was revised down slightly to 5.7 percent, from 5.8 percent.

Hospitals in Alaska struggle to handle a worsening outbreak.

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Credit...Loren Holmes/Anchorage Daily News, via Associated Press

Alaska, once a leader in vaccinating its citizens, is now in the throes of its worst coronavirus surge of the pandemic, as the Delta variant rips through the state, swamping hospitals with patients.

As of Thursday, the state was averaging 125 new cases a day for every 100,000 people, more than any other in the nation, according to recent data trends collected by The New York Times. That figure has shot up by 46 percent in the last two weeks, and by more than twentyfold since early July.

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About this data Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.

On Wednesday, the state said it had activated “crisis standards of care,” giving hospitals legal protections for triage decisions that force them to give some patients substandard care. The state also announced an $87 million contract to bring in hundreds of temporary health care workers.

Gov. Mike Dunleavy, a Republican, said that while hospitals were strained, he did not see a need to implement restrictions aimed at curbing transmission. Still, he encouraged people who had not yet received a vaccination to seriously consider it.

“We have the tools available to us for individuals to be able to take care of themselves,” Mr. Dunleavy said. While the state led the nation in vaccinations early in the year, it has been lagging in recent months, with half of its population fully vaccinated, compared with 55 percent nationally, according to federal data.

Jared Kosin, the head of the Alaska State Hospital and Nursing Home Association, called the surge “crippling” in an interview on Tuesday. He added that hospitals were full, and health care workers were emotionally depleted. Patients recently were kept waiting for care in their cars outside overwhelmed emergency rooms.

There is growing anxiety in outlying communities that depend on transferring seriously ill patients to hospitals in Anchorage, Mr. Kosin said. Transfers are getting harder to arrange and are often delayed, he said.

“We are all wondering where this goes, and whether that transfer will be available, even tomorrow,” Mr. Kosin said.

Critically ill people in rural areas, where many Alaska Natives reside, often have to be taken by plane to a hospital that can provide the treatment they need, said Dr. Philippe Amstislavski, an associate professor of public health at the University of Alaska Anchorage.

“Unlike in the lower 48, you don’t have that ability to move people quickly, because of the distances and remoteness,” said Dr. Amstislavski, who was formerly the public health manager for the Interior Region of Alaska, focusing on rural and predominantly Alaska Native communities.

Mr. Kosin said that if hospitalizations rise much further, hospitals and clinics around the state could be forced to apply crisis standards of care and more extreme triage decisions. “That is the worst-case scenario we could be heading to,” he said.

Alaska Natives, who have historically suffered from health disparities in the state, are disproportionately struggling during the latest virus wave, Dr. Amstislavski said.

Dr. Anne Zink, Alaska’s chief medical officer, said several factors may be contributing to the surge, including summer tourists bringing in and spreading the virus.

“We’re hoping that as the snow falls and we have less people visiting, those numbers will settle down,” Dr. Zink said in an interview Tuesday night.

On the other hand, she noted that cooling weather drives residents indoors, where the virus spreads more readily.

The state’s Canadian neighbors to the east, Yukon and British Columbia, have not suffered such severe outbreaks, Dr. Amstislavski said, possibly because of that country’s stricter travel restrictions and less strained health care system.