Amid a deepening crisis in India, growing numbers of medical experts are adding their voices to a chorus of condemnation of the government’s response and calling for nationwide restrictions to try to limit the horrifying death toll.
Although the official figures are already staggering — more than 350,000 new infections daily this month and nearly 250,000 total deaths — some experts say that the numbers are a vast undercount and estimate that India is on pace to suffer more than one million deaths by August.
The Indian Medical Association said it was time for a “complete, well-planned, pre-announced” lockdown to replace the scattershot regional restrictions currently in place across the nation of 1.4 billion.
The association, in a statement released over the weekend, said it was “astonished to see the extreme lethargy and inappropriate actions from the Ministry of Health in combating the agonizing crisis born out of the devastating second wave of the Covid-19 pandemic.”
Much of the criticism has been directed at Prime Minister Narendra Modi and his government, which allowed hundreds of thousands to gather at a large religious festival and held campaign rallies even as the virus surged.
“India squandered its early successes in controlling Covid-19,” the editorial said.
The medical journal also cited an estimate by the Institute for Health Metrics and Evaluation that projected that India would witness a total of more than a million coronavirus deaths by August — far higher than government figures would suggest.
On May 2, for example, the institute said that total deaths were actually about 642,000, about three times higher than the government’s own number for that date, just over 217,000.
Referring to the possibility that there may actually be a million victims by August, the Lancet editorial said, “If that outcome were to happen, Modi’s government would be responsible for presiding over a self-inflicted national catastrophe.”
On Monday, India recorded more than 365,000 new cases and 3,754 deaths, according to data from the Health Ministry.
Dr. Ashish K. Jha, dean of the School of Public Health at Brown University, wrote in a tweet on Sunday that it was likely that between two to five million people were being infected every day and that India’s “true” coronavirus death toll was “closer to 25,000 deaths” each day.
He based his own calculations, he wrote, on the number of cremations taking place in the country.
Early in the pandemic, there was hope that the world would one day achieve herd immunity, the point when the coronavirus lacks enough hosts to spread easily. But over a year later, the virus is crushing India with a fearsome second wave and surging in countries from Asia to Latin America.
That means if the virus continues to run rampant through much of the world, it is well on its way to becoming endemic, an ever-present threat.
Virus variants are tearing through places where people gather in large numbers with few or no pandemic protocols, like wearing masks and distancing, according to Dr. David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.
While the outbreak in India is capturing the most attention, Dr. Heymann said the pervasive reach of the virus means that the likelihood is growing that it will persist in most parts of the world.
As more people contract the virus, developing some level of immunity, and the pace of vaccinations accelerates, future outbreaks won’t be on the scale of those devastating India and Brazil, Dr. Heymann said. Smaller outbreaks that are less deadly but a constant threat should be expected, Dr. Heymann said.
“This is the natural progression of many infections we have in humans, whether it is tuberculosis or H.I.V.,” said Dr. Heymann, a former member of the Epidemiology Intelligence Service at the Centers for Disease Control and Prevention and a former senior official at the World Health Organization. “They have become endemic and we have learned to live with them and we learn how to do risk assessments and how to protect those we want to protect.”
Vaccines that are highly effective against Covid were developed rapidly, but global distribution has been plodding and unequal. As rich countries hoard vaccine doses, poorer countries face big logistical challenges to distributing the doses they manage to get and vaccine hesitancy is an issue everywhere. And experts warn the world is getting vaccinated too slowly for there to be much hope of ever eliminating the virus.
Only two countries have fully vaccinated more than half of their populations, according to the Our World in Data project at the University of Oxford. They are Israel and the East African nation of the Seychelles, an archipelago with a population of fewer than 100,000. And just a handful of other countries have at least partially vaccinated nearly 50 percent or more, including Britain, tiny Bhutan, and the United States.
Less than 10 percent of India’s vast population is at least partly vaccinated, offering little check to its onslaught of infections.
In Africa, the figure is slightly more than 1 percent.
Still, public health experts say a relatively small number of countries, mostly island nations, have largely kept the virus under control and could continue keeping it at bay after vaccinating enough people.
New Zealand, through stringent lockdowns and border closures, has all but eliminated the virus. Dr. Michael Baker, an epidemiologist at the University of Otago who helped devise the country’s coronavirus response, said New Zealand would likely achieve herd immunity by immunizing its population, but it has a long way to go with only about 4.4 percent of New Zealanders at least partially vaccinated.
“All of the surveys show there is a degree of vaccine hesitancy in New Zealand, but also a lot of people are very enthusiastic,” Dr. Baker said. “So I think we will probably get there in the end.”
While new daily cases have remained at near-world record levels, the number of deaths has dropped from a peak in February, going against the normal pattern of high cases followed eventually by high deaths. If that trendline continues, it could offer a glimmer of hope for a future scenario that scientists are rooting for: Even as the virus spreads and seems to be hurtling toward becoming endemic, it could become a less lethal threat that can be managed with vaccines that are updated periodically to protect against variants.
“It may be endemic, but not in a life-threatening way,” Dr. Michael Merson, a professor of global health at Duke University and former director of the World Health Organization’s Global Program on AIDS said. “It may be more like what we see with young kids, a common cold like disease.”
Madeleine Ngo contributed reporting.
One-armed, two-armed, side-armed: once an unceremonious greeting, hugging became a far from casual move during the deadly coronavirus pandemic — replaced by waves, nods and the fist or elbow bump.
But in England, hugging friends and family will be government-approved starting next Monday as the government loosens more restrictions, part of a gradual reopening of society and the economy that began this spring after months of national restrictions. Prime Minister Boris Johnson announced the changes Monday evening.
Mr. Johnson said that England was taking “the single biggest step” on its road out of lockdown, adding that the public should “protect these gains” by being cautious and using common sense. On Monday, England, Scotland and Northern Ireland reported zero coronavirus deaths in a 24-hour period. There were four deaths in Wales.
In this new stage, outdoor gatherings of up to 30 people will be allowed and indoor gatherings will be allowed for up to six people or two households. Indoor dining, movie theaters and museums will also be able to resume operations, among other places. Hostels, hotels and bed and breakfasts will reopen. Mr. Johnson said people would be allowed to make their own decisions about close contact — such as hugs — with family and friends, though he urged social distancing in places like offices, pubs, restaurants and other settings.
After a year where many people abstained from physical contact for fear of infecting themselves or others, news the embrace would be legal was welcomed, though with some mirth. Some joked that they had forgotten entirely how to execute the move. Others took issue with the fact that the government had tried to stop people from hugging at all, or worried that it was too soon to allow such close contact.
“I’m a hugger ,” said the mayor of London, Sadiq Khan, to reporters on Monday, adding that many Londoners were looking forward to relaxation of the ban. “I enjoy people’s company and I know people are ready for me to be hugging again. The first person I’m going to hug is my mum.”
And there were hints that hugs, among other types of physical touch, had already made a comeback.
Still, some experts warned that those wanting to hug their friends with wild abandon should save those arms for their favorite friends.
“It would worry me if we were advocating we can hug all of our friends every time we meet them again,” said Catherine Noakes, a professor from the University of Leeds and member of a government advisory body, to the BBC. Hugging should not be “too frequently,” she advised. “Keep it short, try and avoid being face to face, so perhaps turn your face away slightly, and even wearing a mask could help.”
Mr. Johnson seemed to agree, saying, “I urge you to think about the vulnerability of your loved ones.”
That impulse control may be too much for writer and actor Stephen Fry, who joked on Twitter while he had largely abided by the rules this past year, he may have a hard time showing restraint. “If you see me in the street — run for it,” he wrote.
Four people are facing nearly $70,000 in civil fines for clashing with airline crews over mask requirements and other safety instructions on recent flights, part of what the Federal Aviation Administration called a “disturbing increase” in the number of unruly passengers who have returned to the skies with the easing of pandemic restrictions.
The latest round of proposed fines, which passengers have 30 days to contest, came just days after the F.A.A. said that it had received more than 1,300 unruly-passenger reports from airlines since February. In the previous decade, the agency said, it took enforcement actions against 1,300 passengers total.
“We will not tolerate interfering with a flight crew and the performance of their safety duties,” Stephen Dickson, the administrator of the F.A.A., said on Twitter on May 3. “Period.”
None of the passengers now facing fines were identified by the F.A.A., which this year imposed a zero-tolerance policy for interfering with or assaulting flight attendants that carries a fine of up to $35,000 and possible jail time.
So far, the F.A.A. has identified potential violations in about 260 of the 1,300 cases referred by airlines, a spokesman for the agency said in an email on Sunday. Officials have begun enforcement actions in 20 of the cases and are preparing a number of additional enforcement actions, the spokesman said.
In 2019, before the coronavirus pandemic, there were 142 enforcement actions that stemmed from unruly passengers, according to the F.A.A. There were 159 in 2018, and 91 in 2017.
A man in California who received more than $5 million in Payment Protection Program loans intended to help struggling businesses during the coronavirus pandemic was arrested on Friday on federal bank fraud and other charges after he used the money to buy a Lamborghini and other luxury cars, federal prosecutors said.
The man, Mustafa Qadiri, 38, of Irvine, was indicted by a federal grand jury on four counts of bank fraud, four counts of wire fraud, one count of aggravated identity theft and six counts of money laundering, the U.S. attorney in the Central District of California announced.
Federal prosecutors said Mr. Qadiri’s efforts to obtain federal loans started in late May 2020 and netted him nearly $5.1 million by early June. Mr. Qadiri is accused of using that money to go on a spending spree that included buying a Ferrari, a Lamborghini and a Bentley and paying for “lavish vacations,” all of which are prohibited under the Payment Protection Program, prosecutors said.
Online court records did not identify a lawyer for Mr. Qadiri, and efforts to reach him by telephone and email on Sunday evening were not successful.
The 2011 Ferrari 458 Italia can sell for more than $100,000, according to Cars.com, which says in a review that the vehicle “can perform as well as strain gawkers’ necks.”
Numerous people have been arrested and charged with misusing pandemic relief funds. Mr. Qadiri is at least the third person to face charges specifying the purchase of a Lamborghini.
European soccer’s governing body will hold talks with the British government on Monday about moving this month’s Champions League final to London. Travel restrictions related to the coronavirus pandemic have made it almost impossible for domestic fans of the finalists — the Premier League rivals Chelsea and Manchester City — to attend the match at its scheduled site in Istanbul.
The final, which is planned for May 29, is the biggest day on the European club soccer calendar; like the Super Bowl and the Wimbledon final, the Champions League decider is one of the tent-pole events in global sports every year.
Questions about where to hold the match have been growing since Turkey announced a lockdown late last month. They intensified on Friday, days after Chelsea and City clinched their places in the final, when the British government announced that Turkey was among the countries to which Britons should avoid all but essential travel.
Officials from the Football Association in England have opened talks with Europe’s governing body, UEFA, about moving the game, and they will be present at Monday’s meeting, when UEFA will outline its requirements for relocation. A decision will most likely be announced within 48 hours.
Is watching a play on your laptop enough? That question will be put to the test starting May 17, when theaters in England reopen after a five-month shutdown.
Some shows in London are experimenting with filmed versions in advance of — or to run alongside — the same play in three dimensions, offering a choice to audiences.
When “A Splinter of Ice” begins a tour of British theaters on June 8, those who wish to can see it live, as long as they wear masks and maintain social distancing, for the first part of its travels at least. (Such protocol may change from June 21 onward, as Britain moves still further out of lockdown.)
For everyone else, a filmed version was shot on the stage of the Everyman Theater in Cheltenham, England. It stars the same actors, Oliver Ford Davies and Stephen Boxer, who will take the play out on the road.
None of this is new. The 2012 National Theater production of “The Curious Incident of the Dog in the Night-Time” was shown in movie theaters around the world long before it opened on Broadway.
The difference this time, of course, is that many potential audience members will be hesitant about crowded auditoriums.
Saudi Arabia said on Sunday that it would hold the hajj, the annual pilgrimage to Mecca that in normal times draws millions of Muslims to the kingdom, but did not say how many pilgrims would be allowed to come, which countries would be allowed to send them or what coronavirus precautions they would have to take.
The hajj, the ritual all Muslims are supposed to complete at least once, was also held last summer, but under tightly controlled conditions. Only about 1,000 Muslims from Saudi Arabia, including Saudis and foreign nationals living in the kingdom, were able to take part, down from about 2.5 million pilgrims in 2019; the rituals were performed at social distance, with masks, and the pilgrims were not allowed to kiss the Kaaba, the holy shrine at the center of Mecca that pilgrims are supposed to circle as they complete the hajj.
For the first time in living memory — the hajj had not been canceled since Saudi Arabia’s founding in 1932, though it has been restricted at various points in history during plagues, wars and political disputes — the holiest mosque in Islam was nearly empty, with a few carefully spaced circles of pilgrims dressed in white rather than the throngs who normally crowd the Grand Mosque.
The near-cancellation came as a spiritual and emotional blow to Muslims who had been hoping (and saving up) to participate, in many cases for years. Because of the demand, it is normally difficult to secure a hajj visa even in normal times.
It is unclear whether Saudi Arabia, which is balancing the much-needed tourism revenue it stands to gain from the hajj with the public health requirements of the coronavirus pandemic, will again restrict the hajj so tightly.
Fahad Nazer, a spokesman for the Saudi Embassy in Washington, said only that details would “be announced at a later date,” though he noted on Twitter that there would be “preventative & precautionary measures that ensure the health & safety of pilgrims.”
In other news from around the world:
Doctors in India are concerned about an increasing number of potentially fatal fungal infections affecting either people who have Covid-19 or those who have recently recovered from the disease. The condition, known as mucormycosis, has a high mortality rate and was present in India before the pandemic. It is caused by a mold that thrives in wet environments and can attack through the respiratory tract, potentially eroding facial structures and harming the brain.
China said on Sunday that it had taken steps to prevent coronavirus cases from entering the country — over the top of the world’s tallest mountain — including the installation of a dividing line on the summit to prevent climbers from the Chinese side and the Nepal side from coming into contact.
President Biden’s chief medical adviser for the pandemic said on Sunday that he was open to relaxing indoor masking rules in the United States as more Americans are vaccinated against the virus. Dr. Anthony S. Fauci said that as vaccinations climb, “we do need to start being more liberal” in terms of rules for wearing masks indoors, though he noted that the nation was still averaging about 43,000 cases of the virus daily. “We’ve got to get it much, much lower than that,” he said.
Mujib Mashal, Abby Goodnough, Austin Ramzy contributed reporting.
Before the pandemic, the trains of New Jersey Transit could be cattle-car crowded, with strangers pressed so closely against you that you could deduce their last meal. That level of forced intimacy now seems unimaginable.
After the outbreak, ridership on New Jersey trains, which in normal times averaged 95,000 weekday passengers, plummeted to 3,500 before stabilizing at about 17,500. A similar pattern held for the Metropolitan Transportation Authority’s Metro-North and Long Island Rail Road lines: in February 2020, nearly 600,000 riders; two months later, fewer than 30,000.
For many months, the commuter parking lots were empty, the train stations closed, the coffee vendor gone. At night, the trains cutting through Croton-on-Hudson in Westchester or Wyandanch on Long Island or in Maplewood, N.J., were like passing ghost ships, their interior lights illuminating absence.
But in recent weeks, as more people have become vaccinated, New Jersey Transit and the M.T.A. have seen a slight uptick, to about a quarter of their normal ridership.
Perhaps this signals a gradual return to how things had been; or, perhaps, it is a harbinger of how things will be, given that many people now feel that they can work just as efficiently from home.