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The Navajo Nation, which once had one of the worst coronavirus case rates in the United States, recently reached an extraordinary milestone: zero cases and zero deaths in a 24-hour period.
The nation, which has over 300,000 enrolled members, is averaging about 11 new cases a day, far below its peak of 250 in late November, according to the latest data from the Navajo Department of Health.
And it has vaccinated more of its population than any state, with more than half of its 170,000 residents living on tribal lands fully vaccinated.
But there are some alarming signs. With infections rising again nationally and dangerous variants circulating, U.S. health officials are warning of another surge. And the first confirmed case of the more contagious and possibly more lethal variant first found in Britain has been confirmed on Navajo territory, which stretches across Arizona, New Mexico and Utah.
The Navajo, the second-largest U.S. tribe, aren’t alone in their struggle against the virus. Indigenous Americans have had Covid-19 death rates nearly twice those of white populations in the United States, amid high rates of comorbidities like diabetes and obesity, according to the Centers for Disease Control and Prevention.
Jonathan Nez, the president of the Navajo Nation, said the tribe was able to tame the virus because members had followed strict lockdown orders and a mask mandate, which was imposed nearly a year ago.
“It wasn’t about restricting people’s freedoms when we told people to wear a mask or to stay home. It was looking at the greater good,” Mr. Nez said on the CBS program “Face the Nation” on Sunday.
Vaccination efforts have also been a big success, Mr. Nez said, with about 218,190 shots administered (nearly 90 percent of the doses allocated) and 88,513 people fully vaccinated.
“I think just because of how hard hit the Navajo Nation was, we’ve seen a big increase in participation in taking the vaccine,” Mr. Nez said, adding that officials have been holding town hall meetings to build trust and answer questions about the virus.
Tribal health officials have also credited the nation’s decision to coordinate closely between the federal Indian Health Service, which oversees care for the more than 500 tribes throughout the country, and Navajo health organizations, a much more streamlined operation than the patchwork approach across the country.
Other tribes have also had successful pandemic responses. Reported cases in the Cherokee Nation, the largest U.S. tribe, dropped sharply in mid-March, when Oklahoma stopped reporting daily virus data. The tribe also quickly administered thousands of vaccine shots but is now facing the problem of getting hesitant people vaccinated.
In the pandemic’s early days, the Navajo Nation struggled to contain the virus. Mr. Nez attributed the difficulties to resource inequities, an underfunded health care system and limited federal help.
The Indian Health Service “has been underfunded since its inception,” he said. A New York Times investigation last year found that the agency struggled to respond to the pandemic because it has long been plagued by shortages of funding, supplies and health care workers.
A more recent NPR analysis, however, found that tribes that decided to receive vaccines through the Indian Health Service — including the White Mountain Apache of Arizona and the Rosebud Sioux of South Dakota — were far ahead of those that went through state systems.
Tribal elders’ deaths have devastated their communities. The lack of local data has further complicated the challenge of controlling outbreaks.
President Biden’s $1.9 trillion pandemic relief package, which he signed last month, provides $31 billion for tribal nations and Indigenous people to address persistent problems like poor health care.
And Mr. Biden appointed former Representative Deb Haaland of New Mexico as secretary of the interior, making her the first Native American to lead a cabinet agency and responsible for the well-being of the nation’s 1.9 million Native people.
“We finally have a seat at the table in getting our information and our advocacy addressed,” Mr. Nez said, referring to collaboration with the White House and the acting director of the Indian Health Service. “With the funds that are coming to the citizens of this country in terms of recovery and rescue, this time around it’s finally helping our nation grow.”
More than a year into the pandemic, India recorded its highest tally of new coronavirus infections on Monday as officials in the hardest-hit state reimposed lockdowns and warned that hospitals even in smaller cities were running out of beds.
The worrisome developments were reminiscent of earlier waves in the pandemic, yet they came even as India continues to vaccinate more than three million people every day, one of the largest efforts in the world.
Officials announced Monday morning that they had recorded 103,558 new cases in 24 hours, making India the second country after the United States to cross the 100,000-case threshold in a single day. After several months of declines, daily infections have surged tenfold since the second week of February.
More than half of the new infections were traced to the western state of Maharashtra, which includes Mumbai, India’s financial capital. The state government ordered all shops, movie theaters, markets and restaurants to close starting Monday evening and imposed a nighttime curfew, exempting only essential services.
With 12.6 million confirmed coronavirus cases, according to a New York Times database, India’s caseload is the world’s third highest after the United States and Brazil. Officials have attributed the recent spike to a relaxed attitude among Indians when it comes to wearing masks and maintaining social distance.
But critics say Prime Minister Narendra Modi’s government has sent mixed signals. Officials have allowed large crowds to gather for a major Hindu religious festival — where hundreds of coronavirus infections have been reported — while Mr. Modi’s party has held crowded rallies in several states where local elections have begun.
In the early days of the pandemic, Mr. Modi enacted one of the world’s severest and most abrupt lockdowns, leaving hundreds of thousands of migrant workers instantly unemployed and forcing many to return to their villages on foot. As India’s already ailing economy contracted even further, Mr. Modi began lifting restrictions last May, and infections started to explode.
The new restrictions in Mumbai have been met with resistance by opposition politicians and business leaders. Representatives of the hotel industry appealed to the Maharashtra state government for financial support and tax waivers, saying the latest lockdown moves would bring economic doom.
India’s vaccination drive has been a rare bright spot domestically, but at a cost to other nations: The government has curtailed exports of vaccines manufactured by its mammoth pharmaceutical industry, dealing a setback to poorer countries that had been relying on India for their doses.
Israel’s vaccination program has been remarkably swift and successful. In recent weeks, new coronavirus infections have dropped significantly, from a peak of 10,000 a day in January to a few hundred by late March. The economy has almost fully reopened.
And just as Israel became a real-world laboratory for the efficacy of the vaccine, it is now becoming a test case for a post-lockdown, post-vaccinated society.
The Green Pass, a document that can be downloaded to a smartphone, is the entry ticket.
Green Pass holders may dine indoors in restaurants, stay in hotels and attend cultural, sports and religious gatherings in the thousands both indoors and out. They can go to gyms, swimming pools and the theater. They can get married in wedding halls.
Local newspapers and television stations are advertising summer getaways for the fully vaccinated in countries prepared to take them, including Greece, Georgia and the Seychelles.
Restaurants ask those booking tables: Do you have a Green Pass? Are you vaccinated?
The system is imperfect, and, beyond the Green Pass, in many ways “system” may be an overstatement. Enforcement has been patchy. There are troubling questions about those who are not vaccinated and noisy debates playing out in real time — some landing in court — about the rules and responsibilities of the return to near normalcy.
Moreover, there’s no guarantee that this really is the start of a post-pandemic future. Any number of factors — delays in vaccine production, the emergence of a new vaccine-resistant variant and the huge numbers of Israelis who remain unvaccinated — could rip the rug out from under it.
The new world has also underscored the inequities and divides between societies with more or less access to the vaccine. Many in the West Bank and Gaza have not been able to get vaccinations yet.
The Palestinian vaccination campaign is just getting started, with doses largely donated by other countries amid a bitter debate over Israel’s legal and moral obligations for the health of people in territory it occupies. Israel has vaccinated about 100,000 Palestinians who work in Israel or in West Bank settlements but has been criticized for not doing more.
More than 5.2 million Israelis have received at least one shot of the Pfizer vaccine. About four million remain unvaccinated, half of them people under 16 who are not yet eligible to receive the vaccine pending regulatory approvals and further testing on children. Hundreds of thousands of citizens who have recovered from Covid-19 were only recently included in Israel’s vaccination program.
And up to a million people have so far chosen not to get vaccinated, despite Israel’s enviable supply of doses.
The Maryland biotech firm at the center of a mix-up that ruined up to 15 million doses of the Johnson & Johnson coronavirus vaccine declared late Sunday that it “continues to own and operate” the Baltimore plant where the problems occurred, even though the Biden administration has put Johnson & Johnson in charge of manufacturing there.
In an apparent bid to reassure its shareholders, Emergent BioSolutions, a contract manufacturer that was making vaccines for both Johnson & Johnson and AstraZeneca, said it was “on track with its manufacturing agreements related to Covid-19 vaccines” and “that there are no changes to its financial guidance for 2021.”
Yet even as the company sought to defend its reputation, it acknowledged that there would be changes in the way its plant, known as Bayview, was managed — and that Johnson & Johnson would in effect run its own vaccine manufacturing operation there.
“Emergent’s top priority continues to be the strengthening of the supply chain for Johnson & Johnson’s vitally needed Covid-19 vaccine,” Robert Kramer, the company’s chief executive, said in the statement. “We have been working closely with Johnson & Johnson and welcome the additional oversight and support at our Bayview facility.”
On Saturday, days after the disclosure that workers at the Baltimore facility had mixed up ingredients from the two vaccines it was making, the Department of Health and Human Services stepped in, instructing Johnson & Johnson to take control of the plant. The department also ordered Emergent to stop making the AstraZeneca vaccine to avoid future mistakes.
Emergent said on Sunday that it would work with the government on a “mutually agreed ramp-down” of AstraZeneca manufacturing. The administration has said that it will look for another site to make that vaccine, which unlike the Johnson & Johnson vaccine does not have emergency authorization from the Food and Drug Administration.
The error in Baltimore has delayed future shipments of Johnson & Johnson doses in the United States while the F.D.A. investigates what happened. It has also created a public relations headache for the Biden administration, which is trying to increase production of coronavirus vaccines and assure skeptics that they are safe.
Emergent is well known in Washington; last month The New York Times published an investigation into the company’s aggressive lobbying for federal contracts, particularly for the Strategic National Stockpile, the nation’s emergency medical reserve. After the article appeared, President Biden canceled a visit to the Baltimore facility.
The Baltimore plant is one of two federally designated “Centers for Innovation in Advanced Development and Manufacturing” that work with the government and are supposed to stand ready to help in a public health emergency. In June, the government awarded Emergent a contract valued at up to $628 million to reserve manufacturing space for coronavirus vaccines and upgrade the Baltimore facility.
The government recently increased the contract by $23 million to allow Emergent to purchase manufacturing equipment specific to Johnson & Johnson’s vaccine — an award the company highlighted in its statement on Sunday. The increase was awarded on March 23, two days before the government learned about the mix-up at the Baltimore facility.