COVID-19

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The official U.S. coronavirus case tally works out to about one in every 13 people in the country.
Credit…Whitney Curtis for The New York Times

The United States has recorded 25 million coronavirus cases, reaching the threshold Saturday afternoon, according to a New York Times database.

Experts say that as staggering as that figure is, it significantly understates the true number of people in the country who have been infected and the scope of the nation’s failure to contain the spread of the virus.

The official tally works out to about one in every 13 people in the country, or about 7.6 percent of the population.

“Twenty-five million cases is an incredible scale of tragedy,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, who called the coronavirus pandemic one of the worst public health crises in history.

As a result, deaths in the country have also inexorably risen, with more than 414,000 linked to the virus. That’s one death out of roughly every 800 people in the country.

Starting with the first reported case in the country last January, it took the United States more than nine months to reach 10 million cases. That milestone was passed on Nov. 8, just before a holiday surge that accelerated the rate of new infections and brought weeks of record-shattering hospitalizations and deaths. By the last day of 2020, the country had added another 10 million cases in just seven weeks.

Getting to 25 million took about three more weeks, after a surge that peaked at more than 300,000 recorded daily cases before retreating a bit in early January. Hospitalizations peaked around then and have since fallen: The latest figure of 116,264 Covid-19 patients is the lowest since Dec. 21, according to the Covid Tracking Project.

Experts now fear that any signs of progress could be undone by the emergence of new variants that appear to be more contagious. The Centers for Disease Control and Prevention recently warned that a virus variant first detected in Britain could become the dominant source of infection in the United States by March, and would very likely lead to further surges in cases and deaths. The warning only added to the urgency of speeding up the country’s lagging vaccination rollout.

In addition, the more viruses spread, the more opportunities they have to mutate. And as it becomes more difficult for the pathogen to survive — whether because of vaccinations or growing natural immunity — mutations that enable the virus to spread more easily or to escape detection by the immune system could multiply.

Epidemiologists say the true number of infections is probably much higher than the official tallies. Even with much more widespread testing now than in the pandemic’s early months, they say, many people who have never experienced symptoms may not have been tested or counted.

Ira Longini, a professor of biostatistics at the University of Florida, estimates that about 20 percent of Americans have had the virus — more than twice the number that is reported. Statistical modeling that he recently completed for Florida suggests that one-third of the state’s population has been infected at some point, quadruple the reported share.

It would take a coordinated nationwide study to move beyond modeling estimates and have a solid grasp of how many people have actually had the virus, he said. The C.D.C. conducts some serology testing, he said, but not enough to provide a full picture.

“The bottom line is, we don’t know, but we can guess from modeling,” Dr. Longini said.

The proportion can vary widely from place to place. In Dewey County, S.D., almost one in four residents has tested positive, but in San Juan County, Wash., only one in 200 has.

Many of the American metropolitan areas with the most reported cases relative to their populations are in the South or Southwest, where the virus has been spreading fast lately, but some are in areas like the Great Plains that were worse off in the fall. The top five are Yuma, Ariz.; Gallup, N.M.; Bismarck, N.D.; and Lubbock and Eagle Pass, Texas.

The metro areas with the greatest number of new cases per capita in the past two weeks reflect the same trend, and also underscore the virulence of the outbreak in California. Those areas are Laredo and Eagle Pass, Texas; Inland Empire, Calif.; Jefferson, Ga.; and Oxnard, Calif.

More than a million people are known to have tested positive in Los Angeles County, one of the nation’s hot spots over the past few months. And George Rutherford, a professor of epidemiology and biostatistics at the University of California, San Francisco, estimated that the true number of infections there is double that figure, or one out of every five Angelenos.

“It’s not enough for herd immunity, but it’s enough to blunt the curve,” he said.

Terry Littlepage received the Moderna coronavirus vaccine in New Braunfels, Texas, on Thursday.
Credit…Mikala Compton/Herald-Zeitung, via Associated Press

As the coronavirus tears across much of Texas, Dr. Esmaeil Porsa is grappling with one of the most formidable challenges he has faced: The Houston hospital system he operates is running out of vaccines.

Dr. Porsa, the chief executive of Harris Health System, which treats thousands of mostly uninsured patients, warned on Friday that its entire vaccine supply could be depleted by midday Saturday. The problem is not one of capability — the vaccination centers that Dr. Porsa oversees have easily been administering as many as 2,000 vaccines a day — but of availability.

“All of a sudden, the distribution of vaccines stopped,” Dr. Porsa said. “It’s perplexing and frustrating because I keep hearing that there are high percentages of vaccines that have been distributed but not administered.”

In the midst of one of the deadliest phases of the pandemic in the United States, health officials in Texas and across the country are growing desperate, unable to get clear answers as to why the long-anticipated vaccines are suddenly in short supply. Inoculation sites are canceling thousands of appointments in one state after another as the nation’s vaccines roll out through a bewildering patchwork of distribution networks, with local officials uncertain about the supplies they will have in hand.

In South Carolina, one hospital in the city of Beaufort had to cancel 6,000 vaccine appointments after it received only 450 of the doses it had expected. In Hawaii, a Maui hospital canceled 5,000 first-dose appointments and placed 15,000 additional requests for appointments on hold.

The situation is especially dire in Texas, which is averaging about 20,000 new coronavirus cases a day, fueling concerns over whether officials will be able to curb the spread when they cannot get their hands on the vaccines that they desperately need to do so.

A man placing flags at the National World War I Museum and Memorial in Kansas City on Tuesday. The flags represent the area residents who died of coronavirus.
Credit…Charlie Riedel/Associated Press

President Biden, by predicting on Friday that the coronavirus-related U.S. death toll would eventually be well over 600,000, could in the end be right.

Or, like others who have tried to forecast the figure, he could be wrong.

Back in March, when Dr. Anthony S. Fauci, the U.S. government’s top infectious disease specialist, said that the pandemic could kill 100,000 to 240,000 people in the country, some thought his projection was too grim to be possible.

On Tuesday, the country surpassed 400,000 deaths. And on Thursday, Mr. Biden predicted — on his first full day on the job — that the death toll would top 500,000 next month, an estimate supported by models from public health experts.

“The virus is surging. We’re 400,000 dead, expected to reach well over 600,000,” Mr. Biden said on Friday evening. “No matter how you look at it, we need to act.”

Meanwhile, an aggregate forecast from the Centers for Disease Control and Prevention comprising various independent models projects that 465,000 to 508,000 deaths could be reported by Feb. 13.

At many points over the past year, even dire death toll projections have fallen short of reality. The U.S. failed to bring the virus under control when it had a chance to do so in the spring. New, more transmissible variants now make the outlook for the virus harder to predict.

Two days after reaching 400,000 deaths, according to data compiled by The New York Times, the country had already passed 410,000. The U.S. added more than 4,100 deaths on Thursday, the third-highest daily total of the pandemic. About 120,000 people are hospitalized with the virus, and the country is adding about 1.3 million new cases a week.

From the start, the Trump administration was loath to acknowledge the carnage from the virus. Last April, Dr. Deborah L. Birx, the former administration’s coronavirus response coordinator, said that aggressive social distancing measures had appeared to slow the spread and suggested the number of dead might be lower than initially feared — perhaps about 60,000.

That figure was reached within weeks. In May, President Donald J. Trump adjusted that projection to between 75,000 and 100,000 deaths. (He then claimed success would be anything less than 2.2 million fatalities, the most extreme prediction if the country had done nothing at all to respond to the pandemic.)

The death total reached 100,000 by May 27 and 200,000 on Sept. 22. On Dec. 14, it hit 300,000, an accelerating pace that continued to speed up, resulting in a mere five weeks between that milestone and the death toll of 400,000.

Betty Rivera, right, contracted the coronavirus and spread it to the five other family members who share a tiny one-bedroom apartment in a crowded immigrant neighborhood in Los Angeles. The coronavirus has disproportionately affected people who live in areas where overcrowding is rampant.
Credit…Karla Gachet for The New York Times

LOS ANGELES — Betty Rivera was the first in her household to get sick, early last month. To protect her family, she locked herself in the bedroom that she usually shared with her grandson. Her daughter left chicken soup and herbal remedies of ginger and garlic and rosemary outside her door.

But it was impossible to stop the spread, not with three generations crammed into a one-bedroom apartment in one of Los Angeles’s most overcrowded communities.

Her three-story brick building is wedged between Koreatown and Pico-Union, neighborhoods filled with immigrants who stock groceries and drive buses and where the streets are dotted with businesses that serve the underprivileged: 99-cent stores, check cashing outfits that dole out payday loans, pawnshops. These days, the wail of ambulance sirens never seems to end.

“It’s all day long,” Ms. Rivera, 69, said in a recent interview in her living room, where her family sleeps and where the fireplace is jammed with toys.

Ms. Rivera’s daughter was the next to become ill, and then her son-in-law and two of her grandchildren. Even Chloe, the black-and-white dachshund and Chihuahua mix scurrying around the apartment, became sick, she said.

Los Angeles may not have the population density of New York, or as many skyscrapers or high-rise apartment buildings or jam-packed subways, but the county does have a higher percentage of overcrowded homes — 11 percent, according to the U.S. Census Bureau — than any other major metropolitan area in America.

Overcrowded housing is defined as more than one person per room, excluding bathrooms. If you drive across the vastness of Los Angeles County, starting at the ocean and going east, the shifting landscape tells the story of the housing inequality that has fueled the virus surge. Mansions give way to smaller, single-family homes, and finally to the immigrant areas like where Ms. Rivera, who moved here from El Salvador almost 40 years ago, lives, six people in a tiny one-bedroom. In some areas, like Westlake, where street vendors line the sidewalks near MacArthur Park, close to 40 percent of homes are considered overcrowded.

It is this Los Angeles, of tight-knit families, of streets packed with food vendors from Central America and Mexico, of encampments of homeless residents, where the virus has spread ferociously, bringing so much sickness and death.

Early in the pandemic, many hoped that Los Angeles — at least the Los Angeles of the popular imagination, with nice houses and backyard pools and everyone in their cars — would somehow be protected from catastrophe.

Now, the hospitals are overrun, and Southern California has become one of the centers of the nation’s outbreak, with alarming daily death tolls. In communities across Los Angeles County, the nation’s largest with a population of more than 10 million people, it is clear those early hopes were misguided.

Ana Facio-Krajcer contributed reporting.

Starbucks is one of the companies that has offered its resources in helping with the national vaccination effort.
Credit…Brittany Greeson for The New York Times

Amazon wrote to President Biden on Thursday offering to assist with communication and technology. Microsoft is opening up its largely empty office campus to be a vaccination center as part of a broader partnership with Washington State. Starbucks is assigning workers from its operations and analytics departments to help design vaccination sites, donating the labor while continuing to pay employees.

Although some retailers and pharmacy chains have been directly involved in the rollout of coronavirus vaccinations, more surprising is the number of companies that have offered help despite having little to do with health care.

What these companies do have are vast national footprints, significant manpower, huge distribution warehouses and, in some cases, empty office buildings. And they have the money to spare for a public service effort that could help both their public image and their bottom line.

“Big companies can think big,” said Arthur Herman, senior fellow at the Hudson Institute, a think tank in Washington, D.C. “They can afford to step back and think about their role as a social force in their state and in the country. They also have enormous supply chains and logistical connections.”

As Mr. Biden tries to ramp up vaccination efforts, he will need all the help he can get. The president has asked Congress for $20 billion to help fund vaccinations at stadiums, pharmacies and the like. He said Friday that he had tapped the Federal Emergency Management Agency to operate up to 100 mass vaccination sites.

But the private sector could assist the administration’s efforts with data storage, appointment scheduling, the delivery of supplies to clinics and hospitals, and more.

“Amazon, Google, Microsoft, these guys are consumer-facing people who can deal with billions of transactions on a daily basis,” said Suketu Gandhi, a partner Kearney, a management and consulting firm.

Washington’s governor, Jay Inslee, included the help of companies like Starbucks, Costco and Microsoft in a plan to vaccinate 45,000 residents a day.

National Guard soldiers standing on the east side of Capitol Hill in Washington on Thursday.
Credit…Amr Alfiky/The New York Times

Among the 26,000 National Guard members deployed to Washington for Joseph R. Biden Jr.’s inauguration, 200 have tested positive for the coronavirus, a defense official said on Friday, as concerns grow that the deployment might amount to a super-spreader event.

The Jan. 6 attack on the Capitol was both a national trauma and a galvanizing force for right-wing extremists. With chat rooms and messaging apps where those extremists congregate filled with celebrations and discussions of possible further attacks, Guard contingents from every state were sent to Washington in the days leading up to and during the inauguration.

Those deploying underwent temperature checks and filled out questionnaires about their symptoms and exposure before arriving in Washington. Those with symptoms were directed to get tested, but infected people without symptoms can also spread the virus.

Even as Guard members were photographed with masks on physically distanced, many had to sleep in tight spaces at the Capitol — and on one night, notoriously, in a parking garage — to make room for lawmakers to keep working, raising concerns about the possibility of the virus spreading among the force.

The Senate Rules Committee is investigating the Guard members’ lack of housing and related coronavirus concerns, Politico reported, citing that panel’s top Republican, Sen. Roy Blunt of Missouri.

The Pentagon said Friday that 19,000 of the nearly 26,000 National Guard troops who had helped secure the event were beginning to return to their home states, a process that will take about five to 10 days and include coronavirus screenings. The governors of New Hampshire, Florida, Texas and Montana called for Guardsmen from their states to come home.

Dr. Ashish Jha, the dean of Brown University’s School of Public Health said that seeing Guard members in close quarters during the week had been concerning. “I worried about what was being done to protect them and wondered why we couldn’t find more space for them to spread out,” he said.

Keeping members, their families and communities safe as they travel back to their homes will require a two-pronged approach, Dr. Jha said.

“The safest thing to do is to quarantine those who were potentially exposed to a member who tested positive and test every single member as they go home,” he said.

But how much testing is being done on returning troops was not immediately clear. Asked a week ago about the screenings Guard members received before arriving in Washington, a spokesman for the National Guard Bureau, Maj. Matt Murphy, said that blanket testing was not feasible.

The restricted area in the Jordan district of Hong Kong on Saturday.
Credit…Anthony Kwan/Getty Images

New infections in recent months and a contagious new variant threatening to accelerate the pandemic have prompted some governments to revert to their harshest social-distancing measures.

In Hong Kong, the authorities said on Saturday that they had locked down part of a densely packed neighborhood and started to test everyone there, one of the most drastic measures that the Chinese territory has taken since the coronavirus surfaced there last winter.

The local government said on Saturday that it had restricted access to some parts of the Jordan District, one of Hong Kong’s most crowded, and that people there would be prevented from leaving until they had been tested, the first such lockdown in the territory. Battalions of police officers were seen guarding the area’s perimeter as health workers in head-to-toe protective gear walked inside.

About 200 buildings in the Jordan area were affected, and more than 1,700 police and other officers were expected to be deployed, The South China Morning Post reported.

Officials said that 162 confirmed coronavirus cases had been recorded across 56 buildings in Jordan in the first 20 days of January.

The government plans to finish testing residents in the restricted area within 48 hours, in time for residents to go to work on Monday morning.

As of Saturday, Hong Kong was averaging 73 daily cases over the past week, according to a New York Times database.

In Madrid, restaurants and bars will need to close early on Monday, as part of a series of new lockdown restrictions announced by the authorities in Spain’s capital region.

The new rules comes only days after Isabel Ayuso, the leader of the Madrid region, pledged instead to avoid any further clampdown on restaurants, saying that “if you want to ruin hostelry, don’t count on me.”

Instead, restaurants will need to close at 9 p.m. — effectively stopping them from serving at traditional Spanish dinner hours — and also limit the number of people sharing a table to four, rather than six. Madrid’s nighttime curfew will also be moved forward to 10 p.m. from 11 p.m.

Madrid is joining other regions of Spain that have been tightening their lockdown since the start of the year, amid particular concerns about the spread of a new variant of Covid-19 first detected in Britain, called B.1.1.7.

But the central government has so far resisted calls from some regional politicians to return the country to a full lockdown, like that enforced in March when the coronavirus first inundated Spain. The average daily number of registered Covid-19 cases in Spain has doubled over the past two weeks, reaching past 35,000 on Friday.

Spain’s vaccine rollout has also been criticized by its residents, who are angry that politicians and well-connected individuals are skipping the line to get a vaccine, as delivery delays halt some vaccination efforts, according to The Associated Press.

One of those politicians includes Spain’s defense ministry chief of staff, who resigned on Saturday, a day after the ministry launched an investigation into whether he and other senior military officers had jumped the queue to get vaccinated early against Covid-19.

The resignation of Spain’s most senior general follows that of some other regional health officials, who got vaccinated even though priority access to vaccines should have been limited to frontline medical workers, like doctors and nurses.

The defense ministry said in a statement that Gen. Miguel Ángel Villarroya Vilalta had resigned “to preserve the image of the armed forces,” although he believed that he had acted in good faith and had “never intended to take advantage of unjustifiable privileges.”

A passenger arrived at the nearly deserted train station in Wuhan on Jan. 23, 2020.
Credit…Hector Retamal/Agence France-Presse — Getty Images

The numbers seemed incomprehensible.

Eleven million residents in Wuhan, China, woke up to learn that they had been indefinitely confined to their homes. More than 30,000 travelers found themselves instantly stranded. And a “mystery virus,” had spread seemingly overnight to at least three countries, killed 17 people and sickened more than 570.

It was the morning of Jan 23, 2020.

Wuhan, the first city to be devastated by the coronavirus, was set to be locked down at 11 a.m. Anyone with the means to leave was doing so. But Chris Buckley, The Times’s chief China correspondent, boarded a train in Beijing and headed into the hot zone.

In a matter-of-fact text message sent to his editors in Hong Kong at 9:35 a.m., he wrote, “I’m on the G79 high-speed train that should get into Wuhan at about 2.”

Simultaneously, The Times had published a live briefing, a dynamic digital article intended to cover the rapidly unfolding story.

In a dispatch to the briefing posted at 11 a.m., Chris wrote that a passenger aboard the train warned him that the authorities “probably won’t let people out” of the city until after the Lunar New Year holiday.

Had she been right, Chris would have been home in four days. Instead, it would be four months before he was able to leave Wuhan, when the lockdown was ultimately lifted.

Within 12 hours of publishing the first version of that briefing, two more Chinese cities, with a combined population of 8 million, went into lockdown, six more deaths were confirmed and the number of known cases jumped by more than 200.

In the 12 months since, this briefing has run unabated. Staffed by editors and reporters around the world, it has borne witness to an unceasing global tragedy.

On this, the first anniversary of the Wuhan lockdown, our staff looks back at the toll the virus took on that city, and interviews individuals who found courage in adversity, calm amid grief, and meaning in chaos.

The briefing goes on: 365 days, 96 million cases, 2 million deaths, 222 countries and territories, 3.9 billion people asked to stay home.

And still the numbers stagger.

Larry King on the set at CNN studios in Los Angeles in 2007. 
Credit…Monica Almeida/The New York Times

Larry King, who shot the breeze with presidents and psychics, movie stars and malefactors in a half-century on radio and television, including 25 years as the host of CNN’s globally popular “Larry King Live,” died on Saturday in Los Angeles. He was 87.

Ora Media, which Mr. King co-founded in 2012, confirmed the death in a statement posted on Mr. King’s own Twitter account and said he had died at Cedars-Sinai Medical Center.

The statement did not specify a cause of death, but Mr. King had recently been treated for Covid-19. In 2019, he was hospitalized for chest pains and said he had also had a stroke.

A son of European immigrants who grew up in Brooklyn, N.Y., and never went to college, Mr. King began as a local radio interviewer and sportscaster in Florida in the 1950s and ’60s, rose to prominence with an all-night coast-to-coast radio call-in show starting in 1978, and anchored CNN’s highest-rated, longest-running program from 1985 to 2010, reaching millions across America and around the world.

With the folksy personality of a Bensonhurst schmoozer, Mr. King interviewed an estimated 50,000 people of every imaginable persuasion and claim to fame — every president since Richard M. Nixon, world leaders, royalty, religious and business figures, crime and disaster victims, pundits, swindlers, “experts” on U.F.O.s and paranormal phenomena, and untold hosts of idiosyncratic and insomniac telephone callers.

Mr. King might have made a fascinating guest on his own show: the delivery boy who became one of America’s most famous TV and radio personalities, a newspaper columnist, the author of numerous books and a performer in dozens of movies and television shows, mostly as himself.

His personal life was the stuff of supermarket tabloids — married eight times to seven women; a chronic gambler who declared bankruptcy twice; arrested on a fraud charge that derailed his career for years; and a bundle of contradictions who never quite got over his own success but gushed, star-struck, over other celebrities, exclaiming, “Great!” “Terrific!” “Gee whiz!”

He made no claim to being a journalist, although his show sometimes made news, as when Ross Perot announced his presidential candidacy there in 1992. And he was not confrontational; he rarely asked anyone, let alone a politician or policy maker, a tough or technical question, preferring gentle prods to get guests to say interesting things about themselves.

New Yorkers waited in line at vaccine hub in Queens last week.
Credit…Hiroko Masuike/The New York Times

Even as New York City officials focus on vaccinating millions of residents, the coronavirus continues to spread, with more than 50 ZIP codes showing a positive test rate over 10 percent.

Each day recently has typically seen about 5,000 new cases of the virus and has recorded more than 60 new deaths. While the numbers of deaths and hospitalizations are nowhere near what they were during the city’s peak of the epidemic in the spring, public health experts wonder how much worse the data needs to get before officials consider new steps and restrictions.

“I feel like people are numbed by the numbers; I worry about the complacency and fatigue,” said Dr. Wafaa El-Sadr, an epidemiologist at Columbia University’s Mailman School of Public Health. “I worry about the focus on vaccines, rather than what’s happening with the virus.”

The 54 ZIP codes in New York City with seven-day average positivity rates of over 10 percent span every borough, city statistics showed on Friday. Two more ZIP codes were at 10 percent. Bronx, Queens and Staten Island have positive test rates higher than 9 percent.

Not long ago, Gov. Andrew M. Cuomo pledged to largely lock down areas where positive test rates consistently topped 4 percent. But as rates rose above that statewide, those plans were scrapped.

Currently the sole measure presented by Mr. Cuomo to trigger a lockdown is a complicated projection regarding hospital capacity. Officials say they are not considering any adjustments to that model.

In the ZIP code that includes Brighton Beach in southern Brooklyn, more than 500 cases were reported from Jan. 13 to 19. In all, more than 36,000 city residents tested positive during that period; nearly 2,500 people with Covid-19 were admitted to hospitals.

Transmission in the city has become so widespread that Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention, recommended that all New Yorkers change their behavior.

“People in New York City should leave home only for outdoors or essential indoors activities given the level of spread in the community,” he said Thursday.

The need to better control brisk transmission is especially essential now that a more contagious variant of the virus from Britain has been detected in the city, Dr. Frieden and other epidemiologists said.

At the current rate of vaccination, experts say, it will take months to change the virus’s trajectory.

A migrant worker on a break from harvesting lettuce in Somerton, Ariz.
Credit…Adriana Zehbrauskas for The New York Times

Yuma County, Ariz., which produces the lettuce, broccoli and other leafy greens that Americans consume during the cold months, is known as “America’s salad bowl.” Now it has become a winter hothouse for Covid-19.

Over the course of the pandemic, the Yuma area has identified coronavirus cases at a higher rate than any other region in the United States. One out of every six residents has contracted the virus.

Each winter, the county’s population swells by 100,000 people, to more than 300,000, as field workers descend on the farms and snowbirds from the Midwest pull into R.V. parks. This seasonal ritual creates jobs and increases local spending and tax revenue. But this year, the influx has turned deadly.

Even as coronavirus cases are starting to flatten across the country, the virus is still raging in many border communities. Three of the six metro areas with the highest rates of known cases since the outbreak began are small cities straddling Mexico: Yuma; Eagle Pass, Texas; and El Centro, Calif. In Laredo, Texas, cases are increasing at more than three times the rate being reported in hard-hit Los Angeles and Phoenix.

Seasonal migration, the daily flow of people back and forth and lax measures to contain the virus’s spread have created a combustible constellation. Arizona has among the highest increases in newly reported deaths of any state over the past two weeks — and it is not clear when this troubling trend will abate.

“Some families have buried multiple relatives,” said the Rev. Emilio Chapa, the pastor of St. Francis of Assisi Catholic Church in central Yuma. “It’s a dire situation.”

A study commissioned by the International Chamber of Commerce calculates the costs of unequal access to vaccinations, foreseeing trillions of dollars of losses in the global economy. 
Credit…Hannah Yoon for The New York Times

In monopolizing the supply of vaccines against Covid-19, wealthy nations are threatening more than a humanitarian catastrophe: The resulting economic devastation will hit affluent countries nearly as hard as those in the developing world.

This is the crucial takeaway from an academic study to be released on Monday. In the most extreme scenario — with wealthy nations fully vaccinated by the middle of this year, and poor countries largely shut out — the study concludes that the global economy would suffer losses exceeding $9 trillion, a sum greater than the annual output of Japan and Germany combined.

Nearly half of those costs would be absorbed by wealthy countries like the United States, Canada and Britain.

In the scenario that researchers term most likely, in which developing countries vaccinate half their populations by the end of the year, the world economy would still absorb a blow of between $1.8 trillion and $3.8 trillion. More than half of the pain would be concentrated in wealthy countries.

Commissioned by the International Chamber of Commerce, the study concludes that equitable distribution of vaccines is in every country’s economic interest, especially those that depend most on trade. It amounts to a rebuke to the popular notion that sharing vaccines with poor countries is merely a form of charity.

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