Covid-19 News: Live Updates on Vaccine Doses, Cases and Deaths

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Winter Storms Delayed Delivery of 6 Million Vaccines, White House Says

Andy Slavitt, a White House pandemic adviser, said a backlog of coronavirus vaccine shipments caused by severe winter storms across the country were expected to be delivered in the next week.

We have a backlog of about six million doses due to the weather. All 50 states have been impacted. The six million doses represents about three days of delayed shipping. There are three places along the distribution chain that have been impacted by the weather. First, FedEx, UPS and McKesson, our logistics and distribution teams, have all faced challenges as workers have been snowed in and unable to get to work to package and ship the vaccines, kits and the required diluent. Second, road closures have held up delivery of vaccines at different points in the distribution process — between manufacturing sites to distribution and to shipping hubs. Third, more than 2,000 vaccine sites are located in areas with power outages, so they’re currently unable to receive doses. Because of 72-hour cold-chain constraints, we don’t want to ship doses to those locations and have them sitting at a site where they might expire. So the vaccines are sitting safe and sound in our factories and hubs, ready to be shipped out as soon as the weather allows. Now, as weather conditions improve, we’re already working to clear this backlog: 1.4 million doses are already in transit today, and we anticipate that all the backlog doses will be delivered within the next week. We’re asking vaccine administration sites to extend their hours even further, and offer additional appointments and to try to reschedule the vaccinations over the coming days and weeks as significantly more supply arrives.

The White House on Friday said that six million doses of coronavirus vaccines had been held up because of snowstorms across the country, creating a backlog affecting every state and throwing off the pace of vaccination appointments over the next week.

Andy Slavitt, a White House pandemic adviser, said at a news conference that the six million doses represented about three days’ worth of shipping delays, and that states had already made up for some of the backlog with existing stock. Of the six million doses, 1.4 million were already in transit on Friday, he said, and the rest were expected to be delivered in the next week.

But Mr. Slavitt pleaded with local officials to make up for the lost time in the coming days.

“We’re asking vaccine administration sites to extend their hours even further and offer additional appointments and to try to reschedule the vaccinations over the coming days and weeks as significantly more supply arrives,” he said.

The delay revealed how interconnected the nation’s vaccine distribution network is, vulnerable to substantial interruptions because of extreme weather. Mr. Slavitt said that FedEx, UPS and McKesson — the drug distribution giant that manages Moderna’s vaccine — had been impeded, with workers snowed in and unable to package and ship vaccines, including the kits and diluent that go with them.

FedEx and UPS would make Saturday deliveries this week, he said.

Closed roads on delivery routes were also forming a bottleneck, and more than 2,000 vaccination sites located in areas with power outages could not receive doses. That prompted federal officials to hold off shipping to areas that might not be able to keep them at the frigid temperatures required.

“They’re sitting safe and sound in our factories and hubs, ready to be shipped out as soon as the weather allows,” Mr. Slavitt said.

Earlier this week, the Centers for Disease Control and Prevention had projected “widespread delays” in vaccine shipments and deliveries because of weather affecting a FedEx facility in Memphis and a UPS facility in Louisville, both vaccine shipping hubs.

Shipment delays had already been reported in California, Colorado, Florida, Illinois, Nevada, New Jersey, Ohio, Oregon, Utah and Washington, among other states, forcing vaccine sites to temporarily shutter and coveted appointments to be rescheduled.

In Texas, where millions of residents lost power during this week’s powerful storm, a delivery of more than 400,000 first doses and 330,000 second doses had been delayed in anticipation of the bad weather. A portion of those shots — roughly 35,000 doses of Pfizer’s vaccine — were sent to providers in North Texas on Wednesday, but shipments will continue to depend on safety conditions.

Chris Van Deusen, a spokesman for the Texas Department of State Health Services, said Thursday that the state was “asking providers that aren’t able to store vaccine due to power outages to transfer it elsewhere or administer it so it doesn’t spoil.”

On Monday, health officials in Texas scrambled to get more than 5,000 shots into arms after a power outage in a storage facility where they were being kept. But Mr. Van Deusen said that “reports of vaccine spoiling have been minimal.”

The Houston Health Department said Thursday that it would restart vaccinations for second doses this weekend, and schedule additional first and second dose appointments next week.

In New York, Gov. Andrew M. Cuomo said at a Friday midday news conference that the snow was a nationwide problem that had hindered the federal government’s ability to deliver vaccines, including in his state.

The delays may affect appointments at state-run vaccination sites, though no appointments had been affected so far, Mr. Cuomo said. Many sites were still using their current allocation of vaccines as they waited for the next batch to arrive, state officials said.

“If there is any impact, we’ll let you know right away,” Mr. Cuomo said.

The governor had said on Thursday night that most of the vaccines for New York, scheduled for delivery between Feb. 12 and Feb. 21, had been delayed.

In New York City, Mayor Bill de Blasio said on Friday during an interview on WNYC that expected shipments of more than 100,000 doses had still not fully arrived from factories, but did not provide an update on when they would come. On Thursday he had said at a news conference that “a vast majority of the resupply we expected for this week has not shipped from the factories yet.”

The city had to hold off on scheduling upward of 35,000 appointments for first vaccine doses because of shipment delays and vaccine shortages, he said then. The opening of two new distribution sites on Thursday had also been postponed, according to the city, with the launch of one at the Empire Outlets on Staten Island moved back to Friday and another in Queens still delayed.

“We still haven’t gotten everything we expect,” Mr. de Blasio said on Friday. “Everything’s been disrupted by the storm.”

In Los Angeles, the city said that appointments for about 12,500 people would be delayed.

Gov. Ron DeSantis of Florida said that while 136,000 Pfizer doses had arrived this week, the state had still not received its shipment for the week of 200,000 Moderna doses. He said the shipment could be delayed as late as Monday.

“Because the storms we are seeing in the rest of the country, it’s basically sitting in the FedEx warehouse — and I don’t think they can even get into it because of everything,” Mr. DeSantis said at a news conference Thursday, encouraging those who had appointments rescheduled to “hang in there, the doses are going to get here.”

The White House on Friday also announced the opening of four new federally-supported community vaccination sites in Florida — in Orlando, Miami, Tampa and Jacksonville — that would be able to vaccinate 12,000 people each day. Another new site in Philadelphia would have the capacity to vaccinate 6,000 people a day. All sites would be functioning within two weeks, Mr. Slavitt, the White House adviser, said.

Nicholas Bogel-Burroughs, Troy Closson, Amanda Rosa and Mihir Zaveri contributed reporting.

An international effort to speed up the manufacture and distribution of coronavirus vaccines around the globe has gotten a boost.

On Friday, during a virtual meeting with other leaders from the Group of 7, President Biden said that his administration would make good on a U.S. promise to donate $4 billion to the campaign over the next two years. Other leaders announced pledges, and at the end of the meeting, the European Union’s chief executive said that new commitments from the E.U., Japan, Germany and Canada had more than doubled the G-7’s total support to $7.5 billion.

The international vaccine effort, known as Covax, has been led by the public-private health partnership known as Gavi, the Vaccine Alliance, as well as the Coalition for Epidemic Preparedness Innovations and the World Health Organization. It aims to distribute vaccines that have been deemed safe and effective by the W.H.O., with a special emphasis on low- and middle-income countries.

Public health experts often say that unless everyone is vaccinated, it is as if no one is vaccinated.

So far, the United States has pledged more than any other nation, with at least one official noting that diminishing the pandemic’s global impact would benefit the country’s own economy and security. White House officials said the money would be delivered in multiple tranches: an initial donation of $500 million right away, followed shortly by an additional $1.5 billion. The remaining $2 billion will delivered by the end of 2022. The funds were approved last year by a Republican-led Senate when President Donald J. Trump was still in office.

President Biden’s engagement in the global fight against the pandemic stands in stark contrast to the approach of Mr. Trump, who withdrew from the World Health Organization and disdained foreign assistance, pursuing a foreign policy he liked to call “America First.” Mr. Biden rejoined the World Health Organization immediately after taking office in January.

National security experts have said the United States should consider donating vaccine doses to poorer countries, as India and China are already doing in an effort to expand their global influence. But an official said that the United States would not be able to share vaccines while the American vaccination campaign is still continuing to expand.

The global vaccination effort also stands to benefit from a commitment by the pharmaceutical company Novavax, whose coronavirus vaccine is still in trials.

Under a memorandum of understanding between Gavi and Novavax, the company agreed to provide “1.1 billion cumulative doses,” though it did not specify a time frame. The vaccine will be manufactured and distributed globally by Novavax and Serum Institute of India, the world’s largest vaccine manufacturer.

Novavax is expected to provide vaccine primarily to high-income countries, the company said in its announcement, while the Serum Institute will supply “low-, middle, and upper-middle-income countries,” using “a tiered pricing schedule.”

Novovax recently reported that its vaccine showed robust protection in a large British trial, but was less effective against a South African variant of the coronavirus. Trials are also underway in the United States, Mexico and the United Kingdom.

In states across the country, officials are trying to pry loose millions of doses of coronavirus vaccine that have been sitting in freezers because they were allocated in excess to nursing homes or stockpiled for second doses.

Federal officials estimate that as many as six million doses are unnecessarily stowed away. Freeing them up could increase the number of doses administered by more than 10 percent — significantly stepping up the pace of the nation’s inoculation program at a time when speed is of the essence to save lives, curb disease and head off more contagious variants of the virus.

So far, 56 million shots have been administered in the United States, and only 12 percent of the population have received one or more doses. And the idea that doses are sitting in cold storage while millions of people languish on waiting lists has deeply frustrated government officials.

Part of the problem stems from when the federal vaccination program for long-term-care facilities began late last year. At the time, the Centers for Disease Control and Prevention based allotments on the number of beds, even though occupancy rates are the lowest in years. Then the C.D.C. doubled that allotment to cover staff. But while four-fifths of long-term-care residents agreed to be vaccinated in the first month of the program, 63 percent of staff members refused, the agency reported. More have since agreed, although exactly how many is not clear.

Despite the lack of uptake, the pharmacy chains that administer the program continued tapping their allotments from the federal government. At one point in Virginia, they had used fewer than one in every three doses they had on hand, according to Dr. Danny Avula, the state’s vaccine coordinator.

The New York Times surveyed all 50 states, and found that at least 20 said they had shifted or planned to shift doses that had been set aside for long-term-care facilities.

The get-tough approach has begun to pay off. The gap between the number of doses shipped to states and the number injected into arms is narrowing: More than three-fourths of the doses delivered are now being used, compared with less than half in late January, according to the C.D.C.’s data tracker.

And many doses have been held back for second shots, though the White House has discouraged the practice and is providing three-week projections of supply as reassurance that they will not come up short.

In the few days since indoor dining resumed in New York City, customers appeared to be trickling in, but usually in modest numbers, and interviews with owners, workers and industry experts suggested that many people were still leery of being inside.

Industry experts also say that allowing restaurants to open their doors to patrons at 25 percent capacity is unlikely to significantly reverse the economic damage that the pandemic has inflicted. Starting next Friday, indoor dining in the city will expand to 35 percent capacity, Gov. Andrew M. Cuomo announced on Friday at a news conference.

Mr. Cuomo said city residents had been traveling to New Jersey to eat indoors, where the capacity has been at 35 percent. In the rest of New York State, indoor dining has been at 50 percent.

Thousands of New York City’s 25,000 restaurants, bars and nightclubs have closed for good. Many others are barely holding on. They are way behind on rent, furloughing or laying off workers and making a fraction of their usual revenues.

The restaurant industry, one of the city’s most vital economic pillars, once employed 325,000 people. It has shed more than 140,000 jobs.

A survey by the New York City Hospitality Alliance, an industry group, found that 92 percent of restaurants reported being unable to afford their rent in December, up from 80 percent in June.

“We have been the eye of this crisis,” said Andrew Rigie, the alliance’s executive director. “When Covid-19 hit, we were told to socially distance, but restaurants are where we come together to socialize. Restaurants are part of not only the economic foundation, but also the social and cultural fabric of New York City.”

The return of indoor dining has renewed public health concerns after a post-holiday spike in infection rates across the city, the emergence of new virus variants and limited vaccine supplies.

W. Ian Lipkin, a professor of epidemiology at Columbia University, said he would still be cautious about where he dined indoors, despite having been vaccinated. He said he would choose only restaurants that took appropriate safety measures, including spacing tables at least six feet apart, maintaining adequate air flow, installing high-quality air filters and requiring servers to wear masks and gloves.

Not even the draw of a warm seat in the frigid winter could bring some diners inside.

“I’m still not ready to do indoor dining,” said Jennifer Brehm, 37, a teacher who huddled with her 8-month-old daughter, Cassia, at an outdoor cabana at Queen Bar & Restaurant in Brooklyn, noting that Cassia “can’t wear a mask yet.”

Ms. Brehm said she was concerned about new virus variants and had been following the vaccinate efforts. “Until it seems more under control,” she said of local virus caseload, “I won’t be ready to eat indoors.”

The two coronavirus vaccines authorized for use in the United States are reassuringly safe, the Centers for Disease Control and Prevention reported on Friday.

As of Thursday, some 41 million Americans have received at least one dose of a Covid-19 vaccine; about 16.2 million people have been fully vaccinated. But some people remain wary, concerned that the vaccines may have been rushed to market or that side effects may have gone unnoticed.

The new data provide ample evidence that the vaccines are safe, although adverse reactions have occurred in few patients.

The C.D.C. gathered reports from a long established national surveillance network and a new safety monitoring system, called V-Safe, created specifically to track the coronavirus vaccines. Participants volunteer to enroll and fill out daily surveys reporting symptoms.

The surveillance is neither uniform nor complete, but the tracking effort nonetheless is “the most intense and comprehensive in U.S. history,” the agency said.

From Dec. 14, to Jan. 13, nearly 14 million doses of the vaccines made by Pfizer-BioNTech and Moderna were administered, mostly to health care workers and residents of long-term care facilities.

There were nearly 7,000 reports of adverse events, the C.D.C. reported, but 91 percent were not serious. The adverse events were consistent with those seen in clinical trials of the vaccines. The most common side effects were headaches, fatigue, muscle aches, chills and dizziness. They tended to occur on the day after people got vaccinated.

The C.D.C. reported data on second-dose reactions only for the Pfizer-BioNTech vaccine, finding that they were more frequent than seen after the first dose.

Deaths following vaccination have been rare — just 113 were reported — and they appeared to be coincidental, unrelated to the vaccines. Seventy-eight deaths occurred among residents of long-term care facilities. Half of those residents were already in hospice or had a do-not-resuscitate order at the time of vaccination.

There have been scattered reports that the vaccines may elicit anaphylaxis, an extreme and potentially deadly allergic reaction to the vaccines. It is the reason people given the shots are asked to remain on site for short periods for monitoring.

The C.D.C. found that there were 4.5 incidents of anaphylaxis per million people receiving inoculations. The incidence is similar to that seen with other vaccines, including those for influenza, pneumococcus and shingles. And anaphylaxis can be effectively and quickly treated, the report noted.

The Vatican has clarified that employees who refuse a coronavirus vaccine will not be punished, after pushback over an internal decree suggesting that those who did not get vaccinated could be dismissed.

Vatican City State said in a statement on Thursday that “alternative solutions” would be found for employees who did not want to be vaccinated.

That came in response to a heated debate over a Feb. 8 directive signed by Cardinal Giuseppe Bertello, the governor of the world’s smallest state. It referred to provisions in a 2011 law for Vatican employees stating that any who refuse preventive health measures can be punished, up to “the interruption of the relationship of employment.”

Pope Francis has said that coronavirus vaccinations are an ethical obligation, and called the refusal to accept them suicidal. Francis, 84, and his predecessor, Benedict VXI, 93, were among the first to be inoculated when Vatican City began its vaccination campaign last month.

The Feb. 8 decree called vaccinating “a responsible decision” for Vatican employees, and said that failure to do so was a risk for others and for public health.

Vatican City has about 5,000 employees, and many live in Italy, where vaccinations are not mandatory.

Cardinal Bertello’s office said on Thursday that its February decree had been issued to protect employees and the working environment “in the case of an event that could set off a public health emergency.” It also said that some jobs — especially those where employees come into contact with the public — might require vaccination. Failure to vaccinate in these cases, it said, would “allow for alternative work solutions for the interested party.”

The note said that the 2011 regulations did not have “a sanctioning or punitive nature” and were instead aimed at “striking a balance between protecting community health and individual freedom of choice.”

Pope Francis has made repeated appeals for the world’s wealthier nations to share vaccines with the most needy and vulnerable.

Maybe it was the bonnets.

Or the gloves that the two women donned, though the temperatures in Orlando, Fla., on Wednesday hovered in the 60s.

In a scene right out of a sitcom, the women went to a coronavirus vaccination site “dressed up as grannies,” said Dr. Raul Pino, the health administrator for Orange County, at a news conference on Thursday. Except they were 34 and 44, not over 65, so despite their get-ups, which included spectacles, they were ineligible to get the shots in Florida.

However, the ruse may have worked before. The women presented valid Centers for Disease Control and Prevention cards indicating that they had already received their first vaccine doses, Dr. Pino said, who did not name them. “I don’t know how they escaped the first time,” he said.

Florida has vaccinated about 42 percent of its more than 4.4 million people 65 and older, according to the state, and health care workers and people with some underlying conditions are also eligible for the shots. It is unclear when the administration of Gov. Ron DeSantis, a Republican, will consider that enough of those populations have been vaccinated to open eligibility more widely.

The state is one of many where vaccines are in high demand because of a lag in shipments from weather delays.

Younger people, teachers, police officers and other essential workers are all clamoring for doses, but Florida has not said which group it will prioritize next.

Agencies administering the shots have had to be “very careful” about people “faking it,” Dr. Pino said. “It’s probably higher than we suspect,” he said, adding that at least one man who was too young for a shot tried to pass himself off as his father, who had the same name.

“Our job as a health department is to vaccinate as many people as possible, as fast as possible,” Dr. Pino said, adding that the state’s Department of Health was following the governor’s priorities, which are based on modified C.D.C. guidelines.

On Wednesday, Health Department staff asked sheriff’s deputies to issue trespass warnings to the bonnet-clad women, whose birth dates did not match those that they had used to register for the vaccines, a spokesperson for the sheriff’s office said.

They were not charged with any wrongdoing. But they did not receive the vaccine.

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W.H.O. Warns of Unequal Vaccine Distribution

The World Health Organization on Friday warned that the unequal distribution of vaccines across the globe could further the spread of the coronavirus.

We need a new treaty if we’re serious enough about pandemics. And that will really help and prepare the world for the future. But the key is working together, considering the world as a small village, very much interconnected, and looking inwards wouldn’t help. And we should cooperate. And we have learned this lesson the hard way, by the way. And it’s a must to cooperate and it’s a must to take attention, to give attention to solidarity. Vaccine equity is not just the right thing to do. It’s also the smart thing to do. The longer it takes to suppress the virus everywhere, the more opportunity it has to change in ways that could make vaccines less effective and opportunity to mutate. We could end up back at square one.

Dr. Tedros Adhanom Ghebreyesus, the director general of the W. H.O., on Friday urged countries and drugmakers to help speed up the manufacture and distribution of vaccines across the globe, warning that the world could be “back at square one” if some countries went ahead with their vaccination campaigns and left others behind.

“Vaccine equity is not just the right thing to do, it’s also the smartest to do,” Dr. Tedros said at the Munich Security Conference, arguing that the longer it would take to vaccinate populations in every country, the longer the pandemic would remain out of control.

Wealthy countries have come under increased criticism in recent weeks for stockpiling doses, and keeping them away from low- and middle-income countries. Dr. Tedros used his comments to condemn the approach to public health in many countries, which he called “a failure even in the most advanced economies in our world.”

“It affects everything, and the whole world is now taken hostage by a small virus,” he said.

Speaking before Mr. Ghebreyesus, Bill Gates, the billionaire philanthropist, said that the tragedy now unfolding across the world because of the pandemic could have been largely avoided.

“It is a tragedy that the modest steps that would have been required to contain this epidemic were not taken in advance,” he said.

While Dr. Tedros welcomed new commitments from wealthy countries to fund international vaccine efforts, he said more needed to be done, and faster.

United Nations Secretary General António Guterres, who also spoke before Mr. Ghebreyesus, said more than 100 countries had not received a single dose, and humanitarian groups have urged the public-private health partnership leading the international vaccine effort, known as Gavi, the Vaccine Alliance, to start delivering on its promises.

“While the Covax mechanism is designed specifically for equitable distribution and vaccine development, it has yet to deliver a single vaccine to a country,” says Claire Waterhouse, a South Africa-based advocacy coordinator for Doctors Without Borders.

More than 190 million people have been vaccinated worldwide, but almost none in Africa. Bodies have piled up on the streets in Bolivia, while in Mexico, oxygen shortage has led many to die at home.

“Accessing vaccines for low- and middle-income countries will remain a serious problem unless systemic issues linked to protectionist agreements between wealthy nations and pharma corporations are dealt with,” said Dr. Tom Ellman, the director of Doctors Without Borders’ medical unit in South Africa.

On Friday, Dr. Tedros called on countries of the Group of 7 to sponsor a new treaty on pandemics. “We know pandemics happen, it’s a matter of when, not if,” Dr. Tedros added. “It’s a must to cooperate and to give attention to solidarity.”

Air travel has recovered somewhat in recent months, but it remains deeply depressed compared with 2019, and no one knows when business will return to previous levels.

Now and for the next several months at least, airlines are flying whomever they can wherever they can. That often means catering to a small group of people who are undeterred by the pandemic to travel to ski slopes or beaches.

“As a quick strategy, fly where people are,” said Ben Baldanza, a former chief executive of Spirit Airlines, the low-cost carrier. “That’s been a real smart strategy, but that’s not a long-term way for those airlines to make money.”

Such leisure travel offers limited comfort to an industry so thoroughly clobbered. Tourists and people visiting family and friends typically take up most of the seats on planes, but airlines rely disproportionately on revenue from corporate travelers in the front of the cabin.

Before the pandemic, business travel accounted for about 30 percent of trips but 40 to 50 percent of passenger revenue, according to Airlines for America, an industry association. And those customers aren’t expected to return in great numbers anytime soon.

The four largest U.S. airlines — American, Delta, United and Southwest — lost more than $31 billion last year, and the industry over all is shedding more than $150 million each day, according to an estimate from Airlines for America.

The industry spent much of the past year scrimping and saving, trimming older, less efficient planes from their fleets; renegotiating contracts; and encouraging tens of thousands of workers to take buyouts or early retirement packages.

But it hasn’t been enough to offset a drop of nearly two-thirds in air travel as public health experts and the Centers for Disease Control and Prevention continue to discourage travel. Airlines for America does not expect passenger numbers to return to 2019 levels until at least 2023. And airlines might have to wait even longer if the economic recovery falters because of the spread of coronavirus variants or a delay in vaccinations.

Some experts say that corporate travel may never return to peak levels, with many in-person meetings replaced by video conferences and phone calls.

Airlines are more hopeful, perhaps because they rely heavily on corporate travel.

Ed Bastian, Delta’s chief executive, said on a conference call last month that about 40 percent of Delta’s big corporate customers expected their business travel to be fully recovered by 2022, and an additional 11 percent by 2023. Citing the airline’s internal research, he said 7 percent expected that business travel might never be fully restored, while the rest said they were unsure when things would return to previous levels.

American is “very optimistic” that corporate travel will return as vaccines are distributed, Vasu Raja, the airline’s chief revenue officer, told investors and reporters last month. But, he added, “the rate of that is unclear at best.”

BANGKOK — Once again, a Thailand hotel guest who posted complaints online faces the threat of a defamation charge. This time, it centers on the guest’s claim of cockroach legs in his macaroni.

Topp Dunyawit Phadungsaeng, who spent 14 days in coronavirus quarantine at the Ambassador City Jomtien Hotel after arriving last month from San Francisco, had plenty of time on his hands to record complaints about the quality of the food, the lack of cleanliness and the presence of bugs.

On Monday, after checking out, he posted on Facebook about his stay, including 46 photographs and four videos that he took of the hotel, a government-designated quarantine facility. His posts were widely shared, especially a photo of what he said were the legs of a cockroach in his stir-fried meal.

“It turned out to be the worst 14 days of my life,” he said in his post. “Don’t call this quarantine. A forced prison stay looks better than this.”

His complaints were widely picked up by the Thai news media. And a day after his post appeared, the hotel issued a statement calling on a “certain group of people” to stop posting “false information” with the intent of damaging the hotel’s reputation. Otherwise, the hotel said, it had the right to pursue civil and criminal charges “to the utmost.”

Because of the coronavirus, anyone coming to Thailand must spend 14 days in quarantine. The government will cover the cost of some hotels, including the Ambassador City Jomtien, which is near Pattaya city. Guests can pay to stay at higher-end hotels, including some with five stars, that are designated quarantine sites.

Mr. Topp said he regretted not paying for better lodging. Among his complaints were that his room had no Wi-Fi but plenty of mosquitoes and cockroaches. Water dripped from the ceiling, bedsheets were moldy, and he was served food that was sometimes inedible, he said.

“I didn’t expect it to be a luxury five-star hotel,” he wrote. “But have you ever been disappointed despite not having any expectations?”

In September, an American hotel guest was arrested and charged with criminal defamation after posting complaints on TripAdvisor about his stay at the Sea View Koh Chang resort on Koh Chang island.

The guest, Wesley Barnes, eventually made a formal apology in exchange for the hotel’s dropping the charges. But the Sea View’s strategy backfired. It was widely criticized on social media, and TripAdvisor posted a notice warning travelers that the hotel was behind the jailing of a guest for harsh reviews.

A spokesman for the defense ministry, which has a role in overseeing quarantine facilities, said he hoped Mr. Topp and the Ambassador City Jomtien Hotel resolve their difference.

“In this case, it is the right of the reviewer,” said the spokesman, Kongcheep Tantravanich, “but we would also ask for sympathy for the hotel owners.”

To get her coronavirus vaccination last weekend, Frances H. Goldman, 90, went to an extraordinary length: six miles. On foot.

It was too snowy to drive at 8 a.m. on Sunday when Ms. Goldman took out her hiking poles, dusted off her snow boots and started out from her home in the Seattle neighborhood of View Ridge. She made her way to the Burke-Gilman Trail on the edge of the city, where she then wended her way alongside a set of old railroad tracks, heading south. Then she traversed the residential streets of Laurelhurst to reach the Seattle Children’s Hospital.

It was a quiet walk, Ms. Goldman said. People were scarce. She caught glimpses of Lake Washington through falling snow. It would have been more difficult, she said, had she not gotten a bad hip replaced last year.

At the hospital, about three miles and an hour from home, she got the jab. Then she bundled up again and walked back the way she had come.

It was an extraordinary effort — but that was not the extent of it. Ms. Goldman, who became eligible for a vaccine last month, had already tried everything she could think of to secure an appointment. She had made repeated phone calls and fruitless visits to the websites of local pharmacies, hospitals and government health departments. She enlisted a daughter in New York and a friend in Arizona to help her find an appointment.

Finally, on Friday, a visit to the Seattle Children’s Hospital website yielded results.

“Lo and behold, a whole list of times popped up,” she said in a phone interview on Wednesday. “I couldn’t believe my eyes. I went and got my glasses to make sure I was seeing it right.”

Then came the snow, which would ultimately drop more than 10 inches, in one of Seattle’s snowiest weekends on record. Wary of driving on hilly, unplowed roads, Ms. Goldman decided to go to the hospital on foot. She took a test walk part of the way on Saturday to get a sense of how long the trip might take.

And on Sunday, she trekked all the way to the hospital to get her vaccine.

“I hope that it will inspire people to get their shots,” she said. “I think it’s important for the whole country.”

The rollout in Washington State, like many around the country, has been complicated by failures of technology, shortfalls in equity and a persistent imbalance of supply and demand. State officials have struggled to set up the infrastructure necessary to schedule and vaccinate the millions of people who are already eligible.

Ms. Goldman is scheduled to receive her second dose of the vaccine next month. She plans to drive.

Israel has raced ahead with the fastest Covid-19 vaccination campaign in the world, inoculating nearly half its population with at least one dose. Now its success is making it a case study in setting rules for a partially vaccinated society — raising thorny questions about rights, obligations and the greater good.

Prime Minister Benjamin Netanyahu’s cabinet voted this week to open shopping malls and museums to the public, subject to social distancing rules and mandatory masking. For the first time in many months, gyms, cultural and sports events, hotels and swimming pools will also reopen, but only for some.

Under a new “Green Badge” system that functions as both a carrot and a stick, the government is making leisure activities accessible only to people who are fully vaccinated or recovered starting from Sunday. Two weeks later, restaurants, event halls and conferences will be allowed to operate under those rules. Customers and attendees will have to carry a certificate of vaccination with a QR code.

Israel is one of the first countries grappling in real time with a host of legal, moral and ethical questions as it tries to balance the steps toward resuming public life with sensitive issues such as public safety, discrimination, free choice and privacy.

“Getting vaccinated is a moral duty. It is part of our mutual responsibility,” said the health minister, Yuli Edelstein. He also has a new mantra: “Whoever does not get vaccinated will be left behind.”

Four million Israelis — nearly half the population of nine million — have received at least one dose of the Pfizer vaccine, and more than 2.6 million have gotten a second dose. But about two million eligible citizens aged 16 or over have not sought vaccines. The average number of new daily infections is hovering around 4,000.

Israel’s central government — eager to bring the country out of its third national lockdown without setting off a new wave of infections — was spurred into action by local initiatives. Chafing under the country’s lockdown regulations, an indoor shopping mall in the working-class Tel Aviv suburb of Bat Yam threw its doors open last week for customers who could prove that they had been vaccinated or had recovered from Covid-19.

In Karmiel, the mayor made a similar decision to open his city in the northern Galilee region for business. Other mayors want to bar unvaccinated teachers from classrooms while some hoteliers threatened unvaccinated employees with dismissal.

Mr. Edelstein, the health minister, said on Thursday that vaccination would not be compulsory in Israel. But his ministry is now proposing legislation that would oblige unvaccinated employees whose work involves contact with the public to be tested for the virus every two days. And he is promoting a bill that would allow the ministry to identify unvaccinated people to the local authorities.

New studies show that people who have had Covid-19 should only get one shot of a vaccine, a dose that is enough to turbocharge their antibodies and destroy the coronavirus — and even some more infectious variants.

Some researchers are trying to persuade scientists at the Centers for Disease Control and Prevention to recommend only one dose for those who have recovered from Covid-19, a move that could free up millions of doses at a time when vaccines are in high demand.

At least 30 million people in the United States — and probably many others whose illnesses were never diagnosed — have been infected with the coronavirus so far.

The results of these new studies are consistent with the findings of two others published over the past few weeks. Taken together, the research suggests that people who have had Covid-19 should be immunized — but a single dose of the vaccine may be enough.

A person’s immune response to a natural infection is highly variable. Most people make copious amounts of antibodies that persist for many months. But some people who had mild symptoms or no symptoms of Covid-19 produce few antibodies, which quickly fall to undetectable levels.

The latest study, which has not yet been published in a scientific journal, analyzed blood samples from people who have had Covid-19. The findings suggested that their immune systems would have trouble fending off B.1.351, the coronavirus variant first identified in South Africa.

But one shot of either the Pfizer-BioNTech or Moderna vaccine significantly changed the picture: It amplified the amount of antibodies in their blood by a thousandfold.

In another new study, researchers at New York University found that a second dose of the vaccine did not add much benefit at all for people who have had Covid-19 — a phenomenon that has also been observed with vaccines for other viruses.

In that study, most people had been infected with the coronavirus eight or nine months earlier, but saw their antibodies increase by a hundredfold to a thousandfold when given the first dose of a vaccine. After the second dose, however, the antibody levels did not increase any further.

ST. PETERSBURG, Russia — In recent months, the Kremlin has scored a sweeping diplomatic win from an unexpected source: the success of its coronavirus vaccine, Sputnik V.

While the United States and European countries have considered or implemented bans on vaccine exports, Russia has earned plaudits by sharing its vaccine with countries around the world in an apparent act of enlightened self-interest.

So far, more than 50 countries from Latin America to Asia have ordered 1.2 billion doses of the Russian vaccine, buffing the image of Russian science and lifting Moscow’s influence around the world.

Yet in Russia things are not always what they seem, and this apparent triumph of soft-power diplomacy may not be all that the Kremlin would like the world to think. While Sputnik V is unquestionably effective, production is lagging, raising questions about whether Moscow may be promising far more vaccine exports than it can supply, and doing so at the expense of its own citizens.

The actual number of doses distributed within Russia is a state secret, said Dmitri Kulish, a professor at the Skolkovo Institute of Science and Technology in Moscow. Nevertheless, Russian officials are boasting of massive vaccine exports, and basking in the warm glow of the vaccine diplomacy that has generated.

“Soft power is the yawning, gaping hole in Russia’s global status,” Cliff Kupchan, chairman of the Eurasia Group risk consultancy and a former American diplomat, said in a telephone interview. “If they play their cards right here, vaccines could be very important.”

European officials have started to push back on Russia’s aggressive marketing of Sputnik.

“We still wonder why Russia is offering, theoretically, millions and millions of doses while not sufficiently progressing in vaccinating its own people,” the European Commission’s president, Ursula von der Leyen, told a news conference Wednesday. “This question should be answered.”

Only 2.2 million Russians (less than 2 percent) have received a first dose of the two-shot vaccine. In the United State, by contrast, 40.3 million people (around 12 percent) have received first injections, despite a rocky rollout.

The reason for that lack of public acceptance, analysts say, is that many Russians are so distrustful of their own government that they dismiss clinical trials that have shown Sputnik V to be safe and highly effective. In a poll taken last fall, 59 percent of Russians said they did not intend to be vaccinated.

So deep is the distrust that fully stocked vaccination sites in Moscow are frequently empty. The fears haven’t been helped by the example of President Vladimir V. Putin, who has yet to take the vaccine himself.