Here’s what you need to know:Dunia Perez and her family huddling inside their apartment in Austin, Texas, on their fourth day with no electricity or running water during the recent winter storm.Credit…Ilana Panich-Linsman for The New York Times

More than a week after a powerful winter storm barreled through Texas, some experts say that the conditions — which forced hundreds of people across the state to huddle together in homes, cars and shelters to seek warmth — could lead to an increase in coronavirus cases.

The devastating storm almost collapsed the state’s power grid, leaving millions of people in dark and unheated homes during some of the most frigid temperatures recorded in the state’s history.

Coronavirus case reporting dropped precipitously for a week in Texas during the storm and has subsequently risen again sharply in the week since, so it is still too early too discern any specific growth or decline in case numbers there. But experts say that the conditions created during the storm raised concerns.

“It is possible to see an uptick from the Texas storm,” said Katelyn Jetelina, an epidemiologist at UTHealth School of Public Health in Dallas. “We had a lot of things going against us,” Dr. Jetelina said, noting that she, like many others, had to go from house to house when she lost power.

People stood in long lines for water and food at grocery stores and food distribution sites, stayed overnight in warming centers, and crashed with friends and family while electricity cut out and pipes burst in their homes.

Although it’s unclear how many people are still displaced because of the storm, reports from various cities suggest that thousands across Texas may have been forced to seek shelter.

In Fort Worth, almost 200 hundred people took refuge at a convention center. In Dallas, a convention center housed about 650 people, The Texas Tribune reported, and one site in Houston had almost 800 people, while some 500 people were living in emergency shelters in Austin, officials said. Even in Del Rio, a smaller city, officials reported that almost 40 people had to stay at the city’s warming center.

“There are very real possibilities that the coronavirus either had superspreader events or was more easily transmissible because people were congregated indoors for long periods of time,” Dr. Jetelina said. “It is a little bit worrying.”

But cases could also go the other way, she said, because millions of people were forced to stay home while work and school were largely canceled. With the data reporting lags, it is still too early to tell, she noted, so the full impact from the Texas storm on case numbers will not be known for at least another week. Even then, Dr. Jetelina said, it will be hard to tell whether an uptick in cases is related to the storm or to new, more contagious variants — or to a combination of both.

Although the average rate of daily new cases reported in Texas has returned to pre-storm levels, it remains about half of what it was in January.

That broader decline mirrors the fall in cases nationally in recent weeks, as the average daily new cases in the United States hovers around 70,000 — far below its peak of 250,000 last month.

The stories of people gathering together in desperate search of heat and water were ubiquitous across Texas.

In San Antonio, Diana Gaitan had more water and power than her relatives did. So several of them ended up crashing at her home, she said while waiting in a food distribution line at the San Antonio Food Bank last weekend. At one point, there were a dozen people staying overnight in Ms. Gaitan’s home.

“We were all stuck inside the house,” she said.

United States ›
United StatesOn Feb. 27
14-day change

New cases
62,694
–28%

New deaths
1,567
–22%

World ›
WorldOn Feb. 27
14-day change

New cases
365,519
–3%

New deaths
8,061
–23%

U.S. vaccinations ›

A police van set on fire in Barcelona on Saturday by protesters demonstrating against the arrest of the rapper Pablo Hasél.Credit…Emilio Morenatti/Associated Press

For 10 nights, Barcelona’s streets, long quiet from pandemic curfews, have erupted in sometimes violent demonstrations that have spread to Madrid and other Spanish hubs.

What began as a protest over the arrest in mid-February of Pablo Hasél, a Spanish rapper known as a provocateur, has become a collective outcry by a generation that has struggled through years of economic hardship and that faces a lost future even after the pandemic ends.

The frustration is not limited to Spain. Across Europe, university life has been deeply altered by the limitations of virtual classes. Social isolation is endemic. Anxiety and depression have reached alarming rates among young people nearly everywhere, mental health experts and studies have found. The police and mostly young protesters have also clashed in other parts of Europe, including last month in Amsterdam.

“It’s not the same now for a person who is 60 — or a 50-year-old with life experience and everything completely organized — as it is for a person who is 18 now and has the feeling that every hour they lose to this pandemic, it’s like losing their entire life,” said Enric Juliana, an opinion columnist with La Vanguardia, Barcelona’s leading newspaper.

Barcelona was once one of the best places in Europe to be young, with all-night bars and music festivals on the beach. But the crisis, which devastated tourism and shrank the national economy by 11 percent last year, was a catastrophe for Spain’s young adults.

For those who lived through the financial crisis of 2008, which took one of its heaviest tolls in Spain, the pandemic brings a strong sense of déjà vu. Once again, young people have had to move back into the homes of their parents, with entry-level jobs being among the first to vanish.

But the pandemic has cut deeper than past economic downturns. It hit at a time when unemployment in Spain for people under 25 was already high, at 30 percent. Now 40 percent of Spain’s youth are unemployed, the highest rate in Europe, according to statistics by the European Union.

For many young people, the arrest of the rapper Mr. Hasél — and his rage-against-the-machine defiance — has become a symbol of the frustration of Spain’s young people.

A Palestinian woman receives the Pfizer-BioNTech coronavirus vaccine at a pop-up vaccination site the Old City of Jerusalem.Credit…Mahmoud Illean/Associated Press

JERUSALEM — The Israeli government approved a measure on Sunday to vaccinate tens of thousands of Palestinian laborers, after facing fierce criticism over the small number of inoculations it had provided to Palestinians living under its military occupation.

Israeli medical teams will soon begin vaccinating Palestinians who have permits to work in Israel or in settlements in the occupied West Bank, according to a statement by the Coordinator of Government Activities in the Territories, the Defense Ministry unit that is responsible for liaising with the Palestinians.

There are approximately 80,000 Palestinians who have permits to work in Israel, and about 30,000 who have permits for work in the settlements. Most are construction workers, but some have jobs on farms or in factories, stores, restaurants and other workplaces.

The tens of thousands of Palestinians who work in Israel without official documents would not be eligible for inoculations.

A heated debate has raged for weeks over whether Israel bears responsibility for the health of Palestinian in the occupied West Bank and the blockaded Gaza Strip. Human rights groups have argued that international law requires Israel to provide Palestinians with the same access to vaccines as its own citizens receive. But supporters of Israel’s policies have contended that the Palestinians assumed responsibility for health services when they signed the Oslo Accords in the 1990s.

As of Sunday, the Palestinian Authority in the West Bank has received about 2,000 doses from Israel and 10,000 from Russia, according to Palestinian officials. Israel has put the number of doses it sent at 2,200, and promised to hand over another 3,000.

The Hamas-controlled Gaza Strip has obtained 20,000 doses from the United Arab Emirates and 2,000 from the Russian shipment to the Palestinian Authority.

A man arriving with his daughter for his vaccination appointment in Haar, Germany, this month.Credit…Lena Mucha for The New York Times

In vaccine-hungry, cash-rich Europe, the hunt for more doses has nations trading with one another, weighing purchases from Russia and China, and fielding offers from middlemen ranging from real to outright frauds.

Amid building anger over a sluggish European Union coronavirus vaccine rollout that has left them far behind several other wealthy countries, many E.U. states are looking beyond the bloc’s joint purchasing strategy, which now seems woefully underwhelming.

An immense black — or at least gray — market has arisen, with pitches from around the world at often exorbitant prices. Sellers have approached E.U. governments with claims of having 460 million doses of vaccines, according to the early results of an investigation by the bloc’s anti-fraud agency that were shared with The New York Times.

While they still plan to get vaccines from the bloc, some nations are also trying to negotiate directly with drug makers and eyeing the murky open market where they are unsure of the sellers and the products. Some have also agreed to swap vaccines with one another, deals some of them now have reason to regret.

The bloc last year was slow to make big advance purchases from drug companies, acting weeks after the United States, Britain and a handful of other countries. This year, the bloc has been blindsided by slower-than-expected vaccine production, and individual countries have fumbled their rollouts.

About 5 percent of the E.U.’s nearly 450 million people have received at least one dose of a vaccine, versus 14 percent in the United States, 27 percent in Britain and 53 percent in Israel, as of this past week, according to databases from Our World in Data and governments.

The stumbles by the world’s richest bloc of nations have turned vaccine politics toxic. Particularly galling to many Europeans is the sight of a former E.U. member — Britain — forging ahead with its vaccination and reopening plans, while E.U. societies remain under lockdown amid a new surge of dangerous variants, their economies sinking deeper into recession.

In the final months of 2020, several countries opted to forgo parts of their population-based shares of E.U.-purchased vaccines. Much of that trade involved less affluent countries, with less infrastructure and hard-to-reach populations, selling their shares of vaccines from Pfizer-BioNTech and Moderna that require ultracold storage, and instead making the cheaper AstraZeneca vaccine, which is easier to handle, the centerpiece of their vaccination campaigns.

But then AstraZeneca, whose vaccine was developed with the University of Oxford, slashed its expected E.U. deliveries because of production problems. And despite experts’ assurances, many Europeans expressed doubts about it after some leaders questioned its efficacy in older age groups, which were not well represented in clinical trials. (Pfizer also suffered a supply slowdown.)

A decision by any country to let go of doses is potential political dynamite, and the recriminations have begun. Poland gave up a chunk of its expensive Moderna quota expected late this year, reasoning that it would not come soon enough to make much difference, considering the country had been anticipating ample deliveries of AstraZeneca and potentially the Johnson & Johnson vaccines by that point.

“I would never give up on buying what is safe and efficient,” said Andrzej Halicki, a Polish member of the European Parliament. “As a former minister, I can tell you that in my view this is criminal action, this is a breach of obligations.”

A German official said the country had secured 50 million Moderna vaccine doses, a significantly larger number than it would get under its population-based allocation of the E.U. supply. E.U. officials confirmed that Germany had obtained at least some of its extra doses from other member states.

Germany also secured a controversial side-deal with Pfizer-BioNTech, for an extra 30 million doses to be delivered later in 2021, prompting anger in parts of the E.U. as the move was seen as the richest E.U. nation leading the bloc to a collective strategy and then hedging by also going at it alone.

The bloc’s fear is that such side-deals could undermine its collective purchasing power and override delivery schedules to all 27 countries.

In a troubling turn, senior government officials and even heads of government have received dozens of unsolicited offers for vaccines. Few of the sellers appear to be legitimate operators, said Ville Itala, director-general of the European Anti-Fraud office, known as OLAF.

A doctor receiving the Johnson & Johnson vaccine at a government hospital in Klerksdorp, South Africa, last week.Credit…Shiraaz Mohamed/Associated Press

The Food and Drug Administration on Saturday authorized Johnson & Johnson’s single-shot Covid-19 vaccine for emergency use, beginning the rollout of millions of doses of a third effective vaccine that could reach Americans by early next week.

The announcement arrived at a critical moment, as the steep decline in coronavirus cases seems to have plateaued and millions of Americans are on waiting lists for shots.

Johnson & Johnson has pledged to provide the United States with 100 million doses by the end of June. When combined with the 600 million doses from the two-shot vaccines made by Pfizer-BioNTech and Moderna scheduled to arrive by the end of July, there will be more than enough shots to cover any American adult who wants one.

But federal and state health officials are concerned that even with strong data to support it, some people may perceive Johnson & Johnson’s shot as an inferior option.

The new vaccine’s 72 percent efficacy rate in the U.S. clinical trial site — a number scientists have celebrated — falls short of the roughly 95 percent rate found in studies testing the Moderna and Pfizer-BioNTech vaccines. Across all trial sites, the Johnson & Johnson vaccine also showed 85 percent efficacy against severe forms of Covid-19 and 100 percent efficacy against hospitalization and death from the virus.

“Don’t get caught up, necessarily, on the number game, because it’s a really good vaccine, and what we need is as many good vaccines as possible,” Dr. Anthony S. Fauci, the government’s top infectious disease expert, said in an interview on Saturday. “Rather than parsing the difference between 94 and 72, accept the fact that now you have three highly effective vaccines. Period.”

If Johnson & Johnson’s vaccine would have been the first to be authorized in the United States instead of the third, “everybody would be doing handstands and back flips and high-fives,” said Dr. James T. McDeavitt, dean of clinical affairs at the Baylor College of Medicine.

Dr. Janet Woodcock, the acting F.D.A. commissioner, said in a telephone briefing with reporters on Saturday that “each of these vaccines will be effective” and would prevent hospitalizations and death. “This is an effective vaccine that meets the federal standards,” she said. “They haven’t been tested head to head against one another, so it’s very difficult to do a numerical comparison.”

On Sunday, a committee of vaccine experts who advise the Centers for Disease Control and Prevention will meet to discuss whether certain population groups should be prioritized for the vaccine, guidance that state health officials have been eagerly awaiting in anticipation of the F.D.A.’s authorization.

One administration official familiar with the distribution of the vaccine said that shipments would begin on Monday and deliveries could arrive as soon as Tuesday.

Johnson & Johnson has said it will ship nearly four million doses as soon as the F.D.A. authorizes distribution and another 16 million or so doses by the end of March. That is far fewer than the 37 million doses called for in its $1 billion federal contract, but the contract says that deliveries that are 30 days late will still be considered timely.

The federal government is paying the firm $10 a dose for a total of 100 million doses to be ready by the end of June, substantially less per dose than it agreed to pay Moderna and Pfizer, which developed its vaccine with a German partner, BioNTech.

Johnson & Johnson’s one-dose vaccine might allow states to rapidly increase the number of people who have been fully inoculated. Unlike the other two vaccines, it can be stored at standard refrigeration temperatures for at least three months.

Dr. Danny Avula, the vaccine coordinator for Virginia, said the Johnson & Johnson shipments would increase the state’s allotment of vaccine next week by nearly one-fifth.

“I’m super-pumped about this,” he said. “A 100 percent efficacy against deaths and hospitalizations? That’s all I need to hear.”

He said the state was planning mass vaccination events specifically for the Johnson & Johnson vaccine, partly to quell any suspicion that it is a lesser product targeted to specific groups.

“It will be super clear that this is Johnson & Johnson — here’s what you need to know about it,” he said. “If you want to do this, you’re coming in with eyes wide open. If not, you will keep your place on the list.”

A member of the National Guard directs traffic at a mass vaccination site at the Oakland Coliseum in Oakland, Calif. earlier this month.Credit…Jim Wilson/The New York Times

With the nation’s coronavirus vaccine supply expected to swell over the next few months, states and cities are rushing to open mass vaccination sites capable of injecting thousands of shots a day into the arms of Americans, an approach the Biden administration says will be crucial for reaching herd immunity in a nation of 330 million.

The Federal Emergency Management Agency has joined in, too: It recently helped open seven megasites in California, New York and Texas, relying on active-duty troops to staff them, and it plans to open many more.

Some mass sites, including those at Dodger Stadium in Los Angeles and State Farm Stadium in suburban Phoenix, aim to inject at least 12,000 people a day once sufficient supplies are in hand; the site in Phoenix already operates around the clock.

On Saturday, the Food and Drug Administration gave emergency authorization to Johnson & Johnson’s single-dose vaccine, and both Moderna and Pfizer had promised much larger weekly shipments of vaccines by early spring.

In addition to using mass sites, President Biden wants pharmacies, community clinics that serve the poor and mobile vaccination units to play major roles in increasing the vaccination rate.

With only about 9 percent of adults fully vaccinated to date, the kind of scale that mass sites provide may be essential in meeting the huge demand, as more people become eligible for the vaccines and as more infectious variants of the virus proliferate in the United States.

But there are clear signs that they won’t be able to address a different challenge lying ahead: the many Americans who are more difficult to reach and who may be reluctant to get the shots.

Drive-through clinics can be better than indoor sites for infection control, some experts say — people roll down their car windows only for the injection — and are more comfortable for recipients than standing in line would be. But a month after a drive-through mass vaccination site opened in East Hartford, Conn., the approach’s weaknesses are also clear.

Traffic can get snarled on the busy road leading to the site, and bad weather can shut it down, requiring hundreds of appointments to be rescheduled on short notice. Spotty vaccine supply, which forced sites in California to close for a few days recently, can also wreak havoc.

More significantly, you need a car, gas money and, for some people, a driver to get to and from the site

People like Annette Carlin of Novato, Calif., find it challenging to navigate the web sites and notification systems associated with getting vaccinated. Credit…Kenny Hurtado for The New York Times

The sometimes-chaotic vaccine rollout has come with a maze of confusing registration pages and clunky health care websites. And the technological savvy required to navigate the text alerts, push notifications and email reminders that are second nature to the digital generation has put older adults who need the vaccine the most at a disadvantage. As a result, people who lack tech skills are missing out on potentially lifesaving shots.

The digital divide between generations has always been stark, but the pandemic’s abrupt curtailing of in-person interactions has made that division even more apparent.

Advocates for older Americans, 22 million of whom lack wired broadband access at home, say it is ridiculous that a program that has vaccinating vulnerable older people as one of its top priorities would be set up to depend on internet know-how, Twitter announcements and online event pages.

“We’re running into a crisis where connectivity is a life-or-death alternative for people,” said Tom Kamber, the executive director of Older Adults Technology Services, a nonprofit organization that trains older people to use technology. “It couldn’t get much more stark than people being told, ‘If you go outside, you’re likely to be at risk of dying.’”

People in nursing homes, among the first to get vaccines, had staff members to assist them. But when vaccines became available to a wider group of older adults in late December and early January, many who lived alone had to navigate the rollout by themselves.

Federal agencies like the Administration for Community Living, a division of the Department of Health and Human Services, as well as nonprofit groups, say they are doing what they can to guide older adults, but they are stretched thin.

As of Saturday, 12.3 million Americans ages 75 or older, or 28 percent, had received at least one coronavirus vaccine dose, according to the Centers for Disease Control and Prevention.

One Medical, which operates locations across the country including in Manhattan, has been cut off from vaccine supplies by several health departments after reportedly giving doses to ineligible patients. Credit…Karsten Moran for The New York Times

One Medical, a premium subscription-based health care provider, has had its vaccine supply cut off by San Francisco Bay Area health departments after the company inoculated people who were ineligible to receive a shot, health officials said Saturday.

The San Francisco Department of Public Health stopped allocating doses to One Medical after it was unable to verify the eligibility of a “cohort” of people who received the vaccine from the company and self-identified as health care workers but were not, the department said in an email on Saturday.

The department asked One Medical on Monday to return 1,620 doses of the Pfizer vaccine, which it said will be given to other providers, though the company will be allowed to retain enough vaccine to administer second doses to people it had given the first shot to.

The San Mateo County Health Department said it found that One Medical had vaccinated 70 ineligible people using doses provided by the county.

After the discovery, the county “promptly ceased providing One Medical with vaccine and terminated its agreement,” Preston Merchant, a spokesman for the department, said in an email on Saturday. He said the episode was “disappointing” and that people who had received their first dose from One Medical would be able to receive a second one.

Friends and family of company executives, employees who were working from home and some One Medical customers were among those who received the vaccine even though they were not eligible under local guidelines, National Public Radio reported.

Two other counties in the Bay Area, Marin and Alameda, have stopped distributing the vaccine to One Medical, ABC News reported. Marin and Alameda Counties did not respond to request for comment. Another Bay Area county, Santa Clara, said it did not have plans to provide more doses to the company but that it was not aware of any improper vaccinations using its doses.

Los Angeles County Public Health said in an email on Saturday that after it received a complaint in January that One Medical had vaccinated someone who was not eligible, the department told the company in a phone call and in emails that “if there are breaches and they are not holding tight to our priority groups, and checking and validating groups, we could not allocate vaccine to them any longer.”

The department said that after the warnings it had not received further complaints.

One Medical has terminated two clinical employees in California “for their intentional disregard” of eligibility requirements, said a spokeswoman for the company. She said the company was not aware of “confirmed instances” of executives facilitating vaccine appointments for family or friends, but that the company was investigating the matter.

The spokeswoman also said that 96 percent of individuals vaccinated by One Medical across the country had eligibility documentation, and noted that “it is impossible for any provider to know how many people misrepresented their eligibility and received vaccinations as a result.”

The Washington State health department paused its vaccine allocation to One Medical on Monday after it received a complaint that people had to sign up for a free trial of the company’s $199 annual membership in order to receive a vaccine there.

The department said One Medical had been cooperative in addressing that matter, as well as questions following the episodes in the Bay Area, adding that the state was “relying on people to be honest” when attesting to their eligibility for a shot.



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