The Biden administration announced on Tuesday that it intends to contribute $150 million over the next three years to a global effort aimed at rapidly producing a vaccine in case a new biological threat emerges. Still, activists and health experts urged the United States to do more to fight the current coronavirus pandemic.
The financial commitment, which will require approval from Congress, is only a small fraction of what is needed for the project being undertaken by the Coalition for Epidemic Preparedness Innovations, a global foundation. The coalition’s chief executive, Dr. Richard Hatchett, has announced a $3.5 billion, five-year effort to “face down the next Disease X with a new vaccine in just 100 days.”
Tuesday’s announcement echoes a plan announced by President Biden in his State of the Union address, when he pledged to invest in an effort to produce new vaccines within 100 days of the arrival of future coronavirus variants. The contribution was announced by Samantha Power, the administrator of the U.S. Agency for International Development, during a summit convened by the British government and the coalition, known as CEPI. The coalition also supports Covax, the international effort to deliver Covid-19 vaccines to the world, which has struggled to get doses into people’s arms.
“Our eyes, like yours, are also on the horizon — on the epidemic or pandemic that has yet to come,” Ms. Power said, addressing the summit’s attendees by video. “While we continue our current efforts to end this pandemic, we are not losing sight of our long-term preparedness goals.”
The administration’s commitment comes as Mr. Biden is under pressure to do more to combat Covid, as well as to prepare for the next pandemic. Last week, the administration asked Congress for an additional $22.5 billion to fight the pandemic at home and overseas, and Mr. Biden is expected to host his own global Covid summit in the coming weeks.
The president has repeatedly said that the United States has contributed more money, and donated more coronavirus vaccine doses, to the world than any other nation.
But two recent analyses, one by the Kaiser Family Foundation and the other by Public Citizen, suggest the United States is not living up to his promise that the nation would be the “arsenal of vaccines” for the world.
The Kaiser Family Foundation’s analysis found that, when donations of money and doses are measured against a country’s gross domestic product, the United States does not lead the world. The analysis found that when gross domestic product is considered, the United States ranks 12th in financial donations and sixth in donations of doses.
“It was a surprise,” said Jen Kates, who directs the foundation’s global health and H.I.V. policy efforts and conducted the analysis. “The White House has said the U.S. is doing more than any other donor. We just wanted to interrogate that a little bit and see: Does it hold up if you look at it from this perspective?”
A new analysis by Public Citizen, entitled “An Incomplete Arsenal,” raises questions about whether the administration is falling behind on its timeline to deliver 1.2 billion doses to the world by this fall, as Secretary of State Antony Blinken pledged in December.
When the White House announced its new pandemic preparedness plan last week, much of which will also need congressional funding, it no longer attached a timeline to the 1.2 billion doses pledge. So far, the State Department says, nearly 487 million doses have been shipped. To meet the 1.2 billion dose target, the United States would have to donate more than 70 million doses a month — a figure that, Public Citizen notes, is far higher than the current reported monthly donation of about 55 million doses.
“The modest targets that the administration itself set out are likely not to be achieved this year, and that’s shocking,” said Zain Rizvi, an expert on pharmaceutical innovation and access to medicines and the report’s author.
White House officials declined to comment on the Kaiser analysis. But they pointed to Tuesday’s announcement, as well as their funding request to Congress and a plan to ramp up vaccine manufacturing announced by Mr. Biden last year, as evidence that the president is committed to doing more.
Vaccination rates continue to lag in low-income countries, even as vaccines become more widely available, for a variety of reasons including vaccine hesitancy and a lack of infrastructure and personnel to administer the shots. Only 14 percent of the population of low-income nations has received at least one dose of a vaccine, according to the Our World in Data project at the University of Oxford.
Mask mandates have disappeared rapidly in the last few weeks in the United States as Omicron cases have receded. But some school districts, cities and one state are holding out, and some teachers, parents and students fear that dropping mask mandates in schools is premature.
As of Monday, Hawaii remains the only U.S. state that is not lifting its statewide indoor mask mandate. About a third of the school districts in the United States still require masks, according to the school tracking site Burbio, which reports that from Jan. 7 through Monday, the number of school districts that ended mask mandates had nearly doubled.
Even Puerto Rico, one of the country’s last holdouts, said on Monday that it would end its mask mandate, including for schools.
As many public health authorities guide Americans to a new maskless era, some in the country have welcomed the new guidelines, while others worry that the moves are premature. More than a third of the country was not fully vaccinated against the coronavirus as of Monday, according to a New York Times database.
In recent weeks, the Centers for Disease Control and Prevention suggested that most Americans do not need to wear a mask, leading more officials to eliminate mask requirements.
Several school districts have their own mask mandates, independent of their cities or states. Public schools in Boston, Washington and Seattle continue to require masks at school, even though officials in most of those cities have ended indoor mask rules.
Robin Ostrov of Buffalo was one of more than 1,000 parents from across the United States who wrote to The Times recently about anxiety over making masks optional in schools. “I’m feeling incredible angst and stress over it,” she wrote. “Our county cases are still in the medium orange level. I realize that masks should go away at some point, but to lift them prematurely doesn’t make sense.”
Experts have pointed out that while the risk Covid poses to children is real, it is now about the same as the risk of the flu. And many doctors cite the mental health strain that children have faced during the pandemic and the educational value of seeing full faces.
Major cities, including Dallas, Houston and Philadelphia, have made masks at school optional or are set to do so soon. In Los Angeles County, school districts will set their own rules about masks starting on Friday, when the county’s mask requirement ends. But the City of Los Angeles, the country’s second-largest district, will continue to require masks at its schools.
The mask mandate in Chicago, home to the third-largest U.S. school district, is set to end on Monday.
This week in New York City, Lorraine Harrigan, 36, told her daughter, Londyn Carroway, a first grader in Brooklyn, to keep her mask on. “I feel like they’re rushing too fast to remove the mask,” Ms. Harrigan said.
Dylan DeGaeta, a fifth-grader in the Tottenville section of Staten Island, said he felt as if he were breaking the rules, because he had become so used to wearing a mask.
“I felt like I was doing something wrong,” he said.
Moderna said this week that it had chosen Kenya to host the company’s first messenger RNA vaccine production facility in Africa. Yet while such a plant would be a major boost for the East African nation and overall efforts to increase vaccine manufacturing capacity in the world’s least-vaccinated continent, it will not assuage Africa’s immediate need for coronavirus vaccines.
The establishment of the Moderna facility also does not answer continuous calls from African leaders and activists to waive vaccine patents in a bid to hasten development, production and distribution of vaccines. And Moderna is not supporting a World Health Organization-led mRNA technology transfer hub in South Africa that was set up to help low- and middle-income countries produce their own vaccines.
After the pharmaceutical company announced on Monday that it would invest up to $500 million in a new facility with the aim of producing up to 500 million vaccine doses annually for Africa, President Uhuru Kenyatta of Kenya said in a statement that his country was “celebrating one of the greatest things that has possibly happened since the onset of Covid-19” in Africa.
The facility will manufacture drug substances and could be extended to become a fill-finish and packaging plant, according to the deal, which was announced in partnership with the United States government and the African Union, and which came five months after Moderna vowed to build a vaccine factory in Africa.
Moderna said it planned to have the facility fill Covid-19 doses as early as next year, over three years after the pandemic began. As of March 6, just over 195 million people — over 14 percent of the continent’s one billion people — had been fully vaccinated against the virus, according to the W.H.O.’s regional office for Africa.
African leaders have accused wealthy nations of hoarding doses and making a “mockery” of vaccine equity by providing booster shots even as Africa struggled with low vaccine coverage.
“We all know the challenges that Kenya and the entire continent of Africa went through in the earlier stages of this pandemic that resulted in Africa being left behind,” Mr. Kenyatta said. “Not because of want, but because of lack, and Moderna has come to fill that space.”
The plant in Kenya will nonetheless complement growing efforts across Africa to bolster local vaccine development. And Mr. Kenyatta expressed hope that the Moderna facility could help Africa fend off the next pandemic.
In October, Rwanda and Senegal signed a memorandum of understanding with BioNTech to build factories that will produce messenger RNA vaccines. And last month, the W.H.O. director general, Tedros Adhanom Ghebreyesus, announced that Kenya and five other African countries — Egypt, Nigeria, Senegal, South Africa and Tunisia — would be the first to get access to the technology needed to produce mRNA vaccines on the continent.
To replicate the Moderna vaccines, the W.H.O. has hired a South African company, Afrigen Biologics and Vaccines, which said last month that it had succeeded in duplicating Moderna’s doses using publicly available data. The South African company will need to carry out clinical trials for its vaccines before the authorities can approve it for mass dissemination.
Besides production, Africa has faced numerous challenges when it comes to administering available vaccine doses.
Data reported to the W.H.O. from 40 African countries indicated a $1.29 billion funding gap for operational costs. And other factors contributing to the low vaccine uptake have included vaccine hesitancy and misinformation, political crises and humanitarian emergencies, and late preparedness to administer vaccines.
Ukraine’s health care system is still grappling with the coronavirus pandemic, even as it tries to cope with the severe effects of an invasion that has sown destruction and dislocation in the country, the World Health Organization’s regional director for Europe said on Tuesday.
“It is my deepest sorrow to see my region, emerging from two terrible pandemic years, being now confronted with the devastating impact of military hostilities on dozens of millions of its people in Ukraine and beyond,” the regional director, Dr. Hans Kluge, said at a news briefing.
Ukraine reported 731 Covid deaths to the organization last week, a figure that probably underestimates the virus’s true toll because of the disruption caused by Russia’s invasion of the country, which began on Feb. 24. Millions of people have fled or been evacuated from besieged cities and combat zones, and health care systems have not been spared from damage and supply shortages.
Even so, Dr. Kluge said that Ukraine had “remarkably” maintained its surveillance and response to the coronavirus. He said of the virus’s death toll, “Sadly, this number will increase as oxygen shortages continue.”
The W.H.O. has sent 500 oxygen concentrators to Ukraine, among other supplies, to help stem oxygen shortages, Dr. Kluge said. He added that older people were likely to be disproportionately affected by the virus, given disruptions to the health care system.
The W.H.O. expressed concern early this year that the highly contagious Omicron variant would sweep through Eastern Europe, which has significantly lower coronavirus vaccination rates than most of Western Europe. Only one-third of people over 60 in Ukraine are fully vaccinated, according to the W.H.O.
Ukraine was reporting more than 30,000 new cases a day in mid-February, and the rate declined to about 25,000 a day just before the invasion, according to agency data. By some estimates, the virus was causing about 300 deaths a day in Ukraine before the invasion.
Catherine Smallwood, a W.H.O. senior emergencies officer, said at the news briefing that Covid hospitalizations in Ukraine had decreased in the past couple of weeks, possibly because of patients being discharged early or unable to seek care because of the war.
Across the organization’s 53-nation Europe region, which also includes Israel and the former Soviet republics in Asia, new cases and Covid deaths have been falling since Feb. 10, Dr. Kluge said.
“While this is good news, I would call on countries to balance optimism with maintaining vaccination and strong vigilance,” he said, adding that as countries lift public health measures, they should be prepared to reintroduce them quickly if needed.
The White House on Monday said that it would begin offering a second round of four free at-home coronavirus tests to all American households, delivering on a pledge President Biden made last week in his State of the Union address, when he framed the offer as part of a broader effort to stay ahead of possible outbreaks and new variants.
The administration is reopening eligibility this week “so we’re prepared no matter what Covid-19 brings,” Mr. Biden said in a brief video the White House posted. A White House spokesman described the announcement as a “soft launch” ahead of a more formal rollout of the free tests on Tuesday. Like the first round, the tests would be delivered through the U.S. Postal Service.
The kits, which can be ordered through the same federal website — covidtests.gov — are part of a program Mr. Biden announced in December that swelled from 500 million to one billion, some of which may eventually be used outside of the mail program, White House officials said.
Dr. Tom Inglesby, the White House testing coordinator, said in an interview Monday that over 275 million tests had been delivered to nearly 69 million households as part of the Postal Service program — more than half of U.S. households. The program’s logistical apparatus, he said, was sprawling, with over 5,000 Postal Service employees in fulfillment centers packing and shipping the tests each day.
“This is the largest government effort of its kind, ever,” he said.
When Mr. Biden announced the program, public health experts criticized the White House as slow to recognize the scale and urgency of at-home testing needed to contend with the highly contagious Omicron variant, which arrived suddenly and had already spread across the nation. Long lines for rapid tests formed across the country, as pharmacy and grocery shelves emptied of them.
While some Americans received tests within days of the website going live in mid-January, many got them weeks after placing orders, a consequence of manufacturers scaling up and delivering the tests in real time after the federal government contracted for them over the winter, Dr. Inglesby said.
“We’ve been procuring the 500 million tests as quickly as they’ve been able to be manufactured,” he said. “As soon as they arrive they’re going to be sent out the door.”
The next tranche of tests should be available with a “pretty rapid turnaround,” Dr. Inglesby said.
New York City officials on Monday eliminated the mask mandate for public school students that had been in place since fall 2020, an aggressive step toward normalcy two years after the coronavirus began battering the city.
Some expressed joy at the chance to remove their masks, but not all the students and parents The New York Times interviewed this week were comfortable with the change.
Oscar Jaffe, 14, a freshman at Stuyvesant High School in Manhattan, said wearing a mask had made it harder for him to participate in class and form friendships. He was one of the few students at his school who chose not to wear a mask on Monday.
“It was hard for people to hear me sometimes,” Oscar said. “Remembering faces was also much more difficult, and remembering names — putting a name to a face — I kind of forgot a lot of names fairly quickly.”
The majority of students passing through the red gates to attend Nelson Mandela High School and Boys and Girls High School, both in Bedford-Stuyvesant, Brooklyn, were still masked on Monday.
Jordan Pickett, 16, a 10th grader at Nelson Mandela High School, where about 40 percent of students are fully vaccinated, said he hadn’t gotten the shot yet because he was waiting for his mother to take him, and she’d been busy with work.
“I just feel unsafe without the mandate,” he said.
Citywide, 52 percent of K-12 public school students are fully vaccinated, according to city data, and 59 percent of students have received at least one dose. But there is wide variation in vaccination rates among neighborhoods.
Green Bay Packers quarterback Aaron Rodgers, a four-time N.F.L. most valuable player, has agreed to remain with the team, concluding his yearlong back-and-forth with the club about his future.
The agreement seemingly resolves a highly publicized rift between Rodgers, 38, and General Manager Brian Gutekunst (and the Packers’ front office), which was rooted in the player’s desire to be more involved in management decisions.
While Rodgers turned in a second consecutive M.V.P. season, the tension between the men amplified scrutiny of Rodgers’s off-field missteps last season, including his admission that he misled reporters about his vaccination status after testing positive for the coronavirus in November and his lashing out at “cancel culture” in an interview with McAfee in the same month.
His public comments there and on Joe Rogan’s podcast, where he said he had petitioned the N.F.L. to reconsider its vaccination policies, made him a lightning rod for the support and derision of politicians, medical experts and people on both sides of a debate over inoculating against Covid-19.
Rodgers tested positive for the coronavirus in November, months after he told reporters that he was “immunized,” against the disease. The N.F.L. fined him $14,650 for violating protocols for unvaccinated players, which included not wearing a mask during his weekly news conferences and attending a Halloween party.
Federal authorities are investigating at least 15 nonprofit groups in the Minneapolis area that received a total of more than $65 million from government food programs during the coronavirus pandemic, according to affidavits filed in federal court.
Raids carried out by the F.B.I. in January revealed a sprawling investigation into a network of groups that had tapped into the huge new sums of money available for programs to feed needy children during the pandemic — and into a much larger nonprofit organization, Feeding Our Future, that was responsible for ensuring that the smaller groups spent the money properly.
In court filings, the F.B.I. said it had discovered a “massive fraud scheme” among groups that Feeding Our Future was supposed to oversee, and that the groups had siphoned off tens of millions of dollars by charging taxpayers for nonexistent meals.
“Almost none of this money was used to feed children,” the government wrote in one filing. “Instead, conspirators misappropriated the money and used it to purchase real estate, cars and other items.”
No one has yet been charged in the case. The leaders of Feeding Our Future and other nonprofit groups have denied wrongdoing.
The case highlights how the federal government’s reliance on nonprofit groups to help carry out an array of programs can make the programs vulnerable to fraud — a problem that has grown as Washington has pumped trillions of dollars into pandemic aid packages.
— David A. Fahrenthold
In the fall of 2020, just before Moderna’s Covid-19 vaccine was found to be highly effective, the company pledged not to enforce patents on its vaccine during the pandemic. The company described the pledge as an effort to help hasten the end of the crisis, and it earned Moderna good will.
On Monday, Moderna announced that it was “updating” its pledge, opening up the possibility of enforcing its patents in middle- and high-income countries. The company said it would continue to “never enforce” its patents for Covid vaccines in 92 of the world’s poorest countries, many of them in Africa or Asia, or against other manufacturers making vaccines exclusively for those markets.
It was unclear precisely what the updated enforcement may look like, or what threats the company is responding to, in part because there is no manufacturing of Moderna vaccines other than by the company itself or its contractors.
Moderna’s patent pledge has yet to produce any results in part because the company hasn’t shared its vaccine formula or transferred its technology to manufacturers that could have produced it at a lower cost for poorer nations.
Although South Africa is not included among the countries protected from patent enforcement, Moderna will not seek to block a World Health Organization-backed effort in South Africa to reverse-engineer the company’s Covid vaccine, said Colleen Hussey, a Moderna spokeswoman.
Despite Moderna’s vow not to block that effort, Zain Rizvi of the advocacy group Public Citizen, who has researched Moderna’s Covid patents, said he is concerned that Moderna’s updated pledge could still “harm efforts to make the vaccine technology available in other developing countries.”
Moderna sold 800 million doses of its Covid vaccine to governments last year, generating $17.7 billion in revenue. The company has booked agreements to sell at least $19 billion worth of its vaccine this year. Pfizer, which manufactures the other mRNA vaccine widely used in the United States and elsewhere, has a similar policy of nonenforcement of its patents in the world’s poorest countries.
Nearly a year ago, when vaccines were in severely short supply in lower-income countries, the Biden administration supported a proposal before the World Trade Organization to waive intellectual property protections for Covid vaccines. That proposal, fiercely opposed by the pharmaceutical industry, has made little progress.
In the news release on Monday, the company said it “remains willing” to license its Covid vaccine technology “on commercially reasonable terms” to manufacturers in middle- and high-income countries.