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As Covid-19 Cases Rise, Europe Enters ‘Living-With-the-Virus Phase’

People across the continent have largely gone back to work, even as the possibility of a second wave looms. Officials in Texas have recorded more than 700,000 coronavirus infections, and India’s caseload has topped five million.

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A cafe in Lille, France, this month. Deaths from the coronavirus in France, about 30 people a day, have reduced markedly from the peak, when hundreds and sometimes more than 1,000 died daily.Credit...Denis Charlet/Agence France-Presse — Getty Images

In the early days of the pandemic, President Emmanuel Macron exhorted the French to wage “war” against an invisible enemy. Today, his message is to “learn how to live with the virus.’’

Much of Europe has opted for a similar strategy as infections keep rising, summer recedes into a risk-filled autumn and the possibility of a second wave looms over the continent. Having abandoned hopes of eradicating the virus or developing a vaccine quickly, people have largely gone back to work and school, leading lives as normally as possible amid a pandemic that has already killed nearly 215,000 in Europe.

The approach contrasts sharply to the United States, where restrictions to protect against the virus have been politically divisive and where many regions have pushed ahead with reopening schools, shops and restaurants without having baseline protocols in place. The result has been nearly as many deaths as in Europe, though among a far smaller population.

Europeans, for the most part, are putting to use the hard-won lessons from the pandemic’s initial phase: the need to wear masks and practice social distancing, the importance of testing and tracing, the critical advantages of reacting nimbly and locally. All of those measures are intended to prevent the kind of national lockdowns that paralyzed the continent and crippled economies early this year.

“It’s not possible to stop the virus,” said Emmanuel André, a leading virologist in Belgium. “It’s about maintaining equilibrium.”

New infections have soared in recent weeks, especially in France, but the country’s death rate is a small fraction of what it was at its peak. That is because those infected now tend to be younger and health officials have learned how to treat Covid-19 better, said Dr. William Dab, an epidemiologist and a French former national health director.

In Germany, too, young people are overrepresented among the rising cases of infections, but they are not generally not becoming severely ill, spurring a debate over the relevance of infection rates in providing a snapshot of the pandemic.

“We are in a living-with-the-virus phase,” said Roberto Speranza, the health minister of Italy, the first country in Europe to impose a national lockdown.

Hendrik Streeck, head of virology at a research hospital in Bonn, cautioned that the pandemic should not be judged merely by infection numbers — health authorities are testing over a million people a week — but instead by deaths and hospitalizations.

“We’ve have reached a phase where the number of infections alone is no longer as meaningful,” Mr. Streeck said.

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Michael R. Caputo, the assistant secretary of health for public affairs, told staff members that he was under stress because of questions about his physical health and threats to his safety and that of his family.Credit...Kevin Lamarque/Reuters

Michael R. Caputo, the assistant secretary of health for public affairs, apologized Tuesday morning to Health Secretary Alex M. Azar II and his staff for a Facebook outburst in which he accused federal scientists working on the pandemic of “sedition” and warned of coming violence from left-wing “hit squads.”

He is considering a leave of absence to address physical health problems, according to one source familiar with the situation.

Mr. Caputo, 58, a longtime Trump loyalist, told staff members in a hastily scheduled meeting that he was under stress because of concerns about his physical health and threats to his safety and that of his family. He said he regretted having embarrassed Mr. Azar and the Health and Human Services department.

Since he was installed at the 80,000-employee department last April by the White House, Mr. Caputo, a media-savvy former Trump campaign aide, has worked aggressively to control the media strategy on pandemic issues. But over the weekend, he was engulfed in two major controversies of his own making.

First Politico, then The New York Times and other media outlets, published accounts of how Mr. Caputo and a top aide, Paul Alexander, had routinely worked to revise, delay or even scuttle the core health bulletins of the Centers for Disease Control and Prevention in an effort to paint the administration’s pandemic response in a more positive light. The C.D.C.’s Morbidity and Mortality Weekly Reports had previously been so thoroughly shielded from political interference that political appointees only saw them just before they were published.

Then on Monday, The Times reported that a Facebook presentation by Mr. Caputo the previous night was filled with bizarre and incendiary comments. He had attacked C.D.C. scientists as anti-Trumpers who had formed a “resistance unit,” engaged in “rotten science” and “haven’t gotten out of their sweatpants” except for coffee shop meetings where they plotted against the president. He urged his gun-owning followers to buy ammunition because “it’s going to be hard to get” and warned that left-wing hit squads across the nation were training for violent attacks. He also referred to physical health concerns and said his mental health “had definitely failed.”

In a statement Monday he said since the spring, he and his family had been continually harassed and threatened, including by some individuals who were later prosecuted.

In other fallout, McMaster University in Canada issued a statement on Monday distancing itself from Dr. Alexander, whom Mr. Caputo hailed to his Facebook followers as a “genius.” He did receive a doctorate from the university, but he is not on the faculty, the university said.

“He is not currently teaching and he is not paid by the university for his contract role as a part-time assistant professor,” a McMaster spokeswoman, Susan Emigh, said in a statement.

As a consultant, he is not speaking on behalf of McMaster University or the Department of Health Research Methods, Evidence and Impact.”

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Speaker Nancy Pelosi at a news conference last week. Ms. Pelosi privately told lawmakers, “We have to stay here until we have a bill.”Credit...Anna Moneymaker for The New York Times

Speaker Nancy Pelosi of California said on Tuesday that the House would not leave for the November elections without acting on an additional round of stimulus to prop up the coronavirus-ravaged economy, responding to growing concern among rank-and-file lawmakers over the prospect of returning home to face voters without doing so.

“We have to stay here until we have a bill,” Ms. Pelosi privately told lawmakers on a conference call on Tuesday morning, according to two people familiar with the remarks who disclosed them on condition of anonymity.

Shortly afterward, Ms. Pelosi repeated the promise in an interview on CNBC.

Her vow came just before a bipartisan group of 50 centrist lawmakers was planning to present a $1.5 trillion stimulus plan, making a last-ditch effort to revive stalled talks between top Democrats and the White House.

Members of the group — which calls itself the House Problem Solvers Caucus — concede privately that their framework stands little chance of becoming law. But the decision to offer it up publicly reflected the frustration among some lawmakers in both parties at the failure by their leaders to agree to another round of pandemic aid.

The proposal includes measures that enjoy bipartisan support, like reviving the popular Paycheck Protection Program for small businesses and direct checks of $1,200 or more for American taxpayers, as well as more contentious ones like new legal rights and protections for workers and their employers.

But the bulk of its proposed spending would fall somewhere in the middle of what Republicans and Democrats have championed. The measure would reinstate lapsed federal jobless aid at $450 per week for eight weeks, then replace up to $600 weekly in lost wages for an additional five weeks. That is more than Republicans wanted, but less than the flat, $600-a-week benefit that lapsed at the end of July. And the proposal would send $500 billion to strapped state and local governments, less than the nearly $1 trillion Democrats included in their $3.4 trillion stimulus plan that passed the House in May, but roughly double what the White House has signaled it could support.

Key Data of the Day

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Gov. Laura Kelly of Kansas addresses members of the media during a news conference Monday.Credit...Evert Nelson/The Topeka Capital-Journal, via Associated Press

Texas surpassed 700,000 coronavirus cases on Tuesday, making it the second state in the country, after California, to reach the milestone, according to a New York Times database.

In recent days, inconsistencies and problems with Covid-19 data collection in Texas had clouded the picture of the pandemic’s trajectory in the state, prompting some residents and officials to say they could not rely on the numbers to tell them the truth. In mid-August, five metropolitan areas in South Texas had the highest rate of new coronavirus cases relative to their population, according to The Times’s data. More than 14,500 people have died in the state.

It has been a bleak week across much of the United States, especially in parts of America’s heartland, with a record number of virus-related deaths over a 7-day period ending on Monday in Kansas and Tennessee, and the highest number of new cases over a 7-day stretch in Missouri, Wisconsin and North Dakota, according to a Times database.

Fifty-eight people in Kansas died from a virus-related condition over a 7-day period ending Monday, and more than half of those deaths were concentrated in the state’s most populous counties. In Tennessee, 228 people have died during the same time period.

Returns to campus have also fueled an increase in cases in Missouri, Wisconsin and North Dakota. Each state reported the most number of cases over the past seven days, compared with all other 7-day stretches.

North Dakota currently has the highest number of new cases per capita in the country. In Cass County, home to North Dakota State University, 400 new cases have been reported in a 7-day period ending Monday. Some of the cases are attributed to the 153 students and employees who tested positive in the past two weeks, according to the university. As of Tuesday morning, more than 200 students were in quarantine in university housing.

And in Wisconsin, nearly 20 percent of the new cases since last Monday have been in Dane County, home to the University of Wisconsin’s Madison campus. On Monday, the university reported another 194 virus cases on campus, which includes 134 people living in student housing.

Global Roundup

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Refugees displaced from Moria camp in Lesbos, Greece, last week.Credit...Mauricio Lima for The New York Times

Germany agreed on Tuesday to take in more than 1,500 refugees now living in Greece, days after blazes destroyed a refugee camp on the island of Lesbos that was under a coronavirus quarantine.

Germany’s move is a challenge to other wealthy European countries that have been reluctant to help the Greek authorities resettle the 12,000 people who were left homeless when fires tore through the Moria refugee camp last week.

Tensions within the camp, Europe’s largest, had reached a boiling point when the authorities placed it under a medical lockdown after at least 35 residents tested positive for the virus. That led to protests by some residents, some of whom lit fires, leading to the camp’s destruction.

The fire left the camp’s residents, including 4,000 children, stranded among tombstones in a nearby cemetery and on rural and coastal roads. Nearly two-thirds of the migrants in the camp are from Afghanistan.

Germany said on Tuesday that it will allow 1,553 people from 408 families who have already been recognized as refugees by Greece to settle in the country. The decision followed intense debate within Chancellor Angela Merkel’s government, with some officials arguing that Berlin should wait to take action until there is a joint European Union response to the crisis in Greece.

The officials feared that a unilateral move by Ms. Merkel, while showing solidarity with Greece, could create the politically unpopular impression that Germany had reopened its borders — as it did in 2015, when it accepted more than one million people from the Middle East, Africa and Asia.

In other news from around the world:

  • India’s overall caseload has surpassed five million. The country, where more than 82,000 coronavirus patients have died despite an early nationwide lockdown that was one of the world’s harshest, reported 90,123 new cases on Tuesday.

  • Vietnam has recovered sufficiently from its second outbreak of the coronavirus that it will resume international flights on Friday to destinations in Asia, although not yet for tourists. After controlling its initial outbreak without any fatalities, Vietnam went nearly 100 days without a case of local transmission. But an outbreak in July in the coastal city of Danang spread throughout the country and caused 35 deaths before it also was contained. Now, without a confirmed case of local transmission for two weeks, the government has lifted travel restrictions in Danang and will resume flights to South Korea, Japan, China and Taiwan for Vietnamese nationals, certain workers, diplomats and investors.

  • Germany will invest 750 million euros, or $891 million, to bolster three domestic companies’ quests for a Covid-19 vaccine, two German ministers said on Tuesday. The goal is to get safe vaccines to the majority of Germans and other Europeans as soon as next summer.

  • The Australian state of Victoria, the center of the country’s outbreak, on Tuesday reported no new coronavirus deaths for the first time in more than two months. The state’s capital, Melbourne, remains in lockdown, but restrictions have been loosened in the rest of the state as cases continue to fall.

  • In England, new lockdown measures went into effect on Tuesday in parts of the West Midlands, which includes Birmingham, the country’s second-largest city. Under the restrictions, people are barred from meeting others who are not part of their household, either indoors or outside. The measure comes after the British government lowered the limit on gatherings to six from 30.

  • The United Nations is about to turn 75, but celebrations will be muted. World leaders are unable to gather in person — the pandemic has reduced the General Assembly beginning this week to virtual meetings — but the organization is also facing profound questions about its own effectiveness, and even its relevance.

People of color have higher rates of coronavirus infection, hospitalization and death during the pandemic than white people do, according to a large-scale analysis of electronic health record data for about 50 million patients from 399 hospitals in 21 U.S. states.

The analysis, released on Wednesday, is a joint project of the nonprofit Kaiser Family Foundation and Epic Health Research Network, a publication of Epic, the electronic health records data company. By providing insight into a large population across a range of states and health care systems, it builds on a growing body of research that shows people of color are disproportionately affected by the coronavirus.

The data show that while testing rates differed little by race and ethnicity, Hispanic patients were more than two and a half times as likely, and Black and Asian patients were nearly twice as likely, as white patients to test positive. Patients of color were also typically sicker than white patients when diagnosed, and were likelier to be in an inpatient setting and likelier to require oxygen or ventilation at the time of diagnosis.

Hispanic and Black people were far likelier than white people to require hospitalization. The study found that for each 10,000 people with Covid-19, 30.4 Hispanic people required hospitalization, while 24.6 Black people required hospitalization, as compared with 7.4 white people. Death rates for Black and Hispanic patients were more than twice as high as for white patients.

“This analysis points to delays in testing for people of color, who are sicker and more likely to be infected when they do get tested,” Drew Altman, the president and chief executive officer of Kaiser Family Foundation, said in a statement.

The authors of the study sought to determine whether socioeconomic factors explained the disparities, and found they did not. Even after controlling for sociodemographic factors and underlying health conditions, the study found, Asian patients were 49 percent likelier than white ones to die from the virus. Hispanic patients were 30 percent likelier to be hospitalized and die compared with white patients with similar characteristics and underlying health conditions, and Black patients were 19 percent likelier to die after controlling for these factors, the research found.

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Visitors at the tomb of Rabbi Nachman, the founder of the Hasidic movement, in the town of Uman in central Ukraine on Tuesday.Credit...Genya Savilov/Agence France-Presse — Getty Images

Hundreds of Hasidic Jewish pilgrims seeking to enter Ukraine from Belarus in defiance of virus travel restrictions were stopped by border guards on Tuesday, as Ukraine mobilized additional guards to bolster its forces.

Ukraine closed its borders last month as cases in the country ticked up, partly to halt the yearly pilgrimage to the city of Uman, the site of the grave of Rabbi Nachman, the founder of the Breslov branch of the Hasidic movement. The pilgrimage is timed to the Jewish New Year, which begins on Friday. Israeli health officials have supported Ukraine’s decision in light of the pandemic.

The pilgrims began arriving at a border crossing with Belarus on Monday afternoon, according to the Ukrainian border guard service. Authorities in Belarus let the group pass and they gathered on a road in the buffer area between the two border stations.

Through the night, hundreds of men and boys danced and sang songs. Their luggage was piled along fields on both sides of the road. The men tried to convince the border guards to let them through to celebrate the new year, the most important religious holiday for Hasidim. Little boys, looking bored and sleepy, stood by watching.

Some of the pilgrims had traveled to the Novi Yarylovychi border crossing believing it was open, which was not the case, Israel Public Broadcasting tweeted. Ukrainian authorities said the foreigners were warned about the border closure.

Ukraine’s border guard service said that 690 pilgrims had gathered along the border by Tuesday, and the agency’s director, Serhiy Deyneko, said that more were expected on charter flights arriving in Belarus. Belarusian media reported a different number of pilgrims on the border, saying about 1,500 had already arrived.

Ukraine’s president, Volodymyr Zelensky, said that the border closure will be enforced until it expires on Sept. 28. The country has reported nearly 20,000 new virus cases over the past week, bringing the total to more than 160,000, according to a Times database.

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Maika Alvarez, a nursing assistant, helps Jose Montoya, a 94-year-old coronavirus patient, speak with his daughter via FaceTime.Credit...Isadora Kosofsky for The New York Times

With its beige walls and fluorescent lighting, the Canyon Transitional Rehabilitation Center, nestled in the foothills of the Sandia Mountains, has all the hallmarks of a nursing home. But except for the occasional medication cart, or a nurse working silently at a keyboard, the hallways are empty. The doors of all 44 rooms are shut tight.

Every resident at Canyon has Covid-19.

In April, after 19 people died from the virus at an Albuquerque retirement community, New Mexico partnered with Genesis HealthCare, which operates 25 nursing homes in the state, to convert Canyon to a long-term care facility for patients infected with the coronavirus.

“Time was of the essence, in terms of mitigating the spread of Covid-19 in long-term care facilities,” said Katrina Hotrum-Lopez, secretary of the New Mexico Aging and Long-Term Services Department, who worked with the governor’s office and the state’s Department of Health to establish the facility.

The pandemic presents a time of reckoning for long-term care. The virus has ravaged nursing homes across the country, with at least 75,000 deaths attributed to long-term care facilities — more than 40 percent of virus deaths in the United States.

Direct care positions, like certified nursing assistants, are predominantly filled by women of color and immigrants.

Rogelio Ramirez volunteered to transfer from the Albuquerque Heights Healthcare and Rehabilitation Center to Canyon out of a sense of helplessness and grief after his aunt and uncle both died from Covid-19 in Mexico, where he is originally from.

His wife, Jeri Ramirez, also works in long-term care. She lost her grandfather to Covid-19 at another facility in the Albuquerque area.

“I felt like I needed to do it,” said Mr. Ramirez of his choice to work as a certified nursing assistant at the facility.

“If I’m not there, who is going to be there?” he asked.

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Raymond Haskins, a custodian at Brattleboro Union High School, in Brattleboro, Vt., sets up an outdoor classroom on Sept. 1.Credit...Kristopher Radder/The Brattleboro Reformer, via Associated Press

Dr. Anthony S. Fauci praised Vermont as a model on Tuesday, using the state’s success in controlling the coronavirus as evidence that the principles he has been touting can lead to a safer reopening. “Listening to the numbers that you said, I wonder if I could bottle that and take it with me when I go around talking to other parts of the country,” he said, appearing via video at the governor’s biweekly Covid-19 briefing.

“This should be the model for the country, how you’ve done it,” he said, adding that states should heed the recommended benchmarks for reopening regardless of their size.

Vermont has the lowest per capita rate of cases of any state, and one of the lowest death rates. According to the state health department’s coronavirus dashboard, only two Covid-19 patients are currently hospitalized.

At the briefing, Gov. Phil Scott said the state’s positivity rate was 0.2 percent.

“When you have a test positivity of 0.2 percent, you are starting the game on your side,” said Dr. Fauci.

The governor delayed the start of school until after Labor Day, and so far there have been few reported cases linked to schools. Most schools have been using a hybrid model of in-person and remote instruction.

He said that cooler weather would bring additional challenges, but added that if people continued to observe safety measures like wearing masks and social distancing, “I don’t think you are inevitably going to have a second wave.”

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At Brown University in Providence, R.I., last year.Credit...Steven Senne/Associated Press

Even as U.S. colleges and universities have become hot spots, forcing some schools to suspend or cancel in-person classes, a few — Brown, Clemson and Miami University of Ohio — are inviting more students back to campus.

They are also beseeching students not to allow the decision to backfire.

“I want to kindly ask each and every one of our students, faculty and staff to do all they can to minimize the spread of this virus,” wrote James P. Clements, Clemson’s president, when announcing that about 7,000 students could move into on-campus housing, and that the South Carolina school would return to some in-person instruction on Monday.

He said the move did not suggest that the outbreak was over, adding that “we should expect to see more cases over the next few weeks.”

A Times tracker has identified at least 782 cases at Clemson since the pandemic began. A Clemson spokesman said the university believed it was safe for students to return.

At Miami University of Ohio, in Oxford, which has recorded at least 836 cases since the spring — and where students were cited by police last week for holding a house party despite being under quarantine — students are allowed to begin moving into residence halls on Monday, although it is limiting campus housing capacity to 40 percent.

Miami’s president, Gregory Crawford, warned students in his reopening message that they would “need to make a conscious commitment to live differently this term.”

A spokeswoman said the university was testing every arriving on-campus student before allowing them to move in, and the positivity rate among them was less than 1 percent.

Brown University is allowing the majority of undergraduates to move back to campus this weekend, and said some smaller classes would begin meeting in person on Oct. 5.

U.S. Roundup

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Under President Trump, international regard for the U.S. has steadily fallen, a survey found.Credit...Anna Moneymaker for The New York Times

The United States’s international standing is at or near its lowest levels in nearly two decades, in part because of Mr. Trump’s mishandling of the pandemic, the nonpartisan Pew Research Center reported Tuesday as it released a new poll.

Pew, which surveyed residents of 13 countries on four continents, found that only 15 percent believe that the United States has done a good job combating the virus.

In every country polled, respondents gave much higher marks to the World Health Organization and China than to the United States, despite Mr. Trump’s attempts to shift blame for the outbreak to Beijing and his repeated criticism of the W.H.O.

“Since Donald Trump took office as president, the image of the United States has suffered across many regions of the globe,” the report’s authors concluded, accelerating a downward trend that began when Mr. Trump took office in 2017 after campaigning on a platform of “America First.”

Before the Trump era, public opinion of the United States remained steadily north of 50 percent in most countries — with the exception of the early 2000s, when President George W. Bush waged an unpopular war in Iraq. In the new survey, the U.S.’s median approval rating among the 13 countries was 34 percent.

Pew surveyed 13,273 adults from June 10 to Aug. 3 in Canada, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden, the U.K., Australia, Japan and South Korea.

In other pandemic news around the U.S.:

  • More than 39,200 new cases and more than 1,280 new deaths were reported in the United States on Tuesday.

  • Although children and young adults are less likely to suffer deadly consequences following infection with the coronavirus, young Americans are not immune. A new study of Covid-19 deaths by the Centers for Disease Control and Prevention suggests that some youth populations may be especially vulnerable, and that many young patients appear to be brought to the hospital only once they have become severely sick.

  • “As they say, the U.S. government — after it’s tried every other thing — does the right thing,” said Bill Gates. He expressed hope about new avenues for foreign aid amid the pandemic in an interview with The Times.

  • As colleges struggle to contain virus outbreaks, administrators and local health authorities are cracking down on fraternities and sororities, putting them under quarantine orders or threatening harsh sanctions for partying

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You can now be fined in Connecticut for failing to wear a mask.Credit...John Moore/Getty Images

In Connecticut, people attending a private party that exceeds the state’s gathering limits will face a fine of $250. Hosting that party? A $500 fine.

Gov. Ned Lamont announced the series of fines on Monday for those caught breaking rules meant to prevent the spread of the virus. Violating the state’s mask mandate will result in a $100 fine, starting as of midnight on Thursday.

Private gatherings across the state are limited to 25 people indoors and 100 people outdoors.

“If you have to count, get out,” Mr. Lamont said at a news conference.

The fines give municipalities “more leverage” to enforce rules without having to charge violators with misdemeanors, he said. Fines can be issued by police officers, local health officials, or local elected official designees, and were set to take effect this week, a state official said Monday.

State officials on Monday also announced an adjustment to the rules for travelers coming from its list of restricted states. Travelers must quarantine for 14 days or have a negative coronavirus test result from three days before arrival. They can also get tested after arriving in Connecticut, but they must remain in quarantine until the results are negative.

If travelers who are required to quarantine fail to do so or do not complete the state’s required travel health form, they face a civil penalty of $1,000.

On Tuesday, Connecticut said travelers from Puerto Rico were now subject to the restricted states rules, joining a list of dozens of states and Guam. California, Hawaii, Maryland, Minnesota, Nevada and Ohio were removed in the weekly update.

Gov. Andrew M. Cuomo of New York said Tuesday that travelers from Puerto Rico were also required to quarantine for 14 days. California, Hawaii, Maryland, Minnesota, Nevada and Ohio were removed from New York’s extensive list of places to which the quarantine applies. Travelers to New Jersey are also subject to a 14-day quarantine if coming from a vast list of places, though compliance is voluntary.

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The German education and research minister, Anja Karliczek, said, “A vaccine can only be used if the proven benefit is significantly higher than possible risks.”Credit...Pool photo by Markus Schreiber

The German government will invest 750 million euros, or $891 million, to bolster three domestic companies’ quests for a Covid-19 vaccine, two German ministers confirmed at a news conference on Tuesday.

The goal is to get safe vaccines to the majority of Germans and other Europeans as soon as next summer.

CureVac and BioNTech are developing vaccines using messenger RNA, which carries instructions for cells to make proteins. There’s never been a vaccine made with this technology that has reached the global market.

CureVac will receive 252 million euros and BioNTech will receive 375 million euros in federal grants, according to Anja Karliczek, the minister for education and research.

At the beginning of the pandemic, the Trump Administration tried to convince CureVac to move its research to the U.S., according to German officials.

In the United States and elsewhere, BioNTech is partnering with Pfizer on its vaccine, which began human trials in May. The U.S. government has a $2 billion contract with the companies for 100 million doses of the vaccine.

Funding talks with a third company, IDT Biologic, which is developing a vaccine using a different technology, will conclude soon, Ms. Karliczek said.

Both Ms. Karliczek and federal health minister Jens Spahn emphasized that the vaccines would not be available until they had been proven safe after extensive testing.

“A vaccine can only be used if the proven benefit is significantly higher than possible risks,” Ms. Karliczek said.

Although children and young adults are less likely to suffer deadly consequences following infection with the coronavirus, young Americans are not immune. A new study of Covid-19 deaths suggests some youth populations may be especially vulnerable and that many young patients appear to be brought to the hospital only once they have become severely sick.

The analysis by the Centers for Disease Control and Prevention, published on Tuesday, looked at 121 infants, children and young adults aged 20 and under who died of Covid-19 between Feb. 12 and the end of July. Deaths in this age group are rare, representing 0.08 percent of all coronavirus deaths in the United States, the researchers found.

Most of those who died had underlying health problems, and many had two or more underlying medical conditions, including chronic lung disease, obesity, neurological and developmental conditions, and cardiovascular conditions. But one-quarter of those who died were healthy before being infected.

The report found that while 65 percent died after being admitted to the hospital, many others died at home, or were critically ill by the time they were brought to the hospital and died in the emergency room. Infants and those 14 to 20 years old were most likely to have died at home or in the emergency department.

Ten percent of those who died were under a year old. And while 70 percent of deaths occurred among those between 10 years and 20 years old, college-aged adults between 18 and 20 years old represented 41 percent of the deaths.

People of color — including Hispanic, Black and American Indian/Alaska Native people — accounted for about three-quarters of the deaths, while representing only 41 percent of the American population in this age group, the study found.

Nearly half of the deaths occurred among Hispanic young people and non-Hispanic Black young people accounted for nearly one-third. Men and boys were also disproportionately affected, representing 63 percent of the deaths.

The researchers concluded that children and young adults of color were disproportionately affected by the pandemic because racial and ethnic minority groups are overrepresented among essential workers who have been unable to work from home, and the virus spreads quickly within households, the researchers concluded.

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Engineers at Sinovac Biotech, a Chinese vaccine producer, in Beijing in April.Credit...Nicolas Asfouri/Agence France-Presse — Getty Images

A senior Chinese health official said a coronavirus vaccine could be available to the public in China as early as November, the state news media reported on Tuesday.

Dr. Wu Guizhen, the chief expert for biosafety at the Chinese Center for Disease Control and Prevention, told the state broadcaster CCTV that “ordinary people” in China could be given the vaccine in November or December.

“Current progress has been very smooth” for vaccine candidates in the final stage of clinical trials, she said.

China now has five vaccine candidates in late-stage clinical trials, including one being developed in collaboration with other countries, Dr. Wu said. Two production factories have been approved for manufacturing, and a third is in the approval process, she said. China, the world’s largest vaccine producer, has put the prospect of a Covid-19 vaccine at the center of a diplomatic charm offensive.

China has already approved at least two experimental vaccines under an emergency use program, which began this summer with soldiers and employees of state-owned companies and has quietly expanded to include health care and aviation workers.

Dr. Wu, who said she was still doing well after receiving one of the experimental vaccines in April, said she expected them to remain effective for one to three years.

Dr. Wu’s estimate that a vaccine could be ready in November is not far-off from predictions made by President Trump. His administration has told state officials to be ready to start distributing one as soon as late October. That would be just before the presidential election, and the timing raised concerns that a vaccine could be rushed for political reasons. A group of drug companies racing to develop a vaccine has pledged not to release anything that does not meet efficacy and safety standards.

A vaccine approved by Russia in August was met with skepticism from experts who warned against rushing normal procedures, and Russian and Chinese vaccines have been criticized over their designs. Health officials have warned against thinking of a vaccine as a “silver bullet,” saying that even if one is approved before the end of the year, it will take time to produce and distribute and will not mean an immediate end to pandemic restrictions.

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In the first half of the year, nearly half of Sweden’s Covid-19 deaths happened in nursing homes, according to a report by the country’s health care watchdog in July.Credit...Jonathan Nackstrand/Agence France-Presse — Getty Images

People in Sweden can again visit their loved ones in nursing homes starting next month after what will have been a 6-month ban, Reuters reported. A falling rate of virus infections and better routines to prevent new cases in nursing homes are contributing factors.

“The national ban on visits to care homes has for many elderly and their relatives, been one of the most difficult restrictions during the pandemic,” Health and Social Affairs Minister Lena Hallengren said.

Last week, Sweden said it had carried out a record number of new coronavirus tests with a 1.2 percent positive rate, the lowest since the start of the pandemic, according to Reuters.

The pandemic has hit the nursing homes of Sweden — and the rest of the world — hard. In the first half of the year, nearly half of Sweden’s Covid-19 deaths happened in nursing homes, according to a report by the country’s health care watchdog in July.

More than 5,800 people have died from the coronavirus in Sweden, and more than 86,500 have tested positive, according to a Times database.

From the beginning of the pandemic, Sweden was an outlier among its European neighbors, not calling for a widespread lockdown in the country, but largely relying on personal responsibility instead. The Swedish Public Health Authority admitted that the country’s seniors had been battered by the virus, which spread through the majority of nursing homes in Stockholm, the capital.

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The Edelweiss Lodge and Resort in Garmisch-Partenkirchen, Germany, a hotel for U.S. Army service personnel and their families, where 24 people were found to be infected.Credit...Philipp Guelland/EPA, via Shutterstock

Bavarian authorities say they are investigating whether to charge a young American woman living in Germany with negligence resulting in bodily harm after the woman interacted with and possibly infected as many as 37 people with the coronavirus despite having been ordered into quarantine.

The authorities believe that, despite feeling sick enough to take a coronavirus test after a trip to Greece, the 26-year woman did not wait for test results to go barhopping in Garmisch-Partenkirchen, a picturesque town at the foot of the Alps. When she received her positive test results, she had already come into contact with dozens of people.

Because the new infections in the community surpassed 50 infections per 100,000 inhabitants in a week, the town of Garmisch-Partenkirchen has had to order bars and restaurants to close early and limit large gatherings. Results from mass systematic tests carried out in the community are expected on Tuesday.

The 26-year-old woman works at the Edelweiss Lodge and Resort, a hotel for U.S. Army service personnel and their families, where 24 people were found to be infected. The lodge is closed until Sept. 28.

German health authorities registered 1,407 new cases nationwide on Monday, according to the federal authority tasked with keeping track of the pandemic. According to a New York Times database, Germany has reported 261,762 cases and 9,362 deaths.

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Gov. Tom Wolf of Pennsylvania during a news conference in June.Credit...Joe Hermitt/The Patriot-News, via Associated Press

A federal judge in Pennsylvania ruled on Monday that several restrictions ordered by Gov. Tom Wolf to combat the pandemic were unconstitutional. The decision struck down stay-at-home orders and the closure of “non-life-sustaining” businesses, directives that were issued in March and have since been suspended.

The judge also declared that a current order limiting the size of gatherings — no more than 25 people indoors and 250 outdoors — violated “the right of assembly enshrined in the First Amendment.”

A spokeswoman for Mr. Wolf, a Democrat, said the administration was seeking a stay of the decision and an appeal. William Shaw Stickman IV, the judge who ruled on the case, was nominated to the bench by President Trump in 2019.

Mr. Trump, at an event in Arizona, celebrated the decision, calling it a “great ruling.”

As in other states, many Republican politicians in Pennsylvania have been steadfastly opposed to their state’s pandemic mitigation strategy, with some urging the governor’s impeachment. In July, the State Supreme Court rejected a suit filed by Republican legislators seeking to end Mr. Wolf’s emergency authority.

Some of the most vocal opponents of the governor, including Representative Mike Kelly, a Republican whose district is in western Pennsylvania, were among the plaintiffs in the suit that was decided on Monday.

“The court believes that defendants undertook their actions in a well-intentioned effort to protect Pennsylvanians from the virus,” Judge Stickman wrote. “However, good intentions toward laudable ends are not alone enough to uphold governmental action against a constitutional challenge. Indeed, the greatest threats to our system of constitutional liberties may arise when the ends are laudable, and the intent is good — especially in a time of emergency.”

In a statement, the governor’s spokeswoman said that “the actions taken by the administration were mirrored by governors across the country and saved, and continue to save, lives in the absence of federal action.”

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Commuters walking across London Bridge toward the City of London on Tuesday. Britain’s unemployment rate rose above 4 percent for the May-July period. Credit...Justin Tallis/Agence France-Presse — Getty Images

Britain’s unemployment rate, which held steady through the early months of the pandemic thanks to the government’s furlough program that keeps people in their jobs, has started to increase.

The rate rose to 4.1 percent for the May-to-July period, the Office for National Statistics said on Tuesday, up from about 3.9 percent. For months, the jobless rate had been held down by the furlough program and by grants for self-employed workers, which “shielded the labor market from the worst consequences of the pandemic,” the statistics agency said.

The ranks of the jobless were also low because many of the people who did lose jobs in the spring were more likely to choose not to look for new work while the economy was in a lockdown, and so were counted as economically inactive.

As the British economy emerged out of lockdown in June and July, some of those people have re-entered the labor market. Although some have found jobs, others have not, helping raise the unemployment rate.

Overall, the agency’s data showed a labor market under the continuing strains of the pandemic.

  • Despite government support programs, in August there were 695,000 fewer payrolled employees than in March, a drop of 2.4 percent.

  • Young people under 25 have been particularly hard hit, continuing to record lower levels of employment as older age groups begin to recover.

  • Layoffs are rising. From May to July, there were 48,000 more redundancies than in the preceding three months, the biggest three-month jump since 2009. There are concerns that this is just the start of a wave of layoffs when the furlough program ends in October. The Institute for Employment Studies estimates there will be 650,000 redundancies in the second half of this year.

The persistently low unemployment rate in Britain stood in contrast to the United States, where the rate climbed above 14 percent in April as people were laid off during the height of state lockdowns and sought government help through unemployment benefits.

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A steady decline in coronavirus cases led Pakistan to reopen universities and high schools. Students were put into two groups, which attend classes on alternate days.CreditCredit...Arif Ali/Agence France-Presse — Getty Images

High schools and universities in Pakistan opened Tuesday after being closed for almost six months. Online classes were offered in most schools.

Students were divided into two groups, which attend classes on alternate days. Officials said that they would monitor the situation for a week and if things remain under control, classes for young children would begin in the coming weeks.

Dr. Faisal Sultan, the special assistant to the prime minister on health, said that school authorities would try to ensure that social distancing is maintained during classes.

“The most important role will be that of a mask,” Mr. Sultan said, stressing that parents should make sure that their children wear masks in schools.

Selected schools will undergo testing to keep a check on any possible spread of the virus. If security protocols are broken, local officials have the power to close or fine a school. The academic year is likely to be prolonged, officials said.

Pakistan has documented at least 300,000 cases of the virus and nearly 6,400 deaths, according to a Times database.

Reporting was contributed by Sarah Almukhtar, Matt Apuzzo, Emma Bubola, Emily Cochrane, Shaila Dewan, Nicholas Fandos, Antonella Francini, James Gorman, Rick Gladstone, Mike Ives, Jennifer Jett, Isadora Kosofsky, Anemona Hartocollis, Eric Lipton, Salman Masood, Donald G. McNeil Jr., Constant Méheut, Claire Moses, Eshe Nelson, Norimitsu Onishi, Richard C. Paddock, Gaia Pianigiani, Roni Caryn Rabin, Campbell Robertson, Amanda Rosa, Christopher F. Schuetze, Michael D. Shear, Jeanna Smialek, Sheryl Gay Stolberg, Eileen Sullivan, Derrick Taylor, Glenn Thrush, Maria Varenikova, Sui-Lee Wee, Ceylan Yeginsu and Elaine Yu.

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