Germany’s health minister, Jens Spahn, holding a phone with the CovPass Covid-19 digital certificate last month in Berlin.
Credit…Sean Gallup/Getty Images

Digital Covid-19 certificates aimed at facilitating free movement in the European Union came into force across the continent on Thursday, a long-awaited milestone as countries of the bloc hope to restart travel and boost their ailing tourism industries.

The certificates have raised concerns that diverging approaches will impose additional burdens on travelers and bring chaos to airports. But free movement is a key pillar of European integration, and E.U. officials said this month that the certificates would “again enable citizens to enjoy this most tangible and cherished of E.U. rights.”

Through a Q.R. code issued by their country of residence, certificate holders will be able to show that they have either been fully vaccinated against Covid, tested negative or have immunity after a recent recovery from a coronavirus infection. That will exempt them from most travel or quarantine restrictions.

Many European governments have already eased such rules, and each member nation can still revive protective measures if a country’s health situation deteriorates. Germany, for instance, has imposed restrictions on travelers coming from Portugal, which has faced a surge of new coronavirus cases driven by the spread of the Delta variant.

But many obstacles remain: While countries have agreed that national health authorities will issue the certificates — most E.U. countries have already been doing so — they remain divided over who should check them, where and when.

Citing privacy concerns, Germany and Austria have not given airlines access to verification devices that they would need to scan the Q.R. codes. France has been distributing such tools in airports, and Spain has built a system whereby the Q.R. code can be checked before a passenger travels to the airport.

The divergences have highlighted the challenges that the E.U. faces in allowing free movement across the bloc.

And one country, Ireland, has yet to set up a verification system for the digital certificates.

This week, a group of airlines and airport representatives urged member states to set up verification systems before departure — alongside online check-ins, for instance — to avoid chaotic situations at airports upon arrival.

Echoing some concerns shared by the travel industry, the European Commission, the bloc’s executive arm, noted that the 27 E.U. member states had planned more than 10 verification processes.

“The digital Covid-19 certificate is an important tool that ideally will give people confidence in the easing of travel restrictions,” said Thomas Reynaert, the managing director of Airlines for Europe, a Brussels-based organization representing the bloc’s largest carriers. “But this can only work for travelers if member states implement it in a harmonized way.”

Medical workers removing a man last week from an emergency tent erected to accommodate a surge of patients at Cengkareng Regional General Hospital in Jakarta, Indonesia.
Credit…Tatan Syuflana/Associated Press

In Indonesia, grave diggers are working into the night, as oxygen and vaccines are in short supply. In Bangladesh, urban garment workers fleeing an impending lockdown are almost assuredly seeding another coronavirus surge in their impoverished home villages.

And in countries like South Korea and Israel that seemed to have largely vanquished the virus, new clusters of disease have proliferated. Chinese health officials announced on Monday that they would build a giant quarantine center with up to 5,000 rooms to hold international travelers. Australia has ordered millions to stay at home.

A year and a half since it began racing across the globe with exponential efficiency, the pandemic is on the rise again in vast stretches of the world, driven largely by the new variants, particularly the highly contagious Delta variant first identified in India. From Africa to Asia, countries are suffering from record caseloads and deaths, even as wealthier nations with high vaccination rates have let their guard down, dispensing with mask mandates and reveling in life edging back toward normalcy.

Scientists believe the Delta variant may be twice as transmissible as the original coronavirus, and its potential to infect some partially vaccinated people has alarmed public health officials. Unvaccinated populations, whether in India or Indiana, may serve as incubators of new variants that could evolve in surprising and dangerous ways, with Delta giving rise to what Indian researchers are calling Delta Plus. There are also the Gamma and Lambda variants.

“We’re in a race against the spread of the virus variants,” said Professor Kim Woo-joo, an infectious disease specialist at Korea University Guro Hospital in Seoul.

Brazil’s minister of health, Marcelo Queiroga, left, and the U.S. ambassador to Brazil, Todd Chapman, receiving a shipment of Johnson & Johnson vaccine doses last week.
Credit…Carla Carniel/Reuters

When a commercial plane carrying 2.5 million doses of Moderna’s coronavirus vaccine took off on Wednesday from Dallas for Islamabad, Pakistan, U.S. officials had just finished a dizzying bureaucratic back-and-forth to get them there.

The United States had arranged a donation agreement with Moderna and Covax, the year-old vaccine-sharing initiative. Covax had previously worked out indemnity agreements with Moderna, which shield the company from liability for potential harm from the vaccine. U.S. Embassy officials in Islamabad had worked with regulators there to evaluate the Food and Drug Administration’s review of the vaccine. And Pakistani regulators had to pore over reams of materials on the vaccine lots and the factory where they were made before authorizing the shots for use.

The result was a so-called tripartite agreement, a type of deal that has increasingly come to consume the Biden administration’s pandemic response efforts.

Amid criticism from some public health experts that President Biden’s vaccine diplomacy efforts have been slow and insufficient, the White House plans to announce on Thursday that it has fulfilled the president’s pledge to share an initial 80 million doses by June 30.

More than 80 million have been formally offered to about 50 countries, the African Union and the 20-nation Caribbean consortium, with around half already shipped and the rest to be scheduled in the coming weeks, said Natalie Quillian, the Biden administration’s deputy Covid-19 response coordinator.

Researchers have estimated that 11 billion doses of Covid vaccines are needed worldwide to try to stamp out the pandemic. To date, more than three billion vaccine doses have been administered worldwide, equal to 40 doses for every 100 people. Some countries have yet to report a single dose, even as the highly contagious Delta variant spreads around the world, further exposing vaccine inequities.

“If this is the pace at which it will continue, then unfortunately, it’s much slower than what is needed,” Dr. Saad B. Omer, the director of the Yale Institute for Global Health, said of the U.S. effort.

Fabiana Lopez and her family in line to get vaccinated in Lake Worth, Fla., in April.
Credit…Saul Martinez for The New York Times

A new poll has found that Americans are sharply divided by household over vaccination status, with 77 percent of vaccinated adults saying everyone in their household is vaccinated and a similar share (75 percent) of unvaccinated adults saying no one they live with is vaccinated.

Sixty-seven percent of Democrats reported living in households where everyone had been vaccinated, compared with 39 percent of Republicans. Ten percent of Democrats said they lived in homes where no one had been vaccinated, compared with 37 percent of Republicans, according to the poll by the Kaiser Family Foundation, which has been tracking the public’s attitudes toward and experiences with vaccinations.

Overall, half of U.S. adults live in a fully vaccinated household and one in four lives in a completely unvaccinated household. The remainder, about one in five adults, lives in a household occupied by both vaccinated and unvaccinated people, including children under 12 who are not currently eligible to receive a vaccine.

The telephone survey of 1,888 adults 18 and older living in the United States was conducted from June 8 to June 21 and had a margin of error of plus or minus three percentage points.

As policymakers continue to experiment with lotteries, free beers and other incentives, the poll found that workers were more likely to get the shot when their employers encouraged them to and provided paid time off to make it easier. Two-thirds of the employed adults surveyed said their employer had encouraged workers to get vaccinated, and half said their employer had provided them paid time off to get the vaccine and to recover from side effects.

The workers who said their employer had taken either one of those steps were more likely to report having been vaccinated, even after the poll controlled for other demographic variables. The finding suggested that more employers’ encouraging vaccination and offering paid time off could lead to higher vaccination rates among workers.

As virus cases fall across much of the United States, the poll found that optimism over the idea that the pandemic may be ending could hamper vaccination efforts, with half of unvaccinated adults polled saying that the number of cases is now so low there is no need for more people to be vaccinated.

If adult vaccinations continue their current seven-day average rate, about 67 percent of U.S. adults will have received at least one shot by July 4, just shy of President Biden’s target of having 70 percent of adults at least partly vaccinated by that date, according to a New York Times analysis.

Lazaro Gamio contributed reporting.

Hasan Gokal, accused of misusing vaccines when he had an opened and soon expiring vial, at his home in Sugar Land, Texas, in February.
Credit…Brandon Thibodeaux for The New York Times

A grand jury in Texas declined on Wednesday to indict a Houston doctor who was accused earlier this year of stealing 10 doses of Covid-19 vaccine — worth a total of $135 — and inoculating a few faint acquaintances and finally his wife in a late-night race in December to use the medicine before it expired.

The doctor, Hasan Gokal, received support for his actions from, among others, the Texas Medical Association and the Harris County Medical Society. But the Harris County district attorney, Kim Ogg, chose to present the case to a grand jury, even after a criminal court judge dismissed the matter in January for lack of probable cause.

The allegation upended Dr. Gokal’s life. He was fired from his government job and his name ricocheted around the world. A news release from the district attorney’s office asserted that the doctor “stole the vial,” and, according to Ms. Ogg, had “abused his position to place his friends and family in line in front of people who had gone through the lawful process to be there.”

After a monthlong investigation by prosecutors and two days of testimony, a grand jury in Harris County disagreed.

Dr. Gokal expressed relief in a telephone call on Wednesday afternoon. “For the first time in six months I’m going to be able to go to bed tonight and not wake up in the middle thinking about this,” he said.

His lawyer, Paul Doyle, said, “What a colossal waste of time.”

In late December, Dr. Gokal, 48, a veteran emergency room doctor then working for the Harris County Public Health Department, set up a vaccination event in the Houston suburb of Humble. Just as the event was about to close for the night, an eligible person showed up. A nurse punctured a new vial to administer the vaccine, which activated the six-hour time limit for its 10 remaining doses.

Dr. Gokal later said that he was determined to abide by his understanding that not a dose of the precious vaccine should be wasted. Colleagues at the event either declined or already had been vaccinated. So as he drove home to a neighboring county, he called acquaintances to ask whether they knew of older people needing to be immunized.

Within a few frantic hours, he had vaccinated various people in need, most of them older or in fragile health, and unknown to him. As midnight approached, he had one last dose and no one to vaccinate, so he presented the situation to his wife, whose pulmonary sarcoidosis made her eligible — but she was hesitant.

“It makes perfect sense,” he later said he told her. “We don’t want any doses wasted, period.”

The next morning, Dr. Gokal submitted the documentation for the 10 people he had vaccinated with that last vial. Several days later, he was fired from his county job; he said he was told that he should have returned the doses to the office, which by then was closed, or thrown them away.

Soon after, the district attorney’s office issued its news release, with the headline “Fired Harris County Health Doctor Charged with Stealing Vial of Covid-19 Vaccine.”

On Wednesday afternoon, Dr. Gokal — who, since his firing, has been volunteering at a nonprofit health clinic for the uninsured — was busy answering congratulatory text messages and telephone calls. He said he was looking forward to a return to normality for his wife and three children.

Meanwhile, the district attorney’s office issued a statement that read in part: “We respect the decision of the grand jury in this and every case. Evidence, not public opinion, is the guiding principle of our work.”

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