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Vital medical supplies reach India as COVID deaths near 200,000

By Shilpa Jamkhandikar, Rupam Jain and Sanjeev Miglani

NEW DELHI (Reuters) – Vital medical supplies began to reach India on Tuesday as hospitals starved of life-saving oxygen and beds turned away coronavirus patients, and a surge in infections pushed the death toll close to 200,000.

A shipment from Britain, including 100 ventilators and 95 oxygen concentrators, arrived in the capital New Delhi, though a spokesman for Prime Minister Boris Johnson said Britain had no surplus COVID-19 vaccine doses to spare.

France is sending eight large oxygen-generating plants this week while Ireland, Germany and Australia are dispatching oxygen concentrators and ventilators, an Indian foreign ministry official said, underlining the crucial need for oxygen.

U.S. President Joe Biden reaffirmed U.S. commitment to helping India, saying he was expecting to send vaccines there while senior officials from his administration warned that the country was still at the “front end” of the crisis.

India’s first “Oxygen Express” train pulled into New Delhi, laden with about 70 tonnes of oxygen from an eastern state, but the crisis has not abated in the city of 20 million people at the epicenter of the world’s deadliest wave of infections.

“The current wave is extremely dangerous and contagious and the hospitals are overloaded,” said Delhi Chief Minister Arvind Kejriwal, adding that a large public area in the capital will be converted into a critical care hospital.

With frustration mounting, relatives of a recently deceased COVID-19 patient assaulted staff with knives at a hospital in the southeast of New Delhi, injuring at least one person, a hospital spokeswoman said.

A video posted on social media showed several people brawling with guards at the same hospital. Delhi High Court has advised local authorities to provide security at hospitals.

The World Health Organization said it was working to deliver 4,000 oxygen concentrators to India, where mass gatherings, more contagious variants of the virus and low vaccination rates have sparked the second major wave of contagion.

With vaccine demand outstripping supply in the country of 1.3 billion people, two U.S. drugmakers have offered support.

Gilead Sciences said on Monday it would give India at least 450,000 vials of its antiviral drug remdesivir. Merck & Co said on Tuesday it was partnering with five Indian generic drugmakers to expand production and access to its experimental COVID-19 drug molnupiravir.

India is also negotiating with the United States, which has said it will share 60 million doses of AstraZeneca’s COVID-19 vaccine with other countries. A senior official participating in the talks said Prime Minister Narendra Modi had been assured of priority for India.

Supply uncertainty could force Maharashtra, India’s hardest-hit state, to postpone inoculations for people aged between 18 and 45, a government official said.

Biden said he had spoken on Monday at length with Modi, including about when the United States would be able to ship vaccines to India, the world’s second most populous country, and said it was his clear intention to do so.

MOUNTING TOLL

India’s 323,144 new cases over the past 24 hours stood below a worldwide peak of 352,991 hit on Monday, and 2,771 new deaths took the toll to 197,894.

But the fewer confirmed infections were largely due to a drop in testing, according to health economist Rijo M John of the Indian Institute of Management in Kerala, a southern state.

“This should not be taken as an indication of falling cases, rather a matter of missing out on too many positive cases,” he said on Twitter.

The U.S. State Department’s coordinator for global COVID-19 response, Gayle Smith, warned India’s challenge will require a sustained effort: “We all need to understand that we are still at the front end of this. This hasn’t peaked yet.”

Dr. K. Preetham, an administrator at the Indian Spinal Injuries Centre, said patients there were having to share oxygen cylinders because of the oxygen shortage.

New Delhi is in lockdown, as are the southern state of Karnataka and Maharashtra, where the country’s financial capital Mumbai is situated.

An uneven patchwork of restrictions, complicated by local elections and mass gatherings such as the weeks-long Kumbh Mela, or pitcher festival, could trigger COVID-19 breakouts elsewhere.

About 20,000 devout Hindus gathered by the Ganges river in the northern city of Haridwar on the last auspicious day of the festival for a bath they believe will wash away their sins.

“We believe Mother Ganga will protect us,” said a woman on the riverbank, where people bathed with few signs of physical distancing measures.

India has turned to its armed forces for help with the pandemic. Even China, which is locked in a military standoff with India along their disputed Himalayan border, said it was trying to get medical supplies to its neighbour.

In some cities, bodies were being cremated in makeshift facilities in parks and parking lots. Television channels showed bodies crammed into an ambulance in the western city of Beed as modes of transport ran short.

SUPPLY UNCERTAINTY

India has converted hotels and railway coaches into critical care facilities to make up for the shortage of beds, but experts say the next crisis will be a lack of healthcare professionals.

Companies ranging from conglomerates such as Tata Group and Reliance Industries Ltd to Jindal Steel and Power have stepped forward to help supply medical oxygen.

The U.S. Chamber of Commerce has said India’s economy, the world’s sixth largest, could falter because of the spike in infections, creating a drag for the global economy.

Australia halted direct passenger flights from India until May 15, joining other nations taking steps to keep out more virulent variants of the virus.

India has an official tally of 17.64 million infections, but experts believe the real number runs much higher.

(Reporting by Anuron Kumar Mitra in Bengaluru, Rupam Jain and Shilpa Jamkhandikar in Mumbai, Amlan Chakraborty and Sanjeev Miglani in Delhi, Saurabh Sharma in Lucknow; additional reporting by Rajendra Jadhav in Satara and Sumit Khanna in Ahmedabad, Humeyra Pamuk, Steve Holland and David Brunnstrom in Washington; Writing by Himani Sarkar and Timothy Heritage; Editing by Clarence Fernandez and Mark Heinrich)

Turkey announces “full lockdown” from April 29 to curb COVID spread

ANKARA (Reuters) -Turks will be required to stay mostly at home under a nationwide “full lockdown” starting on Thursday and lasting until May 17 to curb a surge in coronavirus infections and deaths, President Tayyip Erdogan announced on Monday.

Turkey logged 37,312 new COVID-19 infections and 353 deaths in the last 24 hours, health ministry data showed, sharply down from mid-April but still the world’s fourth highest number of cases and the worst on a per-capita basis among major nations.

Announcing the new measures after a cabinet meeting, Erdogan said all intercity travel would require official approval, all schools would shut and move lessons online, and a strict capacity limit would be imposed for users of public transport.

Turks will have to stay indoors except for essential shopping trips and urgent medical treatment. Certain groups including emergency service workers and employees in the food and manufacturing sectors will be exempt.

The new restrictions take effect from 1600 GMT on Thursday and will end at 0200 GMT on May 17.

“At a time when Europe is entering a phase of reopening, we need to rapidly cut our case numbers to below 5,000 not to be left behind. Otherwise we will inevitably face heavy costs in every area, from tourism to trade and education,” Erdogan said.

The measures will be implemented “in the strictest manner to ensure they yield the results we seek”, he said.

Two weeks ago Turkey announced a night-time curfew from 7 p.m. till 5 a.m. on weekdays, as well as full weekend lockdowns, after cases surged to record levels, but the measures proved insufficient to bring the pandemic under control.

Total daily cases in Turkey peaked above 63,000 on April 16 before dropping sharply to below 39,000 on Sunday.

The total death toll in Turkey, a nation of 84 million, stood at 38,711 on Monday, the health ministry data showed.

(Reporting by Tuvan Gumrukcu and Ezgi Erkoyun; Editing by Jonathan Spicer and Gareth Jones)

India sends army to help hospitals hit by COVID-19 as countries promise aid

By Shilpa Jamkhandikar and Neha Arora

NEW DELHI (Reuters) – India ordered its armed forces on Monday to help tackle surging new coronavirus infections that are overwhelming hospitals, as countries including Britain, Germany and the United States pledged to send urgent medical aid. In a meeting with Prime Minister Narendra Modi, the Chief of Defense Staff General Bipin Rawat said oxygen would be released to hospitals from armed forces reserves and retired medical military personnel would join COVID-19 health facilities.

And where possible, military medical infrastructure will be made available to civilians, a government statement said, as new coronavirus infections hit a record peak for a fifth day.

“Air, Rail, Road & Sea; Heaven & earth are being moved to overcome challenges thrown up by this wave of COVID19,” Health Minister Harsh Vardhan said on Twitter.

Modi on Sunday urged all citizens to get vaccinated and to exercise caution amid what he called a “storm” of infections, while hospitals and doctors in some northern states posted urgent notices saying they were unable to cope with the influx.

In some of the worst-hit cities, bodies were being burnt in makeshift facilities offering mass cremations.

The southern state of Karnataka, home to the tech city of Bengaluru, ordered a 14-day lockdown from Tuesday, joining the western industrial state of Maharashtra, where lockdowns run until May 1, although some states were also set to lift lockdown measures this week.

The patchy curbs, complicated by local elections and mass festival gatherings, could prompt breakouts elsewhere, as infections rose by 352,991 in the last 24 hours, with crowded hospitals running out of oxygen supplies and beds.

“Currently the hospital is in beg-and-borrow mode and it is an extreme crisis situation,” said a spokesman for the Sir Ganga Ram Hospital in the capital, New Delhi.

FIRE

Following a fire at a hospital in the western diamond industry hub of Surat, five COVID-19 patients died after being moved to other hospitals that lacked space in their intensive care units, a municipal official told Reuters.

Television channel NDTV broadcast images of three health workers in the eastern state of Bihar pulling a body along the ground on its way to cremation, as stretchers ran short.

“If you’ve never been to a cremation, the smell of death never leaves you,” Vipin Narang, a political science professor at Massachusetts Institute of Technology (MIT) in the United States, said on Twitter.

“My heart breaks for all my friends and family in Delhi and India going through this hell.”

On Sunday, President Joe Biden said the United States would send raw materials for vaccines, medical equipment and protective gear. Germany joined a growing list of countries pledging supplies.

In Moscow, which expects 50 million doses of its Sputnik V vaccine to be made each month in India this summer, a Kremlin spokesman expressed concern over the situation.

India, with a population of 1.3 billion, has an official tally of 17.31 million infections and 195,123 deaths, after 2,812 deaths overnight, health ministry data showed, although health experts say the figures probably run higher.

The surge in infections hit oil prices amid worries about a fall in fuel demand in the world’s third-biggest oil importer.

RALLY BACKLASH

Several cities have ordered curfews, while police enforce social distancing and mask-wearing. Politicians, especially Modi, have faced criticism for holding rallies during state election campaigns that draw thousands into packed stadiums.

About 8.6 million voters were expected to cast ballots on Monday in the eastern state of West Bengal, in the final phases of a contest set to wrap up this week. Also voting in local elections was the most populous state of Uttar Pradesh, which has been reporting an average of 30,000 infections a day.

Modi’s plea on vaccinations came after inoculations peaked at 4.5 million doses on April 5, but have since averaged about 2.7 million a day, government figures show.

Virologists said more infectious variants of the virus, including an Indian one, have fueled the resurgence.

The government told people to stay indoors and follow hygiene protocols. “Please don’t invite people into your home… It has become clearer that the transmissibility of this virus is faster,” said senior health official Vinod Kumar Paul.

Vaccine demand has outpaced supply as the inoculation campaign widened this month, while companies struggle to boost output, partly because of a shortage of raw material and a fire at a facility making the AstraZeneca dose.

However, the federal government will not import vaccines itself but expects states and companies to do so instead, in a step aimed at backing domestic manufacturers, two government officials told Reuters. [L4N2MF3ZM]

Neighboring Bangladesh sealed its border with India for 14 days, its foreign ministry said, though trade will continue. Air travel has been suspended since Bangladesh imposed a lockdown on April 14 to combat record infections and deaths.

(Reporting by Shilpa Jamkhandikar and Neha Arora; Additional reporting by Sumit Khanna, Krishna Das, Anuron Kumar Mitra, Chandini Monnappa in Bengaluru, Rajendra Jadhav in Satara, Ruma Paul in Dhaka and Dmitry Antonov in Moscow; Writing by Clarence Fernandez and William Maclean; Editing by Simon Cameron-Moore and Gareth Jones)

More therapeutics but no surge in vaccine for Michigan, Biden administration says

By Jeff Mason and Carl O’Donnell

WASHINGTON (Reuters) -The White House said on Monday it was prepared to send additional therapeutic treatments to the state of Michigan, which is experiencing a worrying number of COVID-19 cases, but declined to promise more vaccine as the state has sought.

White House coronavirus adviser Andy Slavitt told reporters the U.S. government would work to ensure that states such as Michigan were ordering the full amount of vaccine that was available to them but said that shifting distribution was not in line with the administration’s public health strategy.

“We have to remember the fact that in the next two to six weeks, the variants that we’ve seen … in Michigan, those variants are also … present in other states,” he told reporters on a conference call.

“So our ability to vaccinate people quickly … (in) each of those states rather than taking vaccines and shifting it to playing Whack-a-Mole isn’t the strategy that public health leaders and scientists … have laid out,” he said.

Michigan Governor Gretchen Whitmer, a Democrat, has pleaded with the federal government to increase the number of vaccines allotted to her state to address a dangerous surge in cases but, despite close ties to the White House, has been rebuffed.

Whitmer was on President Joe Biden’s list of potential running mates before he chose now Vice President Kamala Harris. Michigan is a political battleground state that Biden won in 2020, helping to secure his victory over former President Donald Trump, a Republican. It is likely to be decisive in the 2024 White House race as well.

The Biden administration has highlighted an increase in vaccination rates across the country while warning Americans to continue wearing masks, maintain social distance, and follow other health protocols to prevent another major COVID-19 surge.

U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said more vaccine was not the answer to Michigan’s problem. She said the state needed to “go back to basics” and shut down.

“I think if we tried to vaccinate our way out of what is happening in Michigan we would be disappointed that it took so long for the vaccine to work,” she said. “Similarly we need that vaccine in other places. If we vaccinate today we will have, you know, impact at six weeks and we don’t know where the next place … is going to be that is going to surge.”

Whitmer has faced fierce political backlash from conservatives in her Midwestern state for her COVID-19 restrictions, including armed groups entering the state capitol and a foiled plot to kidnap her. She was a frequent target of criticism from Trump.

Slavitt said that Johnson & Johnson is on track to deliver around 24 million COVID-19 shots to the United States in April whether or not it receives U.S. regulatory clearance for its Baltimore vaccine production plant, which is owned by contract manufacturer Emergent BioSciences Inc.

J&J has faced delays on vaccine shipments because of challenges at its Emergent plant, which ruined 15 million doses in recent weeks due to manufacturing error.

Jeff Zients, the White House’s COVID-19 response coordinator, said last week J&J would ship relatively few shots each week until the Emergent plant received authorization from the U.S. Food and Drug Administration.

(Reporting by Jeff Mason and Carl O’Donnell; additional reporting by Susan Heavey and Caroline HumerEditing by Chizu Nomiyama and Marguerita Choy)

Italy’s old pay high price for regional vaccine lottery

By Crispian Balmer and Angelo Amante

ROME (Reuters) – Agostino Airaudo, 86, died of the coronavirus on March 21. Ninety minutes earlier he had received an SMS telling him that, after weeks of waiting, he had got an appointment for a vaccine.

Ten days later, his 82-year-old wife Michela also died of the disease.

Unlike many other European countries, Italy did not give automatic precedence to its army of pensioners when it launched its inoculation campaign in December, even though they were bearing the brunt of the disease.

The failure to provide swifter protection has cost thousands of lives, experts say, and stoked anger about a fragmented health system under which regions take most of the decisions and the central government has struggled to impose a clear strategy.

“People could have been saved,” said Giorgio Airaudo, the son of Agostino and Michela, and the head of Italy’s powerful FIOM metalworkers’ union in the northern region of Piedmont.

“As soon as the vaccines arrived, there was no justification for not giving priority to fragile people and the elderly…,” he told Reuters by telephone.

“But this did not happen. The government made suggestions and each region did as they pleased.”

More than 110,000 people have died of COVID-19 in Italy, the world’s seventh highest tally. Their average age was 81, and 86% of them were 70 or over, data from the ISS national health institute shows.

Many countries, including Britain and the United States, vaccinated old people first, recognizing their great vulnerability.

Italy’s government also said the over 80’s should get priority, but a haphazard rollout has allowed professionals including lawyers, magistrates and university professors to move to the head of the queue in many places.

As the death rate has fallen in much of Europe thanks to the early impact of the vaccines, Italy’s has stayed stubbornly high, and its average daily toll of 431 during the past week was the highest on the continent, according to Reuters data.

Acknowledging the problem, Prime Minister Mario Draghi – the epitome of measured calm during his eight-year stint as head of the European Central Bank – on Thursday made an impassioned plea to fellow Italians to wait their turn.

“With what conscience does someone jump the line knowing that they are leaving a person who is over 75 or fragile exposed to the real risk of dying?” Draghi told reporters.

“Stop vaccinating people under 60,” he said, raising his voice.

‘DEATH, PAIN AND GRIEF’

At the start of this year, Italy’s 20 regions focused almost exclusively on protecting health workers, even those in their 20s with no contact with patients. Most places did not begin mass vaccinations for over 80’s until mid-February.

By that stage, France and Germany had already given a first dose to 20% of their over 80s.

Italy has since caught up with the EU average, with data from the European Centre for Disease Prevention and Control showing it had given at least one shot to 62% of its over 80’s. But just 13.4% of people in their 70’s have had a first dose, the lowest rate in Europe after Bulgaria.

Regional governors say they followed government guidelines and blame delays on slower-than-expected vaccine deliveries.

They also say they were blindsided in January when the national drug regulator advised that the AstraZeneca/Oxford shot should only be used for the under 55’s.

They had planned to give this shot to older residents and had to change strategy. Now guidance has swung round again with a recommendation that it should be used only for over-60s after concern emerged that it may cause rare blood clots in young adults.

Matteo Villa, a researcher with the ISPI think-tank, says other EU nations facing the same issues were more agile. His analysis suggests Italy could have saved 11,900 lives had it focused more on the elderly.

“Central government did not control the situation and then, amazingly, many of the regions did not prepare carefully for the rollout,” Villa told Reuters.

He said some regions competed with each other to see who could administer the most shots, and found it easier to corral health workers than the elderly.

“This isn’t a race …This is a situation where there is death, pain and grief,” said the union boss Airaudo.

His parents lived in Piedmont, which is centered on Turin. They both had serious ailments and had registered with their doctor for the vaccine. An algorithm adopted by the region decides who gets a vaccine, and when.

Piedmont health officials did not respond to questions over why they had not received timely shots.

‘AN INCREDIBLE MESS’

Adding to the confusion, each region uses its own booking system.

Franco Perco, 81, lives in the central Marche region, a COVID-19 hotspot. He is still waiting for a vaccine appointment despite numerous phone calls to helplines and efforts to book online.

“I feel very scared. There is no clarity,” said Perco, the former head of one of Italy’s major national parks. “I am going out as little as possible.”

Under the constitution, Italian regions have broad autonomy over healthcare decision-making, even during a pandemic.

In Tuscany, Abruzzo and Sicily, magistrates and lawyers were given priority status. In the southern region of Molise, journalists were allowed early vaccinations. Lax supervision in Sicily meant one priest was able to get his congregation vaccinated regardless of age.

“It created an incredible mess. It has served as a lesson for us to be more careful,” said Angelo Aliquò, the health agency director general in the Sicilian city of Ragusa.

Health undersecretary Andrea Costa, who took office in February, told Reuters that mistakes had been made in not clearly identifying priority groups.

“There will be time in the future to analyze what happened, but now we need to achieve as soon as possible immunization which will allow a return to normal life,” he said.

Angered by the sudden death of both his parents, Airaudo hopes there will be a reckoning.

“I always thought that decentralization was about being close to the people. Instead, today we have confusion, difference, injustice and delays,” he said.

Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients

By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) – Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada’s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”

The ECMO situation is under control for now, but things can change very quickly, Cypel cautioned.

When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff – seven or more people to start the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada’s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.

‘SEEING BURNOUT’

In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada’s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

Brazil’s COVID-19 death surge set to pass the worst of record U.S. wave

By Pedro Fonseca

RIO DE JANEIRO (Reuters) – Brazil’s brutal surge in COVID-19 deaths will soon surpass the worst of a record January wave in the United States, climbing well beyond an average 3,000 fatalities per day, scientists predict, as contagious new variants overwhelm hospitals.

Brazil’s overall death toll trails only the U.S. outbreak, with nearly 333,000 killed, according to Health Ministry data, compared with more than 555,000 dead in the United States.

But with Brazil’s healthcare system at the breaking point, the country could also exceed total U.S. deaths, despite having two-thirds the population, two experts told Reuters.

“It’s a nuclear reactor that has set off a chain reaction and is out of control. It’s a biological Fukushima,” said Miguel Nicolelis, a Brazilian doctor and professor at Duke University, who is closely tracking the virus.

Right-wing President Jair Bolsonaro has pushed back against mask-wearing and lockdowns that public health experts consider necessary. The country dragged its feet last year as the world raced to secure vaccines, slowing the launch of a national immunization program.

With weak measures failing to combat contagion, Brazil’s COVID-19 cases and deaths are accumulating faster than ever. On the other hand, a widespread U.S. vaccination campaign is rapidly curtailing what has been the world’s deadliest outbreak.

Nicolelis and Christovam Barcellos, a researcher at Brazilian medical institute Fiocruz, are separately predicting that Brazil could surpass the United States in both overall deaths and the record for average deaths per day.

As soon as next week, Brazil may break the record U.S. seven-day average for deaths, forecasts the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. The U.S. average for daily deaths peaked at 3,285 in January.

The IHME forecast does not currently extend beyond July 1, when it projects Brazil could reach 563,000 deaths, compared with 609,000 U.S. casualties expected by then.

(Reporting by Pedro Fonseca; Writing by Jake Spring; Editing by Brad Haynes and Jonathan Oatis)

U.S. COVID-19 cases rise for third straight week, hospitalizations also up

(Reuters) – New cases of COVID-19 in the United States rose 5% to more than 450,000 last week, the third week in a row that infections have increased, according to a Reuters analysis of state and county data.

The average number of COVID-19 patients in hospitals rose 4% to more than 37,000 in the week ended April 4, breaking a streak of 11 weeks of falling admissions.

Health officials have expressed concerns about the increase in travel around the Easter holiday and school spring breaks, at a time when more infectious variants of the coronavirus are circulating.

While flu viruses tend to be seasonal, with cases falling as the weather warms, health officials said they have not seen similar trends with the novel coronavirus, pointing to a surge in COVID-19 cases in some regions last summer.

“I don’t think we should even think about relying on the weather to bail us out of anything we’re in right now,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said at a news briefing on Monday.

Twenty-seven out of 50 states reported increases in new cases last week compared with the previous seven days, according to the Reuters analysis.

Per 100,000 people, Michigan, New Jersey and New York reported both the highest number of new cases and the highest number of hospitalizations.

Deaths from COVID-19, which tend to lag infections by several weeks, fell 17% to about 5,800 last week, or about 834 per day. Health officials have said the country’s vaccination effort could limit deaths even with rising cases.

For a sixth week, vaccinations set a record, with an average of 3.1 million shots given per day last week. As of Sunday, 32% of the U.S. population has received at least one dose and 19% was fully vaccinated, according to the CDC.

(Graphic by Chris Canipe, writing by Lisa Shumaker, editing by Tiffany Wu)

Tropical cyclone kills at least 113 in Indonesia, East Timor

By Yos Seran and Agustinus Beo Da Costa

MALAKA, Indonesia (Reuters) – Floods and landslides triggered by tropical cyclone Seroja in a cluster of islands in southeast Indonesia and East Timor have killed 113 people, with many still unaccounted for and thousands displaced, officials said on Monday.

At least 86 deaths were reported on several islands in Indonesia’s West and East Nusa Tenggara provinces, while 71 others were missing, after the cyclone brought flash floods, landslides and strong winds amid heavy rain over the weekend, disaster agency BNPB said.

In East Timor, which shares the Timor island with Indonesia, at least 27 people were killed by landslides, flash floods and a falling tree, while 7,000 were displaced, its government said.

On Lembata island, authorities feared bodies had been washed away.

“We are using rubber boats to find bodies at sea. In several villages, flash floods hit while people were sleeping,” Thomas Ola Langoday, deputy head of Lembata district government, told Reuters by phone.

About 30,000 people have been impacted by floods in Indonesia, some already taking shelter in evacuation centers, but rescue operations have been made difficult after five bridges collapsed and falling trees blocked some roads, BNPB spokesman Raditya Jati said.

A continuing storm had also halted evacuations in some places, local authorities said.

Hundreds of houses and other facilities such as a solar power plant were damaged, BNPB said. Ships and motor boats sank as the cyclone set off waves as high as 6 meters.

Powerful currents continued to flow through villages in the Malaka district on Timor island on Monday, even though the rain had stopped.

Some residents there hauled themselves to their roofs to escape flood water rising to 3-4 meters.

“We had to dismantle the zinc roof. We went out through the back door and pulled ourselves out with a rope,” Agustina Luruk, 36, told Reuters as she and her three daughters waited to be evacuated by the side of a muddy road.

President Joko Widodo offered his condolences and ordered speedy disaster relief efforts.

The Seroja cyclone hit the Savu sea southwest of Timor island in the early hours of Monday, Indonesia’s weather agency said.

Within 24 hours, the cyclone’s intensity could strengthen, bringing yet more rain, waves and winds, although it was moving away from Indonesia, the agency said.

Dwikorita Karnawati, the agency’s head, said that the cyclone would be weakening in the next two days.

(Reporting by Yos Seran in Malaka, Agustinus Beo Da Costa in Jakarta, Nelson Da Cruz in Dili; Additional reporting by Bernadette Christina Munthe; Writing by Gayatri Suroyo; Editing by Martin Petty, Giles Elgood, Kirsten Donovan)

India AstraZeneca shot delay could be ‘catastrophic’ for Africa: health official

ADDIS ABABA (Reuters) – India’s temporary hold on major exports of AstraZeneca’s COVID-19 shot will undermine Africa’s vaccination plans, and could have a “catastrophic” impact if extended, the head of the continent’s disease control body said on Thursday.

India decided to delay big exports of the shots made in its territory by the Serum Institute of India (SII) to make sure it could meet local demand, two sources told Reuters last week.

The hold “will definitely impact our ability to continuously vaccinate people,” the director of the Africa Centers for Disease Control and Prevention, John Nkengasong, told a news conference in Addis Ababa.

The African Union had planned to vaccinate 30-35% of the continent’s population by the end of the year he said. “If the vaccines are delayed we are unlikely to meet our target,” he added.

That AU target primarily relies on supplies from the global COVAX vaccine-sharing facility, through which 64 poorer countries including many in Africa are supposed to get doses from the SII. COVAX aims to provide enough shots for African countries to inoculate at least 20% of their populations.

“If the delay continues, I hope it’s a delay and not a ban, that would be catastrophic for meeting our vaccinations schedule,” Nkengasong said.

African countries have reported 4.25 million coronavirus infections and 112,000 related deaths, though experts have said the actual numbers could be higher.

The AU has also been negotiating with manufacturers to help member states secure the additional doses they will need to achieve 60% coverage.

On Monday, Johnson & Johnson announced it would supply the AU with up to 400 million doses of its COVID-19 vaccine. Delivery of those doses is due to begin in the third quarter of this year and will continue through 2022.

Those doses are separate from the GAVI/WHO-backed global COVAX facility.

Nkengasong said on Thursday the AU has “pivoted” towards the J&J shot in part as a result of the delay in the delivery of AstraZeneca shots, and also because it is a single-dose shot.

The J&J doses will begin to arrive in June or July, which will ease any shortage caused by the delay in the AstraZeneca doses, Nkengasong said. The gap until the arrival of the J&J doses is a concern, he added.

(Reporting by Addis Ababa newsroom; Writing by Maggie Fick; Editing by Andrew Heavens)