World Passes 4 Million Reported Coronavirus Deaths

The world’s known coronavirus death toll passed four million on Thursday, a loss roughly equivalent to the population of Los Angeles, according to the Center for Systems Science and Engineering at Johns Hopkins University.

It took nine months for the virus to claim one million lives, and the pace has quickened since then. The second million were lost in three and a half months, the third in three months, and the fourth in about two and a half months. The number of daily reported deaths has declined recently.

Those are officially reported figures, which are widely believed to undercount pandemic-related deaths.

“The numbers may not tell the complete story, and yet they’re still really staggering numbers globally,” said Jennifer B. Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health.

Ms. Nuzzo said the number of excess deaths reported around the world suggested that “lower-income countries have been much harder hit than their official numbers would suggest.”

Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, called four million dead a tragic milestone on Wednesday, and said the toll was continuing to mount largely because of dangerous versions of the virus and inequities in the distribution of vaccines.

“Compounded by fast-moving variants and shocking inequity in vaccination, far too many countries in every region of the world are seeing sharp spikes in cases and hospitalizations,” Dr. Tedros said at a news conference.

The official death toll numbers tell only part of the horrifying pandemic story. In many places, people have died without family to comfort them because of rules to prevent the spread of the virus. And many countries were completely overrun.

The dead overwhelmed cremation grounds in India in May, where at least 400,000 confirmed deaths have been reported and the actual number is likely higher. That was also the case in funeral homes in the United States, which surpassed 600,000 known deaths last month.

Latin America ravaged

The virus has hammered Latin America since the start of the pandemic, and some of those nations have been grappling with their deadliest outbreaks to date.

As of Tuesday, seven of the 10 countries with the highest death rates relative to their populations over the past week were in South America, according to data from Johns Hopkins, and the virus has been a destabilizing force in many countries in the region.

Government health data in Colombia show that more than 500 people died from the virus each day in June. The country has also gone through weeks of explosive protests over poverty made worse by the pandemic that were sometimes met with a violent police response.

A wave of cases in Peru cost many people their livelihoods, and thousands of impoverished people occupied empty stretches of land south of Lima. In Paraguay, which as of Tuesday had the highest number of Covid-19 deaths per capita of any country during the previous week, social networks often resemble obituary pages.

Brazil, which recently passed 500,000 official deaths, had the highest number of new cases and deaths of any country in the past week. A recent study found that Covid-19 had led to a significant decrease in life expectancy in Brazil.

Vaccines make a difference

Several vaccines have proven effective against the coronavirus, including the highly contagious Delta variant, and death rates have dropped sharply in many parts of the world where large numbers of people have been vaccinated, like the United States and much of Europe.

But the virus is still running rampant in regions with lower rates of vaccination, like parts of Asia, Africa and South America. Some places with relatively high vaccination rates, like England, are also seeing spikes in cases, though fewer of those cases have been leading to hospitalizations and deaths.

Dr. Maria Van Kerkhove, who works on coronavirus response for the W.H.O., said that there were “more than two dozen countries that have epidemic curves that are almost vertical.”

“The virus is showing us right now that it’s thriving,” she said.

Wealthy countries and international organizations have pledged billions of dollars to Covax, a global vaccine-sharing initiative, and nations like the United States have promised to supply hundreds of millions of doses. But those numbers pale in comparison with the 11 billion vaccine doses that experts estimate will be needed to rein in the virus around the world.

To date, just under 3.3 billion vaccine doses have been administered worldwide, according to vaccination data from local governments compiled by the Our World in Data project at the University of Oxford. Nearly all have been of vaccines that require more than one dose to be fully effective.

Country-to-country differences in progress are stark, with some already inoculating most of their adult citizens while others have yet to report administering a single dose.

The assassination of President Jovenel Moïse of Haiti on Wednesday could complicate efforts to contain the Covid-19 pandemic in the Caribbean nation, which has yet to begin vaccinating its citizens, officials from the World Health Organization warned.

Carissa Etienne, the director of the Pan American Health Organization, which is part of the W.H.O., said her organization had made Haiti a priority in recent weeks as reported cases have surged.

“I am hopeful that the arrival of vaccines in the country can start to turn the tide of the pandemic and bring some relief to the Haitian people during these very difficult times,” Dr. Etienne said. “We continue to stand with them now and will redouble our efforts.”

Haiti did not experience the kind of surge early in the pandemic that many experts feared could devastate the country, the poorest in the Western Hemisphere. But the pandemic has grown worse in recent weeks, with a rise in reported cases that experts say is almost certainly an undercount, considering the country’s limited testing capacity.

Last month, Covid-19 claimed the life of René Sylvestre, the president of Haiti’s Supreme Court — a leading figure who might have helped to establish order in the wake of an assassination that has plunged the country into even deeper political uncertainty.

Dr. Etienne’s organization said in an email that while it was too soon to evaluate the impact of the assassination, “further deterioration of the security situation in Haiti could have a negative impact on the work that has been done to curtail Covid-19 infections,” as well as on vaccination plans.

The organization said that Haiti was also facing challenges from the start of hurricane season and the recent detection of the Alpha and Gamma virus variants on the island. Though “vaccines are expected to arrive shortly” in Haiti, the organization said it did not have a specific delivery date.

In June, Dr. Etienne urged the global community to do more to help Haiti cope with rising coronavirus cases and deaths. “The situation we’re seeing in Haiti is a cautionary tale in just how quickly things can change with this virus,” she said.

Haiti is an extreme example of the “stark inequities on vaccine access,” Dr. Etienne said. “For every success, there are several countries that have been unable to reach even the most vulnerable in their population.”

Across Latin America and the Caribbean, there are millions of people who “still don’t know when they will have a chance to be immunized,” she said.

She said the inequitable distribution of vaccines posed practical and moral problems.

“If we don’t ensure that countries in the South have the ability to vaccinate as much as countries in the North, this virus will keep circulating in the poorest nations for years to come,” Dr. Etienne said. “Hundreds of millions will remain at risk while the wealthier nations go back to normal. Obviously, this should not happen.”

— Daniel Politi

Britain could reach a record 100,000 new Covid cases per day, the country’s top health official acknowledged this week, even as he strongly defended the government’s plan to lift most virus restrictions on July 19.

The health secretary, Sajid Javid, said that vaccines had “severely weakened” the link between infections and hospitalizations and deaths.

About 51 percent of adults in Britain are fully vaccinated, according to data compiled from government sources by the Our World in Data project at the University of Oxford. And despite a surge driven by the highly contagious Delta variant that has pushed average new cases past 27,000 a day, hospitalizations are in the hundreds and daily deaths remain in the lower double digits.

“The vaccine has been our wall of defense — jab by jab, brick by brick, we have been building a defense against this virus,” Mr. Javid told the House of Commons on Tuesday.

Mr. Javid spoke forcefully in support of Prime Minister Boris Johnson’s bold experiment to jettison most virus restrictions — including capacity limits, social-distancing rules and mask mandates — even as cases are rising steeply and the highly contagious Delta variant is spreading globally.

Mr. Javid said modeling suggested that infections could be as high as 50,000 per day, double the current rate, on July 19, or “Freedom Day,” as it has been dubbed by the British press.

After that, Britain could reach 100,000 new cases per day, Mr. Javid said, although he cautioned that virus models are less certain further into the future.

Britain reported 27,334 new cases on Monday and 178,128 over the last week, an increase of 53 percent over the previous week.

In a speech to the House of Commons on Monday, Mr. Javid also warned that cases could rise, but said the vaccines would mitigate the worst effects of the virus.

“There is no risk-free — absolutely risk-free — way to move forward,” Mr. Javid said then. “But we do need to start returning things back towards normal and learning to live with Covid.”

As the speed of vaccinations has slowed around the United States, reported coronavirus cases are on the rise in several states, including Nevada, where nearly 40 percent of the adult population has not gotten a shot.

Nevada had the third-highest count of new coronavirus cases per capita of any state as of Wednesday, with 14 per 100,000 people, trailing only Missouri (where 45 percent of the population has had at least one shot) and Arkansas (where 42 percent have gotten at least one shot).

But Nevada had the highest increase in average number of hospitalizations, which had risen nearly 62 percent over the previous two weeks, to 441.

Dr. Fermin Leguen, the district health officer for Nevada’s southern district, which includes Clark County, said that about 95 percent of Covid patients hospitalized in the past three months had not been vaccinated.

Both Nevada and Missouri have asked for help from federal “surge response teams” that the White House announced last week to help states with largely unvaccinated populations cope with the highly transmissible Delta variant of the virus. The Centers for Disease Control and Prevention estimates that about 73 percent of the coronavirus infections in Missouri involve the Delta variant, as do about 40 percent of the cases in Nevada.

The C.D.C. now estimates that Delta has become the dominant variant across the United States. Only full vaccination affords significant protection against it.

Fifty-three percent of the country’s population has not been fully vaccinated, including many children under 12 who are not eligible. And persuading unvaccinated people to get inoculated is a critical challenge for the government.

President Biden this week renewed his call to the nation to get vaccinated — pressing employers to give employees paid time off to get inoculated and to offer vaccines at work — after the country failed to meet his goal of at least partly vaccinating 70 percent of American adults by July 4.

For most of the country, the virus has receded. The seven-day average of new reported cases has held steady at about 12,000 a day, the lowest totals since testing became widely available. That is a drastic drop from the worst days of the pandemic last winter, when new cases sometimes averaged more than 250,000 a day, according to a New York Times database.

The surge in Nevada has also not come near winter’s levels, but the Times database shows that the seven-day average of cases there is about double what it was a month ago when Gov. Steve Sisolak, a Democrat, relaxed most of the state’s coronavirus restrictions.

Most of the state’s surge in cases is in Clark County, home to Las Vegas and most of the state’s population. The city rejoiced when tourists were allowed return to the casinos, theaters and other entertainments on the strip without limitations after more than a year of economic stagnation.

In a statement last week, Mr. Sisolak connected the state’s rise in cases to the emergence of the Delta variant and the low rate of vaccination in Clark County, where only 39 percent of the population is fully vaccinated.

But Brian Labus, an infectious-disease epidemiologist at the University of Nevada, Las Vegas, linked the rise to the relaxation of restrictions.

“It’s not necessarily reopening the strip to tourists — it’s that our entire community is open 100 percent,” Dr. Labus said. “It’s not just the resort hotels. It’s every restaurant, store and business in southern Nevada.”