Global Virus Death Toll Passes 5 Million

The coronavirus is responsible for more than five million confirmed deaths around the world as of Monday, according to data from the Center for Systems Science and Engineering at Johns Hopkins University. Such a loss would wipe out almost the entire population of Melbourne, Australia, or most of the nation of Singapore.

Experts say that five million is an undercount. Many countries are unable to accurately record the number of people who have died from Covid-19, like India and African nations; experts have questioned the veracity of data from other countries, like Russia.

“All of these estimates still rely on data being available, or someone going and collecting it before antibodies and local memories wane,” said Adam Kucharski, an associate professor at the London School of Hygiene & Tropical Medicine who mathematically analyzes infectious disease outbreaks. “Globally, there will have been numerous local tragedies going unreported.”

The real number of people lost to Covid-19 could be underestimated by “a multiple of two to 10” in some nations, said Denis Nash, an epidemiologist at the City University of New York Graduate School of Public Health and Health Policy. Overall, he said, the true global toll could be as high as twice the reported figure (not up to 10 times, as an earlier version of this item incorrectly implied).

The pace of confirmed deaths seems to have slowed slightly since the world reached four million in early July, despite the rapid spread of the Delta variant since then — a sign that the spread of vaccines could be having an impact, at least in some parts of the world. It took nine months for the virus to kill one million people, three and a half more to reach two million, another three to claim three million and about two and a half to exceed four million.

The United States leads all other countries, with more than 745,000 deaths confirmed in total. The nations with the highest reported death tolls after the United States are, in order, Brazil, India, Mexico and Russia.

The global rate of reported deaths climbed over the past two weeks after trending downward for much of September and the first half of October, but at an average of over 7,000 deaths per day remains about 3,000 less than its August peak. The World Health Organization said last week in a report on pandemic conditions that confirmed deaths had increased in Europe and Southeast Asia, and declined in parts of Africa, the Middle East and Asia.

Dr. Nash said that the death rate appeared to be slowing “in places around the world where we are doing a good job at counting deaths, which also happen to be places in the world that have the best access to vaccines.”

But, he continued, “I think there are places where there are increases in the death rates, but we’re just not measuring them.”

The 20 countries that have recorded the most reported deaths per capita in recent weeks are mostly in Eastern Europe and the Caribbean, and most of them have vaccinated far less than half of their populations.

Coronavirus cases are rising in Europe, even though three-quarters of the European Union’s adult population has been fully vaccinated. Those inoculation rates plummet in countries like Bulgaria and Romania, and are even lower in nations that are outside of the bloc, like Armenia.

That vaccination gap persisted even when shots became more widely available. A September report on perceptions of the pandemic by the European Council on Foreign Relations said that the disparity seemed to be driven largely by misinformation, distrust and skepticism.

Vaccine hesitancy is also a major problem for Caribbean nations, and many of them also face unequal distribution of doses and logistical hurdles, the W.H.O. said in October.

W.H.O. officials have pressed wealthy nations to provide more vaccines to poorer ones. They and others have decried vaccine hoarding and most booster shot programs when much of the world has yet to be inoculated. Worldwide, about 76 percent of shots that have been administered have been so in high- and upper-middle-income countries, according to the Our World in Data project at the University of Oxford. Only 0.6 percent of doses have been administered in low-income countries.

Dr. Nash said he was hopeful that expanded access to vaccines and new pharmaceutical treatments, including an antiviral pill by Merck, would eventually rein in the virus.

Dr. Kucharski said that the actual number of dead would not be known for a long time.

“People need to be aware that it may take years to truly understand the toll of Covid-19,” he said.

New York City started to enforce its Covid vaccine mandate for municipal workers on Monday, and about 9,000 workers who refused to get vaccinated were placed on unpaid leave.

Mayor Bill de Blasio said on Monday that the vaccination rate for city workers continued to climb, reaching 91 percent, and that the city was running smoothly despite the absences.

“We’re not seeing disruptions to any city services,” he said, before urging workers to get vaccinated and return to work.

City officials said that they were coping with the reduction in workers without a significant slowdown of city services. With measures like shuffling firefighters between companies and extending the workday for sanitation workers, city agencies have been shoring up coverage.

Unvaccinated municipal employees without an approved medical or religious exemption — or a pending request for one — were placed on unpaid leave.

The number of vaccinated workers at city agencies has surged in the last few days, including at the New York Police Department, where 85 percent of employees were vaccinated on Monday, up from 70 percent when the mandate was announced.

Police Commissioner Dermot Shea said on Monday that placing unvaccinated officers on unpaid leave was having “literally no effect on service at this point.”

The city has a total of about 378,000 workers; about 6 percent remain unvaccinated, including those put on unpaid leave and about 12,000 workers who have applied for a medical or religious exemption. Those seeking exemptions are allowed to continue to work, while being tested weekly, until their cases are decided.

At the New York Police Department, officials had recently estimated that as many as 2,500 employees could be placed on leave on Monday as the department begins enforcing the vaccine mandate, according to a high-ranking official, who added that the number was falling because some personnel were getting immunized at the last minute.

The Police Department, which has about 36,000 uniformed officers and 19,000 civilian employees, was confident that it could manage the absences without taking measures such as canceling days off and moving to 12-hour shifts, said the official, who was not authorized to speak publicly.

The Sanitation Department has put workers on 12-hour shifts and told many to plan to come in on Sundays.

The vaccine mandate has been especially contentious within the tight-knit Fire Department. More than 2,000 New York City firefighters — out of a total uniformed force of about 11,000 — have taken sick days over the past week in what city officials describe as a large-scale protest against the mandate.

“Irresponsible bogus sick leave by some of our members is creating a danger for New Yorkers and their fellow firefighters,” the fire commissioner, Daniel A. Nigro, said in a statement. He attributed the uptick in sick leave to “anger at the vaccine mandate.”

The personnel shortage has put a strain on Fire Department operations. The department said that all its firehouses remained open, but that maintaining coverage across the city had required shuffling personnel around to reconstitute fire companies.

Andrew Ansbro, president of the Uniformed Firefighters Association, the union that represents rank-and-file firefighters, said that there had been no organized sickout. But hundreds of firefighters were feeling the side effects of vaccine doses and were too unwell to work, Mr. Ansbro said in a phone interview Sunday morning. “Hundreds of guys are feeling flulike symptoms, because that’s what the shot does to people,” Mr. Ansbro said.

By Sunday, some 90 percent of municipal workers had gotten at least one shot, leaving just under 23,000 unvaccinated.

The number of employees with approved exemptions — or pending ones — is unclear. But it could be that the number of people placed on unpaid leave on Monday is relatively small compared with the number that go on leave in the days ahead — should those applications for exemptions be mostly rejected.

The Police Department, for instance, has received applications for exemptions for some 6,500 officers, according to the official. Over the next two weeks, the department is expected to decide most of those cases, the official said, adding that a large portion of the requests would most likely be denied.

Nevertheless, the city reported on Sunday that 84 percent of the Police Department had gotten at least one dose of the vaccine, up from 70 percent on Oct. 19. Three-quarters of firefighters had gotten their first doses by Sunday, officials said.

Organizing a global summit with leaders from more than 100 nations and tens of thousands of delegates and activists — while preparing for more than 100,000 protesters to fill the streets outside the conference halls — would be a daunting challenge at any time.

This is not any time. With the coronavirus still stalking the planet, officials at this year’s COP26 climate summit, already delayed a year because of the pandemic, are under pressure to address the dangers posed by a warming planet even as the invisible threat of the virus looms. As the summit kicked off, the official global virus death toll passed five million.

And just as the changing climate has already had some of the most devastating consequences on the world’s poorest nations, the failure to equitably distribute lifesaving vaccines has left the world divided between the protected and the exposed.

Vaccine inequity is also having an impact on the summit, with activists saying that the voices from some of the nations most affected by climate change are not being properly represented.

Dorothy Guerrero, of the advocacy group Global Justice Now, told reporters over the weekend that the refusal to give more manufacturers access to produce the vaccines was part of the reason that some delegates from developing nations were unable to attend.

“You are already saddled by the fact that your country was affected already for many decades, and you are the least responsible for this climate change,” she said at a news conference in Glasgow. “Yet you could not come here and raise your voice in this important meeting simply because you don’t have access to the vaccine.”

Britain offered to help any delegates who need a Covid-19 vaccination obtain one, but attendees are not required to be inoculated. Instead, delegates must show proof of a negative coronavirus test every day to be admitted to the conference center.

Thailand reopened on Monday to fully vaccinated tourists arriving by air from 63 countries as it strives to revive its economy despite struggling to reduce Covid-19 case numbers.

Bangkok also lifted its nighttime curfew, which had been in place for four months, and will allow some restaurants to resume serving alcohol. Bars, nightclubs and entertainment venues will remain closed at least until December.

With the moves, Thailand became one of the first countries in Southeast Asia to reopen to tourists without requiring quarantine. Singapore opened in September to tourists from two countries without quarantine and has expanded its list to 10.

Indonesia opened Bali and two other islands last month but imposed so many restrictions, including four nights of quarantine, that foreign tourists have yet to arrive. Cambodia and Vietnam plan to reopen selected areas to foreign tourists at the end of November.

About a fifth of Thailand’s economy depends on tourism and, before the pandemic, it was one of the world’s top tourist destinations, drawing nearly 40 million visitors in 2019. People who depend on tourism for a living said that they were desperate for business and welcomed the prospect of foreigners returning.

“I am optimistic that by opening the country, our economic condition will improve,” said Rujira Komonsing, owner of a shoe shop in Bangkok’s sprawling Chatuchak market. “I see that we have to live with Covid. The disease will not go away.”

The government is reopening now, in time for the coming peak tourism season, even though it is struggling to contain a monthslong outbreak. On Monday, it reported 8,165 new cases. But merchants and tourism industry workers said that going hungry was a greater risk than Covid.

“I am not worried about the number of cases,” said Puncharee Wongraungaram, a ceramics vendor at Chatuchak, once a popular tourist destination. “We can’t afford to close the country any longer. People have expenses to pay and need to eat.”

The list of 63 points of origin that Thailand has deemed to be low risk includes the United States, China, India, Southeast Asia and much of Europe.

Fully vaccinated visitors from those areas will not have to undergo quarantine but must take a P.C.R. test on arrival and stay one night in an approved hotel while awaiting the result. If they test negative, they can travel around the country.

After a slow start in obtaining vaccines, Thailand’s reopening has followed an aggressive inoculation campaign, especially in popular tourist areas. Bangkok reports that about two-thirds of its population is fully vaccinated.

The Biden administration will release the highly anticipated details of a federal vaccine mandate for private employers “in coming days,” a representative for the Department of Labor said Monday. When the details become public, a flurry of corporate vaccine mandates is expected to follow.

President Biden instructed the Department of Labor and its Occupational Safety and Health Administration in September to draft an emergency temporary standard requiring businesses with 100 or more employees to mandate vaccinations against the coronavirus or weekly testing. The process has been particularly painstaking given likely legal challenges to the rule.

The Office of Management and Budget completed its review of the rule on Monday, the Labor Department representative said. It will now go to the Federal Register for review, which will publish it “in the coming days,” the representative said.

The Department of Labor has received comments on the mandate from trade groups, including the Chamber of Commerce, as well as executives from companies like UPS, the Walt Disney Company, Fidelity Investments. Many companies have a long list of questions about how the requirement will work, including who will pay for testing associated with the mandate and how the federal government will track compliance.

Some companies, like 3M, Procter & Gamble, IBM, American Airlines, Alaska Airlines and JetBlue, have already moved forward with vaccine mandates, but others have said they are awaiting more details from the federal government.

Noam Scheiber contributed reporting.

After being separated from his parents for two years, Jimmy Sugandi, 42, touched down on Monday in Melbourne, Australia, after traveling from Indonesia with his wife and two young children.

“It’s unbelievable,” he said. “We thought we were never coming back.”

Mr. Sugandi and his family are Australian permanent residents who live in Indonesia. During the pandemic, he tried to travel to Melbourne to see his parents, who live in the city. But Mr. Sugandi couldn’t get a spot on one of the extremely limited flights because of Australia’s strict border restrictions.

Tens of thousands of Australians have been stranded overseas by the border rules brought in by their country about 18 months ago to combat the coronavirus pandemic. But on Monday, the states of New South Wales, which includes Sydney, and Victoria, which includes Melbourne, lifted restrictions on citizens and permanent residents seeking to return. For the first time since the start of the pandemic, Australians are also now able to leave the country without needing to be granted an exemption from the government.

New South Wales and Victoria are allowing vaccinated Australians to return without quarantining. The states are also removing the caps on the number of citizens allowed to fly back into the country each week, which had previously made it difficult to obtain airline tickets.

The moves come a little over a week after Melbourne lifted one of the world’s longest cumulative lockdowns.

Other Australian states remain largely closed, both to overseas visitors and to Australians returning from abroad or traveling from other states in the country.

At Melbourne airport, the first international flight to touch down was from Singapore. Families reunited with tears and kisses as airport staff handed out bouquets of flowers.

After 21 months apart, Kirsty Rae, 57, and Keely Briggs, her 25-year-old daughter, embraced.

“It’s been pretty surreal,” said Ms. Briggs, who returned from South Korea, where she had been working as a teacher, via a flight from Hong Kong. “It’s been really difficult to get back,” she noted.

“I want to confiscate her passport so she doesn’t take off again,” her mother said with a laugh.

Joy and relief were tempered by reminders of important moments missed and lives upended.

Elva Duan, who spent 18 months away, returned from Hong Kong with three young children in tow. Her husband was to pick them up outside the airport, and the children grabbed at her clothes and clamored: “Where’s daddy? Is daddy here yet?”

Ms. Duan said that her youngest son was only a few months old when they left Australia. “Now he knows how to run, how to walk, how to speak,” she said.

Jen Psaki, the White House press secretary who earlier in the week said that she would not join President Biden on a diplomatic trip to Europe because of a family emergency, said on Sunday that she had tested positive for the coronavirus.

“While I have not had close contact in person with the president or senior members of the White House staff since Wednesday,” Ms. Psaki said, “I am disclosing today’s positive test out of an abundance of transparency. I last saw the president on Tuesday, when we sat outside more than six feet apart, and wore masks.”

Ms. Psaki said that members of her household had tested positive for the virus earlier in the week, and quarantined once she learned that they had contracted the virus. She tested negative on Wednesday, Thursday, Friday and Saturday before testing positive on Sunday. Karine Jean-Pierre, the White House principal deputy press secretary, traveled on the trip while Ms. Psaki stayed home and went into quarantine.

“Thanks to the vaccine, I have only experienced mild symptoms, which has enabled me to continue working from home,” Ms. Psaki said.

The White House did not immediately respond to questions about whether Ms. Psaki had received a booster shot, and did not immediately identify the administration officials she had been in close contact with earlier in the week.

Mr. Biden traveled abroad with a large delegation that included Jake Sullivan, his national security adviser, Antony Blinken, the secretary of state, and several press officials, all of whom have interacted both with White House officials and a large group of journalists traveling with the president.

“I will plan to return to work in person at the conclusion of the 10-day quarantine following a negative rapid test,” Ms. Psaki said, “which is an additional White House requirement, beyond C.D.C. guidance, taken out of an abundance of caution.”

In July, after a White House staff member tested positive for the virus, Ms. Psaki warned that there would be more breakthrough cases and said that precautions were in place to protect the president.

Novavax, a Maryland-based company that received $1.75 billion from the United States government to develop a protein-based Covid-19 vaccine, announced Monday it had won emergency authorization for its vaccine in Indonesia.

After months of production delays, this is the first authorization for Novavax and its manufacturing partner, the Serum Institute of India. They have also applied for clearance in India and the Philippines, and Novavax has applied on its own to other countries, including Britain and Canada.

In its Monday announcement, Novavax said it would be submitting an application to the U.S. Food and Drug Administration by the end of the year.

In a statement, Stanley C. Erck, Novavax’s president and chief executive, said that the green light from Indonesia “is the first of many authorizations that Novavax expects in the coming weeks and months for our vaccine globally.”

Novavax’s vaccine is fundamentally different from the Covid-19 vaccines now authorized in the United States from Johnson & Johnson, Moderna and Pfizer-BioNTech. It consists of microscopic particles studded with viral proteins, mixed with an immune-boosting compound called an adjuvant.

In clinical trials in the United States and elsewhere, Novavax’s vaccine proved highly effective. But the company has struggled to ramp up its manufacturing and demonstrate the purity of its vaccines to regulators.

As a result, Novavax fell behind other vaccine developers supported by Operation Warp Speed, the Trump administration’s program to expedite Covid vaccines, missing the first wave of vaccinations in the United States. If authorized in the United States, Novavax might potentially serve as a booster for people who have gotten other vaccines as their primary doses.

Since last year, Novavax was also expected to make up a large portion of the vaccines that would be distributed globally. In February, it announced an agreement to supply 1.1 billion doses to Covax, an initiative to deliver vaccines to low and middle-income countries. In September, Covax had to cut its projected delivery of doses in 2021 by a quarter, in part because Novavax had yet to win authorization for its vaccine.

Indonesia initially began vaccinating its citizens with vaccines from China, but a bout of breakthrough infections among health care workers raised concerns that their immunity had waned quickly. The country subsequently made deals to secure doses from Novavax, as well as Pfizer-BioNTech, AstraZeneca and Moderna.

Indonesia has secured 320 million total doses through these deals, including 50 million from Novavax. Once those vaccines are delivered, they will be enough for 160 million people in a country of 237 million.

So far, only 43 percent of people in Indonesia have received at least one dose, while almost 27 percent are fully vaccinated.

Winning authorization in Indonesia will not on its own enable Novavax to live up to its promises to Covax. Covax accepts vaccines that have won authorization from the World Health Organization or a country that it recognizes as having stringent regulations. Indonesia is not on that list.

As cultural institutions come back to life this fall after the long pandemic shutdown, many are trying to lure audiences back with shorter shows, often free of intermissions.

The Metropolitan Opera is taking a different tack.

In an audacious bit of counterprogramming, the Met is currently staging the longest opera in its repertory, Wagner’s nearly six-hour “Die Meistersinger von Nürnberg.” Even in prepandemic times, the work was a herculean undertaking, requiring an army of more than 400 artists and stagehands, breakneck set changes, spirited fight scenes and two 40-minute intermissions.

“We are providing hope for opera lovers,” Peter Gelb, the Met’s general manager, said in an interview. “To be able to put on an opera like ‘Meistersinger’ is a symbol of the Met’s resolve.”

But it is unclear if audiences will turn out for “Meistersinger” and other operas, which tend to be lengthy, at a time when the Delta variant of the coronavirus remains a concern and when audiences must show proof of vaccination wear masks during performances.

The pandemic also added new levels of complexity to presenting the opera, as singers, orchestra players, dancers and stagehands spent long hours preparing to bring it back to the stage. They are all required to wear masks wherever they go at the Met, except onstage. But once onstage, forget about social distancing: “Meistersinger” demands tender embraces, close-quarter brawls and impassioned singing, often within spitting distance of dozens of people.

Wearing masks during early rehearsals was taxing for some singers. “It’s really torture,” said the baritone Michael Volle, who plays the central role of the shoemaker and poet Hans Sachs. “You can’t breathe freely.”

The Met has made safety a priority, requiring coronavirus tests twice a week for all employees and guest artists. Masks and hand sanitizing stations are ubiquitous. Signs posted backstage remind people to report their symptoms if they feel ill.

Buoyed by shortages in labor and supplies that leave employers more vulnerable, and frustrated by what they see as unfair treatment during the pandemic, many American workers are standing up for a better deal.

Data collected by the School of Industrial and Labor Relations at Cornell University shows that the number of workers on strike across the country increased in October to more than 25,000, compared with an average of around 10,000 over the previous three months.

“Labor market leverage and the fact that workers have been through incredibly difficult working conditions over the past year and a half with the pandemic are combining to explain a lot of this labor activism now,” said Johnnie Kallas, a Ph.D. student and the project director of Cornell’s Labor Action Tracker.

Large companies continue to have considerable power, and it is not clear whether the recent job actions point to a new era of widespread strikes.

Still, the fitful economic recovery from the pandemic has eroded management’s advantages. Many employers are having unusual difficulty in filling jobs — this summer, the Labor Department recorded the highest number of job openings since it began keeping such data in 2000. And for some companies, supply-chain disruptions have taken a toll on the bottom line.

Many workers also contend that their employers have failed to share enormous pandemic-era profits with them, even though the workers sometimes risked their lives to make those earnings possible.

Workers say that when companies do offer raises, the increases are often limited and don’t make up for the weakening of benefits that they have endured for years.

Yet for every force pushing workers toward a strike, there are others that push in the other direction, and some unions that were threatening to strike recently have pulled back from the brink.