Meet Eric Adams’s Inner Circle

Ingrid P. Lewis-Martin, deputy Brooklyn borough president

Ms. Lewis-Martin has worked with Mr. Adams for years, including as his chief of staff when he was a state senator, and now as his deputy in Brooklyn Borough Hall. She is regarded in some corners as fiercely protective of that relationship and of her role in Mr. Adams’s world — a dynamic that can at times cause friction, according to some who have dealt with her. But she is seen as having Mr. Adams’s ear and is likely to join his administration.

Katie Moore, campaign manager

Ms. Moore was the political director of the Hotel Trades Council, a powerful union that represents hotel workers and whose endorsement was critical for Mr. Adams. Mr. Adams respects her political savvy and calm demeanor, and she could join him at City Hall.

Frank Carone, prominent lawyer and Adams confidant

Mr. Carone, a longtime counsel to the Brooklyn Democratic Party with a reputation as an old-school power broker, has been an ally of Mr. de Blasio’s. He is politically influential, though some of his dealings over the years have drawn scrutiny. He has been a key donor, adviser and friend to Mr. Adams — Mr. Adams has worked out of office space belonging to Mr. Carone’s firm, an arrangement that Mr. Adams had to account for during the campaign.

Tracey Collins, his longtime partner

A former school principal, Ms. Collins is a high-ranking official at the city’s Department of Education. Ms. Collins, who co-owns an apartment in Fort Lee, N.J., with Mr. Adams, has not appeared with him on the campaign trail and is unlikely to join him at Gracie Mansion if he is elected. But she is his most important adviser on schools, and Mr. Adams published a book last year about their plant-based diet.

Jordan Coleman, his son

Mr. Adams is close with his 25-year-old son. Mr. Coleman has lived at times with his father in Brooklyn, where he studied for a master’s degree at Brooklyn College. Mr. Adams asks his son for advice about what is important to younger New Yorkers.

Vito R. Pitta, lawyer and lobbyist

Mr. Pitta, a lawyer for the Adams campaign, is a partner at the law firm Pitta LLP and works for a lobbying firm that has lobbied Mr. Adams on behalf of clients — an arrangement that has been criticized by government watchdogs.

Matthew Rey, political strategist

A partner at Red Horse Strategies with roots in New York politics, Mr. Rey advised Mr. Adams and was well regarded — even by rival campaigns — as a numbers expert, with a background in political targeting and strategy.

AstraZenecas weekly-once diabetes drug gets U.S. approval for children – Reuters

July 23 (Reuters) – AstraZeneca Plc (AZN.L) said on Friday its diabetes drug Bydureon was approved in the United States for use in patients as young as age 10 to help reduce blood sugar levels along with diet and exercise.

The drug, chemically called exenatide, is an injectable suspension taken once a week for 10-to 18-year olds who have type-2 diabetes, the most common form of the condition where the body does not produce enough of the sugar-checking hormone, insulin.

Reporting by Pushkala Aripaka in Bengaluru; Editing by Bernard Orr

Our Standards: The Thomson Reuters Trust Principles.

Covid: The Mexican villages refusing to vaccinate

Coquilteel is one of millions of small, rural communities around the world where this is sorely lacking. For now, all Pascuala can do is keep trying to convince people to get vaccinated and she’s focusing her efforts on those who leave the village, like truck drivers. But until everyone is vaccinated, she can only put her trust in other powers.

Organisers warn participants against eating out over COVID-19 risks – Reuters

Police officers patrol outside the National Stadium, the main venue of Tokyo 2020 Olympics and Paralympics in Tokyo, Japan, July 19, 2021. REUTERS/Naoki Ogura

TOKYO, July 19 (Reuters) – Organisers of the Tokyo Olympics have warned accredited participants against visiting restaurants that open after 8 p.m. or serve alcohol, citing a “grave reputational risk”, according to the note they sent out.

Japan has declared a state of emergency for Tokyo that will run through its hosting of the Olympics. Public concern has grown that staging an event with tens of thousands of overseas athletes, officials and journalists could accelerate infection rates in Japan’s capital and introduce variants that are more infectious or deadlier.

Japanese media reported cases where those accredited for the Games were seen drinking in Tokyo’s downtown areas or violating quarantines.

“These incidents have also been raised in the National Diet, and have the potential to severely damage the reputation of the Tokyo 2020 Games and your organisations,” the organisers said, referring to the recent media reports in Japan.

The organisers told the attendees to “not visit restaurants that are open after 20:00 or that serve alcohol.”

“Even after your first 14 days in Japan, this will be perceived as visiting a business that operates illegally and could constitute a grave reputational risk to yourself, your organisation, and the Tokyo 2020 Games,” said the note sent to COVID-19 liaison officers responsible for ensuring the participants follow the protocols.

Spectators have been barred from almost all events and infections have hit a number of teams arriving in Japan less than a week ahead of the July 23 opening ceremony. read more

Reporting by Ju-min Park and Antoni Slodkowski; Editing by Hugh Lawson

Our Standards: The Thomson Reuters Trust Principles.

No Need for Speed at Grants Pass Downs in Oregon

Scriver, however, has a dream.

“I want to go to Kentucky and ride,” she said. “I want to ride at Churchill Downs — even a small race.”

Scriver has been atop a horse since learning to walk — as a little girl in 4H in Curlew, Wash., and barrel racing at rodeos as an adolescent. When she was 13, she asked a friend of her father’s, who owned thoroughbreds, to teach her to gallop.

“I wanted to go fast,” she said.

By 16, she was galloping horses for $12 a ride in the mornings and playing high school volleyball and softball in the afternoons. She got her jockey license at 18, winning for the first time in her 11th start aboard Bobbygenesjustice on Aug. 10, 2019, at the Tillamook County Fair.

She has had about 500 starts since then, has won 77 of them and finished in the money in nearly half to earn more than $590,000 in purse money. She won the riding title here in the fall and held her own over the winter against more experienced competition at Turf Paradise in Arizona.

Scriver keeps up a steady diet of galloping horses in the morning. She has to — those $12 spins add up. But trainers at bigger tracks such as Emerald Downs near Seattle have noticed her, and she is starting to get two, three, up to six mounts a day there.

“All the girls here can ride, but Joree has the drive to match her talent,” said Smith, who gives Scriver first call on her horses. “She can go as far as she wants.”

Grants Pass Downs has long been Boersma’s refuge from the world. He followed his father here as a boy, prowling the grandstand for winning tickets mistakenly thrown away, then using the proceeds to pick winners.

Brazils Bolsonaro could be discharged in next few days – hospital – Reuters

Brazil’s President Jair Bolsonaro speaks during a ceremony to sign a law for the privatization of state-controlled electricity utility Eletrobras, at the Planalto Palace in Brasilia, Brazil, July 13, 2021. REUTERS/Adriano Machado/File Photo

BRASILIA, July 17 (Reuters) – Brazilian President Jair Bolsonaro, undergoing hospital treatment for complications following a near-fatal 2018 stabbing, is making satisfactory progress and may be discharged within days, the Vila Nova Star hospital said on Saturday.

Bolsonaro will be offered a diet of soups and purees on Saturday, and assuming he shows no negative reaction, he could be discharged in the next few days, the hospital said in a statement.

Bolsonaro, 66, has been in the Sao Paulo hospital since Wednesday for treatment relating to an obstructed intestine following the 2018 knifing.

In a live online event on Saturday to mark the opening of a Caixa Economica bank branch in the northern state of Ceará, Bolsonaro said he is feeling fine and itching to get back to work.

“I’m fine, thank God. The problem I had earlier this week was still due to the stab wound I received in 2018 … from time to time it affects the gut,” Bolsonaro said in the live event, explaining that he will not undergo surgery.

“I can’t wait to get back to work, see friends, and really get Brazil moving,” he added.

Reporting by Alexandre Caverni and Jamie McGeever; editing by Diane Craft

Our Standards: The Thomson Reuters Trust Principles.

Brazils Bolsonaro recovering after second night in hospital – Reuters

Brazil’s President Jair Bolsonaro speaks during a ceremony to sign a law for the privatization of state-controlled electricity utility Eletrobras, at the Planalto Palace in Brasilia, Brazil, July 13, 2021. REUTERS/Adriano Machado

SAO PAULO, July 16 (Reuters) – Brazilian President Jair Bolsonaro spent a second night in hospital, being treated for an intestinal blockage linked to a stabbing in 2018, with his condition improving and surgery less likely.

On Thursday evening the president’s doctors said in a statement that they had removed a gastric catheter from Bolsonaro and that he would begin eating again on Friday.

They said they still had no forecast for when he would leave the hospital. That contradicted comments the president made in an earlier interview with Rede TV network, in which he said he might leave on Friday.

In his first spoken comments since going into hospital on Wednesday morning in the capital Brasilia, after days of chronic hiccups, Bolsonaro also told Rede TV that he would probably not need to go undergo surgery.

“I arrived here yesterday with a very strong chance of surgery, but surgery is now far less likely,” he said.

O Globo newspaper columnist Lauro Jardim wrote on Friday that Bolsonaro had passed the night well and would now begin a liquid diet.

Bolsonaro has faced several health issues during his presidency, mainly stemming from longterm complications after he suffered a perforated intestine when he was stabbed on the campaign trail in 2018. He was also ill with COVID-19 last year.

Bolsonaro is in a weak political moment as the Senate probes a corruption scandal over the purchase of coronavirus vaccines and he faces criticism over his handling of the pandemic. COVID-19 has killed nearly 540,000 people in Brazil – the world’s second highest death toll behind the United States.

Reporting by Marcelo Rochabrun
Editing by Stephen Eisenhammer and Frances Kerry

Our Standards: The Thomson Reuters Trust Principles.

Backed by $5M led by General Catalyst, Evvy launches a vaginal microbiome test to support women’s health research

Another US femtech startup has joined the race to build up data-sets to support research into and understanding of a range of health issues that can affect women.

Evvy has today launched an at-home test kit for the vaginal microbiome. The user returns their swab to the startup for analysis — and gets detailed information and analysis of the microbes (fungi and bacteria) that are present in their vagina and may be associated with a variety of health concerns.

Users of the test also get personalized suggestions for things they could try (such as diet and lifestyle changes) to improve the balance of microbes — potentially helping with related heath issues they may be suffering from, like yeast infections or BV.

Variances in the microbes present in an individual’s vaginal microbiome are thought to have broad implications for women’s health — playing a role in relatively minor infections (like thrush) but Evvy also flags research linking imbalances in the vaginal microbiome to more serious issues like infertility or pre-term birth, or even linkages to the progression of cervical cancer.

Decoding the vaginal microbiome is thus seen as an opportunity to support a broad range of women’s health goals.

“We give users back a full understanding of everything that’s present. So here are all of the bacteria and fungi and importantly what is the relative amount of each of those bacteria,” explains CEO and co-founder Priyanka Jain, noting that users also get their test data in a downloadable format so they can take the information to their healthcare provider if they wish.

“There are certain bacteria that play really important roles in the vagina, either positive or negative, and understanding if that’s 90% of your vagina vs 5% makes a big difference… For every single microbe that we show to a woman we also fully explain what that microbe is, what the scientific understanding of it is today, how it might contribute to symptoms, how it might be behaving with other microbes that exist in your vagina — as well as if research has shown that it’s related to any health outcomes that you might care about.”

“We also give every woman a full personalized plan — that includes ways to help reduce any type of disruptive bacteria, ways to promote their protective bacteria and ways to overall maintain their vaginal health based on their personal life experiences,” she adds.

As with many such femtech startups, Evvy is targeting the women’s health data gap. This refers to how women can have a relatively poor experience of traditional healthcare, perhaps especially when seeking help or support with conditions related to female biology, because of historic under-representation of women in medical research — which means female health conditions tend to be less well researched and understood vs conditions affecting biological men.

Even relatively common conditions which can affect the vagina — such as a simple yeast infection — can be frustratingly difficult to connect to individual triggers. And while over-the-counter treatments do work, some women report recurrent infections — and may benefit from a better understanding of why the infections may be occurring in the first place.

The problem of less research into women’s health issues does also mean that femtech startups can have a lot of ground to cover to live up to enticing pitches of ‘demystifying’ the female body, as Evvy couches it. In its case, a key challenge is clearly analyzing the vaginal microbiome data it gets from users and turning it into useful recommendations for each person — without overpromising, given there may be relatively little research to back up possible links to wider health conditions.

Evvy says it tackles this challenge by signposting the level of research associated with each of the personalized suggestions it offers.

“I always say treat women like they’re smart,” says Jain. “What we actually do on each of our recommendations is we rate them. So they’re either rated as ‘novel’, ’emerging’ or ‘established’. And we show the women this is the research that exists on this type of treatment [and how relevant it might be to them personally — based on] if it was done on people that resemble you enough that you are actually interested in what the results are.

“Our goal is to highlight everything that’s out there. Because women are… looking for answers everywhere — and you see this kind of amazing crowdsourcing of knowledge, of people trying to figure out what might work for them — and our goal is to say, from a scientific perspective, this is everything that has been studied and we are actually just transparent about how well researched each of those things are.”

Jain says wider research-related goals include trying to identify biomarkers with suspected links to a swathe of serious female health issues — such as infertility, preterm birth, STI acquisition and cervical cancer progression.

Although it’s important to note that Evvy’s commercial offering comes with a disclaimer that it’s not providing medical advice — and is only selling a “wellness” test for now. This is because the service is not a regulated medical device. Hence Evvy specifies it’s only providing customers with “information” about their vaginal microbiome (although the co-founders told us they may consider applying for FDA clearance in the future).

The gap in knowledge around female health issues has led to a proliferation of ‘wellness’ claims and products targeted at women — some of which are, unfortunately, peddling what amounts to ‘snake oil’; i.e. selling products that lack rigorous scientific research to underpin a fuzzy range of ‘holistic benefits’ suggested by the associated marketing (crystal-healing yoni eggs, anyone?).

Being in the unregulated ‘wellness’ category therefore has risks for any femtech startup. But Evvy also sees an opportunity to cut through some of the noise and dubious claims by arming women with robust data on what’s going on in their bodies and connecting them with genuine scientific expertise that can help them interpret it.

Education is a key goal for the startup, per CMO Laine Bruzek.

“How can we bring the scientific community, care providers and women together in the same place to get their questions answered quickly and with the best scientific information… Education is just such an important goal for us because there’s not a lot of great information that exists on the Internet,” she says.

“Not just about your vaginal microbiome — which is sort of a new and emerging space — but just vaginal health in general. There’s so much misinformation, there’s so much snake oil that people are selling. So we want to make sure that we have, not just a chance to bring the women together, but that we give them access to people who are pushing the bounds of vaginal health research so that they can get the best information when they need it.”

Evvy’s approach — which includes bringing in OBGYNs and experts in gynecology & reproductive health as advisors (although the founders themselves have data science and product design backgrounds) — has attracted some top-tier investors: Today it’s announcing a $5 million seed round led by General Catalyst which will see the fund’s Margo Georgiadis (formerly the CEO of join the board.

Commenting in a statement, Georgiadis said: “Evvy is breaking boundaries to advance women’s health with more affordable and comprehensive testing starting with its vaginal microbiome metagenomics test. The team has bold plans to enable greater early detection, improved treatment, and enhanced therapeutics using new female-specific biomarkers.”

“There is a huge opportunity to build new datasets that will transform our understanding of these conditions in the female body, and I truly believe that Evvy’s unique platform combined with the development of new therapeutics will catalyze a new era in women’s health,” added Dr. Craig Cohen, professor of obstetrics, gynecology & reproductive sciences at UCSF and advisor to Evvy in another supporting statement.

Evvy is not the first startup to sell a home testing kit for the vaginal microbiome, targeting women who may be suffering from conditions related to microbial imbalances, or — well — just women who want to learn more about their own bodies.

Juno Bio, for example, launched an at-home test kit last year.

But Evvy is using a technique — called metagenomic sequencing — which the founders say is able to capture more data than other commercial tests, or the typical tests a woman is able to obtain via a doctor’s office (where scans may only look for a few specific pathogens). So the pitch is the approach provides a higher fidelity view of what’s going on inside a woman’s vagina.

“A lot of the work that we’ve done is specifically incorporating what’s called metagenomic sequencing into the analysis of the vaginal microbiome,” explains Jain. “When you go to the doctor’s office the type of test that they can run is what’s called a PCR test — essentially they take a sample and they look for a specific pathogen within that sample. So oftentimes when you go to the doctor you’ll get a PCR test that looks for one to three different individuals pathogens.

“Since then there have been a few iterations of improvements on that done by other companies. Some are not using what’s called 16-S sequencing — which is a form of amplicon sequencing — which is definitely a large step up from PCR but the downside is it’s only able to look at certain variable regions of the genome. And you actually have to pre-define what you’re looking for. So it’s much harder to do discovery and you’re not able to find all bacteria and fungi that are present. Because 16-S actually can’t detect fungi at all so you have to separately test for it — which means you can’t understand their relative relationships.

“So our test is really the first time anyone is using metagenomics at scale to better understand the vaginal microbiome; both for individual woman and the healthcare system as a whole… In the same way that 16-S was an improvement on PCR, metagenomics is just an improvement on 16-S; it allows us to understand everything that’s possibly present across all bacteria and fungi.”

Per Jain, the service is the only commercially available vaginal microbiome test that’s able to use metagenomics.

A key part of Evvy’s work as a startup is then the analysis of this higher dimension data it’s capturing — to map different microbes to potential health outcomes (based on its analysis of existing research) — and understand how to interpret individual findings and offer relevant and actionable information to each user.

“A lot of our work has been on the data analysis part,” confirms Jain. “So when you do metagenomics sequencing you get much, much higher fidelity data back — and we had to build out everything from, we co-developed an amazing bioinformatics pipeline that is able to analyze that type of data and understand which bacteria and fungi they are. And then actually mapped out for each of those bacteria and fungi how are they related to the vaginal microbiome? What type of symptoms might they cause, and also what type of health implications might they be related to.

“Lastly we’ve done a tonne of work with our science advisory board around putting together personalized recommendations that take into account — not only the microbial data that we get from the test — but also someone’s health history and their symptoms, and if what stage of menopause they’re in, or all of this other information so that we can actually make this information actionable for the women.”

Once data from paying users starts to flow the idea is also to support a range of Evvy’s own research initiatives and partnerships (on the latter, specific details are being kept under wraps for now) — all aimed at furthering knowledge of women’s health and supporting what they hope will be more products in future.

“There’s been so much research done showing that the vaginal microbiome is for example related to pre-term birth,” says Jain. “When you look at women who deliver early or pre-term, they tend to have very different vaginal microbiomes than women who don’t. But a lot of the sequencing that’s been done in that space has been using things like 16-S — and our goal is to bring a much higher level of fidelity. And so, more specifically, we can look at the strain level of bacteria — whereas 16-S and other forms of sequencing can only get you to the species level. And when we’re looking at something as complex as pre-term birth, cervical cancer progression and STI acquisition it’s not just what’s there — but it’s getting to the very, very high fidelity information of specifically what strains are there. So that we can actually start to discover what are the biomarkers that might be leading to differences between people who deliver pre-term and people who don’t.”

“The other value of metagenomic sequencing is it gives us functional profiling,” she adds. “Which helps us not only understand who’s there but also what they might be doing — and all of that information together is more likely able to help us better understand these complex conditions that research has shown is related but no-one’s been able to figure out exactly how.”

While the overarching goal is that data from users’ vaginal swab samples will support research into a range of women’s health issues, Evvy’s users are also paying for a commercial service to get their individual analysis — so what can they expect?

The at-home swab test kit is being priced at $129 for one test kit — which delivers them with a personalized analysis after two weeks.

Evvy is also offering a membership rate for users who want to be able to carry out multiple tests — to be able to track changes to their vaginal microbiome — and for those users tests will cost $99 each (with the user able to take a test every three months).

As they launch the service across the US’ 20 states, Evvy’s co-founders say they’re hoping “thousands” of women will sign up to quantify their vaginal microbiome and support the wider goal of backing research into female health.

“Why is it that looking at the bacteria in the vaginal microbiome is 94% accurate in predicting whether or not a cycle of IVF works?” asks Jain. “Why is it that women who give birth pre-term have a differing vaginal microbiome than people who don’t? Or the whole cervical cancer progression, STI acquisition, pelvic inflammatory disease.

“There’s so many conditions that seem to be — either the vaginal microbiome is an interesting diagnostic opportunity [or] there’s even some very early research showing that women who have PCOS [polycystic ovary syndrome] or endometriosis have varying markers in their vaginal microbiome from women who don’t have those conditions — so everything from helping to detect disease to helping diagnose things, to helping predict risk for so many of these conditions that often we don’t catch for too long.

“Also thinking about treatment as well — something like IVF success or pre-term birth — if we’re able to identify risk earlier can we actually come up with interventions that are personalized to that individual person so that we’re able to avoid that negative outcome in the long term?”

Nutro pet food maker must face suit over limited ingredients – Reuters

Pet food is seen for sale in a supermarket at The Mall of Cyprus in Nicosia, Cyprus, December 7, 2017. REUTERS/Peter Cziborra

  • Judge allows claims under Illinois law to proceed
  • Plaintiffs say food contained chicken, soy, wheat

The company and law firm names shown above are generated automatically based on the text of the article. We are improving this feature as we continue to test and develop in beta. We welcome feedback, which you can provide using the feedback tab on the right of the page.

(Reuters) – Mars Inc’s pet food unit must face a proposed class action accusing it of misleading consumers about the contents of its “limited ingredient” Nutro dog foods, a federal judge has ruled.

U.S. District Judge Manish Shah in Chicago on Monday denied Mars Petcare U.S. Inc’s motion to dismiss claims brought by Illinois residents under Illinois state law, though he dismissed claims brought by residents of other states for lack of jurisdiction.

Mars Petcare, its attorney Brett Doran of Greenberg Traurig and plaintiffs’ attorney Greg Coleman of Milberg Coleman Bryson Phillips Grossman did not immediately respond to requests for comment.

The lawsuit, filed last year, concerns Mars Petcare’s Nutro Limited Ingredient Diet products. Limited ingredient pet foods are often recommended by veterinarians and chosen by pet owners for their perceived health benefits for pets. Mars is a major player in the pet food market, and their other brands include Whiskas, Pedigree and Royal Canin.

The plaintiffs, who sought to represent a class of consumers who bought six Mars Petcare products, were six dog owners, three of whom bought Nutro dog food in Illinois, two in South Carolina and one in Wisconsin.

According to the lawsuit, the Nutro food was marketed as having 10 or fewer “key ingredients” per bag, and containing no chicken, wheat or soy. However, they allege that genetic testing revealed more than trace amounts of chicken, wheat and soy in the products they purchased.

The plaintiffs brought claims for breach of warranty, unjust enrichment and violation of their states’ consumer protection laws.

Mars Petcare moved to dismiss on various grounds, including lack of personal jurisdiction as to the non-Illinois claims. It also sought to dismiss claims relating to two of the six products in the lawsuit on the grounds that none of the plaintiffs had bought them.

Shah agreed Monday that the claims related to products that the named plaintiffs had not actually bought must be dismissed for lack of standing. He also said that claims for future injunctive relief, as opposed to monetary damages, must be dismissed because the plaintiffs have not shown likelihood of future harm, since they allege they now know the products to be defective.

The judge also found that the purchases outside of Illinois lacked a sufficient connection to the district and must be dismissed.

The Illinois plaintiffs conceded their warranty claims because they failed to give Mars Petcare pre-suit notice and opportunity to cure, according to the opinion.

However, Shah rejected Mars Petcare’s argument that the plaintiffs’ remaining claims of unjust enrichment and violation of the Illinois Consumer Fraud and Deceptive Business Practices Act simply restated their warranty claims.

“Because plaintiffs allege that they paid a premium as compared to other dog foods that were available to them, and that the defendant’s dog food was defective, the complaint alleges actual damages,” he wrote.

The case is Bakopoulos v. Mars Petcare U.S. Inc, U.S. District Court, No. 20-cv-06841.

For plaintiffs: Greg Coleman of Milberg Coleman Bryson Phillips Grossman

For Mars Petcare: Brett Doran of Greenberg Traurig

Brendan Pierson reports on product liability litigation and on all areas of health care law. He can be reached at

Short on vaccines, Asia grapples with Delta-driven outbreaks.

Graveyard workers taking a rest from burying coronavirus victims at a cemetery in Surabaya, Indonesia, on Friday.
Credit…Juni Kriswanto/Agence France-Presse — Getty Images

In recent days, Indonesia has reported nearly twice as many coronavirus cases as the United States. Malaysia’s per capita caseload is roughly on par with those of Brazil and Iran. And the latest Covid surges in Japan and South Korea have prompted harsh new restrictions on movement there, effective Monday.

Across the Asia-Pacific region, the Delta variant is driving new outbreaks in places where transmission was once kept relatively low, but where the pace of vaccination has been too slow to contain the latest outbreaks. One result is that everyday activities are again being restricted, just as they were in the anxious, early days of the pandemic — even as the West edges back to normalcy.

Indonesia, the world’s fourth most populous country, is a case in point. Its government once hoped that its archipelagic geography and youthful population would spare it a debilitating outbreak. But only about 13 percent of its 270 million people have received at least one dose of a Covid-19 vaccine, and the rise of Delta is pushing its health system to the brink and forcing some patients to hunt for oxygen.

On July 3, the government closed mosques, schools, shopping malls and sports facilities on two of Indonesia’s major islands for two weeks. But the daily average of new cases — more than 33,000 as of Sunday — has continued to climb. Officials said on Friday that they would extend the same emergency rules to other islands.

Intensive care wards in and around the capital, Jakarta, have been operating at full capacity, and doctors who received the vaccine made by the Chinese company Sinovac have been falling ill or dying. The government has said it will administer a third dose, of the Moderna vaccine, to about 1.5 million health workers starting this week.

In other Southeast Asian countries, too, the percentages of populations that have gotten even one shot are in the single or low double digits. And as variant-driven infections proliferate, some are seeing their worst outbreaks yet.

In Myanmar, where health workers have been striking to protest the military’s February coup, cases are sharply rising and schools have been closed until July 23. People in several Malaysian cities are chafing under strict lockdowns as the country reports the region’s highest per capita caseload. Vietnam is restricting movement in its two major cities and scrambling to import vaccines. And a terminal at Thailand’s largest international airport is being converted into a field hospital.

Richer countries in the region have more resources to throw at the virus. But they, too, are vulnerable because they have made little progress in their vaccination drives. In Australia, Japan, New Zealand and South Korea, less than one person in three has had a shot, according to a New York Times tracker.

New South Wales, Australia’s most populous state, reported its largest daily increase in cases this year on Sunday, as well as Australia’s first coronavirus-related death this year, a woman in her 90s. Sydney, the state capital, has already been under a stay-at-home lockdown, and the authorities have warned that it could be extended past July 17, when it is set to expire.

South Korea reported 1,378 new cases on Saturday, its third consecutive daily record. The government plans to raise restrictions to the highest level in Seoul, the capital, and some neighboring regions as of Monday. Schools will be closed, bars and nightclubs will be shut, and no more than two people will be allowed to meet in public after 6 p.m.

And in Japan, Tokyo’s fourth state of emergency will take effect on Monday, less than two weeks before the Summer Olympics begin there. Restaurants, department stores and other businesses will be asked to close early, and organizers of the Summer Games have said they will bar spectators from most events in Tokyo and its surrounding areas. A ceremony marking the Olympic torch’s arrival in the city late last week was held in a nearly empty park.

On Saturday, Fukushima Prefecture said that it would also ban spectators from Olympic events because of the surging caseload, reversing a position announced two days earlier by Olympic organizers.

People, mostly residents of Iran, waited in line to receive Covid-19 vaccines in Yerevan, Armenia, on Friday. Armenia’s offer of free vaccines to any foreign visitor has drawn many people from neighboring countries.
Credit…Lusi Sargsyan/PHOTOLURE, via Associated Press

Thousands of Iranians frustrated with the government’s chaotic vaccine rollout and desperate for protection after enduring wave after wave of the coronavirus are flocking by air and land to neighboring Armenia to be vaccinated against Covid-19.

Iran is enduring a fifth wave of the pandemic, with Tehran and 143 cities declared high-risk “red” zones and the highly contagious Delta variant of the virus spreading quickly. Over the past two weeks, Iran’s average daily caseload has risen by 62 percent, to more than 16,000, according to a New York Times database.

Only about 2 percent of Iran’s 84 million people been fully vaccinated, according to the Our World in Data project at the University of Oxford. With U.S.- and British-made vaccines banned by Ayatollah Ali Khamenei, Iran’s top leader, the country is waiting for shipments of vaccines made by China and Russia.

Across the border in Armenia, a country of three million, there are more vaccine doses than people willing to take them, largely because of widespread conspiracy theories and misinformation. Officials there announced in May that they would provide free vaccines to foreigners without registration. Mobile clinics were set up in the streets to make them easily accessible to tourists and visitors. Iranians don’t need a visa to travel to Armenia, and the drive from the border to the capital, Yerevan, is about seven hours.

Based on Iran’s vaccine eligibility chart, Parvin Chamanpira, 53, and her husband calculated that it would be months before they qualified, so they traveled from Tehran to Yerevan last week and received their shots from an ambulance parked on the side of the road. She said it took about five minutes, requiring only a blood pressure check and no paperwork. They will return in a few weeks for their second shots.

“This is not an ideal choice for Iranians to be forced to travel and spend a lot of money and be stressed out for getting a vaccine,” Ms. Chamanpira said. “We would not do it if we didn’t have to.”

Armenian officials have not said how many foreign nationals have received vaccinations, but the number of flights between Tehran and Yerevan has been increased to meet the demand. Tickets are sold out until late August, travel agents said. Bus tours centered around vaccinations are also booked. Some Iranians are chartering their own buses and vans or driving their own cars across the border, according to several people organizing the trips.

In a social media group dedicated to planning vaccination trips to Armenia, Iranians at the border posted videos on Friday showing lines of cars and people stretching for miles, saying the wait was at least 13 hours.

Among ordinary Iranians and medical workers facing the surge in cases, anger at the government is mounting. Some prominent physicians have called for the health minister to be prosecuted for his mishandling of the pandemic and the vaccine rollout.

“Our only weapon is immediate and fast vaccination of the public,” Dr. Saeedreza Mehrpour, the head of Shariati Hospital in Tehran, said on his Instagram page on Thursday, criticizing the country’s leaders for putting defiant ideology over public health. “I wish we had better relations with the worlds.”

President Hassan Rouhani said this month that Iran would expand its vaccine distribution effort in the coming weeks by importing more foreign vaccines and producing domestic ones. So far it has received more than 2.1 million doses of the AstraZeneca vaccine through Covax, the global vaccine-sharing program.

In the meantime, Iranians seeking vaccination have been largely left on their own, including those in higher-risk groups. Fahimeh Hosseini, 72, a retired banker, said she recently waited for four hours with dozens of other older people outside a clinic in Tehran for a second dose of the vaccine, only to be told there were no more. The clinic told them appointments for a second dose could not be scheduled because there was no predicting when the vaccine would be in stock.

“They told us to keep coming back until you get lucky,” she said.

The lack of vaccines has led some Iranians to turn to the black market. One 37-year-old manager of a trade company, who declined to use his name because he had acted illegally, said he was told he was buying the AstraZeneca vaccine but had no way to know if that was true.

Iran’s intelligence ministry announced this week that it had made arrests among several networks illegally selling and distributing Covid vaccines.

Emily Robart, a clinical research coordinator at the University of Ohio, demonstrated the Covid-19 breathalyzer test that is currently under review by the F.D.A.
Credit…Maddie McGarvey for The New York Times

Scientists have long been interested in creating portable devices that can quickly and painlessly screen a person for disease simply by taking a whiff of their breath. But delivering on this dream has proved to be a challenge. Different diseases may cause similar breath changes. Diet can affect the chemicals someone exhales, as can smoking and alcohol consumption, potentially complicating disease detection.

Still, scientists say, advances in sensor technology and machine learning, combined with new research and investment spurred by the pandemic, mean that the moment for disease-detecting breathalyzers may have finally arrived.

“I’ve been working in the area of breath research for almost 20 years now,” said Cristina Davis, an engineer at the University of California, Davis. “And during that time, we’ve seen it progress from a nascent stage to really being something that I think is close to being deployed.”

In May, when musicians from dozens of countries descended on Rotterdam, the Netherlands, for the Eurovision Song Contest, they had to pass a breath test before they were allowed onstage. The musicians were asked to exhale into a device the size of a water bottle called the SpiroNose, which analyzed the chemical compounds in their breath to detect signatures of a coronavirus infection. If the results came back negative, the performers were cleared to compete.

The SpiroNose, made by the Dutch company Breathomix, is just one of many breath-based coronavirus tests under development across the world. In May, Singapore’s health agency granted provisional authorization to two such tests, made by the domestic companies Breathonix and Silver Factory Technology. And researchers at Ohio State University say they have applied to the U.S. Food and Drug Administration for an emergency authorization of their coronavirus breathalyzer.

“It’s clear now, I think, that you can detect this disease with a breath test,” said Paul Thomas, a chemist at Loughborough University in England. “This isn’t science fiction.”


Auckland, New Zealand, in June. The country, which closed its borders early in the pandemic, has all but eliminated the coronavirus.
Credit…Sylvie Whinray/New Zealand Herald, via Associated Press

Strict lockdowns in New Zealand last year appear to have contributed to a recent outbreak in children of respiratory syncytial virus, or R.S.V., a highly contagious, flulike illness whose symptoms include a runny nose, coughing, sneezing and fever.

Children in New Zealand were mostly stuck indoors amid lockdowns last autumn, which runs from March to May in the Southern Hemisphere. After the country reopened last winter, health officials say, few of them contracted seasonal viruses and infections, probably because they had been underexposed to germs.

In a typical year, New Zealand sees a peak of cases of respiratory infections from June to September. But in 2020, the country experienced “the complete absence of an annual winter influenza epidemic,” with a 99.9 percent reduction in flu cases and a 98 percent reduction in R.S.V., according to a study published in Nature in February.

This year, however, the same children have been more vulnerable than usual to those same ailments.

Since the start of winter five weeks ago, during which there have been no coronavirus restrictions, children’s wards in New Zealand have seen dozens of patients, many of them infants, battling the sometimes deadly disease, while some elementary schools have reported having as many as half their students absent because of respiratory illnesses.

The country has reported 969 cases of R.S.V. in five weeks, compared with an average of 1,743 cases over the entire 29-week winter season in the five years before the pandemic, according to New Zealand’s Institute of Environmental Science and Research.

The recent surge has yet to reach a plateau, said Dr. Sue Huang, a virologist at the Institute of Environmental Science and Research and the lead author of the Nature study.

“The exponential increase is very sharp,” she said in a statement. “The absence of R.S.V. last winter meant there is a young cohort of children from last year, plus a new cohort this year, who have not been exposed to the seasonal virus.”

Doctors around the world have warned of the risk of “immunity debt,” when a decline in the number of viral and bacterial infections during lockdowns is followed by more sickness once restrictions are lifted.

In a paper published in May in the journal Infectious Diseases Now, a team of French medical researchers suggested that less exposure to microbial agents could create a lack of “immune stimulation” for susceptible people, particularly in children. “The longer these periods of ‘viral or bacterial low-exposure’ are, the greater the likelihood of future epidemics,” they wrote.

New Zealand closed its borders early in the pandemic, unveiling stringent lockdown measures that were lifted last April and May and have allowed the country to all but eliminate coronavirus transmission. No community cases have been reported for more than four months.

In other developments around the world:

  • Spain is facing a further hit to its summer tourism season after Germany classified the entire country as a “risk area.” As of Sunday, travelers entering Germany from anywhere in Spain, including its Balearic and Canary archipelagoes, will have to provide a negative coronavirus test or proof of vaccination or recovery to avoid quarantine. The Italian government also warned on Saturday that it was considering greater restrictions on travelers from Spain as well as Portugal. Both countries have been grappling with a surge in coronavirus cases fueled by the highly contagious Delta variant, particularly among unvaccinated young people.