Virus Tightens Its Grip on Texas

Texas hospitals are overrun with patients, though the U.S. overall is making gains in flattening its curve. As Biden and Harris were sworn at the Capitol, masks were the order of the day.

Biden and Harris take office in a pandemic inauguration with few events, fewer people than typically, and many masks.

Doctors in Peru stage a hunger strike over the government’s pandemic response.

Much of Texas remains overrun by the virus, threatening U.S. progress.

Zimbabwe’s foreign minister dies from Covid-19.

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India delivers vaccine to its neighbors, and other news from around the world.

Leaders of a doctors’ union in Peru went on a hunger strike Tuesday to protest what they called the national authorities’ “shameless lack of preparation” for a second wave of coronavirus infections that has quickly overwhelmed the country’s hospitals, with reports of patients dying for lack of available ventilators.

As countries across Latin America gird themselves for a new round with the virus, the Peruvian union, made up of 12,000 doctors in the state-run EsSalud health care network, said that public hospitals were faced with the same problems that stymied their efforts early in the pandemic.

Once again, they are said, they are being asked to face a surge of Covid-19 patients without sufficient personal protective equipment, medical supplies or support staff. The union called for the chief executive of EsSalud, Fiorella Molinelli, who is under investigation for corruption, to be replaced.

Teodoro Quiñones, the secretary general of the union, said that instead of hiring more medical workers during the relative calm after the first wave of infections, EsSalud dismissed Covid specialists, and failed to hire them back when case counts started climbing in December. Now, he said, many hospitals lack both the ventilators that patients need and the staff to intubate the patients.

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“We’re working with a deficit of 6,000 specialist doctors, at least 1,500 intensive-care physicians, and 6,000 to 8,000 intensive-care nurses,” Dr. Quiñones said.

Dr. Quiñones began the hunger strike along with a half-dozen other union leaders at a demonstration on Tuesday outside the labor ministry in Lima, the capital. The strikers said they would refuse to eat until their demands were met.

EsSalud did not immediately respond to a request for comment.

Peru is not the only South American country to be battered by the second wave.

The virus took a heavy toll on the region from May to August, and now coronavirus cases are surging once again in many countries, leading to widespread concern.

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In Colombia, new cases have climbed to about 15,000 a day, twice the pre-Christmas number, and intensive care units are at or near 100 percent capacity. And widespread vaccination appears to be many months away in Colombia.

But Bogotá, the capital, like other major cities across South America, has not returned to a full lockdown, instead opting for a more flexible quarantine, with only some neighborhoods shuttered, and an 8 p.m. curfew in place.

Many doctors in Peru say the second wave of infections appears to be hitting the country as hard or harder than the first wave, when the country recorded one of the highest death tolls in the world relative to its population. Hospitals are overflowing, and intensive-care beds are scarce.

“In my hospital, for example, we have 20 patients on a waiting list and only have 11 I.C.U. beds,” said Dr. Manuel Vásquez, an EsSalud doctor from the Ica region who joined the protest in Lima. “You hear of the same phenomena in every hospital.”

The country’s interim president, Francisco Sagasti, acknowledged the new wave last week, but he said he would not impose a new lockdown except as “an extreme option,” because of the impact on employment.

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Peru lags far behind its peers in securing vaccines for its population of 32 million. It announced a deal for one million doses from the Chinese company Sinopharm, but it does not yet have a delivery date.

Some officials expressed hope that antibodies carried by the large number of people who were infected in the first wave — nearly 40 percent of the population in Lima and up to 70 percent in some other cities, according to the government — might help contain a second surge. But the virus is spreading fast now, Dr. Vasquez said, and the patients needing hospitalization tend to be younger and in worse condition than before.

“And this is just the beginning,” he said.

The persistently rapid spread of the coronavirus in Texas, the second most populous state in the U.S., is threatening the gradual progress the country has been making toward flattening the curve of new cases.

Counties along the Mexican border in particular have seen steep spikes. The city of Laredo sent residents an emergency cellphone alert over the weekend — the second in three days — warning that local hospitals were near capacity.

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“Our medical professionals and hospitals are overwhelmed with the surge in Covid-19 cases,” the message read. “The current situation is at its most critical level, and lives are at stake. We are asking you to stay home unless it is absolutely necessary.”

Since the start of the pandemic, Texas has reported more than 2.1 million cases, the second highest total in the country after California, which in recent weeks has been in the throes of a devastating flood of cases that has pushed hospitals to the brink.

The United States as a whole has been averaging more than 200,000 new virus cases a day since Jan. 2, with California and Texas fueling that surge. Arizona, Oklahoma and South Carolina have been swept by high numbers of cases for days, and New York now has the country’s fourth worst outbreak, though deaths per day in the state have not come close to the tragic levels seen in the spring.

For more than a month, Laredo has had 35 to 40 percent of its hospital beds filled with Covid-19 patients, a higher ratio than anywhere else in the state, a city spokeswoman said. On Tuesday, she added, the figure was nearing 50 percent.

In Del Rio, another border town, Dr. Laura Palau of the Val Verde County Health Authority said officials were still seeing cases emerge from maskless family gatherings and parties over the holidays. An alarming 30 percent of coronavirus tests performed in the city are coming back positive, she said. The sheriff’s office is issuing quarantine orders to people who test positive.

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Dr. Palau said she was worried about the way deaths are rising.

“The people that were hospitalized in December or early January are starting to expire,” she said.

Texas has received more than 1.7 million doses of the coronavirus vaccine, and administered 1.3 million, Gov. Greg Abbott said on Tuesday. More than 800,000 more doses were expected this week, he said.

But Clay Jenkins, the top elected official in Dallas County, warned that a new, more transmissible variant of the virus, which is circulating in the United States after forcing Britain to lock down again, could make any progress in taming the pandemic fleeting.

“January and February will be our toughest months here in North Texas,” he said. “Right now, we just need everyone to avoid crowds, wear their mask, forgo get-togethers. Really think about ways to make patriotic sacrifices to protect the community.”

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David Montgomery contributed reporting.

But this inauguration was a far more sober affair, with extremely limited attendance.

Tickets went only to certain high-ranking officials and members of Congress, who were each allowed to bring one guest, for a live audience of about 1,000, according to the committee.

Many lawmakers and high-profile guests were in attendance, including three former presidents, Barack Obama, George W. Bush and Bill Clinton; the 2016 Democratic presidential nominee, former Secretary of State Hillary Clinton; the top two Democrats in Congress, Senator Chuck Schumer and Speaker Nancy Pelosi; Senator Joe Manchin III of West Virginia, a centrist Democrat who is likely to be the deciding vote on many of the new administration’s priorities; and Senators Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts, two of Mr. Biden’s rivals for the Democratic nomination in 2020.

“We’re entering what may be the toughest and deadliest period of the virus. We must set aside politics and finally face this pandemic as one nation,” Mr. Biden said. “We will get through this together.”

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The new president then led a moment of silent prayer to remember the more than 400,000 Americans who have died after contracting the virus.

After the swearing-in, the Bidens set out for Arlington National Cemetery, where they laid a wreath at the Tomb of the Unknowns at Arlington National Cemetery with the Bushes, the Clintons and the Obamas. The Bidens were then escorted to the White House.

They will include an executive order making Jeff Zients the government’s official Covid-19 response coordinator, reporting to the president. The order will also restore the directorate for global health security and biodefense at the National Security Council, a group that Mr. Trump had disbanded.

HARARE, Zimbabwe — Zimbabwe’s minister of foreign affairs and international trade, Sibusiso Busi Moyo, has died, the office of the president said on Wednesday. The cause was complications related to Covid-19. Mr. Moyo became the fourth high-ranking official in Zimbabwe to succumb to the virus since the start of the pandemic.

“The late minister succumbed to Covid-19 at a local hospital,” read a short statement from President Emmerson Mnangagwa’s office, giving no further detail.

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“We wish to make it abundantly clear that this is not a military takeover of government,” Mr. Moyo said on state television, reading a statement after the military commandeered the national broadcaster. “What the Zimbabwean Defense Force is doing is to pacify a degenerating a political, social and economic situation.”

In this new role, much of his work centered on reviving Zimbabwe’s battered international image. Mr. Moyo often criticized sanctions imposed on Zimbabwe’s new elite by the international community. In one of his last tweets, Mr. Moyo took aim at the United States after the Jan. 6 riots on Capitol Hill, which he described as “unprecedented scenes of chaos and politically-motivated violence in Washington’s ‘citadel of democracy.’”

Within the ruling Zanu-PF, Mr. Moyo represented the influential military faction who cemented their political power in the new dispensation.

Mr. Moyo was born in 1961 in Mberengwa, a rural district in central Zimbabwe. He is survived by his wife, Justice Loice Matanda-Moyo, a judge on the High Court in Zimbabwe and the chair of the Zimbabwe Anti-Corruption Commission, and their two children. (An ealier version of this article misstated the year of Mr. Moyo’s birth.)

Last week, Ellen Gwaradzimba, the minister of state for the country’s Manicaland Province, died from complications linked to Covid-19. In the same week, Morton Malianga, a member of the ruling party’s highest decision-making body and former deputy finance minister, also succumbed to Covid-19. In July, the minister of agriculture, Perrance Shiri, also died from Covid-19.

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The southern African nation has seen a spike in Covid-19 cases and deaths since the start of this year, with the Health Ministry on Tuesday recording 52 deaths and 783 new infections in 24 hours, forcing officials to impose a new lockdown, shuttering businesses and imposing a curfew. Zimbabwe has recorded a total of 28,675 cases and 825 deaths and since the start of the pandemic.

Jeffrey Moyo reported from Harare and Lynsey Chutel from Johannesburg.

The airport in Cedar Rapids, Iowa, will conduct mandatory coronavirus screenings for all outbound passengers starting on Monday, one of the first airports in the country to take advantage of a decision to allow such evaluations by the Federal Aviation Administration last month.

Under the new “Travel Well” program, the Eastern Iowa Airport will ask a handful of short screening questions and take the temperature of each departing passenger. Travelers who show no signs of having the coronavirus and have no exposure to it will be sent on to the Transportation Security Administration checkpoint.

“The Travel Well program will provide an efficient approach to screening passengers and employees,” Marty Lenss, the airport’s director, said in a statement.

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Travelers who might be infected with or exposed to the virus will receive a private second screening. The ultimate decision on whether individuals may board their flight will rest with individual airlines. Eastern Iowa Airport offers nonstop service to 14 destinations on flights operated by American Airlines, Delta Air Lines, United Airlines and others.

It is not clear how useful the screenings will be. The value of screening passengers has diminished as the virus has become widespread throughout the country. A passenger who shows no symptoms on the day of travel could still infect others on their journey or at their destination.

The airport had first talked about its screening plan, which it developed with Mercy Medical Center and MercyCare Business Health Solutions, in July. But the plan’s implementation was put on hold pending approval by the F.A.A., which regulates airport spending. Earlier last year, the agency had said that airports could spend money to screen employees, but not passengers. In December, the agency approved passenger screening, too.

The first doses were expected to be delivered to Bangladesh, Bhutan, the Maldives, Myanmar, Nepal and the Seychelles beginning on Wednesday, India’s Foreign Ministry said in a statement.

Bangladesh said that it expected to receive a shipment of two million doses of Covishield on Thursday as “a gift of India,” in addition to 30 million doses that it has ordered from the Serum Institute. Bhutan is expected to receive about 150,000 doses in its initial shipment, and the Maldives 100,000.

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India’s capacity for mass vaccine production will be central to efforts to curb the coronavirus in poor countries. The Serum Institute aims to distribute a billion doses of its coronavirus vaccine by the end of 2021.

In other news from around the world:

New York City postponed 23,000 vaccination appointments that were scheduled for Thursday and Friday because of a shipping delay, Mayor Bill de Blasio said Wednesday, a day after warning that the city was expected to soon exhaust its vaccine supply.

“We already were feeling the stress of a shortage of vaccine,” Mr. de Blasio told reporters at a news conference. “Now the situation has been made even worse.”

More than 100,000 doses of the Moderna vaccine that the city had expected to receive on Tuesday are now arriving on Wednesday and Thursday, Dr. Dave Chokshi, the city’s health commissioner, said at the news conference.

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The appointments being postponed by the delay are all for people receiving the first of the vaccine’s two required doses, and will be rescheduled for next week, Dr. Chokshi said.

The city government would concentrate on the hardest-hit communities, the mayor said, announcing a goal to inoculate 50,000 residents of public housing who are over 65 in the next few weeks, assuming the city can get more vaccine doses from the federal government.

Mr. de Blasio said he had faith that the Biden administration would step up vaccine production enough to make second doses available for the expanded pool of people eligible to be vaccinated. The two companies whose vaccines are authorized for use in the U.S., Moderna and Pfizer, are running flat out, and it is not clear whether the Biden administration could significantly expand the overall supply any time soon.

Though Mr. Biden has indicated that his administration would release more vaccine doses as they became available and keep fewer in reserve for shortages or delays, he said on Friday that he would not change the recommended timing for second doses: 21 days after the first dose for Pfizer’s vaccine, and 28 days for Moderna’s.

New York City expects to have 140,000 first doses and 250,000 second doses on hand for use this week, Dr. Chokshi said on Wednesday. “We are going to very rapidly work through that supply.”

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Despite the delivery delay, Mr. de Blasio said on Wednesday that New York City expected to have administered 500,000 doses by the end of the day.

GENEVA — The global death toll from Covid-19 hit a record in the last week at the same time as the number of new cases declined, the World Health Organization reported on Wednesday.

Yet the number of new cases dropped slightly in the Americas in the last week and by 6 percent globally. The W.H.O. explained the diverging trends, noting that a high number of cases leads, after a short time lag, to increased hospitalizations and deaths.

Most of the decline in cases occurred in Europe, which registered a drop of 15 percent in the past week, according to the W.H.O. data. New cases dropped last week by 11 percent in the United States and 19 percent in Britain, two of the world’s worst affected countries. Britain is in lockdown, while the United States has a patchwork of state rules.

The decline occurred despite the emergence of new, more contagious variants of the virus. The W.H.O. said new variants had spread to 10 more countries in the past week, bringing the total affected countries to 60 across all regions.

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“These are dark weeks — we have to get past this time,” Hugo de Jonge, the minister of health, said during a news conference.

The curfew, which would be the first imposed across the Netherlands since World War II, requires approval from Parliament in a vote scheduled for Thursday. It would last from 8:30 p.m. to 4:30 a.m. nightly until Feb. 10.

The country is already under a lockdown that closed restaurants, gyms and pools, places of entertainment and most shops, as well as halting most in-person schooling.

Under the new rules, the number of guests that people can entertain at home will be reduced to one and travelers to the Netherlands via plane and boat will have to take a rapid coronavirus test in the hours before they board, as well as show a negative result from a PCR test taken within the past 72 hours. These new measures come despite the fact that cases have been slowly declining.

The country will also delay second doses of the Pfizer vaccinations to six weeks from three, after a decision to lower the number kept in stock, Mr. de Jonge announced. “This way we can protect more people sooner, this is also important because of the spread of the British mutation,” he said.

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Health experts in the Netherlands say they fear that without these new measures the more transmissible variant will be dominant in the country by March.

Italy plans to take legal action against the American drugmaker Pfizer for delays in the delivery of coronavirus vaccines, Domenico Arcuri, Italy’s special commissioner for the pandemic, said in a statement on Tuesday night.

On Friday, Pfizer and its German partner, BioNTech, said they would deliver fewer doses than expected to European Union countries this week because they were changing the production process to increase future supply. They said deliveries would return to the original schedule next week.

Italian officials discussed the situation with company officials on Tuesday.

“The result of today’s dialogue with Pfizer did not have the effect we were hoping for,” Mr. Arcuri wrote, announcing that Italy would press charges, both “civil and criminal, where possible” in coming days.

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Mr. Arcuri said that Pfizer would not make up the shortfall in next week’s delivery, which would instead be smaller than previously expected. Italian officials worried that a shortage of doses could dangerously slow the country’s vaccination program, which has reached more than 1.2 million people so far, starting with health care workers and nursing-home residents.

Some regional governors announced that they would pause new vaccinations because of the shortage, and focus on distributing the second dose of the vaccine to people who had already received the first. But they warned that if the delays continued even the distribution of the booster doses would be at risk.

“The health care of Italian citizens is not a negotiable issue,” Mr. Arcuri said in the statement. “The vaccination campaign cannot be slowed down, especially for giving the second doses to the many Italians who already received the first.”

Pfizer did not immediately respond to a request for comment.