Cambodia’s Reopening Is Propelled by Vaccinations – The New York Times

ImageAngkor Wat temple in Siem Reap province, Cambodia, in 2020, may be seeing greater numbers of tourists as Cambodia is set to welcome vaccinated international tourists without quarantine.
Credit…Tang Chhin Sothy/Agence France-Presse — Getty Images

Cambodia reopened for fully vaccinated tourists from overseas this week without quarantine after a nationwide campaign succeeded in achieving one of the world’s highest vaccination rates.

The move was welcomed by desperate tourism operators and workers, who have struggled to make a living since the start of the pandemic.

“I rejoice at and fully support the news of reopening the country to vaccinated tourists without quarantine,” said Chhay Sivlin, the president of the Cambodia Association of Travel Agents. Tourism directly accounted for more than 12 percent of the country’s economy in 2019 and provided jobs to 630,000 people, she said.

Last month, the Southeast Asian nation of about 16 million announced plans to let fully vaccinated foreign tourists begin entering the country at the end of November if they first quarantined in selected areas for five days.

But citing the rapid pace of inoculations and a vaccination rate of 88 percent, Prime Minister Hun Sen accelerated that plan and said that fully vaccinated tourists could arrive without quarantine, effective on Monday.

“This is a big step towards reopening the entire country,” said Mr. Hun Sen, an authoritarian leader who came to power in 1984. “I hope our compatriots enjoy our reopening. It is widely due to the country having achieved such an outstanding rate of vaccination.”

While the prime minister put the fully vaccinated rate at 88 percent based on a population of 16 million, The New York Times database puts the rate at 80 percent, based on a population of nearly 16.5 million.

More than two million people also have received a third dose.

About 90 percent of Cambodia’s vaccines came from China, including more than nine million doses of Sinovac and nearly four million doses of Sinopharm.

Under the new rules, travelers arriving from abroad can skip quarantine if they are fully vaccinated, test negative before departure and test negative again on arrival. Travelers who are not vaccinated must still spend 14 days in quarantine.

Ms. Sivlin said that tourist bookings were beginning to pick up and that airlines were working to increase the number of flights to Cambodia.

Some flights are scheduled to the capital, Phnom Penh, but none for Siem Reap, the town near the ancient city of Angkor that is one of the most popular destinations in Southeast Asia.

Like many of its neighbors, Cambodia reported relatively few virus cases in 2020 but faced a deadly surge this year. Still, its overall numbers have remained relatively low, with about 120,000 total cases and 2,900 deaths.

Credit…Erin Schaff/The New York Times

The secretary of the Army has issued a memo warning the hundreds of thousands of soldiers in its National Guard that if they decline to get vaccinated against the coronavirus, they may not be renewed in the guard.

“I have determined that all soldiers who refuse the mandatory vaccination order will be flagged,” wrote Christine E. Wormuth, the secretary, in a memo this week, which would prevent them from promotions, awards, bonuses and the like. If troops persist in declining, they will not be permitted “continued service” unless granted an approved exemption from the vaccine, she wrote.

Last week, Oklahoma’s newly appointed adjutant general for the National Guard, Brig. Gen. Thomas H. Mancino, announced on behalf of Gov. Kevin Stitt that guardsmen in the state would not be required to get a Covid-19 vaccine. The policy defies a Pentagon directive issued in August that makes vaccination mandatory for all troops, including the National Guard, by deadlines set by each service branch.

The memo created a testy stand off between Oklahoma officials and the Pentagon, which insists that all National Guard members must follow the same vaccine procedures as active duty troops. Guard troops are under the authority of the governor unless federally deployed. However, the Pentagon has stood its ground on the notion that its vaccine mandate trumps states’ rights.

In Oklahoma, 89 percent of airmen in the Guard have been vaccinated, while only 40 percent of Army guardsmen have had shots; the deadline for members of the Army National Guard is coming next month. All branches of the military have been permitted to come up with their own vaccine mandate deadlines for active duty and guard troops, as well as their own punishment systems for refusing shots.

The Pentagon has been wary that other states may follow Oklahoma’s lead.

Texas Guard officials, for instance, said in an email that the Pentagon appeared to be imposing vaccine mandates on military and National Guard members without adequate protections in place for individuals with religious objections and hinted it, too, might permit members to skip the shots.

The governor of Alaska, Mike Dunleavy, has also issued a memo noting that “President Biden and his Administration have taken actions, or announced plans to act, that threaten the sovereign authority of the State of Alaska,” which included “imposing vaccine mandates on military and National Guard members without adequate protections in place for individuals with religious objections.”

In essence, Texas and Alaska appear to be engaged in a passive version of the Oklahoma written policy. “We are awaiting additional guidance from the Departments of the U.S. Army and Air Force that addresses National Guard requirements,” said Candis Olmstead, a spokeswoman for the Alaska Guard, in an email.

So far, the Defense Department has granted a smattering of exemptions from vaccines, including for people who were already leaving the military or who have medical issues, but those for religious reasons are still pending.

Credit…Alkis Konstantinidis/Reuters

Prime Minister Kyriakos Mitsotakis of Greece announced additional restrictions for the country’s unvaccinated population on Thursday, a bid to keep a recent spike of coronavirus infections from increasing further.

As of next Monday, access to more indoor spaces will be limited to the vaccinated, he said during a televised address. Proof of a negative test will no longer be sufficient for unvaccinated people to enter cinemas, theaters, museums and gymnasiums, he said. The new restrictions broaden those imposed in mid-September, which barred the unvaccinated from the indoor areas of cafes and restaurants.

To increase demand for booster shots, Mr. Mitsotakis also said that the vaccination certificates of those over 60 would expire after seven months. Greece opened eligibility for booster shots last week for all those over 18 who had their last shot at least five and a half months ago. Those who got the Pfizer, AstraZeneca or Moderna vaccines initially were advised to get a Pfizer or Moderna booster. Those who received the Johnson & Johnson shot were advised to get Pfizer, Moderna or a second Johnson & Johnson shot as a booster.

Mr. Mitsotakis appealed to all, particularly the unvaccinated elderly, to get their shots without delay.

“Greece is mourning unnecessary losses as it very simply does not have the vaccination rates of other European countries,” he said.

About 61 percent of Greeks are fully vaccinated, below the average rate in the European Union of 65.4 percent, according to the vaccine tracker of the European Centre for Disease Prevention and Control. Since the end of September, new daily cases have shot up from an average of about 2,100 to more than 6,500, according to the Our World in Data project at Oxford University, and daily Covid deaths have spiked over the same period, going from an average of around 30 to more than 74.

With Europe as a whole experiencing a sustained wave of cases, the sharp restrictions in Greece have been matched or surpassed by other E.U. nations. Austria, for instance, will impose full lockdowns in two states — Salzburg and Upper Austria — next week, after having imposed broad restrictions on the activities of unvaccinated people.

On Thursday, lawmakers in Germany’s Parliament approved a bill whose measures include a rule that only people who are vaccinated against the virus, have recovered from an infection or test negative can ride public transit or attend work in person. The measure is expected to be passed by all 16 states on Friday.

France and Italy have allowed people to enter indoor areas such as cafes, museums and gyms with a health pass that shows the holder has been vaccinated, has recovered from Covid-19 or has tested negative for the virus. However, both countries are reportedly considering restricting access to such areas to the vaccinated.

The Czech Republic, which is experiencing some of its highest caseloads since the pandemic began, will bar people without a vaccination pass or proof of a previous Covid infection from restaurants, bars and hair salons as of Monday. They will also be barred from attending large events.

And lawmakers in the Netherlands, which is reporting record case numbers and sharply rising positive tests, recently restored mask mandates in some public indoor places and instituted a three-week partial lockdown that includes earlier closing hours for restaurants, bars and shops. However, the Dutch government has resisted urgings to close schools, despite significant outbreaks among those aged 4 through 12.

Credit…Pool photo by Matt Stone

Utah and Massachusetts on Thursday joined a growing number of states in broadening access to coronavirus vaccine boosters for all adults, just as federal regulators consider granting requests for Pfizer-BioNTech and Moderna boosters to be authorized for all adults as early as this week, according to people familiar with the planning.

The administration of Gov. Charlie Baker announced that all Massachusetts residents ages 18 and older could get a booster, if they met the federal timing rules: six months after receiving the second dose of the Pfizer or Moderna vaccines or two months past getting the single-dose Johnson & Johnson vaccine.

At a news conference on Thursday, Gov. Spencer J. Cox of Utah asked all health care providers to provide boosters to “any adult in the state of Utah who would like to receive a booster” beginning on Friday, in accordance with the same federal guidelines that Massachusetts was using.

While federal regulators have signed off on boosters for only certain categories of people, some states have used a range of justifications to expand access, including heightened risks posed by holiday gatherings and the pervasive spread of the virus.

In Connecticut, Gov. Ned Lamont encouraged vaccinated adults to get a booster provided they meet timing rules, even if they might not appear to fit into federal eligibility categories.

“C.D.C. speaks Latin, I can’t figure out who’s eligible, who’s not eligible,” said Mr. Lamont at a news conference on Thursday, referring to the Centers for Disease Control and Prevention. “If you smoked while you were in high school back in the 1970s, you’re eligible. I think if you haven’t been vaccinated in more than six months, now’s the time to get the booster. Self report, you’re at risk or public facing, you’re out there, get the booster.”

The moves came as Kansas, Kentucky, Maine and Vermont also moved to expand access to boosters, following several other states and New York City.

The director of Rhode Island’s department of health, Dr. Nicole Alexander-Scott, announced on Tuesday that all adults could get a booster if they were past the federal timing rules. “Winter’s coming, our cases have gone up and everyone 18 and older is at higher risk of exposure. And so we want the message to go out that you can go ahead and get your booster shots,” she said at a news conference.

On Thursday, Jen Psaki, the White House press secretary, said the administration would “wait for the process to proceed” at the federal level. She also encouraged people already eligible according to federal categories to get a booster for extra protection ahead of the holiday season when people may be traveling more and gathering inside because of colder weather.

Currently, federal regulators say people who received two doses of the Pfizer-BioNTech or Moderna vaccines, meet timing rules, and are 65 or older, or adults who are considered to be at special risk because of their medical conditions, jobs or living environments are eligible for boosters. Anyone who received the Johnson & Johnson shot can already get a booster two months after the first shot. Eligible people can select from any of three vaccine brands as a booster.

A growing body of global research has shown that the vaccines available in the United States have remained highly protective against the disease’s worst outcomes over time, even during the summer surge of the highly transmissible Delta variant. And there has been an ongoing debate among experts over whether extra shots are necessary for younger, healthy adults.

Liam Stack and Todd Gregory contributed reporting.

Credit…Noel Celis/Agence France-Presse — Getty Images

A scientist who has pored over public accounts of early Covid-19 cases in China reported on Thursday that an influential World Health Organization inquiry had likely gotten the early chronology of the pandemic wrong. The new analysis suggests that the first known patient sickened with the coronavirus was a vendor in a large Wuhan animal market, not an accountant who lived many miles from it.

The report, published on Thursday in the prestigious journal Science, will revive, though certainly not settle, the debate over whether the pandemic started with a spillover from wildlife sold at the market, a leak from a Wuhan virology lab or some other way. The search for the origins of the greatest public health catastrophe in a century has fueled geopolitical battles, with few new facts emerging in recent months to resolve the question.

The scientist, Michael Worobey, a leading expert in tracing the evolution of viruses at the University of Arizona, came upon timeline discrepancies by combing through what had already been made public in medical journals, as well as video interviews in a Chinese news outlet with people believed to have the first two documented infections.

Dr. Worobey argues that the vendor’s ties to the Huanan Seafood Wholesale Market, as well as a new analysis of the earliest hospitalized patients’ connections to the market, strongly suggest that the pandemic began there.

“In this city of 11 million people, half of the early cases are linked to a place that’s the size of a soccer field,” Dr. Worobey said. “It becomes very difficult to explain that pattern if the outbreak didn’t start at the market.”

Several experts, including one of the pandemic investigators chosen by the W.H.O., said that Dr. Worobey’s detective work was sound and that the first known case of Covid was most likely a seafood vendor.

But some of them also said the evidence was still insufficient to decisively settle the larger question of how the pandemic began. They suggested that the virus probably infected a “patient zero” sometime before the vendor’s case and then reached critical mass to spread widely at the market. Studies of changes in the virus’s genome — including one done by Dr. Worobey himself — have suggested that the first infection happened in roughly mid-November 2019, weeks before the vendor got sick.

Credit…Doug Mills/The New York Times

The leaders of Canada and Mexico will announce a pledge to send millions of coronavirus vaccines to much of Latin America and the Caribbean on Thursday during a summit with President Biden, according to a White House official with knowledge of the agenda.

Prime Minister Justin Trudeau of Canada and President Andrés Manuel López Obrador of Mexico are expected to unveil the plan during a meeting with Mr. Biden on Thursday, the first meeting of all three leaders of North America in five years.

In addition to the announcement regarding vaccines, leaders are expected to review and update a regional plan from 2012 for addressing animal and pandemic influenza, and to address delicate issues around trade and migration.

[Read our latest coverage of the summit meeting.]

The donations come as part of a regional strategy through which the United States first shared millions of Covid vaccine doses with Mexico and Canada, and those countries now are moving ahead to distribute doses to the rest of the region.

In March, shortly after coronavirus vaccines became widely available, the United States announced that it would share 2.5 million doses with Mexico and 1.5 million with Canada as part of a larger diplomatic effort to rebuild ties with its neighbors.

The United States has since donated nearly 11 million doses to Mexico, or nearly 10 percent of that country’s total vaccine stock, according to the official.

Canada’s distribution of Covid vaccines was hampered by delays and bottlenecks in the spring, but vaccination rates there have since climbed dramatically. The country quickly surpassed the United States and now has fully vaccinated 77 percent of its population, as compared to the U.S. total of 59 percent, according to vaccination data compiled by The New York Times.

But the leaders appeared eager to project a sense of cooperativeness in confronting public health in the region, marking a significant change from their countries’ idled diplomatic efforts under the Trump administration.

Credit…Andy Brownbill/Associated Press

Two of Australia’s biggest sports events — the Australian Open tennis tournament and the annual Boxing Day cricket test match in Melbourne — will be allowed to take place before full-capacity stadiums as part of an easing of coronavirus restrictions.

With 90 percent of people over 16 expected to be fully vaccinated by this weekend in the state of Victoria, of which Melbourne is the capital, the authorities are easing pandemic-related rules, including capacity limits for public events.

Events with up to 30,000 spectators can be held without state government approval, and larger events can go ahead at full capacity if they have a government-approved coronavirus safety plan in place.

Attendees at all sports events will be required to be fully vaccinated.

The Australian Open, which is played early each year in Melbourne, attracted about 820,000 spectators over two weeks the last time it was held at full capacity, in 2020. The Grand Slam tournament is played in a variety of venues, with the largest, Rod Laver Arena, able to seat about 15,000 spectators.

Last year, attendance was capped at 30,000 fans a day for the first five days before spectators were barred as Melbourne dealt with another outbreak. The tournament’s final four days were played at 50 percent capacity.

It is unclear whether unvaccinated tennis players or players who do not reveal their vaccination status — including the world No. 1, Novak Djokovic — will be able to attend the Australian Open. The Victoria government said in late October that it would not seek exemptions for unvaccinated players to enter the country. International visitors require a government exemption in order to enter Australia.

Spectators will also be able to fill the Melbourne Cricket Ground, which has a capacity of 100,000, to watch the Boxing Day cricket test match between Australia and England on Dec. 26. The test match is part of the Ashes, a series between England and Australia that is held every two years and is one of the biggest events in cricket.

“Whether it’s 100,000 people at the M.C.G. on Boxing Day or a smaller group of people standing up at the public bar of their pub having a beer, this is the Covid-normal that every Victorian has built,” the premier of Victoria, Daniel Andrews, said at a news conference on Thursday.

Other restrictions in Victoria are also being lifted. Starting on Friday, restrictions end on the number of people allowed in restaurants and bars, and masks will no longer be mandatory in most settings.

Credit…Rebecca Conway for The New York Times

NEW DELHI — Rajiv Nath’s factories were cranking out more than 7,600 syringes a minute when India decided to limit their export last month to shore up its own vaccination campaign.

The products were meant for clients around the world as nations scramble to inoculate their people and bring the pandemic to an end, but instead Mr. Nath’s warehouses were left with stocks of more than 45 million syringes that he had largely promised to UNICEF and the Pan American Health Organization.

And with India’s export restrictions on syringes in place through the end of this year, experts say the world could experience a shortfall of two billion to four billion needles through the end of next year. The shortages are expected to hit African countries the hardest.

“That will be truly disappointing,” said Prashant Yadav — a senior fellow at the Center for Global Development, a Washington research organization, and an expert on health care supply chains — “that after having waited for over a year to get a reasonable quantity of vaccines, when they do obtain the vaccines, they don’t have syringes to administer them.”

Although India is a small player in overall global exports, it is a major producer of the type of syringe that is being used globally for coronavirus vaccinations. The syringes break on second use to prevent the spreading of disease through reuse.

Covax, the vaccine-sharing initiative, is seeking the syringes from manufacturers around the world, and India was expected to meet at least 15 percent of the global demand for use with Covid vaccines and other inoculations.

The situation became so acute last month that the World Health Organization and PAHO asked India to allow Mr. Nath’s company, Hindustan Syringes and Medical Devices, one of the world’s largest syringe makers, to ship the orders it had agreed to before the restrictions were announced. Prime Minister Narendra Modi’s government subsequently increased the export quota for the health organizations but did not allow a blanket exemption.

The World Health Organization and UNICEF have warned that the syringe shortage could have “dire consequences” for the global vaccination effort.

In India, more than half of the 1.4 billion-strong population has received at least one shot of a Covid vaccine, but only 28 percent of people are fully vaccinated, according to a New York Times database. And new inoculations have slowed recently.

Unlike vaccine doses, syringes are bulky and are typically transported by sea. The shortage comes amid large disruptions in the global supply chain of shipped goods, and experts say that a Covax-like initiative is needed, with nations coming together to better supply syringes to poorer countries.

UNICEF, a major buyer of syringes for Covax, said in a statement on Wednesday that “syringe nationalism” could be addressed if big producers and wealthy countries “influence global markets in a way that unlocks access for other countries in the global south.”

The agency also said it was considering expanding use of another type of syringe approved by the W.H.O. that also prevents reuse.

Dozens of Indian syringe makers spent millions of dollars to scale up manufacturing last year, but buyers are increasingly relying on manufacturers in China.

ProcureNet, a Hong Kong-based supplier of pharmaceutical products, said this week that it would invest $20 million in Anhui Tiankang Medical, a Chinese manufacturer, to produce 750 million syringes for PAHO and other buyers.

“We continue to spend billions on the vaccine,” said Gurbaksh Chahal, ProcureNet’s chief executive, “but what good is the vaccine if we don’t have the tools to deliver the vaccine to the people?”

Credit…Rebecca Blackwell/Associated Press

Almost entirely along party lines, Republican Florida lawmakers passed four bills on Wednesday to curtail mask and vaccine mandates, the culmination of a three-day special legislative session that Gov. Ron DeSantis called so swiftly that it caught even Republican leaders by surprise.

Mr. DeSantis said the session was urgently needed to combat federal government overreach. In addition to Florida, at least five other states have considered or held special sessions on pandemic mandates, according to the National Conference of State Legislatures.

Early this year, Mr. DeSantis crisscrossed Florida to promote Covid vaccines, visiting retiree communities and hospitals, and celebrating people who had gotten their shots. But it was a remarkably different picture this week, when Florida’s lieutenant governor, Jeanette Nuñez, was a prominent speaker at a rally organized by anti-vaccination campaigners on the State Capitol steps.

15,000 hospitalized

7–day average


Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.

That scene moved the state further away from the guidance of federal public health officials, reflecting how a highly politicized pandemic has become more so as Republican-controlled states confront the Biden administration’s wide-ranging attempts to ease it.

Perhaps no state has been more aggressive than Florida, where Mr. DeSantis and his allies are betting that the anger over public health restrictions that drove Republicans to the polls this month in Virginia, New Jersey and other states will grow their political base and keep voters fervently engaged going into the 2022 midterms.

Credit…Aaron Favila/Associated Press

The Philippines has granted emergency-use authorization for Novavax’s Covid-19 vaccine for people 18 and older, giving a boost to the Maryland-based company and becoming the second country after Indonesia to allow the shots.

Novavax has also submitted applications for emergency use in India and with the World Health Organization. And the European Union’s main drug regulator said on Wednesday that it could decide whether to issue conditional marketing authorization “within weeks” if the drugmaker’s data show the vaccine to be safe and effective.

The Novavax shots proved highly effective in clinical trials, but the company fell behind other manufacturers despite receiving $1.75 billion from the U.S. government. Novavax struggled to ramp up its manufacturing and to demonstrate the purity of its vaccines to regulators, and it said in August that Washington would not pay for further production until it had resolved regulators’ concerns.

The vaccine involves two doses, given at least 21 days apart, the company said. It differs from the shots now authorized in the United States in that it involves viral proteins assembled into nanoparticles, mixed with an immune-boosting compound called an adjuvant.

Indonesia approved Novavax’s vaccine for emergency use this month.

Novavax’s chief executive, Stanley C. Erck, said in an announcement on Wednesday that the shots would “contribute substantially to increased vaccination rates” in the Philippines, where only about 37 percent of the population is fully vaccinated, according to the Our World in Data project at the University of Oxford.

The vaccine doses will be manufactured by the Serum Institute in India.

The E.U. drug regulator, the European Medicines Agency, has approved the use of the AstraZeneca, Janssen, Moderna and Pfizer-BioNTech vaccines. The approval of a fifth vaccine could bolster inoculation drives on the continent at a time when it is experiencing the world’s biggest Covid outbreaks.

The Philippines had already approved eight other vaccines for emergency use, according to Dr. Rolando Enrique Domingo, director of the Philippine Food and Drug Administration: AstraZeneca, Bharat Biotech, Gamaleya Sputnik V, Johnson & Johnson, Moderna, Pfizer-BioNTech, Sinopharm, and Sinovac.

Vince Dizon, an adviser to President Rodrigo Duterte, has said that because of unequal vaccine distribution, the Philippines needed to approve as many vaccines as it could.

“There is a really big problem with the global supply of vaccines, because many of these vaccines are in rich countries,” he said. “We need to be vaccinated quickly.”


An earlier version of this item misidentified the person who said that because of unequal vaccine distribution throughout the world, the Philippines needed to approve as many vaccines as it could. It was Vince Dizon, an adviser to the Philippine president, not Rolando Enrique Domingo, the director of the Philippine Food and Drug Administration. 

Credit…Scott Olson/Getty Images

Airline travel this Thanksgiving season is expected to approach prepandemic levels, Transportation Security Administration officials said on Wednesday. The agency is preparing to handle about 20 million air passengers.

“We are staffed and prepared for the holiday travelers,” David Pekoske, the T.S.A. administrator, said in a statement.

The large volume of travelers expected comes as inoculation rates across the United States have risen, allowing many families to gather safely for the first time since 2019, when T.S.A. screened 26 million people. The uptick also signals a willingness by people to resume customary holiday travel.

“I recommend that travelers pay attention to the guidance that the T.S.A. officers are providing at the checkpoint,” Mr. Pekoske said. “They may be directing you to a shorter line or guiding you around someone who is moving slowly, and they may be giving you some advice that will lessen the likelihood that you’ll need a pat-down.”

The busiest days during the Thanksgiving travel period are usually the Tuesday and Wednesday before Thanksgiving and the Sunday afterward, the T.S.A. statement said. While the travel volume this year is not expected to reach 2019 levels, the agency said it could be higher in the time leading up to Thanksgiving.

The increase comes as airlines deal with an uptick in cases of unruly passengers. The Federal Aviation Administration has issued fines, and the president of the Association of Flight Attendants union, Sara Nelson, has attributed the rising tensions to the politically charged atmosphere over health protocols.

In an interview with “CBS Mornings,” Mr. Pekoske said the number of such reports were higher than he can recall ever having seen.

“We’re working very closely with the carriers, the flight attendants, the flight deck crews, the air force and the F.A.A., to do everything that we can to message how dangerous this behavior is,” he said.

Credit…Chang W. Lee/The New York Times

One Canadian said it felt like a painful poke to his brain. An American heard crunching sounds in her head. A Frenchwoman suffered a severe nosebleed. Others got headaches, cried or were left in shock.

They were all tested for the coronavirus with deep nasal swabs. While many people have no complaints about their experience, for some, the swab test — a vital tool in global efforts to quash the coronavirus — engenders visceral dislike, severe squirming or buckled knees.

“It felt like someone was going right into the reset button of my brain to switch something over,” Paul Chin, a music producer and DJ in Toronto, said of his nasal swab test. “There’s truly nothing like it.”

Nasal cavity

Nasal cavity

Nasal cavity

Since the coronavirus emerged, millions of swabs have been stuck into millions of noses to test for a pernicious virus that has killed millions across the planet. One of the ways to fight the virus, officials say, is to test widely and to test often.

The imperative has been to use a test that people are willing to take repeatedly, and the swab generally fits the bill.

Yet the range of swabbing raises questions: Who is doing it right? How deeply should the swab slide into the nostril? How long should it spend up there? Does an accurate test have to be uncomfortable?

Credit…Nicole Craine for The New York Times

CVS will close about 300 stores a year in the next three years, the company said on Thursday, as the pharmacy chain focuses on offering more health care services and expanding its digital services.

The closures, which will affect about 9 percent of the company’s stores, are part of an effort to realign its retail strategy, CVS said in statement on its website.

The company operates more than 9,900 stores in the United States, according to its website. A CVS spokesman said the company did not expect CVS pharmacies in Target stores to be affected.

“We remain focused on the competitive advantage provided by our presence in thousands of communities across the country, which complements our rapidly expanding digital presence,” said Karen S. Lynch, the president and chief executive of CVS Health.

CVS is aiming to remake many of its stores. Some will offer primary care services, and others will offer broader health care services than standard pharmacies, such as treatment for diabetes. The company will also maintain traditional CVS stores, which provide prescription services and health products.

“Hybrid models really took off during the pandemic, including rapid delivery services, curbside pickup and buy online/pick up in-store,” said Ted Rossman, a senior analyst at “Those approaches could be particularly advantageous for CVS.”

CVS said earlier this month that about 70 percent of CVS Pharmacy customers were enrolled in its text messaging program.

“We continue to modernize our operating systems and enhance the integration of pharmacy models, simplifying consumer interactions and driving further engagement with our customers,” Ms. Lynch said during the company’s earnings conference call on Nov. 3.

Credit…Filip Singer/EPA, via Shutterstock

German lawmakers approved tighter Covid restrictions on Thursday, a day after the head of the national agency responsible for monitoring the pandemic warned of a “really bad Christmas” and said that the coronavirus had again become a countrywide emergency.

“Every man and mouse who can vaccinate should vaccinate now,” Lothar Wieler, the head of the agency, the Robert Koch Institute, said in a video discussion with the leader of Saxony, the German state with the highest infection rates.

“Otherwise,” Dr. Wieler added, “we will not get this crisis under control.”

The apparently off-the-cuff remarks by a normally composed scientist came as Germany posted yet another record in daily new infections. The agency on Wednesday reported more than 65,000 new cases — a 61 percent increase over two weeks earlier — and 264 deaths.

On Thursday, lawmakers in Parliament approved a bill whose measures include a rule that only people who are vaccinated against the virus, have recovered from an infection or test negative can ride public transit or attend work in person. Less than 70 percent of Germany’s population is fully vaccinated.

The new measures, proposed by the parties that are expected to replace Chancellor Angela Merkel in government, would also require employers to offer a work-from-home option when possible.

To come into force, the rules must also be approved by the leaders of Germany’s 16 states, a move that is expected to occur on Friday. Since proposing the bill early last week, the parties have tightened some of the proposals amid criticism that the measures were insufficient to curb the latest outbreak.

Saxony’s governor, Michael Kretschmer, said on Thursday that his state’s lawmakers would vote on tough new lockdown measures on Friday. He described the restrictions as a “hard, clear wave breaker” that would last several weeks.

Ms. Merkel is scheduled to meet with state governors on Thursday afternoon to try to form a unified strategy and to discuss ways to increase the vaccination rate.

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Cambodia’s Reopening Is Propelled by Vaccinations – The New York Times

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