India on Saturday began one of the most ambitious and complex initiatives in its history: the nationwide rollout of coronavirus vaccines to 1.3 billion people, an undertaking that will stretch from the perilous reaches of the Himalayas to the dense jungles of the country’s southern tip.

The campaign is unfolding in a country that has reported more than 10.5 million coronavirus infections, the second-largest caseload after the United States, and 152,093 deaths, the world’s third-highest tally.

Prime Minister Narendra Modi kicked off the vaccine drive on Saturday with a live television address as 3,000 centers nationwide were set to inoculate a first round of health care workers.

“Everyone was asking as to when the vaccine will be available,” Mr. Modi said. “It is available now. I congratulate all the countrymen on this occasion.”

The government had hoped to inoculate about 300,000 people on Saturday, but government data showed that 165,000 people received a shot. The plan is to give the vaccine to millions more health care and frontline workers by the spring.

At Kamala Nehru Hospital in Pune, a city of about 3.1 million southeast of Mumbai, 100 long-stemmed red roses were stacked neatly on a table beside a bottle of hand sanitizer. Each person registered to receive the Covishield vaccine, developed by AstraZeneca and Oxford University and manufactured by the Pune-based Serum Institute of India, was to get a rose.

Covishield and another vaccine called Covaxin were authorized for emergency use in India this month.

Neither Covaxin’s manufacturer, Bharat Biotech, nor the Indian Council of Medical Research, which contributed to the vaccine’s development, has published data proving that it works. In a Covaxin consent form at District Hospital Aundh, one of a handful of sites in Pune where the vaccine was being administered, the manufacturer noted that clinical efficacy was “yet to be established.”

Dr. Rajashree Patil, one of the health workers who received the Covishield vaccine at Kamala Nehru Hospital, said she was both excited and nervous. After contracting the coronavirus while working in the government hospital’s emergency room in May, she spent 12 days in a Covid ward at another hospital, having lost her senses of smell and taste and experiencing extreme fatigue.

“I’m a little bit worried. Actually we’re on a trial basis,” Dr. Patil said. “But I am happy we are getting it so we can one day be corona-free.”

Another doctor who received the Covishield vaccine at that hospital, Usha Devi Bharmal, said that she had wanted to get a shot to dispel people’s fears about coronavirus vaccines. “There are rumors on social media,” she said, adding that she hoped to help show that vaccines are a “positive thing.”

Mr. Modi has pledged to inoculate 300 million health care and frontline workers, including police officers and, in some cases, teachers, by July. But so far the Indian government has purchased only 11 million doses of Covishield and 5.5 million doses of Covaxin.

Indian television stations showed Dr. Randeep Guleria, the director of the All India Institute of Medical Sciences in New Delhi and a prominent government adviser on Covid-19, receiving a jab on Saturday. It was unclear whether Mr. Modi was vaccinated.

India’s rollout, among the first in a major developing country, comes as millions of people in the United States, Britain, Israel, Canada and the European Union have received at least one dose.

India’s vaccination effort faces a number of obstacles, including a growing sense of complacency about the coronavirus. After reaching a peak of more than 90,000 new cases per day in mid-September, the country’s official infection rates have dropped sharply. Fatalities have fallen about 30 percent in the last 14 days, according to a New York Times database.

City streets are buzzing. Air and train travel have resumed. Social distancing and mask-wearing standards, already lax in many parts of India, have slipped further. That alarms experts, who say the real infection rate is probably much worse than official numbers suggest.

A fast-spreading variant could become the dominant source of infection in the U.S. by March, C.D.C. says.


Even as President-elect Joseph R. Biden Jr. makes public his ambitious plans to tame Covid-19, a far more contagious variant of the virus is causing researchers to fear that another wrenching surge of cases and deaths is looming.

Federal health officials sounded the alarm on Friday about the fast-spreading variant, which was first identified in Britain. They warned that it could become the dominant source of infection in the United States by March.

“I think we are going to see in six to eight weeks major transmission in this country, like we’re seeing in England,” said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of Mr. Biden’s coronavirus advisory board.

In a study released Friday, the Centers for Disease Control and Prevention called for a doubling down on preventive measures to fight the variant, including more robust distribution of vaccines, which remain far below the benchmarks the government has set.

Tweeting on Friday that his administration “will move Heaven and Earth” to get more people vaccinated as soon as possible, Mr. Biden was still sober about his plans for broadening vaccine distribution even as supplies remain limited. He said he would create mobile vaccine clinics and widely — and equitably — expand access to the shots across the country.

The variant, though it spreads more rapidly, is not known to be more deadly or to cause more severe disease. But further study is needed, the C.D.C. says, to determine whether existing vaccines and treatments will be effective in treating the variant — as well as others that have been discovered in Brazil and South Africa.

As of Friday, the variant first discovered in Britain had been detected in more than 70 cases from 13 states — most recently in Oregon — but the actual numbers are likely to be much higher, said Dr. Jay Butler, deputy director for infectious diseases at the C.D.C.

“I want to stress that we are deeply concerned that this strain is more transmissible and can accelerate outbreaks in the U.S. in the coming weeks,” Dr. Butler said. “We’re sounding the alarm and urging people to realize the pandemic is not over and in no way is it time to throw in the towel.”

“We know what works, and we know what to do,” he said.

Current spikes in cases threaten to cripple already overwhelmed hospitals and nursing homes in many parts of the country. Some are at or near capacity. Others have faced troubling rates of infection among their staff, causing shortages and increasing patient loads.

Covid-19 cases and deaths have broken record after record across the country, with a peak number of deaths, 4,400, announced on Tuesday. More than 3,350 new deaths and at least 201,700 new cases were reported on Saturday, and the nation is nearing a milestone of 400,000 deaths.

And with the possibility that yet another surge from the new variant will overtake the country’s ability to inoculate enough people to stamp out the virus altogether anytime soon, it will be awhile before people can relax their guard.

“The honest truth is this: Things will get worse before they get better,” Mr. Biden said. “And the policy changes we are going to be making, they’re going to take time to show up in the Covid statistics.”

Biden and Harris introduce key members of their science team.

President-elect Joseph R. Biden Jr. and Vice President-elect Kamala Harris introduced key members of their White House science team on Saturday.

President-elect Joseph R. Biden Jr. said on Saturday that he was “always going to lead with science and truth” as he announced top science and technology officials on his White House staff, reaffirming trust in the kind of expert research that the Trump administration often ignored or disdained.

“This is how we are going to, God willing, overcome the pandemic and build our country back better than it was before,” he said on Saturday while announcing the top members of his White House science team.

Extolling what he called “some of the most brilliant minds in the world,” Mr. Biden said his new team’s mission would be to ask: “How can we make the impossible possible?”

The team includes Eric S. Lander, Alondra Nelson, Frances H. Arnold and Maria Zuber. Mr. Biden will nominate Mr. Lander to be director of the White House Office of Science and Technology Policy, a position that will for the first time hold cabinet rank.

Mr. Biden also said that Dr. Francis S. Collins would remain as the director of the National Institutes of Health.

On Friday, Mr. Biden pledged to increase vaccination availability in pharmacies, build mobile clinics to get vaccines to underserved rural and urban communities, and encourage states to expand vaccine eligibility to people 65 and older. He also vowed to make racial equity a priority in fighting a virus that has disproportionately infected and killed people of color.

The coronavirus pandemic is just one aspect of science in America that the team has been tasked with working on in the coming years. Others include economic prosperity, how science can help confront the climate crisis, ensuring that the U.S. leads the way in tech and industries critical for future development, and finally, building long-term health and trust in science and technology among Americans.

Although neither Mr. Biden nor Vice President-elect Kamala Harris mentioned President Trump by name, they drew comparisons to the current administration’s handling of the pandemic and decisions to ignore scientists and research.

Ms. Harris said that her mother taught her the importance of “making decisions, not based on intuition or ideology, but based on evidence.”

The Trump administration repeatedly rejected guidance from government scientists on issues including climate change and the pandemic. Mr. Trump left the position of science adviser unfilled for 18 months.

“The science behind climate change is not a hoax,” Ms. Harris said. “The science behind the virus is not partisan. The same laws apply. The same evidence holds true regardless of whether or not you accept them.”

In other developments around the world:

China’s National Health Commission said on Saturday that it had recorded 130 new coronavirus cases, all but 15 of them locally transmitted, a day after it said that more than 1,000 people nationwide were being treated for Covid-19. The authorities in Nangong, a city in the hard-hit northern province of Hebei, also said on Saturday that they had finished building the first of six coronavirus hospitals.

Hospitals across England are stretched to the brink with Covid-19 patients, medical workers are at their breaking point, and the death toll is soaring. The number of hospitalized Covid-19 patients in England has risen sharply since Christmas and now dwarfs the spring peak by 70 percent, with almost 14,000 more patients in hospitals than on April 12. Prime Minister Boris Johnson warned this week that there was a “very substantial” risk that many hospitals will soon run out of beds in intensive-care units.

South Korea said on Saturday that it would extend social distancing restrictions in and around Seoul, the capital, for another two weeks. The rules ban private gatherings of five people or more and restrict business operations after 9 p.m.

AstraZeneca’s Covid-19 vaccine became the first to be approved for emergency use by Pakistan, Reuters reported on Saturday, citing the country’s health minister.

The New York Times