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Health

WHO chief warns ‘variants are currently winning the race against vaccines’ as Delta spreads

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On the same day that the world reached the grim milestone of 4 million COVID-19 deaths, World Health Organization chief Tedros Adhanom Ghebreyesus warned that variants are causing a “wave of death” in some parts of the world with less access to vaccines. 

“Variants are currently winning the race against vaccines because of inequitable vaccine production and distribution,” Ghebreyesus said Wednesday at his biweekly conference in Geneva. “It didn’t have to be this way and it doesn’t have to be this way going forward.”

Ghebreyesus called on economic leaders of the Group of 20 countries, who are set to meet this week, to work together on getting vaccines and other health tools to less developed countries. 

“Vaccine nationalism, where a handful of nations have taken the lion’s share, is morally indefensible,” Ghebreyesus said Wednesday. “At this stage in the pandemic, the fact that millions of health and care workers have still not been vaccinated is abhorrent.”

Maryland’s mobile vaccination clinic was staffed with members of the Maryland National Guard and part of the Maryland Vaccine Equity Task Force, which works with local health departments and community organizations to focus COVID-19 vaccination efforts on “underserved, vulnerable, and hard-to-reach populations.”

WHITE HOUSE LAUNCHES COVID SURGE RESPONSE TEAMS TO TACKLE DELTA VARIANT

WHO COVID-19 technical lead Maria Van Kerkhove noted that the Delta variant, which began in India, has now been detected in 104 countries. 

“The Delta variant has even more increased transmissibility than the Alpha variant,” Van Kerkhove said Wednesday. “If that virus takes hold, it will spread.”

The Delta variant became the dominant strain in the United States on Wednesday, as it is responsible for 51.7% of new cases, according to the CDC. 

In some states, the Delta variant is even more dominant. It’s currently responsible for 80% of cases in Utah, which has averaged nearly 400 new cases a day over the past week, almost double the state’s case count in early June, deputy director of the state’s health department said this week. In Missouri, the Delta variant is responsible for 73.3% of new cases, according to the CDC. 

While the spread of the Delta variant is concerning, the three vaccines that have been approved for emergency use in the United States appear to protect people from it. 

The Biden administration is now moving forward with a new “door-to-door” vaccination drive after it failed to meet its Fourth of July goal of vaccinating 70% of the population. 

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“We need to go community-by-community, neighborhood-by-neighborhood, and oft times door-to-door, literally knocking on doors,” Biden said Tuesday of his administration’s new vaccination plan, which sparked a backlash from some conservative lawmakers. 

According to the CDC, 67.2% of American adults have received at least one dose of a vaccine and 58.4% are fully vaccinated as of Wednesday.

The Associated Press contributed to this report. 

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Health

Some in US pushing for more COVID restrictions, masking, as Delta variant spreads

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As the Delta variant of the COVID-19 virus spreads around the world and within the United States, some in the U.S. are pushing to bring back health measures from the peak of the pandemic, like mask-wearing, even for vaccinated people. 

No jurisdiction has reinstituted a mask requirement or other similar mandate yet, and officials in some states have said the evidence currently suggests doing so is unnecessary. But other jurisdictions are raising the alarm that the Delta variant, which was first discovered in India, could require a retreat to pandemic health measures. And some individuals are explicitly calling for mask mandates. 

“With increase circulation of the highly transmissible Delta variant, the Los Angeles County Department of Public Health… strongly recommends everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure,” Los Angeles County said in a statement last week. 

Barbara Ferrer, the county’s director of public health, acknowledged that vaccines are “very effective” in protecting against the Delta variant. But, she added, “Mask wearing remains an effective tool for reducing transmission, especially indoors where the virus may be easily spread through inhalation of aerosols emitted by an infected person.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, arrives for a Senate Health, Education, Labor and Pensions Committee hearing to discuss the ongoing federal response to COVID-19 on May 11, 2021, in Washington, D.C. 
(Greg Nash-Pool/Getty Images)

LA COUNTY ‘STRONGLY RECOMMENDS’ MASKS INDOORS OVER DELTA VARIENT, REGARDLESS OF VACCINATION STATUS

Dr. Anthony Fauci, the U.S. government’s chief epidemiologist, is also encouraging vaccinated people to wear masks if they are somewhere with a low vaccination rate. He said on NBC’s “Meet the Press” Sunday that there’s “good reason” to wear masks if you are vaccinated and in an area where the vaccination rate is low. “Nothing is 100%,” he added. 

But others experts say the concern about the Delta variant is overblown and returning to strict health measures could be harmful. Johns Hopkins School of Medicine professor Dr. Marty Makary told Fox News that guidance like Los Angeles’ “sends the wrong message” for increasing vaccination levels.

“While 40-60% more contagious,” Makary said of the Delta variant, “the COVID in all its variant forms is circulating at very low levels in the population. The only people who should be concerned are those who do not have immunity either through vaccination or natural immunity.”

“At this point, everyone at-risk has had the opportunity to get vaccinated,” Makary continued. “Those who are not immune are choosing to do so at their own personal risk.”

Markary added that the initial reasoning for COVID restrictions in early 2020 wasn’t to prevent all infection but to prevent hospitals from being overrun. “That is no longer a concern… We have to put things in perspective,” Markary said. 

The statements from Fauci and Ferrer follow recommendations from the World Health Organization (WHO) that vaccinated people continue to wear masks. 

“This continues to be extremely important, even if you are vaccinated,” WHO Assistant Director General Mariangela Simao said in a news briefing last month of masking and other measures. “People cannot feel safe just because they had the two doses.” 

FAUCI SAYS VACCINATED PEOPLE SHOULD ‘GO THE EXTRA MILE’ AND WEAR MASKS IN AREAS WITH LOW VACCINATION RATE

Other places in the United States are leaning toward stronger recommendations on public health measures, especially in crowded situations. Among them is Illinois.

“Illinois’ access to and utilization of vaccines has allowed us to remove our capacity restrictions in phase 5 of the Restore Illinois plan,” Illinois Gov. J.B. Pritzker said last week. “But it’s imperative that we remember that this doesn’t meant that the pandemic is over.” 

“Israel, which has led the world in vaccinations, has reinstated its indoor mask mandate and other mitigations in light of fully vaccinated adults getting infected with the Delta variant,” Pritzker added. “It is just out of an abundance of caution I wanted to wear a mask today… When we leave our home every day I would encourage everybody whether you’re vaccinated or not to bring your mask with you.”

Virginia is not instituting a mask mandate, but the deputy director of its epidemiology office recommends those who are vaccinated continue to wear masks, according to WRIC. And the state, at least for now, is requiring that all people in schools continue to wear masks “regardless of vaccination status.” 

Others have been more frank in their pro-masking calls. 

 Illinois Gov. J.B. Pritzker attends the Idas Legacy Fundraiser Luncheon on April 12, 2018, in Chicago. Pritzker urged vaccinated people to bring masks with them when they leave the house last week. (Scott Olson/Getty Images)
((Scott Olson/Getty Images))

UNVACCINATED PEOPLE ENTERING ‘DEATH LOTTERY,’ WEST VIRGINIA GOV SAYS

Dr. Shad Marvasti of the University of Arizona College of Medicine-Phoenix told Yahoo Finance bringing back mask mandates “is a good idea.” “We don’t want to wait until after the fact and get caught with this thing already ahead of us when we know that masks work,” the doctor said.

And the National Education Association last week considered a resolution from Oakland, Calif., delegate Mark Airgood that would call for mandatory vaccination, mask-wearing and social distancing in schools. The resolution was defeated but reflects the sentiment among some that in-person instruction for students in the fall could be in jeopardy without significant pandemic health measures. 

“We need to demand that no student return to in-site instruction until there’s vaccines for every student. It makes no sense to bring together young people at a single site, especially when the variants are spreading just as quickly among young people as among adults,” Airgood said.

Other officials, meanwhile, are more suspicious of bringing back mask mandates, citing the fact virus numbers are largely down in the U.S.

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Washington State Epidemiologist Dr. Scott Lindquist told King 5 that the state is “not at this time” reimplementing restrictions because the state’s “rates are going down” even with the Delta variant. And Michigan officials say they are not planning to reimplement restrictions, The Detroit News reported. 

White House Press Secretary Jen Psaki said Tuesday the federal government isn’t considering implementing new national health measures beacuse of the United States’ vaccination rate. 

New Jersey Gov. Phil Murphy also touted the fact his state is currently in “really good shape” on coronavirus cases, according to NJ.com. 

“I hope we don’t have to go back,” Murphy added. But, he said, “If we have to, we will, clearly.” 



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US

Biden Suggests Door-To-Door Vaccination As Delta Variant Spreads

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As the more transmissible Delta variant spreads throughout the US, President Joe Biden is scrambling to find ways to get more Americans vaccinated, including going door-to-door. 

In a press briefing on Tuesday, Biden said mass vaccination sites across the country are closing down, and now “we need to go to community by community, neighborhood by neighborhood, and oftentimes, door to door — literally knocking on doors — to get help to the remaining people protected from the virus.”

Experts have said communities with the least vaccination rates are more at risk of outbreaks caused by the more transmissible Delta variant, which originated in India. The variant may also be able to evade protection from existing vaccines, as Insider’s Aria Bendix reported.   

The variant has already been found in all 50 states and is dominant in five, including California. It’s expected to be the most dominant strain in the country in the coming weeks. 

Delta poses the most risks to the unvaccinated. A recent Associated Press analysis found almost all of the COVID-19 deaths in the US are among those who are unvaccinated.

“Our fight against this virus is not over,” Biden said. “Right now, as I speak to you, millions of Americans are still unvaccinated and unprotected. And because of that, their communities are at risk, their friends are at risk. The people that they care about are at risk.”

Read more: Here are 9 people you should watch as Rep. Matt Gaetz’s legal drama escalates

The president’s approach is to change from large public messaging into more local approaches, equipping local medical experts and professionals to work with their communities to get more people vaccinated. 

As mass vaccine sites close, the president said he wanted vaccines to be given at local settings like pharmacies, churches, festivals, or workplaces. He wants the experience to be like “going in to get toothpaste or something else you need from a drugstore.”

“We’re going to put even more emphasis on getting vaccinated in your community, close to home, conveniently at a location you’re already familiar with,” he said. 

About 55% of all Americans are fully vaccinated, CDC data shows, but vaccination rates are declining. While more than 3 million Americans received vaccines daily during the peak in April, the rate has been declining in recent weeks, at one point seeing only 700,000 people getting shots per day. 

Additionally, a Washington Post-ABC News poll from last week found that 29% of Americans say they most likely won’t take a vaccine.

Experts have warned that unvaccinated people are not only risking their own health but risk allowing for more variants.

“Unvaccinated people are potential variant factories,” Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, told CNN.

“The more unvaccinated people there are, the more opportunities for the virus to multiply,” he added.

Biden warned that while were close to getting out the pandemic, it’s important for everyone to do their part and stay vigilant. 

“We are emerging from one of the darkest years in our nation’s history into a summer of hope and joy, hopefully.  Think about where you were — where you were last year, where you are today; what you were able to do last year at this time and do today. It’s a year of hard-fought progress. We can’t get complacent now,” he said. 

 

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Health

Pfizer vaccine protection takes a hit as Delta variant spreads, Israeli government says

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In a brief statement issued on Monday, the government said that as of June 6, the vaccine provided 64% protection against infection. In May — when the Alpha variant dominated in Israel and the Delta strain had not yet spread widely — it found that the shot was 95.3% effective against all infections.

The government added that the vaccine was now 93% effective in preventing severe disease and hospitalizations, compared to 97% reported in the medical journal The Lancet in May.

The statement cited top line figures, but did not release underlying data or other details about its analysis. A team at Hebrew University said in a separate statement that it was too soon to tell how much the Delta variant was affecting vaccine efficacy.

Dr. Ashish Jha, dean of Brown University’s School of Public Health, was also cautious about drawing conclusions. “Best data still suggest mRNA vaccines offer high degree of protection against infection and superb protection against severe illness. Lets await more data but as of now … If you’re vaccinated, I wouldn’t worry,” he tweeted.

In another statement Tuesday, Israel’s Ministry of Health released some data about illness caused by Covid-19 and offered an expanded explanation of the vaccine’s protectiveness. Despite an apparent decline in the vaccine’s ability to prevent all infections during the spread of the Delta variant, the statement emphasized its continuing benefit in preventing severe cases.

Israel has deployed the Pfizer vaccine to everyone over the age of 12, and its early and quick rollout gave scientists one of the first real-world snapshots of its efficacy.

The government said the drop in efficacy is likely due to the spread of the Delta variant in Israel. This more infectious strain of the virus was first identified in India earlier this year and is also known as B.1.617.2.
Pfizer said it could not comment on unpublished data, but a recently published lab study it conducted with the University of Texas Medical Branch that found its vaccine was effective against lab-made versions of the Delta strain and others. The study found that full vaccination elicits an immune response that should be expected to protect people well against infection with the new variants.

Israel is one of the most vaccinated countries in the world, with more than 60% of the population fully inoculated and two-thirds having received at least one dose.

The statement highlights a big risk going forward: the emergence of new variants that might evade some of the protection provided by vaccines.

Public health officials are stressing that the current shots offer good protection against the Delta variant.

A study by Public Health England found this month that the Pfizer-BioNTech and Oxford-AstraZeneca vaccines were each highly effective — at 96% and 92% respectively — against hospitalizations from the Delta variant after two doses.

Separately, preliminary findings of a Scottish study published in The Lancet last month found that the Pfizer vaccine provided 79% protection against all infections from the Delta variant, compared with 92% against the Alpha variant. The same study, which analyzed data from 5.4 million people in Scotland found the the Oxford-AstraZeneca vaccine offered 60% protection against infection with the Delta variant compared with 73% for the Alpha variant.

Moderna’s vaccine was found in lab experiments to work against new variants such as the Delta strain, the company said.

Johnson & Johnson said lab tests of its one-shot coronavirus vaccine suggest it provides protection against the Delta variant.
However, this can change if the virus mutates further. That’s why doctors and public health officials want more people to get vaccinated. “The more we allow the virus to spread, the more opportunity the virus has to change,” the World Health Organization (WHO) advised last month.

Israel lifted most of its coronavirus restrictions in early June. However, the government then reinstated an indoors mask mandate after a spike in cases caused by the Delta variant. It also appointed a “special manager” to prevent the entry of the coronavirus and its variants into Israel and approved a plan to build a permanent testing facility at Ben Gurion Airport.

The country has reported a slight increase in daily cases in the past few weeks, but only a handful of people have died of the disease in Israel in the past month.

Meanwhile, England, where the Delta variant has become the dominant strain, is pushing ahead with its plan to drop most of its remaining restrictions in just two weeks’ time — despite strong warnings from many scientists.

Speaking at a government news briefing on Monday, UK Prime Minister Boris Johnson said the effectiveness of the vaccine against death was allowing the government to unlock further, even though the number of cases is rising rapidly. He said the government needed to balance the risk from the virus and the impact of the restrictions on people and added the country “must find a new way of living with the virus.”

“I want to stress form the outset that this pandemic is far from over … we’re seeing cases rise fairly rapidly. There could be 50,000 cases detected per day by the 19th [of June] and again as we predicted we’re seeing rising hospital admissions, and we must reconcile ourselves sadly to more deaths form Covid,” Johnson added.

The WHO has warned against this approach. “Many countries seem to be completely abandoning the idea that we have some control over this virus,” Dr. Mike Ryan, WHO’s executive director for health emergencies, said during a live Q&A session Monday. He warned against any “premature rush” to reopen at a time when cases are on the rise.

“We seem to be very much caught in the headlines that there is nothing we can do, it’s inevitable that we will going to see these waves and it’s inevitable that hospitals will fill up and inevitable that the graveyards are going to fill up,” he said. “It’s not inevitable, it can be stopped, but it’s going to take yet another effort from communities that are exhausted.”

CNN’s Maggie Fox, Amir Tal and Lauren Kent contributed reporting.

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Health

California virus cases rising as delta variant spreads

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LOS ANGELES (AP) — California broadly reopened its economy barely two weeks ago and since then an especially contagious coronavirus variant has spread among the unvaccinated, a development that has health officials on edge and already has prompted Los Angeles County to strongly recommend everyone resume wearing masks inside.

The nation’s most populous state is averaging close to 1,000 additional cases reported daily, an increase of about 17% in the last 14 days. Officials expected an increase when capacity limits were lifted for businesses and most mask restrictions and social distancing requirements were eliminated for vaccinated people.

But public health officials raised concern this week with the more transmissible delta variant spreading among the unvaccinated, who comprise the vast majority of new infections. LA County, where a quarter of the state’s nearly 40 million people live, recommended Monday that vaccinated residents resume wearing face coverings indoors after detecting that about half of all cases were the delta variant.

“The new wrinkle in this is really this new variant. It just sort of rips very quickly through people who are susceptible to being infected, which overwhelmingly is people who are not vaccinated,” said Kirsten Bibbins-Domingo, professor of epidemiology at the University of California, San Francisco. “We just opened up two weeks ago, everything was hunky dory.”

Gov. Gavin Newsom lifted a series of pandemic-related restrictions on June 15 after a final push to get more people vaccinated. Everyone 12 and older is eligible for shots and among that population 59% is fully vaccinated and another 10% has received a first dose.

In Contra Costa County, where 72% of eligible residents are fully vaccinated, officials recently began publishing virus case rates by vaccination status. Since the county has a high inoculation rate, the number of new coronavirus cases is generally low but unvaccinated residents remain at risk, said Dr. Chris Farnitano, the county’s health officer.

For example, the seven-day average of new virus cases per 100,000 people in the county was recently 7.0 for those who are unvaccinated, and 0.4 for those who are vaccinated.

“The overall numbers don’t look that concerning, but we know that there’s this population that hasn’t been vaccinated that still is at very high risk, and those overall numbers can give a false sense of security thinking COVID is still under control where it’s still spreading quite rapidly among the unvaccinated population,” Farnitano said.

In Los Angeles, a mix of masked and unmasked people walked around Echo Park Lake on Wednesday. G. Williams, who waited for a bus nearby, wore a black cloth mask over a blue surgical one — something she expects she’ll do for years to come.

The 69-year-old isn’t vaccinated, saying she still has concerns about possible long-term side effects. She supports her county’s latest recommendation and said she doesn’t understand why people wouldn’t wear a mask to protect others.

“To me, my mask is as important as any article of clothing,” she said.

At Raven Things Collected, an LA gift shop selling crystals, tarot cards and jewelry, a table full of merchandise has been pulled in front of the counter to keep everyone distanced.

Employee Yesenia Rego said she feels protected because she’s vaccinated and distanced from customers. Most people wear masks when they come in anyway, she said, adding those who don’t rarely ask if they should.

“They don’t even care anymore,” said Rego, 23, who wore a green cloth mask.

Vaccination rates vary widely across California. A San Francisco ZIP code reports more than 95% of those eligible are fully inoculated, while one in rural Modoc County has a 37% rate, according to state data.

Health officials said areas with low vaccination rates are especially at risk as the delta variant, first reported in India, spreads across the United States. The variant — which accounts for a fifth of new U.S. infections — was found in 15% of specimens sequenced in California in June, up from 5% in May.

In Orange County, the variant accounts for 45% of sequenced cases in the most recent week, said Dr. Regina Chinsio-Kwong, the county’s deputy health officer. Contact tracers reaching out to those infected with the virus find 95% are unvaccinated, and the few who are vaccinated report minor symptoms and aren’t hospitalized, she said.

“Because we’re starting to see these highly transmissible strains, it is only a matter of time for us to be exposed again,” she said. “So the question is how severe is the illness going to be when you actually get COVID.”

Public health officials said they hope measures like the one taken by Contra Costa County might help encourage more people to get the shots.

“It’s a demonstration in the real world, outside of the clinical trials, of the power of the vaccine,” said Andrew Noymer, a public health professor at University of California, Irvine. “COVID is going to seek out unvaccinated populations. The virus has a way of just sort of bouncing around until it finds a host it can infect, and those will be unvaccinated people.”

———

Taxin reported from Orange County, California.

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World

Rage Spreads in Paraguay as Virus Surges, Exposing Corruption

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ASUNCIÓN, Paraguay — For nearly a year, Paraguay was a leader in keeping the pandemic at bay, and despite its persistent troubles, the country remained fairly calm. Not any more.

Paraguay’s coronavirus infection rate has soared, becoming one of the worst in the Americas, and its already shaky health system has been stretched to the breaking point. In the last few days, demonstrators by the thousands have filled streets, demanding the ouster of President Mario Abdo Benítez, and in a few instances there have been bloody clashes with the police.

For many Paraguayans, corruption and elite entitlement that were once just unpleasant facts of life have become intolerable in the face of the pandemic. There is a shortage of basic drugs that doctors and nurses blame on graft; nonemergency surgery has been suspended because of a shortfall in medical supplies, and there are few vaccines to be had.

The crisis has spilled into the streets with a level of rage the county’s leaders have not faced in years. Daily protests started last Friday with medical workers, who were quickly joined by other frustrated people. Most have been peaceful, but in some cases security forces have met the demonstrators with rubber bullets, tear gas and water cannons.

“There are so many deaths and it is all the fault of the thieves who run our corrupt institutions,” said Sergio Duarte, who joined a demonstration outside of Congress on Saturday in Asunción, Paraguay’s capital and largest city.

The unrest in Paraguay is a snapshot of the massive challenges Latin America faces as the virus continues to take a heavy toll, while governments struggle to provide adequate health care and acquire enough vaccines.

The virus has sickened and killed Latin Americans in disproportionate numbers. The region has just over 8 percent of the world’s population, and about one-quarter of its confirmed Covid-19 deaths.

Paraguay’s official case and death rates remain well below the peaks suffered by much of the world, including the United States, but they are getting worse — the number of daily new infections has doubled in less than a month, to the highest level yet — even as many other countries improve.

“We’re here because we’re tired,” said Rosa Bogarín, one of thousands of protesters in Asunción. “We need free vaccines for everybody, medicine, education and a way out of this situation.”

Anger over the pace of vaccine rollout has hit many countries, aggravated in some places by the powerful and well-connected jumping the line and getting early access early access to shots.

In Paraguay, there has barely been a line to jump. A nation of 7 million people, by last week it had only received 4,000 doses of Russia’s Sputnik V vaccine. Over the weekend, Chile donated a shipment of 20,000 doses made by China’s Sinovac.

The pandemic recession has worsened poverty, inequality and food insecurity in Latin America, as it has around the world, compounding frustrations over the handling of the virus. The United Nations Economic Commission for Latin America and the Caribbean recently estimated that 209 million people in the region were living in poverty at the end of 2020, an increase of 22 million from a year earlier.

The crisis has fed longstanding frustrations with the wealthy and political leaders who do not feel bound by the same rules as others, said Alejandro Catterberg, a political analyst and pollster who runs Poliarquía, a Buenos Aires-based consultancy.

“In Latin America there is a general social structure in which the powerful have certain privileges and the political class has a self-imposed status as being different from the average citizen,” he said.

In Paraguay, the basis of the current crisis, including corruption, poverty and a weak health care system, “was exacerbated by the pandemic,” but existed much earlier, said Verónica Serafini Geoghegan, an economist at the Center for the Analysis and Dissemination of the Paraguayan Economy, a nongovernmental organization.

Mr. Abdo ousted his health minister, Julio Mazzoleni, and three other members of his cabinet over the weekend, but it did not quell the demonstrations. Mr. Mazzoleni followed in the footsteps of his counterparts in Peru, Brazil, Ecuador and Argentina, all forced out over the handling of the pandemic.

Paraguay was applauded, along with nearby Uruguay, for taking swift and decisive actions that kept their coronavirus outbreaks modest during the early months of the pandemic. But contagion began surging late last year, pushing intensive care units to the brink.

Opposition leaders have encouraged the demonstrations against Mr. Abdo, a conservative leader who has two years left in his term. On Saturday, the president asked all his ministers to draft resignation letters and told demonstrators that he understood their frustration.

“I’m a man of dialogue and not of confrontation,” Mr. Abdo said.

Many demonstrators say they intend to remain on the street until the government falls. Popular chants have included “Elections now!” and “Marito must resign,” a reference to the president’s nickname.

Paraguay’s foreign minister, Euclides Acevedo, said the government is scrambling to get the vaccines it has ordered from suppliers delivered, as the health ministry declared a heightened state of alert.

“Paraguay is determined to obtain vaccines from anywhere, by any means,” he said Tuesday in an interview. “Here everyone needs to get vaccinated, and for free, that’s the government’s intention.”

But many young demonstrators say they have waited long enough for decent governance.

“We won’t stop until Marito resigns,” protester Melisa Riveros said.

Santi Carnieri reported from Asunción, Paraguay. Daniel Politi reported from Buenos Aires. Ernesto Londoño contributed reporting from Rio de Janeiro.



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