Some Californians Willing to Travel a Distance to Get COVID-19 Shots – NBC Bay Area

Everyday it seems many people are hearing stunning stories of friends and neighbors going to great lengths to get vaccinated as soon as they can as Bay Area counties continue to struggle with vaccine supply issues.

For example, thousands of cars coming and going at the Levi’s Stadium mass vaccination site in Santa Clara all day long but don’t be misled.

Santa Clara County Health Officer Dr. Marty Fenstersheib told NBC Bay Area the county received just 40,000 doses last week. “However, I would warn people, basically, that there aren’t many first dose appointments,” he said.

Fenstersheib said he expects numbers to remain flat again this week. That means for at least one more week, it’s going to be difficult to get your first shot in Santa Clara county.

For Santa Cruz county resident Vijay Char, he said it seemed impossible to find his first shot in his county, so he went to the MyTurn website. “It prompted me to go look in Solano, so I absolutely looked there,” he said.

Char tells NBC Bay Area that he and his wife drove more than two hours from their Aptos home, six days ago to a site in Fairfield, only to find a note above the door stating no vaccines ran out.

Char added that dozens of people showed up in the few hours as he waited there to see if more vaccines would arrive. “It was sad to see some of the older folks that were struggling out of their wheelchairs and getting into their walkers and hobbling over to the door only to find that rejection there,” he said.

The couple did not give up, finally setting up their appointments directly through CVS Pharmacy’s vaccination page. But it was a CVS that was located two and a half hours away in Fresno. “The drive, I mean, it’s okay during these times to get out of the routine and go somewhere,” Char said.

Another looming issue could drag out the supply problem. There is mounting skepticism over AstraZeneca’s vaccine, which is still awaiting FDA emergency authorization. This comes after the company revealed that its publicly stated efficacy findings may have not been final.

Fenstersheib said he’s sure that the FDA and every federal and state agencies involved in approving the drug will vet the vaccine thoroughly. “To the point of making sure that no vaccine is authorized for this country that has unacceptable safety issues around it,” he said.

Fenstersheib believes everyone who wants to be fully vaccinated will be able to do so before the end of summer.

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Covid-19: U.S. Virus Cases Fall as Variants Spread

A healthcare worker tests for the coronavirus at Beltzville State Park in Lehighton, Pa., on Wednesday. New coronavirus variants have the potential to slow progress in the fight against the virus.
Credit…Hilary Swift for The New York Times

In recent days, coronavirus cases have been dropping steadily across the United States, with hospitalizations falling in concert. But health officials are growing increasingly concerned that quickly circulating variants of the virus could cause new surges of cases faster than the country is managing to distribute Covid-19 vaccines.

Public health experts likened the situation to a race between vaccination and the virus’s new variants — and the winner will determine whether the United States is approaching a turning point in its battle against the coronavirus, now entering a second year.

“We’re definitely on a downward slope, but I’m worried that the new variants will throw us a curveball in late February or March,” said Caitlin M. Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

Nationwide, new coronavirus cases have fallen 21 percent in the last two weeks, according to a New York Times database, and some experts have suggested this could mark the start of a shifting course after nearly four months of ever-worsening case totals.

This week, the University of Washington’s Institute for Health Metrics and Evaluation, which puts out a predictive model that is widely used for planning, including by some government agencies, released a projection saying new cases in the United States would decline steadily from now on.

“We’ve been saying since summer that we thought we’d see a peak in January and I think that, at the national level, we’re around the peak,” said Dr. Christopher J.L. Murray, director of the institute. Still, Dr. Murray cautioned that variants of the virus could “totally change the story.”

Health officials warned that they have little foresight into what the rest of the winter and spring will bring. President Biden’s new administration has vowed to impose speed and order to what has been a slow, bumpy rollout of vaccinations, in which some 15 million people have received at least one dose of a Covid-19 vaccine. But it is not clear how many vaccines will be available in cities across the country in the coming weeks. The public should still wear masks, officials say, avoid large gatherings and sign up to be vaccinated as soon as they are eligible.

Some experts, looking abroad at how new viral variants sent cases surging in Britain, Ireland, South Africa and northern Brazil, said the United States could merely be in a lull before a new spike begins. Even after an epidemic’s peak, it remains dangerous: Sometimes just as many people are infected after the peak as were before.

Nicolas A. Menzies, one of several scientists running the Prevention Policy Modeling Lab at Harvard’s T.H. Chan School of Public Health, which tracks levels of herd immunity, said he felt it was “more probable than not” that infections would climb again.

It is important to spot regions where variant strains are turning up, he said, since they would be the most likely to have early surges. Thus far, the variant that has been prevalent in Britain and a new variant have been found most often in Southern California and Florida, according to the Centers for Disease Control and Prevention. Cases are slowly declining in both regions. But it’s “still too early to tell,” he said.

The United States continues to average 181,000 new cases each day, more than any point of the pandemic before December. Deaths from the coronavirus also remain extraordinarily high, with more than 4,300 deaths announced on Wednesday, the second-highest daily total of the pandemic.

Another 3,730 deaths were announced across the country on Friday, and Florida became the fourth state where the death toll has surpassed 25,000.




Cuomo Warns New York Will Temporarily Run Out of Vaccine

On Friday, Gov. Andrew M. Cuomo warned that New York State would run out of vaccine doses by the end of the day, and said providers should only schedule appointments for “allocations they know they will receive.”

We run out of allocation today, the Week 1 to 5 allocation will be exhausted by the end of the day, Friday. We may already be exhausted, frankly, midday on Friday. And we’re now going week to week on the next week’s allocation. We have 28,000 dosages left in the state, from Week 1 to 5. If you add up all the dosages that are not in arms in the state, it’s 28,000. Problem is, we administer about 80,000 dosages per day. Right, so 28,000 does not get you through the day. Providers should only schedule appointments for allocations they know they will receive. In other words, in this confusing situation, the last thing we want to do is cancel appointments. Right, so don’t schedule an appointment unless you know you have an allocation.

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On Friday, Gov. Andrew M. Cuomo warned that New York State would run out of vaccine doses by the end of the day, and said providers should only schedule appointments for “allocations they know they will receive.”CreditCredit…Mary Altaffer/Associated Press

New York State expected to run out of its supply of coronavirus vaccines before the end of Friday, but more doses would arrive in the coming days, Gov. Andrew M. Cuomo announced at a news conference.

“We will — by the end of today fully — utilize all of the dosages that have been delivered,” Mr. Cuomo said Friday.

Ninety-seven percent of New York State’s vaccine inventory, accumulated over the past five weeks, has been administered, the governor noted, and a total of 28,000 first doses were left in inventory Friday morning. Mr. Cuomo added that the state inoculates roughly 80,000 people per day.

Vaccines have been slowly rolling out in the United States and states are dealing with shortages just as new virus variants, some more contagious, are spreading.. The C.D.C. has warned that the more transmissible variant first discovered Britain, which is thought to be 50 percent more contagious, might become the dominant source of infection in the United States by March. Although public health experts are optimistic that the existing vaccines will be effective against that variant, known as B.1.1.7, it may drive up the infection rate if enough people remain unvaccinated.

So far, New York State has found 25 confirmed cases of that variant, but no cases of the variants found in South Africa or Brazil, Mr. Cuomo said.

Mr. Cuomo urged vaccine providers to only schedule appointments based on the number of doses they know they will receive.

“Some providers think if they schedule appointments ahead of time, people will feel more comfortable — not if you cancel those appointments,” Mr. Cuomo said. “So don’t schedule any appointment unless you know you have an approved state allocation coming, and appointments will be honored. “

Some parts of the state — including New York City and the Rochester and Buffalo areas — have had to delay vaccination appointments scheduled for this week because of supply issues.

New York State should receive 250,400 vaccine doses for use next week, with some arriving Friday. If supply allowed, New York State could inoculate 700,000 people each week, Mr. Cuomo said.

On Friday afternoon, Mayor Bill de Blasio sent a letter to President Biden requesting more doses and the “flexibility” to use second doses to vaccinate more New Yorkers sooner.

“While maintaining a secure reserve of second doses (two-week supply), the City is seeking the flexibility during this time to temporarily use the remaining supply of second doses to bridge the gap to a time of increased production, replenishing the second dose supply as production ramps,” Mr. de Blasio’s letter to Mr. Biden read.

But it was not immediately clear whether the Biden administration could guarantee any increase in supply. Federal health officials and corporate executives agree that it will be impossible to increase supply before April because of the lack of manufacturing capacity. And the current vaccination effort, which had little central direction under the Trump administration, has so far sown confusion and frustration. Some areas are complaining they are running out of doses, while others have unused vials sitting on shelves.

When asked about Mr. de Blasio’s request and New York’s dwindling supply of doses during Friday’s new conference, Jen Psaki, the White House press secretary, said the administration has “advocated for releasing additional access from the reserves, but we have really deferred to health and medical experts” about whether it was safe to delay second doses past the tested three to four-week window. She added that the Biden administration has “asked the C.D.C. to look into what the options are.”

According to a senior administration official, Pfizer-BioNTech and Moderna are on track to deliver up to 18 million doses a week. Together, they have pledged to deliver 200 million doses by the end of March.

A third vaccine maker, Johnson & Johnson, is due to report the results of its clinical trial shortly. If approved, that vaccine would also help shore up production. If all of that supply were used, the nation could average well over two million shots a day.

In April and afterward, the outlook brightens. Pfizer and Moderna have each committed to supply another 100 million doses by the end of July; the companies may be able to provide even more. A week ago, Pfizer and BioNTech, its German partner, increased their global production target for the year to two billion doses from 1.3 billion doses.

A healthcare worker administers a Covid-19 vaccine in Harlem on Friday. The C.D.C. has updated its guidelines on vaccine doses from multiple manufacturers.
Credit…James Estrin/The New York Times

The Centers for Disease Control and Prevention has quietly changed its recommendations for coronavirus immunizations to allow patients to switch the authorized vaccines between the first and second doses in “exceptional situations,” and to extend the interval between doses to six weeks, even though such changes have not been studied in large clinical trials.

The new guidelines were posted on the agency’s website on Thursday with little public notice. With the possibility of vaccine shortages on the horizon and little expectation that supply can be increased before April, the changes may offer a way to vaccinate more people — a high priority for President Biden, who outlined his national Covid-19 strategy on Thursday.

A C.D.C. spokeswoman, Kristen Nordlund, said the agency’s “intention is not to suggest people do anything different, but provide clinicians with flexibility for exceptional circumstances.”

Dr. Anthony S. Fauci, the president’s special adviser for Covid-19, has repeatedly advised against delaying the second dose or making any other changes in vaccination protocol without the data to support them. But on Friday, he seemed open to delaying second doses, at least for short periods.

“What the C.D.C. is saying, sometimes, the situation is stressed where it’s very difficult to be exactly on time,” Dr. Fauci told CNN. “So we’re saying, you can probably do it six weeks later, namely, two additional weeks. Quite frankly, immunologically, I don’t think that’s going to make a big difference.”

Earlier this month, Britain quietly updated its vaccination playbook to allow for a mix-and-match vaccine regimen if the second dose of the vaccine a patient originally received isn’t available, or if the manufacturer of the first shot isn’t known. Some scientists questioned the move at the time, saying Britain was gambling with its new guidance.

In the United States, two vaccines have emergency federal authorization — one by Pfizer and BioNTech, and the other by Moderna — and both rely on the same mRNA technology and call for two doses. Until now, the C.D.C. has strictly adhered to the recommendations from its Advisory Committee on Immunization Practices, which specifically stated that the vaccines were not to be mixed.

The updated C.D.C. guidance still states that the authorized vaccines are “not interchangeable with each other or with other Covid-19 vaccine products.” The agency put the word “not” in bold on its website, and noted that the safety and efficacy of mixing doses has not been studied.

But “in exceptional situations in which the first-dose vaccine product cannot be determined or is no longer available,” the guidelines added, any available mRNA vaccine can be used for the second dose.

With respect to dosing, the guidance says that the second dose should be administered as close as possible to the recommended interval — three weeks for the Pfizer-BioNTech vaccine and four weeks for Moderna. But if that is “not feasible,” the agency wrote, the interval between doses may be extended to six weeks.

The pace of vaccination is critical not just to curbing disease and death, but also to heading off the impact of more infectious forms of the virus. The C.D.C. has warned that one variant, which is thought to be 50 percent more contagious, might become the dominant source of infection in the United States by March.

Although public health experts are optimistic that the existing vaccines will be effective against that variant, known as B.1.1.7, it may drive up the rate of new cases if enough people remain unvaccinated.

At a White House briefing on Thursday — his first since November — Dr. Fauci said that experts are particularly concerned about new variants of the virus in South Africa and Brazil, which have not yet reached the United States. He said vaccines still appear effective against those variants, but the variants may sidestep the immune system to some degree, making it all the more urgent for people to be vaccinated.

“Replicating viruses don’t mutate unless they replicate,” Dr. Fauci said, “and if you can suppress that by a very good vaccine campaign, then you can actually avoid this deleterious effect that you might get from the mutations.”

Federal health officials and corporate executives agree that it will be impossible to increase the immediate supply of vaccines before April because of lack of manufacturing capacity. And the current vaccination effort, which had little central direction under the Trump administration, has so far sown confusion and frustration. Some localities are complaining they are running out of doses, while others have unused vials sitting on shelves.

According to a senior administration official, Pfizer-BioNTech and Moderna are on track to deliver up to 18 million doses a week. Together, they have pledged to deliver 200 million doses by the end of March.

A third vaccine maker, Johnson & Johnson, is due to report the results of its clinical trial shortly. If approved, that vaccine would also help shore up production. If all of that supply were used, the nation could average well over two million shots a day.

In April and afterward, the outlook brightens. Pfizer and Moderna have each committed to supply another 100 million doses by the end of July; the companies may be able to provide even more. A week ago, Pfizer and BioNTech, its German partner, increased their global production target for the year to two billion doses from 1.3 billion doses.

The restricted area in the Jordan district of Hong Kong on Saturday.
Credit…Anthony Kwan/Getty Images

New infections in recent months and a contagious new variant threatening to accelerate the pandemic have prompted some governments to revert to their harshest social-distancing measures.

In Hong Kong, the authorities said on Saturday that they had locked down part of a densely packed neighborhood and started to test everyone there, one of the most drastic measures that the Chinese territory has taken since the coronavirus surfaced there last winter.

The local government said on Saturday that it had restricted access to some parts of the Jordan District, one of Hong Kong’s most crowded, and that people there would be prevented from leaving until they had been tested, the first such lockdown in the territory. Battalions of police officers were seen guarding the area’s perimeter as health workers in head-to-toe protective gear walked inside.

About 200 buildings in the Jordan area were affected, and more than 1,700 police and other officers were expected to be deployed, The South China Morning Post reported.

Officials said that 162 confirmed coronavirus cases had been recorded across 56 buildings in Jordan in the first 20 days of January.

The government plans to finish testing residents in the restricted area within 48 hours, in time for residents to go to work on Monday morning.

As of Saturday, Hong Kong was averaging 73 daily cases over the past week, according to a New York Times database.

In Madrid, restaurants and bars will need to close early on Monday, as part of a series of new lockdown restrictions announced by the authorities in Spain’s capital region.

The new rules comes only days after Isabel Ayuso, the leader of the Madrid region, pledged instead to avoid any further clampdown on restaurants, saying that “if you want to ruin hostelry, don’t count on me.”

Instead, restaurants will need to close at 9 p.m. — effectively stopping them from serving at traditional Spanish dinner hours — and also limit the number of people sharing a table to four, rather than six. Madrid’s nighttime curfew will also be moved forward to 10 p.m. from 11 p.m.

Madrid is joining other regions of Spain that have been tightening their lockdown since the start of the year, amid particular concerns about the spread of a new variant of Covid-19 first detected in Britain, called B.1.1.7.

But the central government has so far resisted calls from some regional politicians to return the country to a full lockdown, like that enforced in March when the coronavirus first inundated Spain. The average daily number of registered Covid-19 cases in Spain has doubled over the past two weeks, reaching past 35,000 on Friday.

A pharmacist from Walgreens talks to staff members at an assisted living home in Jackson, Miss., about the coronavirus vaccine.
Credit…Rogelio V. Solis/Associated Press

Walgreens, one of the big pharmacy chains tapped by federal officials to help vaccinate the residents and staff of nursing homes and other long-term care centers against Covid-19, acknowledged on Friday that the rollout had not gone as smoothly or as quickly as had been promised.

The company said it had administered more than 1 million shots across the country to long-term care residents. “We’re already seeing the impact of those vaccinations,” noted Rina Shah, a group vice president at Walgreens.

Federal officials and states have made vaccinating the roughly three million people who live in long-term care facilities and those who care for them a priority group for inoculation. Long-term care residents are particularly vulnerable, and these facilities account for nearly 40 percent of the nation’s Covid-19 deaths.

Despite an optimistic timetable set by health officials in the Trump administration for how quickly people in these facilities would be vaccinated, patients, families and employees have expressed growing frustration over the slow pace of inoculations.

CVS Health is the other major drugstore chain involved in administering Covid vaccines at nursing homes, and said it had vaccinated some 1.6 million residents and staff of long-term care facilities. Walgreens said it would schedule three visits to each facility to ensure that people receive both doses.

“It’s been a monumental effort,” Dr. Shah said. Many facilities had trouble scheduling the vaccinations, and have encountered some hesitancy, especially among staff, toward getting the shots, she added.

But broadening outreach to inoculate people on site, inside drugstore locations, isn’t likely to be entirely in place by late February as had initially been planned. Earlier this week, Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, warned that the timetable seemed unrealistic and noted the need for sufficient supply and the need to address accessibility and vaccine hesitancy.

Walgreens said it was working closely with federal and state officials to determine who would be eligible for a shot at one of its pharmacies, but acknowledged the process for Americans to figure out how to get vaccinated was “confusing” and “not easy to navigate.” Unlike flu shots, the Covid-19 vaccines would only be given by appointment.

Pfizer’s contract with the federal government requires that it be paid by the dose.
Credit…James Estrin/The New York Times

Pfizer, after discovering it could squeeze an extra vaccine dose out of vials that were supposed to contain only five, plans to count the surprise sixth dose toward its previous commitment of 200 million doses of Covid vaccine by the end of July. That means it will be providing fewer vials than once expected for the United States.

And yet, pharmacists at some vaccination sites say they are still struggling to reliably extract the extra doses, which require the use of a specialty syringe.

For weeks, Pfizer executives pushed officials at the Food and Drug Administration to change the wording of the vaccine’s so-called emergency use authorization so that it formally acknowledged that the vials contained six doses, not five.

The distinction was critical: Pfizer’s contract with the federal government requires that it be paid by the dose.

At one point, Pfizer executives lashed out at the top federal vaccine regulator over the government’s reluctance to budge on the request, according to people familiar with the discussions who were not authorized to discuss them.

On Jan. 6, Pfizer got what it wanted. The F.D.A. changed the language in its fact sheet for doctors to confirm that the vials contain a sixth dose. The change mirrors similar labeling updates by the World Health Organization and the F.D.A.’s counterpart in the European Union.

Company officials, including the chief executive, Dr. Albert Bourla, have said that the sixth dose allows Pfizer to stretch its supply of scarce vaccine even further — it was one factor, for example, in the company’s new estimates that it will be able to manufacture two billion doses for the world this year, instead of the 1.3 billion it had originally planned.

The U.S. negotiations come at a particularly harrowing time, as the Biden administration is said to be discussing the purchase of a third round of 100 million doses of Pfizer’s vaccine later in the year. The country is racing to vaccinate as many people as possible before more contagious virus variants become widespread, potentially spurring a wave of new hospitalizations and deaths.

Health care workers gathering samples at a coronavirus testing site in Harare, Zimbabwe on Friday. The Covax global initiative is purchasing vaccine doses from Pfizer to distribute among its member nations.
Credit…Tafadzwa Ufumeli/Getty Images

Pfizer announced Friday that it has agreed to sell up to 40 million doses of its Covid-19 vaccine to Covax, a global initiative organizing the purchase of vaccines for 92 poor countries and dozens of other nations, and that a small portion of those doses would start rolling out the first quarter of this year.

The agreement, which has not yet been finalized, comes amid an extraordinary gap in access to the vaccines around the world.

Wealthy countries have laid claim to more than half the vaccine doses that could come on the market by the end of the year, in some cases lining up enough doses to immunize their entire populations multiple times over, and are already rolling out large quantities of the Pfizer and Moderna vaccines. In stark contrast, most poor countries may receive, through Covax, only enough doses to vaccinate 25 percent of their populations this year, and have so far not had access to any vaccines.

In a news conference with the heads of the World Health Organization and two of the organizations leading and implementing Covax, Pfizer’s chief executive, Albert Bourla, said the agreement was an example of the company being “firmly committed to working toward equitable and affordable prices of Covid-19 vaccines for people around the world.” The doses for poor countries will be sold at nonprofit prices, he said.

But it’s unclear exactly when most of those doses will be made available. Gavi, one of organizations running Covax, said Pfizer would provide one million of the doses by the end of March, but could not say when the 39 million doses would materialize. Pfizer refused to provide a timeline other than to say that distribution would occur throughout 2021.

“Details on schedule will not be made public at this time,” Sharon Castillo, a spokeswoman for Pfizer, said in an email.

Some wealthy countries that have deals with Pfizer have complained they weren’t getting access to doses as quickly as they liked. And the company has announced delays for some of its orders because it needed to upgrade its Belgian factory. Pfizer has said it will be able to follow through with all of its commitments. And Mr. Bourla said Friday that it was on track to produce 2 billion doses by the end of the year.

Covax also expects to roll out as many as 150 million doses of the AstraZeneca vaccine to its participating countries in the first quarter. Two separate manufacturers of that vaccine first need to receive the necessary regulatory approvals, which could happen as early as February, Dr. Seth Berkley, chief executive of Gavi, said on Friday. Covax also has agreements to purchase Novavax, Sanofi, and J&J vaccines, which have not yet completed their clinical trials. The initiative expects to eventually receive 2.3 billion vaccine doses this year, with 1.8 billion going to the 92 poor countries, Dr. Berkley said.

The first doses distributed through Covax will go to health care workers, with other priority groups getting access down the line.

The United States had been absent from Covax, which has pulled in financial support from the European Union, Britain and Canada, among other countries. But earlier this month, the U.S. approved $4 billion for the initiative. Thursday, addressing the World Health Organization, Dr. Anthony Fauci, President Biden’s chief medical adviser for the pandemic, said the United States would become an official member of Covax.




Johnson Hints Variant May Be More Deadly, Though It’s Too Soon to Tell

Prime Minister Boris Johnson of Britain’s scientific advisers urged restraint in interpreting preliminary evidence about the variant.

I must tell you this afternoon that we’ve been informed today that in addition to spreading more quickly, it also now appears that there is some evidence that the new variant, the variant that was first identified in London and the southeast, may be associated with a higher degree of mortality. It’s largely the impact of this new variant that means the N.H.S. is under such intense pressure. Current evidence continues to show that both the vaccines we’re currently using remain effective, both against the old variant and this new variant. And so you’ll also want to know that our immunization program continues at an unprecedented rate: 5.4 million people across the U.K. have now received their first dose of the vaccine. And over the last 24 hours, we can report a record 400,000 vaccinations. In England, one in 10 of all adults have received their first dose, including 71 percent of over-80s and two-thirds of elderly care home residents.

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Prime Minister Boris Johnson of Britain’s scientific advisers urged restraint in interpreting preliminary evidence about the variant.CreditCredit…John Sibley/Reuters

For weeks, Britain has reported alarming coronavirus death numbers, hospitals have continued to fill up, and fears have risen that it will take months to control the spread of a more transmissible variant first detected in the Kent region of England last year.

On Friday, Prime Minister Boris Johnson said at a news conference the new variant may also be associated with a slightly higher chance of death, even as he acknowledged it was too soon to be sure, and his own scientific advisers urged restraint in interpreting preliminary evidence.

Patrick Vallance, the government’s chief scientific adviser, said that the data indicating an increase in the risk of death in those infected with the new variant are preliminary and based on small numbers. The absolute risk of dying from Covid-19 still remains low.

“That evidence is not yet strong, it’s a series of different bits of information that come together to support that,” Mr. Vallance said.

Referring to the country’s overstretched National Health Service, Mr. Johnson said that “it’s largely the impact of this new variant that means the N.H.S. is under such intense pressure.”

Yet as Britain’s top health authorities have warned about grim weeks ahead, the latest vaccination figures have offered a glimmer of hope: Nearly 5.5 million people had received a first vaccine dose in Britain as of Friday, according to government data. That amounts to about 8 percent of the population.

By comparison, the United States has vaccinated around 4.5 percent of its population, and most European countries have vaccinated less than 2 percent.

Fewer than 500,000 people in Britain have received a second injection, as the National Health Service is prioritizing first injections and second doses are being given up to 12 weeks after the first. England’s chief medical officer, Chris Whitty, said the first shot of the Pfizer-BioNTech and Astra Zeneca vaccines gave a “great majority of the protection.”

Since the authorities imposed new lockdown restrictions in England this month, Britain has reported its highest daily death figures. The country remains one of the worst-hit in Europe. and the authorities have said that England’s lockdown could remain in place throughout the spring.

“We will have to live with the coronavirus, one way or another, for a long time to come,” Mr. Johnson said on Friday.

The situation is so bleak that, according to British news reports, the authorities are considering offering £500 (about $680) to anyone testing positive for the virus to help them stay in quarantine for the full 10 days, which many currently do not.

There are also fears that cuts in vaccine deliveries from Pfizer, which is retooling a major manufacturing plant in Belgium, may slow down the vaccination campaign, and that variations in vaccination rates are putting some areas of the country at a disadvantage.

In Britain, a racecourse, rugby fields and religious buildings have been turned into vaccination centers, and shots are also being given at 1,200 hospitals and medical offices. More than two million people were vaccinated in the past seven days, twice as many as two weeks ago.

At that rate, Britain could still fall short of its goal to vaccinate 13.9 million people by mid-February, but the authorities have said they can reach the target if they continue to increase the pace.




Biden Calls Coronavirus Aid an ‘Economic Imperative’

President Biden signed two executive orders Friday, directing more federal aid to Americans struggling due to the coronavirus pandemic and laying the groundwork to institute a $15 minimum wage for federal employees.

We remain in a once-in-a-century public health crisis that’s led to the most unequal job and economic crisis in modern history. And the crisis is only deepening, it’s not getting better. It’s deepening. We can not, will not let people go hungry. We can not let people be evicted because of nothing they did themselves, and can not watch people lose their jobs. And we have to act. We have to act now. It’s not just to meet the moral obligation to treat our fellow Americans with the dignity, respect they deserve. This is an economic imperative. I’m signing an executive order that directs the whole of government, a whole of government effort, to help millions of Americans who are badly hurting — requires all federal agencies to do what they can do to provide relief to families, small businesses and communities. And in the days ahead, I expect agencies to act. Let me touch on two ways these actions can help change Americans’ lives. The Department of Agriculture will consider taking immediate steps to make it easier for the hardest-hit families to enroll and claim more generous benefits in the critical food and nutrition assistance area. I expect the Department of Labor to guarantee the right to refuse employment that will jeopardize your health, and if do so, you’ll still be able to qualify for the insurance. That’s a judgment. the Labor Department will make. We’re in a national emergency. We need to act like we’re in a national emergency. So we’ve got to move with everything we’ve got. We’ve got to do it together. The first one is the economic relief related to Covid-19 pandemic. Second one is protecting the federal workforce.

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President Biden signed two executive orders Friday, directing more federal aid to Americans struggling due to the coronavirus pandemic and laying the groundwork to institute a $15 minimum wage for federal employees.CreditCredit…Anna Moneymaker for The New York Times

After issuing a series of executive orders on his first full day in office and pledging a “full-scale wartime effort” to combat the coronavirus pandemic, President Biden on Friday continued apace with two more executive orders aimed at steering additional federal aid to families struggling to afford food amid the pandemic and helping workers stay safe on the job.

Mr. Biden, who has vowed to use the power of the presidency to help mitigate economic fallout from the pandemic, directed the Treasury Department to find ways to deliver stimulus checks to millions of eligible Americans who have not yet received the funds.

Mr. Biden also signed a second executive order that will lay the groundwork for the federal government to institute a $15 an hour minimum wage for its employees and contract workers, while making it easier for federal workers to bargain collectively for better pay and benefits.

“The crisis is only deepening,” Mr. Biden said during remarks at the White House, calling the need to help those out of work and unable to afford enough food “an economic imperative.”

“We have the tools to help people. So let’s use the tools. All of them. Now,” he said.

The executive actions are part of an attempt by Mr. Biden to override his predecessor, former President Donald J. Trump, on issues pertaining to workers, the economy and the federal safety net. The orders Mr. Biden signed on Friday are a break from the Trump administration’s attempts to limit the scope of many federal benefits that Trump officials said created a disincentive for Americans to work.

The orders follow an ambitious raft of measures Mr. Biden took on his first full day in office, on Thursday. He signed a string of executive orders and presidential directives aimed at combating the worst public health crisis in a century, including new requirements for masks on interstate planes, trains and buses and for international travelers to quarantine after arriving in the United States.

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Listen to ‘The Daily’: Biden’s Executive Orders

On his first day, President Biden reversed some of his predecessor’s most divisive policies. But governing by decree can be fraught.



Listen to ‘The Daily’: Biden’s Executive Orders

Hosted by Michael Barbaro; produced by Sydney Harper and Eric Krupke; edited by Lisa Chow; and engineered by Chris Wood.

On his first day, President Biden reversed some of his predecessor’s most divisive policies. But governing by decree can be fraught.

michael barbaro

From The New York Times, I’m Michael Barbaro. This is The Daily.


Today: In his first hours as president, Joe Biden signed a flurry of executive orders, reversing the legacy of President Trump. White House reporter Mike Shear on what’s in the orders and the upside and downside of governing by executive action.

It’s Friday, January 22.

archived recording (president biden)

Well, this is going to be the first of many engagements we’re going to have in here. And I thought —

michael barbaro

Mike, I wonder if you can set the scene for us — a man, a plan, a pen.

michael d. shear

Right. So the scene is the Oval Office. This is late afternoon on the 20th. So Joe Biden has been inaugurated under high security, under threat of a pandemic.

archived recording (president biden)

And I thought with the state of the nation today, there’s no time to waste — get to work immediately.

michael d. shear

Now, he’s sitting at the Resolute desk in the Oval Office, looks very different already than President Trump. They’ve already redecorated a little bit. They’ve hung different curtains, got a different carpet. They’ve put up photos of Joe Biden’s family, bust of Cesar Chavez behind him. So the visuals already look a little bit different than we’ve come to be used to for the last four years.

archived recording (president biden)

We’re going to be signing a number of executive orders over the next several days of a week. And I’m going to start today on the compounding crisis of Covid, Covid-19, along with the economic crisis following that.

michael d. shear

Sitting next to him is a huge stack of folders with the seal of the presidency on it, each one containing a different executive order, executive action, some kind of memo that he’s going to sign. And cameras are rolling. He takes one and begins to sign them.

archived recording

Mr. President?

archived recording (president biden)

Thank you.

archived recording

Mr. President?

michael barbaro

And just as a civics reminder here, executive orders are actions that require nothing but a presidential signature. They’re kind of unique in how we govern.

michael d. shear

That’s right. And there’s a lot that presidents have to do with others in our form of government. The Constitution was very clear. Congress controls the purse. Congress controls spending. So there are limits on what a president can do in terms of spending money. But executive orders are actions that the president can direct the government to take on his authority alone.

michael barbaro

And my sense is that the last president, Donald Trump, made very liberal use of executive orders in a way that was quite unpopular with Democrats.

michael d. shear

Yeah, absolutely. I mean, look, presidents turn to executive orders, they turn to the power of their office, when they get stymied in other ways, when they can’t work with Congress. Donald Trump obviously had a very volatile and difficult relationship with Congress. And so you saw him in all sorts of ways. He issued executive orders directing the Census not to count certain individuals — undocumented immigrants. You saw him issuing executive orders about what federal architecture should look like in Washington, D.C., because he didn’t like certain buildings. You saw him shut down the border with Mexico at various times to asylum-seekers. It was a kind of never-ending barrage of executive orders, big and small. Some of them had huge impact, some of them less so. But that was essentially the way he governed.

michael barbaro

Right. And among the critics of those Trump executive orders was Joe Biden, not yet president. And the critique of the executive orders, and I remember it very vividly, was that they represent the imperial presidency — government by executive fiat. No effort to work with Congress or create consensus, but just one leader’s view suddenly turning into the full force of the American government.

michael d. shear

Right. And I think for Biden, that was an especially powerful critique, because that argument played into exactly the caricature of Donald Trump that we all saw over these last four years — somebody who thinks he knows best and isn’t interested in finding some sort of common ground. Rather, he wants to impose his view, and that’s what he did through the use of these executive orders.

michael barbaro

OK, so with that in mind, how much thought did President-elect, now President, Joe Biden and those around him put into the question of how aggressively they would or should use executive orders?

michael d. shear

So I think they are mindful of the critique, especially of the hypocrisy that they will be accused of, given the path that they’re taking. But I think they draw a distinction — or at least they give themselves a pass — because their thinking, in the conversations that I’ve had with them, is that Donald Trump gave them an opening by putting in place so much of his agenda through executive orders. By not making the changes that Donald Trump wanted to make permanent through legislation, they gave the incoming administration an opportunity to move much more quickly to reverse things than would have been the case if all of these changes had been done through legislation. If Donald Trump, for example, had made some big, sweeping changes to immigration policy by law, and had gotten a bipartisan consensus, in order to roll that back, the Biden Administration would have had to do the same. Instead, they can act in the same way as the Trump Administration did, only reverse.

michael barbaro

Right. So their internal argument and rationale is, he did it, so we get to do it. It’s a little bit of a playground-level version of government, but there is some logic to it.

michael d. shear

Well, and let’s not forget, I mean, while Donald Trump was probably the most aggressive user of executive action that we’ve seen in the last number of presidents, he’s not the first. Barack Obama used executive action pretty aggressively as well, especially towards the end of his eight years, when the Senate and the House were not in his camp. And so it’s been a ping pong ball for a while.

michael barbaro

OK, so given all that, Mike, let’s talk about these executive orders that President Biden signs in the Oval Office in his opening hours of his presidency.

michael d. shear

Right. So the executive orders and various different actions that he took all fell into a series of buckets. You had executive actions that the president took on Covid and the pandemic. You had another set that were largely around climate change and the environment and rolling back some of President Trump’s policies there. And then you had a third really big bucket on immigration and pushing back against President Trump’s policies at the border and with enforcement inside the country.

michael barbaro

Got it. So let’s start with the pandemic. What were those executive orders?

michael d. shear

So the first one is he issued an executive order that mandated the wearing of masks. Now, it wasn’t a federal mandate across the country. The president does not have the power to order everybody in the country to wear masks all the time. But he does have the power to make people on federal property, federal employees, wear a mask when they’re on the job. So for example, you think about the Post Office, right?

michael barbaro


michael d. shear

Whenever anybody goes in there, it will now be law you have to wear a mask.

michael barbaro

So there’s both a practical impact of that — if you don’t wear a mask you’re in trouble with the federal government, your boss. But there’s also the symbolism of saying to the country that the government and its employees are going to lead by example when it comes to wearing masks.

michael d. shear

Absolutely. And the executive order — I think they understood the limited practical impact of this order. But I think President Biden definitely understood the dramatic contrast that he was drawing with President Trump, who had so resisted — to the last day, frankly — ever pressuring people or modeling for the American public the idea that a mask is an important thing to do. And so I think the Biden Administration and President Biden were thinking, look, let’s do what we can to send that message. They also tried to do some steps to address the economic fallout from the pandemic. Obviously, there’s going to be a big fight in Congress over some of the biggest economic ways that they can help people. But one thing they did do through executive order was to extend a moratorium on foreclosures and evictions, which is aimed at helping people who might have lost their job because of the pandemic, can’t pay the rent. This was a bipartisan effort that had been put in place before and needed to be extended. And so the president was able to extend it with an executive order. They also won one more. They rejoined the World Health Organization, which you’ll remember President Trump had pulled the United States out of the World Health Organization after concluding that he thought the World Health Organization was too friendly to China. That was seen as a mistake, I think. frankly all over the world by health officials. And the Biden folks made sure that was reversed on day one.

michael barbaro

Got it. OK, let’s now turn to the Biden executive orders on climate. What did he do there?

michael d. shear

So probably the best-known executive order that he did was rejoining the Paris Climate Accords. Remember, this was this global agreement that the United States had been a leader in during President Obama’s time to corral the nations of the world to fight climate change and to reduce emissions as a globe, as a world of nations. President Trump very famously took the United States out of the Accord — basically said we’re not part of this anymore early in 2017. President Biden had long said that was a mistake. And with the stroke of a pen, we’re back in.

michael barbaro

And finally, that brings us to immigration.

michael d. shear

Look, immigration was at the heart of what the Trump presidency was all about. He campaigned on building the wall across the southern border. He used really harsh immigration rhetoric. And so if I had to pick one area, this was where President Biden’s actions on the 20th really took aim at unraveling and pushing back against Donald Trump’s legacy in a really big way.

michael barbaro

We’ll be right back.

So Mike, describe these executive orders by Biden that started to dismantle Donald Trump’s legacy on immigration. What were they?

michael d. shear

So I think the most dramatic was probably Joe Biden’s revocation of Donald Trump’s Muslim travel ban. President Trump, when he was a candidate, had literally campaigned on keeping Muslims out of the country. And so when Donald Trump got into office, the first week, the travel ban he put in place limited entry into the United States from a bunch of countries — Muslim countries — Somalia, Yemen, some other countries as well. So I think in some ways Joe Biden’s revocation of that travel ban had both practical implications for the people in those countries who, going forward, will now be able to come into the United States. But it also had a really symbolic feature, which is a rejection of that kind of rhetoric — that Donald Trump had sent the message that we don’t want those people coming in. And I think it was important for Joe Biden to deliver the reverse message — that no, we’re not a country that bans people on the basis of their ethnicity or their race or because they’re from a country that we don’t like.

michael barbaro

OK. What else did Biden do via executive order on immigration?

michael d. shear

Let me tick through a couple of these. He stopped construction of Trump’s border wall. Remember, that was something that President Trump had advocated since from day one of his presidency and had fought with Congress for the money to do it, and ultimately managed to get various pots of money to construct about 200 or 300 miles worth of border wall along the southern border. President Biden said, you know what? We’re going to stop construction. We want to look at whether or not the money that President Trump used for construction was legal and appropriate, and whether or not they want to look into the contracts that were signed with companies to build the wall. And so that’s paused. He also repealed — one of the most controversial executive orders that President Trump had issued was one on what they call “interior enforcement,” which is essentially directing the immigration agents throughout the country, not necessarily on the border, but in the rest of the country, to be more aggressive — to find and deport any immigrant that is undocumented, that doesn’t have the valid papers to be in the United States, even if those people aren’t violent, even if they’ve only committed a misdemeanor. Essentially, that had been a kind of effort by the Trump administration to really get aggressive on deporting and kicking people out of the country. And the Biden executive order on Wednesday will reverse that — will essentially go back to a policy in which immigration agents have more of a sense of prioritization. You know, we’re going to go after the real bad guys, but we’re not going to spend a lot of time going after people who aren’t hardened criminals.

michael barbaro

Mike, the unmistakable theme here, and you’ve talked about it throughout this conversation, is that these executive orders — most of them — they either reverse President Trump’s actions, or they rebuke his policy approach. So given that, how did these executive orders from Biden on day one — how do they fit with his message from that inaugural stage of unity? And we talked to our colleague yesterday, Astead Herndon, about how deeply Joe Biden believes in bipartisanship, in working with Republicans. And that was the absolute core of his message. And so is signing these executive orders in conflict with that? And I ask that because several Republicans certainly see it that way.

michael d. shear

Yeah, so, look, I think you can look at that question through two different lenses, one philosophical and one pragmatic. So I think from a philosophical standpoint, President Biden would say this doesn’t conflict with that message because so much of the substance of what his executive orders are trying to achieve is a rejection of the divisiveness of Donald Trump. So if you look at the immigration executive orders, he’s trying to get the country back to a place where we’re not pitting us against them, the insider against the outsider, us versus the other, right? Through that lens, it is not in conflict. But I think from the pragmatic side, a lot of the last four years a lot of Republicans liked. They might not have liked everything, but in terms of the president’s economic policies, in terms of his border security policies, there was a lot that Republicans liked. And I think that one of the things that President Biden is going to have to confront over the next 100 days, let’s say, is how much does the quick pace of these executive actions and the extent to which he’s trying to quickly erase the Trump legacy — how much does that leave a bad taste in the mouth of Republicans, especially in the Senate, where he’s got a 50-50 split? He’s going to need Republicans to pass any kind of big, broad agenda. And a lot of them, as I think you hinted a minute ago, a lot of them won’t see this as unity. They won’t see this as unifying. They will see this as unilateral and acting without the kind of consultation and cooperation and compromise that is part of his shtick. And so my sense is that as he pursues this goal of repairing the soul of the nation, purging the last four years of divisiveness and anger, that he will accept some cost to that, and that some cost of that might be a political cost. And we’ll just have to see.

michael barbaro

So I want to zoom out for just a moment to this question we started with, which is this history of presidents using executive orders over and over again, and where it’s left us as a government. Because we now have a President Biden having reversed many of the actions of a President Trump in 24 hours, and so we’ve now entered a pretty clear cycle of one president using executive orders to theatrically wipe away the legacy of a last president. And is that any way to govern?

michael d. shear

I covered Obama for eight years and Trump for four years. And for most of that time, we’ve been locked in this cycle of impermanence, where everything is temporary. Everything is a sort of quick reaction to what can I do quickly because I can’t accomplish anything that’s really substantive and that’s really permanent? And look, the only thing that is permanent in our way of governance is if you can get a big piece of legislation passed through the House, through the Senate, with bipartisan majorities, where there’s an actual consensus among the people who are our representatives, and then signed by the President of the United States. And if you can get that, that can be a permanent, lasting legacy which lasts generations. If you don’t, then we’re locked into what we’ve had now, where businesses have trouble knowing what the road map is. The countries around the world don’t know who to believe in terms of which way the United States is going because it could go one way one day and the other way a different day. And I think that’s where we are right now.

michael barbaro

Right. Just to highlight the point you made, I think of the Affordable Care Act, for example — passed into law by the House of Representatives, the United States Senate, signed into law by President Obama. There have been dozens of efforts to repeal it, to chip away at it, to sue it out of existence. But because it’s a law, it has pretty much remained with modification in place since it was passed 10 years ago. And that is probably going to be true for several of the pieces of legislation that Donald Trump passed — his tax cuts, for example, or his criminal justice reform.

michael d. shear

Absolutely. I was there at the White House the night that the Affordable Care Act passed. I remember it feeling like a historic moment, a permanent moment. And I think the question for Joe Biden, and the thing that he sold to voters is that he’ll get us back there. He’ll get his back to a place where, for example, he submitted an immigration overhaul bill to Congress on his first day, saying not only do I want to do these executive orders, but I want the Congress to come together and say, let’s design a new immigration system for the country. And we’ll see. I mean, that’s been tried for decades, and the country hasn’t been able to get there.

michael barbaro

But he sent it to Congress, so we know that he wants a legislative solution, not just an executive order.

michael d. shear

Right. And the question is, can he deliver it?


Can he help get us past this place in American politics that we’ve been for these last number of years, where those kinds of big things get jammed up and don’t go anywhere? And if he can, then that legacy will be a whole lot longer lasting and will be much harder for the next president to unravel, because it’ll not just be another executive order that can be wiped away with a pen.

michael barbaro

Right. It will be law.

michael d. shear

Yeah, exactly.

michael barbaro

Thank you, Mike. Appreciate it.

michael d. shear

Sure, happy to do it.

michael barbaro

We’ll be right back.

Here’s what else you need to know today.

archived recording (president biden)

Let me be very clear. Things are going to continue to get worse before they get better.

michael barbaro

On Thursday, President Biden warned Americans that the death toll from the coronavirus would likely reach 500,000 by next month. The prediction came after the United States reported 4,367 deaths on the day of Biden’s inauguration, one of the highest daily death tolls since the start of the pandemic. And The Times reports that Senator Mitch McConnell, the Republican minority leader, plans to ask Democrats to delay the start of President Trump’s impeachment trial until February to give Trump’s lawyers time to prepare a defense.

archived recording (nancy pelosi)

I don’t think it’s very unifying to say, oh, let’s just forget it and move on. That’s not how you unify.

michael barbaro

During a news conference, House Speaker Nancy Pelosi defended the plan to pursue a trial in the Senate and rejected claims from Republicans that it would detract from Biden’s calls for unity.

archived recording (nancy pelosi)

And just because he’s now gone — thank God — you don’t say to a president, do whatever you want in the last months of your administration, you’re going to get a get-out-of-jail card free because people think we should make nice-nice and forget that people died here on January 6. I think that would be harmful to unity.

michael barbaro

Today’s episode was produced by Sydney Harper and Eric Krupke. It was edited by Lisa Chow and engineered by Chris Wood.

That’s it for The Daily. I’m Michael Barbaro. See you on Monday.

During the presidential campaign, he had called for using the Korean War-era law to increase the nation’s supply of essential items like coronavirus tests and personal protective equipment. On Thursday, he signed an executive order directing federal agencies to make use of it to increase production of materials needed for vaccines.

With thousands of Americans dying every day from Covid-19, a national death toll that exceeds 400,000 and a new, more infectious variant of the virus spreading quickly, the pandemic poses the most pressing challenge of Mr. Biden’s early days in office. How he handles it will set the tone for how Americans view his administration going forward, as Mr. Biden himself acknowledged.

In a 200-page document released earlier Thursday called “National Strategy for the Covid-19 Response and Pandemic Preparedness,” the new administration outlined the kind of centralized federal response that Democrats have long demanded and that Mr. Trump had refused.

But the Biden plan is in some respects overly optimistic and in others not ambitious enough, some experts say. It is not clear how he would enforce the quarantine requirement. And his promise to inject 100 million vaccines in his first hundred days is aiming low, since those 100 days should see twice that number of doses available.

Efforts to untangle and speed up the distribution of vaccines — perhaps the most pressing challenge for the Biden administration that is also the most promising path forward — will be a desperate race against time, as states across the country have warned that they could run out of doses as early as this weekend.

Maggie Astor and Alan Rappeport contributed reporting.




European Union Wants Vaccinations to Be ‘Accelerated’

European Union leaders on Thursday expressed frustration over the coronavirus vaccine rollout and urged the bloc to accelerate the delivery of more vaccine doses.

“Leaders want vaccination to be accelerated, and in this respect, commitments on deliveries made by companies must be respected. Leaders reaffirmed the vaccines should be distributed at the same time, and must be on pro rata population basis. And we reaffirmed the need to have a close follow-up of the vaccination process.” “Indeed, across Europe, the health situation remains very serious. And yes, there is reason for hope because of the vaccines. But there’s also strong reason for concern with the new variants we are observing. We must therefore remain focused, and we must remain determined in our response. We must ensure delivery of vaccines from the companies. And we must ensure the quick and efficient use of the available vaccines.”

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European Union leaders on Thursday expressed frustration over the coronavirus vaccine rollout and urged the bloc to accelerate the delivery of more vaccine doses.CreditCredit…Andrea Mantovani for The New York Times

AstraZeneca informed the European Union on Friday that it would deliver fewer doses of the vaccine it created with the University of Oxford than planned, a fresh blow to the bloc’s efforts to ramp up its sluggish inoculation efforts.

The news comes a week after Pfizer abruptly notified the European Union and several countries outside of the United States that deliveries of its vaccine would be heavily disrupted until the second week of February because of upgrades being made to its facility in Puurs, Belgium, in order to ramp up output.

AstraZeneca said that it still intended to get “tens of millions of doses” to the bloc’s 27 member states in February and March, but that the deliveries would “be lower than originally anticipated due to reduced yields at a manufacturing site within our European supply chain.” AstraZeneca noted that it would eventually ramp up production but did not provide a timeline.

The European health commissioner, Stella Kyriakides, said that the European Union had “expressed deep dissatisfaction” with the company’s announcement. “We insisted on a precise delivery schedule on the basis of which Member States should be planning their vaccination programs,” she said in a tweet, adding that the bloc needed “predictability and stability of deliveries, and acceleration of the distribution of doses.”

The AstraZeneca vaccine is awaiting approval for use in the European Union. The company applied for authorization on Jan. 12, and the European Medicines Agency, the bloc’s drug regulator, has said it will likely make a decision at a meeting on Jan. 29.

The European Union has come under criticism for being slower than the United States and Britain to authorize coronavirus vaccines, and its member states are lagging behind the two countries in rolling out immunizations. Frustrated countries like Austria have pushed for faster approval of the AstraZeneca vaccine, though that would not mean delivery would be any swifter.

The 10 cases of anaphylaxis mentioned in the C.D.C. report occurred in people who had previously had allergic reactions to drugs or foods.
Credit…Jim Wilson/The New York Times

Fifteen people have had a severe allergic reaction, anaphylaxis, after receiving Moderna’s coronavirus vaccine, the Centers for Disease Control and Prevention reported on Friday. The reactions have been rare, occurring at a rate of 2.1 cases per million Moderna doses administered, the agency said.

So far, anaphylactic reactions to the Pfizer-BioNTech Covid vaccine appear somewhat more common: 45 have occurred, with a rate of 6.2 cases per million doses given.

The estimated rates for the two vaccines “may change as additional doses of Covid-19 vaccine are administered and C.D.C. continues to collect more information,” the agency said in a statement. It also said no deaths from the reactions had been reported.

When anaphylaxis occurs, it usually starts within minutes of the injection. Symptoms may include breathing trouble, dropping blood pressure, hives, wheezing, nausea and swelling of the tongue. The condition is life-threatening, and vaccination centers must be ready to provide immediate treatment with a shot of epinephrine and transport patients to hospitals, the agency said in a report published on Friday.

The rates are comparable to those for other vaccines, the agency said, and noted that anaphylaxis “is readily diagnosed, and effective treatments are available.”

The vaccines, combined with measures like masks and social distancing, “are one of the best tools we have to fight the pandemic,” the C.D.C. said.

The published report was based on data from Dec. 21 to Jan. 10, and included only 10 cases of anaphylaxis, out of 4,041,396 first shots of the Moderna vaccine given. But the statement issued on Friday updated the total, including five more cases.

The 10 cases in the published report all occurred in people who had previously had allergic reactions to drugs or foods, including five who had had anaphylaxis before, though not from vaccines. All 10 patients were women, ages 31 to 57, which may be partly because more women than men received the vaccine. But the report also noted that 80 percent of anaphylactic reactions to other vaccines reported to the government tracking system were in adult women.

All 10 women received epinephrine. Six were hospitalized, including five in intensive care, four of whom had to be intubated. The published report said follow-up information was available for only eight of the 10, and that those eight “were discharged home or had recovered” at the time their information was submitted.

The report also described 43 allergic reactions that occurred within 24 hours of the vaccination and were not anaphylaxis, with symptoms like rashes, itching, itchy sensations in the mouth and throat, sensations of throat closure and respiratory symptoms. Most of those reactions, 91 percent, occurred in women. Sixty percent of the reactions were considered nonserious.

The report was based on data from the government’s Vaccine Adverse Event Reporting System, which relies on health care providers and patients to submit information.

The Moderna and Pfizer-BioNTech vaccines are the only ones authorized for emergency use in the United States. They are similar, consisting of genetic material called mRNA encased in minute fatty bubbles known as lipid nanoparticles.

In Philadelphia International Airport last month. President Biden’s new executive orders will require all interstate travelers to wear masks.
Credit…Stefani Reynolds for The New York Times

A year into the worst global health crisis in a century, and much of the world feels frozen in place.

Countries that had loosened up their frontiers after imposing restrictions earlier in the pandemic are now tightening them again, worried about new, more contagious variants of the coronavirus. Some are tightening travel restrictions or imposing new rules on travelers.

In the United States, President Biden signed a series of executive orders aimed at thwarting the pandemic, including a requirement that travelers coming from abroad quarantine after arriving in the United States, though it is not clear how that will be enforced.

He also signed an order requiring masks for many kind of interstate travel. Travelers will have to wear masks in airports, as well as on commercial airplanes, trains and public maritime vessels, including ferries, and on certain other modes of public transportation like intercity buses.

While the United States is merely making traveling less hospitable, countries in Europe are going further, with plans to tighten its borders.

European Union leaders agreed to limit nonessential travel within the bloc and from nonmember countries in a bid to slow the spread of two variants that are already present in multiple countries in the region.

Leaders from the bloc’s 27 nations, meeting via teleconference late Thursday, agreed to take coordinated action in response to the variants, which scientists believe originated in Britain and in South Africa and appear to be significantly more contagious than others.

Some E.U. countries have already limited access for their neighbors, a move that is generally avoided in the principally borderless bloc but has been tolerated because of the extraordinary circumstances.

After the conference call, President Emmanuel Macron’s office announced that France would make PCR tests compulsory for all travelers coming from other European Union countries, starting Sunday at midnight. The tests must be done no later than 72 hours before departure.

In Britain, which completed its exit from the bloc on Jan. 1, flights from Latin America and Portugal were banned over fears of a variant first discovered in Brazil. Flights from South Africa, where another highly contagious variant was discovered last month, are also banned.

In all, Britain itself is isolated from more than a dozen countries.

And in China, where the virus spiraled out of control during the Chinese Lunar New Year in 2020, officials are discouraging travel over the holiday, which begins Feb. 12. The new year is usually the occasion for the largest annual human migration in the world.

Beijing is restricting the number of passengers allowed on public transit and has extended the quarantine period for travelers returning from overseas. Schools have been closed, and the authorities said on Wednesday that people returning to rural areas for the holiday must test negative for the virus and quarantine at home for 14 days.

Ma Xiaowei, the National Health Commission minister, has blamed the recent outbreak on travelers returning from overseas and on workers handling imported food.

Three locally transmitted coronavirus cases were confirmed on Thursday in Shanghai, China’s largest city, the first in the city in about two months.




Fauci Promises Coronavirus Response Based on Science

Dr. Anthony S. Fauci, President Biden’s chief medical adviser for Covid-19, addressed reporters from the White House on Thursday, and warned the nation was “still in a very serious situation” because of the pandemic.

First of all, obviously, we are still in a very serious situation. I mean, to have over 400,000 deaths is something that, you know, is unfortunately historic in the very in the very bad sense. When you look at the number of new infections that we have, it’s still at a very, very high rate. Hospitalizations are up. There are certain areas of the country, as I think you’re all familiar with, which are really stressed from the standpoint of beds, from the standpoint of the stress on the health care system. However, when you look more recently at the seven-day average of cases, remember, we were going between three and 400,000, and two and 300,000. Right now, it looks like it might actually be plateauing. One of the things that we’re going to do is to be completely transparent, open and honest. If things go wrong, not point fingers, but to correct them and to make everything we do be based on science and evidence. It was very clear that there were things that were said, be it regarding things like hydroxychloroquine hydroxychloroquine and other things like that, that really was an uncomfortable because they were not based on scientific fact. I can tell you, I take no pleasure at all in being in a situation of contradicting the president. So it was really something that you didn’t feel that you could actually say something, and there wouldn’t be any repercussions about it. The idea that you can get up here and talk about what you know, what the evidence, what the science is, and know, that’s it. Let the science speak. It is somewhat of a liberating feeling.

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Dr. Anthony S. Fauci, President Biden’s chief medical adviser for Covid-19, addressed reporters from the White House on Thursday, and warned the nation was “still in a very serious situation” because of the pandemic.CreditCredit…Doug Mills/The New York Times

Dr. Anthony S. Fauci, the longtime government infectious disease expert, has returned to the White House spotlight, offering both reassurances and warnings.

Dr. Fauci, shunned by President Donald J. Trump but embraced by President Biden, appeared in the White House briefing room on Thursday to speak to reporters about the pandemic.

He did not mince words, and appeared to enjoy feeling that he no longer had to.

“Historic, in the very bad sense,” was his take on the pandemic, as total cases in the United States edged near the 25 million milestone.

He warned that the nation was “still in a very serious situation,” even if the number of cases appears to be plateauing, pointing to more infectious variants of the virus that could cause spikes in cases in the coming months.

Dr. Fauci, who is now Mr. Biden’s chief medical adviser for the pandemic, said that the vaccines now in use in the United States appeared effective against the new variants so far.

And even if variants do end up diminishing the vaccines’ effectiveness, the drugs will still provide good protection, he said, citing their considerable “cushion effect.”

If need be, he said, the vaccines can be modified.

“That is not something that is a very onerous thing,” he said. “We can do that given the platforms we have.”

The federal government and the states have stumbled, however, in vaccinating Americans on a large scale. And it is more important than ever to do so, Dr. Fauci said. The more viruses spread, the more opportunities they have to mutate.

“If you can suppress that by a very good vaccine campaign, then you could actually avoid this deleterious effect that you might get from the mutations,” he said.

If the United States can vaccinate 70 percent to 85 percent of the population by the middle or end of the summer, he predicted, “by the time we get to the fall, we will be approaching a degree of normality.”

On Thursday, speaking of the problems ahead without a president glowering over his shoulder, Dr. Fauci appeared to be enjoying his own return to normality. Asked how it felt, he paused a beat or two before delivering his review.

“It is somewhat of a liberating feeling,” he said.

Credit…Riccardo Antimiani/EPA, via Shutterstock

An unusual experiment to prevent nursing home staff members and residents from infection with the coronavirus has succeeded, the drug maker Eli Lilly said on Thursday.

A drug containing monoclonal antibodies — laboratory-grown virus fighters — prevented symptomatic infections in residents who were exposed to the virus, even the frail older people who are most vulnerable, according to preliminary results of a study conducted in partnership with the National Institutes of Health.

The researchers found an 80 percent reduction in infections among residents who got the drug compared with those who got a placebo, and a 60 percent reduction among the staff, Eli Lilly said.

The study included 965 participants at nursing homes: 666 staff members and 299 residents. The data have not yet been peer-reviewed or published. The company expects to present the findings at a future medical meeting and to publish them in a peer-reviewed journal, but did give a timeline.

The drug, bamlanivimab, has an emergency-use authorization from the Food and Drug Administration that allows it to be provided to symptomatic patients early in the course of their infection. This study sought to establish whether the drug could stop infections before they started.

It was an unusual experiment: In trucks equipped with mobile labs, medical workers sped to nursing homes the moment a single infection was detected there. Then they set up temporary infusion centers to administer the drug.

Although the study has ended, Dr. Daniel Skovronsky, Eli Lilly’s chief scientific officer, said the company would continue to rush to nursing homes in its study network when an outbreak is detected.

“Everyone will get the drug,” he said.

Dave Chappelle had been hosting socially distanced shows since June.
Credit…Owen Sweeney/Invision, via Associated Press

The comedian Dave Chappelle has tested positive for the coronavirus and has canceled several upcoming shows at the Stubb’s Waller Creek Amphitheater in Austin, Texas, a spokeswoman told The Associated Press.

The venue’s website showed cancellations for four shows through Tuesday.

Mr. Chappelle, who had been hosting socially distanced shows in Ohio since June, with rapid testing for audience members and himself, moved his shows to Austin during the winter, the spokeswoman said.

Mr. Chappelle is asymptomatic and quarantining, she said.

Joe Rogan, a comedian and podcast host who had been scheduled to perform with Mr. Chappelle on Friday and Saturday, apologized for the cancellations. “We’ll reschedule them as soon as we can,” Mr. Rogan said early Friday in an Instagram post.

Mr. Chappelle’s positive test result came about three months after he hosted “Saturday Night Live” and commented on the pandemic in a monologue that also heavily touched on the presidential election.

“Do you guys remember what life was like before Covid?” Mr. Chappelle said. “I do. There was a mass shooting every week. Anyone remember that? Thank God for Covid. Someone had to lock these murderous whites up and keep them in the house.”

A nursing home resident receiving the Pfizer-BioNTech coronavirus vaccine in Budapest this month.
Credit…Zoltan Balogh/EPA, via Shutterstock

The Hungarian government has for months lauded the opportunities of Russia’s Sputnik vaccine. In November, the foreign minister made public his talks with Russian counterparts about the possibility of manufacturing the Russian vaccine in Hungary. On Thursday, the country approved the Russian vaccine and one made by AstraZeneca for use.

And on Friday, after a meeting in Moscow with his Russian counterpart, Hungary’s foreign minister said that Hungary would buy two million doses of the Russian vaccine.

The moves make Hungary the first European Union nation to move outside the bloc’s supply chain, which the country’s president, Viktor Orban, said was moving too slowly.

“What I need, and what the Hungarian people need, is not an explanation, but a vaccine,” Mr. Orban said. “And if it is not coming from Brussels, then it must come from elsewhere.”

The European Union has approved two coronavirus vaccines: one made by Moderna and one made by Pfizer and BioNTech. The bloc is expected to decide this month whether to authorize the AstraZeneca vaccine.

Each E.U. member state is allotted vaccine doses based on population size, and the bloc has ordered 2.3 billion doses of several vaccines, some of which are still in development.

But a disruption in Pfizer’s production facility in Puurs, Belgium, has stalled or stopped deliveries in Europe and elsewhere, causing frustration. The company has vowed to resume deliveries by mid-February, and says that production upgrades will enable it to increase its output.

In a radio interview on Friday morning, Mr. Orban called the E.U.’s vaccination rate “simply unacceptable.” He added, “It cannot be that Hungarian people are dying because vaccine procurement in Brussels is slow.”

Some Hungarian experts have expressed concern that the government’s approach might increase vaccine skepticism, which might thwart a national vaccination plan.

“The Hungarian authority suddenly approved these two vaccines under political pressure,” said Dr. Ferenc Falus, Hungary’s former chief medical officer, said in reference to the AstraZeneca and Sputnik vaccines. “It would have been better for them to wait for the approval of the European Union’s medicine agency. This is especially incomprehensible in the case of Astra, which will receive the European Union’s approval within days.”

The European Union drugs regulator, the European Medicines Authority, said that the developer of the Sputnik vaccine had “submitted a request for scientific advice to the agency.” That step comes well before a company is ready to submit data for the regulator’s review of its work, let alone applying for authorization to distribute a vaccine to European Union countries.

Covid-19 patients in Lviv, Ukraine, this month.
Credit…Evgeniy Maloletka/Associated Press

KYIV, Ukraine — After a revolution seven years ago, Ukrainians discovered that their ousted president had used public money to build himself a gigantic palace with a private zoo, a golf course and a garage full of antique cars.

To prevent repeats of such corruption, a raft of reforms were put in place, including a requirement that nearly all government contracts be made public, lest secret kickbacks slip into the pockets of high-ranking officials.

The overhaul, widely seen as a rare success in the country’s otherwise halting anticorruption drive, covered tens of millions of dollars in annual medical procurement deals.

But to secure coronavirus vaccine supplies, Ukraine has been forced to largely abandon the rule — a move that the government says is not its choice but rather a demand of the pharmaceutical giants that control the supply.

In negotiating with national governments, drug companies like Pfizer, Moderna and Johnson & Johnson have insisted that many of the deals’ terms amount to trade secrets and must therefore be kept confidential.

Health advocacy groups have criticized those arrangements, saying that governments far better positioned than Ukraine to spend vast sums on doses have been too willing to accept such secrecy.

The requirement has hamstrung the Ukrainian government and forced one state-owned procurement company that was set up to prevent graft in the medical system to be sidelined because it was legally required to disclose the terms of all contracts.

“This is due to extremely strict privacy rules and nondisclosure policies, which the procurement company will not be able to comply with under Ukrainian law,” Svitlana Shatalova, a deputy minister of health, said at a news conference on Thursday.

The nondisclosure agreements allow pharmaceutical companies to negotiate prices, delivery timelines and other conditions for vaccine deals without governments or their citizens comparing the agreements to those struck with other nations.

According to a document that a European official posted on social media in December and quickly deleted, the European Union negotiated a lower price for Pfizer’s vaccine — 12 euros, or about $14.60, per dose — than the U.S. government, which agreed to pay $19.50 per dose. European nations tend to pay substantially lower prices for drugs than the United States does.

global roundup




Long Lines as Beijing Starts Mass Coronavirus Testing

The authorities in Beijing set up temporary testing sites after a spike in coronavirus infections. Long lines formed as the city tested nearly two million people on Friday.


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The authorities in Beijing set up temporary testing sites after a spike in coronavirus infections. Long lines formed as the city tested nearly two million people on Friday.CreditCredit…Thomas Peter/Reuters

Nearly two million residents of Beijing were being tested for the coronavirus on Friday as the city rushed to stem mainland China’s worst outbreak since the virus was first detected.

Health officials set up temporary testing facilities in two major districts of Beijing, China’s capital, after three locally transmitted cases were confirmed there on Thursday.

The authorities in Shanghai, China’s business capital and biggest city, were also testing hospital employees after two health care workers tested positive on Thursday. Shanghai recorded six new locally transmitted cases on Friday.

New infections were also reported on Friday in four northern provinces — Hebei, Heilongjiang, Jilin and Shanxi — and in the eastern province of Shandong. That brings the total number of new cases across China this week to at least 500.

While the active case count is still far lower than that of the United States and other countries, the outbreak threatens to undermine the government’s success in stamping out the virus and bringing life in China back to normal.

More than 28 million people have been placed under some kind of lockdown across China in recent weeks, mostly in northern areas. Officials fear that new infections could lead to another major outbreak during the Lunar New Year holiday, when hundreds of millions of people travel across the country to celebrate with their families.

Last January, the coronavirus was spread far beyond its original epicenter, the central Chinese city of Wuhan, in part by people traveling home for Lunar New Year — weeks before health officials in Beijing acknowledged the risk of human-to-human transmission.

In Beijing this month, the authorities have closed all schools, limited the number of passengers allowed on public transit and extended quarantine requirements for travelers returning from overseas to three weeks, up from two weeks.

The central authorities are also requiring anyone traveling to rural areas for Lunar New Year to first test negative for the virus and then quarantine for 14 days — a move that could discourage many people from returning to their hometowns for the seven-day holiday.

In other developments around the world:

  • Bangladesh will begin a nationwide coronavirus vaccination campaign starting with a gift from India — two million vaccine doses — by next week. Bangladesh, whose population is about 163 million, will also buy 30 million additional doses from India, said Muhibur Rahman, a health ministry secretary. He said that Gavi, the Vaccine Alliance, had pledged to cover doses for 20 percent of Bangladesh’s population. The rollout plan includes “freedom fighters of Bangladesh’s war of independence in the priority list,” Mr. Rahman said, referring to the 1971 conflict with Pakistan that led to Bangladesh’s creation. The country’s health minister told reporters this week that 42,000 volunteers had been trained to carry out the inoculation drive.

  • Paraguay’s health minister announced that the country had arranged to buy three million doses of coronavirus vaccines from two pharmaceutical companies and plans to start vaccinations in the second half of February, Reuters reported. The minister, Julio Mazzoleni, said the companies would be named when the contracts are signed. The country plans to purchase another 4.2 million doses through Covax, a World Health Organization program.

Because of the high number of deaths related to the coronavirus, a crematorium in Meissen, Germany, is struggling to store coffins.
Credit…Filip Singer/EPA, via Shutterstock

Despite early successes in handling the pandemic, Germany’s health authorities have now registered a total of 50,000 Covid deaths since the virus was first detected in the country nearly a year ago. And 30,000 of those deaths have occurred since Dec. 9.

“These are not just numbers. These are people who died in loneliness,” Chancellor Angela Merkel said at a news conference on Thursday. “These are families who mourn them. We have to be aware of that, too, again and again.”

Daily reported new infections in the country are decreasing amid a weekslong lockdown, with the authorities registering 17,862 new cases on Thursday, almost 4,500 fewer than a week earlier. But rising death tolls typically trail behind spikes in infection numbers.

In response to the coronavirus’s first wave, Germany locked down early and effectively. Experts attributed the country’s relatively low early fatality rate to high testing rates, well-equipped hospitals and the young age of many of the first people to become infected there.

Since mid-December, however, the daily tolls have regularly surpassed 1,000, in a country of about 83 million people.

Early this month, pictures taken inside a mortuary in Meissen, in the east of the country, showed coffins stacked three-high. And on Thursday of last week — the country’s worst pandemic day so far — 1,244 people died from Covid in 24 hours.

The official U.S. coronavirus case tally works out to about one in every 13 people in the country.
Credit…Whitney Curtis for The New York Times

The United States has now recorded 25 million coronavirus cases, reaching the threshold Saturday afternoon, according to a New York Times database.

Experts say that as staggering as that figure is, it significantly understates the true number of people in the country who have been infected and the scope of the nation’s failure to contain the spread of the virus.

The official tally works out to about one in every 13 people in the country, or about 7.6 percent of the population.

“Twenty-five million cases is an incredible scale of tragedy,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, who called the coronavirus pandemic one of the worst public health crises in history.

As a result, deaths in the country have also inexorably risen, with more than 414,000 linked to the virus. That’s one death out of roughly every 800 people in the country.

Starting with the first reported case in the country last January, it took the United States more than nine months to reach 10 million cases. That milestone was passed on Nov. 8, just before a holiday surge that accelerated the rate of new infections and brought weeks of record-shattering hospitalizations and deaths. By the last day of 2020, the country had added another 10 million cases in just seven weeks.

Getting to 25 million took about three more weeks, after a surge that peaked at more than 300,000 recorded daily cases before retreating a bit in early January. Hospitalizations peaked around then and have since fallen: The latest figure of 116,264 Covid-19 patients is the lowest since Dec. 21, according to the Covid Tracking Project.

Experts now fear that any signs of progress could be undone by the emergence of new variants that appear to be more contagious. The Centers for Disease Control and Prevention recently warned that a virus variant first detected in Britain could become the dominant source of infection in the United States by March, and would very likely lead to further surges in cases and deaths. The warning only added to the urgency of speeding up the country’s lagging vaccination rollout.

In addition, the more viruses spread, the more opportunities they have to mutate. And as it becomes more difficult for the pathogen to survive — whether because of vaccinations or growing natural immunity — mutations that enable the virus to spread more easily or to escape detection by the immune system could multiply.

Epidemiologists say the true number of infections is probably much higher than the official tallies. Even with much more widespread testing now than in the pandemic’s early months, they say, many people who have never experienced symptoms may not have been tested or counted.

Ira Longini, a professor of biostatistics at the University of Florida, estimates that about 20 percent of Americans have had the virus — more than twice the number that is reported. Statistical modeling that he recently completed for Florida suggests that one-third of the state’s population has been infected at some point, quadruple the reported share.

It would take a coordinated nationwide study to move beyond modeling estimates and have a solid grasp of how many people have actually had the virus, he said. The C.D.C. conducts some serology testing, he said, but not enough to provide a full picture.

“The bottom line is, we don’t know, but we can guess from modeling,” Dr. Longini said.

The proportion can vary widely from place to place. In Dewey County, S.D., almost one in four residents has tested positive, but in San Juan County, Wash., only one in 200 has.

Many of the American metropolitan areas with the most reported cases relative to their populations are in the South or Southwest, where the virus has been spreading fast lately, but some are in areas like the Great Plains that were worse off in the fall. The top five are Yuma, Ariz.; Gallup, N.M.; Bismarck, N.D.; and Lubbock and Eagle Pass, Texas.

The metro areas with the greatest number of new cases per capita in the past two weeks reflect the same trend, and also underscore the virulence of the outbreak in California. Those areas are Laredo and Eagle Pass, Texas; Inland Empire, Calif.; Jefferson, Ga.; and Oxnard, Calif.

More than a million people are known to have tested positive in Los Angeles County, one of the nation’s hot spots over the past few months. And George Rutherford, a professor of epidemiology and biostatistics at the University of California, San Francisco, estimated that the true number of infections there is double that figure, or one out of every five Angelenos.

“It’s not enough for herd immunity, but it’s enough to blunt the curve,” he said.

A protest in Ulaanbaatar, the Mongolian capital, on Wednesday over the treatment of a Covid patient.
Credit…Byambasuren Byamba-Ochir/Agence France-Presse — Getty Images

Mongolia’s prime minister has resigned after protests in the country’s capital, Ulaanbaatar, over the government’s pandemic response.

The country’s Parliament on Friday approved the resignation of Prime Minister Khurelsukh Ukhnaa, who will be replaced by the chief cabinet minister, the state news media reported. The deputy prime minister and health minister also submitted their resignations.

Protesters took the streets on Wednesday after a widely circulated video showed a Covid-19 patient and her newborn baby being hastily escorted from a hospital to a quarantine facility. Demonstrators were protesting the treatment of the patient, who was still wearing a nightgown and slippers when she was escorted out of the hospital. Some protesters wore nightgowns and slippers in a show of support for the woman.

The World Health Organization praised Mongolia early on in the pandemic for its quick response, with the country shutting down its borders and ceasing much of its coal mining activity. Mining makes up nearly half of its export revenue and provides some of the best-paying jobs in the country.

And although Mr. Khurelsukh won landslide elections last year, the government has faced dissatisfaction over a flailing economy and unemployment. He said in a resignation letter that he would “accept the demand of the public.”

“I remember the second time I thought I would die,” said Laura M. Holson, a Times reporter and editor.
Credit…Adam Ferguson for The New York Times

Laura M. Holson, a Times reporter and editor, caught Covid-19 during the New York City outbreak last April, but the acute phase of the illness was just the beginning. Here, she tells her story.

I remember the second time I thought I would die.

The first time was April 17, 2020, when, after finding out I had Covid-19 nine days earlier with aches and a cough, my fever shot up to 101.8, I could barely breathe, and my family doctor told me I had bacterial pneumonia.

The second time I thought I would die was different, yet eerily the same. It was June 22, nearly three months after the initial diagnosis. By then the cough had softened, and I was well past the acute phase of Covid-19, having tested negative twice. The chest tightness had passed, supplanted by a nagging ache. I had lost eight pounds as nausea tamped my appetite, and my heart seemed to race without reason. I was so tired I sometimes fell asleep upright in my chair. And my fever persisted, too.

On that cloudless day in June, the temperature outside hovered at a pleasant 85. I was seated on the couch, working on my laptop when, at about 4 p.m., the crushing chest pain I experienced during Covid’s earliest days suddenly returned. My pulse began to quicken, and a shawl of heat gathered around my shoulders, crept up my neck and swallowed my head. I began to sweat. It felt as if the air was being squeezed out of my lungs. Breathe, I told myself. BREATHE. I stood up, gasping, and walked to the window to look outside.

Could this really be happening again?

Read her full account.

Harvesting oranges in New South Wales in October. The neighboring state of Victoria is one of the last in Australia to allow in Pacific Islanders to help on farms.
Credit…Lukas Coch/EPA, via Shutterstock

About 1,500 people from Pacific Island nations are due to be flown into the Australian state of Victoria to pick fruit on farms. And although the move will help alleviate a shortage of farm hands that has plagued the industry for months because of the coronavirus, it also underscores the greater health risks and economic effects that poorer and non-white populations have faced in the pandemic.

Victoria is one of the last states in Australia to allow Pacific Islanders in to help on farms. Nearly 200 workers from Vanuatu flew into the Northern Territory to harvest mangos in August, and other states have since followed.

Over the summer, the country has been flooded with news reports of fruit and vegetables being left to rot in fields amid a shortage of workers to pick them.

Farmers say they have had difficulty attracting locals to do the work, while some Australians counter that farmers have been unwilling to employ locals because they are “not as exploitable as a foreigner.” The sector has also been the subject of recent reports of underpaying and exploiting workers.

The supply of backpackers and foreign seasonal workers who typically make up the majority of the industry has been cut off since the country shut its borders last March in an effort to stop the spread of the virus.

Before arriving in Victoria, the Pacific Islander workers will be required to quarantine for two weeks on the Australian island state of Tasmania, Victoria’s government said on Friday. In exchange, 330 Tasmanians who have been stuck overseas will be able to return to the country and quarantine in Melbourne hotels.

Victoria has eased its pandemic restrictions after 16 consecutive days with no cases of community infection.

A migrant worker on a break from harvesting lettuce in Somerton, Ariz.
Credit…Adriana Zehbrauskas for The New York Times

Yuma County, Ariz., which produces the lettuce, broccoli and other leafy greens that Americans consume during the cold months, is known as “America’s salad bowl.” Now it has become a winter hothouse for Covid-19.

Over the course of the pandemic, the Yuma area has identified coronavirus cases at a higher rate than any other region in the United States. One out of every six residents has contracted the virus.

Each winter, the county’s population swells by 100,000 people, to more than 300,000, as field workers descend on the farms and snowbirds from the Midwest pull into R.V. parks. This seasonal ritual creates jobs and increases local spending and tax revenue. But this year, the influx has turned deadly.

Even as coronavirus cases are starting to flatten across the country, the virus is still raging in many border communities. Three of the six metro areas with the highest rates of known cases since the outbreak began are small cities straddling Mexico: Yuma; Eagle Pass, Texas; and El Centro, Calif. In Laredo, Texas, cases are increasing at more than three times the rate being reported in hard-hit Los Angeles and Phoenix.

Seasonal migration, the daily flow of people back and forth and lax measures to contain the virus’s spread have created a combustible constellation. Arizona has among the highest increases in newly reported deaths of any state over the past two weeks — and it is not clear when this troubling trend will abate.

“Some families have buried multiple relatives,” said the Rev. Emilio Chapa, the pastor of St. Francis of Assisi Catholic Church in central Yuma. “It’s a dire situation.”

A man placing flags at the National World War I Museum and Memorial in Kansas City on Tuesday. The flags represent the area residents who died of coronavirus.
Credit…Charlie Riedel/Associated Press

President Biden, by predicting on Friday that the coronavirus-related U.S. death toll would eventually be well over 600,000, could in the end be right.

Or, like others who have tried to forecast the figure, he could be wrong.

Back in March, when Dr. Anthony S. Fauci, the U.S. government’s top infectious disease specialist, said that the pandemic could kill 100,000 to 240,000 people in the country, some thought his projection was too grim to be possible.

On Tuesday, the country surpassed 400,000 deaths. And on Thursday, Mr. Biden predicted — on his first full day on the job — that the death toll would top 500,000 next month, an estimate supported by models from public health experts.

“The virus is surging. We’re 400,000 dead, expected to reach well over 600,000,” Mr. Biden said on Friday evening. “No matter how you look at it, we need to act.”

Meanwhile, an aggregate forecast from the Centers for Disease Control and Prevention comprising various independent models projects that 465,000 to 508,000 deaths could be reported by Feb. 13.

At many points over the past year, even dire death toll projections have fallen short of reality. The U.S. failed to bring the virus under control when it had a chance to do so in the spring. New, more transmissible variants now make the outlook for the virus harder to predict.

Two days after reaching 400,000 deaths, according to data compiled by The New York Times, the country had already passed 410,000. The U.S. added more than 4,100 deaths on Thursday, the third-highest daily total of the pandemic. About 120,000 people are hospitalized with the virus, and the country is adding about 1.3 million new cases a week.

From the start, the Trump administration was loath to acknowledge the carnage from the virus. Last April, Dr. Deborah L. Birx, the former administration’s coronavirus response coordinator, said that aggressive social distancing measures had appeared to slow the spread and suggested the number of dead might be lower than initially feared — perhaps about 60,000.

That figure was reached within weeks. In May, President Donald J. Trump adjusted that projection to between 75,000 and 100,000 deaths. (He then claimed success would be anything less than 2.2 million fatalities, the most extreme prediction if the country had done nothing at all to respond to the pandemic.)

The death total reached 100,000 by May 27 and 200,000 on Sept. 22. On Dec. 14, it hit 300,000, an accelerating pace that continued to speed up, resulting in a mere five weeks between that milestone and the death toll of 400,000.

New Yorkers waited in line at vaccine hub in Queens last week.
Credit…Hiroko Masuike/The New York Times

Even as New York City officials focus on vaccinating millions of residents, the coronavirus continues to spread, with more than 50 ZIP codes showing a positive test rate over 10 percent.

Each day recently has typically seen about 5,000 new cases of the virus and has recorded more than 60 new deaths. While the numbers of deaths and hospitalizations are nowhere near what they were during the city’s peak of the epidemic in the spring, public health experts wonder how much worse the data needs to get before officials consider new steps and restrictions.

“I feel like people are numbed by the numbers; I worry about the complacency and fatigue,” said Dr. Wafaa El-Sadr, an epidemiologist at Columbia University’s Mailman School of Public Health. “I worry about the focus on vaccines, rather than what’s happening with the virus.”

The 54 ZIP codes in New York City with seven-day average positivity rates of over 10 percent span every borough, city statistics showed on Friday. Two more ZIP codes were at 10 percent. Bronx, Queens and Staten Island have positive test rates higher than 9 percent.

Not long ago, Gov. Andrew M. Cuomo pledged to largely lock down areas where positive test rates consistently topped 4 percent. But as rates rose above that statewide, those plans were scrapped.

Currently the sole measure presented by Mr. Cuomo to trigger a lockdown is a complicated projection regarding hospital capacity. Officials say they are not considering any adjustments to that model.

In the ZIP code that includes Brighton Beach in southern Brooklyn, more than 500 cases were reported from Jan. 13 to 19. In all, more than 36,000 city residents tested positive during that period; nearly 2,500 people with Covid-19 were admitted to hospitals.

Transmission in the city has become so widespread that Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention, recommended that all New Yorkers change their behavior.

“People in New York City should leave home only for outdoors or essential indoors activities given the level of spread in the community,” he said Thursday.

The need to better control brisk transmission is especially essential now that a more contagious variant of the virus from Britain has been detected in the city, Dr. Frieden and other epidemiologists said.

At the current rate of vaccination, experts say, it will take months to change the virus’s trajectory.

A singer performing in a nightclub in Dubai in November. Dubai has been hesitant to shut down its entertainment sector but is finally enacting restrictions amid a rise in coronavirus cases.
Credit…Kamran Jebreili/Associated Press

The party is coming to an end — or at least to a pause — in Dubai, which allowed its hotels, restaurants and clubs to continue offering live entertainment for the last half-year in the hope of sustaining its economically vital tourism industry. On Thursday, Dubai, one of the seven sheikhdoms that make up the United Arab Emirates, said that it would immediately suspend issuing new entertainment permits because coronavirus cases were mounting.

The resurgence of the virus in Dubai has forced the city to backtrack on promoting itself as one of the world’s few remaining havens for fun during the pandemic. Though it imposed a strict lockdown early on, Dubai reopened to tourists in July, and by the winter holidays, tourism had come alive again as bars and clubs filled with people escaping lockdowns in other countries.

Industry analysts reported that hotels there were 71 percent full in December, and the Emirates had begun inoculating its population with vaccines from Pfizer and Sinopharm faster than any other country except Israel. Much of the Emirates’ population is young, which may have helped hold down the country’s death toll.

But as reports of new coronavirus cases began to rise in recent weeks, Dubai’s greatest source of tourists, Britain, announced that it would start requiring anyone who returned from Dubai to quarantine. Israel, which sent thousands of tourists to Dubai after the Emirates and Israel agreed to normalize relations late last year, imposed the same restriction.

The Emirates announced 3,529 new cases on Thursday, setting a record for the 10th straight day.

Bars and restaurants in Dubai remain open, but the city’s tourism office said it would stop issuing permits for live performances and concerts in the interest of “public health and safety.” It did not say when the permits might resume.

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Covid-19 Live News and Updates

Credit…Cody O’Loughlin for The New York Times

The drugmaker Moderna said it would apply on Monday to the Food and Drug Administration to authorize its coronavirus vaccine for emergency use.

The first injections may be given as early as Dec. 21 if the process goes smoothly and approval is granted, Stéphane Bancel, the company’s chief executive, said in an interview.

Moderna’s application is based on data that it also announced on Monday, showing that its vaccine is 94.1 percent effective, and that its study of 30,000 people has met the scientific criteria needed to determine whether the vaccine works. The finding from the complete set of data is in line with an analysis of earlier data released on Nov. 16 that found the vaccine to be 94.5 percent effective.

The new data also showed that the vaccine was 100 percent effective at preventing severe disease from the coronavirus. The product was developed in collaboration with government researchers from the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.

Mr. Bancel said the company was “on track” to produce 20 million doses by the end of December, and 500 million to a billion in 2021. Each person requires two doses, administered a month apart, so 20 million doses will be enough for 10 million people.

Shares of Moderna surged nearly 18 percent, to $149.50, by early afternoon, after the company’s announcement Monday.

Moderna is the second vaccine maker to apply for emergency use authorization; Pfizer submitted its application on Nov. 20. Pfizer has said it can produce up to 50 million doses this year, with about half going to the United States. Its vaccine also requires two doses per person.

Speaking on “CBS This Morning” on Monday, Alex M. Azar II, the secretary of the Department of Health and Human Services, reiterated that distribution would begin quickly after the expected approvals of the Pfizer and Moderna vaccines.

“We could be seeing both of these vaccines out and getting into people’s arms before Christmas,” he said.

Asked about the role of states in the distribution process, Mr. Azar said that doses would be shipped out through normal vaccine distribution systems, and governors would be “like air traffic controllers” determining which hospitals or pharmacies receive shipments. While governors will determine which groups are prioritized, he said he hoped that they would follow the federal recommendations. He added that he would speak to governors on Monday afternoon with Vice President Mike Pence.

The first shots of the two vaccines are likely to go to certain groups, including health care workers; essential workers like police officers; people in other critical industries; and employees and residents in nursing homes. On Tuesday, a panel of advisers to the Centers for Disease Control and Prevention will meet to determine how to allocate initial supplies of vaccine.

Mr. Azar said that C.D.C. experts will base their recommendations on the latest data on virus cases around the country.

But generally, “Be thinking people in nursing homes, the most vulnerable, be thinking health care workers who are on the front lines,” he said.

The White House moved quickly on Monday to take credit for the Moderna vaccine’s development.

“President Trump’s Operation Warp Speed is rapidly advancing on a trajectory of success to save millions of American lives — five times faster than any other vaccine in history,” Michael Bars, a spokesman for President Trump, said in an emailed statement.

The hopeful news arrives at a particularly grim moment in the U.S. health crisis. Virus cases have surged and overwhelmed hospitals in some regions, and health officials have warned that the numbers may grow even worse in the coming weeks because of Thanksgiving travel and gatherings. In November alone, there have been more than four million new cases and 25,500 deaths.

More than 70 vaccines are being developed around the world, including 11 that, like Pfizer’s and Moderna’s vaccines, are in large-scale trials to gauge effectiveness.

Moderna’s application for emergency use authorization will include data from its Phase 3 study of 30,000 people. F.D.A. scientists will examine the information, and the application is likely to undergo a final review on Dec. 17 by a panel of expert advisers to the agency, Mr. Bancel said, adding that he expected the advisers to make a decision within 24 to 72 hours. The F.D.A. usually follows the recommendations of its advisory panels.

Officials at Operation Warp Speed, the government’s program to accelerate vaccine development, have said vaccinations could begin within 24 hours after the F.D.A. grants authorization.

Mr. Bancel said that Moderna had not yet begun shipping vaccines across the country, and would not do so until the emergency authorization is granted.

The government has arranged to buy vaccines from both Moderna and Pfizer and to provide it to the public free of charge. Moderna has received a commitment of $955 million from the U.S. government’s Biomedical Advanced Research and Development Authority for research and development of its vaccine, and the United States has committed up to $1.525 billion to buy 100 million doses.

The federal government will also begin a publicity campaign to encourage vaccinations, with ads on radio this week and on TV soon, he said.

In response to a question about how officials can guard against people using money or connections to jump the proverbial line, Mr. Azar vowed to “call out any inequities or injustices that we see.”

Credit…Jonah Markowitz for The New York Times

While many in the United States celebrated a muted Thanksgiving over Zoom, millions of people traveled instead, rejecting the advice of public officials.

According to Transportation Safety Administration data, about 800,000 to one million people passed through T.S.A. checkpoints each day in the days before and after the holiday — far lower than the same period last year, but likely far higher than epidemiologists had hoped to see.

A United Airlines spokeswoman, Annabelle Cottee, said the week of Thanksgiving was “the busiest since March” for the carrier.

Americans also took to the roads. AAA predicted significant declines in bus, train and cruise travel, but predicted only a modest drop in car travel.

For several days leading up to Thanksgiving, as case numbers and hospitalizations across the country grew exponentially, political leaders and medical experts warned of the dangers of compounding the virus spread by being with others. In November alone, there have been more than 4.1 million cases and more than 25,500 deaths.

There were 91,635 current hospitalizations as of Nov. 28, according to the Covid Tracking Project, almost twice as many as there were on Nov. 1, and triple the number on Oct. 1.

Aware of the emotional resonance of the holiday, experts tried to thread a narrative from these numbers that would convince people of the danger. Their warnings were direct — sometimes stern, sometimes impassioned pleas.

“Keep the gatherings, the indoor gatherings as small as you possibly can,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on “Good Morning America” last week. By making that sacrifice, he said, “you’re going to prevent people from getting infected.”

The Centers for Disease Control and Prevention was also urging people not to travel. “All Americans want to do what they can to protect their loved ones,” Dr. Henry Walke, a Covid-19 incident manager at the C.D.C., said at a news briefing.

And though it would have been unrealistic to expect a public that is restive from months of restrictions to universally abide by such recommendations, the aftermath of those decisions will begin to unfold in the weeks ahead.

Dr. Fauci, during an appearance on the Sunday news program “This Week,” said the best course for Thanksgiving travelers might be “to quarantine yourself for a period of time.”

Dr. Deborah L. Birx, the White House coronavirus response coordinator, said that travelers “have to assume that you were exposed and you became infected and you really need to get tested in the next week.” She urged that travelers avoid anyone in their family over 65 or with underlying illnesses.

That guidance comes as the C.D.C. is considering shortening the recommended isolation period for infected people. And while it is too early to know if holiday travel will affect the virus’s spread, new research suggests that people are most infectious about two days before symptoms begin and for five days afterward, meaning this week will likely be crucial in containment.

On Monday, Mayor Bill de Blasio of New York City urged residents who had ignored official guidance and attended Thanksgiving gatherings to get tested.

In anticipation of a renewed demand, the city has opened 25 new testing locations in the last week. It will also now post online the wait times at its testing sites, which had seen growing lines as New Yorkers scrambled to get tests before their holiday plans.

The city’s seven-day average positive test rate was at 4.03 percent, Mr. de Blasio said, but he warned that the data may be skewed because fewer tests were conducted during Thanksgiving weekend.

“Some of our numbers may be skewed by that,” he said.

The U.S. map shows a country where almost every region is a hot spot. States that were once spared, like Montana and Wyoming, have reported record deaths and infections, while states that were pummeled in the first wave are straining anew.

On Sunday, California became the first state to report more than 100,000 cases in a week, according to a New York Times database.

And in New Jersey, hospitalizations have increased 60 percent in the last two weeks and deaths have increased by 78 percent. Over three days in November, the positivity rate in Newark, the largest city in the state, was 19 percent.

“We begged people to have a somber, respectful, small Thanksgiving,” Gov. Philip D. Murphy said on Fox News Sunday. “And I want to give a shout out to New Jerseyans because I think overwhelmingly that’s what happened, but there’s a lot of fatigue out there.”

Mr. Murphy called the next few months “the fight of our lives,” while also citing the progress of vaccines and noting that there was “light at the end of the tunnel.”

And there was something to celebrate on Sunday in New York City, at least for some parents, when Mr. de Blasio announced that he would reopen the city’s public elementary schools, abruptly shifting policy after an outcry from critics who questioned why gyms and bars remained open while schools were shut.

Credit…Mike Groll/Office of Governor Andrew M. Cuomo, via Associated Press

As he warned that New York State had entered a new phase in fighting the spread of coronavirus, Gov. Andrew M. Cuomo announced on Monday a new series of emergency measures to combat rising hospitalizations and case numbers statewide.

Among other steps, Mr. Cuomo urged hospitals to identify retired nurses and doctors in case of staff shortages, develop emergency field plans and prepare to add 50 percent of bed capacity. In Erie County in western New York, all elective surgeries will be stopped on Friday and similar protocols could be enacted in other areas of the state.

“It’s a new phase in the war against Covid,” Mr. Cuomo said at his news conference in New York City. “It’s a war in terms of preparation and mobilization.”

The number of New Yorkers hospitalized with the virus has more than tripled over November, from 1,125 on Nov. 1 to 3,532 on Sunday, he said.

“We are not going to live through the nightmare of overwhelmed hospitals again,” he says. “If a hospital does get overwhelmed there will be a state investigation.”

Mr. Cuomo has warned that the holidays and indoor social gatherings during the winter season could trigger a further resurgence of the virus. Still, instead of regional or statewide shutdowns, Mr. Cuomo had opted for a “micro-cluster” approach to targeting communities where rates of positive test results are particularly high.

On Monday, the governor said new metrics — including hospitalization rates, death rates and available hospital beds — would be used to determine lockdown levels under the state’s color-coded restriction system. Mr. Cuomo also called on hospital networks across the state to better prepare for a surge in patients than they did in the spring, and plan to spread patients out between individual sites.

“We lived this nightmare, we learned from this nightmare, we are going to correct for the lessons we learned during this nightmare,” he said.


Credit…David W Cerny/Reuters

The traditional Christmas markets that dot European cities, drawing thousands of festive revelers into plazas to enjoy mulled wine, colorful lights and public art, have largely been canceled this year.

But on Advent Sunday, the official start of the holiday season, celebrations continued in different forms. In partially locked-down Bratislava, the capital of Slovakia, the mayor, Matus Vallo, led viewers of a Facebook livestream on a walk through the city’s historic center.

Wearing a cheerful Christmas sweater, Mr. Vallo met musicians and artists along the way, received soothing words from a local priest, eyed winter-themed paintings from art galleries and lit up a Christmas tree in the main square.

“We know what the situation is, but we decided that we won’t let Advent be ruined anyway,” he said to the camera.

Locals and visitors in Bratislava will still be able to gawk at the Christmas lights on a stroll, but officials wanted to avoid the large holiday crowds. Moving traditional events online was part of that effort; a series of holiday concerts and events will be streamed throughout December.

It’s just one of several creative solutions as markets were canceled across the continent. In Landshut, Germany, visitors must experience the Christmas markets as a drive-through, according to Agence France-Presse. They can observe the spectacle from inside their cars as mask-wearing employees hand them menus offering typical treats like roasted chestnuts and gingerbread hearts.

And in the United States, New York City will require reservations to see the Christmas tree at Rockefeller Center, in a bid to fight the holiday crowds that usually pack the surrounding plazas and sidewalks. The city will keep the viewing time to 5 minutes, Mayor Bill de Blasio said. Groups will be limited to four people.

Still, the mayor, who has expressed concern that cases of the virus could surge during the holiday, encouraged people to watch the annual tree-lighting ceremony — scheduled for Wednesday — at home instead of flocking to Midtown Manhattan. “Please, if you can make a decision to watch it on TV, that’s so much better,” he said.

  • Hong Kong will limit gatherings in public to two people, including two per table at restaurants, as it battles a surge in cases. Playgrounds, swimming pools and karaoke rooms will close, while gyms will remain open but be limited to two mask-wearing participants, the city’s chief executive, Carrie Lam, said at a news conference on Monday. Hong Kong has reported an average of 85 new daily cases in the past week, far above the near-zero tallies it had reported after a summer surge.

  • Italy approved a stimulus package worth $9.6 billion, or 8 billion euros, on Sunday to support struggling businesses. The deal will postpone or suspend tax deadlines for some businesses, subsidize amateur sports associations and send checks of 1,000 euros to seasonal workers in the tourism, spa and entertainment industries. Italy is currently under a nationwide 10 p.m. curfew with bars and restaurants closing at 6 p.m., and some regions have further restrictions.

  • In Russia, a hospital near Moscow reported on Monday that it had administered the first known batch of the Russian-made Sputnik V vaccine to civilians. The Domodedovo Central City Hospital confirmed in a phone interview that the vaccine had been delivered and that the first shipment available for general use had already run out. Russia’s government backed efforts to develop a vaccine before other countries has been widely criticized for cutting corners. The rush to deliver a vaccine to the general public has also been spurred by the growing number of new cases and deaths in the country, with the total number of cases in Russia nearing 2.3 million.

Credit…Korean Central News Agency/Korea News Service, via Associated Press

North Korea’s leader Kim Jong-un “harshly criticized” his government agencies for mishandling the economy, the country’s state media reported on Monday, as new data revealed just how much the pandemic had slashed the country’s already dwindling trade with China.

Signs had already emerged earlier this month that North Korea’s economic trouble was deepening, driven by long-standing international sanctions and the impact of the pandemic. According to customs data released by Beijing last week, North Korea’s imports from China from January to October plummeted by 76 percent to $487 million, while its exports shrank 74 percent to $45 million in the same period.

​China is North Korea’s only major trading partner, accounting for more than 90 percent of its external trade. In October, the North’s import from China amounted to a mere $253,000, nearly a 99-percent drop from the previous month. South Korean officials and analysts have warned that a sharp decline in imports from China in recent months could drive up domestic prices in the North.

The Chinese government only ​records official trade and does not cover smuggling that takes place across the borders​ between the two neighbors​. Still, the figures provide​d​ fresh evidence that the coronavirus was squeezing the North Korean economy more effectively than international sanctions ever have.

During a meeting of the Workers’ Party that Mr. Kim presided over on Sunday, the government agencies responsible for the economy w​ere harshly criticized for “failing to provide scientific guidance” and “failing to overcome subjectivism and formalism in their work,” the North’s official Korean Central News Agency reported.

But this was not the first time Mr. Kim has admitted to his country’s deepening economic woes, acknowledging in August that his five-year plan for economic growth had failed. Mr. Kim all but sealed North Korea’s borders with China​ earlier this year over fears of the potentially catastrophic consequences the pandemic could inflict on the country’s poor health system.

North Korea insists that it has registered no coronavirus cases, but outside experts remain skeptical.

Credit…Jose A. Alvarado Jr. for The New York Times

With New York City’s unemployment rate at 13.2 percent, many people have turned to working for food delivery apps like DoorDash, Uber Eats and Grubhub, which have seen huge demand from customers.

While delivery drivers have been essential to feeding New Yorkers and keeping them safe, their working conditions, already precarious before the pandemic, have gotten worse.

Even as the food delivery companies have seen sales surge, the workers’ pay has remained erratic. Because the drivers are independent workers, they are not entitled to a minimum wage, overtime or any other benefits, like health insurance. Undocumented immigrants, who are not eligible for unemployment or federal coronavirus assistance, make up the bulk of the work force in New York.

The added competition from the surge in new workers has compounded the financial challenges. Advocacy groups estimate that there were roughly 50,000 delivery workers before the pandemic — a number they say has grown exponentially. Uber alone said it had added 36,000 couriers in New York since March.

DoorDash and Uber said they had provided extra help to delivery drivers during the pandemic, including offering sick pay to those who were infected. DoorDash, the nation’s largest food delivery app, said it provided access to low-cost telemedicine appointments.

DoorDash also said it had changed its pay model, which came under fire last year after it was revealed that tips were being used to subsidize its payments to workers. The company recently reached a $2.5 million settlement with prosecutors in Washington, D.C., after being accused of misleading consumers over how it tipped its workers.

Drivers for food delivery apps are typically paid per delivery depending on the estimated duration and distance of a trip, plus tips. The work can be convenient for people supplementing a main source of income, but a struggle for those who depend on it as a primary job, advocates for the workers said.

Credit…Andrew Testa for The New York Times

While some in the creative community on TikTok joke about the coronavirus vaccine or tease people who are part of the anti-vaccine movement, scientists and coronavirus vaccine participants are hoping to be a source to fight misinformation on the app.

In February, a scientist who goes by Dr. Noc on TikTok started noticing a need for science-based videos about the coronavirus that his expertise in working to develop an antibody treatment for Covid-19 could help provide.

He has since posted many videos addressing the coronavirus, including updates on vaccines, mink infected with the coronavirus and how some people with the virus can lose their sense of taste and smell. The videos, he said, have left him vulnerable to harassment from people against vaccines and masks.

Lately, Dr. Noc has found himself answering questions reflecting the fears and misconceptions about coronavirus vaccines that are sometimes perpetuated on the platform by jokes about side effects or forays into fictional narrative, like a sci-fi scenario in which the government kills those who refuse a vaccine.

“While people may appreciate them, they’re not going to go viral,” he said about his videos. “It’s a game of catch-up.”

So, no, nanoparticles can’t send people’s biometric data to a cloud, as he has posted, and no, mRNA can’t change people’s D.N.A.

Vaccine trial participants have also been describing their experiences and answering questions about the process for viewers.

Ashley Locke, 29, from Nashville, said she posted about her experience as a participant in AstraZeneca’s trial to document a journey in her life, but didn’t expect the more than two million views it has gotten, or the thousands of questions and comments.

Since that post, she’s been creating videos and answering questions from her comment section about side effects and wearing masks after being a part of the trial. She even brought in a friend, also a part of a trial, to talk.

But with all that, she said, she isn’t always successful in demystifying the vaccine.

“There are some people that are really out there that are convinced that it’s a microchip,” she said. “They’re a little too far gone to convince.”

Credit…Paul Miller/Australian Associated Press, via Associated Press

A cohort of 63 international students on Monday arrived in Australia under a pilot program that allows them to resume their studies, even as the country’s borders remain closed because of the pandemic.

The students, the first group of international students allowed in since March, arrived at Darwin International Airport in the Northern Territory from Singapore. They are from mainland China, Hong Kong, Japan, Vietnam and Indonesia.

All of them tested negative for the coronavirus 72 hours before boarding the charter flight. They will be required to quarantine at a former workers’ camp outside the city of Darwin for 14 days before being allowed to re-enter the campus at Charles Darwin University.

The education sector, crucial to the Australian economy, is set to lose billions of dollars if the country’s borders do not reopen before the end of 2021. According to research from Victoria University, the loss of international students is also affecting the makeup of Australia’s cities.

In September, Charles Darwin University made a deal with the state and the federal government that would enable students to return from overseas to study. The success of the program could influence whether more international students can return to study in other states, including South Australia and the Australian Capital Territory.

Speaking to the local news media, the students — some of who had become stranded while visiting family overseas — said they felt lucky to return to Australia, which is beginning to reopen as states eliminate, or come close to eliminating, the spread of the coronavirus.

Xitao Jiang, a 23-year-old student from China returning to Australia, told the Australian Broadcasting Corporation on Sunday that was “very lucky” to have the opportunity to return to the country and study at the university in Darwin.

Credit…Andrew Testa for The New York Times

By the end of the third week of England’s second national lockdown, which began early this month in a bid to stem a second wave of coronavirus infections, the number of new cases has fallen 30 percent, according to new data.

Some parts of northern England, which had been hit particularly hard by the new outbreak, experienced an even greater drop, the latest interim findings from Imperial College London’s React study showed.

But Matt Hancock, the British health secretary, warned that the data, while promising, showed the country could not “take our foot off the pedal just yet,” according to the BBC. In a post on Twitter late Sunday, Mr. Hancock cautioned that “we mustn’t waste our progress now we can see light at the end of the tunnel” with mass testing and promising coronavirus vaccine candidates on the horizon.

England’s current lockdown is set to end just after midnight Wednesday. But the lifting of restrictions will be different across the country, as regions move into one of three tiers based on their current rate of infection. Britain is still grappling with the highest number of Covid-19 deaths in Europe and its deepest recession on record, with experts warning that the knock-on effects of the pandemic could last for years.

Credit…Brett Carlsen for The New York Times

All through the fall, teachers have been at the center of vehement debates over whether to reopen schools for in-person instruction — often vilified for challenging it, sometimes praised for trying to make it work.

But these debates have often missed just how thoroughly the coronavirus has upended learning in the 130,000 schools in the United States, and glossed over how emotionally and physically draining pandemic teaching has become.

In more than a dozen interviews with The New York Times, educators described the immense challenges, and exhaustion, they have faced. Some recounted whiplash experiences of having their schools abruptly open and close, sometimes more than once.

Others described the stress of having to lead back-to-back group video lessons for remote learners, even as they continued to teach students in person in their classrooms. Some educators said their workloads had doubled.

Many teachers said they had also become impromptu social workers for their students, directing them to food banks, acting as grief counselors for those who had family members die of Covid-19 and helping pupils work through their anxiety, depression and isolation. Often, the teachers said, their concern for their students came at a cost to themselves.

“Teachers are not OK right now,” said Evin Shinn, a literacy coach at a public middle school in Seattle, noting that many teachers were putting students’ pandemic needs above their own well-being.

Experts and teachers’ unions are warning of a looming burnout crisis among educators that could lead to a wave of retirements, undermining the fitful effort to resume normal public schooling. In a recent survey by the National Education Association, the country’s largest teachers’ union, 28 percent of educators said the coronavirus had made them more likely to leave teaching or retire early.

Those We’ve Lost

Credit…Selene Meda-Schlamel

Iris Meda, 70, didn’t feel right sitting on the sidelines when the pandemic hit. She’d been retired only a few months, and still had a lifetime of nursing experience in hospitals, prisons, schools and long-term care facilities to share.

So she went back to work in August, teaching nursing skills to high school students through Collin College, north of Dallas. But within weeks, she had come down with Covid-19 herself. After nearly a month in the hospital, most of it on a ventilator, she died on Nov. 14.

Her daughter, Selene Meda-Schlamel, said her mother was exposed to the virus on Oct. 2 while teaching a laboratory class, despite the precautions she was taking.

“I wasn’t worried, because I knew she was wearing an N95, and that she was some distance from the students,” Ms. Meda-Schlamel recalled, in an interview.

“I said to myself, ‘If something happens to her, it happens to her doing something she loves, fulfilling her calling and benefiting the world,’” she said. “But that’s a very different outlook from, ‘My best friend is gone, my kids don’t have a grandmother. Everything that we planned on doing will never occur.’”

Ms. Meda grew up in New York, the oldest of nine siblings, and was a natural caretaker from childhood, her daughter said. She married at 20, expecting to be a stay-at-home mother, but at her husband’s urging, she went back to school and earned a nursing degree from City College.

“She had a very personal touch,” Ms. Meda-Schlamel said. “You never felt like she was rushing you.”

Ms. Meda worked as a nurse at the jail on Rikers Island before moving to Texas in 1993, where she spent the rest of her career before retiring in January. When she took up teaching, she wanted to pass along to her students the kind of encouragement she had gotten to pursue an education. After class, she often returned home “lit up” from the thrill she got from teaching, her daughter said.

When her Covid-19 symptoms worsened in mid-October and she began struggling to breathe, Ms. Meda called her daughter for a ride to the hospital. Ms. Meda-Schlamel recalled that in the car, her mother handed her an envelope containing her medical documents and a handwritten card that she forgot about in the hectic days that followed.

When she finally opened it, she said, she found a note her mother had written after their phone call, telling her how proud she was of her and what a wonderful life she had before her. And two signed checks fell out, meant to help her daughter cover the hospital bills. On one, the amount was left blank.

“That was kind of symbolic of how she was as a person,” Ms. Meda-Schlamel said. “She was always giving people blank checks, blank emotional checks: ‘Whatever you need from me, if I have it, I’ll provide it.’”

Credit…Mary Turner for The New York Times

When Lisa Bloor heard that her daughter Abby’s elite-level soccer club was being shut down in England’s latest coronavirus lockdown, she faced a tough problem: how to explain that boys at the same level were allowed to keep playing.

“How do I tell my daughter it’s because she’s a girl?” Ms. Bloor asked. “It’s disheartening. There’s no logic in it at all.”

As the coronavirus has upended lives across the world, women have found themselves disproportionately affected, whether by taking on the often invisible labor of an outsize share in household duties, caring for children and relatives or finding the hard-fought gains they made in the workplace in past years almost entirely wiped out.

In early November, after Britain’s government reluctantly admitted the need for a second lockdown of all but England’s most essential services to stop the number of Covid-19 cases spiraling out of control, the restrictions — and exceptions to the rules — laid bare yet another gender gap: the one between women and men’s sports.

When the British government granted “elite sport” special dispensations for the duration of a four-week lockdown, the top six tiers of men’s soccer could carry on training and competing. But only the top two women’s soccer leagues were permitted to continue.

The Football Association, which governs the sport in England, ruled that the men’s F.A. Cup tournament would not stop, but postponed the women’s F.A. Cup until the national lockdown lifts in early December.

Nowhere was the gender divide more transparent than in the decision surrounding the soccer clubs’ academies, which sharpen the skills of the most promising school-age players and prepare them to turn professional.

Boys’ training at more than 80 English Football League and Premier League clubs’ academies could remain open under “elite” protocols, but the F.A. decided that girls’ academies at clubs such as Everton — where Abby Clarke, Ms. Bloor’s 16-year-old daughter, trains at least four times a week as part of the development squad — were “nonelite” and would have to suspend all activity throughout the lockdown.

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Pipetting Tip Market 2020: Potential growth, attractive valuation make it is a long-term investment | Know the COVID19 Impact | Top Players: Eppendorf, Mettler Toledo, Thermo Fisher Scientific, Sartorius, Biotix, etc.

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