Categories
World News

Covid-19 Information: Stay Updates – The New York Occasions

Here’s what you need to know:

Credit…Sergio Flores for The New York Times

The Centers for Disease Control and Prevention on Friday urged that K-12 schools be reopened and offered a comprehensive science-based plan for doing so speedily, an effort to resolve an urgent debate roiling in communities across the nation.

The new guidelines highlight the growing body of evidence that schools can openly safely if they put in effect layered mitigation measures. The agency said that even when students lived in communities with high transmission rates, elementary students could receive at least some in-person instruction safely — a finding echoed by an independent survey of 175 pediatric disease experts conducted by The Times.

Middle and high school students, the agency said, could attend school safely at most lower levels of community transmission — or even at higher levels, if schools put into effect weekly testing of staff and students to identify asymptomatic infections.

Among the pediatric experts surveyed by The Times, the point of most agreement was requiring masks for everyone: students, teachers, administrators and other staff. All respondents said universal masking was important, and many said it was a simple solution that made the need for other preconditions to opening less essential.

“C.D.C.’s operational strategy is grounded in science and the best available evidence,” Dr. Rochelle Walensky, director of the C.D.C., said on Friday in a call with reporters.

The guidelines arrive in the middle of a debate that is already highly fraught. Some parents whose schools remain closed are becoming increasingly frustrated, and public school enrollment has declined in many districts across the country.

Education and civil rights leaders are despairing about the harms being done to children who have not been in classrooms for nearly a year. And many of the pediatric health experts also expressed deep concern about other risks to students of staying home, including depression, hunger, anxiety, isolation and learning loss.

“Children’s learning and emotional and, in some cases, physical health is being severely impacted by being out of school,” said Dr. Lisa Abuogi, a pediatric emergency medicine physician at the University of Colorado, expressing her personal view. “I spend part of my clinical time in the E.R., and the amount of mental distress we are seeing in children related to schools is off the charts.”

The Biden administration has made a high priority of returning children to classrooms, and the new recommendations try to carve a middle ground between school officials as well as some parents who are eager to see a resumption of in-person learning and powerful teachers’ unions resisting a return to school settings that they regard as unsafe amid the coronavirus pandemic.

Whether the guidelines will persuade powerful teachers’ unions — allies of Mr. Biden — to support teachers returning to classrooms remains to be seen. In advice that may be disappointing to some unions, the document states that, while teachers should be vaccinated as quickly as possible, teachers do not need to be vaccinated before schools can reopen.

“I completely understand teachers’ and other school employees’ fear about returning to school, but there are now many well-conducted scientific studies showing that it is safe for schools to reopen with appropriate precautions, even without vaccination,” said Dr. Rebecca Same, an assistant professor in pediatric infectious disease at Washington University in St. Louis. “They are much more likely to get infected from the outside community and from family members than from school contacts.”

The C.D.C. document embraces the often-repeated mantra that schools should be the last settings to close in a community and the first to reopen. But that has been followed nowhere in the country, and these guidelines have no power to force communities where transmission remains high to take steps, such as closing nonessential businesses, to decrease it.

As a result, some teachers’ unions will continue to argue that the overall environment remains unsafe to return to in-person classrooms.

A majority of districts in the country are offering at least some in-person learning, and about half of the nation’s students are learning in classrooms. But there are stark disparities in who has access to in-person instruction, with urban districts, which serve mostly poor, nonwhite children, more likely to be closed than nonurban ones.

United States › United StatesOn Feb. 11 14-day change
New cases 105,600 –36%
New deaths 3,878* –15%

*Includes many deaths from unspecified days

World › WorldOn Feb. 11 14-day change
New cases 396,594 –27%
New deaths 11,468 –16%

U.S. vaccinations ›

Where states are reporting vaccines given

Moderna currently supplies about half of the nation’s vaccine stock. Credit…Jim Wilson/The New York Times

The Food and Drug Administration has informed the drugmaker Moderna that it can put up to 40 percent more coronavirus vaccine into each of its vials, a simple and potentially rapid way to bolster strained supplies, according to people familiar with the company’s operations.

While federal officials want Moderna to submit more data showing the switch would not compromise vaccine quality, the continuing discussions are a hopeful sign that the nation’s vaccine stock could increase faster than expected, simply by allowing the company to load up to 14 doses in each vial instead of 10.

Moderna currently supplies about half of the nation’s vaccine stock. A 14-dose vial load could increase the nation’s vaccine supply by as much as 20 percent at a time when governors are clamoring for more vaccine and more contagious variants of the coronavirus are believed to be spreading quickly.

Two people familiar with Moderna’s manufacturing, who spoke on the condition of anonymity, said retooling the company’s production lines to accommodate the change could conceivably be done in fewer than 10 weeks, or before the end of April. That is because while the amount of liquid in each vial would change, the vials themselves would remain the same size, so the production process would not drastically change.

“It would be a great step forward,” said Dr. Moncef Slaoui, who served as the scientific leader of the Trump administration’s vaccine development program. “I think it will have an impact in the short term.”

In a recent email response to questions about the company’s discussions with regulators, Stéphane Bancel, the chief executive officer of Moderna, wrote, “No comment.” Ray Jordan, the company’s spokesman, said talks with federal officials were continuing.

Outreach workers try to sign up homeless people to go to shelters at the Woodlawn subway station in The Bronx.Credit…Victor J. Blue for The New York Times

Advocates for homeless people in New York City sued the Metropolitan Transportation Authority on Friday over a series of Covid-19 rules that the suit says unfairly target people who shelter in the city’s subways.

The rules prohibit people from staying in a subway station for more than an hour or after a train is taken out of service, and ban carts more than 30 inches long or wide. They were enacted on an emergency basis last April and made permanent in September.

Last spring, the pandemic and shutdowns emptied the subways of regular commuters, and dozens of transit workers died of the coronavirus. Images of trains half-filled with sleeping homeless people accompanied by the sprawl of their belongings became a symbol of a city in crisis and helped prompt Gov. Andrew M. Cuomo to shut down the system every night for cleaning.

The rules’ stated purposes were to “safeguard public health and safety,” help first responders get to work and “maintain social distancing.” But the rules exempt so many activities from the one-hour limit — including public speaking, campaigning, leafleting, artistic performances and collecting money for religious or political causes — as to make it “clearly apparent” that their real purpose is to exclude homeless people from the subways, the suit says.

The lawsuit was filed by the Urban Justice Center’s Safety Net Project on behalf of Picture the Homeless and a homeless man named Barry Simon.

Mr. Simon had been ordered out by the police “dozens of times” while resting in a station and threatened with arrest on several occasions, according to the lawsuit. Mr. Simon, 54, was ejected from stations at least 10 times because the cart he wheels his possessions in was too big, the suit says.

Because those experiencing homelessness in New York City are disproportionately Black and Latino and people living with disabilities, the rules violate state human and civil rights law, the suit says. It also says that the rules were enacted without proper review.

Abbey Collins, a spokeswoman for the M.T.A., said in a statement: “We are reviewing the lawsuit that we first learned of in the press. We will vigorously defend the regulations in court that were put in place to protect the health and safety of customers and employees in the midst of a global pandemic — period.”

Homeless people’s use of the subways as de facto shelters, long a fact of life in New York, has become a hot-button issue. Many homeless people now avoid the city’s barracks-style group shelters for fear of contracting the coronavirus. While the city is adding hundreds of private rooms in hotels to the shelter system, the contested rules and the nightly shutdown have left some people to choose between sleeping outdoors in winter and taking their chances in the group shelters.

Calls have grown in recent days to end the nightly shutdown.

Rosario Sabio, 77, receiving a coronavirus vaccine in San Diego last month.Credit…Ariana Drehsler for The New York Times

Although vaccines for the coronavirus were developed and approved in record time, distribution efforts in the United States and elsewhere have been plagued with problems.

The rollout, which has largely prioritized older people and health care workers, has faced difficulties, delays and confusion as people try to figure out whether their state is now allowing them to get shots, how to sign up and where to go.

But American health officials say that while current vaccine supply levels still limit how many doses they can administer, states are becoming more efficient at immunizing people as shipments arrive.

On Jan. 1, just a quarter of Covid-19 vaccine doses delivered across the United States had been used. As of Thursday, that figure had risen to 68 percent. A handful of states have administered more than 80 percent of the doses they have received, and even states with slower vaccine uptake are making strides.

“We are in a much better place now,” said Claire Hannan, the executive director of the Association of Immunization Managers.

The Biden administration says it has secured enough vaccine to inoculate every American adult. On Thursday, officials said that they had arranged to get 200 million more doses of vaccine by the end of summer, which amounts to a 50 percent increase. That should be enough vaccine to cover 300 million people — enough for all adults in the country, with tens of millions of doses to spare. And Friday was the start of a new federal effort to deliver doses directly to grocery store pharmacies and drugstores.

But President Biden warned that logistical hurdles would most likely mean that many Americans will still not have been vaccinated by the end of the summer.

He also expressed open frustration with the former administration. “It was a big mess,” he said on Thursday. “It’s going to take time to fix, to be blunt with you.”

The average number of shots administered daily has been increasing steadily since late December. The Centers for Disease Control and Prevention on Friday reported more than two million new vaccinations, bringing the latest seven-day average to about 1.66 million a day. About 35.8 million people have received at least one dose of a Covid-19 vaccine, and about 12.1 million of them have also received the second dose, according to the C.D.C.

But many places are still plagued by shortages, as demand far outpaces supply and health care providers struggle to predict how many doses they might receive.

Some countries are faring far worse. While wealthier countries have been able to make deals with drug manufacturers to secure enough vaccine to ensure their citizens can be vaccinated, poorer countries have been not, leaving many unprotected — an imbalance that is expected to have global ripple effects.

The leaders of the World Health Organization and the United Nations agency for children, Unicef, warned in a joint statement this week that the vast chasm of inequality in the global vaccine rollout will “cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.”

Of the 128 million vaccine doses administered globally, more than three quarters were in just 10 countries, while nearly 130 other countries are yet to administer a single dose, the statement said.

The French National Authority for Health has recommended a single dose of the vaccine for people who have already been infected with Covid and have had the results confirmed by a P.C.R. or antigen test.Credit…Andrea Mantovani for The New York Times

France’s top health authority said Friday that one dose of the coronavirus vaccine, rather than two, would be sufficient for most people who have recovered from Covid-19.

The Pfizer-BioNTech, AstraZeneca and Moderna vaccines — all of which are approved for use in the European Union — are meant to be injected in two doses spaced a few weeks apart.

But most people who have been infected with the coronavirus have already developed a strong immune response. In those cases, the French National Authority for Health said in a news release, a single shot could suffice, essentially serving as a booster.

It said the shot should be administered at least three months — and ideally closer to six months — after a Covid-19 infection.

While Britain and a number of other countries are delaying second doses to prioritize getting first doses to more people, the French announcement appeared to be the first to recommend only a single dose for those who have had the virus.

The independent body’s recommendation came with exceptions for people with compromised immune systems. It added that people who contract Covid-19 shortly after getting a single dose of the vaccine should wait three to six months before getting a second dose.

By contrast, the U.S. Centers for Disease Control and Prevention says that people who become infected in the days after their first dose can get their second dose after they recover, but that they can also choose to delay receiving the second dose.

According to a study posted online this month, which was not peer reviewed, researchers at Icahn School of Medicine at Mount Sinai in New York found that Covid survivors had far higher antibody levels after both the first and second doses of the vaccine and might need only one shot. But some scientists have urged caution, warning that more data was needed to prove that those antibodies could effectively stop the virus from replicating.

The pandemic has devastated businesses in San Francisco’s Chinatown, where banquet halls are closed and few shoppers are in the mood to buy Lunar New Year decorations.Credit…Jim Wilson/The New York Times

SAN FRANCISCO — The fish and crab tanks at the back of the wood-paneled restaurant are empty, and chairs are stacked here and there. Bill Lee, the owner of the Far East Café in San Francisco’s Chinatown, surveyed the empty second-floor banquet hall that during any other Lunar New Year would be packed with hundreds of customers.

“I keep losing money,” Mr. Lee said of his century-old restaurant, a former Cantonese social club and speakeasy. “If it continues this way, I’d rather to close down.”

As the Year of the Ox began on Friday, there were only muted attempts to celebrate. The pandemic has hit San Francisco’s Chinatown, America’s oldest and largest, particularly hard. The lack of tourists, a spate of violent attacks and robberies in Chinese neighborhoods across the Bay Area, and pandemic-related racism against Asian-Americans have combined to exacerbate the economic pain felt in Chinatown.

From a strictly medical perspective, the neighborhood has fared better than many other parts of the country, heading off a mass outbreak early. And mask wearing was ubiquitous this week on the streets of the densely packed neighborhood, where shoppers strolled through the handful of shops selling Lunar New Year decorations.

But a few blocks away, in a park where older residents gathered to play board games, Will Lex Ham, a New York-based actor, was helping lead a neighborhood safety patrol, handing out whistles and a Chinese-language pamphlet titled “How to Report a Hate Crime.”

“During the Lunar New Year there is an assumption that the elderly have money on them,” Mr. Ham said.

He flew in from New York on Wednesday after seeing video on social media that has rocketed around the world of attacks on Asian-Americans in Oakland and San Francisco, including the killing of Vicha Ratanapakdee, an 84-year-old Thai man who was shoved to the ground last month and died of his injuries.

“So often, people in the community don’t speak out when violence happens to them for fear of repercussions and a sense that nothing ever comes of it,” Mr. Ham said. “This is our time to speak out.”

Across the Bay, Carl Chan, the president of the Oakland Chinatown Chamber of Commerce, has tallied more than 20 assaults in the area over the past two weeks. Many of them were not reported, Mr. Chan said, partly because it can take hours for police officers to arrive at the scene.

“Our seniors are afraid to walk their own streets,” Mr. Chan said.

David Lee, a political science lecturer at San Francisco State University who is an expert on the history of the Chinatowns in Oakland and San Francisco, said these neighborhoods were among the first in the nation to feel the effects of the pandemic last year.

Last February, before any lockdowns, tourists had deserted San Francisco’s Chinatown, prompting Nancy Pelosi, the House speaker, whose district includes Chinatown, to visit in a show of support.

Mr. Lee says that many of the shops that are boarded up and padlocked in San Francisco’s Chinatown may not return. But the neighborhood, he says, has survived fires, an emergence of the bubonic plague at the turn of the 20th century and decades of racism.

“We will not let Chinatown die,” Mr. Lee said. “It is too important to the cultural fabric of the people of San Francisco. But is Chinatown going to look the way it did before the pandemic? That is the question I have.”

Global Roundup

Video

transcript

Back

transcript

‘We Need a Circuit Breaker’: Victoria Enters Lockdown

After multiple new cases of coronavirus were identified in Victoria, Australia, officials placed the region under lockdown, despite the tennis tournament currently taking place there.

I am sad to have to report it is the advice to me that we must assume that there are further cases in the community than we have positive results for, and that it is moving at a velocity that has not been seen anywhere in our country over the course of these last 12 months. Because this is so infectious and is moving so fast, we need a circuit breaker. Therefore, I’m announcing on advice from the chief health officer and after a meeting of relevant cabinet committees and the full cabinet, that from 11:59 p.m. tonight, Victoria, all of Victoria, will go to Stage 4. These restrictions are all about making sure that we respond appropriately to the fastest-moving, most infectious strain of coronavirus that we have seen. I know this is not the news that Victorians want to hear today. I know it’s not the place that we want it to be in. However, we’ve all given so much. We’ve all done so much.

Video player loadingAfter multiple new cases of coronavirus were identified in Victoria, Australia, officials placed the region under lockdown, despite the tennis tournament currently taking place there.CreditCredit…Darrian Traynor/Getty Images

More than six million people in Victoria, Australia, will enter into a snap lockdown for five days in response to a coronavirus outbreak at a quarantine hotel.

The order came as the Australian Open was being held in Melbourne, Victoria’s capital, but the tennis tournament will continue — without spectators — the authorities said on Friday.

Victorians will be allowed to leave home only for essential shopping, work, exercise and caregiving, and must wear masks whenever they leave home.

But while sports and entertainment venues will be shut down, professional athletes like tennis players will be classified as “essential workers” and allowed to continue their matches.

“There are no fans; there’s no crowds. These people are essentially at their workplace,” Daniel Andrews, the premier of Victoria, told reporters on Friday. “It’s not like the only people that are at work are supermarket workers.”

Tennis Australia said in a statement that it would notify all ticket holders of the changes and continue “to work with the government to ensure the health and safety of everyone.”

The lockdown, which goes into effect at 11:59 p.m. on Friday, comes after an outbreak at a Holiday Inn near the Melbourne Airport that was being used to house returned travelers.

By Friday, 13 people linked to the hotel had tested positive with the new virus variant that first emerged in Britain. In the past 24 hours, five new cases have been identified, bringing the state’s total number of cases to 19.

Describing the lockdown as a “circuit breaker,” the authorities said it was critical to stopping the spread of the variant, which is highly infectious and has outwitted contact tracers before they can contain outbreaks. Similar snap lockdowns in Perth and Brisbane in recent months were successful in quashing infections.

“The game has changed,” Mr. Andrews said. “This is not the 2020 virus.”

He said he hoped Victorians, who endured among the longest lockdowns in the world last year, would work together to prevent the state from entering a third wave of the coronavirus. “We will be able to smother this,” he said.

The order had ripple effects in Australia’s other states, which all announced travel restrictions with Victoria. International flights, excluding freight, into Melbourne were also canceled.

In other global developments:

  • Germany will close its border to the Czech Republic and the Austrian state of Tyrol starting Sunday as it tries to protect against new variants of the virus. As part of that effort, Germany this week extended its national lockdown for another month.

  • Canadian Prime Minister Justin Trudeau announced new travel restrictions on Friday. Beginning Feb. 22, all travelers by both land and air must show proof of a negative virus test taken within 72 hours before arrival in the country and they will be given another test when they arrive at the border. Air travelers will also be required to book a three-night stay in a government-authorized hotel at their own expense to quarantine while they await test results. All travelers must complete a full 14-day quarantine or risk heavy fines and possible jail time.

    “These are some of the strongest restrictions in the world. But with new variants emerging, we’re stepping them up even further,” Trudeau said during a news conference Friday.

  • New Zealand will receive the first batch of its 1.5-million-dose order of the Pfizer-BioNTech vaccine next week and expects to begin vaccinating its border workers on Feb. 20, ahead of schedule, Prime Minister Jacinda Ardern said on Friday. The country, which has all but eliminated local transmission of the virus, has additional purchase agreements with Janssen Pharmaceutica, Novavax and AstraZeneca, and expects to start vaccinating its wider population in the second quarter of this year, Ms. Ardern said.

Funeral proceedings in Cape Town, South Africa, in June of last year. The World Health Organization said that deaths across the African continent had risen by 40 percent in the last month. Credit…Marco Longari/Agence France-Presse — Getty Images

NAIROBI — The number of people dying from the coronavirus has swelled in more than half of the countries in Africa in the past month, the World Health Organization has warned, linking the rise to overwhelmed hospitals and health workers.

“The increasing deaths from Covid-19 we are seeing are tragic, but are also disturbing warning signs that health workers and health systems in Africa are dangerously overstretched,” said Dr. Matshidiso Moeti, the W.H.O.’s regional director for Africa. “This grim milestone must refocus everyone on stamping out the virus.”

The global health body said on Thursday said that deaths had increased in 32 of the continent’s 55 countries in the last month, pushing the overall African death toll near 100,000. Mortalities rose overall by 40 percent, the W.H.O. said, with more than 22,300 deaths recorded in the last 28 days compared with 16,000 deaths in the 28 days preceding that.

The rise in deaths comes as the continent faces a second deadlier wave of the virus, the emergence of new variants that vaccines may not fight effectively — particularly in hard-hit South Africa — and growing concerns around inequalities in distributing vaccines.

To forestall more deaths, the W.H.O. directed governments to ramp up investments in health care systems and to enforce measures including mask wearing, washing hands and social distancing.

Dr. Moeti also encouraged Africans to “go out and get vaccinated when a vaccine becomes available in your country.”

Her statement came just a week after she urged Tanzania’s government to start sharing data on its Covid-19 situation and begin preparations for a vaccination campaign. The East African nation has not submitted information about coronavirus cases to the W.H.O. since last April. The country’s president, John Magufuli, insists that Tanzania is coronavirus free and argues that “vaccines don’t work.”

In a leaked phone call, Melissa DeRosa, Gov. Andrew M. Cuomo’s top aide, told lawmakers that “basically, we froze.”Credit…Justin Lane/EPA, via Shutterstock

Gov. Andrew M. Cuomo and his top aides were facing new allegations on Friday that they covered up the scope of the coronavirus death toll in the state’s nursing homes, after admissions that they withheld data in an effort to forestall potential investigations into state misconduct.

The latest revelations came in the wake of private remarks by the governor’s top aide, Melissa DeRosa, and a cascading series of reports and court orders that have nearly doubled the state’s official toll of nursing home deaths in the last two weeks.

The disclosures have left Mr. Cuomo, a third-term Democrat, scrambling to contain the political fallout.

In a conversation reported on by the New York Post, Ms. DeRosa told a group of top lawmakers on Wednesday during a call to address the nursing home situation that “basically, we froze,” after being asked last summer for information by the Trump administration’s Department of Justice.

At the time, the governor’s office was simultaneously facing requests from the State Legislature for similar information.

“We were in a position where we weren’t sure if what we were going to give to the Department of Justice, or what we give to you guys, and what we start saying, was going to be used against us and we weren’t sure if there was going to be an investigation,” Ms. DeRosa told lawmakers, according to a partial transcript obtained by The New York Times.

The news of Ms. DeRosa’s remarks sparked a flurry of angry denunciations from both Democrats and Republicans. Early on Friday, Ms. DeRosa sought to clarify the context for her remarks, saying she was trying to explain that “we needed to temporarily set aside the Legislature’s request to deal with the federal request first.”

“We informed the houses of this at the time,” she said, referring to the upper and lower chambers of the Legislature.

Inoculations at Gillette Stadium in Foxborough, Mass.Credit…Joseph Prezioso/Agence France-Presse — Getty Images

This week, Massachusetts launched a first-in-the-nation experiment, offering vaccinations to younger people who accompany people who are 75 and older to mass vaccination sites.

The plan was intended to ease access problems for older people, who have struggled to book online appointments and travel to sports stadiums. Right away, it met with criticism from state legislators and some public health experts, who said it could result in scarce doses going to young, healthy people.

It also gave rise to an unusual online market, as entrepreneurial Massachusetts residents sought to forge caregiving relationships at top speed.

“I have a great driving record and a very clean Toyota Camry,” said one person in an advertisement on Craigslist. “I can pay $100 cash as well. I am a friendly conversationalist and will allow you to choose the music and show me all the pictures of your grandkids!”

Other inquiries were made more delicately.

At a Thursday news conference, Gov. Charlie Baker acknowledged that some were approaching the program opportunistically, and warned seniors to be cautious about offers of help from strangers.

“You should only reach out to somebody that you know or trust to bring you as your companion, whether that’s a child, a companion, a spouse, a neighbor or a caregiver,” he said. “Don’t take calls or offers from people you don’t know well or trust, and never share your personal information with anyone.”

Public health experts offered divergent opinions on the companion program, a concept that was not widely discussed before it was rolled out.

Andrew Lover, an assistant professor of epidemiology at the University of Massachusetts Amherst, said the plan would accelerate vaccinations by providing an “extra push” for older people who live alone.

“There’s definitely potential for people to game the system, but my assumption is it’s a reasonably small number,” he said. “The more people we can get vaccinated the better, in the grand scheme of public health, and we are more than happy to accept that small problematic fraction.”

Others worried that the policy allows young, healthy people doses that are in short supply.

VideoVideo player loadingOhio officials said on Thursday they discovered about 4,000 overlooked Covid-19 deaths that occurred over the past several months after the state’s Health Department said the deaths had not been properly merged between the internal death certificate database and the federal database.CreditCredit…Doral Chenoweth/The Columbus Dispatch, via Associated Press

Ohio health officials said they had overlooked about 4,000 deaths that occurred over the past several months and would begin reporting them to the public this week. The announcement came just as deaths nationwide had started to ebb after peaking in mid-January.

The first 650 or so of Ohio’s older deaths were reported Thursday, accounting for about 17 percent of all coronavirus deaths announced nationwide that day. The backlog in Ohio was expected to inflate the national death average in the coming days.

“You’ll see a jump today, tomorrow, maybe the next day,” Gov. Mike DeWine said at a news conference on Thursday. “We’re not sure exactly how many days it’s going to take, but you’re going to see a distorted number.”

During a routine employee training event, Ohio health officials discovered that thousands of deaths, some of which dated back to October, had not been properly merged between one reporting system and another, according to the state’s Department of Health. “This was a failure of reconciliation not taking place,” Mr. DeWine said, “so we’re getting that straightened out.”

The unreported deaths represent a significant portion of the state total. Through Thursday, about 12,500 deaths had been announced statewide over the course of the pandemic.

Ohio is not the first state to report a major backlog of cases or deaths. Earlier this month, Indiana added more than 1,500 deaths to its total after reviewing death certificates. In June, New York City reported hundreds of deaths from unspecified dates. And in September, Texas reported thousands of backlogged cases, causing a one-day spike.

A laboratory assistant with a tube of Russia’s Sputnik V vaccine in Budapest.Credit…Matyas Borsos/via Reuters

Hungary has begun administering the Sputnik V coronavirus vaccine, sidestepping the European Medicines Agency to become the first European Union member state to use the vaccine developed by the Gamaleya Research Institute, part of Russia’s Ministry of Health.

On Friday, an official at Honved Hospital in Budapest confirmed in a telephone interview that it had begun administering the vaccine.

Cecilia Muller, Hungary’s chief medical officer and head of the government’s coronavirus task force, had called on 560 general practitioners in Budapest on Tuesday to find five people each to receive the Sputnik V vaccine. The initial 2,800 doses available are what remain from a 6,000-dose batch that arrived for testing in December.

The government said it would receive two million doses of Sputnik V from Russia over the next three months. Hungary had said in November that it was in talks with the Russian manufacturer about importing, and even manufacturing, the Sputnik V vaccine.

Prime Minister Viktor Orban has cited Serbia, which has a sizable ethnic Hungarian population, as an example of a country whose vaccination strategy includes the Russian Sputnik and Chinese Sinopharm vaccines.

In a report this month in the respected British medical journal The Lancet, late-stage trial results showed that the Sputnik V vaccine was safe and highly effective. The Sinopharm vaccine has been approved for use in China, Bahrain and the United Arab Emirates, but the company has yet to publish detailed results of its Phase 3 trial.

The Hungarian government’s approach to vaccine procurement and approval has raised alarm in the country’s medical community.

Last month, its Chamber of Physicians released a statement calling on the government and regulators to approve vaccines only after transparently following drug safety rules and testing in accordance with European Medicines Agency standards. They cited a need to strengthen the public’s confidence in vaccines and to ensure that doctors can administer the inoculations “in good conscience.”

Dr. Ferenc Falus, Hungary’s former chief medical officer, said Mr. Orban’s push to acquire vaccines from as many sources as possible raised serious concern.

“The responsibility of the National Center for Public Health in this respect is huge,” Dr. Falus said, “especially concerning how they are evaluating the batches that have arrived in Hungary. We simply do not know the origins of these batches.”

He noted that the emergence of new virus variants complicates matters further. The variant that was first detected in Britain has surfaced in Hungary, Hungarian officials said.

“Hungary is moving against the E.U.,” Dr. Falus said, urging regulators to wait for the vaccines to be approved by the European Medicines Agency and cooperate with the European Union on procuring and distributing tested vaccines.

A livery cab driver waiting in a recovery area after getting his first vaccine dose in the Bronx last month.Credit…James Estrin/The New York Times

More than 34 million Americans have received Covid vaccines, but the much-touted system that the government designed to monitor any dangerous reactions won’t be capable of analyzing safety data for weeks or months, according to numerous federal health officials.

For now, federal regulators are counting on a patchwork of existing programs that they acknowledge are inadequate because of small sample sizes, missing critical data or other problems.

Clinical trials have shown both of the vaccines authorized in the United States — Pfizer-BioNTech’s and Moderna’s — to be highly protective against the coronavirus and safe. But even the best trials have limited ability to detect adverse reactions that are rare, that occur only in certain population groups or that happen beyond the trials’ three-month period.

In interviews, F.D.A. officials acknowledged that a promised monitoring system, formally called the Biologics Evaluation Safety Initiative but more widely known as BEST, is still in development. They expect it to start analyzing vaccine safety data soon, but probably not for another month or two.

The government is now relying mostly on a 30-year-old monitoring system that relies on self-reporting from patients and health care providers, known as the Vaccine Adverse Event Reporting System, or VAERS, and a smartphone app that people who get vaccinated can download and use to report problems.

So far, few serious problems have been reported through these channels and no deaths have conclusively been linked to the vaccines. There have been a few severe allergic reactions, but they are treatable and considered rare. To date, the rate at which the potentially fatal reaction called anaphylaxis has occurred — 4.7 cases in every million doses of the Pfizer-BioNTech vaccine, and 2.5 cases per million for Moderna’s — are in line with the rates of other widely used vaccines.

Bruising and bleeding caused by lowered platelet counts have also been reported, though that could be coincidental. In total, 9,000 adverse events were reported, with 979 serious and the rest classified as nonserious, according to the most recent C.D.C. report available.

In interviews, public health experts, including current and former officials at the F.D.A. and the C.D.C., said that funding shortages, turf wars and bureaucratic hurdles had slowed BEST’s progress.

But even BEST will suffer from a data problem that hinders existing systems. Because the vaccines are free, there is a dearth of health insurance claims to show who got which vaccine and when — information crucial to tracking vaccine safety.

Dining in plastic igloos outside an East Village restaurant in Manhattan in November. Indoor dining has been banned in New York City since mid-December.Credit…Hiroko Masuike/The New York Times

Indoor dining is restarting in New York City at 25 percent capacity on Friday, more than a month after Gov. Andrew M. Cuomo banned it and just in time for Valentine’s Day weekend. (Outside the five boroughs, indoor dining is available at 50 percent capacity.)

Mr. Cuomo originally said the city’s restaurants could open their dining rooms on Sunday, but later bumped up the date by two days.

Statewide, restaurants are still required to close by 10 p.m.

New York is one of several states that are loosening restrictions aimed at containing the coronavirus. On Thursday, Gov. Mike DeWine of Ohio lifted a statewide late-night curfew after the number of hospitalizations continued to decline.

The Ohio curfew, first declared in November, required people to stay home during late evening and overnight hours with exceptions for emergencies, grocery shopping and other essential activities.

Mr. DeWine cautioned that virus variants that are gaining a foothold across the United States could land Ohio “back in a situation of climbing cases” — and in that case the curfew could be reinstated.

Also on Thursday, Gov. Jay Inslee of Washington said that most areas in the state would be able to loosen virus-related restrictions starting next week, when limited indoor dining could resume.

Christian Smalls speaks to a group of protestors and media as he leads a workers strike at JFK8 Amazon Fulfillment Center on May Day last year.Credit…Gabriela Bhaskar for The New York Times

Amazon on Friday sued New York’s attorney general, Letitia James, in an attempt to stop her from bringing charges against the company over safety concerns at two of its warehouses in New York City.

The company also asked the court to force Ms. James to declare that she does not have authority to regulate workplace safety during the Covid-19 pandemic or to investigate allegations of retaliation against employees who protest their working conditions.

In the case, filed with the U.S. District Court for the Eastern District of New York, Amazon said Ms. James’s office had been investigating pandemic safety concerns raised by employees at its large fulfillment center on Staten Island and at a delivery depot in Queens. It said Ms. James “threatened to sue” Amazon if it did not agree to her demands, including subsidizing bus service, reducing worker productivity requirements, disgorging profits and reinstating Christian Smalls, an worker Amazon fired in the spring.

Mr. Smalls has said he was retaliated against for leading a protest at the Staten Island warehouse. Amazon has said he was fired for coming to the work site for the protest even though he was on paid quarantine leave after he had been exposed to a colleague who tested positive for Covid-19.

Mr. Smalls became the most visible case in the clashes between workers and Amazon, which faced a surge of orders from consumers hunkering down. As the pandemic spread across the country, many Amazon workers said the company missed early opportunities to provide better protection against Covid-19.

Amazon has strongly defended its safety measures and has gone on the offensive against its critics. In its 64-page complaint, Amazon said its safety measures “far exceed what is required under the law,” and it argued that federal law, not the state law enforced by the New York attorney general, has primary oversight for workplace safety concerns.

Amazon declined to comment beyond the filing.

Ms. James, in a statement, said the suit was “nothing more than a sad attempt to distract from the facts and shirk accountability for its failures to protect hardworking employees from a deadly virus.”

She said her office was reviewing their legal options. “Let me be clear: We will not be intimidated by anyone, especially corporate bullies that put profits over the health and safety of working people,” she said.

Categories
Politics

Trump Was Sicker Than Acknowledged With Covid-19

WASHINGTON – President Donald J. Trump was sicker with Covid-19 in October than was publicly recognized at the time, with extremely low blood oxygen levels at one point and a lung problem related to coronavirus-related pneumonia, according to four people familiar with him.

His prognosis became so worrying before he was taken to the Walter Reed National Military Medical Center that officials believed he needed to be put on a ventilator, said two of those familiar with his condition.

Those familiar with Mr. Trump’s health reported having pulmonary infiltrates, which occur when the lungs are inflamed and contain substances such as fluid or bacteria. Their presence, especially when a patient shows other symptoms, can be a sign of an acute case of illness. They can be easily spotted on an x-ray or scan if parts of the lungs appear opaque or white.

Mr Trump’s blood oxygen levels alone were of extreme concern and, according to those familiar with his assessment, went back to the 1980s. The disease is considered severe when blood oxygen levels drop to the low 90s.

It was previously reported that Mr Trump had difficulty breathing and a fever on October 2, the day he was rushed to the hospital, and the type of treatment he was receiving indicated that his condition was serious. But the new details about his condition and efforts in the White House to give him special access to an unapproved drug to fight the virus help cement one of the worst episodes of Mr. Trump’s presidency.

The new revelations about Mr. Trump’s fight against the virus also underscore the limited and sometimes misleading nature of the information released about his condition at the time.

The former president resisted the handover from the White House to Walter Reed and relented when aides told him he could go alone or risk waiting until U.S. intelligence was forced to take him out if he fell ill, two people familiar with the events said.

While Mr. Trump was hospitalized with Walter Reed, his medical team tried to downplay the gravity of the situation, saying he was on an upswing. At 74 years of age and overweight, he was at risk for serious illness and received aggressive treatment. He left the hospital after three days of taking a short ride in his armored sport utility vehicle to wave to the crowd of trailers in front of the building.

A person close to the former president denied being seriously ill and reiterated the comments Mr Trump himself made after his illness.

There are still unanswered questions about whether Mr Trump was already ill with Covid-19 when he attended a presidential debate on September 29, just two days before the public announcement that he was diagnosed with the disease and three days before his deteriorating condition forced him to go to Walter Reed.

Trump’s doctor, Dr. Sean P. Conley, repeatedly downplayed concerns about Mr. Trump’s condition during his illness. At a briefing, Dr. Conley that Mr. Trump received X-rays and CT scans. When asked if there were signs of pneumonia or tissue damage, however, he said only that “the findings are expected but there are no major clinical concerns.”

Dr. Conley also told reporters that while Mr. Trump’s oxygen levels had dropped to 93 percent, it never dropped to the “low 80s”.

Mr. Trump had difficulty breathing in the White House. He was given oxygen twice before being taken to Walter Reed as Dr. Conley confirmed after this was reported by the New York Times.

Updated

Apr. 11, 2021, 3:40 p.m. ET

While still in the White House, Mr. Trump received a drug that was developed by the biotechnology company Regeneron Pharmaceuticals. The antibody cocktail, which is currently not widely used, helps people who are infected with the virus fight it off.

After Mr Trump was hospitalized, he began treatment with a steroid, dexamethasone, which is usually only recommended for Covid-19 patients with severe or critical forms of the disease, often for those who need mechanical ventilation or supplemental oxygen .

And he received a five-day course on the antiviral drug remdesivir. At the time, medical experts believed his medication course was a clear signal of significant lung problems related to his lungs.

In press conferences outside the hospital this weekend, Dr. Conley presented data that suggested his patient was recovering quickly. He noted that Mr. Trump had done well on a spirometry test that measures lung capacity. “He’s everything,” said Dr. Conley. “He’s fine.”

Medical experts say a spirometry test is practically meaningless in Covid-19 patients.

When Mark Meadows, the White House chief of staff, tried to secretly tell reporters that the situation was worse, Mr Trump went mad, according to people who spoke to him.

On Sunday October 4th, Dr. Conley admits he’d given a rosy version of Mr. Trump’s condition.

“I tried to reflect the optimistic attitude of the team, the president and his disease progression,” he said. “I didn’t want to give any information that could steer the course of the disease in any other direction, and it turned out that we were trying to hide something that wasn’t necessarily true.”

Mr Trump’s medical team said he had a “high fever” that Friday and that his oxygen levels had dropped, requiring him to be given oxygen. Mr. Trump’s oxygen levels dropped again on Saturday.

Mr. Trump still appeared to be struggling with the disease when he returned to the White House, where he stood on a balcony in a choreographed scene, tearing off his mask and saluting his helicopter. Doctors at the time noticed how Mr. Trump used his neck muscles to breathe in those moments, a classic sign that someone’s lungs were not getting enough oxygen.

On the night of his diagnosis, October 1, White House officials sought to get the Regeneron antibody cocktail – which was not yet approved for treatment by the Food and Drug Administration at the time – to Mr Trump.

Patrick F. Philbin, a senior attorney with the White House law firm, called then FDA Commissioner Dr. Stephen M. Hahn came in to discuss how the agency could approve the use of the drug for two senior administrators whom he did not want to identify, according to someone who heard about the call.

Mr. Philbin investigated how normal FDA procedures could give the President quick access to the drug. Regeneron has already approved the use of the cans, Philbin told Dr. Rooster.

Dr. Hahn and other FDA officials including Dr. Patrizia Cavazzoni, the federal supreme drug agency, worked to eliminate the drug through a standard procedure known as an emergency use for new drugs, often used on very sick patients who agree to conduct an experiment that the drug is still in clinical Studies tested. The agency is reviewing these patients’ medical histories to determine if treatment could pose serious risks.

Regeneron provided a pack of cans containing extras “in case of administrative problems,” said a company spokeswoman.

The extras were never returned. Dr. Conley once told staff that they sat in a refrigerator in the White House doctor’s office.

It wasn’t until the days after the application was approved that White House officials recognized that the doses were for Mr Trump and First Lady Melania Trump, who also tested positive for the coronavirus but turned down the drug, which took about an hour long intravenous infusion. The person close to the former president also denied that Ms. Trump had turned down the drug.

Around this time, when other people close to Mr. Trump were getting sick, his son-in-law and senior advisor Jared Kushner offered to facilitate Regeneron treatment for them, two people with knowledge of the discussions said. An aide to Mr. Kushner denied that he had made such an offer at the time.

In the weeks following his hospital stay, Mr. Trump was convinced that Regeneron treatment had saved his life and told the helpers, “I am proof that it works.”

That line became a hoax among leading health officials, who asked each other if anyone would tell Mr Trump that he was, in fact, a failed clinical trial result for Regeneron, as the goal is to prevent people from being hospitalized After receiving it, a former senior administration official said.

Noah Weiland, Mark Mazzetti and Annie Karni reported from Washington and Maggie Haberman from New York. Katie Thomas reported from Chicago and Denise Grady from New York.

Categories
World News

Covid-19 Information: Stay Updates – The New York Instances

Here’s what you need to know:

Video

transcript

Back

transcript

Los Angeles Temporarily Closes 5 Coronavirus Vaccination Sites

Mayor Eric Garcetti said on Wednesday the city would close five of its Covid-19 vaccination sites, including Dodger Stadium, because of a supply shortage.

We’re vaccinating people faster then new vials are arriving, here in Los Angeles, and I’m very concerned right now. I’m concerned as your mayor that our vaccine supply is uneven, it’s unpredictable and too often, inequitable. By tomorrow, the city will have exhausted its current supply of the Moderna vaccine for first-dose appointments. This is an enormous hurdle in our race to vaccinate Angelenos, and unfortunately, it means that we will have to temporarily close Dodger Stadium and the other four non-mobile vaccination sites for two days on Friday and Saturday. As soon as we receive more supply, and I hope that we get — I’d love a call tonight or tomorrow from some source at the state or national level, saying we found some more, but most likely, hopefully Tuesday or Wednesday, we will reopen and start the business up again.

Mayor Eric Garcetti said on Wednesday the city would close five of its Covid-19 vaccination sites, including Dodger Stadium, because of a supply shortage.CreditCredit…Philip Cheung for The New York Times

Facing a shortage of coronavirus vaccine doses, Los Angeles will temporarily close five of its inoculation sites, including one of the country’s largest, at Dodger Stadium, raising new questions about the federal government’s handling of supplies and distribution.

By Thursday, the city will have exhausted its supply of the Moderna vaccine for first-dose appointments, Mayor Eric Garcetti said at a news conference. The centers will be closed on Friday and Saturday with plans to reopen by Tuesday or Wednesday of next week, he said.

“We’re vaccinating people faster than new vials are arriving here in Los Angeles,” Mr. Garcetti said. “I’m concerned as your mayor that our vaccine supply is uneven, it’s unpredictable and too often inequitable.”

The United States has struggled to mount a mass vaccination campaign in the face of limited supply and logistical hurdles. President Biden has promised to administer 100 million vaccines by his 100th day in office, which falls on April 30.

The Centers for Disease Control and Prevention said on Wednesday that about 33.8 million people have received at least one dose of a Covid-19 vaccine, including about 10.5 million people who have been fully vaccinated.

The federal government has delivered about 66 million doses to states, territories and federal agencies, with many kept in reserve for second doses. State and federal officials have come under fire for their handling of vaccines, as demand far outpaces supply and health care providers struggle to predict how many doses they might receive.

About 10 percent of Californians have received a vaccine, according to C.D.C. data.

The city-run Dodger Stadium site opened on Jan. 15 and vaccinated more than 85,000 people in its first two weeks, despite waits that could sometimes last hours. Administrators have reduced wait times, and the site was averaging more than 6,000 shots a day last week, far more than the city’s other sites.

Mr. Garcetti said Los Angeles had received only 16,000 new doses of the vaccine this week.Starting in December, California faced a dramatic spike in virus cases concentrated in the southern part of the state and in its main agricultural region, the Central Valley, as well as the spread of a new local strain that may be more transmissible.

California now leads the nation in cases and deaths. Infections peaked around the holidays and have declined since mid-January, but deaths remain at record highs.

Mr. Garcetti said that hospitalizations in Los Angeles were down to about 3,700 on Wednesday, the lowest number in months.

Despite shortage concerns, the city will continue its mobile vaccination program, Mr. Garcetti said. “We can’t afford to see the outbreaks and, quite frankly, the unequal deaths that we’re seeing in communities of color,” he said.

United States › United StatesOn Feb. 10 14-day change
New cases 94,893 –36%
New deaths 3,255 –22%
World › WorldOn Feb. 10 14-day change
New cases 442,450 –26%
New deaths 13,572 –14%

U.S. vaccinations ›

Where states are reporting vaccines given

A dose of vaccine manufactured in India being administered in Colombo, Sri Lanka, in January.Credit…Dinuka Liyanawatte/Reuters

It’s one of the world’s most in-demand commodities and has become a new currency for international diplomacy: Countries with the means or the know-how are using coronavirus vaccines to curry favor or thaw frosty relations.

India, the unmatched vaccine manufacturing power, is giving away millions of doses to neighbors friendly and estranged. It is trying to counter China, which has made doling out shots a central plank of its foreign relations. And the United Arab Emirates, drawing on its oil riches, is buying shots on behalf of its allies.

But the strategy carries risks.

India and China have vast populations of their own that they need to inoculate. Although there are few signs of grumbling in either country, that could change as the public watches doses be sold or donated abroad.

“Indians are dying. Indians are still getting the disease,” said Manoj Joshi, a distinguished fellow at the Observer Research Foundation, a New Delhi think tank. “I could understand if our needs had been fulfilled and then you had given away the stuff. But I think there is a false moral superiority that you are trying to put across where you say we are giving away our stuff even before we use it ourselves.”

For India, its soft-power vaccine drive has given it a rejoinder to China after years of watching the Chinese make political gains in its own backyard — in Sri Lanka, the Maldives, Nepal and elsewhere. Beijing offered deep pockets and swift answers when it came to big investments that India, with a layered bureaucracy and slowing economy, has struggled to match.

So India has sent vaccine doses to Nepal, a country that has fallen increasingly under China’s influence. And Sri Lanka, in the midst of a diplomatic tug of war between New Delhi and Beijing, is getting doses from both.

The donating countries are making their offerings at a time when the United States and other rich nations are scooping up the world’s supplies. Poorer countries are frantically trying to get their own, a disparity that the World Health Organization recently warned has put the world “on the brink of a catastrophic moral failure.”

With their health systems tested as never before, many countries are eager to take what they are offered — and the donors could reap some political good will in reward.

“Instead of securing a country by sending troops, you can secure the country by saving lives, by saving their economy, by helping with their vaccination,” said Dania Thafer, the executive director of the Gulf International Forum, a Washington-based think tank.

Still, efforts to use vaccines to win hearts and minds aren’t always successful.

The United Arab Emirates, which is rolling out vaccines faster than any country except Israel, has begun donating Chinese-made Sinopharm vaccine doses that it purchased to countries where it has strategic or commercial interests.

But in Egypt some doctors balked at using them, because they said they did not trust the data the U.A.E. and the vaccine’s Chinese maker had released about trials.

And the government of Malaysia, one of the Emirates’ biggest trading partners, declined an offer of 500,000 doses, saying that regulators would have to independently approve the Sinopharm vaccine. After regulatory approval, Malaysia bought vaccines instead from Pfizer of the United States, the AstraZeneca-Oxford vaccine and one made by another Chinese company, Sinovac.

A seizure of counterfeit masks at a port warehouse in El Paso, Texas.Credit…U.S. Immigration and Customs Enforcement, via Associated Press

Many were clever fakes.

They were stamped with the 3M logo and shipped in boxes that read, “Made in the U.S.A.”

But these supposed N95 masks were not produced by 3M and weren’t made in the United States, federal investigators said on Wednesday.

They were counterfeits, and millions were bought by hospitals, medical institutions and government agencies in at least five states, the federal authorities said as they announced an investigation.

Homeland Security Investigations, which is part of the Department of Homeland Security, said the masks were dangerous because they might not offer the same level of protection against the coronavirus as genuine N95s.

“We don’t know if they meet the standards,” said Brian Weinhaus, a special agent with Homeland Security Investigations.

Cassie Sauer, the president and chief executive of the Washington State Hospital Association, said that about two million counterfeit masks might have made it into the state. They were “really good fakes,” she said.

“They look, they feel, they fit and they breathe like a 3M mask,” Ms. Sauer said.

News of the investigation came the same day the Homeland Security Department’s intelligence branch warned law enforcement agencies that criminals have been selling counterfeit coronavirus vaccines online for “hundreds of dollars per dose.”

A mass vaccination site at Fenway Park in Boston.Credit…Charles Krupa/Associated Press

In a bid to get more residents age 75 and older vaccinated, Massachusetts officials say they will also inoculate the people accompanying them, regardless of age, to mass vaccination sites, which can be confusing to navigate.

“The idea for a mass vaccination site can seem a bit daunting,” Marylou Sudders, the secretary for health and human services in Massachusetts, said at a news conference on Wednesday.

The knowledge that the person accompanying them to the vaccination site will also be inoculated, Ms. Sudders said, may “bring an extra level of comfort to those who may be hesitant or don’t want to bother their caregiver or loved one or a good friend to book an appointment.”

Massachusetts has administered almost a million vaccine doses at nearly 130 sites statewide, said Gov. Charlie Baker. About 10 percent of residents have received at least one dose of the vaccine, and 2.8 percent have received two doses, according to a New York Times tracker.

Starting on Thursday, companions can schedule their vaccine along with that of the older resident.

Joan Hatem-Roy, the chief executive of Elder Services of Merrimack Valley, a nonprofit group in northeastern Massachusetts, called the idea “a game changer.”

“I get nervous going to a Patriots game at Gillette, so I can imagine a senior trying to think about going to Gillette Stadium,” one of the vaccination sites, Ms. Hatem-Roy said.

Some expressed concern that younger people who are less susceptible to serious illness from the virus might be vaccinated before people who are 65 or older or who have chronic health conditions. But Mr. Baker said the immediate goal was to make sure people 75 and older are vaccinated.

“Those communities are far more likely to lose their life and get hospitalized as a result of Covid,” he said. “We want to make sure that we make it as easy as we possibly can for folks who fall into that over-75 category to get vaccinated and to get vaccinated early in this process.”

The state’s decision to vaccinate companions came as a surprise to Dr. Ashish Jha, the dean of Brown University’s School of Public Health, who said Massachusetts had not moved as quickly as he had expected on vaccinations. He said he would rather see more vulnerable groups be deemed eligible for the vaccination first and for any transportation issues to be resolved without companions getting shots.

“I do know that the governor is feeling a lot of pressure to improve the performance in the state,” Dr. Jha said. “That may be part of the motivation for doing this, because it will certainly bump up those numbers.”

He did not expect other states to follow suit — at least not right away. But Dr. Jha said it might be different in April or May, when the vaccine supply may outweigh the demand.

In some places, a similar model has been tried on a smaller scale.

In Albemarle County, Va., 70 caregivers and family care providers for people with intellectual disabilities were vaccinated, according to local affiliate NBC29. In Texas, older and disabled residents said they wanted their home health workers to be vaccinated, but many workers were declining the inoculation, according to The Texas Tribune.

With fraud already popping up in vaccines, tests and stimulus checks, Dr. Jha worried that scammers might try to use the new Massachusetts program to take advantage of older residents.

“I don’t know how you carefully police that,” he said. “There are bad actors who may try to manipulate this.”

Ms. Sudders offered her own warning on Wednesday, urging older residents’ not to accept offers from strangers to be their vaccine companions.

A woman walking near Anichkov bridge in St. Petersburg, Russia.Credit…Sergey Ponomarev for The New York Times

The coronavirus has been used as an excuse to restrict free speech in dozens of countries, according to a report released Thursday by Human Rights Watch, a New York-based advocacy organization.

Pointing to cases of censorship, arbitrary arrest and physical assault, the report found that at least 83 governments around the world have used the pandemic to justify silencing critics or preventing peaceful assembly.

It found that in at least 18 countries, military or police forces assaulted journalists, bloggers or critics of the government’s response to the pandemic, and that in at least 10 countries, officials used social distancing concerns to prevent or disband protests, even while allowing other large gatherings.

The findings expose a tension at the heart of coronavirus restrictions: Some of the same tools officials have used to save lives and slow the spread of Covid-19 — such as restricting large gatherings, countering misinformation or instituting lockdowns — can also be used by authoritarian governments as a pretext to monitor citizens or quash dissent.

China, Cuba, India, Egypt and Russia are among the countries where the restrictions on free speech have been felt most broadly, according to Human Rights Watch.

“The obligation of governments to protect the public from this deadly pandemic is not a carte blanche for placing a chokehold on information and suppressing dissent,” Gerry Simpson, associate crisis and conflict director at the organization, said in a news release.

The report relied on research from Human Rights Watch as well as data and reports from other nongovernmental organizations including the United Nations.

Robert F. Kennedy Jr. addressing a rally against coronavirus-related restrictions in Berlin last year.Credit…Sean Gallup/Getty Images

Instagram took down the account of Robert F. Kennedy Jr., the political scion and prominent anti-vaccine activist, on Wednesday over false information related to the coronavirus.

“We removed this account for repeatedly sharing debunked claims about the coronavirus or vaccines,” Facebook, which owns Instagram, said in a statement.

Mr. Kennedy, the son of the former senator and U.S. Attorney General Robert F. Kennedy, worked for decades as an environmental lawyer but is now better known as an anti-vaccine crusader. A 2019 study found that two groups including his nonprofit, now called Children’s Health Defense, had funded more than half of Facebook advertisements spreading misinformation about vaccines.

He has found an even broader audience during the pandemic on platforms like Instagram, where he had 800,000 followers. Though Mr. Kennedy has said he is not opposed to vaccines as long as they are safe, he regularly endorses discredited links between vaccines and autism and has argued that it is safer to contract the coronavirus than to be inoculated against it.

Facebook is becoming more aggressive in its efforts to stamp out vaccine misinformation, saying this week that it would remove posts with erroneous claims about the coronavirus, coronavirus vaccines and vaccines in general, whether they are paid advertisements or user-generated posts. In addition to Mr. Kennedy’s Instagram account, the company said it had removed multiple other Instagram accounts and Facebook pages on Wednesday under its updated policies.

They did not include Mr. Kennedy’s Facebook page, which was still active as of early Thursday and makes many of the same baseless claims to more than 300,000 followers. The company said it did not automatically disable accounts across its platforms and that there were no plans to take down Mr. Kennedy’s Facebook account “at this time.”

Children’s Health Defense did not immediately respond to a request for comment.

Members of Mr. Kennedy’s family have spoken out against his anti-vaccine efforts, including a brother, sister and niece who accused him of spreading “dangerous misinformation” in a column they wrote for Politico in 2019. Another niece, Kerry Kennedy Meltzer, a doctor at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, wrote an opinion essay in The New York Times in December challenging his claims.

“I love my uncle Bobby,” she wrote. “I admire him for many reasons, chief among them his decades-long fight for a cleaner environment. But when it comes to vaccines, he is wrong.”

Dr. Hasan Gokal in his home in Sugar Land, Texas, on Tuesday.Credit…Brandon Thibodeaux for The New York Times

A Texas doctor with only six hours to administer expiring doses of a Covid-19 vaccine inoculated 10 people, but the move got him fired and charged with stealing the doses.

The doctor, Hasan Gokal, had scrambled in December by making house calls and directing people to his home outside Houston. Some were acquaintances; others, strangers. A bed-bound nonagenarian. A woman in her 80s with dementia. A mother with a child who uses a ventilator.

After midnight, and with just minutes before the vaccine became unusable, Dr. Gokal gave the last dose to his wife, who has a pulmonary disease that leaves her short of breath.

For his actions, Dr. Gokal was fired from his government job and then charged with stealing 10 vaccine doses worth a total of $135 — a misdemeanor that sent his name and mug shot rocketing around the globe.

“It was my world coming down,” he said in a telephone interview on Friday. “To have everything collapse on you. God, it was the lowest moment in my life.”

The matter is playing out as pandemic-weary Americans scour websites and cross state lines chasing rumors in pursuit of a medicine in short supply.

Late last month, a judge dismissed the charge as groundless, but the local district attorney vowed to present the matter to a grand jury. And while prosecutors portray the doctor as a cold opportunist, his lawyer says he acted responsibly — even heroically.

“Everybody was looking at this guy and saying, ‘I got my mother waiting for a vaccine, my grandfather waiting for a vaccine,’” the lawyer, Paul Doyle, said. “They were thinking, ‘This guy is a villain.’”

Global Roundup

Sister André, who is Europe’s oldest known person, became infected with the coronavirus last month as it swept through her nursing home in France.Credit…Nicolas Tucat/Agence France-Presse — Getty Images

Sister André has lived through the 1918 flu pandemic, two World Wars and “many sad events,” she once said. As Europe’s oldest known person, she turns 117 on Thursday and has now accomplished another feat: defeating the coronavirus, with barely any complication.

“She’s recovered, along with all the residents here,” said David Tavella, the spokesman at the Ste. Catherine Labouré nursing home in Toulon, a city in southeastern France, where Sister André lives. “She is calm, very radiant and she is quite looking forward to celebrating her 117th birthday,” he said, adding that the home’s most famous resident was resting on Wednesday and needed a break from interviews.

The coronavirus swept through the nursing home last month, just as nurses began consulting residents about vaccinations; 81 of its 88 residents became infected, including Sister André, and 11 eventually died.

Mr. Tavella said that until last month no case had been detected in the nursing home since the beginning of the pandemic. Still, the outbreak was a stark reminder that the virus has been devastating in places where the most vulnerable reside, even with stringent restrictions that have turned many care homes into fortresses.

Sister André remained isolated for weeks and felt a bit “patraque,” or off color, Mr. Tavella said, but she blamed the virus and not her age. She slept more than usual, but she prayed and remained asymptomatic. This week, she became the oldest known person to have survived Covid-19.

“She kept telling me, ‘I’m not afraid of Covid because I’m not afraid of dying, so give my vaccine doses to those who need them,’” Mr. Tavella said.

Sister André’s story has made headlines in France, providing some uplifting news in a country where thousands of nursing home residents have died.

France began vaccinating health care workers this week, but the authorities have faced criticism for a sluggish rollout as France continues to struggle with a rising number of infections, and no end to restrictions in sight. As of Wednesday, 2.2 million people had been vaccinated, less than 3 percent of the population.

In other developments around the world:

  • The coronavirus variant first detected in Britain is going “to sweep the world, in all probability,” the director of the country’s genetic surveillance program, Sharon Peacock, told the BBC on Thursday. The variant, known as B.1.1.7., has been detected in 75 countries, including the United States.

  • Mexico authorized China’s Sinovac vaccine for emergency use, said Hugo Lopez-Gatell, the deputy health minister, Reuters reported. This month the country also authorized the Russian coronavirus vaccine, Sputnik V, for use.

A closed restaurant at Grand Central Market in Los Angeles. Workers in leisure and hospitality industries have been hit especially hard by job losses during the pandemic.Credit…Philip Cheung for The New York Times

Even as layoffs in the United States remain extraordinarily high by historical standards, unemployment claims continue to decline as coronavirus cases and restrictions on activity recede.

New claims for unemployment benefits declined last week for the fourth week in a row, the Labor Department reported Thursday morning.

Last week brought 813,000 new claims for state benefits, compared with 850,000 the previous week. Adjusted for seasonal variations, last week’s figure was 793,000, a decrease of 19,000.

There were 335,000 new claims for Pandemic Unemployment Assistance, a federally funded program for part-time workers, the self-employed and others ordinarily ineligible for jobless benefits. That total, which was not seasonally adjusted, was down from 369,000 the week before.

New coronavirus cases have fallen by a third from the level two weeks ago, prompting states like California and New York to relax restrictions on indoor dining and other activities.

“We’re stuck at this very high level of claims, but activity is picking up,” said Julia Pollak, a labor economist with ZipRecruiter, an online employment marketplace. Indeed, job postings at ZipRecruiter stand at 11.3 million, close to the 11.4 million level before the pandemic hit.

The improving pandemic situation has eased the strain on dining establishments, Ms. Pollak added. More generally, however, the leisure and hospitality industry is still under pressure.

Plenty of other signs of weakness remain. On Friday, the Labor Department reported that employers added just 49,000 jobs in January, underscoring the challenges for the nearly 10 million unemployed.

President Biden cited the weak showing to press for approval of his $1.9 trillion pandemic relief package. It would send $1,400 to many Americans, provide aid to states and cities, and extend unemployment benefits that are due to expire for millions in mid-March.

Ms. Pollak said postings by employers at ZipRecruiter in recent days offered hope. “We’ve seen employers smash all of our expectations and show a great deal of exuberance,” she said.

Dr. Marcella Nunez-Smith is the chairwoman of President Biden’s Covid-19 equity task force.Credit…Yale University, via Associated Press

President Biden wants racial equity to be at the essence of a fair national coronavirus response. And Dr. Marcella Nunez-Smith, a Yale epidemiologist who grew up in the U.S. Virgin Islands, is in charge of the effort.

Dr. Nunez-Smith, the chairwoman of Mr. Biden’s Covid-19 equity task force, spoke to The New York Times about the challenges ahead in her role.

She is charged with advising the president on how to allocate resources and reach out to underserved populations to fight a pandemic that has taken a devastating toll on people of color. Black and Latino people have been nearly twice as likely as white people to die from Covid-19.

“Make no mistake about it — beating this pandemic is hard work,” Dr. Nunez-Smith told reporters on Wednesday, after the White House named the members of the task force. “And beating this pandemic while making sure that everyone in every community has a fair chance to stay safe or to regain their health, well, that’s the hard work and the right work.”

Q. You’ve been in office just a few weeks. What have you learned?

A. What’s great about this is being public facing. I hear from everyday Americans every day. People write all the time with their own experiences.

Obviously you cannot cure racial disparities in health care overnight, so what are you aiming for, at least in the near term? And then in the long term?

We’re charged with rapid response recommendations and then paving the way for equity in the recovery. We talk a lot about vaccines, but we can’t forget about everything else. We think about frontline essential workers and others who still have challenges in terms of having inadequate protection in the workplace. Access to testing is also uneven.

It’s exciting to see new technologies emerge, but we also have to make sure that everybody can benefit from all of the scientific discoveries.

Cougars are among several types of cats known to have contracted the coronavirus.Credit…Martin Mejia/Associated Press

A cougar has tested positive for the coronavirus, the first such instance in the United States. And a tiger at the same Texas facility that exhibits wild animals also tested positive, the Department of Agriculture said on Wednesday.

After several cats at the facility, which the department did not name, began coughing and wheezing, the facility took samples for testing.

The National Veterinary Services Laboratory confirmed the infection in the two cats. While several tigers in the United States have caught the virus, along with lions, snow leopards and many domestic cats, this was the first report of a cougar.

The animals have mild symptoms and are expected to recover, according to the announcement, as have other zoo cats that have been infected with the virus.

Dogs, mink and gorillas have also caught the coronavirus in the United States. The Agriculture department keeps a list, updated weekly, of all confirmed tests.

Farmed mink infected with the virus have passed it to humans in some cases, which caused Denmark to cull its entire farmed mink population, about 17 million. There is no evidence of domestic or zoo animals passing the virus to humans, and advice from the Centers for Disease Control and Prevention largely concerns how people who have Covid-19 should avoid infecting their pets.

Credit…John Moore/Getty Images

Officials in Michigan have confirmed the presence of a highly contagious coronavirus variant in one of its state prisons, the first such case documented in an American correctional facility — and a potential harbinger of even wider dispersion of the virus in prisons, public health officials said.

Michigan prison and health officials said Wednesday that an employee at the Bellamy Creek Correctional Facility, in Ionia, Mich., was found to have been infected with the B.1.1.7 variant. That strain was first detected in December in the United Kingdom. It has been found to spread more easily than other coronavirus variants.

The variant’s potential to disseminate rapidly in prisons and jails, which are typically overcrowded, unsanitary and have poor ventilation, has alarmed public health experts.

When we see increased levels of contagiousness in spaces that are overcrowded that really do not lend themselves to social distancing, what we know is going to happen is that there will just be really an explosion of cases,” said Lauren Brinkley-Rubenstein, an assistant professor at the University of North Carolina School of Medicine. “And so it just means more cases, more rapid transmission, and more devastation for incarcerated people and staff that work in jails and prisons.”

Correctional facilities and detention centers have already been devastated by Covid-19, with more than 600,000 infections and 2,700 dead among inmates and correctional officers, according to a New York Times database tracking infections in prisons, jails and detention centers.

Michigan prison officials said that once they had confirmed the presence of the variant, they ordered daily testing of all inmates and staff members in the prison, which has more than 1,600 inmates. As of Thursday, about 500 inmates and 100 correctional officers at the facility had been infected with the coronavirus, and one inmate had died.

As of Thursday morning, it was not clear whether anyone at the prison — aside from the staff member — had been infected by the new variant.

But prison authorities have expressed concern about the possible diffusion of the variant because inmates had been transferred from the Bellamy Creek Correctional Facility to two other prisons, the Duane Waters Health Center and the Macomb Correctional Facility, before officials were aware that the staff member had been sickened.

The Duane Waters facility, in Jackson, is reserved for some of the state prison system’s most severely ill inmates.

The prison system “will be taking extra steps to identify where this variant is present amongst staff and the prisoner population and we will continue to do everything we can to keep the prisoners, our staff and the community safe,” Heidi Washington, director of the Michigan prison system, said in a news release.

Maura Turcotte and

Categories
World News

Stay World Covid-19 Pandemic and Vaccine Updates

Here’s what you need to know:

Video

transcript

Back

transcript

C.D.C. Says Layering and Improving Mask Fit Increases Protection

Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said wearing more tightly fitting masks or layering masks increases effectiveness in preventing Covid-19.

Research has demonstrated that Covid-19 infections and deaths have decreased when policies that require everyone to wear a mask have been implemented. So with cases, hospitalizations and deaths still very high, now is not the time to roll back mask requirements. I have also seen very many well-meaning people wearing masks that do not fit well or fit incorrectly. In fact, recent survey data from Porter Novelli found that among adults who reported wearing masks in the past week, half said they wore their masks incorrectly in public. New data released from C.D.C. today underscore the importance of wearing a mask correctly and making sure it fits closely and snugly over your nose and mouth. The C.D.C. is updating the mask information for the public on the C.D.C. website to provide new options on how to improve mask fit. This includes wearing a mask with a moldable nose wire, knotting the ear loops on your mask or wearing a cloth mask over a procedure or disposable mask. There are also new options available to consumers called mask fitters, small reusable devices that cinch a cloth or medical mask, and that can create a tighter fit against the face, and thus improve mask performance. The bottom line is this: Masks work and they work best when they have a good fit, and are worn correctly.

Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said wearing more tightly fitting masks or layering masks increases effectiveness in preventing Covid-19.CreditCredit…Philip Cheung for The New York Times

Wearing a mask — any mask — reduces the risk of infection with the coronavirus, but wearing a more tightly fitted surgical mask, or layering a cloth mask atop a surgical mask, can vastly increase protections to the wearer and others, the Centers for Disease Control and Prevention reported on Wednesday.

New research by the agency shows that transmission of the virus can be reduced by up to 96.5 percent if both an infected individual and an uninfected individual wear tightly fitted surgical masks or a cloth-and-surgical-mask combination.

Dr. Rochelle P. Walensky, director of the C.D.C., announced the findings during Wednesday’s White House coronavirus briefing, and coupled them with a plea for Americans to wear “a well-fitting mask” that has two or more layers. President Biden has challenged Americans to wear masks for the first 100 days of his presidency, and Dr. Walensky said that masks were especially crucial given the concern about new variants circulating.

“With cases hospitalizations and deaths still very high, now is not the time to roll back mask requirements,” she said, adding, “The bottom line is this: Masks work, and they work when they have a good fit and are worn correctly.”

Virus-related deaths, which resurged sharply in the United States in November and still remain high, appear to be in a steady decline; new virus cases and hospitalizations began to drop last month. But researchers warn that a more contagious virus variant first found in Britain is doubling roughly every 10 days in the United States. The C.D.C. cautioned last month that it could become the dominant variant in the nation by March.

As of Feb. 1, 14 states and the District of Columbia had implemented universal masking mandates; masking is now mandatory on federal property and on domestic and international transportation. But while masks are known to both reduce respiratory droplets and aerosols exhaled by infected wearers and to protect the uninfected wearer, their effectiveness varies widely because of air leaking around the edges of the mask.

“Any mask is better than none,” said Dr. John Brooks, lead author of the new C.D.C. study. “There are substantial and compelling data that wearing a mask reduces spread, and in communities that adopt mask wearing, new infections go down.”

But, he added, the new research shows how to enhance the protection. The agency’s new laboratory experiments are based on the ideas put forth by Linsey Marr, an expert in aerosol transmission at Virginia Tech, and Dr. Monica Gandhi, who studies infectious diseases at the University of California, San Francisco.

One option for reducing transmission is to wear a cloth mask over a surgical mask, the agency said. The alternative is to fit the surgical mask more tightly on the face by “knotting and tucking” — that is, knotting the two strands of the ear loops together where they attach to the edge of the mask, then folding and flattening the extra fabric at the mask’s edge and tucking it in for a tighter seal.

Dr. Brooks cautioned that the new study was based on laboratory experiments, and it’s unclear how these masking recommendations will perform in the real world (the experiments used three-ply surgical and cloth masks). “But it’s very clear evidence that the more of us who wear masks and the better the mask fits, the more each of us benefit individually.”

Other effective options that improve the fit include using a mask-fitter — a frame contoured to the face — over a mask, or wearing a sleeve of sheer nylon hosiery material around the neck and pulled up over a cloth or surgical mask, the C.D.C. said.

Even as vaccines are being slowly rolled out across the country, the emergence of the new variants, which may respond differently to treatments or dodge the immune system to some degree, has prompted public health officials to emphasize that Americans should continue to take protective measures like masking.

United States › United StatesOn Feb. 9 14-day change
New cases 96,488 –35%
New deaths 3,170 –20%
World › WorldOn Feb. 9 14-day change
New cases 398,538 –26%
New deaths 14,751 –13%

U.S. vaccinations ›

Where states are reporting vaccines given

A mass vaccination site at Fenway Park in Boston.Credit…Charles Krupa/Associated Press

In a bid to get more residents age 75 and older vaccinated, Massachusetts officials say they will also inoculate the people accompanying them, regardless of age, to mass vaccination sites, which can be confusing to navigate.

“The idea for a mass vaccination site can seem a bit daunting,” Marylou Sudders, the secretary for health and human services in Massachusetts, said at a news conference on Wednesday.

The knowledge that the person accompanying them to the vaccination site will also be inoculated, Ms. Sudders said, may “bring an extra level of comfort to those who may be hesitant or don’t want to bother their caregiver or loved one or a good friend to book an appointment.”

Massachusetts has administered almost a million doses of the vaccine at nearly 130 sites statewide, said Gov. Charlie Baker. About 10 percent of residents have received at least one dose of the vaccine, and 2.8 percent have received both doses, according to a New York Times tracker.

Companions should be able to schedule their vaccine along with that of the older resident, the governor said, and effective Thursday, they now can.

Joan Hatem-Roy, the chief executive of Elder Services of Merrimack Valley, a nonprofit group in Northeast Massachusetts, called the idea “a game changer.”

“I get nervous going to a Patriots game at Gillette, so I can imagine a senior trying to think about going to Gillette Stadium,” one of the vaccination sites, Ms. Hatem-Roy said.

Some expressed concern that younger people who are less susceptible to serious illness from the virus might get a vaccine before people who are 65 or older or who have chronic health conditions.

But Governor Baker said the immediate goal was to make sure people 75 and older are vaccinated.

“Those communities are far more likely to lose their life and get hospitalized as a result of Covid,” he said. “We want to make sure that we make it as easy as we possibly can for folks who fall into that over-75 category to get vaccinated and to get vaccinated early in this process.”

The state’s decision to vaccinate companions came as a surprise to Dr. Ashish Jha, the dean of Brown University’s School of Public Health, who said Massachusetts had not moved as quickly as he had expected on vaccinations. He said he would rather see more vulnerable groups be deemed eligible for the vaccination first and for any transportation issues to be resolved without companions getting shots.

“I do know that the governor is feeling a lot of pressure to improve the performance in the state,” Dr. Jha said. “That may be part of the motivation for doing this, because it will certainly bump up those numbers.”

He does not expect other states to follow suit — at least, not right away.

But Dr. Jha said it might be different in April or May, when the supply of vaccine may outweigh the demand.

In some places, a similar model has been attempted on a smaller scale.

In Albemarle County, Va., 70 caregivers and family care providers for people with intellectual disabilities were vaccinated, according to local affiliate NBC29. In Texas, older and disabled residents said they wanted their home health workers to be vaccinated, but many workers were refusing the inoculation, according to The Texas Tribune.

With fraud already popping up in everything from vaccines to tests to stimulus checks, Dr. Jha worried that scammers might try to use the new Massachusetts program to take advantage of older residents.

“I don’t know how you carefully police that,” he said. “There are bad actors who may try to manipulate this.”

Ms. Sudders offered her own warning on Wednesday, urging older residents’ not to accept offers from strangers to be their vaccine companions.

A vaccination site at Citi Field in Queens on Wednesday.Credit…Kena Betancur/Agence France-Presse — Getty Images

Gov. Andrew M. Cuomo of New York said that large arenas and stadiums across the state would be able to open for events with spectators, at very limited capacity, as soon as Feb. 23. Attendees will be required to provide a negative coronavirus test result.

Venues that hold 10,000 people or more would be allowed to host 10 percent of their normal capacity, if they are approved by the state’s Department of Health.

Attendees will have to provide a negative P.C.R. test, taken within 72 hours of the event, before they can enter. Socially distanced assigned seating will be mandatory, as will face coverings and temperature checks.

While controlling the spread of the coronavirus, the state has to simultaneously “get this economy open intelligently,” Mr. Cuomo said, adding that “this hits the balance of safe reopening, and again a P.C.R. test is as safe as you can get.”

The governor cited the success of a recent Buffalo Bills’ playoff game, attended by about 6,700 people who had to provide a negative coronavirus test before they could enter, as the inspiration for his decision. A negative test result is a snapshot in time of whether the virus can be detected if a person is infected, and may miss individuals who are infected but do not yet carry enough of the virus for the test to come back positive.

“The testing is the key,” Mr. Cuomo said at a news conference on Wednesday.

Mr. Cuomo said that the Barclays Center in Brooklyn would reopen on Feb. 23, for a Brooklyn Nets game against the Sacramento Kings.

But the Bills’ stadium is open air, unlike the Barclays Center. Public health experts say the quality of ventilation is crucial when considering indoor gatherings because the virus is known to spread more easily indoors.

At his news conference, Mr. Cuomo did not offer details on ventilation, but a release from his office later said that in order to reopen venues to professional sports, sites had to “meet enhanced air filtration, ventilation and purification standards.”

Attending an indoor event is risky even with ample ventilation and other precautions, said Saskia Popescu, an epidemiologist at George Mason University.

“Bringing thousands of people indoors for an event that elicits screaming and socializing is not ideal right now,” Dr. Popescu said in an email.

As for playing games at venues like Citi Field or Yankee Stadium, which are being used as vaccination sites, the governor joked that “between innings, people will do vaccines.”

Gareth Rhodes, a member of the governor’s Covid-19 task force, said the state planned to work with teams so the vaccinations could continue.

The Citi Field vaccination site, which serves eligible Queens residents and taxi drivers and food service workers from all five boroughs, opened Wednesday. It will have 200 appointments a day available during its first week of operation and will offer 24-hour service starting next Wednesday, officials said. The site will be able to administer 4,000 doses of the vaccine a week by next week, Mayor Bill de Blasio said at an appearance outside the stadium. It could provide 5,000 doses a day if the city had more supply, he added.

“This site is the beginning of something very big,” Mr. de Blasio said. “The Mets are doing something crucial today for the people of Queens.”

The site was supposed to open the week of Jan. 25, but it was postponed because of vaccine shortages.

The mayor also said that mass vaccination sites were still planned at Empire Outlets in Staten Island and at the Barclays Center, though he did not specify dates when they will open.

The AstraZeneca vaccine being administered in Brazil on Tuesday.Credit…Bruno Kelly/Reuters

A World Health Organization panel of experts on Wednesday recommended that the vaccine developed by AstraZeneca and the University of Oxford be used in countries where concerning new variants of the coronavirus are circulating.

The recommendation came days after a decision by South Africa to halt at least temporarily plans to roll out AstraZeneca’s vaccine.

The decision was announced after a small clinical trial indicated that the vaccine might not protect against mild and moderate cases caused by avariant of the virus first seen in that country. Researchers were unable to draw a conclusion about the impact of the variant, known as B.1.351, on the vaccine’s ability to prevent severe disease.

Despite recommending the AstraZeneca vaccine for use everywhere, W.H.O. scientists conceded that each country should take into account the state of the virus and the type of variants spreading there.

The W.H.O. has not yet granted an emergency-use listing for the AstraZeneca vaccine, a step that would set into motion the rollout of the vaccine in many lower- and middle-income countries.

The W.H.O. will separately consider the vaccine’s two manufacturers: AstraZeneca and the Serum Institute, the Indian producer that will supply many doses for the Covax initiative to bring vaccines to poorer parts of the world. The W.H.O. will weigh those decisions in the next week, with decisions expected around the middle of this month.

The W.H.O. at the end of last year approved Pfizer’s vaccine. Its decision on AstraZeneca’s vaccine is highly anticipated, because countries around the world are counting on the cheap and easy-to-store product.

Countries are expected to begin receiving their first tranches of the AstraZeneca vaccine from Covax later in February.

The W.H.O.’s decisions come as concern is rising about whether certain variants may reduce the effectiveness of Covid-19 vaccines and treatments. The B.1.351 variant has so far generated the most worry. The AstraZeneca vaccine and other leading vaccines still appear to provide strong protection against another, more contagious coronavirus variant first identified in Britain, known as B.1.1.7.

But scientists have cautioned against drawing firm conclusions from preliminary data.

“We are so in the early stages of understanding what any specific change in the virus means for the performance of one or another of the vaccines or the vaccines as a whole,” said Katherine O’Brien, the W.H.O.’s director of immunization, vaccines and biologicals, at Wednesday’s news conference.

For now, South Africa is planning to inoculate health workers starting next week with the Johnson & Johnson vaccine, which prevented hospitalizations and deaths in clinical trials in the country. The vaccine is not yet authorized there, but officials said they would use it as part of an ongoing clinical trial.

As for the AstraZeneca vaccine, South African health officials indicated on Wednesday that they were considering selling or swapping their million doses of the vaccine for different shots. W.H.O. scientists said that they were open to discussing such plans as part of the Covax initiative.

The W.H.O. panel that issued recommendations on Wednesday, known as the Strategic Advisory Group of Experts on Immunization, also advised that the AstraZeneca vaccine be given to adults regardless of their ages, breaking with a number of European countries that have opted to restrict the use of the vaccine to younger people.

The W.H.O. panel also recommended that the two doses of the AstraZeneca vaccine be given between four and 12 weeks apart. The guidance follows the release of a paper last week that found that the vaccine appears to work better when second doses are delayed. Britain and other countries have opted to delay second doses of the vaccine in an effort to get more first doses into their populations.

The University of California campus  in Berkeley.Credit…Jeff Chiu/Associated Press

At the Berkeley campus of the University of California, this was to be the month that academic life began inching back toward normal. Some students who had been sent home last year returned to their dorms in January. The first handful of in-person classes since the pandemic began had been set to resume on Feb. 1.

Instead, a wave of coronavirus infections has sent the campus into an unprecedented lockdown.

Since the beginning of the month, some 2,000 students have been confined to their rooms around the clock, unable even to visit floor-mates. The students are allowed out to go to the bathroom, get food and take twice-weekly coronavirus tests. (There are also exceptions for rare medical needs or emergencies.)

Classes are being held remotely for the foreseeable future.

Confined students are barred even from going outside to sunbathe or exercise, although the university is talking with city health officials about relaxing that prohibition.

“It’s been a little bit of a struggle,” Veronica Roseborough, a freshman quarantined in one eight-story residence hall, said on Wednesday, “but the university is doing what it can to keep cases low.”

The lockdown was ordered after the university reported 44 new infections among its staff and 43,000-plus students on Jan. 30. Since then, 183 more cases have been found, bringing the total since Sept. 9 to 724.

The number of new infections has declined since the quarantine began, officials said, but the lockdown will not end until Feb. 15.

The quarantine is not the only one on a college campus. (Last year, the University of Wisconsin-Madison shuttered 2,000 students in two dorms, and schools nationwide are struggling to control outbreaks.) But it might be the most rigid.

Security has been increased in residence halls to spot rule breakers and unwanted visitors. A cellphone-based “badge” (green for already tested, yellow for a missed test, orange and red for quarantined and Covid-19-positive) is subject to checking by so-called health ambassadors.

Flouting the rules can be costly. Violators can be suspended from classes, and student organizations can be deregistered.

But some students remain undeterred by the penalties.

“Some may disagree with me,” said one student who claimed to slip out regularly to socialize with friends (“I make sure they have a test”).

“My mental health is very important,” the student said.

A hospital worker put a warning label on a body bag holding a deceased patient at Providence Holy Cross Medical Center in Los Angeles last month.Credit…Jae C. Hong/Associated Press

Coronavirus-related deaths, which rose sharply in the United States beginning in November and remain high, appear to be in a steady decline, following in the tracks of new virus cases and hospitalizations, which began to drop last month.

The country has reported about 2,800 deaths a day recently, an average that excludes one anomalous day last week when Indiana announced a large number of backlogged death reports. That national average remains far above the level of early November, before the country’s recent surge, when roughly 825 deaths were being reported daily. But it is down significantly from the peak just a few weeks ago, when the average was more than 3,300 a day.

New coronavirus cases are a leading indicator for deaths, and that statistic has been improving markedly for a month. On Tuesday, the country reported 96,400 new cases, the third day in a row of having fewer than 100,000 new recorded cases, a level not seen since early November.

The seven-day average of new cases, a more reliable indicator of the pandemic’s direction, has fallen more than 50 percent since it peaked on Jan. 8.

Whether that will continue remains in doubt. Researchers warn that a more contagious virus variant first found in Britain is doubling roughly every 10 days in the United States. The Centers for Disease Control and Prevention cautioned last month that it could become the dominant variant in the nation by March.

Deaths tend to lag behind new cases by several weeks, and the day-to-day statistics can be prone to reporting vagaries. For a while, it was hard to discern clear signs that deaths had begun to decline. But the national trend now is unmistakable: The daily average has dropped about 18 percent since Jan. 12.

Although deaths are still rising in some states, including Alabama and South Carolina, far more are reporting sustained declines. Over the past two weeks, reports of virus deaths have dropped more than 40 percent in New Mexico and more than 30 percent in Arkansas, Colorado and Connecticut.

The declines are heartening but are not a reason for people to let down their guard, said Bill Hanage, an epidemiologist and associate professor at Harvard.

Dr. Hanage said the surges in new cases and deaths in December and early January had probably stemmed from the increase in gatherings over the holidays and from the onset of winter. Influenza and most kinds of coronavirus infections peak during winter, and there is little reason to think that Covid-19 is any different. (Influenza is not a coronavirus infection, as an earlier post suggested.)

The more infectious nature of the Covid-19 virus, and the appearance of variants that may spread even more easily, remain a significant cause for caution, he said.

“If in response to these dropping numbers people relax, then it is entirely possible and expected that we will see that decline start to bottom out and even start to increase again,” he said.

A New York Times analysis found that about half of the country’s roughly 465,000 Covid-19 deaths have occurred since the brutal surge began in November.

Maggie Owens and her children, Louise and August, playing in their Chicago home. The city’s teachers approved a deal early Wednesday that would send students, including Louise, back to classrooms.Credit…Jamie Kelter Davis for The New York Times

After a two-week pause of in-person instruction, the Chicago Teachers Union said early Wednesday that its members had approved an agreement to reopen classrooms in the country’s third-largest public school system.

More than 20,000 ballots were cast, with 13,681 members voting in favor and 6,585 voting against, the union said.

Under the agreement, prekindergarten and some special education students will return to classrooms on Thursday. Staff in kindergarten through fifth-grade classrooms will return on Feb. 22, and students in those grades will return on March 1. Staff members in sixth- through eighth-grade classrooms will return March 1, and students on March 8.

The Daily Poster

Listen to ‘The Daily’: What Will It Take to Reopen Schools?

The Biden administration is determined to restart in-person learning quickly. But there are some major hurdles.

As part of the agreement, the city committed to offering 2,000 coronavirus vaccine doses this week to staff members in classrooms that were set to reopen on Thursday and any other employees who live with people who were at high risk from the virus. It would then provide 1,500 doses a week to school staff in the weeks after that.

Teachers who have no students attending in-person classes could continue to teach remotely, and unvaccinated teachers could take unpaid leaves of absence for the next quarter instead of teaching in person. The agreement also set thresholds for what would lead the district, as well as individual schools or classrooms, to temporarily revert to distance learning.

“This plan is not what any of us deserve,” Jesse Sharkey, the president of the Chicago Teachers Union, said in a statement. “This agreement represents where we should have started months ago, not where this has landed.”

“We will protect ourselves by using the school safety committees created under this agreement to organize and see that C.P.S. meets safety standards and mitigation protocols,” Mr. Sharkey said. “Safety Committees will enforce this agreement, have access to information and the ability to change unsafe practices in their school.”

Ms. Sharkey criticized Mayor Lori Lightfoot over her handling of the situation and said that union delegates had passed a vote of no confidence in the mayor and school leadership on Monday night.

Ms. Lightfoot and the chief executive of the district, Janice K. Jackson, said in a statement, “This vote reaffirms the strength and fairness of our plan, which provides families and employees certainty about returning to schools and guarantees the best possible health and safety protocols.”

Ms. Lightfoot, a Democrat, and the union have been locked in one of the most intense disagreements over reopening anywhere in the country. The mayor has argued that the city’s most vulnerable students need the opportunity to return to school in person, while the union condemned the city’s reopening plan as unsafe.

Jill Biden and Doug Emhoff hosted a series of phone calls on Wednesday with nurses’ unions.Credit…Chandler West/White House Photo Office

Jill Biden, the first lady, and Doug Emhoff, the second gentleman, held a series of phone calls on Wednesday with nurses’ unions, including one representing several rural areas around the country that have struggled to keep up with the coronavirus surge, according to an administration official.

In one call, nurses in Huntington, W.Va., shared concerns about dozens of colleagues they said had contracted the virus at a local hospital. In Columbus, Ohio, nurses told stories of health workers’ having to share and reuse N95 masks and fearful that their ranks will be strained by infection.

Nurses are at particularly high risk to contract the virus, according to the federal Centers for Disease Control and Prevention. Nurses, along with doctors and other workers on the front lines, have also reported high rates of depression, trauma and burnout during the pandemic.

And shortages of protective gear remain a chronic issue.

On the calls, Dr. Biden and Mr. Emhoff “told them that this administration is fighting for them,” according to a spokesman for the first lady. But mostly they listened to the nurses and promised to share what they had learned with President Biden and Vice President Kamala Harris.

In the calls, each of which lasted 10 to 20 minutes, the nurses said they were thankful for the administration’s work, but they reiterated the need for more protective gear and more vaccine doses. The conversations turned emotional at times, the spokesman said.

The calls came as Dr. Biden’s broader platform began to emerge during her husband’s first weeks in office.

The first lady has made a point of publicly praising emergency workers. After the Bidens moved into the White House, one of her first official acts was to film a video to thank them, along with members of the military, for ensuring that the inauguration went safely. (When she made the video, she was still wearing her inauguration dress.)

Every four years, we celebrate the beginning of a new administration. It’s the start of a bright new chapter. A time for us all to come together. I’m so grateful to all who worked to create an incredible day – especially in this uniquely difficult year. pic.twitter.com/P3L7OYoANR

— Jill Biden (@FLOTUS) January 21, 2021

Dr. Biden’s other efforts have included a videotaped message with her husband that aired at the Super Bowl last weekend.

“We wanted to thank all the frontline health care heroes, both at the game and watching across the country,” the first lady said. “You and your families carried us through this year with courage, compassion and kindness.”

DemeTech, in Miami, Fla., and other businesses that have jumped into making masks must overcome the ingrained purchasing habits of hospitals, medical supply distributors and state governments.Credit…Scott McIntyre for The New York Times

A year into the pandemic, the disposable, virus-filtering N95 mask remains a coveted piece of protective gear. Continuing shortages have forced doctors and nurses to reuse their N95s, and ordinary Americans have scoured the internet — mostly in vain — to get them.

But Luis Arguello Jr. has plenty of N95s for sale — 30 million of them, in fact, which his family-run business, DemeTech, manufactured in its factories in Miami. He simply can’t seem to find buyers.

After the pandemic exposed a huge need for protective equipment, and China closed its inventory to the world, DemeTech, a medical suture maker, dived into the mask business. The company invested tens of millions of dollars in new machinery and then navigated a nine-month federal approval process that allows them to market the masks.

But demand is so slack that Mr. Arguello is preparing to lay off some of the 1,300 workers he had hired to ramp up production.

“It’s insane that we can’t get these masks to the people who desperately need them,” he said.

In one of the more confounding disconnects between the laws of supply and demand, many of the nearly two dozen small American companies that recently jumped into the business of making N95s are facing the abyss — unable to crack the market, despite vows from both former President Donald Trump and President Biden to “buy American” and buoy domestic production of essential medical gear.

These businesses must overcome the ingrained purchasing habits of hospital systems, medical supply distributors and state governments. Many buyers are loath to try the new crop of American-made masks, which are often more expensive than those produced in China. Another obstacle comes from companies like Amazon, Facebook and Google, which banned the sale and advertising of N95 masks in an effort to thwart profiteers from diverting vital medical gear needed by frontline medical workers.

What’s required, public health experts and industry executives say, is an ambitious strategy that includes federal loans, subsidies and government purchasing directives to ensure the long-term viability of a domestic industry vital to the national interest.

“The government needs to call the outsourcing of America’s mask supply what it is: a national security problem,” said Mike Bowen, the owner of Prestige Ameritech, a Texas mask producer who has testified before Congress about the need to support domestic manufacturers.

Residents waited in their cars to get the Pfizer vaccine at Ratliff Stadium in Odessa, Texas, in January.Credit…Eli Hartman/Odessa American, via Associated Press

The White House, attempting to ramp up its mass coronavirus vaccination effort, is standing up five new inoculation centers, including three in Texas and two in New York that are specifically aimed at vaccinating people of color, officials said Wednesday.

President Biden has said repeatedly that racial equity will be at the core of his coronavirus response, but there are stark racial disparities in the vaccination campaign. In some cities, wealthy white people have been flocking to clinics that primarily serve Black people and Latinos, using up scarce supplies of vaccine.

And the administration’s effort to gather race and ethnicity data on vaccine recipients is faltering.

“This is a perfect example of our equity work coming to life, and this is a model for the potential we have to do this well around the country,” Dr. Marcella Nunez-Smith, the chair of Mr. Biden’s Covid-19 Equity Task Force, said Wednesday during a news conference with Governor Andrew M. Cuomo of New York, referring to the new centers.

“It’s a bold step that we should take as a sign of hope,” Mr. Cuomo said.

On his first day in office, the president directed the Federal Emergency Management Agency to begin establishing federally supported community vaccination centers, with the goal of having 100 centers in operation within a month. On Tuesday, the administration announced that it intends to start shipping one million doses of vaccine per week to federally supported community health centers in underserved neighborhoods.

On Sunday, Mr. Biden told Norah O’Donnell of CBS News that Roger Goodell, the commissioner of the National Football League, had extended an offer for the administration to use all 30 league stadiums to distribute Covid-19 vaccines.

People in underserved neighborhoods face a variety of obstacles in getting vaccinated, experts say, including registration phone lines and websites that can take hours to navigate, and a lack of transportation or time off from jobs to get to appointments. And people of color, particularly Black people, are more likely to be hesitant about getting vaccinated, in light of the history of unethical medical research in the United States.

But Mr. Cuomo said he rejected the term “vaccine hesitancy,” adding, “Let’s call it what it is. It’s a lack of trust — for understandable reasons.”

The New York centers will be located at York College in Queens and Medgar Evers College in Brooklyn, Mr. Cuomo said, and will be capable of vaccinating 3,000 people a day. The federal government will provide a special dosage allocation for the sites, and they will be staffed jointly by the federal government, military personnel and members of the National Guard.

Last week, the administration announced that it was building two mass vaccination clinics in California, one in Los Angeles and the other in Oakland. The Texas clinics will be located in Arlington, Dallas and Houston, White House officials said.

Dr. Evan Saulino, a family physician in Portland, Ore., called for multiple strategies to distribute vaccines.Credit…Tojo Andrianarivo for The New York Times

Primary care doctors have grown increasingly frustrated with their exclusion from the nation’s vaccine rollout, unable to find reliable supplies for even their eldest patients and lacking basic information about distribution planning for the shots.

“The centerpiece should be primary care,” said Dr. Wayne Altman, the chairman of family medicine at Tufts University School of Medicine, who also sees patients in Arlington, Mass. State officials there are using Fenway Park and Gillette Stadium as mass vaccination sites, rather than ensuring practices like his can inoculate patients who are at high risk from the coronavirus.

“If you distribute the vaccine to all these practices and let them go at their pace, it would accelerate this rollout dramatically,” Dr. Altman said.

There are roughly 500,000 primary care doctors in the United States, who have traditionally administered nearly half of all adult vaccinations, inoculating their patients against pneumonia, flu and other infectious diseases. While most physician offices can’t handle storage for the Pfizer-BioNTech vaccine because of its need for special freezers, doctors say they could easily administer the Moderna vaccine with adequate storage measures as well as some of the others likely to become available soon.

“We’re ready,” said Dr. Elizabeth Kozak, an internist in Grand Rapids, Mich. She was approved in early January to deliver the Moderna vaccine. “We haven’t seen a thing, but we’re ready.”

While some physicians say they have received small amounts of the vaccine, many say they are still waiting for any indication about when they might get doses and how they fit into the long-range timetable for broader distribution.

Doctors say they are critical to reaching people who would not otherwise get a vaccine because they are unable or unwilling to go to mass vaccination sites or even their local pharmacy.

“We can’t have one or two strategies for vaccine distribution,” said Dr. Evan Saulino, a family physician in Portland, Ore., who has talked to patients, including those who are Black or Spanish-speaking, who are not sure they want the vaccine. Some of his patients are distrustful of the government and may not want to get a shot from someone in uniform. One person he spoke with would not go to the drugstore but might consider being inoculated at his clinic.

Dr. Kozak, the internist from Michigan, agreed, saying doctors like her could focus their attention on people who can’t easily navigate the current set up. “We might not be able to do the numbers but we are able to do the more fragile and vulnerable populations,” she said.

Global Roundup

Travelers at Heathrow airport in London last month.Credit…Hollie Adams/Getty Images

Vacationing abroad may not be possible for residents of Britain until all adults in the country have been vaccinated, a government official said on Wednesday, raising questions about how the tourism industry might cope with such restrictions and dashing hopes of many who hoped that a relatively successful vaccine rollout in Britain could let them enjoy trips abroad this summer.

The transportation secretary, Grant Shapps, said on British television that international travel would depend on “everybody having their vaccinations” in Britain, and that restrictions could remain as long as other countries have not made significant progress in vaccinations.

“We’ll need to wait for other countries to catch up as well, in order to do that wider international unlock,” Mr. Shapps said.

As of Wednesday, Britain had administered more than 12.5 million vaccine doses, equivalent to about 18 percent of its population, one of the highest rates in the world. At the current pace, the country is on track to give the first shot of a two-dose coronavirus vaccine to its entire population by the end of June.

The authorities have reported a sharp drop in the number of infections in recent days, and Prime Minister Boris Johnson is expected to announce a potential loosening of restrictions this month.

But on Wednesday, Mr. Shapps urged caution about travel plans for this year and advised people not to book vacations either within Britain or abroad. “I’m afraid I can’t give you a definitive ‘will there or will there not be’ the opportunity to take holidays,” he told Sky News.

Mr. Shapps’s warning came a day after the authorities announced new travel restrictions, including prison sentences of up to 10 years for anyone traveling to Britain who lies about where they’ve been.

Mr. Shapps called the measures, including the jail sentence, “appropriate.” Under other restrictions that are set to come into force on Monday, British residents arriving in England from more than 30 countries where coronavirus variants are believed to be widespread, will have to pay up to 1,750 pounds ($2,410) for a 10-day quarantine in government-managed hotel rooms.

Britain has reported 114,000 deaths from the coronavirus, the world’s fifth-highest known death toll.

In other developments around the world.

  • Mexico authorized China’s Sinovac Covid-19 vaccine for emergency use, said Hugo Lopez-Gatell, the deputy health minister, Reuters reported. Earlier this month, the country also authorized the Russian coronavirus vaccine, Sputnik V, for use.

  • Prime Minister Yoshihide Suga of Japan said on Wednesday that the country would begin its vaccination program next week, starting with medical workers.

  • The leaders of the World Health Organization and the United Nations agency for children, Unicef, warned in a joint statement that the vast chasm of inequality in the global vaccine rollout will “cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.” Of the 128 million vaccine doses administered globally, more than three quarters were in just 10 countries, while nearly 130 other countries are yet to administer a single dose, the statement said.

A seizure of counterfeit masks at a port warehouse in El Paso, Texas.Credit…U.S. Immigration and Customs Enforcement, via Associated Press

Many were clever fakes.

They were stamped with the 3M logo, and shipped in boxes that read, “Made in the U.S.A.”

But these supposed N95 masks were not produced by 3M, and not made in the United States, federal investigators said Wednesday.

They were counterfeits, and millions of them were bought by hospitals, medical institutions and government agencies in at least five states, federal authorities said as they announced an investigation.

Homeland Security Investigations, which is part of the Department of Homeland Security, said the masks were dangerous because they may not offer the same level of protection against the coronavirus as genuine N95s.

“We don’t know if they meet the standards,” said Brian Weinhaus, a special agent with Homeland Security Investigations.

Cassie Sauer, the president and chief executive of the Washington State Hospital Association, said about two million counterfeit masks might have made it into the state. They were “really good fakes,” she said.

“They look, they feel, they fit and they breathe like a 3M mask,” Ms. Sauer said.

News of the investigation came the same day the Homeland Security Department’s intelligence branch warned law enforcement agencies that criminals on the dark web have been selling counterfeit coronavirus vaccines for “hundreds of dollars per dose.”

Berlin and the rest of Germany have been in lockdown since before Christmas with nonessential stores and schools closed.Credit…Lena Mucha for The New York Times

Germany will remain in lockdown for at least another month because of the danger of more infectious variants of the virus, Chancellor Angela Merkel and governors decided on Wednesday.

“We know that this mutation is a reality now and we know it will increase,” said Ms. Merkel after meeting with governors from the 16 German states. “The question is how quickly will it increase.”

Although a sharp drop in new daily infections shows that a nearly two-month lockdown is having an effect, the authorities worry about the spread of more infectious variants. Nearly 6 percent of the positive coronavirus cases in Germany were found to be caused by more contagious variants, with the variant that has been found in Britain dominating.

The lockdown extension is designed to prevent the contagious variants from gaining steam.

Most shops, museums and services will remain closed until the number of new infections reaches an average of 35 cases per 100,000 people over a week, a rate that should be reached by March if the current trend holds. Over the past week, there has been an average of 68 cases per 100,000 people. The reopening of schools and day care centers, which the government has prioritized, will be overseen by the states and will most likely happen sooner. Hair salons are allowed to open on March 1 under strict safety rules. The opening of other businesses, such as gyms, bars and restaurants, will be discussed at a future meeting, Ms. Merkel said.

Over the past week, there has been an average of 8,887 new cases per day in Germany, far fewer than the nearly 25,000 a day around Christmas, according to a New York Times database.

The lockdown rules are in effect until March 7. Ms. Merkel and state governors will meet again on March 3, to decide on future measures.

Ursula von der Leyen, the European Commission president, addressing lawmakers in Brussels on Wednesday.Credit…Johanna Geron/Reuters

A top European Union official said on Wednesday that the bloc was “not where we want to be” in handling the pandemic, after missteps in lining up vaccine supplies left it lagging behind other countries.

“We were late to authorize,” the official, Ursula von der Leyen, the president of the European Commission, the bloc’s executive arm, told lawmakers in Brussels.

“We were too optimistic when it came to massive production, and perhaps too confident that what we ordered would actually be delivered on time,” she said. “We need to ask ourselves why that is the case.”

She stood by the view that buying vaccine doses as a bloc had been the right decision, however.

“I cannot even imagine what would have happened if just a handful of big players — big member states — had rushed to it and everybody else would have been left empty-handed,” she said, adding that it would have been “the end of our community.”

Her comments came as criticism has mounted over Ms. Von der Leyen’s handling of negotiations with pharmaceutical companies to secure vaccines for the 450 million people living in the bloc’s 27 member states.

Whereas Britain and United States have surged ahead in rolling out vaccines, the European Union has been more cautious and price-conscious, leading to a crisis after vaccine producers said there were delays in filing orders.

Its tensions with Britain, which left the bloc’s authority at the end of last year, were magnified after the Commission reversed an attempt last month to restrict vaccine exports into the country via Northern Ireland.

“The bottom line is that mistakes were made in the process leading up to the decision,” Ms. von der Leyen said on Wednesday. “And I deeply regret that. But in the end, we got it right.”

Over 17 million people, or about 4 percent of people living in the bloc, have received at least one vaccine dose, she said.

Categories
Health

Have You Had Covid-19? Examine Says You Might Want Solely One Vaccine Dose

Shannon Romano, eine Molekularbiologin, kam Ende März mit Covid zusammen, ungefähr eine Woche nachdem sie und ihre Kollegen ihr Labor im Mount Sinai Hospital geschlossen hatten. Zuerst kam es zu schwächenden Kopfschmerzen, gefolgt von einem Fieber, das weiter anstieg, und dann zu qualvollen Körperschmerzen. „Ich konnte nicht schlafen. Ich konnte mich nicht bewegen “, sagte sie. “Jedes meiner Gelenke tut nur innerlich weh.”

Es war keine Erfahrung, die sie wiederholen wollte – niemals. Als sie Anfang dieses Monats für den Covid-19-Impfstoff in Frage kam, bekam sie den Schuss.

Zwei Tage nach ihrer Injektion entwickelte sie Symptome, die sich sehr vertraut anfühlten. “Die Art und Weise, wie mein Kopf schmerzte und mein Körper schmerzte, war die gleiche Kopfschmerzen und Körperschmerzen, die ich hatte, als ich Covid hatte”, sagte sie. Sie erholte sich schnell, aber die intensive Reaktion ihres Körpers auf den Stoß überraschte sie.

Eine neue Studie könnte erklären, warum Dr. Romano und viele andere, die Covid hatten, diese unerwartet intensiven Reaktionen auf den ersten Schuss eines Impfstoffs melden. In einer am Montag online veröffentlichten Studie stellten Forscher fest, dass Personen, die zuvor mit dem Virus infiziert waren, nach dem ersten Schuss häufiger über Müdigkeit, Kopfschmerzen, Schüttelfrost, Fieber sowie Muskel- und Gelenkschmerzen berichteten als diejenigen, die noch nie infiziert waren. Covid-Überlebende hatten sowohl nach der ersten als auch nach der zweiten Dosis des Impfstoffs weitaus höhere Antikörperspiegel.

Basierend auf diesen Ergebnissen, sagen die Forscher, benötigen Menschen, die Covid-19 hatten, möglicherweise nur einen Schuss.

“Ich denke, eine Impfung sollte ausreichen”, sagte Florian Krammer, Virologe an der Icahn School of Medicine am Berg Sinai und Autor der Studie. “Dies würde auch Personen vor unnötigen Schmerzen bewahren, wenn sie die zweite Dosis erhalten, und es würde zusätzliche Impfstoffdosen freisetzen.”

Eine zweite am Montag veröffentlichte Studie bestätigt die Idee. Die Studie umfasste 59 Beschäftigte im Gesundheitswesen, von denen 42 zuvor Covid hatten (mit oder ohne Symptome). Die Forscher bewerteten die Nebenwirkungen nicht, stellten jedoch fest, dass diejenigen, die zuvor infiziert waren, auf den ersten Stoß mit hohen Antikörperniveaus reagierten, vergleichbar mit den Mengen, die nach der zweiten Dosis bei Menschen beobachtet wurden, die noch nie infiziert waren. In Laborexperimenten banden diese Antikörper an das Virus und verhinderten, dass es in die Zellen eindrang. Um die Impfstoffversorgung zu erweitern, kommen die Autoren zu dem Schluss, dass diejenigen, die zuvor Covid hatten, in die Prioritätenliste aufgenommen werden sollten und nur eine Dosis des Impfstoffs erhalten sollten, während die Versorgung begrenzt ist.

Während einige Wissenschaftler dieser Logik zustimmen, sind andere vorsichtiger. Eine Änderung der Anzahl der Dosen könnte “einen wirklich kniffligen Präzedenzfall” schaffen, sagte E. John Wherry, Direktor des Instituts für Immunologie der Universität von Pennsylvania. “Wir nehmen keine FDA-Zulassungen für beispielsweise ein Chemotherapeutikum entgegen und werfen dann einfach den Dosierungsplan weg”, sagte er.

Dr. Wherry wies auch darauf hin, dass Menschen mit leichten Fällen von Covid offenbar niedrigere Antikörperspiegel aufweisen und möglicherweise keinen Schutz gegen ansteckendere Varianten des Virus haben. Es kann auch schwierig sein zu identifizieren, welche Personen zuvor infiziert wurden. “Die Dokumentation wird zu einem wirklich potenziell chaotischen Problem für die öffentliche Gesundheit”, sagte er.

Nebenwirkungen nach der Impfung sind völlig zu erwarten. Sie zeigen, dass das Immunsystem eine Reaktion auslöst und besser darauf vorbereitet ist, eine Infektion abzuwehren, wenn der Körper mit dem Virus in Kontakt kommt. Die Impfstoffe von Pfizer und Moderna können besonders gut eine starke Reaktion hervorrufen. Die meisten Teilnehmer an den Studien der Unternehmen berichteten von Schmerzen an der Injektionsstelle, und mehr als die Hälfte berichtete von Müdigkeit und Kopfschmerzen.

Die klinischen Studien mit den zugelassenen Impfstoffen von Pfizer und Moderna, an denen jeweils mehr als 30.000 Teilnehmer teilnahmen, legen nahe, dass die meisten Menschen nach dem zweiten Stoß die schlimmsten Nebenwirkungen haben. Und in der Moderna-Studie hatten Menschen, die zuvor infiziert waren, tatsächlich weniger Nebenwirkungen als diejenigen, die dies nicht getan hatten.

Aber anekdotisch hören Forscher von einer wachsenden Anzahl von Menschen wie Dr. Romano, die sich nach einem Schuss krank fühlten. “Sie beschreiben diese Symptome viel energischer”, sagte Dr. Wherry.

Das entspricht dem, was Dr. Krammer und seine Kollegen in ihrer neuen Studie gefunden haben, die noch nicht in einer wissenschaftlichen Zeitschrift veröffentlicht wurde. Die Forscher bewerteten die Symptome nach der Impfung bei 231 Personen, von denen 83 zuvor infiziert waren und 148 nicht. Beide Gruppen berichteten weithin über Schmerzen an der Injektionsstelle nach der ersten Dosis. Aber diejenigen, die zuvor infiziert worden waren, berichteten häufiger von Müdigkeit, Kopfschmerzen und Schüttelfrost.

Das Team untersuchte auch, wie das Immunsystem bei 109 Personen auf den Impfstoff reagierte – 68 davon waren zuvor nicht infiziert und 41 waren infiziert – und fand in der letzteren Gruppe eine robustere Antikörperantwort. Die Zahlen sind jedoch gering, und daher müssen die Schlussfolgerungen der Studie mit mehr Forschung weiter untersucht werden, sagten Experten.

Es ist nicht unbedingt überraschend, dass zuvor infizierte Personen möglicherweise intensivere Reaktionen erfahren. Beide Aufnahmen enthalten genetisches Material, das den Körper zur Herstellung von Spike-Proteinen anspornt, den knorrigen Vorsprüngen auf der Oberfläche des Coronavirus. Menschen, die bereits mit dem Virus infiziert wurden, haben Immunzellen, die darauf vorbereitet sind, diese Proteine ​​zu erkennen. Wenn die Proteine ​​nach der Impfung auftauchen, greifen einige dieser Immunzellen an und die Menschen fühlen sich krank.

Dr. Susan Malinowski, eine Augenärztin in Michigan, die im März Covid-19 hatte, hatte zweifellos das Gefühl, dass ihr Körper angegriffen wurde, nachdem sie den Moderna-Impfstoff erhalten hatte. Sie bekam den ersten Schuss vor dem Mittagessen am Silvesterabend. Beim Abendessen wurde ihr langsam schlecht. Sie verbrachte die nächsten zwei Tage elend im Bett.

„Ich hatte Fieber. Ich hatte Schüttelfrost. Ich hatte Nachtschweiß. Ich hatte überall in meinem Körper Schmerzen “, sagte sie. “Ich war nach dem Impfstoff tatsächlich kranker als mit Covid.”

Fragen zu schwereren Impfreaktionen bei Personen, die Covid bereits hatten, wurden auf einer Sitzung eines Expertenausschusses am 27. Januar gestellt, der die Zentren für die Kontrolle und Prävention von Krankheiten berät.

Dr. Pablo J. Sánchez, ein Komiteemitglied des Forschungsinstituts des Nationwide Children’s Hospital in Columbus, Ohio, bemerkte, dass er von Menschen gehört habe, die auf den Impfstoff schlechter angesprochen hätten als ihre früheren Erfahrungen mit Covid-19. Er schlug vor, eine Frage zur vorherigen Infektion zu den Informationen hinzuzufügen, die die CDC von den Impfstoffempfängern anfordert. “Es wird nicht gefragt”, sagte Dr. Sánchez. “Ich denke, das ist wirklich wichtig.”

Covid19 Impfungen >

Antworten auf Ihre Impfstofffragen

Bin ich in meinem Bundesstaat für den Covid-Impfstoff berechtigt?

Derzeit können mehr als 150 Millionen Menschen – fast die Hälfte der Bevölkerung – geimpft werden. Aber jeder Staat trifft die endgültige Entscheidung darüber, wer zuerst geht. Die 21 Millionen Beschäftigten im Gesundheitswesen des Landes und drei Millionen Einwohner von Langzeitpflegeeinrichtungen waren die ersten, die sich qualifizierten. Mitte Januar forderten Bundesbeamte alle Bundesstaaten auf, die Berechtigung für alle über 65-Jährigen und für Erwachsene jeden Alters mit Erkrankungen zu öffnen, bei denen ein hohes Risiko besteht, dass sie schwer krank werden oder an Covid-19 sterben. Erwachsene in der Allgemeinbevölkerung stehen am Ende der Reihe. Wenn Gesundheitsbehörden von Bund und Ländern Engpässe bei der Verteilung von Impfstoffen beseitigen können, sind alle ab 16 Jahren bereits im Frühjahr oder Frühsommer förderfähig. Der Impfstoff wurde bei Kindern nicht zugelassen, obwohl derzeit Studien durchgeführt werden. Es kann Monate dauern, bis ein Impfstoff für Personen unter 16 Jahren verfügbar ist. Aktuelle Informationen zu den Impfrichtlinien in Ihrer Region finden Sie auf Ihrer staatlichen Gesundheitswebsite

Ist der Impfstoff frei?

Sie sollten nichts aus eigener Tasche bezahlen müssen, um den Impfstoff zu erhalten, obwohl Sie nach Versicherungsinformationen gefragt werden. Wenn Sie nicht versichert sind, sollten Sie den Impfstoff trotzdem kostenlos erhalten. Der Kongress hat in diesem Frühjahr ein Gesetz verabschiedet, das es Versicherern verbietet, eine Kostenteilung wie eine Zuzahlung oder einen Selbstbehalt anzuwenden. Es bestand aus zusätzlichen Schutzmaßnahmen, die es Apotheken, Ärzten und Krankenhäusern untersagten, Patienten, einschließlich nicht versicherter Patienten, in Rechnung zu stellen. Trotzdem befürchten Gesundheitsexperten, dass Patienten in Schlupflöcher geraten, die sie für Überraschungsrechnungen anfällig machen. Dies kann bei Personen der Fall sein, denen zusammen mit ihrem Impfstoff eine Arztbesuchsgebühr berechnet wird, oder bei Amerikanern, die bestimmte Arten der Krankenversicherung haben, die nicht unter die neuen Vorschriften fallen. Wenn Sie Ihren Impfstoff von einer Arztpraxis oder einer Notfallklinik erhalten, sprechen Sie mit ihnen über mögliche versteckte Kosten. Um sicherzugehen, dass Sie keine Überraschungsrechnung erhalten, ist es am besten, wenn Sie Ihren Impfstoff an einer Impfstelle des Gesundheitsministeriums oder in einer örtlichen Apotheke erhalten, sobald die Aufnahmen breiter verfügbar sind.

Kann ich wählen, welchen Impfstoff ich bekomme?Wie lange hält der Impfstoff? Brauche ich nächstes Jahr noch einen?

Das ist zu bestimmen. Es ist möglich, dass Covid-19-Impfungen genau wie die Grippeimpfung zu einem jährlichen Ereignis werden. Oder es kann sein, dass der Nutzen des Impfstoffs länger als ein Jahr anhält. Wir müssen abwarten, wie dauerhaft der Schutz vor den Impfstoffen ist. Um dies festzustellen, werden Forscher geimpfte Menschen aufspüren, um nach „Durchbruchsfällen“ zu suchen – jenen Menschen, die trotz Impfung an Covid-19 erkranken. Dies ist ein Zeichen für eine Schwächung des Schutzes und gibt Forschern Hinweise darauf, wie lange der Impfstoff hält. Sie werden auch die Spiegel von Antikörpern und T-Zellen im Blut geimpfter Personen überwachen, um festzustellen, ob und wann ein Auffrischungsschuss erforderlich sein könnte. Es ist denkbar, dass Menschen alle paar Monate, einmal im Jahr oder nur alle paar Jahre Booster benötigen. Es geht nur darum, auf die Daten zu warten.

Benötigt mein Arbeitgeber Impfungen?Wo kann ich mehr erfahren?

Dr. Tom Shimabukuro von der CDC, der dem Ausschuss Sicherheitsdaten vorlegte, sagte, dass die Agentur das Problem untersucht. “Derzeit gibt es nur begrenzte Daten dazu, aber wir suchen nach Möglichkeiten, um bessere Informationen zu erhalten”, sagte er.

Menschen, die Covid hatten, scheinen „auf die erste Dosis zu reagieren, als wäre es eine zweite Dosis“, sagte Akiko Iwasaki, Immunologe an der Yale School of Medicine. Eine Dosis ist also wahrscheinlich “mehr als genug”, sagte sie.

Eine Anfang dieses Monats veröffentlichte Studie berichtete, dass das Überleben einer natürlichen Infektion einen Schutz von 83 Prozent vor einer erneuten Infektion innerhalb von fünf Monaten bot. “Zwei Dosen zusätzlich zu geben, scheint vielleicht übertrieben”, fügte sie hinzu.

Shane Crotty, Immunologe am La Jolla Institute for Immunology, wies darauf hin, dass eine intensivere Impfreaktion typischerweise einen besseren Schutz bedeutet. Wenn jemand eine große Reaktion auf die erste Dosis hätte, “würde ich erwarten, dass das Überspringen dieser zweiten Dosis sinnvoll wäre und dass die zweite Dosis wahrscheinlich unnötig ist”, sagte er.

Andere Immunologen schlagen jedoch vor, dass sich jeder an zwei Dosen hält. “Ich bin ein großer Befürworter der richtigen Dosierung und des richtigen Zeitplans, denn so wurden die Studien durchgeführt”, sagte Maria Elena Bottazzi, Immunologin am Baylor College of Medicine in Houston.

Und zwei Schüsse zu bekommen scheint keine Gefahr für diejenigen zu sein, die Covid hatten.

Dennoch wünscht sich der Augenarzt Dr. Malinowski, es gäbe weniger Fragen und mehr Antworten. Wenn die Nebenwirkungen von Impfstoffen bei bereits infizierten Menschen wirklich stärker sind, könnten Gesundheitsbeamte den Menschen einen Hinweis geben, sagte sie.

“Es wäre schön zu wissen, dass Sie vielleicht zwei Tage lang nicht aufstehen können”, sagte Malinowski. Sie hat beschlossen, nicht für eine zweite Dosis zurückzukehren.

Dr. Romano vom Mount Sinai Hospital wird voraussichtlich im Februar zum zweiten Mal erschossen und ist sich nicht sicher, was sie tun wird. “Meine Freunde, die Immunologen sind, wir haben das alle unter uns besprochen”, sagte sie. „Wahrscheinlich bekomme ich es. Aber ich möchte noch ein bisschen darüber nachdenken, bevor ich es tue. “

Denise Grady und Apoorva Mandavilli haben zur Berichterstattung beigetragen.

Categories
Health

Covid-19 Information: Even in Poorer Neighborhoods, the Rich Are Lining Up for Vaccines

“It looked like Ward 3 was being punished for being more familiar with computers,” said Mary Cheh, a member of the city council who represents the station, who routinely has homes near American University or the Potomac River sold for more than $ 2 million. “I was inundated with emails from people who were just really angry about it.”

The day after the policy change, Ms. Cheh wrote to constituents, quoting the shooting data, and saying that “our fear of getting one right away shouldn’t tarnish the pursuit of fair vaccine distribution.”

“When I sent this message, people were like, ‘Oh, thanks, I understand now,” Ms. Cheh said. Still, she called the city’s new system “a very blunt instrument” and said it was fairer to meet the needs of that Basing the risk of an individual, not that of a whole neighborhood.

70-year-old Adora Iris Lee lives in one of Washington’s most important neighborhoods – Congress Heights, part of Ward 8 in the southern part of the district, which is severely black and has seen the highest number of Covid deaths. She said she was on hold for more than three hours but was given appointments for herself and her mother, who is 93 years old.

“Being able to call at a time that was reserved for us was good for me,” said Ms. Lee. “People who live in Station 3 and people who live in Station 8 have different social realities. We’re not kidding. “

Even so, Mr. Jones of Bread for the City said that even with the new system, hardly any of the people who came to his clinic for admissions were his regular patients. The clinic began reaching out to its regulars and, with the permission of the city, reserved all first doses for them and for clients of other social organizations last week.

“It’s not just about keeping the seats for the people,” said Jones. “Somehow we have to persuade them to use these spots.”

Categories
World News

World Covid-19 Reside Updates: Information on Vaccine, Variants, Stimulus and Circumstances

Here’s what you need to know:

Credit…Rory Doyle for The New York Times

Vaccinations in the United States are slowly picking up speed as the Biden administration pushes to accelerate inoculations and blunt the spread of more contagious virus variants.

The United States has administered about 30 million doses, and, as of Sunday, is averaging more than 1.3 million doses administered over the past seven days, compared with an average of less than one million per day two weeks earlier, according to a New York Times vaccine tracker.

President Biden, under pressure to speed up coronavirus vaccinations, has recently suggested the nation could soon reach an average of 1.5 million shots a day.

But just as there are signs of progress, another problem has taken root: the spread of the variants, which scientists warn must be contained before they become dominant. Several hundred cases of the more contagious variant discovered in Britain, which experts have said could be the dominant form in the United States by March, have already been confirmed.

The country has also recorded its first two cases of the variant spreading rapidly in South Africa, which has proved to reduce the effectiveness of vaccines.

“If we didn’t have these variants looming,” we would be in a good place, said Dr. Peter Hotez, a vaccine scientist and pediatrician at Baylor College of Medicine in Houston. If those variants take over by spring, “as many of us are predicting,” he said, “it changes everything. Now, we really have to vaccinate the American population by late spring, early summer.”

Two key challenges in the weeks ahead are “increasing the supply of vaccines” and “speeding up the time it takes to administer them,” Andy Slavitt, a White House adviser, said in a news briefing on Friday. Many experts have pushed for bringing other vaccine options out and releasing the first doses more widely.

The most effective state programs, said Dr. Ashish Jha, the dean of the Brown University School of Public Health, are “very simple, age-based, not a lot of complex rules. They focus on getting the vaccines out.”

Here is a snapshot of how five of the best-performing states are doing:

  • West Virginia has given at least one dose to 10.7 percent of its population, second only to Alaska, and leads the nation in the percentage of its population that has received two doses (3.7 percent). Early on, the state got a head start because it opted out of a federal program to vaccinate people in nursing homes and other long-term care facilities. While other states chose the federal plan, which teamed with Walgreens and CVS, officials decided the idea made little sense in West Virginia, where many communities are miles from the nearest chain store, and about half of pharmacies are independently owned. Instead the state created a network of pharmacies, pairing them with about 200 long-term care facilities.

  • According to health officials in Alaska, there are several reasons behind the state’s relatively high vaccination rate, The Anchorage Daily News has reported. Those factors include: the state’s having received a high number of doses through the Indian Health Service; the decision to receive doses monthly, versus weekly, as most states do; and declining virus caseloads, which has allowed health care workers to focus on inoculations. The state has vaccinated 13 percent of its population, according to a Times database.

  • North Dakota has used 91 percent of the vaccines distributed to the state, according to the Times vaccine tracker. It is the only state above 90 percent; more populous states like California (58 percent) and New York (64 percent) have used less, proportionally. North Dakota was among the first states to lower the minimum age eligible for vaccination, from 75 to 65.

  • In a recent interview with the American Medical Association, health officials in New Mexico attributed part of the state’s success to its “data-oriented and science-oriented” governor, Michelle Lujan Grisham, and to an app that allowed easy registration and close coordination among hospitals and providers. The state has given 9.8 percent of residents at least one shot, and has used 83 percent of its doses.

  • Connecticut got mass vaccination sites up and running early, and uses an inventory system that allocates unused doses to places that need them. But older residents have complained about long waits.

United States › United StatesOn Jan. 31 14-day change
New cases 111,478 –32%
New deaths 1,875 –5%
World › WorldOn Jan. 31 14-day change
New cases 389,735 –21%
New deaths 8,093 +2%

U.S. vaccinations ›

Where states are reporting vaccines given

A shopping mall in Cergy-Pontoise, near Paris, on Sunday. France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed.Credit…Andrea Mantovani for The New York Times

PARIS — Public frustration with lockdowns is palpable across Europe, with pensioners protesting this weekend in Vienna, restaurateurs taking to the streets in Budapest and demonstrators clashing with the police in Belgium, prompting dozens of arrests. The Dutch authorities fined more than 10,000 people last week for violating the national curfew.

While none of the protests resulted in the kind of violence seen in the Netherlands in recent weeks, they reflect a growing impatience as political leaders extend restrictions to guard against a resurgence of the virus fueled by new variants.

In France, President Emmanuel Macron has resisted a full lockdown, making a calculated gamble that his government can tighten the rules just enough to avoid a new wave of infections.

Prime Minister Jean Castex appeared in front of television cameras for an unexpected statement on Friday night, announcing a handful of new curbs, including strict border closures.

“Even if the path is very narrow, we must take it,” Mr. Macron was reported to have said at a cabinet meeting last week, according to the Journal du Dimanche, pushing back against the advice of several senior aides. According to the newspaper, he added: “When you are French, you have all you need to get by, as long as you dare to try.”

Polls in France have shown weariness with restrictions, and grumbling about the rules is growing in some quarters.

France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed. Schools and shops are open.

After a widely publicized breach of the rules at a restaurant in the southern city of Nice last week and a call to “civil disobedience” by some restaurant owners, the French economy minister, Bruno Le Maire, warned on Monday that any establishments that flouted the rules would be cut off from coronavirus aid.

In the French Alps, protesters blocked roads on Monday to demand that ski lifts reopen.

Critics say that Mr. Macron’s approach may simply be delaying the inevitable and that he could be forced to change course if cases started to surge.

“It’s a risk, I’m hoping it was a calculated risk,” Karine Lacombe, an infectious-disease specialist, told the French news channel LCI on Sunday.

Mr. Macron’s plan is rooted partly in the relative stability of the pandemic in France. The number of new daily cases has inched up only slowly and while hospitalizations remain high, there has been no sudden surge. More contagious variants of the virus have been registered in the country, but the authorities say they believe that their spread, so far, is under control.

“Everything suggests that a new wave could occur because of the variant,” Olivier Véran, the French health minister, told the Journal du Dimanche. “But perhaps we can avoid it thanks to the measures that we decided early and that the French people are respecting.”

Aurelien Breeden reported from Paris, and Marc Santora from London.

Video

transcript

Back

transcript

N.Y.C. Snowstorm Delays Vaccinations

On Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.

The storm is disrupting our vaccination effort, and we need to keep people safe. We don’t want folks, especially seniors, going out in unsafe conditions to get vaccinated. We know we can reschedule appointments very quickly because, of course, we have supply. We’re going to use the supply we have. Our problem is lack of supply. So we can take the supply we have and distribute it very quickly in the days to come, and make sure everyone gets the appointments. But it’s not safe out there today. So vaccinations are canceled today. They’re also going to be canceled tomorrow. Based on what we are seeing right now, we believe that tomorrow, getting around the city will be difficult, it’ll be icy, it’ll be treacherous. We do not want seniors, especially, out in those conditions. So we’re going to have vaccinations off for today and tomorrow, come back strong on Wednesday. We’ll be able to catch up quickly because, again, we have a vast amount of capacity. We don’t have enough vaccine. So we’ll simply use the days later in the week. Crank up those schedules, get people rescheduled into those days.

Video player loadingOn Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.CreditCredit…James Estrin/The New York Times

Mayor Bill de Blasio of New York said on Monday that coronavirus vaccinations scheduled for Tuesday would be postponed because of the winter storm, the second day in a row that they have been delayed.

Heavy snow was also complicating vaccination efforts in Washington, Philadelphia, New Jersey and elsewhere.

At a news conference on Monday, Mr. de Blasio of New York City said he did not want older residents traveling to vaccine appointments amid blizzard-like conditions with gusty winds.

“Based on what we are seeing right now, we believe tomorrow, getting around the city will be difficult,” Mr. de Blasio said. “It will be icy, it will be treacherous.”

He said he believed the city could quickly make up the appointments later in the week.

“We have a vast amount of capacity; we don’t have enough vaccine,” he said. “We’ll simply use the days later in the week, crank up those schedules, get people rescheduled into those days.”

The storm will temporarily derail a vaccine rollout that has been plagued by inadequate supply, buggy sign-up systems and confusion over the New York State’s strict eligibility guidelines. The vaccine is available to residents 65 and older as well as a wide range of workers designated “essential.”

About 800,000 doses have been administered so far in the city, Mr. de Blasio said.

Vaccine appointments originally scheduled for Monday at several sites in the region — the Javits Center in Manhattan, the Aqueduct Racetrack in Queens, a drive-through site at Jones Beach in Long Island, SUNY Stony Brook and the Westchester County Center — would be rescheduled for this week, according to a statement from Melissa DeRosa, a top aide to Gov. Andrew M. Cuomo. “We ask all New Yorkers to monitor the weather and stay off the roads tomorrow so our crews and first responders can safely do their jobs,” she said.

Mr. Cuomo said at a news conference on Monday that New York’s seven-day average positive test rate was 4.8 percent, the 24th straight day it had declined.

Mr. Cuomo added that the state had administered about 1.96 million doses of the vaccine.

In the Philadelphia area, city-run testing and vaccine sites were closed on Monday. Connecticut, New Jersey, Rhode Island and parts of the Washington, D.C., area were following suit. Some areas away from the center of the storm were expected to remain open for vaccinations, including parts of Massachusetts and upstate New York.

A medical technician at a coronavirus testing site in Austin, Texas, last month.Credit…Tamir Kalifa for The New York Times

The past few weeks in the United States have been the deadliest of the coronavirus pandemic, and residents in a majority of counties remain at an extremely high risk of contracting the virus. At the same time, transmission seems to be slowing throughout the country, with the number of new average cases 40 percent lower on Jan. 29 than at the U.S. peak three weeks earlier.

Other indicators reinforce the current downward trend in cases. Hospitalizations are down significantly from record highs in early January. The number of tests per day has also decreased, which can obscure the virus’s true toll, but the positivity rate of those tests has also gone down, indicating that the slowed spread is real.

Still, the average reported daily death rate over the past seven days remains above 3,000, compared with less than 1,000 per day in September and October.

Experts say the decrease could mark a turning point in the outbreak after months of ever-higher caseloads. But new, more contagious variants threaten to upend progress and could even send case rates to a new high if they take hold, especially if the national vaccine rollout faces hurdles.

Video

transcript

Back

transcript

Biden to Discuss Pandemic Relief Package With Republicans

President Biden will meet with 10 Republican senators on Monday who have proposed a much smaller Covid-19 relief package. Jen Psaki, the White House press secretary, told reporters that the Mr. Biden’s biggest concern is releasing a package that is too small.

The president has been clear since long before he came into office that he’s open to engaging with both Democrats and Republicans in Congress about their ideas. And this is an example of doing exactly that. So as we said in our statement last night, it’s an exchange of ideas, an opportunity to do that. This group obviously sent a letter with some outline, some top lines of their concerns and their priorities, and he’s happy to have a conversation with them. What this meeting is not, is a forum for the president to make or accept an offer. His view — it remains — what was stated in the statement last night, but also what he said on Friday, which is that the risk is not that it is too big, this package, the risk is that it is too small. And that remains his view, and it’s one he’ll certainly express today. But it’s important to him that he hears this group out on their concerns, on their ideas. He’s always open to making this package stronger. And he also, as was noted in our statement last night, remains in close touch with Speaker Pelosi with Leader Schumer, and he will continue that engagement throughout the day, and in the days ahead.

Video player loadingPresident Biden will meet with 10 Republican senators on Monday who have proposed a much smaller Covid-19 relief package. Jen Psaki, the White House press secretary, told reporters that the Mr. Biden’s biggest concern is releasing a package that is too small.CreditCredit…Doug Mills/The New York Times

White House officials offered a pointed, if polite, warning to 10 Senate Republicans planning to pitch a scaled-back coronavirus relief package to President Biden at the White House on Monday evening: Think bigger.

Jen Psaki, the White House press secretary, played down expectations of the meeting, a critical first test of Mr. Biden’s dueling commitments to bipartisanship and speeding pandemic aid, saying no deal would be done without further negotiations — a statement aimed at reassuring Democrats leery of a fast, weak deal.

“What this meeting is not is a forum for the president to make or accept an offer,” Ms. Psaki told reporters on Monday afternoon, repeating the president’s determination to push through a $1.9 trillion stimulus bill.

“The risk is not that it is too big, this package,” Ms. Psaki added. “The risk is that it is too small. That remains his view.”

A coalition of center-right Republican senators, led by Susan Collins of Maine, on Monday outlined a more limited $618 billion stimulus plan, which they are billing as a way for Mr. Biden to pass a pandemic aid bill with bipartisan support and make good on his inauguration pledge to unite the country.

With 10 Republicans on board, joining the Senate’s 50 Democrats, a bipartisan bill could overcome the chamber’s 60-vote filibuster rule. But Democrats have shown little enthusiasm for a measure that amounts to less than one third of what the president says is needed.

Still, after receiving a letter from the senators on Sunday requesting a meeting, Mr. Biden called Ms. Collins and invited her and the other signers to the White House. He also spoke with Speaker Nancy Pelosi of California and Senator Chuck Schumer of New York, the majority leader.

The Republican proposal is likely to be met with resistance from congressional Democrats, who are preparing this week to begin laying the groundwork for passing Mr. Biden’s plan through a process known as budget reconciliation, which would allow it to bypass a filibuster and pass solely with Democratic votes.

The proposal would include $160 billion for vaccine distribution and development, coronavirus testing and the production of personal protective equipment; $20 billion toward helping schools reopen; more relief for small businesses; and additional aid to individuals. The package would also extend enhanced unemployment benefits of $300 a week — currently slated to lapse in March — until June 30.

“We recognize your calls for unity and want to work in good faith with your administration,” wrote the Republican group, which includes Senators Lisa Murkowski of Alaska, Bill Cassidy of Louisiana and Mitt Romney of Utah.

The measure omits a federal minimum wage increase that Mr. Biden included in his plan. It would also whittle down his proposal to send $1,400 checks to many Americans, and limit it to lower-income earners.

The proposal calls for checks of up to $1,000 for individuals making $50,000 a year or less and families with a combined income of up to $100,000, with individuals earning less than $40,000 — and families earning less than $80,000 — receiving the full amount.

Previous rounds of direct payments were targeted to Americans earning less than $99,000 annually, with those earning less than $75,000 receiving the full amount.

Congress approved more than $4 trillion through a series of bills last year to address the coronavirus crisis and its economic fallout. Most recently, in December, lawmakers passed a $900 billion stimulus plan that included $600 direct checks to many Americans.

Mr. Biden received an important boost on Monday ahead of his meeting with the senators: Gov. Jim Justice of West Virginia, a close ally of former President Trump, said he supported a bigger relief package than the one that the center-right Republicans are proposing.

“If we actually throw away some money right now, so what?” said Mr. Justice, a former Democrat who switched parties to support Mr. Trump in 2017, told CNN.

A shuttered business in Los Angeles. It may take years to return to the pre-pandemic levels of employment.Credit…Kendrick Brinson for The New York Times

The American economy will return to its pre-pandemic size by the middle of this year, even if Congress does not approve any more federal aid for the recovery, but it will be years before everyone thrown off the job by the pandemic is able to return to work, the Congressional Budget Office projected on Monday.

The new projections from the office, which is nonpartisan and issues regular budgetary and economic forecasts, are an improvement from the office’s forecasts last summer. Officials told reporters on Monday that the brightening outlook was a result of large sectors of the economy adapting better and more rapidly to the pandemic than originally expected.

They also reflect increased growth from a $900 billion economic aid package that Congress passed in December, which included $600 direct checks to individuals and more generous unemployment benefits.

The budget office now expects the unemployment rate to fall to 5.3 percent at the end of the year, down from an 8.4 percent projection last July. The economy is expected to grow 3.7 percent for the year, after recording a much smaller contraction in 2020 than the budget office initially expected.

The rosier projections are likely to inject even more debate into the discussions over whether to pass President Biden’s $1.9 trillion economic rescue package. It could embolden Republicans who have pushed Mr. Biden to scale back the plan significantly, saying the economy does not need so much additional federal support and that another big package could “overheat” the economy.

But the report shows little risk of that happening. The economy is projected to remain below potential levels until 2025 on its current path. And big economic risks remain. The number of employed Americans will not return to its pre-pandemic levels until 2024, officials predicted, reflecting the prolonged difficulties of shaking off the virus and returning to full levels of economic activity.

The Federal Reserve chair, Jerome H. Powell, warned last week that the economy was “a long way from a full recovery” with millions still out of work and many small businesses facing pressure.

Budget officials said the rebound in growth and employment could be significantly accelerated if public health authorities were able to more rapidly deploy coronavirus vaccines across the population.

As it stands, the budget office sees little evidence of growth running hot enough in the years to come to spur a rapid increase in inflation. It forecast inflation levels below the Federal Reserve’s target of 2 percent for years to come, even with the Fed holding interest rates near zero.

Other independent forecasts, including one from the Brookings Institution last week, have projected that another dose of economic aid — like the $1.9 trillion package Mr. Biden has proposed — would help the economy grow more rapidly, topping its pre-pandemic path by year’s end.

Dr. Ricardo Cigarroa hugging a patient at the Laredo Medical Center in Laredo, Texas.Credit…Verónica G. Cárdenas for The New York Times

During January, the pandemic’s deadliest month, Laredo, Texas, held the bleak distinction of having one of the most severe outbreaks of any city in the United States. The death toll in the overwhelmingly Latino city of 277,000 now stands at more than 630 — including at least 126 in January alone.

When the virus made its way to the borderlands almost a year ago, Dr. Ricardo Cigarroa could have just hunkered down. He could have focused on his profitable cardiology practice, which has 80 employees. He could have kept quiet.

Instead, Dr. Cigarroa has become a top crusader and the de facto authority on the pandemic along this stretch of the U.S.-Mexico border.

On regional television stations, he calmly explains, in both English and Spanish, how the virus is evolving. Known for making Covid-19 house calls around Laredo in his old Toyota Tacoma pickup, he is interviewed so often that Texas Monthly called him “The Dr. Fauci of South Texas,” comparing him to Dr. Anthony S. Fauci, the country’s top infectious disease expert — though Dr. Cigarroa holds no official government portfolio.

Lately, Dr. Cigarroa has been losing his patience.

Looking exhausted in a video posted on Facebook, he blasted political leaders for allowing the virus to rampage through this part of South Texas. Dr. Cigarroa singled out Gov. Greg Abbott, a Republican, for refusing to allow Laredo to impose stricter mitigation measures.

“To the governor: It’s OK to swallow your pride,” Dr. Cigarroa said, stunning some viewers with a warning that the virus could kill 1 in 250 Laredoans by midyear. “It’s OK to say that you’re not going to do it, and then do it to save lives.”

Pleading with the people of Laredo to consider civil disobedience in the form of staying home from work if politicians fail to act, he added, “The only thing that will save lives at this point will be staying home and shutting down the city.”

Students waiting to be admitted at a public school in Brooklyn in December. In New York City, about 12,000 more white children have returned to classrooms than Black students.Credit…Victor J. Blue for The New York Times

Even as more districts reopen their buildings and President Biden joins the chorus of those saying schools can safely resume in-person education, hundreds of thousands of Black parents say they are not ready to send their children back. That reflects both the disproportionately harsh consequences the coronavirus has visited on nonwhite Americans and the profound lack of trust that Black families have in school districts, a longstanding phenomenon exacerbated by the pandemic.

It also points to a major dilemma: School closures have hit the mental health and academic achievement of nonwhite children the hardest, but many of the families that education leaders have said need in-person education the most are most wary of returning.

That is shifting the reopening debate in real time. In Chicago, only about a third of Black families have indicated they are willing to return to classrooms, compared with 67 percent of white families, and the city’s teachers’ union, which is hurtling toward a strike, has made the disparity a core part of its argument against in-person classes.

In New York City, about 12,000 more white children have returned to classrooms than Black students, though Black children make up a larger share of the overall district. In Oakland, Calif., just about a third of Black parents said they would consider in-person learning, compared with more than half of white families. And Black families in Washington, Nashville, Dallas and other districts also indicated they would keep their children learning at home at higher rates than white families.

Education experts and Black parents say decades of racism, institutionalized segregation and mistreatment of Black children have left Black communities to doubt that school districts are being upfront about the risks.

“For generations, these public schools have failed us and prepared us for prison, and now it’s like they’re preparing us to pass away,” said Sarah Carpenter, the executive director of Memphis Lift, a parent advocacy group in Tennessee. “We know that our kids have lost a lot, but we’d rather our kids to be out of school than dead.”

In many cities and districts, Latino and Asian-American families are also less likely than white families to send their children back. Asian-Americans have opted out of in-person classes at the highest rates of any ethnic group in New York City. Latino families in Chicago were most likely to say they would keep their children at home when schools reopened.

Still, the pattern is most consistent and pronounced with Black families, which have been particularly affected by decades of underinvestment. By one estimate, a $23 billion gap, or $2,226 per pupil, separates funding for predominantly white districts and nonwhite districts, and Jessica Calarco, a sociologist at Indiana University Bloomington who has studied reopening, said the pandemic had amplified that inequity.

“If you know your school doesn’t have hot running water, how would you feel about sending your child to that school knowing they can’t fully wash their hands before they eat lunch?” she asked.

GLOBAL ROUNDUP

Workers loading South Africa’s first coronavirus vaccine doses at OR Tambo airport in Johannesburg on Monday.Credit…Elmond Jiyane for GCIS, via Reuters

A million doses of the Oxford-AstraZeneca coronavirus vaccine arrived in South Africa on Monday, paving the way for the country to begin vaccinating its population of nearly 60 million. Health care workers will be the first to be offered the shots, officials said.

The country has reported by far the most cases and deaths from the coronavirus on the African continent. It has participated in clinical trials of several vaccines.

The plane delivering the eagerly awaited doses from the Serum Institute of India, which produced them, was met at the airport by President Cyril Ramaphosa. The president has come under criticism over the country’s lagging start to widespread vaccination, with many countries in Asia and the West able to start immunizing their populations weeks before South Africa could secure a supply.

South Africa experienced a surge in new cases around the turn of the year, fueled by the more transmissible variant of the virus that was first detected in the country. But the surge has begun to ease in recent weeks. Information has not yet been released on the AstraZeneca vaccine’s effectiveness against the variant, which is now predominant in the country.

Over the course of the pandemic, South Africa has reported about 1.45 million cases, and has lately been averaging about 5,800 new cases a day, according to a New York Times database.

In other developments around the world:

  • Seeking a better understanding of the pandemic’s origins, a team of 15 World Health Organization experts is visiting some of the places first hit by the coronavirus in the Chinese city of Wuhan, including a live animal market, a hospital and a disease control center. The inquiry is expected to take months to complete. Scientists initially believed the outbreak began at the Huanan Seafood Wholesale Market in Wuhan, but many experts now doubt that theory.

  • The European Union will get 75 million additional doses of vaccine in the next few months, the German pharmaceutical company BioNTech announced on Monday. The vaccine jointly developed by the company and Pfizer was the first to be authorized for use in the E.U., but supplies have been limited by production issues in the early going, and several countries, including Germany, are off to slower than expected starts in vaccinating their populations.

  • The police in China said they had broken up a criminal ring that manufactured and sold more than 3,000 fake coronavirus vaccine doses, the state-run Xinhua news agency reported on Monday. More than 80 people were arrested, the agency said. According to Xinhua, the police said that since September, the main suspect had been selling vials of “vaccine” that was really just saline solution.

Congressman Adriano Espaillat of New York at the Capitol this month.Credit…J. Scott Applewhite/Associated Press

The scattered reports from around the country can play like a cruel irony: Someone tests positive for the coronavirus even though they have already received one or both doses of a Covid-19 vaccine.

It’s happened to at least three members of Congress recently:

But it’s been reported in people in other walks of life too, including Rick Pitino, a Hall of Fame basketball coach, and a nurse in California.

Experts say cases like these are not surprising and do not indicate that there was something wrong with the vaccines or how they were administered. Here is why.

  • Vaccines don’t work instantly. It takes a few weeks for the body to build up immunity after receiving a dose. And the vaccines now in use in the U.S., from Pfizer-BioNTech and Moderna, both require a second shot a few weeks after the first to reach full effectiveness.

  • Nor do they work retroactively. You can already be infected and not know it when you get the vaccine — even if you recently tested negative. That infection can continue to develop after you get the shot but before its protection fully takes hold, and then show up in a positive test result.

  • The vaccines prevent illness, but maybe not infection. Covid vaccines are being authorized based on how well they keep you from getting sick, needing hospitalization and dying. Scientists don’t know yet how effective the vaccines are at preventing the coronavirus from infecting you to begin with, or at keeping you from passing it on to others. (That’s why vaccinated people should keep wearing masks and maintaining social distance.)

  • Even the best vaccines aren’t perfect. The efficacy rates for Pfizer-BioNTech and Moderna vaccines are extremely high, but they are not 100 percent. With the virus still spreading out of control in the U.S., some of the millions of recently vaccinated people were bound to get infected in any case.

Gov. Andrew M. Cuomo of New York has said that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials.Credit…Pool photo by Mary Altaffer

The deputy commissioner for public health at the New York State Health Department resigned in late summer. Soon after, the director of its bureau of communicable disease control also stepped down. So did the medical director for epidemiology. Last month, the state epidemiologist said she, too, would be leaving.

The high-level departures came as morale plunged in the Health Department and senior health officials expressed alarm to one another over being sidelined and treated disrespectfully, according to five people with direct experience inside the department.

Their concern had an almost singular focus: Gov. Andrew M. Cuomo.

Even as the pandemic continues to rage and New York struggles to vaccinate a large and anxious population, Mr. Cuomo has all but declared war on his own public health bureaucracy. The departures have underscored the extent to which pandemic policy has been set by the governor, who with his aides designed a vaccination program hampered by early delays.

The troubled rollout came after Mr. Cuomo declined to use the longstanding vaccination plans that the State Department of Health had developed in recent years in coordination with local health departments. Mr. Cuomo instead adopted an approach that relied on large hospital systems to coordinate vaccinations.

In recent weeks, the governor has repeatedly made it clear that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials, who he said had no understanding of how to conduct a real-world, large-scale operation like vaccinations. After early problems, in which relatively few doses were being administered, the pace of vaccinations has picked up and New York is now roughly 20th in the nation in percentage of residents who have received at least one vaccine dose.

“When I say ‘experts’ in air quotes, it sounds like I’m saying I don’t really trust the experts,” Mr. Cuomo said at a news conference on Friday, referring to scientific expertise at all levels of government during the pandemic. “Because I don’t. Because I don’t.”

His comments reflected a rift between the state’s top elected official and its career health experts of the sort that has occurred across different levels of government during the pandemic.

In Albany, tensions worsened in recent months as state health officials said they often found out about major changes in pandemic policy only after Mr. Cuomo announced them at news conferences — and then asked them to match their health guidance to the announcements.

That was what happened with the vaccine plan, when state health officials were blindsided by the news that the rollout would be coordinated locally by hospitals.

At least nine senior state health officials have left the department, resigned or retired in recent months. They include Dr. Elizabeth Dufort, the medical director in the division of epidemiology; and Dr. Jill Taylor, the head of the renowned Wadsworth laboratory — which has been central to the state’s efforts to detect virus variants — and the executive in charge of health data, according to state records.

Categories
Health

Truth Verify: Hank Aaron’s Demise Was Not Associated to Covid-19 Vaccine

On January 5, Hank Aaron, the legendary homerun hitter, posted on Twitter that he had been vaccinated against the coronavirus at Morehouse School of Medicine along with other prominent Atlanta civil rights activists who were 75 years or older and were part of the group with the highest priority to be vaccinated.

“I hope you do the same!” he wrote.

Seventeen days later, Mr. Aaron died at the age of 86.

Now anti-vaccine activists including Robert F. Kennedy Jr., a well-known vaccine skeptic, are seizing his death to suggest – with no evidence – that there may be a connection.

“That was pure coincidence,” countered Dr. Louis W. Sullivan, Founding Dean of Morehouse Medical School and Secretary for Health and Human Services in the George HW Bush Administration, who was vaccinated with Mr. Aaron. He told Atlanta broadcaster WSB-TV: “However, it is if you could say that Hank was in a car before he died, and we are trying to attribute his death to being in a car.”

The Fulton County medical examiner also said there was nothing to suggest that Mr. Aaron had an allergic or anaphylactic reaction related to the vaccine.

Even so, Mr Aaron’s death has been embroiled in a vortex of misinformation and misunderstanding regarding the coronavirus and society’s efforts to fight it. Skepticism about the vaccines has emerged as one of the most recent forms of resistance health officials faced during the pandemic, as critics broke social distancing rules and were reluctant to cover their faces with masks.

Protesters forced Los Angeles authorities to close the entrance to Dodger Stadium, one of the largest vaccination sites in the country, for an hour on Saturday. About 50 demonstrators had gathered there, some holding placards saying “99.96% survival rate” and “End the lockdown”.

Health officials say the two vaccines already approved for use appear reasonably safe to date, with more than 23 million doses administered in the US. There have been some serious allergic reactions, including anaphylaxis, but they are treatable and considered rare, and no deaths have been reported. The rates at which anaphylaxis has occurred to date – five cases per million doses for the vaccine from Pfizer and BioNTech and 2.8 cases per million for the vaccine from Moderna – are in line with other widely used vaccines.

At a meeting of expert advisors from the Centers for Disease Control and Prevention on Wednesday, Dr. Tom Shimabukuro of the CDC: “Overall, the safety profiles of the Covid-19 vaccines are reassuring and in line with those seen in the pre-approval clinical trials.”

He said the federal government had “conducted the most intense and comprehensive vaccination safety surveillance program in history.”

Even so, anti-vaccine activists have tried to undermine public confidence in the vaccines by using social media to spread unsubstantiated reports of people dying or suffering from drastic side effects.

Covid19 vaccinations>

Answers to your vaccine questions

Am I eligible for the Covid vaccine in my state?

Currently more than 150 million people – almost half of the population – can be vaccinated. But each state makes the final decision on who goes first. The country’s 21 million healthcare workers and three million long-term care residents were the first to qualify. In mid-January, federal officials asked all states to open eligibility to anyone over the age of 65 and adults of any age with medical conditions that are at high risk of becoming seriously ill or dying of Covid-19. Adults in the general population are at the end of the line. If federal and state health authorities can remove bottlenecks in the distribution of vaccines, everyone over the age of 16 is eligible as early as spring or early summer. The vaccine has not been approved in children, although studies are ongoing. It can take months before a vaccine is available to anyone under the age of 16. For the latest information on vaccination guidelines in your area, see your state health website

Is the Vaccine Free?

You shouldn’t have to pay anything out of pocket to get the vaccine, despite being asked for insurance information. If you don’t have insurance, you should still get the vaccine for free. Congress passed law this spring banning insurers from applying cost-sharing such as a co-payment or deductible. It consisted of additional safeguards prohibiting pharmacies, doctors, and hospitals from charging patients, including uninsured patients. Even so, health experts fear that patients will end up in loopholes that make them prone to surprise bills. This may be the case for people who are charged a doctor’s visit fee with their vaccine, or for Americans who have certain types of health insurance that are not covered by the new regulations. If you received your vaccine from a doctor’s office or emergency clinic, talk to them about possible hidden costs. To make sure you don’t get a surprise invoice, it is best to get your vaccine at a Department of Health vaccination center or local pharmacy as soon as the shots become more widely available.

Can I choose which vaccine to get?How long does the vaccine last? Do I need another next year?

That is to be determined. It is possible that Covid-19 vaccinations will become an annual event just like the flu vaccination. Or the vaccine may last longer than a year. We’ll have to wait and see how durable the protection from the vaccines is. To determine this, researchers will track down vaccinated people to look for “breakthrough cases” – those people who get Covid-19 despite being vaccinated. This is a sign of a weakening of protection and gives researchers an indication of how long the vaccine will last. They will also monitor the levels of antibodies and T cells in the blood of people who have been vaccinated to see if and when a booster shot might be needed. It is conceivable that people might need boosters every few months, once a year, or just every few years. It’s just a matter of waiting for the data.

Does my employer need vaccinations?Where can I find out more?

Surveys have shown that public confidence in vaccines has generally strengthened over the past few months, but African American confidence is lower than that of other populations, even though the virus has permeated this community with punitive anger.

Because of this, the Morehouse School of Medicine gathered pioneering civil rights activists like Aaron and Andrew Young, former United Nations Ambassadors, to get vaccinated and lead by example.

“They marched in the elections to secure our rights,” Valerie Montgomery Rice, dean and president of the medical school, said in a statement. “And now they are rolling up their sleeves to save lives.”

Categories
Health

What Can Covid-19 Educate Us In regards to the Mysteries of Scent?

Meyer felt he knew the people personally – those who described smells in terms of tea and fruit, or meat and gasoline, or blue powerade and lollipops. The way they described their senses felt so intimate that he would later say, “You could almost see what kind of person they are.” He believed that people believed they could smell bad describe just because so often in laboratories they are asked to sniff single, isolated molecules (when the more familiar smell of coffee is a mix of many hundreds of them) away from the context of their real life and the smells that actually mattered to them . On the right occasion he said, “People get very, very verbal.”

This was exciting news for Meyer, an IBM researcher who specializes in using algorithms to analyze biological data and who insisted that the GCCR surveys contain open text boxes. For years, scientists studying odors have only worked on a few extremely flawed sets of data relating different chemicals and the way people perceive them. For example, there was a record made by a single perfumer in the late 1960s describing thousands of smells, and study after study was based on a single “Atlas of Odor Character Profiles” published in 1985. It relied on the observations of volunteers who had been asked to smell various single molecules and chemical mixtures, to rate and name them according to a list of descriptors provided, which many scientists believed to be flawed and dated.

More recently, Meyer and many others had used a new data set carefully compiled by scientists at Rockefeller University in New York and published in 2016. (I visited the lab in 2014 while Leslie Vosshall and her colleagues were compiling their data.) And was surprised to see that I could “smell” one of the vials, even though it probably only triggered my trigeminal system. When I told Vosshall that it seemed minty, she replied, “Really? Most people say ‘dirty socks’. Although the new dataset was a significant improvement, 55 people smelled 480 different molecules and rated them for intensity, comfort, familiarity, and how well they matched a list of 20 descriptions, including “garlic”, “spice”, “flower”. “Bakery,” “musk,” “urine” and so on – it was still a sign of how limited the field was.

For this reason, Meyer and his colleague Guillermo Cecchi pushed for these open text fields in the GCCR survey. They were interested in the possibilities of natural language processing, a branch of machine learning that uses algorithms to analyze patterns of human expression. Cecchi was already using the technology to predict the early onset of Alzheimer’s when it was most treatable by analyzing details of the way people speak. Many researchers had written about the possibilities of using artificial intelligence to finally create a predictive odor map and study relationships between changes in odor formation and any diseases that these changes are associated with, but adequate data was never available.

Now Covid had provided the researchers with a large, complicated data set that linked the olfactory experience and the progression of a particular disease. It wasn’t constrained by numerical rankings, monomolecules, or some adjectives on offer, but instead allowed people to speak freely about real smells in the real world in all their complex and subjective glory.

When Meyer and Cecchi’s colleague Raquel Norel had finished analyzing the open-ended responses from the English-speaking respondents, they were surprised and delighted to find that their text analysis predicted a Covid diagnosis as well as the numerical ratings of odor losses. The algorithms worked because people with Covid used very different words to talk about odor than those without Covid. Even those who had not completely lost their smell tended to describe their sensations in the same way and use words like “metallic,” “decayed,” “chemical,” “sour,” “sour,” “burned” and ” Urine ”to repeat. “It was encouraging finding to examine a proof of concept that they couldn’t wait to look further into – first in the GCCR responses in other languages, and then in the future in other datasets related to other diseases. Meyer was excited when he talked about it. “Anything where the smell changes,” he told me. “Depression, schizophrenia, Alzheimer’s, Parkinson’s, neurodegeneration, cognitive and neuropsychiatric diseases. The whole enchilada, as they say. “

I had a hard time Imagine the olfactory “map” that scientists have dreamed of for so long. I asked Mainland, would it look something like a periodic table? He suggested I think instead of the maps that scientists have made out of “color space” and arrange the colors to show their mathematical relationships and mixtures. “We didn’t know how useful color space was until people started inventing things like color TV and Photoshop,” he explained, adding that the map itself isn’t the goal, but the ability to use it to understand why we are what do we smell. What will be really interesting after that are the applications that we cannot yet imagine. “It’s hard to understand how useful the card is,” he said, “until you have the card.”

Categories
Business

How the Seek for Covid-19 Therapies Faltered Whereas Vaccines Sped Forward

Fast ein Jahr nach Beginn der Coronavirus-Pandemie, da in den USA täglich Tausende von Patienten sterben und die weit verbreitete Impfung noch Monate entfernt ist, haben Ärzte nur wenige Medikamente zur Bekämpfung des Virus.

Eine Handvoll Therapien – Remdesivir, monoklonale Antikörper und das Steroid Dexamethason – haben die Versorgung von Covid-Patienten verbessert und die Ärzte in eine bessere Position gebracht als zu dem Zeitpunkt, als das Virus im vergangenen Frühjahr anstieg. Aber diese Medikamente sind keine Allheilmittel und nicht jedermanns Sache, und die Bemühungen, andere Medikamente wiederzuverwenden oder neue zu entdecken, waren nicht sehr erfolgreich.

Die Regierung investierte 18,5 Milliarden US-Dollar in Impfstoffe, eine Strategie, die zu mindestens fünf wirksamen Produkten mit Rekordgeschwindigkeit führte. Die Investitionen in Medikamente waren jedoch weitaus geringer, etwa 8,2 Milliarden US-Dollar, von denen die meisten nur an wenige Kandidaten gingen, beispielsweise an monoklonale Antikörper. Studien zu anderen Medikamenten waren schlecht organisiert.

Das Ergebnis war, dass viele vielversprechende Medikamente, die die Krankheit frühzeitig stoppen könnten, sogenannte Virostatika, vernachlässigt wurden. Ihre Studien sind ins Stocken geraten, entweder weil die Forscher nicht genügend Mittel oder Patienten zur Teilnahme gefunden haben.

Gleichzeitig haben einige Medikamente trotz enttäuschender Ergebnisse nachhaltige Investitionen erhalten. Es gibt jetzt eine Fülle von Beweisen dafür, dass die Malariamedikamente Hydroxychloroquin und Chloroquin nicht gegen Covid wirkten. Laut dem Covid Registry of Off-Label & New Agents an der University of Pennsylvania gibt es dennoch 179 klinische Studien mit 169.370 Patienten, in denen zumindest einige die Medikamente erhalten. Und die Bundesregierung hat zig Millionen Dollar in ein erweitertes Zugangsprogramm für Rekonvaleszenzplasma gesteckt, das fast 100.000 Covid-Patienten infundierte, bevor es belastbare Beweise dafür gab, dass es funktionierte. Im Januar haben diese Studien gezeigt, dass dies zumindest bei Krankenhauspatienten nicht der Fall ist.

Das Fehlen einer zentralisierten Koordination führte dazu, dass viele Studien mit Covid-Virostatika von Anfang an zum Scheitern verurteilt waren – zu klein und schlecht konzipiert, um nützliche Daten zu liefern, so Dr. Janet Woodcock, die amtierende Kommissarin der Food and Drug Administration. Wenn die Regierung stattdessen ein organisiertes Netzwerk von Krankenhäusern eingerichtet hätte, um große Studien durchzuführen und Daten schnell auszutauschen, hätten die Forscher jetzt viel mehr Antworten.

“Ich beschuldige mich bis zu einem gewissen Grad”, sagte Dr. Woodcock, der die Bemühungen der Bundesregierung zur Entwicklung von Covid-Medikamenten überwacht hat.

Sie hofft, das Chaos mit neuen Anstrengungen der Biden-Administration zähmen zu können. In den nächsten Monaten, sagte sie, plane die Regierung, große und gut organisierte Studien für bestehende Medikamente zu starten, die zur Bekämpfung von Covid-19 umfunktioniert werden könnten. “Wir arbeiten aktiv daran”, sagte Dr. Woodcock.

Brandneue antivirale Medikamente könnten ebenfalls helfen, aber erst jetzt stellen die National Institutes of Health eine wichtige Initiative zusammen, um sie zu entwickeln, was bedeutet, dass sie nicht rechtzeitig bereit sind, die aktuelle Pandemie zu bekämpfen.

“Es ist unwahrscheinlich, dass diese Bemühungen im Jahr 2021 Therapeutika liefern”, sagte Dr. Francis Collins, der Leiter des NIH, in einer Erklärung. “Wenn ein Covid-24 oder Covid-30 kommt, wollen wir vorbereitet sein.”

Obwohl die Zahl der Fälle und Todesfälle im ganzen Land gestiegen ist, hat sich die Überlebensrate der Infizierten erheblich verbessert. Eine kürzlich durchgeführte Studie ergab, dass die Sterblichkeitsrate der Krankenhausinsassen bis Juni von 17 Prozent zu Beginn der Pandemie auf 9 Prozent gesunken war, ein Trend, der in anderen Studien bestätigt wurde. Forscher sagen, dass die Verbesserung teilweise auf das Steroid Dexamethason zurückzuführen ist, das die Überlebensraten schwerkranker Patienten erhöht, indem es das Immunsystem unterdrückt, anstatt das Virus zu blockieren. Patienten suchen möglicherweise auch früher im Verlauf der Krankheit Pflege. Und Masken und soziale Distanzierung können die Virusexposition verringern.

Als sich das neue Coronavirus Anfang 2020 als globale Bedrohung herausstellte, versuchten die Ärzte verzweifelt, eine Auswahl bestehender Medikamente zu finden. Die einzige Möglichkeit, festzustellen, ob sie tatsächlich arbeiteten, bestand darin, große klinische Studien durchzuführen, in denen einige Personen Placebos erhielten und andere das betreffende Medikament einnahmen.

Hunderte oder Tausende von Menschen in solche Prozesse zu bringen, war eine enorme logistische Herausforderung. Anfang 2020 beschränkte sich das NIH auf einige vielversprechende Medikamente. Diese Unterstützung führte zur raschen Zulassung von Remdesivir- und monoklonalen Antikörpern. Remdesivir, das die Replikation von Viren in Zellen verhindert, kann die Zeit, die Patienten zur Genesung benötigen, geringfügig verkürzen, hat jedoch keinen Einfluss auf die Mortalität. Monoklonale Antikörper, die das Eindringen des Virus in die Zellen verhindern, können sehr wirksam sein, jedoch nur, wenn sie verabreicht werden, bevor Menschen krank genug sind, um ins Krankenhaus eingeliefert zu werden.

Hunderte von Krankenhäusern und Universitäten begannen ihre eigenen Versuche mit bestehenden Medikamenten, die bereits als sicher und weit verbreitet gelten und möglicherweise auch gegen das Coronavirus wirken. Die meisten dieser Studien waren jedoch klein und unorganisiert.

In vielen Fällen waren die Forscher allein, um Studien ohne die Unterstützung der Bundesregierung oder der Pharmaunternehmen durchzuführen. Im April, als New York City von einer Covid-Welle heimgesucht wurde, hörte Charles Mobbs, Neurowissenschaftler an der Icahn School of Medicine am Mount Sinai, von interessanten Arbeiten in Frankreich, die auf die Wirksamkeit eines Antipsychotikums hinweisen.

Ärzte in französischen psychiatrischen Krankenhäusern hatten festgestellt, dass im Vergleich zu den Mitarbeitern, die sich um sie kümmerten, relativ wenige Patienten an Covid-19 erkrankten. Die Forscher spekulierten, dass die Medikamente, die die Patienten einnahmen, sie schützen könnten. In Laborexperimenten wurde gezeigt, dass eines dieser Medikamente, das Antipsychotikum Chlorpromazin, die Vermehrung des Coronavirus verhindert.

Aktualisiert

Jan. 30, 2021, 3:17 ET

Die Ärzte versuchten, einen Versuch mit Chlorpromazin zu beginnen, aber die Pandemie ließ in Frankreich – wie sich herausstellte – vorübergehend nach, als sie fertig waren. Dr. Mobbs verbrachte dann Wochen damit, Vorkehrungen für einen eigenen Versuch mit Patienten zu treffen, die am Berg Sinai im Krankenhaus waren, um dann gegen dieselbe Wand zu stoßen. “Wir haben keine Patienten mehr”, sagte er.

Wenn Ärzte wie Dr. Mobbs landesweite Netzwerke von Krankenhäusern nutzen könnten, könnten sie genügend Patienten finden, um ihre Studien schnell durchzuführen. Diese Netzwerke existieren, wurden jedoch nicht für die Wiederverwendung von Drogen geöffnet.

Viele Wissenschaftler vermuten, dass der beste Zeitpunkt zur Bekämpfung des Coronavirus früh in einer Infektion liegt, wenn sich das Virus schnell vermehrt. Es ist jedoch besonders schwierig, freiwillige Probanden zu rekrutieren, die sich nicht in einem Krankenhaus befinden. Forscher müssen Menschen direkt nach dem positiven Test ausfindig machen und einen Weg finden, ihnen die Testmedikamente zu liefern.

An der University of Kentucky begannen Forscher im Mai mit einem solchen Versuch, ein Medikament namens Camostat zu testen, das normalerweise zur Behandlung von Entzündungen der Bauchspeicheldrüse verwendet wird. Die Wissenschaftler dachten, es könnte auch als antivirales Covid-19 wirken, da es ein Protein zerstört, von dem das Virus abhängt, um menschliche Zellen zu infizieren. Da Camostat eher in Pillenform als als Infusion erhältlich ist, wäre es besonders nützlich für Menschen wie die freiwilligen Probanden, von denen viele in abgelegenen ländlichen Gebieten lebten.

Aber die Forscher haben in den letzten acht Monaten versucht, genügend Teilnehmer zu rekrutieren. Sie hatten Probleme, Patienten zu finden, die kürzlich eine Covid-Diagnose erhalten haben, insbesondere mit dem unvorhersehbaren Anstieg und Abfall der Fälle.

“Dies war die Ursache für die Verzögerungen bei im Wesentlichen allen Studien auf der ganzen Welt”, sagte Dr. James Porterfield, ein Kliniker für Infektionskrankheiten am University of Kentucky College of Medicine. Wer leitet den Prozess?

Während Ärzte wie Dr. Porterfield Schwierigkeiten hatten, selbst Studien durchzuführen, sind einige Medikamente zu Sensationen geworden, die trotz fehlender Beweise als Allheilmittel gelobt werden.

Das erste vermeintliche Allheilmittel war Hydroxychloroquin, ein Medikament gegen Malaria. Fernsehexperten behaupteten, es habe Heilkräfte, ebenso wie Präsident Trump. Anstatt eine große, gut konzipierte Studie in vielen Krankenhäusern zu starten, begannen die Ärzte einen Schwarm kleiner Studien.

“Es gab keine Koordination und keine zentralisierte Führung”, sagte Ilan Schwartz, Experte für Infektionskrankheiten an der Universität von Alberta.

Trotzdem erteilte die FDA dem Medikament eine Notfallfreigabe zur Behandlung von Personen, die mit Covid ins Krankenhaus eingeliefert wurden. Als große klinische Studien endlich Ergebnisse lieferten, stellte sich heraus, dass das Medikament keinen Nutzen brachte – und sogar Schaden anrichten könnte. Die Agentur hat ihre Genehmigung im Juni zurückgezogen.

Viele Wissenschaftler waren verbittert und betrachteten all diese Arbeiten als Verschwendung wertvoller Zeit und Ressourcen.

“Die klare, eindeutige und überzeugende Lehre aus der Hydroxychloroquin-Geschichte für die medizinische Gemeinschaft und die Öffentlichkeit ist, dass Wissenschaft und Politik sich nicht vermischen”, schrieb Dr. Michael Saag von der Universität Alabama in Birmingham im November im New England Journal of Medicine.

Jetzt wird ein anderes Medikament populär, bevor es starke Beweise dafür gibt, dass es wirkt: die parasitentötende Verbindung Ivermectin. Senator Ron Johnson, Republikaner von Wisconsin, der im April Hydroxychloroquin pries, hielt im Dezember eine Anhörung ab, bei der Dr. Pierre Kory über Ivermectin aussagte. Dr. Kory, ein Lungen- und Intensivspezialist am Aurora St. Luke’s Medical Center in Milwaukee, nannte es “effektiv ein” Wundermittel “gegen Covid-19”. Es gibt jedoch keine veröffentlichten Ergebnisse aus groß angelegten klinischen Studien, die solche Behauptungen stützen, sondern nur kleine, suggestive.

Selbst wenn die Bundesregierung ein zentrales Versuchsnetzwerk eingerichtet hätte, wie es jetzt versucht wird, wären Wissenschaftler immer noch mit unvermeidlichen Hürden konfrontiert gewesen. Es braucht Zeit, um sorgfältige Experimente durchzuführen, um vielversprechende Medikamente zu entdecken und dann zu bestätigen, dass es sich wirklich lohnt, sie weiter zu untersuchen.

“In der Arzneimittelentwicklung sind wir an Landebahnen mit einer Laufzeit von 10 bis 15 Jahren gewöhnt”, sagte Sumit K. Chanda, Virologe am Sanford Burnham Prebys Medical Discovery Institute in La Jolla, Kalifornien.

Im Februar begannen Dr. Chanda und seine Kollegen eine andere Art der Suche nach einem Covid-19-Antivirusmittel. Sie untersuchten eine Bibliothek mit 13.000 Medikamenten und mischten jedes Medikament mit Zellen und Coronaviren, um festzustellen, ob sie Infektionen gestoppt hatten.

Ein paar Medikamente erwiesen sich als vielversprechend. Die Forscher testeten eine von ihnen – eine billige Lepra-Pille namens Clofazimin – über mehrere Monate und führten Experimente an menschlichem Lungengewebe und Hamstern durch. Clofazimin bekämpfte das Virus bei den Tieren, wenn sie es kurz nach der Infektion erhielten.

Jetzt, fast ein Jahr nach Beginn seiner Forschung, hofft Dr. Chanda, dass er den schwierigsten Teil der Drogentests finanzieren kann: große und randomisierte klinische Studien, die Millionen von Dollar kosten können. Um diese Phase effizient abzuschließen, benötigen Forscher fast immer die Unterstützung eines großen Unternehmens oder der Bundesregierung oder von beidem – wie dies bei den großen klinischen Studien für die neuen Coronavirus-Impfstoffe der Fall war.

Es ist unklar, wie die neuen Drogentestbemühungen der Biden-Regierung entscheiden werden, welche Medikamentenkandidaten unterstützt werden sollen. Wenn die Versuche jedoch in den nächsten Monaten beginnen, könnten sie möglicherweise bis Ende des Jahres nützliche Daten liefern.

Pharmaunternehmen beginnen auch, einige Studien mit wiederverwendeten Arzneimitteln zu finanzieren. Eine in dieser Woche in Science veröffentlichte Studie ergab, dass ein 24 Jahre altes Krebsmedikament namens Plitidepsin 27-mal wirksamer als Remdesivir ist, um das Coronavirus in Laborexperimenten zu stoppen. Im Oktober berichtete ein spanisches Pharmaunternehmen namens PharmaMar über vielversprechende Ergebnisse einer kleinen Sicherheitsstudie mit Plitidepsin. Jetzt bereitet sich das Unternehmen darauf vor, eine Spätstudie in Spanien zu starten, um festzustellen, ob das Medikament im Vergleich zu einem Placebo wirkt.

Der Pharmakonzern Merck führt eine große Studie im Spätstadium mit einer Pille namens Molnupiravir durch, die ursprünglich von Ridgeback Biotherapeutics gegen Influenza entwickelt wurde und nachweislich Frettchen von Covid-19 heilt. Die ersten Ergebnisse der Studie könnten bereits im März vorliegen.

Experten sind besonders gespannt auf diese Daten, da Molnupiravir möglicherweise mehr als nur Covid-19 behandelt. Im April fanden Wissenschaftler heraus, dass das Medikament auch Mäuse behandeln kann, die mit anderen Coronaviren infiziert sind, die SARS und MERS verursachen.

Alle Virostatika, die im Jahr 2021 auftauchen könnten, werden nicht das Leben retten, das Covid-19 bereits verloren hat. Es ist jedoch möglich, dass eines dieser Medikamente gegen künftige Coronavirus-Pandemien wirkt.

Noah Weiland und Katie Thomas haben zur Berichterstattung beigetragen.