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Health

Pfizer Will Ship Fewer Covid-19 Vaccine Vials to Account for ‘Additional’ Doses

However, the federal health authorities that manage the government’s syringe contracts told the FDA that more than 70 percent of the sites are using more efficient syringes and that more syringes can be bought or made according to another person who is aware of the situation.

Still, Pfizer’s attempts to pressurize the FDA worried some health officials, especially since the company itself originally calculated the vials contained five doses. If an extra dose could be extracted, it would mean the vaccine supply could be stretched, protecting more Americans from the virus. On the other hand, too few specialty syringes would mean the government could pay for wasted doses.

In early January, the debate was resolved after a “standard and customary legal review process,” said an FDA spokeswoman. On January 6, in a change to the emergency approval, the FDA officially changed the vaccine datasheet to specify six doses.

“Syringes and / or needles with low dead volume can be used to extract six doses from a single vial,” says the new US bulletin. It also warned, “If standard syringes and needles are used, there may not be enough volume to extract a sixth dose from a single vial.”

In a statement, an FDA spokeswoman said the agency considered several factors in approving Pfizer’s request, including the availability of the specialty syringes, the fact that other health officials had made a similar decision, and that the change would vaccinate Americans faster.

Pfizer and the federal government have agreed to keep track of which locations receive the syringes and other equipment needed to extract the extra dose, and that the company will not bill the US for six doses per vial for locations without these devices. According to a person familiar with the negotiations who was not allowed to speak because the conversations are confidential.

Beginning next week, the number of Pfizer vaccines the federal government will allocate to each state could be based on the assumption that each vial contains six doses, according to a federal official with no legal capacity to discuss the matter. The CDC and the Department of Health and Human Services did not discuss when they could do the shift until Friday afternoon.

Categories
Politics

Right here’s What’s in Biden’s Government Orders Geared toward Covid-19

WASHINGTON – President Joseph R. Biden Jr. published a series of new presidential ordinances and guidelines on Thursday aimed at expediting the production of Covid-19 consumables, increasing testing capacity, and requiring masks to be worn during interstate travel – part of a He announced the extensive 200-page edition of the National Pandemic Strategy at an event in the White House.

Taken together, the orders signal Mr Biden’s earliest priorities to achieve a more central federal response to the spread of the coronavirus. Some of them reflect actions taken during the Trump administration, while most are trying to change course.

Here is the goal of the orders.

A mandate calls on those in charge of the authorities to look for bottlenecks in areas such as personal protective equipment and vaccine supply and to determine where the administration could apply the Defense Production Act to increase production. The White House has announced that it will use the Korean War-era law that the Trump administration used in its vaccine development program to increase production of a type of syringe that pharmacists can use to extract an extra dose from vaccine bottles.

The Biden team said they identified 12 “immediate supply shortages” critical to the pandemic response, including N95 surgical masks and isolation gowns, and swabs, reagents and pipettes used for testing.

“On the asymptomatic screening side, we are completely undercapacitive, so we need the money to really move the testing forward, which is so important for schools and businesses to reopen,” said Jeffrey D. Zients, the white’s new Covid-19 House response coordinator.

Another assignment is to set up a Pandemic Testing Board, an idea that came from President Franklin D. Roosevelt’s War Production Board, to speed up testing. The new government promises to expand the country’s range of rapid tests and double tests, and expand the laboratory space for testing and monitoring for coronavirus hotspots.

“These efforts will ensure we test where it is needed and where it is most needed, helping schools and businesses reopen safely and protect the most vulnerable, such as those living in long-term care facilities.” said Biden in his Thursday remarks.

Mr. Biden has vowed to use his powers as President to influence the wearing of masks wherever legally entitled, including on federal property and when traveling across state lines. An order issued on Thursday requires masks to be worn at airports and on many planes, intercity buses and trains.

The same ordinance also requires international travelers to demonstrate that they recently had a negative coronavirus test before traveling to the U.S. and adhere to the Centers for Disease Control and Prevention Quarantine guidelines after landing.

On a mandate, the Secretary for Health and Human Services and the White House Covid-19 Response Coordinator are being asked to re-evaluate the federal government’s Covid-19 data collection systems and report on their findings. It also calls on the heads of “all executive departments and agencies” to collect and share coronavirus-related data.

The Biden Administration

Updated

Jan. 22, 2021, 1:25 p.m. ET

The Trump administration struggled to agree on a centralized system last year, competing programs from the Department of Health and Human Services and the CDC. Alex M. Azar II, the former secretary for health and personnel services, ordered hospitals to send daily reports of virus cases to a private provider, who submitted them to a centralized database in Washington instead of the CDC, which held the data previously were stored. The decision, which remains in effect, disgruntled CDC scientists.

Another mandate is to set up a Covid-19 Task Force for “Health Justice”, which recommends providing more funds for parts of the population that are particularly hard hit by the virus and, among other things, the needs of race, ethnicity, Analyze geography and disability. Mr Biden said Thursday that the task force would address hesitation in taking the vaccines.

The panel, which is housed in the Department of Health and Human Services, is part of a larger effort by the Biden government to draw more attention to persistent racial and ethnic differences in access to health care as minorities have been hospitalized and involved in Covid-19 died much higher rates. Mr. Biden appointed Dr. Marcella Nunez-Smith, an Associate Professor of Internal Medicine, Public Health, and Management at Yale, to lead the task force.

Mr Biden issued an order to protect workers’ health during the pandemic and asked the occupational safety and health authority to publish new guidance for employers. The regulation also calls on the agency to step up enforcement of existing regulations to stop the spread of Covid-19 in the workplace.

The president also directed education, health and human services departments to issue new guidelines for safely reopening schools – a major controversy during the summer when White House and Health Department officials pressured the CDC to reduce the risk of posting Downplaying students back.

The Biden government is calling on the Secretary of Health and Human Services and the Director of the National Institutes of Health to work out a plan to support large, randomized trials of new drugs for Covid-19 and future public health crises . According to the Executive Order, the treatments should be “easy to manufacture, sell and administer, both domestically and internationally”.

The focus on randomized trials is on two emergency approvals – for convalescent plasma and the malaria drug hydroxychloroquine – that the Food and Drug Administration signed last year. Federal health officials, including FDA scientists, remain angry about the agency’s decisions under pressure from the Trump administration to clarify treatments without strong evidence from randomized trials.

Categories
World News

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

Here’s what you need to know:

Credit…Hilary Swift for The New York Times

A day after President Biden reinstated American ties with the World Health Organization, Dr. Anthony S. Fauci told the organization that the United States was committed to working closely with other nations to implement a more effective global response to the pandemic.

“Given that a considerable amount of effort will be required by all of us,” Dr. Fauci, the nation’s leading infectious disease expert, said via video link during a meeting of the group’s executive board, “the United States stands ready to work in partnership and solidarity to support the international Covid-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and well-being of all people throughout the world.”

Dr. Fauci said the United States would re-engage at all levels with the W.H.O. and intended to join Covax, a program set up by the agency to distribute vaccines to poorer nations.

His comments, which he said came exactly one year after the United States recorded its first Covid-19 case, underscored the alacrity with which the new administration is reversing both the substance and tone of the Trump administration’s approach.

“This is a good day for the W.H.O. and a good day for global health,” the agency’s leader, Dr. Tedros Adhanom Ghebreyesus, said, thanking President Biden for honoring his pledge to resume W.H.O. membership and Dr. Fauci for his personal support to the body over many years as well as his leadership in America’s response to the pandemic.

On Thursday, Mr. Biden put forward national strategy that includes aggressive use of executive authority to protect workers, advance racial equity and ramp up the manufacturing of test kits, vaccines and supplies. The “National Strategy for the Covid-19 Response and Pandemic Preparedness” outlines the kind of muscular and highly coordinated federal response that Democrats have long demanded and that President Donald Trump rejected.

Since virtually the moment Mr. Biden was sworn into office, he announced a series of actions to try to blunt the pandemic, including restoring the National Security Council’s Directorate for Global Health Security and Biodefense, a group disbanded under Mr. Trump in 2018.

He is requiring social distancing and the wearing of masks by federal employees, contractors and others on federal property, and is starting a “100 days masking challenge” urging all Americans to wear masks and state and local officials to implement public measures to prevent the spread of the coronavirus.

His moves come in stark contrast to the response of President Trump, who announced the United States would pull out of the W.H.O. in May last year, accusing the organization of kowtowing to China. Mr. Trump had sought to blame China for not doing enough to stop the spread of the disease, and he accused Beijing of hiding the true scope of infections from the W.H.O., targeting the agency in the process.

A panel established by the organization said in a damning report that there was much blame to go around. It criticized the slow response of governments and public health organizations. Investigators, who are still working on their final report, said they could not understand why a W.H.O. committee waited until Jan. 30 to declare an international health emergency. (The Chinese government had lobbied other governments against declaring such an emergency.) The investigators also said that despite years of warnings that a pandemic as inevitable, the agency was slow to make changes.

On Thursday, addressing “my dear friend” Dr. Tedros, Dr. Fauci thanked the W.H.O. for its leadership of the global response to the pandemic. “Under trying circumstances,” he said, “this organization has rallied the scientific and research and development community to accelerate vaccines, therapies and diagnostics; conducted regular, streamed press briefings that authoritatively track global developments; provided millions of vital supplies from lab reagents to protective gear to health care workers in dozens of countries; and relentlessly worked with nations in their fight against Covid-19.”

The United States, he said, would fulfill its financial obligations to the W.H.O., halt the previous administration’s moves to draw down American staff seconded to it and saw technical collaboration at all levels as a fundamental part of its relationship with the agency.

Dr. Fauci also set out broader aims for increasing global pandemic preparedness, including developing an improved early warning and rapid response mechanism for dealing with biological threats, and strengthening pandemic supply chains.

“We will work with partners around the world to build a system that leaves us better prepared for this pandemic and for the next one,” he said.

Sheryl Gay Stolberg contributed reporting.

United States › United StatesOn Jan. 20 14-day change
New cases 184,754 –16%
New deaths 4,367 +14%
World › WorldOn Jan. 20 14-day change
New cases 693,073 –1%
New deaths 17,614 +23%

Where cases per capita are
highest

Credit…Miles Fortune for The New York Times

One year ago today, health officials told Americans about a traveler who had just come home from Wuhan, China, sought treatment at an urgent-care clinic north of Seattle after falling ill — and set off alarm bells.

The man had the first confirmed coronavirus case in the United States.

In announcing the news, the officials struck a tone at once reassuring and worrisome. They said they believed the risk to the public was low. But they also cautioned that more cases were likely to come.

And come they did: The nation has now recorded more than 24 million cases and 400,000 deaths.

It began slowly.

In the first five weeks, American officials reported about 45 known cases and no known deaths from the virus.

But in the past five weeks, the country recorded over 7.4 million cases and close to 100,000 deaths. On Wednesday alone, officials recorded at least 184,237 new cases and at least 4,357 deaths. In terms of deaths, it was the second-worst day of the pandemic.

It was also a day on which a new president took office after ousting an incumbent widely derided for his handling of the pandemic — and vowed to do better.

The first known case, of the traveler from Wuhan, took place in Snohomish County, Wash., and it led to an extensive effort to isolate the patient and monitor the contacts he had encountered since returning from China.

Other travelers also ended up testing positive, and genomic sequencing showed that a different branch of the virus took root independently on the East Coast of the United States.

Although the Seattle area became the epicenter of an early outbreak at the end of February, researchers are not sure if the man who returned to the Seattle area set it off.

Genomic sequencing suggested that the man, who is now 36, was part of a virus branch that spread across the region. But researchers looking at timing and genetic variations across the region believe the outbreak may have begun with another, unknown person.

Washington’s early outbreak led the state to record 37 of the nation’s first 50 coronavirus deaths. But the state has since fared far better than the nation as a whole. If the United States had maintained a death rate comparable to Washington’s, there would be some 220,000 fewer coronavirus deaths.

A vaccination in Atlanta.Credit…Nicole Craine for The New York Times

That Covid-19 vaccine appointment may not just be hard to get — it may not even be all that secure.

Thousands of people across the country learned that their appointments had been abruptly canceled in the last few days, after vaccine shipments to local health departments and other distributors fell short of what was expected.

The health department in Erie County, N.Y., which includes Buffalo, canceled seven days of appointments this week, affecting 8,010 people, saying the state had sent far fewer doses than the county ordered. All future appointments should be considered “tentative, and are subject to vaccine availability,” the department said in a statement on Wednesday.

“We made appointments based on our hope and expectation that we would be able to fill those,” said Kara Kane, a department spokeswoman. “There’s a lot of confusion, a lot of questions, a lot of concern.”

Dianne Bennett, 78, lost a first-dose appointment at the Erie County Medical Center because of the cancellations, as did her husband. They were told to try again later, but Ms. Bennett said they had no idea when another appointment would be available.

“It’s such a lottery,” she said. “I just think it’s outrageous.”

Similar issues have cropped up across the country, as demand far outpaces supply and vaccine providers struggle to predict how many doses will arrive.

At Beaufort Memorial Hospital in South Carolina, hospital officials canceled 6,000 scheduled appointments through March 30 after they were notified that thousands of vaccine doses they expected were not coming.

San Francisco’s public health department expects to run out of vaccine on Thursday, The Los Angeles Times reported, because the city’s allocation dropped sharply from a week ago and the state did not replace doses that had to be discarded.

Local health officials throughout California say they have trouble scheduling appointments because they are unsure how much vaccine they will receive from week to week, the paper said.

In New York City, 23,000 vaccination appointments scheduled for Thursday and Friday were postponed because of a shipping delay, Mayor Bill de Blasio said on Wednesday, a day after warning that the city’s supply would soon be exhausted.

“We already were feeling the stress of a shortage of vaccine,” the mayor said at a news conference. “Now the situation has been made even worse.”

Recent moves to open up eligibility have aggravated the situation.

After the state of Georgia announced that anyone 65 or older could get the vaccine, the 10-county Northwest Health District was swamped with more than 10,000 appointment requests in one weekend — far more than it could satisfy with the supply it had on hand. So it shut down its scheduling website, and told people to call their local health department to arrange an appointment instead, frustrating many people who thought they had already secured a slot.

“We’re having to schedule appointments at least a week out, based on anticipated delivery, but we don’t know what will show up on a daily basis,” said Logan Boss, the spokesman for the health district. “It’s difficult to explain that to the public.”

Global Roundup

A police cordon on a street near Renji Hospital following a suspected Covid-19 infection in Shanghai, China, on Thursday.Credit…China Daily, via Reuters

Three locally transmitted coronavirus cases were confirmed on Thursday in Shanghai, China’s largest city, as fears rose over another large-scale outbreak in the country where the virus was first detected.

The three cases, the first in the city in about two months, were connected to prominent hospitals in the city, China’s business capital. Two of the infected individuals worked at the hospitals, one at Fudan University Shanghai Cancer Center and the other at Renji Hospital. They lived in the same residential complex. The third person was a close contact.

The infections were found during routine nucleic tests for hospital employees. The positive results led to closures at the outpatient sections of both hospitals and a citywide campaign to test all hospital employees.

Shanghai is the latest Chinese city to experience a recent outbreak, the worst since the pandemic first emerged in late 2019.

Beijing, the capital, and the provinces of Hebei, Heilongjiang, Jilin, Shanxi and Shandong have all recently reported new infections. This week alone, China reported more than 400 local infections, a steep and sudden increase.

Beijing has implemented new rules restricting the number of passengers allowed on public transportation, and extended the quarantine period for travelers returning from overseas.

Schools have been closed and the authorities on Wednesday announced that travelers returning to rural areas for the Chinese New Year holiday, the largest annual human migration in the world, must test negative for the virus and quarantine at home for 14 days.

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

The authorities said on Wednesday that two cases recently found in Beijing were of the more contagious B.1.1.7 variant, first found in Britain.

Here are other developments from around the world:

  • Five people were killed in a fire on Thursday that roared through an unfinished plant at the Serum Institute of India, which is producing millions of doses of the AstraZeneca and Oxford University coronavirus vaccine. Adar Poonawalla, the chief executive of Serum, the world’s largest vaccine manufacturer, said in a tweet that the destruction would not disrupt production of the vaccine, labeled Covishield in India. Covishield and a locally developed vaccine were rolled out as part of India’s massive inoculation drive this week, and Serum has promised 200 million doses to Covax, an international health group that has negotiated vaccine purchases for less wealthy countries, as soon as the end of January.

  • A senior member of South Africa’s government, Jackson Mthembu, died on Thursday from complications related to Covid-19, the office of President Cyril Ramaphosa said. Mr. Mthembu, 62, was a minister in the office of the presidency and a prominent figure in the governing African National Congress, who led media briefings on the government’s Covid-19 response. “Minister Mthembu was an exemplary leader, an activist and lifelong champion of freedom and democracy,” Mr. Ramaphosa said in a statement. It was unclear whether Mr. Ramaphosa had come into recent contact with Mr. Mthembu, who said he had tested positive on Jan. 11. But a spokesman for Mr. Ramaphosa, Tyrone Seale, said that the president was not in quarantine and that much of the government’s work had been carried out remotely.

  • Glastonbury Festival, Britain’s largest music event, has been canceled for a second year because of the Covid-19 pandemic, the organizers said on Thursday. The summer music festival has in recent years seen headline performances from Adele, The Killers and Kanye West, and usually attracts around 200,000 attendees. With Britain now under its third lockdown, Glastonbury’s organizers Michael and Emily Eavis said in a statement that it had “become clear that we will simply not be able to make the festival happen this year.” Those who paid deposits for tickets last year would now have spaces reserved in 2022, they said, when “we are very confident that we can deliver something really special.”

President Biden signed several executive orders on Wednesday, including a mask mandate.Credit…Doug Mills/The New York Times

President Biden planned to use Thursday, his first full day in office, to go on the offensive against the coronavirus, with a national strategy that includes aggressive use of executive authority to protect workers, advance racial equity and ramp up the manufacturing of test kits, vaccines and supplies.

The “National Strategy for the Covid-19 Response and Pandemic Preparedness,” previewed Wednesday evening by Mr. Biden’s advisers, outlines the kind of muscular and highly coordinated federal response that Democrats have long demanded and that President Donald J. Trump rejected. Mr. Trump insisted that state governments take the lead.

Mr. Biden intends to make expansive use of his authority to sign a dozen executive orders or actions related to Covid-19 — including one requiring mask-wearing “in airports, on certain modes of public transportation, including many trains, airplanes, maritime vessels, and intercity buses,” according to a fact sheet issued by his administration.

With its nominees for top health positions not yet confirmed by Congress, the Biden team has asked Mr. Trump’s surgeon general, Dr. Jerome Adams, to stay on as an adviser and to help with the transition. But Mr. Biden’s advisers were not shy about taking aim at the former president, whose vaccine rollout has been the object of intense criticism.

Biden advisers said they were stunned by the vaccination plan — or the lack of one — that it inherited from the Trump administration, and said the Trump team failed to share crucial information about supplies and vaccine availability.

“What we’re inheriting is so much worse than we could have imagined,” said Jeff Zients, the new White House Covid-19 response coordinator, adding, “The cooperation or lack of cooperation from the Trump administration has been an impediment. We don’t have the visibility that we would hope to have into supply and allocations.”

The Biden team said it had identified 12 “immediate supply shortfalls” that were critical to the pandemic response, including N95 surgical masks and isolation gowns, as well as swabs, reagents and pipettes used in testing — deficiencies that have dogged the nation for nearly a year. Jen Psaki, the new White House press secretary, told reporters on Wednesday evening that Mr. Biden “absolutely remains committed” to invoking the Defense Production Act, a Korean War-era law, to bolster supplies.

Local officials have expressed hope that the Biden administration would step up vaccine production enough to make second doses available for an expanded pool of eligible people.

Production of the Moderna and Pfizer vaccines authorized in the U.S. are running flat, and it is not clear whether the administration could significantly expand the overall supply any time soon.

Though Mr. Biden has indicated his administration would release more doses as they became available and keep fewer in reserve, he said on Friday that he would not change the recommended timing for second doses: 21 days after the first dose for Pfizer’s vaccine, and 28 days for Moderna’s.

“We believe it’s critical that everyone should get two doses within the F.D.A.-recommended time frame,” Mr. Biden said while discussing his vaccine distribution plans.

Passengers wearing protective face masks in Berlin. Requirements on public transportation tightened this week.Credit…Stefanie Loos/Agence France-Presse — Getty Images

As European countries brace for a potential surge of coronavirus cases linked to the new variants, countries have reimposed strict lockdown measures, and some have made “medical” grade masks mandatory in some areas.

Starting this week in Germany, N95 or surgical-grade masks are compulsory for people on public transportation, in office spaces and in shops. Such masks are also set to become mandatory in public transport and in shops in Austria next week, and France could soon follow. The French authorities are considering whether they should implement a recommendation from the country’s health advisory council that people drop homemade masks, and wear surgical or highly protective fabric masks instead.

Chancellor Angela Merkel said concerns about the new variants had driven the decision on masks.

“We have to slow the spread of this variant. That means we cannot wait until the danger is palpable,” the chancellor told reporters on Thursday, in explaining the decision to further tighten restrictions. “There is still some time to ward off the danger posed by this virus. All of the measures that we have agreed to are preventive.”

Effectively, the German authorities are trying to buy time by slowing the spread of the new variant long enough for the weather to warm and for the number of people vaccinated to increase, Ms. Merkel said. Her government has been criticized for weeks for failing to acquire enough doses of the vaccine to inoculate everyone who wants one.

The chancellor pushed back against the charge on Thursday, saying that everyone in Germany would have the opportunity to be vaccinated “by the end of the summer,” or Sept. 21. “But I cannot guarantee how many people will get themselves vaccinated,” she added.

The more contagious variant discovered in Britain has been found in 60 countries, according to the World Health Organization, but how it spreads, and whether it has already contributed to countries’ surges, remains unclear. Other variants have been detected in South Africa and in Brazil, and while none is known to be more deadly or to cause more severe disease, the authorities in some European countries have scrambled to impose measures like new mask rules or tightened lockdowns to limit their spread.

In Germany, people now have to wear N95, FFP2 or FFP3 masks, or generic surgical ones — the disposable masks that are usually blue — in some public spaces. Cloth masks and other face coverings such, like face shields, are not considered sufficient and are no longer accepted in highly trafficked areas, including stores and public transportation.

The new rules imposed in Germany are tougher than guidelines from the World Health Organization, which recommends medical masks only for health care workers, people with Covid-19 symptoms and those over 60 years old or who have underlying conditions. Wearing what it calls a nonmedical mask both indoors and outdoors is enough for the general public, according to the organization.

There is widespread evidence that masks limit the risk of infection, but not all masks provide the same level of protection. A study that compared transmission rates in 16 countries and was published in The Lancet in June found that while face masks contributed to a large reduction in risk of infection, the risks were even lower when people wore a N95 mask or a similar model compared with disposable surgical masks.

N95 masks are more expensive, raising concerns that the new rules will be discriminatory for low-income families. The Austrian government has promised free masks for people on low incomes and those over 65, and Germany is making masks available to those who are vulnerable, or 60 and older.

In France, the recommendations from the country’s health advisory council are not compulsory, but the authorities could decide to make them so. At the beginning of the pandemic, French officials stumbled over recommendations on masks, and the country later faced a widespread shortage that threatened the safety of health care workers and pushed people to make their own masks. Wearing a mask in public spaces, whether indoors or outdoors, has been compulsory for months.

Neither Germany nor Britain, which in recent weeks has faced a resurgence of cases and its highest numbers of daily deaths since the beginning of the pandemic, require people to wear masks outdoors.

A Covid-19 patient receiving treatment on Wednesday at a hospital in Milton Keynes, England. Deaths in Britain are at their highest levels of the pandemic.Credit…Toby Melville/Reuters

When Britain’s tally of deaths from Covid-19 passed 1,000 last March, a senior health official said that it would be “a good result” to keep the eventual total below 20,000.

After two consecutive days of record death reports, the figure now stands at 93,290, the highest in Europe and the fifth highest worldwide. Speaking to reporters on Wednesday, when 1,820 deaths were reported, Prime Minister Boris Johnson described recent numbers as “appalling.”

Mr. Johnson also warned of “more to come,” as a wave of cases that began late last year, many of them from the more transmissible coronavirus variant, continues to push Britain to new extremes.

Britain has relied on national lockdown measures, implemented in early January after Mr. Johnson was forced to roll back plans for a Christmas easing of restrictions, to reduce the pressure on its National Health Service. It’s also seeking to vaccinate widely and rapidly, concentrating on first doses in a program that has so far reached 4.6 million people, about 7 percent of the population.

Though case figures have shown declines in recent days, the latest interim results from one of the country’s largest studies into coronavirus infections, released on Thursday, brought less encouraging news. Scientists said infections in England had “plateaued” at the highest levels their study had recorded so far.

“We’re not seeing the decline that we really need to see given the pressure on the N.H.S. from the current very high levels of the virus in the population,” Prof. Paul Elliott of Imperial College London, who leads the research program, told the BBC.

Looking at infections in England from Jan. 6 to 15, the report warned of a “worrying” potential uptick in cases, though it cautioned that the results do not yet reflect the impact of the latest lockdown.

“If prevalence continues at the high rate we are seeing then hospitals will continue to be put under immense pressure, and more and more lives will be lost,” Professor Elliott said in a summary of the report.

Laura Lima watching the inauguration at Martin Luther King, Jr. Community Hospital in South Los Angeles.Credit…Isadora Kosofsky for The New York Times

There is no shortage of screens in the intensive-care units treating Covid-19 patients, but at one I.C.U. in Los Angeles on Wednesday, some of the screens showed not blood pressure and oxygen levels but images of the 46th president of the United States being sworn in.

“I just wanted to see and listen,” said Laura Lima, a nurse watching the inauguration on an iPhone propped on her work station. “It’s important stuff.”

Ms. Lima works at Martin Luther King, Jr. Community Hospital in South Los Angeles, and as she watched President Biden address the nation, a monitor beeped. She put on an isolation gown and gloves and entered the room of one of her patients, a man in his early 60s on a ventilator whose intravenous line needed to be adjusted.

Ms. Lima took note of the new president’s statements about hastening the rollout of vaccines.

“I think this community should be prioritized,” she said.

The neighborhood around the hospital, filled with low-income workers who often have poor access to health care, has been one of the hardest hit in Southern California’s surge.

Mario Torres Hernandez, a 63-year-old being treated with oxygen for Covid-19, had his television tuned to Telemundo during Mr. Biden’s visit to Arlington cemetery. “I hope he does more for us,” he said.

But it was another busy day at the I.C.U., and so the vast majority of its staff members were not watching the proceedings in Washington. One respiratory therapist said he had forgotten the inauguration was happening.

Some did think it was a day of hope.

“I’m so tired of zipping black body bags,” another nurse, Amanda Hamilton, said as the ceremony continued. “It’s exciting we have a president who actually cares and might do something about it.”

Health workers tending to a Covid-19 patient in Port Elizabeth, South Africa, in November.Credit…Samantha Reinders for The New York Times

Confirmed coronavirus cases from new variants found first in Britain, then in South Africa, Brazil and the United States have people worried about whether vaccines can protect against altered versions of the virus. Experts said in interviews that so far vaccines are capable of providing that protection.

But two small new studies, posted online Tuesday night, suggest that some variants may pose unexpected challenges to the immune system, even in those who have been vaccinated — a development that most scientists had not anticipated seeing for months, even years.

The findings result from laboratory experiments with blood samples from groups of patients, not observations of the virus spreading in the real world. The studies have not yet been peer-reviewed.

But experts who reviewed the papers agreed that the findings raised two possibilities. People who had survived mild cases may still be vulnerable to infection from a new variant; and the vaccines may be less effective against the variants.

Existing vaccines will still prevent serious illness, and people should continue getting them, said Dr. Michel C. Nussenzweig, an immunologist at Rockefeller University in New York, who led one of the studies: “If your goal is to keep people out of the hospital, then this is going to work just fine.”

But the vaccines may not prevent people from becoming mild or asymptomatic infections with the variants, he said. “They may not even know that they were infected,” Dr. Nussenzweig added. If the infected can still transmit the virus to others who are not immunized, it will continue to claim lives.

The studies published Tuesday night show that the variant identified in South Africa is less susceptible to antibodies created by natural infection and by vaccines made by Pfizer-BioNTech and Moderna.

Neither the South African variant nor a similar mutant virus in Brazil has yet been detected in the United States. The more contagious variant that has blazed through Britain does not contain these mutations and seems to be susceptible to vaccines.

Workers preparing for the reopening of Bandaranaike International Airport in Colombo, Sri Lanka, on Wednesday.Credit…Chamila Karunarathne/EPA, via Shutterstock

Sri Lanka reopened its airports to foreign arrivals on Thursday for the first time in 10 months amid a surge in new coronavirus cases, including that of a minister photographed drinking a shaman’s tonic that some in the island nation believe protects against the disease.

Thousands of people defied Covid-19 restrictions in central Sri Lanka for a shot of the tonic touted by the holy man Dhammika Bandara as lifelong protection against the virus.

Mr. Bandara said the recipe for the tonic, which includes honey and nutmeg, came to him in a trance from the Hindu goddess Kali. TV networks that support the government of President Gotabaya Rajapaksa have given Mr. Bandara airtime to promote the tonic.

Sri Lanka’s health ministry is conducting clinical trials into its potential benefits, according to Chatura Kumaratunga, the commissioner of Ayurveda, an ancient form of alternative medicine rooted in the Indian subcontinent.

In the meantime several lawmakers have become ill even after drinking the tonic. “The minister who had the tonic had only one dose,” Mr. Bandara told The New York Times, adding that it had to be taken twice a day for two days to work.

Coronavirus cases in Sri Lanka have surged from about 3,300 in October to more than 55,000. At least one case of the more contagious variant of the virus first found in Britain has been reported.

Dr. Haritha Aluthge of the Government Medical Officers’ Association said the surge was partly a result of the throngs who visited the central district of Kegalle for Mr. Bandara’s tonic.

“There were no local cases in Kegalle before this incident,” he said.

But general complacency and greater movement across the island were also driving up numbers, he said.

After a trial run with a group of about 1,500 Ukrainian tourists last month, Sri Lanka decided to welcome back all foreign tourists, hoping for a much-needed boost to its tourism-dependent economy. Tourists, however, have to show negative PCR tests, are limited to 55 hotels across the country and must be accompanied by government officials for the first two weeks of their trips.

Teresa Bautista, a student at the High School for Environmental Studies in Manhattan, collecting goose dropping samples at Van Cortlandt Park in the Bronx.Credit…Christine Marizzi/BioBus

Over the next few months, New York area high school students will gather samples from the city’s birds as a part of the Virus Hunters program, hosted by the nonprofit science outreach organization BioBus. Their goal is to catalog the flu viruses that often lurk in urban fowl, some of which might have the potential to someday hop into humans.

The surveillance program, which was developed in partnership with virologists at the Icahn School of Medicine at Mount Sinai, is one of several outreach efforts that have emerged in recent years to equip young scientists with hands-on experience in outbreak preparedness — a quest that has only gained urgency since the new coronavirus started its tear across the globe.

For many months to come, Covid-19 will continue to shutter schools and thwart efforts to gather. The changes have forced educators and researchers to change their teaching tactics. But several groups have met the challenge head on, not merely weathering the pandemic’s inconveniences but transforming them into opportunities for scientific growth.

Flu viruses are fairly cosmopolitan pathogens that are capable of jumping into a wide range of animals, including birds, and changing their genetic material along the way. Only some of these viruses pose a possible threat to people, experts said. But which ones? Researchers won’t know unless they check.

Doses of the Moderna vaccine, which must be kept cold, had to be discarded in Ohio after SpecialtyRX found that it had not properly monitored or recorded storage temperatures.Credit…Jae C. Hong/Associated Press

A pharmacy services company responsible for vaccinating residents at eight Ohio nursing homes allowed 890 doses of the Moderna vaccine — more than half its supply — to become spoiled by failing to make sure they were kept cold enough, state officials said.

The episode is being investigated by Ohio’s state Board of Pharmacy, and the state Department of Health has cut the company off from any more allocations of vaccine.

Before the new year, the company, SpecialtyRx, was given 1,500 doses to vaccinate residents at the eight facilities. After administering a first round of shots, the company found that it had not properly monitored or recorded the temperatures in its refrigerators and freezers where the remaining doses were stored.

State investigators determined that the 890 stored doses were no longer viable, the Department of Health said in a statement. The nursing home residents are still awaiting their second shots, and the facilities will have to arrange with another provider to obtain them.

The Moderna vaccine can be stored for up to 30 days if it is kept between 36 and 46 degrees Fahrenheit. Officials with SpecialtyRx could not be immediately reached for comment.

Like many other states, Ohio has gotten off to a slow start with its vaccination program. About 456,100 Ohioans — less than 4 percent of the population — had received first doses as of Wednesday, according to The Cincinnati Enquirer.

Gov. Mike DeWine said at a news conference on Tuesday that most of the state’s frontline health care workers and nursing-home residents had received a dose. “We are trying to juggle a lot of things and do a lot of things with not enough vaccines,” Mr. DeWine said.

The state plans to open up eligibility next week to all residents 75 years and older, as well as to younger people with certain severe illnesses and disorders.

The number of new cases reported in Ohio has been declining over the past week, but death reports have remained high after jumping upward after Christmas.

Credit…via Sakal family

Patty Sakal, an American Sign Language interpreter who translated updates about the coronavirus for deaf Hawaiians, died on Friday of complications related to Covid-19. She was 62.

Ms. Sakal, who lived in Honolulu, died at Alvarado Hospital Medical Center in San Diego, where she had gone last month to visit one of her daughters, according to Ms. Sakal’s sister, Lorna Mouton Riff.

Ms. Sakal, who worked as an A.S.L. interpreter for nearly four decades in a variety of settings, had become a mainstay in coronavirus news briefings in Hawaii, working with both the former mayor of Honolulu, Kirk Caldwell, and the state’s governor, David Y. Ige, to interpret news for the deaf community.

In a statement, Isle Interpret, an organization of interpreters to which Ms. Sakal belonged, called Ms. Sakal “Hawaii interpreter ‘royalty.’”

This was in part because Ms. Sakal understood Hawaiian Sign Language, a version of American Sign Language developed by deaf elders to which she had been exposed while growing up.

“She was highly utilized and highly desired by the deaf in the community because they could understand her so well and she could understand them,” said Tamar Lani, the president of Isle Interpret.

In an interview with Hawaii News Now, Mr. Caldwell, whose second term as mayor of Honolulu ended this month, praised Ms. Sakal for “truly putting herself on the frontline.”

“Here it was, a pandemic and it was not safe to go, yet she went out and she helped do a job that was critical to people who needed this information,” Mr. Caldwell told Hawaii News Now. Neither he nor Mr. Ige could immediately be reached for comment on Wednesday.

Categories
World News

US Surpasses 400,000 Deaths: Stay Covid-19 Updates

Here’s what you need to know:

Credit…Victor J. Blue for The New York Times

More than 400,000 people in the United States who had the coronavirus have died, according to data compiled by The New York Times on Tuesday, as the anniversary of the country’s first known death in the pandemic approaches.

The pace at which Americans have been dying accelerated through the fall and into the winter, exploding to record levels in January. During some weeks this month, the average deaths per day exceeded 3,300, more than the number of people killed in the Sept. 11 terrorist attacks. Tuesday’s harrowing milestone came a day after the United States surpassed 24 million total cases.

The single deadliest day of the pandemic so far was Jan. 12, when more than 4,400 deaths were reported. Unlike in the early days of the outbreak in the United States, which was centered in a handful of big, mostly Northeastern cities, this surge is widespread. As of Monday, Arizona, California, South Carolina, New York and Oklahoma had reported the most new cases per capita over the previous week. Much of the latest surge has been attributed to people gathering over the holidays, from Thanksgiving to New Year’s Eve.

The length of time it has taken to log each 100,000 deaths has decreased dramatically since the country’s first known Covid-19 death, which occurred in Santa Clara County, Calif., on Feb. 6, 2020. The first 100,000 U.S. deaths were confirmed by May 27; it then took four months for the nation to log another 100,000 deaths; the next, about three months; the latest, just five weeks.

Public health experts do not expect mortality rates to peak until the end of the month. By the end of February, the death toll might hit 500,000, a number that would have seemed unthinkable a year ago. Dr. Anthony S. Fauci, the country’s top infectious disease expert, estimated last March that up to 240,000 Americans might lose their lives, an enormous figure that still fell far short of reality.

The United States has had more total virus-related deaths than any other country in the world. In total, New York alone has recorded more than 40,000 known

deaths. In all, more than two million people have died with the virus worldwide, a number that is almost certainly an undercount.

The blame for the enormous loss of American life, many experts say, lies in a failure of leadership by President Trump, whose administration politicized the use of masks and left states to implement a patchwork of inconsistent measures that did not bring the virus under control.

“It wasn’t that he was just inept,” said Jeffrey Shaman, a Columbia University professor of environmental health sciences who has modeled the virus’s spread. “He made something that could have very easily turned into a point of patriotism, pride and national unity — protecting your neighbors, protecting your loved ones, protecting your community — into a divisive issue, as is his wont, and it cost people’s lives.”

By comparison, Vietnam, a nation of 97 million people, has confirmed just 35 virus-related deaths, Dr. Shaman added.

President-elect Joseph R. Biden Jr., who is set to be inaugurated on Wednesday, has called for an aggressive national strategy to beat the virus, including ramping up the availability of Covid-19 vaccines, though he has not committed to a federal mask mandate.

“You have my word that we will manage the hell out of this operation,” Mr. Biden said on Friday, noting the disproportionate deadly outcomes of the virus for Black, Latino and Indigenous Americans. “Our administration will lead with science and scientists.”

With the virus rampaging everywhere for so many months, hospitals have been stretched. In rural areas, doctors have at times been unable to transfer gravely ill patients to larger medical centers for more sophisticated treatment.

As of Monday, the seven-day average of cases across the United States was 200,000 a day, though it has started to decline from recent weeks. Hospitalizations also have finally begun to level off and on Sunday reached their lowest level since Jan. 2. In the Midwest, hit by its worst surge in the fall, case numbers have fallen sharply in recent weeks, but that progress seems to be slowing.

However, new variants of the virus, some of which make it more transmissible, could soon spread throughout and threaten to make infections rise again.

“There’s no clear end in sight anytime in the near future,” said Ira M. Longini Jr., a biostatistics professor at the University of Florida.

The variants have made it even more urgent to administer the coronavirus vaccines developed at record speed that brought so much hope to people when they started to become available last month.

But at the slow rate that shots are being administered — about 10.6 million people had received at least the first dose as of Friday — Dr. Shaman warned, it could take more months than expected to reach enough of a critical mass of vaccinated people for the inoculations to make a dent in the pandemic.

United States › United StatesOn Jan. 18 14-day change
New cases 142,587 –7%
New deaths 1,441 +21%
World › WorldOn Jan. 18 14-day change
New cases 521,538 +5%
New deaths 9,940 +21%

Where cases per capita are
highest

Students waited outside Sleepy Hollow Middle and High School before they took the SAT in Sleepy Hollow, N.Y., in September.Credit…Hilary Swift for The New York Times

The College Board, which administers the SAT college entrance examination and has seen its business battered by the coronavirus pandemic, said Tuesday that it will drop the optional essay section from the SAT and stop administering subject-matter tests in the United States.

“The pandemic accelerated a process already underway at the College Board to simplify our work and reduce demands on students,” the organization said in a statement, adding that it would also continue to develop a version of the SAT test that could be administered digitally — something it tried and failed to do quickly with an at-home version last year after the pandemic shut down testing centers.

The board gave no time frame for when a digital version of the SAT, which would be administered at testing centers by live proctors, might be introduced, but said it would provide more information in April.

The changes to the SAT come as more and more colleges are dropping the requirement that students take the test, as well as its competitor the ACT, a trend driven in part by concerns about equity that received a boost during the pandemic.

Critics of the College Board said the decision was almost certainly driven by financial considerations. The SAT has in the past represented a substantial portion of the College Board’s more than $1 billion in annual revenue.

“The SAT and the subject exams are dying products on their last breaths, and I’m sure the costs of administering them are substantial,” Jon Boeckenstedt, the vice provost of enrollment management at Oregon State University, said in an email.

At the same, he said, the College Board was likely to try to use the elimination of the subject tests to try to convince elite high schools to offer more Advanced Placement courses, whose tests the College Board also administers, as a way to burnish their students’ transcripts. But because A.P. tests have to be taken at the end of a student’s junior year or earlier for their scores to be considered in admissions decisions, more focus on A.P. scores in the admissions process would likely only increase pressure on students.

“Overall, it’s good for College Board, and probably not so good for students,” Mr. Boeckenstedt said. “In other words, par for the course.”

Indeed, in its announcement, the board said that A.P. courses provided students “rich and varied opportunities to showcase their knowledge and skills” and that the “expanded reach of A.P. and its widespread availability for low-income students and students of color” made the subject tests no longer necessary.

David Coleman, the chief executive officer of the College Board, said the organization’s goal was not to get more students to take A.P. courses and tests, but to eliminate redundant exams, thereby reducing the burden on high school students applying to college.

“Anything that can reduce unnecessary anxiety and get out of the way is of huge value to us,” he said.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, receiving his first dose of the coronavirus vaccine at the National Institutes of Health, in Bethesda, M.D., last month.Credit…Pool photo by Patrick Semansky

Dr. Anthony S. Fauci, the government’s top infectious disease expert, received his second dose of Moderna’s coronavirus vaccine on Tuesday morning at the National Institutes of Health’s vaccination center, a Department of Health and Human Services spokeswoman confirmed, drawing him closer to full protection against Covid-19.

Joining Dr. Fauci were Alex M. Azar II, the health and human services secretary, and Dr. Francis Collins, the N.I.H. director, who also received their second shots. Scientists are still working to determine how long protection from Moderna’s second dose — which follows the first after 28 days — will last. In a recent study, the company found that volunteers were still making high levels of antibodies three months after the second dose. But it is unknown what levels are needed to maintain immunity.

Dr. Fauci’s second dose came at a time when the country is struggling — with a limited supply — to get every available dose of Moderna’s and Pfizer’s vaccines into the arms of health workers and older Americans. Scientists at N.I.H. and Moderna are now analyzing data to see if they can double the supply of the vaccine by cutting doses in half.

Dr. Fauci and other government scientists have repeatedly emphasized the importance of the second dose as a way to achieve long-term immunity. At an event sponsored by the Harvard Business Review on Tuesday afternoon, he reiterated that, but said protection that people might get from a first dose is insufficient for providing fuller immunity.

He also struck an optimistic note, saying that the U.S. may have enough protection against the virus to achieve “some form of normality” by the fall. To get there, he warned that the country would need to adhere much more closely to public health measures and to successfully implement a vaccine program that can reach the vast majority of Americans.

Tuesday functioned as something of a wind-down for the Trump administration’s top health officials who will leave their roles on Wednesday, when President-elect Joseph R. Biden Jr. is sworn in. Mr. Azar delivered a final “state of the department” address in the morning, listing what he viewed as the administration’s accomplishments in funding and developing vaccines and tests for the virus, and thanking the department’s employees for working long hours and weekends during the pandemic.

On Tuesday afternoon, Vice President Mike Pence was scheduled to oversee his final meeting with the White House coronavirus task force, which Mr. Azar and Dr. Fauci are members of. Dr. Fauci will cross over into the next administration as the chief medical adviser to Mr. Biden.

As of Friday, about 10.6 million people in the United States had received at least one dose of a Covid-19 vaccine, and about 1.6 million people had been fully vaccinated, according to the Centers for Disease Control and Prevention. That is far short of the goal set by federal officials to give at least 20 million people their first shots before the end of 2020.

A field of flags from U.S. states planted on the National Mall on Monday to represent the thousands of Americans who would normally attend the inauguration.Credit…Todd Heisler/The New York Times

With the United States reaching a once-unthinkable coronavirus pandemic death toll of 400,000 people on Tuesday, the eve of his inauguration as president, Joseph R. Biden Jr. is assuming the role of mourner in chief and projecting an air of command of the issue that has vexed the Trump administration for the past year.

The president-elect will arrive in the nation’s capital Tuesday evening for a somber inauguration-eve ceremony at the Lincoln Memorial, where 400 lights will be illuminated along the perimeter of the reflecting pool. Each is meant to represent approximately 1,000 Americans who have died during the pandemic.

On Monday night, as President Trump ordered an end to the ban on travelers from Europe and Brazil that had been aimed at stopping the spread of the coronavirus to the United States, Mr. Biden’s aides said he would rescind the move when he takes office on Wednesday, before it was scheduled to go into effect.

Mr. Trump’s order was issued at a time of heightened anxiety over the coronavirus and what Mr. Biden has warned will be a “dark winter.” The country has experienced a post-holidays surge in cases that has overwhelmed some hospitals and led to record numbers of deaths. The national vaccination rollout has been slow and chaotic. And a more contagious virus variant is spreading, while others are being discovered.

Mr. Biden has declared getting control of the pandemic the central issue of his administration, and has been highly critical of how his predecessor handled the worst public health crisis in more than 100 years.

Mr. Trump, in a proclamation, said that the travel restrictions, which apply to noncitizens trying to come to the United States, would no longer be needed on Jan. 26, once the Centers for Disease Control and Prevention start requiring proof of a negative virus test before boarding for all passengers from abroad.

The proclamation appeared to be an effort to help the airline and hospitality industries.

Mr. Trump wrote that Alex M. Azar II, the secretary of health and human services, had recommended ending the restrictions for most parts of Europe and Brazil, while maintaining them for Iran and China, which Mr. Trump said had not been cooperative.

Jennifer Psaki, who will be Mr. Biden’s White House press secretary, said the new administration would not allow the directives to take effect.

“With the pandemic worsening, and more contagious variants emerging around the world, this is not the time to be lifting restrictions on international travel,” she tweeted.

In Washington, the Tuesday night event at the Lincoln Memorial will kick off “a national moment of unity” at 5:30 p.m. Eastern that will include similar commemorations at the Empire State Building in New York, the Space Needle in Seattle and other landmarks, with events also planned for Mr. Biden’s hometowns, Scranton, Pa., and Wilmington, Del.

The inaugural committee’s chief executive, Tony Allen, the president of Delaware State University, said in a statement that the inauguration “represents the beginning of a new national journey — one that renews its commitment to honor its fallen and rise toward greater heights in their honor.”

Michael D. Shear and Glenn Thrush contributed reporting.

A longstanding teacher shortage in the United States has been exacerbated by the pandemic.Credit…Ruth Fremson/The New York Times

Across the United States, state education and district officials say the pandemic has intensified a longstanding teacher shortage to crisis levels.

As spikes in cases and exposures have forced more teachers to stay home, the shortage is among the main reasons that schools or whole districts have had to halt in-person instruction, often for weeks.

“It’s just such a ripple effect,” said Laura Penman, the superintendent of Eminence Community Schools, a tiny district in rural Indiana. The district had to briefly close its only elementary school in November because an infected educator had come into contact with several colleagues.

Desperate to stanch staffing shortfalls, districts are increasing pay for substitutes and even advertising for temporary positions on local billboards. Some states and districts have suspended college course requirements, or permitted abbreviated online training, for emergency substitute teachers.

Although stopgap solutions may be necessary during the pandemic, education experts say they could diminish the quality of in-person learning, further disrupting education for a generation of children.

Public school systems in the United States have been grappling with a shortage of full-time teachers for years. There is reduced education funding in many states, and one study before the pandemic reported that schools nationwide needed more than 100,000 additional full-time licensed teachers, particularly in science and special education. The coronavirus is vastly exacerbating that shortfall, experts say, by prompting many teachers to quit or retire early.

Education researchers said the pandemic teaching shortage was likely to intensify learning disparities, especially in high-poverty schools where experienced substitutes often chose not to work.

“It’s a disaster. Those kids who have already got the worst of Covid and its consequences are the ones who are going to face a larger lack of sufficient, and sufficiently qualified, teachers,” said Emma Garcia, an education economist at the Economic Policy Institute in Washington. “It’s going to have negative consequences immediately and it’s going to take them longer to be able to catch up.”

A CVS pharmacist preparing a Covid-19 vaccination for residents of a nursing home in Harlem on Friday. Nearly a third of nursing home workers in New York State have declined to be vaccinated.Credit…Yuki Iwamura/Associated Press

The number of nursing home workers in New York State who have declined the coronavirus vaccine rivals the number who have been inoculated, raising concerns about vaccine hesitancy among those who are in contact with some of the individuals at highest risk of a severe infection.

As of Monday, about 37 percent of the more than 130,000 people working in “skilled nursing” facilities in the state have been vaccinated, according to the governor’s office.

But 32 percent of the workers have declined to be vaccinated.

In some parts of the state, staff members who have declined outnumber those who have been vaccinated. On Long Island, 46 percent declined while 34 percent have been vaccinated.

Officials cautioned that the vaccination process for long-term-care facilities was still in its early stages — the first of three inoculation phases concluded on Sunday, and many workers have not had the chance to get vaccinated. They said they hoped the proportion of staff members declining would decrease as they saw their colleagues getting vaccinated safely.

Gov. Andrew M. Cuomo said at a news conference on Monday that the state had earmarked 225,000 doses for residents and workers in long-term care facilities and that 105,000 had been used. Of the 120,000 unused doses, 15,000 will be reserved for residents and 40,000 for staff members; the remainder will be reallocated to the main vaccination program, Gareth Rhodes, a top aide to Mr. Cuomo, said Tuesday.

The vaccination rate among residents was higher: 67 percent have been inoculated, while 16 percent have declined. Workers and residents who are medically able to get the vaccine but had previously declined will still be able to get a shot if they decide to.

The state health department has done online events and other educational outreach with nursing homes, largely to address vaccine hesitancy.

Many of the workers are lower-income and people of color, communities that tend to have higher rates of vaccine hesitancy. In a speech on Monday marking Martin Luther King’s Birthday, Mr. Cuomo said he understood their distrust, citing the decades-long Tuskegee experiment in which government researchers withheld treatment from Black men infected with syphilis.

“No one can ameliorate or justify the victimization and discrimination the Black community has endured,” Mr. Cuomo said.

But, he said, “We have had New York’s doctors, the best on the planet, review the vaccine, and they vouch for it. I will take it as soon as I am eligible.”

People in the United States have been dying of Covid-19 at the highest rate of the pandemic. The new milestone of 400,000 deaths, reached on Tuesday, is the equivalent of wiping out a city the size of Oakland, Calif. It is on the order of Sept. 11 deaths more than a hundred times over. At that scale, the human brain compensates with a defense that political psychologists call “psychic numbing.”

On one single day in a monthlong period during which the United States lost more people to Covid-19 than in any other during the pandemic, Stacey Williams, a beloved youth football coach and father of five in Florida, was among more than 2,000 Americans with the virus to die.

Along with Mr. Williams, Jose H. Garcia, 59, the longtime chief of the Roma Police Department in the South Texas border region who was known to friends and family as Beto, died of Covid-19 complications. So did Nelson Prentice Bowsher II of Washington, D.C., 80, an affordable-housing advocate whose family’s feed mill business was a fixture of South Bend, Ind., through the 1960s.

Credit… 

Combing through hundreds of local obituaries, county records and interviews with families, New York Times reporters were able to piece together a tapestry of some of the lives lost on that day, Jan. 4.

Sherri Rasmussen, 51, of Lancaster, Ohio, was one. She is survived by a daughter who said she will always remember the day her mother gave her purse to a woman who complimented it in a CVS store, saying, “I want to pay it forward.”

And then there was Pedro Ramirez, 47, who loved his Puerto Rican homeland, salsa dancing and restoring Volkswagen bugs. Days before, he told his wife, Shawna Rodriguez, about the vaccine and how people like him, with chronic medical issues, would be getting it soon.

“I told him I loved him and how sorry I was that he had to be in the hospital by himself,” said Ms. Ramirez, 52, who works in a bridal salon in Macon, Ga.

The surge in deaths reflects how much faster Americans have spread the virus to one another since late September, when the number of cases identified daily had fallen to below 40,000. Since early in the pandemic, deaths have closely tracked cases, with about 1.5 percent of cases ending in death three to four weeks later.

A dose of the Pfizer-BioNTech vaccine being prepared at the Michener Institute in Toronto earlier this month.Credit…Frank Gunn/The Canadian Press, via Associated Press

Canada will not receive any vaccine shipments from Pfizer next week, but that should not affect the government’s plan to administer six million doses of the Pfizer and Moderna vaccines by the end of March, officials said Tuesday.

Last Friday, Pfizer said it would be temporarily limiting shipments of the vaccine it developed with BioNTech to Canada and European countries while it revamped a plant in Belgium to increase production. The announcement triggered outrage among health officials across the European Union and added to concerns over the sluggish pace of immunizations. (The United States is not affected by the change; doses for its domestic market are manufactured in Kalamazoo, Mich.)

Maj. Gen. Dany Fortin, the Canadian military officer in charge of vaccine distribution, told reporters that while the change had relatively little effect on Canada this week, the company will not send any vaccine during the final week of January. Previously he had said that shipments during that period would only be cut in half. Shipments of the vaccine made by Moderna to Canada are not affected.

Anita Anand, Canada’s minister in charge of procurement, said that subsequent shipments of the Pfizer-BioNTech vaccine will be increased, and that the changes will not affect the government’s plan to administer six million doses of the two vaccines over the next two months.

Some Canadian news outlets had suggested that Europe would see its shipments return to normal more quickly than Canada, based on statements from Pfizer. But Ms. Anand said that she spoke with the company over the weekend and it “assured me and Canada of equitable treatment.”

Doug Ford, the premier of Ontario, urged Prime Minister Justin Trudeau on Tuesday to pressure Albert Bourla, the chief executive of Pfizer, to increase Canada’s allotment.

“I’d be on that phone call every single day,” Mr. Ford told a news conference.

Officials in Delaware are offering a variety of incentives to encourage prisoners to consent to being vaccinated. The James T. Vaughn Correctional Center is in Smyrna, Del.Credit…Suchat Pederson/The News Journal, via Associated Press

Officials at U.S. prisons and jails are running into widespread unwillingness among prisoners to consent to be vaccinated. To combat it, some are turning to offering incentives like free snack bags, extra visiting time and even a little time off sentences.

Incarcerated people are at much greater risk from Covid-19 than the general public: Studies have shown that they are four times as likely to become infected, and twice as likely to die. But many say they are wary both of the vaccines and of the prison medical staff members who administer them.

A recent survey at a jail in Billerica, Mass., found that only 40 percent of the inmates would volunteer for a vaccination, even though there had been more than 130 infections at the jail.

Many prison systems around the nation have yet to receive any vaccine doses or offer them to prisoners. Those that have tend to provide little or no educational material about the vaccines, inmates say.

At the Allenwood federal prison complex in Pennsylvania, inmates said medical workers arrived without any prior notice on Jan. 6, carrying clipboards and pushing carts containing vaccine doses.

“They didn’t give us any information beyond, basically, ‘Hey, this is safe, and you don’t have any worries taking it,’” said Domingo Ramirez, who is incarcerated there.

At the same prison, Andres Azner said that more than half of the inmates in his unit had refused vaccination when it was offered, including him.

“They didn’t give me enough time to think about it,” he said. “They didn’t give me enough information to make a solid, sound, prudent decision. They kind of just tried to force it upon me. And, no, no, I’m not taking it.”

The Bureau of Prisons did not respond to a request for comment.

The Delaware state prison system is trying to overcome the skepticism with incentives to receive the shot, and the North Carolina system is considering doing the same.

Delaware is offering credits that shorten sentences by a few days, as well as a 30-minute video visit with loved ones and either a free commissary snack bag or a “special meal.”

The idea is not unprecedented. In November, Kansas state prisons began offering inmates $5 to get a flu shot. The prisons have not yet received coronavirus vaccines to offer to prisoners, and officials declined to say whether the same policy would apply when they do.

Lauren Brinkley-Rubinstein, a professor at the University of North Carolina School of Medicine, said that a “very dark history of experimentation on prisoners” was responsible for fostering mistrust — and that certain incentives, involving expanded visitation privileges, were ethically questionable.

Brant Addison, an inmate at the Wake Correctional Center in North Carolina, described a string of sleepless nights as he weighed whether to receive the vaccine. Mr. Addison, who is African-American, cited the infamous Tuskegee syphilis study, and said that two of his relatives who are nurses shared his concerns.

He said he might feel safer receiving the vaccine after more people have taken it, including those outside prison walls.

“I have such a short time left, just a few months,” he said, referring to his sentence. “And I want to be able to walk out of here with a sound mind and body.”

Denise Saylor, right, taking a selfie as Lara Comstack gave her the Modern vaccine at the Callen-Lorde Community Health Center in Manhattan this month.Credit…James Estrin/The New York Times

New York City expects to exhaust its supply of coronavirus vaccine on Thursday, and will then have to cancel inoculation appointments at many city inoculation sites, according to Mayor Bill de Blasio.

“We will literally have nothing left to give as of Friday,” Mr. de Blasio said at a news conference Tuesday.

New York City received 53,000 doses this week, the mayor said, and had a total of 116,000 doses in inventory Tuesday morning. But Mr. de Blasio said that was not nearly enough to keep up with the pace at which New Yorkers are being inoculated. The mayor, who raised concerns last week about a coronavirus vaccine shortage after an initially sluggish rollout, said the city is not currently scheduled to receive any more doses until next Tuesday.

Mr. de Blasio and Gov. Andrew M. Cuomo have urged the federal government to send more vaccine to New York, now that the state’s eligibility pool has been expanded to include anyone 65 or older.

Statewide, more than 835,000 people have received the first of the two doses of a vaccine — both federally authorized vaccines are two-dose vaccines — and nearly 84,000 have received the second dose, Mr. Cuomo said in a statement on Tuesday. Even so, pressure is mounting to speed up vaccinations as hospitalizations across the state surpassed state 9,000, according to Mr. Cuomo on Tuesday, for the first time since early May.

The supply issue threatens the success of the mass vaccination sites the city has been setting up in each of the five boroughs, Mr. de Blasio said. Sites at CitiField, the Mets’ home stadium in Queens, and at the Empire Outlets shopping center in Staten Island are scheduled to open next week. “This is not the way it should be,” the mayor said. “We have the ability to vaccinate a huge number of people. We need the vaccine to go with it.”

The city’s vaccination program has run into several obstacles since eligibility was expanded. Buggy websites and complex sign-up systems have made it difficult for many New Yorkers to schedule appointments. Mr. de Blasio said the city expects to have vaccinated 500,000 people by the end of Wednesday. The city had previously set a goal of one million doses by the end of January.

Gov. Andrew M. Cuomo of New York, unveiling a budget proposal, said the state was facing a $15 billion shortfall.Credit…Pool photo by Hans Pennink

Gov. Andrew M. Cuomo on Tuesday warned that New York State was facing an enormous $15 billion deficit as he unveiled a 2022 budget proposal laden with urgency and uncertainty caused by the coronavirus pandemic.

The governor pleaded with leaders in Washington to deliver $15 billion in emergency relief, but the precariousness of the situation led Mr. Cuomo to lay out two different budget possibilities: one assuming a federal aid package of $6 billion, and another with the full $15 billion.

If the federal government provided a $6 billion aid package, which the governor called the “worst-case” scenario, Mr. Cuomo said the state would be unable to fill its budget gap, resulting in cuts of about $2 billion in school funding, $600 million in Medicaid funding and $900 million in across-the-board reductions.

There are other question marks, primarily a lack of clarity about how much money the state would have on hand because of diminished tax revenues.

“This budget is really the economic reconciliation of the Covid crisis, the cost of the Covid crisis,” Mr. Cuomo said during a virtual address from the State Capitol’s Red Room in Albany. “This year, it’s going to be about reconciling the responsibility of the battle and completing the battle.”

In crafting a budget for the next fiscal year, which begins April 1, state officials face similar challenges as last year, when the pandemic devastated the economy and upended one of the nation’s largest budgets.

But the political climate in Washington is certainly different: Senator Chuck Schumer, who will take over as majority leader in Washington this week, has promised “better days ahead out of Washington for New York,” though he has stopped short of promising a complete bailout.

Last week, Mr. Schumer announced that the city and state would receive $2 billion in emergency funding related to expenses incurred as part of the coronavirus response.

The incoming Biden administration is promising $350 billion in direct aid to states and local municipalities, as part of a $1.9 trillion Covid response plan. Even so, Mr. Cuomo has maintained that without a substantial infusion of cash from Washington, the state would need to resort to a mix of tax increases, spending cuts and borrowing.

“We don’t know what level of aid we will get,” Mr. Cuomo said on Tuesday, adding, “New Yorkers deserve and demand fairness.”

Skylar Mack, the 18-year-old Georgia college student who was sentenced to two months in prison for violating coronavirus restrictions in the Cayman Islands, was released on Friday after a month behind bars.Credit…ABC News

Skylar Mack, the American college student who was released from a prison in the Cayman Islands last week for violating coronavirus restrictions, said in an interview that she “deserved it.”

In a segment that aired on ABC’s “Good Morning America” on Tuesday, Ms. Mack, 18, apologized for breaking the rules and said that any anger toward her was justified, adding that if she had gotten someone sick, she would not have been able to live with herself.

She was released on Friday after spending more than a month behind bars.

“I deserved it,” she said. “I was like, ‘You know what, I made this mistake, and it sucks, you know, but you did it to yourself.’”

After finishing the semester at Mercer University in Georgia in late November, Ms. Mack flew to the Cayman Islands to watch her boyfriend, Vanjae Ramgeet, 24, compete in the islands’ Jet Ski racing national championship.

She arrived on a Friday and tested negative for the coronavirus. While the British territory’s laws required her to remain in her hotel room for 14 days, on Sunday, the day of the championship, she slipped the electronic monitoring bracelet from her wrist. She went to the beach and cheered on Mr. Ramgeet as he won first place.

In mid-December, a Cayman Islands court sentenced Ms. Mack and Mr. Ramgeet to four months in prison. After an outcry that the punishment was too harsh, a panel of judges reduced the sentence to two months. Her release after a little more than half that time was in line with what her lawyer expected. Mr. Ramgeet was also released on Friday, according to Ms. Mack’s family.

Thousands of others around the world have been similarly punished for breaching quarantine restrictions. Extensive travel restrictions have failed to stop the virus from spreading, with some people viewing themselves as above the rules.

Global roundup

The government district in Berlin this month. Chancellor Angela Merkel was meeting with state governors on Tuesday about new lockdown rules.Credit…Lena Mucha for The New York Times

As German authorities prepare stricter lockdown measures, some German states are planning guarded mandatory quarantine centers for the very few who repeatedly disobey quarantine rules, according to an investigation by Die Welt am Sonntag, a national Sunday paper.

States like Schleswig-Holstein in the north, Brandenburg around Berlin and Baden–Württemberg in the southwest are preparing such mandatory quarantine sites in hospitals, refugee centers and a youth detention center.

“Pandemic control lives or dies with public acceptance,” Sönke Schulz, a regional leader in Schleswig-Holstein, told Kieler Nachrichten, a local daily. “This would suffer if noncompliance remained without consequence.”

However, since there are very few known cases of people who repeatedly flout quarantine and isolation rules and fines — which are imposed because someone either has Covid, has had close and prolonged contact with an infected person or has come back from a high-risk foreign country — the states are only planning for a few sites.

On Tuesday Chancellor Angela Merkel and governors are meeting to agree on new and extended lockdown rules. As of Monday, the seven-day average number of cases was 16,886, according to a New York Times database, slightly higher than when the national lockdown began at the beginning of November. Starting in mid-December, politicians strengthened the lockdown, closing most nonessential shops and most schools.

But even as numbers start to decline slowly, the German authorities are worried about a more transmissible variant of the virus that is thought to be responsible for a spike in infections in Britain.

Among the other developments around the world:

  • Rwanda announced restrictions on movement and businesses in the capital, Kigali, on Monday, as coronavirus cases continued to surge across the country. The authorities closed all places of worship, shut down public transportation, banned travel between the capital and other parts of the country, and ordered all workers other than those providing essential services to work from home. Farming can continue, and businesses selling food, medicine, fuel or cleaning products may operate but must close by 6 p.m. Funeral gatherings are permitted but cannot exceed 15 people. Foreign tourists will continue to be allowed to enter and travel around the country during the two-week lockdown, but they must present a negative P.C.R. test on arrival and departure. Rwanda has reported 11,259 coronavirus cases and 146 deaths so far, and the rate of positive test results has risen sharply since mid-November, reaching 7.7 percent on Tuesday.

  • A survey about coronavirus infections in Britain from the Office for National Statistics estimates that one in eight people in England — about 5.4 million people over the age of 16 — had antibodies against the virus in December, suggesting they were infected in the past. The report suggests about one in 10 people across Britain had such antibodies. Excess deaths were at the highest level since last May, the analysis found, and in England the Covid-19 mortality rate in the most deprived areas last month was more than twice that in the least deprived.

  • Officials in Hong Kong said on Tuesday that current social distancing measures, which include a ban on dine-in service after 6 p.m., would be extended for at least another week, a day after the number of new coronavirus cases returned to the triple digits for the first time this year. They also said they would bar entry to travelers who had spent more than two hours in Ireland or Brazil in the past 21 days — the same rule as applied to Britain and South Africa, where two more transmissible variants of the virus were first detected.

  • Starting Jan. 26, everyone flying to New Zealand will have to show proof before departure that they have tested negative for the virus, the government said on Tuesday, unless they are coming from Australia, Antarctica or most Pacific islands. Two weeks of quarantine continues to be mandatory for all travelers to New Zealand, which last recorded a locally transmitted case in November. Last week, the country began requiring predeparture tests for passengers from the United States and Britain.

  • Japan’s southernmost prefecture, Okinawa, declared a state of emergency after a spike in cases, Reuters reported. Okinawa Governor Denny Tamaki said emergency measures include asking restaurants and bars to close by 8 p.m. and residents to refrain from non-urgent outings after 8 p.m. The emergency is scheduled to last until Feb. 7. The prefecture confirmed 113 cases on Tuesday, its third-highest daily tally on record, the public broadcaster NHK reported. Shizuoka prefecture, home to Mount Fuji, also declared “an emergency alert” of its own on Tuesday after it found cases of a more contagious coronavirus variant, Kyodo News reported.

  • Britain’s health secretary, Matt Hancock, said on Tuesday that he would isolate at home for the next six days after a notification from the National Health Service coronavirus app told him he had been in close contact with someone who tested positive. Mr. Hancock, a key figure in country’s virus response, appeared in a televised coronavirus briefing Monday evening and tested positive himself in March.

  • Scotland’s lockdown will be extended to mid-February and its schools and kindergartens will remain closed until then, First Minister Nicola Sturgeon said on Tuesday. Early in January, people were asked to stay at home for all but essential purposes, and most students returned to remote learning, as the country tried to clamp down on the more transmissible British variant of the coronavirus. The restrictions were originally set to expire at the end of the month, but Ms. Sturgeon said on Tuesday that the country’s case numbers were still high and that staying locked down was vital to protect the National Health Service from becoming overwhelmed.

People wait in line to receive the Sputnik V coronavirus vaccine at the State Department Store GUM in Moscow.Credit…Sergey Ponomarev for The New York Times

The Russian government is considering issuing coronavirus health certificates that could ease travel and commerce for people who have been vaccinated or who have antibodies from surviving the disease, while sharply limiting the liberties of others — an idea that has also been floated in the European Union and by private companies.

Proponents say that such documents, often called Covid passports, could ease airline travel and hasten the reopening of theaters, cruise lines and other settings where people congregate.

Opponents fear a dystopic system that would limit the rights of people who have been careful to avoid infection and are unable or unwilling to be vaccinated. Russia has a grim history rooted in the Soviet era of controlling citizens’ movements, through a residency permit system that was never fully abolished.

Internationally, airlines have already tested electronic certificates showing negative test results for passengers. Those systems could be expanded to show the status of those with some immunity.

The head of the Russian Parliament’s committee on public health, Dmitri Morozov, said on Tuesday that a Covid passport was “very important and needed.”

Collecting people’s Covid health status in a government system, he said, could also provide important data for public health officials. “This is great, this is the new world,” he said. Mr. Morozov did not specify what kinds of information a Covid passport would display.

A regional governor in Russia, Radi Khabirov, proposed on Monday that Covid passport holders receive discounts at stores, as an incentive for people to obtain the certificate.

President Vladimir V. Putin’s spokesman, Dmitri S. Peskov, said on Tuesday that the government is considering issuing Covid passports, perhaps in digital form, but that Russia wanted to coordinate with other countries to agree on standards for them.

Stella Kyriakides, the European Union’s health commissioner, speaking during a plenary session on E.U. global strategy on coronavirus vaccinations at the E.U. parliament in Brussels on Tuesday.Credit…Pool photo by John Thys

The European Union’s executive arm on Tuesday set ambitious Covid-19 vaccination goals for its 450 million citizens, after a sluggish start to its inoculation efforts.

The European Commission said that the bloc’s 27 member states should aim to have at least 80 percent of their citizens over the age of 80, as well as at least 80 percent of their health care workers, vaccinated by March, and at least 70 percent of the whole population vaccinated by this summer.

“We are racing against time, but not against each other,” said Stella Kyriakides, the bloc’s health commissioner. “And we’re all racing together as one team.”

The commission’s call comes as E.U. countries face a resurgence of coronavirus cases, turbocharged by emerging new variants, as well as the grim reality of prolonged lockdowns. E.U. leaders are due to meet by teleconference on Thursday to endorse the Commission’s proposals.

The commission also urged the bloc’s national governments to update their testing strategies, which remain the competence of member states, and urged them to genome sequence more positive coronavirus test results: 10 percent of them, up from the current rate of below 1 percent. Genome sequencing helps quickly identify new variants, while also keeping track of the progress of known ones.

“If we do not act now with determination, we might not be able to contain the risk of a potentially harsh third wave,” warned Ms. Kyriakides. “The numbers are already worrying across the E.U., and hospitals are under a lot of pressure. We cannot be complacent.”

In order to salvage border-free travel across the bloc, the commission also opened the debate over using so-called vaccination certificates, which could permit easier travel for people who’ve been vaccinated. The concept has been advocated by Greece and other smaller states, which heavily depend on tourism, but opposed by several larger E.U. countries such as France.

The bloc intends to determine a common approach by the end of January. For the moment, the commission recommended that all nonessential travel be strongly discouraged. Traveling restrictions, as well as testing and quarantine rules, are currently the prerogative of national governments, and have resulted in a patchwork of chaotic measures across the continent.

Andrew Yang announced that he was running for mayor last week in Manhattan’s Morningside Park.Credit…James Estrin/The New York Times

Less than a week after his vigorous launch into the New York City mayor’s race, Andrew Yang said on Tuesday that he was halting in-person events and quarantining because a campaign staffer had tested positive for the coronavirus.

Mr. Yang, the former presidential candidate, had been seemingly everywhere in recent days, meeting with elected officials across the city and riding the subway and bus to campaign events. His whirlwind appearances were in sharp contrast to the mostly virtual campaigns that his rivals have been conducting.

Now Mr. Yang will enter quarantine for at least eight days, his campaign said in a statement.

“This morning, we learned that a member of the campaign staff received a positive result on a rapid Covid test,” the statement said. “Since that time, Andrew has tested negative and is not experiencing any symptoms.”

On Monday, Mr. Yang attended an event at the Rev. Al Sharpton’s headquarters in Harlem to commemorate Martin Luther King Jr.’s Birthday. He spoke without a mask before a large crowd that included many of the other mayoral candidates.

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World News

Trump getting ready to carry Europe, UK, Brazil Covid-19 journey restrictions Jan. 26

A traveler leaves a test center at Heathrow Airport in London on January 17, 2021.

Hollie Adams | Getty Images News | Getty Images

The Trump administration plans to lift travel restrictions on Covid-19 for most foreign visitors from Europe, the UK and Brazil later this month, according to a person familiar with the matter.

The White House set the rules at the beginning of the pandemic to contain the spread of the virus. Last week, the U.S. said overseas travelers, including U.S. citizens, would need to test negative for Covid-19 before flying. This requirement will go into effect Jan. 26 if the Trump administration plans to lift the travel ban previously reported by Reuters.

Airlines have repeatedly urged the U.S. government to use pre-flight tests to lift travel bans, which have contributed to a sharp drop in demand for air travel.

This is the latest news. Check for updates again.

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Business

Brooklyn Nets star Kyrie Irving fined for violating NBA Covid-19 guidelines

Kyrie Irving # 11 of the Brooklyn Nets looks on during the game against the Washington Wizards on February 1, 2020 at Capital One Arena in Washington, DC. (Photo by Ned Dishman / NBAE via Getty Images)

Ned Dishman / NBAE via Getty Images

Brooklyn Nets stars Kyrie Irving have been fined $ 50,000 for violating Covid-19 protocols, the National Basketball Association said on Friday.

The NBA President Byron Spruell made the decision after Irving was seen wearing no mask at a “private indoor party” last weekend. His presence violated NBA rules, which prohibit players from “attending indoor social gatherings of 15 or more people or entering bars, lounges, clubs, or similar facilities.”

Irving, who will be paid $ 33 million by the Nets this season, will lose his salary for games he missed during his quarantine period. Despite having to suspend the networks for the last five games, Irving will only be docked for two games and will have to forego over $ 400,000 per game.

The NBA said Irving will be allowed to return on Saturday if he clears league logs.

Covid-19 outbreaks have hit the NBA hard this week, forcing the league to postpone numerous games since Monday, including Saturday’s Indiana Pacers competition against the Chicago Bulls. The league also released its latest pandemic test report, which found 16 new players tested positive.

To combat the outbreaks, the NBA tightened Covid-19 protocols to mandate more masks in team areas and issued a two-week stay-at-home policy. Players and team members must remain in their homes outside of team activities at practice areas or in arenas in their home markets.

In addition to Irving’s possible return, the Nets will also welcome James Harden to the club. The team traded with four teams for Harden on Wednesday.

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Health

Moderna seems to be to check Covid-19 booster photographs a yr after preliminary vaccination

One of the boxes containing the Moderna COVID-19 vaccine is prepared for shipment at the McKesson distribution center in Olive Branch, Mississippi, USA, on December 20, 2020.

Paul Sancya | Reuters

Moderna plans to test a booster shot of its Covid-19 vaccine a year after the first two-dose immunization, as the duration of protection from the new vaccines is still unclear.

The biotech company plans to start the study in July. This emerges from a company presentation at the JPMorgan Healthcare Conference on Monday. According to an email shared by one of those people, employees at the clinical trial sites have already started contacting participants in previous trials.

“From what we’ve seen so far, we’re assuming the vaccination will take at least a year,” said Dr. Tal Zaks, Moderna’s Chief Medical Officer, told investors and analysts at the conference. “To the extent that you need a booster shot, we make a data-based recommendation, and for that we need to pull the data.”

The first participants in Moderna’s human clinical trials received their recordings in mid-March. a second was given four weeks later. Since multiple doses of the vaccine were tested in previous studies, those with doses lower than the ultimately approved – 100 micrograms – would get their booster sooner, while those with 100 micrograms or higher would get their booster at the end of the year, according to an email to the Attendees.

The booster that is now planned is the same version of the vaccine that is on the market, but Stephane Bancel, CEO of Moderna, said it might be necessary to adapt the vaccine in the coming years to cover new variants.

“I think this is going to be a market like the flu,” he told CNBC. Moderna also recently started a seasonal flu vaccination program.

The booster study for Moderna’s Covid-19 vaccine will assess both safety and the immune response that an additional shot generates a year later, Bancel said at the conference.

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Health

Which People Can Get a Covid-19 Vaccine Now? Full Steering

The U.S. government this week made recommendations on which people in the country should be vaccinated first, amid an unstoppable spike in coronavirus cases. Here you can find answers to some frequently asked questions.

Alex M. Azar II, the Minister of Health, on Tuesday called on all states to open eligibility to anyone over 65 and to adults of all ages with conditions that are at high risk of becoming seriously ill or contracting Covid- 19 die.

In total, that’s more than 150 million people – almost half of the population. They are now joining millions of healthcare workers and residents of long-term care facilities who have previously qualified.

Mr Azar did not specify the conditions under which someone would now be eligible for vaccination. Presumably, it will be up to the governors to decide, as will the question of what documents are required. However, the federal centers for disease control and prevention have published a list of particularly high-risk diseases, including cancer, diabetes, and obesity.

Although the CDC issued recommendations last month as to which group states should be vaccinated first while vaccine supplies are still relatively low, priorities are non-binding and each state has its own groupings.

The federal government cannot ask states to change the prioritization plans already announced, although renewed pressure from Mr Azar and the growing impatience of the public as deaths from the virus continue to hit new highs could lead many to do so.

When drawing up priority groups, state officials considered such criteria as the likelihood that they would be most likely to die if they contract Covid-19 – including people of color, the elderly, and those with underlying diseases – and which professions were critical to fully reopening the economy are . The demographics of each state also played a role.

This depends on which state or county you live in.

Some local health departments have set up portals where people can make appointments. Others host mass vaccination events and vaccinate people on a first-come, first-served basis.

In general, medical practices and pharmacies have asked patients and customers not to call them yet to schedule a vaccination appointment and instead wait to be contacted.

Most pharmacies don’t offer the vaccine yet, but CVS, Walgreens, and a number of other pharmacy chains, including some in grocery stores and large stores, will soon do so through a partnership with the federal government.

In some states, yes.

Health workers in all states were the first to be offered the vaccine. And prior to Mr Azar’s instruction this week, several states had already initiated vaccination against certain categories of “frontline” workers such as police officers, firefighters, teachers, childcare workers and public transport workers.

But other states that had planned to offer the vaccine to some key workers soon can now re-prioritize based on Mr. Azar’s new guidance.

Nothing prevents states from opening vaccination to a new priority group before they have reached all members of a previous group, but care is an important consideration.

Pfizer and Moderna, the two companies whose emergency vaccines were approved in the United States, have jointly committed to delivering 400 million doses over the next seven months.

Both vaccines require two doses, so 200 million out of around 260 million people who can currently be vaccinated will be enough. Children under 16 are not yet eligible for Pfizer’s vaccine, and children under 18 cannot yet take Moderna.

Johnson & Johnson, whose single-dose vaccine candidate is in late-stage clinical trials, has signed a contract with the US government to provide 12 million doses by the end of February and a total of 100 million doses by the end of June. However, the company has fallen behind on its production schedule.

The publicly available data is delayed by at least a few days, so it’s hard to know for sure. However, the CDC reported Wednesday that about 10.3 million people had received a starting dose of 29.4 million doses so far distributed across the country.

This includes nearly 1.1 million doses given to residents and staff in nursing homes and other long-term care facilities.

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Business

India kicks off large Covid-19 vaccination drive on Saturday, Jan. 16

Bangalore Airport employees transfer cardboard boxes of vials of Covishield vaccine developed by the Serum Institute of India on January 12, 2021 in Bangalore, India.

Stringer | Xinhua | Getty Images

SINGAPORE – India is preparing for one of the largest mass vaccination exercises in the world starting Saturday.

The South Asian country plans to vaccinate around 300 million people, or more than 20% of its 1.3 billion population, against Covid-19 in the first phase of the exercise.

Indian airlines have started delivering the first doses of vaccine to Delhi and other major cities, including Kolkata, Ahmedabad and the Bengaluru Technology Center. The Minister of Civil Aviation, Hardeep Singh Puri, announced earlier this week.

Priority for the recordings is given to healthcare and other frontline workers – an estimated 30 million people. That would be followed by people over the age of 50 and other younger people at high risk.

The rollout will involve close cooperation between the central government and the states.

India has also developed a digital portal called Co-WIN Vaccine Delivery Management System. According to the Ministry of Health, real-time information on “vaccine stocks, their storage temperature and individual tracking of the beneficiaries” is provided.

India has a long history of vaccination campaigns … and will rely on this expertise in spreading coronavirus vaccines.

“India’s vaccine manufacturing expertise and experience with mass vaccination campaigns have prepared it well for the Phase 1 vaccinations scheduled to begin this weekend,” Akhil Bery, South Asia analyst with Eurasia Group, wrote in this week a report.

“India has a long history of vaccination campaigns, including its universal immunization program that vaccinates 55 million a year, and will rely on that expertise in distributing coronavirus vaccines,” he added.

Emergency approval

The Indian Medicines Agency has approved the restricted use of two coronavirus vaccines in emergency situations, both of which will be delivered to the various vaccination centers before Saturday.

One of them is a vaccine developed by the Anglo-Swedish company AstraZeneca and Oxford University, made domestically by the Serum Institute of India (SII) and known locally as Covishield.

Another vaccine was called Covaxin Developed domestically by India’s Bharat Biotech in collaboration with the Indian State Medical Research Council. Emergency clearance has been granted as clinical trials continue.

Covaxin’s approval has reportedly been criticized by some after the regulator gave the green light shortly after asking Bharat Biotech for further analysis.

India’s Minister of Health said Tuesday the Indian government had signed procurement agreements for 11 million doses of Covishield at Indian rupees 200 ($ 2.74) per dose and 5.5 million doses of Covaxin at an average cost of Rs 206 per shot, which is likely cheaper than what it will cost in the private market.

Several other candidates, including a second domestically developed vaccine from Zydus Cadila, are currently in clinical testing.

Possible risks

India currently has more than 10.5 million reported coronavirus cases, second only to the US. According to the Johns Hopkins University, more than 151,000 people have died of Covid-19 in India. However, figures reported daily show that the number of cases of active infections is decreasing.

South Asia’s largest country is also the world’s largest manufacturer of vaccines and is believed to produce about 60% of all vaccines sold worldwide.

As a result, India’s production of Covid vaccines is expected to play an important role in global immunization against the disease.

Eurasia Group’s Bery said that despite the government’s optimism, two major risks could potentially slow the launch of the vaccination campaign.

“First, vaccine production capacity will be limited even in best-case scenarios,” he said, adding that if local vaccine manufacturers cannot produce the 600 million doses needed to vaccinate the first 300 million people, “India’s vaccination schedule – and the export of vaccines to other countries could be significantly delayed. “

The second risk is that India’s vaccination campaign is highly dependent on state governments, “whose capacities and expertise vary widely,” Bery said. “Effective coordination between the central government and the state government is required, which has not been (Prime Minister Narendra) Modi’s strength.”

Categories
Politics

Feds Order States to Increase Vaccine Targets as Covid-19 Deaths Surge

The Centers for Disease Control and Prevention last month recommended that states vaccinate, after vaccinating health workers and residents of long-term care facilities, people over 75 and certain “frontline workers” who cannot do their jobs from home should. Only then, the CDC advised, should states turn to people ages 65 to 74 and adults of all ages with high-risk diseases. The CDC recommendations were not binding, but many states have largely followed them while demand far outstrips supply.

How Mr Azar’s enforcement threat will work is unclear. In two weeks, Mr. Biden will have been sworn in as President. Mr Azar said the upcoming Biden administration will be informed of the changes, although he added that Americans “are working with a government at a time and this is the approach we believe will best serve the mission.”

Mr Biden is expected to release details of his own vaccination schedule this week, which will include federal government-sponsored mass vaccination clinics. The Biden transition team declined to comment on the new Trump policy on Tuesday. However, a person familiar with the president-elect’s plans said Mr Biden also had plans to expand the universe of those eligible for vaccination.

Mr Azar said that people searching for gunfire because they are at high risk of disease are required to provide “some form of medical documentation as defined by the governors,” but he did not elaborate. A significant portion of the population suffers from conditions that the CDC has determined to increase the risk of serious Covid disease, starting with obesity, which affects at least 40 percent of adults.

Other people who would qualify for vaccines immediately under Mr Azar’s policy are more than 30 million adults with heart disease, 37 million with chronic kidney disease and 1 in 10 with diabetes.

The new distribution plan, first announced by Axios Tuesday morning, is a reversal for the Trump administration, which had withheld about half of its vaccine supplies – millions of vials – to ensure second doses were available. Mr Azar said the administration always expected to make the move if they were convinced of the supply chain.

Dr. Paul Offit, a professor at the University of Pennsylvania and a member of the Food and Drug Administration’s Vaccine Advisory Board, praised the government’s decision and compared the current situation to the Titanic, where there weren’t enough lifeboats to save everyone. “And you have to decide who you want to pass on. “