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How China Censored Covid-19 – The New York Occasions

How China Censored Covid-19 - The New York Times

This article is copublished with ProPublica, the nonprofit investigative newsroom.

In the early hours of Feb. 7, China’s powerful internet censors experienced an unfamiliar and deeply unsettling sensation. They felt they were losing control.

The news was spreading quickly that Li Wenliang, a doctor who had warned about a strange new viral outbreak only to be threatened by the police and accused of peddling rumors, had died of Covid-19. Grief and fury coursed through social media. To people at home and abroad, Dr. Li’s death showed the terrible cost of the Chinese government’s instinct to suppress inconvenient information.

Yet China’s censors decided to double down. Warning of the “unprecedented challenge” Dr. Li’s passing had posed and the “butterfly effect” it may have set off, officials got to work suppressing the inconvenient news and reclaiming the narrative, according to confidential directives sent to local propaganda workers and news outlets.

They ordered news websites not to issue push notifications alerting readers to his death. They told social platforms to gradually remove his name from trending topics pages. And they activated legions of fake online commenters to flood social sites with distracting chatter, stressing the need for discretion: “As commenters fight to guide public opinion, they must conceal their identity, avoid crude patriotism and sarcastic praise, and be sleek and silent in achieving results.”

The orders were among thousands of secret government directives and other documents that were reviewed by The New York Times and ProPublica. They lay bare in extraordinary detail the systems that helped the Chinese authorities shape online opinion during the pandemic.

At a time when digital media is deepening social divides in Western democracies, China is manipulating online discourse to enforce the Communist Party’s consensus. To stage-manage what appeared on the Chinese internet early this year, the authorities issued strict commands on the content and tone of news coverage, directed paid trolls to inundate social media with party-line blather and deployed security forces to muzzle unsanctioned voices.

Though China makes no secret of its belief in rigid internet controls, the documents convey just how much behind-the-scenes effort is involved in maintaining a tight grip. It takes an enormous bureaucracy, armies of people, specialized technology made by private contractors, the constant monitoring of digital news outlets and social media platforms — and, presumably, lots of money.

It is much more than simply flipping a switch to block certain unwelcome ideas, images or pieces of news.

China’s curbs on information about the outbreak started in early January, before the novel coronavirus had even been identified definitively, the documents show. When infections started spreading rapidly a few weeks later, the authorities clamped down on anything that cast China’s response in too “negative” a light.

The United States and other countries have for months accused China of trying to hide the extent of the outbreak in its early stages. It may never be clear whether a freer flow of information from China would have prevented the outbreak from morphing into a raging global health calamity. But the documents indicate that Chinese officials tried to steer the narrative not only to prevent panic and debunk damaging falsehoods domestically. They also wanted to make the virus look less severe — and the authorities more capable — as the rest of the world was watching.

The documents include more than 3,200 directives and 1,800 memos and other files from the offices of the country’s internet regulator, the Cyberspace Administration of China, in the eastern city of Hangzhou. They also include internal files and computer code from a Chinese company, Urun Big Data Services, that makes software used by local governments to monitor internet discussion and manage armies of online commenters.

The documents were shared with The Times and ProPublica by a hacker group that calls itself C.C.P. Unmasked, referring to the Chinese Communist Party. The Times and ProPublica independently verified the authenticity of many of the documents, some of which had been obtained separately by China Digital Times, a website that tracks Chinese internet controls.

The C.A.C. and Urun did not respond to requests for comment.

“China has a politically weaponized system of censorship; it is refined, organized, coordinated and supported by the state’s resources,” said Xiao Qiang, a research scientist at the School of Information at the University of California, Berkeley, and the founder of China Digital Times. “It’s not just for deleting something. They also have a powerful apparatus to construct a narrative and aim it at any target with huge scale.”

“This is a huge thing,” he added. “No other country has that.”

China’s top leader, Xi Jinping, created the Cyberspace Administration of China in 2014 to centralize the management of internet censorship and propaganda as well as other aspects of digital policy. Today, the agency reports to the Communist Party’s powerful Central Committee, a sign of its importance to the leadership.

The C.A.C.’s coronavirus controls began in the first week of January. An agency directive ordered news websites to use only government-published material and not to draw any parallels with the deadly SARS outbreak in China and elsewhere that began in 2002, even as the World Health Organization was noting the similarities.

At the start of February, a high-level meeting led by Mr. Xi called for tighter management of digital media, and the C.A.C.’s offices across the country swung into action. A directive in Zhejiang Province, whose capital is Hangzhou, said the agency should not only control the message within China, but also seek to “actively influence international opinion.”

Agency workers began receiving links to virus-related articles that they were to promote on local news aggregators and social media. Directives specified which links should be featured on news sites’ home screens, how many hours they should remain online and even which headlines should appear in boldface.

Online reports should play up the heroic efforts by local medical workers dispatched to Wuhan, the Chinese city where the virus was first reported, as well as the vital contributions of Communist Party members, the agency’s orders said.

Headlines should steer clear of the words “incurable” and “fatal,” one directive said, “to avoid causing societal panic.” When covering restrictions on movement and travel, the word “lockdown” should not be used, said another. Multiple directives emphasized that “negative” news about the virus was not to be promoted.

When a prison officer in Zhejiang who lied about his travels caused an outbreak among the inmates, the C.A.C. asked local offices to monitor the case closely because it “could easily attract attention from overseas.”

News outlets were told not to play up reports on donations and purchases of medical supplies from abroad. The concern, according to agency directives, was that such reports could cause a backlash overseas and disrupt China’s procurement efforts, which were pulling in vast amounts of personal protective equipment as the virus spread abroad.

“Avoid giving the false impression that our fight against the epidemic relies on foreign donations,” one directive said.

C.A.C. workers flagged some on-the-ground videos for purging, including several that appear to show bodies exposed in public places. Other clips that were flagged appear to show people yelling angrily inside a hospital, workers hauling a corpse out of an apartment and a quarantined child crying for her mother. The videos’ authenticity could not be confirmed.

The agency asked local branches to craft ideas for “fun at home” content to “ease the anxieties of web users.” In one Hangzhou district, workers described a “witty and humorous” guitar ditty they had promoted. It went, “I never thought it would be true to say: To support your country, just sleep all day.”

Then came a bigger test.

Dr. Li’s death in Wuhan loosed a geyser of emotion that threatened to tear Chinese social media out from under the C.A.C.’s control.

It did not help when the agency’s gag order leaked onto Weibo, a popular Twitter-like platform, fueling further anger. Thousands of people flooded Dr. Li’s Weibo account with comments.

The agency had little choice but to permit expressions of grief, though only to a point. If anyone was sensationalizing the story to generate online traffic, their account should be dealt with “severely,” one directive said.

The day after Dr. Li’s death, a directive included a sample of material that was deemed to be “taking advantage of this incident to stir up public opinion”: It was a video interview in which Dr. Li’s mother reminisces tearfully about her son.

The scrutiny did not let up in the days that followed. “Pay particular attention to posts with pictures of candles, people wearing masks, an entirely black image or other efforts to escalate or hype the incident,” read an agency directive to local offices.

Larger numbers of online memorials began to disappear. The police detained several people who formed groups to archive deleted posts.

In Hangzhou, propaganda workers on round-the-clock shifts wrote up reports describing how they were ensuring people saw nothing that contradicted the soothing message from the Communist Party: that it had the virus firmly under control.

Officials in one district reported that workers in their employ had posted online comments that were read more than 40,000 times, “effectively eliminating city residents’ panic.” Workers in another county boasted of their “severe crackdown” on what they called rumors: 16 people had been investigated by the police, 14 given warnings and two detained. One district said it had 1,500 “cybersoldiers” monitoring closed chat groups on WeChat, the popular social app.

Researchers have estimated that hundreds of thousands of people in China work part-time to post comments and share content that reinforces state ideology. Many of them are low-level employees at government departments and party organizations. Universities have recruited students and teachers for the task. Local governments have held training sessions for them.

Government departments in China have a variety of specialized software at their disposal to shape what the public sees online.

One maker of such software, Urun, has won at least two dozen contracts with local agencies and state-owned enterprises since 2016, government procurement records show. According to an analysis of computer code and documents from Urun, the company’s products can track online trends, coordinate censorship activity and manage fake social media accounts for posting comments.

One Urun software system gives government workers a slick, easy-to-use interface for quickly adding likes to posts. Managers can use the system to assign specific tasks to commenters. The software can also track how many tasks a commenter has completed and how much that person should be paid.

According to one document describing the software, commenters in the southern city of Guangzhou are paid $25 for an original post longer than 400 characters. Flagging a negative comment for deletion earns them 40 cents. Reposts are worth one cent apiece.

Urun makes a smartphone app that streamlines their work. They receive tasks within the app, post the requisite comments from their personal social media accounts, then upload a screenshot, ostensibly to certify that the task was completed.

The company also makes video game-like software that helps train commenters, documents show. The software splits a group of users into two teams, one red and one blue, and pits them against each other to see which can produce more popular posts.

Other Urun code is designed to monitor Chinese social media for “harmful information.” Workers can use keywords to find posts that mention sensitive topics, such as “incidents involving leadership” or “national political affairs.” They can also manually tag posts for further review.

In Hangzhou, officials appear to have used Urun software to scan the Chinese internet for keywords like “virus” and “pneumonia” in conjunction with place names, according to company data.

By the end of February, the emotional wallop of Dr. Li’s death seemed to be fading. C.A.C. workers around Hangzhou continued to scan the internet for anything that might perturb the great sea of placidity.

One city district noted that web users were worried about how their neighborhoods were handling the trash left by people who were returning from out of town and potentially carrying the virus. Another district observed concerns about whether schools were taking adequate safety measures as students returned.

On March 12, the agency’s Hangzhou office issued a memo to all branches about new national rules for internet platforms. Local offices should set up special teams for conducting daily inspections of local websites, the memo said. Those found to have violations should be “promptly supervised and rectified.”

The Hangzhou C.A.C. had already been keeping a quarterly scorecard for evaluating how well local platforms were managing their content. Each site started the quarter with 100 points. Points were deducted for failing to adequately police posts or comments. Points might also be added for standout performances.

In the first quarter of 2020, two local websites lost 10 points each for “publishing illegal information related to the epidemic,” that quarter’s score report said. A government portal received an extra two points for “participating actively in opinion guidance” during the outbreak.

Over time, the C.A.C. offices’ reports returned to monitoring topics unrelated to the virus: noisy construction projects keeping people awake at night, heavy rains causing flooding in a train station.

Then, in late May, the offices received startling news: Confidential public-opinion analysis reports had somehow been published online. The agency ordered offices to purge internal reports — particularly, it said, those analyzing sentiment surrounding the epidemic.

The offices wrote back in their usual dry bureaucratese, vowing to “prevent such data from leaking out on the internet and causing a serious adverse impact to society.”

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Business

The U.Okay. has recognized a brand new Covid-19 pressure that spreads extra shortly. This is what they know

The U.K. has identified a new Covid-19 strain that spreads more quickly. Here's what they know

England’s top medical officer announced Saturday that the UK had identified a new variant of the coronavirus that “can spread faster” than previous strains of the virus, prompting Prime Minister Boris Johnson to impose new restrictions on parts of the nation to control its spread.

“We learn from this over time, but we already know enough, more than enough, to be sure that we need to act now,” Johnson said during a press conference on Saturday setting new restrictions on London and other parts of England before the Christmas holidays.

“If the virus changes its method of attack, we’ll have to change our method of defense,” said Johnson.

The UK government announced the new strain of coronavirus on Monday after cases increased in the south and east of England. According to a statement from Public Health England, just over 1,100 Covid-19 cases had been identified with the new variant by Sunday.

Now it is believed the new strain could be up to 70% more communicable than the original strain of the disease, Johnson said on Saturday, adding that it appears to be fueling the rapid spread of infections. Johnson urged residents not to travel and “stay on-site” to keep the new strain from moving around the country and abroad.

The UK reports around 24,061 new Covid-19 cases daily based on a weekly average, an increase of more than 40% from the previous week, according to a CNBC analysis of data compiled by Johns Hopkins University.

“This is early data that needs to be verified, but it is the best we have right now and we need to respond to information as we have it because it is now spreading very quickly,” said Johnson.

Professor Chris Whitty, England’s chief medical officer, said at the press conference that “viruses are constantly mutating”. Seasonal influenza mutates every year, and other new variants of the coronavirus have already been identified in countries like Spain, according to Public Health England.

What needs to be answered is whether the new strain will transmit more easily, make people sick, and whether it will change the way a person’s immune system responds to the virus if they are already infected or vaccinated, Whitty said.

So far, a body of evidence from genetic studies, frequency studies, and laboratory studies suggests that the new strain “has a significant, substantial increase in transmissibility,” Whitty said. So far, however, there is no evidence that the new strain causes a higher mortality rate.

Health officials believe the new variant first appeared in London or Kent in mid-September, and by mid-November it is believed to have caused about 28% of cases in London and other parts of south-east England, Whitty said.

Now those numbers are much higher, he said. In London last week, data suggests the new variant accounts for more than 60% of new cases, Whitty said.

“So that tells us that this new variant is not only moving fast, it also transmits better, it also becomes the dominant variant. It beats everyone else in terms of transmission,” he said.

However, there is “no evidence” that it causes more severe illness, more hospitalizations, or “more problems than the other virus,” Whitty said. While there are reasons to suspect the new variant might alter a person’s immune response to the disease, nothing suggests that it has so far, he said.

“We are currently assuming by all scientists that the vaccine response for this virus should be appropriate,” he said. “Obviously this has to be checked in the future, and we have to remain vigilant in this regard.”

The UK has alerted the World Health Organization and will continue to analyze data on the new strain.

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Health

Employers Can Require Employees to Get Covid-19 Vaccine, U.S. Says

Employers Can Require Workers to Get Covid-19 Vaccine, U.S. Says

Even so, employers may need to be careful about how they handle the process.

Pre-screening vaccination questions could violate an ADA provision for disabled-related inquiries. According to the guidelines, employers who administer vaccines must demonstrate that pre-screening questions are “job-related and consistent with business need”.

Covid19 vaccinations>

Answers to your vaccine questions

With a coronavirus vaccine spreading out of the US, here are answers to some questions you may be wondering about:

    • If I live in the US, when can I get the vaccine? While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.
    • When can I get back to normal life after the vaccination? Life will only get back to normal once society as a whole receives adequate protection against the coronavirus. Once countries have approved a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible that people spread the virus without knowing they are infected because they have mild symptoms or no symptoms at all. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.
    • Do I still have to wear a mask after the vaccination? Yeah, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This seems to be sufficient protection to protect the vaccinated person from disease. What is not clear, however, is whether it is possible for the virus to bloom in the nose – and sneeze or exhale to infect others – even if antibodies have been mobilized elsewhere in the body to prevent that vaccinated person gets sick. The vaccine clinical trials were designed to determine if people who were vaccinated are protected from disease – not to find out if they can still spread the coronavirus. Based on studies of flu vaccines and even patients infected with Covid-19, researchers have reason to hope that people who are vaccinated will not spread the virus, but more research is needed. In the meantime, everyone – including those who have been vaccinated – must imagine themselves as possible silent shakers and continue to wear a mask. Read more here.
    • Will it hurt What are the side effects? The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection in your arm feels no different than any other vaccine, but the rate of short-lived side effects seems to be higher than with the flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. The side effects, which can be similar to symptoms of Covid-19, last about a day and are more likely to occur after the second dose. Early reports from vaccine trials suggest that some people may need to take a day off because they feel lousy after receiving the second dose. In the Pfizer study, around half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headache, chills, and muscle pain. While these experiences are not pleasant, they are a good sign that your own immune system is having a strong response to the vaccine that provides lasting immunity.
    • Will mRNA vaccines change my genes? No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given moment, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can hold for a few days at most before it is destroyed.

The instruction takes place in the midst of the skepticism about the vaccinations among large parts of the public. A recent survey of about 2,000 New York firefighters found that, according to CNN, nearly 55 percent said they would not get a vaccine if offered by their department.

According to a poll by Pew Research, only 42 percent of black Americans say they have been vaccinated. According to a November Gallup panel poll, 58 percent of Americans said they were receiving a total of one Covid-19 vaccine.

Suspicions about vaccinations are also being fueled by political commentators and groups.

On his Fox News Show this week, Tucker Carlson shared the stories of a small number of Americans who have had side effects from Pfizer’s vaccine. And extremism experts have warned that groups that have protested election results and Covid-19 bans in the United States are now turning their attention to the anti-vaccine movement.

The introduction of a vaccine and urgent logistical questions about its spread signals that the end of the pandemic is in sight, but the virus is also deadlier than ever. The US reports more than 3,000 deaths per day for the first time this month.

As the federal and state governments prepare for extensive vaccination efforts, the Trump administration’s message about the pandemic remains mixed up.

Vice President Mike Pence hosted a Christmas party a few days ago at his residence, at which, according to the participants, the guests posed for pictures without a mask. But on Friday morning, Mr Pence received his first vaccine shot on live television. He was joined by his wife, Karen Pence, and surgeon-general Jerome Adams.

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Health

She Saved 1000’s of Greatest Associates. Then Covid-19 Killed Her.

She Saved Thousands of Best Friends. Then Covid-19 Killed Her.

Valerie Louie saved our beloved Uncle Mort from a life of abuse. Then she became a victim of a pandemic. Their deaths are being mourned by households of four paws in San Francisco and the Bay Area.

Ms. Louie spent two decades rescuing dogs like Uncle Mort from animal shelters and making them like our homes to have a new best friend. Her specialty was rescuing the truly abandoned and broken puppy, the abused, the blind, the deaf, and the long tooth.

The day she dropped the sad-eyed mutt I identified at one of her shelter events, the little guy immediately put a poop on our dining room carpet.

“It’s just a little,” said Ms. Louie. She had a generous smile and the patience of a clergyman.

Ms. Louie, who died of Covid-19 on November 25 after two weeks in an intensive care unit, didn’t just save rescue dogs. She also saved people. She was a nurse and worked at Oakland Highland Hospital for 32 years, starting in the emergency room. Her last position was as an advanced life support coordinator.

She was a single mother. She leaves behind her son Andrew Louie (21), who lived with her and was also infected with the corona virus at the end of October. He has since recovered.

Ms. Louie died on the Mission Bernal campus of California Pacific Medical Center in San Francisco, the city she was born and raised in. She was 60. Her legacy lives on.

“I can’t imagine how many dogs she saved, probably thousands,” her son said, repeating a number estimated by other volunteers. She farmed the canines to families after they were retrieved from animal shelters, including so-called killing shelters in central California, where many dogs are bred, adopted, and abandoned.

Friends said she had a special talent as a matchmaker between dog and family. She would keep a mental record of the people looking for rescue dogs and when the right fit came up she would call with the good news.

Some dogs she held – like Ida, a French bulldog found in the mountains of China in 2012. The person who abandoned the dog and found it blind after it was used for breeding discovered Ms. Louie online through an organization she worked with at the time called Rocket Dog Rescue. Ms. Louie let the dog fly to San Francisco, her son said.

“She was a powerhouse,” said Meg McAdam, a close friend who also rescues dogs and works at Oakland Animal Services, “and a San Francisco institution.”

During the pandemic, Ms. Louie rescued about 80 dogs, found them in animal shelters, and bred them to their homes, according to Ms. McAdam.

Honors have been received on a GoFundMe website that Ms. McAdam set up to support Ms. Louie’s son.

“Valerie gave us our cute boomer,” wrote one grateful mourner. “I’ve been praying for her every day since we heard the news.”

Updated

Apr. 17, 2020 at 1:23 am ET

“Valerie gave us our Reggie.”

“She helped us a lot with our Zito.”

I can also testify. In early 2018 I saw Uncle Mort, a tormented little soul, for the first time on the back of Ms. Louie’s Toyota RAV4. It was just another Saturday for Valerie taking dogs to an adoption event at a mall on the southern edge of San Francisco.

I had been lurking at the event for the past two weekends and this feeling of having a dog rose inside me. My wife Meredith, who had long been reluctant because her husband didn’t care for the dog, seemed to temper the idea.

The huddled creature was part long-haired Chihuahua, part depressed. He was 3 years old and much of his life had been spent outside because the man in the house didn’t like his mood, Ms. Louie told me

I told her I would like to try the dog, but I had to convince on the home front. She understood immediately. She’d done it hundreds of times – the real test run for the family on the fence to get a new member with fur and a troubled past.

I signed the papers and a few days later Ms. Louie dropped him off and assessed the fit. She looked around approvingly as the dog laid his opening game on our carpet. His first name was Franco. That didn’t fit.

Franco sounded like a Spanish dictator. The weathered soul in our house looked more like an old Member of Parliament when it was only three years old. We named him Uncle Mort. That was the name of a character in a comic book I’d been writing for a decade; The dog and cartoon character were strikingly similar.

The new name was all the more fitting now that we witnessed his early behavior that made you look nervous when awake but mostly slept with an oversized snore that sounded like your great-uncle after Thanksgiving dinner and passed out on the couch .

We called a dog trainer to see if Mort could learn to love and be loved. The coach was doubtful. “He’ll be a good dog, but don’t get your hopes up that he’ll be the family dog ​​you imagined. He’s had a hard time. “

We raised our hopes. We were rewarded.

Uncle Mort has become the most loving and beloved creature in our house and on some days outperformed the children on both counts. My wife is his “person” and when she returns home from even the briefest of absence, he goes bananas as if he had just discovered the ocean.

Now Meredith calls Uncle Mort her “forever puppy”. Nowadays, Mort is so relaxed that he regularly lies in various positions of seemingly impossible geometry and vulnerability, all four limbs in the air so that he can be caressed around his chest, neck and ears in the way he has become used.

Uncle Mort – or simply “good boy” – became the real dog in the window that we had always dreamed of taking home, and so it really hit our household when we found out that Ms. Louie was on the Intensive care unit was

Your tragedy is a typical Covid-19 tragedy. It’s not clear how she contracted the disease, and she went on a fatal roller coaster ride.

On October 29th, she wrote to Ms. McAdam, her close friend, “I haven’t been this sick forever. I can’t break the fever. “

On November 2, she wrote: “I still sleep days. I lose a lot of time. “

On November 11th, a friend went to her house to check on Ms. Louie and found her in dire straits. She was taken to the hospital and immediately intubated.

Ms. Louie’s son is taking college classes, studying to be a nurse, and recently took on his mother’s role, helping find homes for the last three dogs she chose.

One was Blitz, a gray terrier mix that is deaf. Then there’s Bronco, a long haired dachshund, and Tavish, a one-eyed pug.

“That was a real Valerie dog,” said Ms. McAdam. “These are the dogs she saved.”

At Highland Hospital, where she worked, her loss was also deeply felt. Michelle Hepburn, director of emergency services and trauma at Alameda Health Systems, who operates Highland, adopted Bella, a pit bull puppy, with the help of Ms. Louie.

“Her passion for caring for people and fur babies was evident every waking moment,” said Ms. Hepburn.

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World News

The primary Covid-19 vaccines deliver People hope in small doses.

The first Covid-19 vaccines bring Americans hope in small doses.

Some of the medical centers that have seen the worst coronavirus outbreak in the United States found the darkness that has long filled their corridors replaced with exhilaration and hope on Monday as healthcare workers first participated in a targeted mass vaccination campaign at the end of the pandemic.

Hundreds of those who have been on the front lines fighting Covid-19 – a nurse from an intensive care unit in New York, an emergency doctor from Ohio, a housekeeper in Iowa – received vaccinations in emotional ceremonies watched by people around the country .

“I have a feeling healing is coming,” said Sandra Lindsay, an intensive care director who was among the first health workers to be vaccinated on Monday morning at the Long Island Jewish Medical Center in Queens.

The vaccinations came when the nation topped 300,000 coronavirus deaths, a higher number than any other country. Even when there was applause in hospitals, many intensive care units remained almost full.

Doctors, nurses, aides, cleaners, and at least one manager who said he would get the vaccine early to encourage all staff to do the same.

Dr. Jason Smith, the first Kentuckian to receive the Covid-19 vaccine, showed off the smiley face patch a health care worker put on his arm. “I didn’t even feel it,” he said.

A group of nuns in Sioux Falls, SD, blessed the vaccine upon arrival before it was placed in a freezer.

Seth Jackson, an Iowa City nurse, cried on the way to the hospital to get his shot. Robin Mercier, a Rhode Island nurse, was delighted to be one step closer than she could kiss her grandchild.

For many Americans who lost loved ones to Covid-19, the introduction of vaccination has been bittersweet. It didn’t come soon enough for Mary Smith’s husband Mike, who died of the virus in November at the age of 64.

“It was so close,” said Ms. Smith, who lives outside of Peoria, Illinois, on Monday.

She expressed frustration with people who said they did not trust the vaccine. “These people who say, ‘I don’t get it,’ all I can say is, ‘Why? Have you lost your mind? Added Ms. Smith. “Didn’t you see how many people died? That is real.'”

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Health

Covid-19 exams for passenger on a Royal Caribbean cruise in Singapore

Covid-19 tests for passenger on a Royal Caribbean cruise in Singapore

Royal Caribbean’s Quantum of the Seas cruise ship docked at the Marina Bay Cruise Center in Singapore on December 9, 2020.

Rosanna Lockwood | CNBC

SINGAPORE – The Singaporean passenger who tested positive for Covid-19 on board a cruise ship subsequently tested negative for the disease, according to the Singapore Ministry of Health.

The passenger, an 83-year-old man, was aboard Royal Caribbean’s Quantum of the Seas, which embarked on a round trip to the city-state with no stopover on December 7th. The ship was forced to return on Wednesday, a day ahead of schedule, after the passenger underwent a polymerase chain reaction (PCR) test on the cruise ship that was positive for Covid-19.

PCR tests have been widely used to detect cases because they are accurate in their diagnosis, but it takes hours for results to return.

“His original sample has since been retested at the National Public Health Laboratory (NPHL) and found negative for (Covid-19) infection. A second fresh sample tested by NPHL also came back negative,” said the Department of Health Health said Wednesday evening, adding that another test would be done the next day to confirm his Covid-19 status.

On Thursday afternoon, the Ministry of Health announced that the passenger did not have Covid-19.

“The sample taken from the individual this morning was negative for the virus. This follows two Polymerase Chain Reaction (PCR) tests performed yesterday by NPHL, one on retesting its original sample and the other on a fresh sample yesterday, which was also negative, “said the Ministry of Health in its daily preliminary update of Covid-19 cases in the city-state.

“We have lifted the quarantine orders of his close contacts, which had previously been quarantined as a precaution during the ongoing investigations,” added the Ministry of Health in its statement.

The passenger was taken to the National Center for Infectious Diseases at 2:30 p.m. Singapore time on Wednesday, according to the Singapore Tourism Board.

The tourism authority added that all 1,680 passengers and 1,148 crew members on board had tested negative for the virus prior to the ship’s departure. Passengers and crew members who came into close contact with the person concerned were isolated while other passengers were subjected to mandatory tests before they were allowed to exit the Marina Bay Cruise Center, where the ship is docked.

In a separate statement, Royal Caribbean said that the entire crew will be subjected to PCR testing on Thursday while the ship is thoroughly cleaned and disinfected.

A cruise with 4 nights that should start on Thursday has been canceled, said the cruise operator.

The coronavirus pandemic has hit the world Travel and tourism sectors this year, including the cruise industry.

Singapore’s “Cruise to Nowhere” program is an attempt to increase demand for travel amid the pandemic. In order to participate, cruise lines must obtain a mandatory safety certification and undergo an audit before they can begin sailing.

Only two operators, Royal Caribbean and Genting Cruise Lines, sail from Singapore under this program.

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Health

Australia Scraps Covid-19 Vaccine That Produced H.I.V. False Positives

Australia Scraps Covid-19 Vaccine That Produced H.I.V. False Positives

Australia on Friday canceled a roughly $ 750 million plan for a major contract for a locally developed coronavirus vaccine after vaccination resulted in false positive test results for HIV in some volunteers participating in an experimental study.

Of the dozen of coronavirus vaccines tested worldwide, the Australian one was the first to be abandoned. While the developers said the experimental vaccine was safe and effective, the false positives risked confidence in efforts to vaccinate the public.

Prime Minister Scott Morrison said Friday that his government would partially offset the loss of 51 million doses it planned to buy from the Australian consortium by increasing orders for vaccines from AstraZeneca and Novavax. The government has announced that it will start vaccinating citizens in March.

“We can’t have problems with trust,” he told reporters, “and now as a nation with a good portfolio of vaccines we are able to make those choices to best protect the Australian people.”

The Australian setback highlighted the missteps that can inevitably occur when scientists shorten the usual year-long process of vaccine development to a few months during a pandemic that killed more than 1.5 million people.

But just as the Australian scientists made their announcement, the fruits of this breed became clearer. The United States got one step closer to getting its first approval for a Covid-19 vaccine when a panel of experts advising the Food and Drug Administration endorsed a Pfizer vaccine that is already in use in the UK.

The problem with the Australian vaccine, developed by the University of Queensland and biotech company CSL, was related to the use of two fragments of a protein found in HIV

The protein was part of a molecular “clamp” that researchers placed on the spikes surrounding the coronavirus and allowed it to penetrate healthy cells. The bracket stabilizes the spikes and allows the immune system to respond more effectively to the vaccine.

Using the HIV protein did not pose a risk of infecting the volunteers with this virus, the researchers said. However, the clamp produced the production of antibodies that were detected by HIV testing at higher levels than scientists expected.

Because HIV tests couldn’t be quickly revised to take this into account, the researchers decided to stop developing the vaccine. The act could have created widespread fears among Australians that the vaccine could cause AIDS.

Early experiments on hamsters showed that the vaccine protected them from the coronavirus. When Phase 1 human trials began in July, the 216 volunteers were “fully informed about the possibility of a partial immune response” to the clamp, the University of Queensland and CSL said in a statement Friday.

Updated

Apr 11, 2020 at 1:26 am ET

The mistake, said John P. Moore, an immunologist at Weill Cornell Medical College in New York, was an “honest mistake” that cost money, not human life.

“I’m sure a lot of people are very embarrassed,” said Professor Moore. “It’s not great to be associated with a bug like this. But when you run at 90 mph, you sometimes trip. “

The coronavirus outbreak>

Things to know about testing

Confused by Coronavirus Testing Conditions? Let us help:

    • antibody: A protein produced by the immune system that can recognize and attach to certain types of viruses, bacteria or other invaders.
    • Antibody test / serology test: A test that detects antibodies specific to the coronavirus. About a week after the coronavirus infects the body, antibodies start appearing in the blood. Because antibodies take so long to develop, an antibody test cannot reliably diagnose an ongoing infection. However, it can identify people who have been exposed to the coronavirus in the past.
    • Antigen test: This test detects parts of coronavirus proteins called antigens. Antigen tests are quick and only take five minutes. However, they are less accurate than tests that detect genetic material from the virus.
    • Coronavirus: Any virus that belongs to the Orthocoronavirinae virus family. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
    • Covid19: The disease caused by the new coronavirus. The name stands for Coronavirus Disease 2019.
    • Isolation and quarantine: Isolation is separating people who know they have a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
    • Nasopharyngeal smear: A long, flexible stick with a soft swab that is inserted deep into the nose to collect samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be obtained with swabs that do not go as deep into the nose – sometimes called nasal swabs – or with mouth or throat swabs.
    • Polymerase chain reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. With the help of PCR tests, researchers can detect the coronavirus even when it is scarce.
    • Viral load: The amount of virus in a person’s body. In people infected with the coronavirus, viral loads can peak before symptoms, if any.

The University of Queensland’s vaccine was one of several vaccines under development that contain a coronavirus protein that triggers an immune system response. Protein-based vaccines have a longer track record than some of the newer approaches used by competing coronavirus vaccines, such as those based on viral genes or called adenoviruses.

Prominent protein-based vaccines include one from Novavax of Maryland, which is in Phase 3 trials, and another from Clover Biopharmaceuticals of China, which is in Phase 1.

In the case of the Australian vaccine, it was found to produce a strong immune response and, according to the scientists in the phase 1 study, did not cause any serious side effects. However, proceeding with the vaccine study would have required “significant changes” in longstanding HIV testing procedures, they said.

“This would delay development for another 12 months, and while this is a difficult decision, the urgent need for a vaccine must be everyone’s priority,” Paul Young, a virologist at the university who directed the vaccine effort, said in the Explanation. He did not immediately respond to a request for comment on Friday afternoon.

Australian Health Secretary Greg Hunt told reporters the country still has access to 140 million units of coronavirus vaccines – more than enough to feed its population of approximately 25 million people.

“This is the scientific process that works,” said Hunt. “It’s the planning process that works. It’s an honest explanation for some of the challenges we’ve faced. “

Carl Zimmer contributed to the reporting.

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World News

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

Gov. Ralph Northam of Virginia.

Here’s what you need to know:

Credit…Steve Helber/Associated Press

Pennsylvania announced statewide restrictions on Thursday that ban indoor dining and close gyms, theaters and casinos for three weeks to stem a “dire” surge in coronavirus cases, and Virginians were asked to stay home from midnight to 5 a.m. until the new year.

The clampdowns came as states across the country reported deaths and cases in numbers never seen before, and hospitals filled beyond capacity. Through Wednesday, there were seven-day records in both cases and deaths.

In Pennsylvania, Gov. Tom Wolf was unsparing Thursday in his characterization of the threat facing his state.

“This virus continues to rage in Pennsylvania,” Mr. Wolf said at a news conference. “Clearly we need to take future mitigation actions and stop the spread of Covid-19. We all hoped it would not come to this. The current state of the surge in Pennsylvania will not allow us to wait.”

And in Virginia, Gov. Ralph Northam announced a new executive order that imposes a nightly curfew, but it was unclear how — and how vigorously — it would be enforced.

The order lists categories of activity that will still be permitted during the curfew, including obtaining food, goods or services; seeking medical or law enforcement help; taking care of people or animals; child care; exercise; traveling to work, school or a house of worship; volunteering for charity; and leaving home to seek safety.

The governor urged residents not to go out without good reason. “We need to take this seriously,” Mr. Northam said. “We need to stay at home.”

But asked how the curfew would be enforced, the governor said it was “about messaging.”

Virginia reported at least 21 new coronavirus deaths and 4,398 new cases on Wednesday. Over the past week, the state has reported an average of 3,521 cases a day, an increase of 41 percent from the average two weeks earlier.

The new order also prohibits all public and private in-person gatherings of more than 10 people who do not live together, with exceptions for work and education, and requires people to wear masks “if they are in an indoor setting shared by others.” The state already requires masks outdoors.

Oklahoma also limited indoor activity, restricting indoor youth sporting events and public gatherings — which includes weddings, funerals and holiday parties held at event centers — to 50 percent capacity for the next 30 days. Places of worship are excluded.

On Wednesday, Pennsylvania reported 8,626 new cases and an additional 247 coronavirus deaths. The daily average over the past week has hovered near 10,000 cases per day, an increase of 51 percent from the average two weeks earlier.

Dr. Jaewon Ryu, the president and chief executive officer of Geisinger Health System, a regional hospital system, said the network was “operating pretty close to 100 percent capacity.”

Mr. Wolf, who announced on Wednesday that he had tested positive for the coronavirus and would be performing his duties remotely, said he was feeling well and that he had tested negative on Thursday. Mr. Wolf’s wife, Francis Wolf, also tested negative.

It was not immediately clear what type of test Mr. Wolf took, or if he had previously felt sick. Some types of coronavirus tests are prone to delivering incorrect results, especially when they are taken by people who are not experiencing symptoms.

Even before Governor Wolf issued his new order, the Pennsylvania House majority leader, Kerry Benninghoff, a Republican, pushed back against what many suspected was coming.

“Governor Wolf, do not cancel Christmas,” Mr. Benninghoff said in a statement. “Do not use your executive order pen to devastate lives and livelihoods. Government mandates will not cure COVID-19 and unilateral shutdowns will not create personal responsibility.”

In Virginia, speaking on the first night of Hanukkah, the governor also called on citizens to remember service members and essential workers during the holiday season.

“I know that Christmas and Hanukkah are truly cherished times,” he said. “The holidays look a bit different this year, and some of the traditions we treasure just aren’t possible.”

But he added, “As we look ahead to a new year, I see reason for hope and optimism that in the coming months, things will be better.”

The Pfizer/BioNTech vaccine being administered at a London hospital this week.Credit…Pool photo by Victoria Jones

Pfizer’s Covid-19 vaccine passed a critical milestone on Thursday when a panel of experts formally recommended that the Food and Drug Administration authorize its use.

The F.D.A.’s vaccine advisory panel, composed of independent scientific experts, infectious disease doctors and statisticians, voted in favor of emergency authorization for people 16 and older.

Although the F.D.A. does not have to follow the advice of its advisory panel, it usually does, and it is likely to do so within days, giving health care workers and nursing home residents first priority to begin receiving the first shots early next week.

The agency may act as soon as Saturday, though officials cautioned that last-minute legal or bureaucratic requirements might delay an announcement.

With that formal blessing, the nation may finally begin to slow the spread of the virus just as infections and deaths surge, reaching a record of more than 3,000 daily deaths on Wednesday.

The initial shipment of 6.4 million doses will leave Pfizer warehouses within 24 hours of being cleared by the F.D.A., according to federal officials. About half of those doses will be sent across the country, and the other half will be reserved for the initial recipients to receive their second dose about three weeks later.

It is the beginning of a complex, monthslong distribution plan coordinated by federal and local health authorities, as well as large hospitals and pharmacy chains.

If successful, the vaccine campaign should help return a grieving and economically depressed country back to some semblance of normal.

“With the high efficacy and good safety profile shown for our vaccine, and the pandemic essentially out of control, vaccine introduction is an urgent need,” Kathrin Jansen, a senior vice president and the head of vaccine research and development at Pfizer, said at the meeting.

The recommendation vote caps a whirlwind year for Pfizer and its German partner BioNTech, which began working on the vaccine 11 months ago, shattering all speed records for vaccine development, which typically takes years.

The Pfizer vaccine has already been given to people in Bahrain and Britain. Canada approved it on Wednesday. A U.S. authorization for it is expected to be followed soon by one for Moderna’s vaccine, which uses similar technology and has also shown promising results in clinical trials.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, testifying before Congress in September.Credit…Anna Moneymaker/The New York Times

The editor in chief of a weekly report from the Centers for Disease Control and Prevention has told House Democrats that she was ordered to destroy an email showing that Trump political appointees attempted to interfere with its publication — and that she believes the order came from Dr. Robert R. Redfield, the agency’s director.

The explosive allegation from Dr. Charlotte Kent, the editor of the C.D.C.’s Morbidity and Mortality Weekly Report — the so-called “holiest of the holy” of health reports — is contained in a letter that Representative James E. Clyburn of South Carolina, the No. 3 House Democrat, sent Thursday morning to Dr. Redfield and the health secretary, Alex M. Azar II.

The email in question, dated Aug. 8, was sent by Dr. Paul Alexander, then a senior H.H.S. adviser, Mr. Clyburn’s letter said. In it, Dr. Alexander demanded that the C.D.C. insert new language in a previously published scientific report on coronavirus risks to children, or “pull it down and stop all reports immediately.”

Dr. Kent was on vacation when it arrived; the request to delete the message, she told investigators, was passed on to her by the woman who was filling in for her. She considered the request “very unusual,” she said. And when she tried to comply, she discovered the email had already been deleted — but she told investigators she had “no idea” by whom.

Dr. Redfield has said that the scientific integrity of the M.M.W.R., as the reports are known, has never been compromised — a point he reiterated in a statement on Thursday. He did not deny the order to delete the email, but said he had “instructed C.D.C. staff to ignore” Mr. Alexander’s comments.

“As I testified before Congress, I am fully committed to maintaining the independence of the M.M.W.R., and I stand by that statement.” Dr. Redfield said.

A separate statement from the C.D.C.’s parent agency, the Department of Health and Human Services, called Mr. Clyburn’s letter “irresponsible” and said it mischaracterized Dr. Kent’s testimony. House Republicans then released excerpts from Dr. Kent’s testimony in which she said she was “very committed to maintaining the scientific integrity of the M.M. WR.,” and would never let anything interfere with that.

Mr. Clyburn, who leads a committee that is investigating political interference with the C.D.C., wrote that after Dr. Kent spoke to the panel on Monday, the Trump administration abruptly canceled four more interviews with top C.D.C. scientists and officials, a move the congressman said amounted to obstructing his investigation.

“I am deeply concerned that the Trump administration’s political meddling with the nation’s coronavirus response has put American lives at greater risk,” Mr. Clyburn wrote, “and that administration officials may have taken steps to conceal and destroy evidence of this dangerous conduct.”

He told Mr. Azar and Dr. Redfield that if theydid not produce documents requested by his panel by Dec. 15, he would subpoena the records.

The issue of political interference in the weekly reports burst into the news in September, when current and former senior health officials disclosed that H.H.S. political appointees had repeatedly asked the C.D.C. to revise, delay and even scuttle reports on the coronavirus that they believed were unflattering to President Trump.

One point of contention was the C.D.C.’s guidance on school openings.

Mr. Clyburn’s letter quoted Mr. Alexander’s email as saying: “C.D.C. tried to report as if once kids get together, there will be spread and this will impact school reopening. … Very misleading by C.D.C. and shame on them. Their aim is clear. … This is designed to hurt this Presidnet [sic] for their reasons which I am not interested in.”

Mr. Alexander was dismissed from the department in September.

The committee is now seeking to interview the four other C.D.C. officials whose appearances were canceled: Dr. Anne Schuchat, the principal deputy director; Nina Witkofsky, the acting chief of staff; Trey Moeller, the acting deputy chief of staff; and Kate Galatas, the acting associate director for communications.

Volunteers for coronavirus vaccine trials in Soweto, South Africa.Credit…Jerome Delay/Associated Press

Wealthy nations have a firm upper hand in securing a coronavirus vaccine compared with developing countries, a global coalition of organizations and activists warned on Wednesday.

In about 70 developing countries, only one in 10 residents is expected to receive a Covid-19 vaccine within the next year, according to the People’s Vaccine Alliance, which consists of organizations such as Amnesty International, Frontline AIDS, Global Justice Now and Oxfam.

“The hoarding of vaccines actively undermines global efforts to ensure that everyone, everywhere can be protected from Covid-19,” said Steve Cockburn, Amnesty International’s head of economic and social justice. “Rich countries have clear human rights obligations not only to refrain from actions that could harm access to vaccines elsewhere, but also to cooperate and provide assistance to countries that need it.”

Rich countries representing 14 percent of the global population have bought over 50 percent of promising Covid-19 vaccines, according to data collected by Airfinity, a London-based software company tracking deals between countries and manufacturers. It looked at supply deals that included eight vaccine candidates in Phase 3 clinical trials.

The alliance called on pharmaceutical companies along with researchers to “share the science, technological know-how and intellectual property” of their vaccines. They also asked governments to ensure their Covid-19 vaccines are free to the public and equitably available.

Recently, countries including South Africa and India have pushed for loosened restrictions on intellectual property rights for Covid-19 vaccines, proposing that the World Trade Organization end global enforcement of the rights in the interest of accessibility.

“Governments must also ensure the pharmaceutical industry puts people’s lives before profits,” said Heidi Chow, a senior campaign and policy manager at Global Justice Now.

Developing countries that the alliance focused on currently have access to the vaccine only through Covax, a global initiative to vaccinate much of the world population. (The United States declined to be a part of the effort.)

The United Kingdom started vaccinations this week, after becoming the first Western country to authorize a Covid-19 vaccine. On Wednesday, the United Arab Emirates approved China’s coronavirus vaccine, signaling a win for that country’s vaccine ambitions. Canada approved Pfizer and BioNTech’s coronavirus vaccine, which was also approved in Britain. Both Pfizer and Moderna have submitted their applications for emergency approvals the U.S. Food and Drug Administration and vaccinations in the U.S. could start before next month.

However, the news of vaccination success in wealthy nations hasn’t necessarily equated to access for developing countries: Wealthy nations have purchased enough doses to vaccinate their populations three times over by the end of 2021, the alliance said.

“By buying up the vast majority of the world’s vaccine supply, rich countries are in breach of their human rights obligations,” Mr. Cockburn said. “Instead, by working with others to share knowledge and scale up supply, they could help bring an end to the global Covid-19 crisis.”

Weekly initial jobless claims through the week ending Dec. 5

Pandemic Unemployment

Assistance claims

Jump in claims the week after Thanksgiving

Weekly initial jobless claims through the week ending Dec. 5

Pandemic Unemployment

Assistance claims

Jump in claims the week after Thanksgiving

Applications for jobless benefits resumed their upward march last week as the worsening pandemic continued to take a toll on the economy.

More than 947,000 workers filed new claims for state unemployment benefits last week, the Labor Department said Thursday. That was up nearly 229,000 from the week before, reversing a one-week dip that many economists attributed to the Thanksgiving holiday. Applications have now risen three times in the last four weeks, and are up nearly a quarter-million since the first week of November.

On a seasonally adjusted basis, the week’s figure was 853,000, an increase of 137,000.

Nearly 428,000 applied for Pandemic Unemployment Assistance, a federal program that covers freelancers, self-employed workers and others who don’t qualify for regular state benefits.

Unemployment filings have fallen greatly since last spring, when as many as six million people a week applied for state benefits. But progress had stalled even before the recent increases, and with Covid-19 cases soaring and states reimposing restrictions on consumers and businesses, economists fear that layoffs could surge again.

“It’s very clear the third wave of the pandemic is causing businesses to have to lay people off and consumers to cut back spending,” said Daniel Zhao, senior economist for the career site Glassdoor. “It seems like we’re in for a rough winter economically.”

Jobless claims rose in nearly every state last week. In California, where the state has imposed strict new limits on many businesses, applications jumped by 47,000, more than reversing the state’s Thanksgiving-week decline.

The monthly jobs report released on Friday showed that hiring slowed sharply in early November and that some of the sectors most exposed to the pandemic, like restaurants and retailers, cut jobs for the first time since the spring. More up-to-date data from private sources suggests that the slowdown has continued or deepened since the November survey was conducted.

“Every month, we’re just seeing the pace of the recovery get slower and slower,” said AnnElizabeth Konkel, an economist with the job site Indeed. Now, she said, the question is, “Are we actually going to see it slide backward?”

Many economists say the recovery will continue to slow if the government does not provide more aid to households and businesses. After months of gridlock in Washington, prospects for a new round of federal help have grown in recent days, with congressional leaders from both parties signaling their openness to a compromise and the White House proposing its own $916 billion spending plan on Tuesday. But the two sides remain far apart on key issues.

The stakes are particularly high for jobless workers depending on federal programs that have expanded and extended unemployment benefits during the pandemic. Those programs expire later this month, potentially leaving millions of families with no income during what epidemiologists warn could be some of the pandemic’s worst months.

Richard Hinch was elected speaker of the New Hampshire House of Representatives at an outdoor meeting Dec. 2. He died a week later.Credit…Elise Amendola/Associated Press

The New Hampshire State Legislature was already fiercely divided over the coronavirus when the new Republican speaker of the House of Representatives, Richard Hinch, died suddenly on Wednesday. Then came the news on Thursday that the cause of his death was Covid-19.

Mr. Hinch, who was 71, died just a week after he was sworn in as speaker — and about three weeks after an indoor meeting of his caucus that led to several members contracting the virus, an event that Mr. Hinch had tried to play down in public remarks. It was not clear whether he, too, had caught the virus at the caucus meeting.

The news will undoubtedly heighten tensions among state lawmakers, who have been at odds over the refusal of many Republican lawmakers to wear masks or take other pandemic precautions seriously. Splits have opened not just along partisan lines but also within the Republican ranks.

William M. Marsh, a Republican state representative, said the responsibility for Mr. Hinch’s death lies on the shoulders of a group of Republican members who refused to take precautions like wearing masks and maintaining social distance, and who leaned on others to do the same. “The peer pressure from colleagues is the root cause of what happened to my friend,” Mr. Marsh said of Mr. Hinch.

Democratic lawmakers, who held a majority before the Nov. 3 election, have been in an uproar over the Republican caucus meeting, which was held on Nov. 20 at a ski area. Democrats say they were kept in the dark about the infected lawmakers while Republicans were informed.

The Democratic former speaker, Steve Shurtleff, said he was troubled by Mr. Hinch’s support of Republican lawmakers who refused to wear masks on the House floor, whom Mr. Hinch had called the “patriot section” and the “freedom group.”

“It’s so ironic, looking back,” Mr. Shurtleff said on Thursday. “I know he was just doing his job as a Republican leader, defending his members and his caucus, but it seems so senseless now.”

Mr. Shurtleff said he hoped that the acting speaker would arrange for the House to meet remotely when its next session convenes in January, because he did not expect the mask-resistant Republicans to change their behavior. “I don’t think there will be any remorse,” he said. “There may be remorse at his passing, but not so much at the cause.”

Gov. Chris Sununu, a Republican, said on Wednesday that Mr. Hinch was “a fierce defender” of the state, “a close friend and a respected public servant.” He, too, was critical of lawmakers who refuse to wear masks. “For those who are out there doing just the opposite, just to make some sort of bizarre political point, it’s horribly irresponsible,” he said. “Use your heads, don’t act like a bunch of children.”

The State Senate and House each held their organizational meetings outdoors in 40-degree weather last week. About 130 members of the 400-seat House did not attend in person and were sworn in remotely, according to The Associated Press.

Republican lawmakers in at least two other states where mask wearing and other restrictions have been politically contentious have tested positive in recent days:

  • A South Dakota state senator who attended a dinner with the governor on Monday, and then joined dozens of lawmakers for a budget speech on Tuesday, tested positive on Wednesday. Senator Helene Duhamel of Rapid City posed for a group photo, shoulder to shoulder with Gov. Kristi Noem and more than two dozen other women who attended the dinner. Governor Noem has fiercely resisted imposing a mask mandate or any other restrictions throughout the pandemic, even as the coronavirus raged through the state in the fall, overwhelming its hospitals. The governor’s office insisted that she had not had close contact with Ms. Duhamel, even though they were photographed standing only a few feet apart.

  • The chairman of the appropriations committee in the North Dakota State Senate, Ray Holmberg, confirmed to The Bismarck Tribune on Thursday that he had tested positive, and said he believed he was infected with the virus during the legislature’s organizational session last week. Three employees of the legislature’s nonpartisan research agency have also tested positive, The Associated Press reported.

Ellen DeGeneres announced in a tweet on Thursday that she had tested positive for the coronavirus.Credit…Chris Pizzello/Invision, via Associated Press

“The Ellen DeGeneres Show” has paused filming after its host said on Thursday that she had tested positive for the coronavirus.

“Fortunately, I’m feeling fine right now,’’ Ms. DeGeneres wrote in a statement she posted to Twitter.

Ms. DeGeneres said that anyone who had been in close contact with her had been notified, and that she was following guidelines from the Centers for Disease Control and Prevention.

“I’ll see you all again after the holidays,’’ she wrote. “Please stay healthy and safe.’’

The production company Telepictures, which is a unit of Warner Bros. Television, said in a statement that it had paused filming until January.

The talk show, which films in Burbank, Calif., has been a staple of daytime television since 2003.

After shifting to virtual audiences amid the pandemic, Ms. DeGeneres had resumed filming with a limited live audience in late October. Attendees were required to wear face masks and sit six feet apart.

Ms. DeGeneres had faced accusations of leading a toxic workplace earlier this year, after BuzzFeed News published an article in July in which former staff members said they faced “racism, fear and intimidation” on set. Warner Bros. announced an investigation, three producers left the show, and Ms. DeGeneres apologized on camera and to employees.

The European Medicines Agency, located in Amsterdam, did not disclose who was behind the cyberattack.Credit…Remko De Waal/EPA, via Shutterstock

The European Medicines Agency, the European Union’s top drug regulator, whose approval is necessary for countries in the bloc to begin rolling out the coronavirus vaccine, has begun an investigation after it was hit by a cyberattack, it said on Wednesday.

The agency, which is reviewing vaccine candidates, did not provide details about the target or the date of the attack. But shortly after the announcement, Pfizer and BioNTech said in their own statement that some documents related to the regulatory submission of their vaccine and which were hosted on a server of the European agency, had been “unlawfully accessed.”

Pfizer and BioNTech said their systems had not been breached, and that no study participants appeared to have been identified as a result of the cyberattack.

The breach comes at a time of heightened threats faced by pharmaceutical companies, health care institutions and agencies involved in the production, approval and distribution of the vaccine.

Last week, IBM said it had detected a series of cyberattacks in September against companies involved in the distribution of coronavirus vaccines across the world and against a branch of the European Commission, the E.U.’s executive arm.

The European Medicines Agency is set to announce a decision on the Pfizer/BioNTech vaccine by Dec. 29. Although each country in the bloc will be in charge of its own rollout, the agency’s approval will pave the way for the largest vaccination campaign in the West, dwarfing the rollout that started this week in Britain and most likely posing more considerable logistical and security challenges.

Canada approved the Pfizer/BioNTech vaccine on Wednesday, becoming the second Western country to do so. Russia began the rollout of its own Sputnik 5 vaccine on Saturday.

The European Medicines Agency didn’t disclose who was behind the cyberattack, saying that it “cannot provide additional details whilst the investigation is ongoing.” Pfizer and BioNTech said in their statement that they were awaiting further information from the agency.

Cybersecurity experts have said that only state actors could carry out such operations. Microsoft revealed last month that hacker groups backed by Russia and North Korea had targeted several vaccine makers in the United States, Canada and France, among other countries.

“The intentions behind those attacks are to parasite Western efforts on the vaccine,” said Julien Nocetti, a researcher at the French Institute of International Relations who studies cybersecurity with a focus on Russian activities.

By breaking into the system of key actors involved in the vaccine or by disrupting distribution efforts, attackers could exact considerable damage, said Claire Zaboeva, a senior cyberthreat analyst at IBM’s Security X-Force.

Ms. Zaboeva said about the production and delivery of the vaccine: “If you manage to get the key to the whole kingdom, you have 500 options on the menu: collecting key timetables, which nations will get the vaccine, how it will get there, what companies will be associated with the delivery, or how it will be handled.”

Healthcare workers and the Connecticut National Guard administering coronavirus tests in Stamford, Conn., on Wednesday.Credit…Dave Sanders for The New York Times

Months into the pandemic, many people still are frustrated and confused about virus testing.

Long lines at testing sites, delays in getting results and even surprise testing bills have discouraged some people from getting tested.

And many people don’t understand what a test can and can’t tell you about your risk, and wrongly think a test result that comes back negative guarantees they can’t spread the virus to others.

We asked some of the nation’s leading experts on testing to help answer common questions about how to get tested, what to expect and what the different tests and results really mean.

Among them:

  • When should be people be tested?

  • What are the tests like?

  • What type of test should people get?

  • And how do you interpret the results?

Airlines are just one piece of a massive global machine cranking up to tackle one of the biggest logistical challenges in recent memory.Credit…Kriston Jae Bethel for The New York Times

Months before anyone knew which of the coronavirus vaccine candidates would pull ahead or when they’d be available, airlines were trying to figure out how to transport doses around the world.

Over the summer, American Airlines, Delta Air Lines and United Airlines spoke with government officials, pharmaceutical companies and experts to understand where vaccines might be produced, how they would be shipped and how best to position people and planes to get them moving. More recently, they have flown batches of vaccines for use in trials and research or to prepare for wider distribution.

The industry will play a vital role in moving billions of doses in the months ahead, putting underused planes and crews to work while circulating the very medicine that airlines hope will get people to book tickets again.

“When a request comes in, it’s going to be urgent and we have to act immediately,” said Manu Jacobs, who oversees shipments of pharmaceuticals and other specialty products for United.

One of the biggest challenges for airlines has been ensuring that vaccines are transported at frigid temperatures. Pfizer’s must be stored at an incredibly low minus-94 degrees Fahrenheit. Moderna’s can be kept at a more easily managed minus-4 degrees.

For its vaccine, Pfizer designed special cooler containers that can be stuffed with dry ice, which is solid carbon dioxide. But aviation authorities limit how much dry ice can be carried on planes because it turns to gas, making the air potentially toxic for pilots and crews.

After running tests that showed it was safe, United last month asked the Federal Aviation Administration to raise the limit so it could fly the Pfizer vaccine from Brussels International Airport to Chicago O’Hare International Airport, according to an F.A.A. letter. The agency allowed the airline to carry up to 15,000 pounds of dry ice aboard a Boeing 777-224 plane, compared to the previous limit of 3,000 pounds, according to the letter. A single 777 can carry up to one million doses, the airline said.

In normal times, about half of all air cargo is transported by airlines, often beneath the feet of passengers. The steep decline in flights this spring removed much of that capacity, but the urgent need for masks, gloves and ventilators created a big opportunity for cash-starved carriers, allowing them to recapture at least some of that lost business.

Quarantine orders for the passenger’s close contacts aboard the ship were rescinded after he tested negative.Credit…Edgar Su/Reuters

An 83-year-old passenger who initially tested positive for the coronavirus on a “cruise to nowhere” from Singapore this week, forcing thousands of passengers and crew members to return to port a day early, did not have the virus after all, officials said on Thursday.

The passenger, who had diarrhea aboard the ship Quantum of the Seas and had taken a mandatory Covid-19 test, has since tested negative several times, Singapore’s Ministry of Health said in a statement.

“The sample taken from the individual this morning came back negative for the virus,” officials said on Thursday. It was the third negative test after two on Wednesday also came back negative.

Quarantine orders for the man’s close contacts and other passengers aboard the ship were then rescinded, the ministry said.

Singapore’s Tourism Board said that contact tracing began immediately after the man’s positive test and that all leisure activities on board were canceled. The ship’s captain had also ordered guests to remain in their cabins during the investigation.

Quantum of the Seas, which is owned by Royal Caribbean, returned to the Marina Bay Cruise Center in Singapore at 8 a.m. Wednesday. All remaining passengers and crew members were required to undergo mandatory testing upon disembarking, the tourism board said.

The board also asked that passengers monitor their health for 14 days and to undergo a swab test at a designated government center at the end of the monitoring period.

When the cruise left the city-state on Monday, all 1,680 passengers and 1,148 crew members had tested negative for Covid-19, according to the tourism board.

The incident underscores the uncertainties the global tourism industry, battered by the pandemic, faces as it struggles to restart. The cruise ship is one of two to operate out of Singapore this month while putting in place a long list of safety precautions to reassure passengers.

A New York Times reporter recently took a trip on the other one, the World Dream.

In February, the coronavirus infected more than 200 people board the Diamond Princess cruise ship, trapping its 3,600 passengers and crew. Governments later banned cruises, crews were sent home, and passengers canceled their bookings. But countries like Singapore, Japan and several in Europe have since allowed cruises to restart under the watchful eye of officials.

Dr. Vivek H. Murthy advised the N.C.A.A. Board of Governors in the early days of the coronavirus pandemic.Credit…Hilary Swift for The New York Times

President-elect Joseph R. Biden Jr.’s choice for surgeon general, Dr. Vivek H. Murthy, had a central role in the National Collegiate Athletic Association’s decision in March to cancel this year’s national basketball tournaments — one of the earliest and most culturally significant signs that the virus would upend ordinary life in America.

The work of Dr. Murthy, a member of the association’s powerful Board of Governors who was surgeon general during part of the Obama administration, offers a view into how he approached the pandemic’s initial threat in the United States, and how he might help shape the federal government’s response under Mr. Biden.

A newcomer to the insular world of college athletics, Dr. Murthy proved a cautious, deliberate expert who was wary of making drastic decisions prematurely, interviews with more than a dozen people who participated in the N.C.A.A.’s meetings suggest. But they said that as the tournaments approached and more data and scientific research emerged, Dr. Murthy was a forceful and effective champion of measures that had been unthinkable to most of society only days or weeks earlier.

Indeed, it was Dr. Murthy who urgently told board members that they risked fueling a deadly crisis if they allowed the tournaments to proceed as scheduled.

“He was instrumental in convincing the board that the time to act was now,” said Kenneth I. Chenault, a former chairman of American Express who sits on the N.C.A.A. board.

But board members like Mr. Chenault said that it was plain that Dr. Murthy understood the cultural and financial repercussions of a decision like canceling the basketball tournaments, which generate hundreds of millions of dollars.

GLOBAL ROUNDUP

A market in Seoul, South Korea, on Tuesday. Health officials warned that ​the number of coronavirus cases could rise to record highs in coming days.Credit…Kim Hong-Ji/Reuters

For most of the year, South Korea has kept its coronavirus numbers so low it was the envy of the world. Now, the country is grappling with the most elusive wave of infections it has seen, just as other nations prepare to roll out vaccinations.

South Korea’s daily number of new cases was once as low as two per day. That number soared to​ 682 on Thursday, with health officials warning it could reach record highs in coming days. On Wednesday​, 686 new cases were reported, the highest daily count since Feb. 29.

“We must exert all we can, considering this is our last hurdle to clear ​in our efforts to curb the coronavirus before vaccines and treatments come online,” President Moon Jae-in said this week. He has instructed his government to mobilize ​​soldiers​, police officers and civil servants ​to help epidemiologists’ contact-tracing efforts.

The country’s struggle to contain the recent surge is a race against time. Mr. Moon’s government announced this week that it had secured enough doses of coronavirus vaccines from companies like AstraZeneca and Pfizer to inoculate roughly 86 percent of the population, but that the first batch would not arrive until March.

South Korea has been hit by four waves of infections since its first case was reported in January. But the latest is by far the ​hardest to control, health officials said.

Previous waves included mass clusters that health officials were able to target and trace. The current wave spread through numerous small clusters that erupted in nursing homes, hospitals, saunas, bars, restaurants, music halls and factories, most of them in the Seoul metropolitan area, but also in towns farther away.

Daily cases continue to rise despite tightened social-distancing ​guidelines and other measures. Na Seong-woong, a deputy commissioner of the Korea Disease Control and Prevention Agency, warned that the daily caseload could surpass 900 next week.

“We are facing our biggest ever coronavirus crisis because the current wave is neither temporary nor regional, but steady and nationwide,” he said. “We don’t have one central cluster that we can shut down with a focused testing and isolating campaign, but it’s popping up here and there and everywhere through our daily lives.”

In other developments across the world:

  • Spain was hit far worse during the first wave of the coronavirus than official data showed at the time, according to new statistics published by Spain’s national statistics institute on Thursday. The institute said 45,684 people had died of Covid-19 between March and May, compared to the 27,127 dead that Spain’s health ministry had reported by May 31. The health ministry counts only deaths officially attributed to Covid-19, while the statistics institute counted those who died with the disease as the most likely cause.

  • Hospitals in Tokyo were strained as Japan’s capital city reported 602 new cases on Thursday, its first time topping 600 cases in a day, officials said. Government officials have recommended that residents avoid outings.

  • Pope Francis will hold midnight Mass in Rome two hours earlier on Christmas Eve than he has in previous years, beginning at 7:30 p.m. to comply with Italy’s 10 p.m. curfew. The pope will also give his annual Christmas Day blessing at noon from inside St. Peter’s Basilica instead of from the loggia, where thousands would usually gather.

  • Secondary school students in the seven worst-hit areas of London will be tested for the virus, Britain’s health secretary, Matt Hancock, said at a news conference on Thursday evening. Mr. Hancock said that group of students, which he described as being ages 11 to 18, is by far accounting for the fastest rise in cases, and that the virus rate among adults in London is “broadly flat.” He urged secondary school students to get tested regardless of whether they had symptoms and said more details on the plan would follow Friday. Mr. Hancock said with the vaccine now being administered in Britain, there is hope on the horizon. “So don’t blow it now.”

  • In New York City, Mayor Bill de Blasio outlined a plan on Thursday, without providing much specific detail, to help students recover from the educational disruption caused by the pandemic. “Clearly, there will be a Covid achievement gap, and we have to close that,” he said. The mayor noted several areas he would focus on before the start of the next school year in September: finding a baseline for the academic ground lost; developing digital content and a learning hub; expanding professional development; enlisting parents to help more in education; and helping students deal with mental health issues and trauma related to the pandemic.

The reopening of theaters, museums and cinemas in France will be delayed for another three weeks.Credit…Abdulmonam Eassa/Agence France-Presse — Getty Images

The French government on Thursday said that it will delay relaxing some Covid-19 lockdown restrictions because rates of new cases were not falling as fast as expected.

The reopening of theaters, museums and cinemas, which was planned for Dec. 15, will be pushed back another three weeks, and a curfew that will replace the current lockdown will run earlier than planned.

The authorities had announced that a reprieve from the restrictions would be implemented on the condition that France reached a target of 5,000 new cases per day and fewer than 3,000 Covid-19 patients in intensive care.

Although the target of 3,000 patients in intensive care is within sight, France on Wednesday reported about 15,000 new cases, dampening hopes that daily new cases could fall to 5,000 by next Tuesday.

“We are not yet at the end of this second wave and we will not reach the objectives we had set,” Prime Minister Jean Castex said at a news conference on Thursday.

“The battle is far from won,” he said, adding that although the health situation improved for the past few weeks, it has plateaued in recent days.

The health minister Olivier Véran said that “we know that from plateau to peak sometimes things can go very fast.”

France will stick to a previously announced plan to end the lockdown on Dec. 15 and replace it with a nightly curfew. But in a departure from the plan, the curfew will start one hour earlier, at 8 p.m., and will not be waived for New Year’s Eve.

An exception will be made for Dec. 24, Christmas Eve, when people will be allowed to move freely during the night.

“The risk is that if we don’t change anything, the second wave will start again in the next few weeks,” Mr. Véran said.

On Thursday, the French Senate released a scathing report of a parliamentary commission that dissected the government’s failures in its handling of the coronavirus crisis and denounced “late and uncoordinated decisions” that delayed the government’s response to the pandemic.

The report specifically pointed to the failure of the government’s management of critical stocks of face masks. “The shortage of masks will remain the unfortunate symbol of the unpreparedness of the country and the lack of anticipation of the health authorities in the face of the crisis,” the report said.

It pointed out that Jérome Salomon, a top official at the health ministry, chose not to replenish stocks of masks in 2018, despite being warned about risks of shortages, and lobbied to retrospectively amend a scientific report in order to justify this decision. In a statement sent on Thursday night, Mr. Salomon denied that any pressure was exerted on the authors of the report.

“The mask fiasco was deliberately concealed by the government during the crisis,” the report said, adding that “a communication crisis has undermined the credibility of public and scientific discourse, the effects of which will be lasting.”

The parliamentary commission added that France’s strategy to test, trace and isolate in order to prevent a second wave of the virus proved unsuccessful, because of backlogs of test results, a limited contact tracing operation and an almost nonexistent isolation strategy.

Mr. Castex did not comment on the report, but acknowledged that a sense of fatigue surrounding the pandemic was growing in the country.

“I know your weariness, your doubts, your suffering,” Mr. Castex said. “I share them.”

Staff aides to Senate Majority Leader Mitch McConnell warned that most Republicans are unlikely to support the bipartisan plan.Credit…Anna Moneymaker for The New York Times

Staff aides to Senator Mitch McConnell of Kentucky, the majority leader, have informed other congressional leaders that it is unlikely that the majority of Republicans could support compromise provisions addressing liability protections and state and local government funding in a $908 billion stimulus deal being hammered out by a bipartisan group of moderates.

Their warning reflected the deep resistance among several Republicans for another large round of federal relief. For months their reluctance has helped to stymie agreement on an economic recovery plan to help struggling businesses and individuals amid the pandemic. Mr. McConnell and Republicans have been particularly resistant to providing billions of dollars to cash-strapped state and local governments, a top Democratic priority that would receive $160 billion under the moderates’ emerging outline.

That package is likely to contain some form of limited liability protection to businesses, schools and hospitals, which most Democrats have dismissed as a nonstarter, but the shield could be temporary and not as sweeping as the one that Mr. McConnell has demanded, which prompted the private skepticism.

The potential Republican antipathy for the compromise that was conveyed by Mr. McConnell’s staff was first reported by Politico, and was relayed on condition of anonymity by a senior Democrat familiar with the conversation. Mr. McConnell’s office declined to comment.

“My view is that the best thing that could happen is the pieces of this that everybody agrees on, take that out — take the funding for state local governments out — and pass the rest of it,” Senator John Thune of South Dakota, the No. 2 Republican, told reporters, offering a suggestion Democrats have panned.”

The bipartisan group is still struggling to finalize its agreement, let alone produce legislation that could be voted on in the coming days.

With just a handful of days before the end of the 116th Congress and a number of critical programs established in previous coronavirus legislation set to expire, lawmakers agree that both chambers should not leave Washington until they reach consensus on both an omnibus government spending package and a pandemic aid deal.

The Senate is expected to approve a one-week stopgap bill before funding lapses on Friday, intended to buy additional time for negotiators on both issues. But the timing of the vote was unclear as of Thursday afternoon.

Top Democrats have signaled support for the bipartisan discussions, led by a handful of moderate lawmakers in both chambers, as a possible avenue for a final agreement. But in doing so, Democrats also rejected a proposal from Mr. McConnell to remove the provisions related to state and local government and liability protections and focus on approving funding for schools, education and small businesses.

Steven Mnuchin, the Treasury Secretary, presented Ms. Pelosi on Tuesday with a $916 billion alternative, but she and other Democrats rejected it given that it failed to revive lapsed federal supplemental jobless payments. Instead, it would include a round of $600 stimulus checks, half the amount initially approved earlier this year.

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Health

‘Small City, No Hospital’: Covid-19 Is Overwhelming Rural West Texas

‘Small Town, No Hospital’: Covid-19 Is Overwhelming Rural West Texas

ALPINE, Texas – It’s one of the fastest growing coronavirus hotspots in the nation, but there are no long lines of cars piled up for drive-through tests and no rush of appointments to be wiped down at CVS.

That’s because in the rugged, rural expanse of far west Texas, there isn’t a county health department that can get daily tests and no CVS business for more than 100 miles. A handful of clinics offer tests for those who can make an appointment.

Behind the teetering oil platforms of Midland and Odessa, where real road runners scurry down two-lane roads and desert bushes freckle the long, beige horizon, the Big Bend region of Texas is one of the most remote parts of the American mainland and one of the least equipped to break out to treat infectious diseases. There is only one 12,000 square kilometer hospital and no heart or lung specialists to treat serious cases of Covid-19.

But as a sign that the virus is on the rise almost everywhere, the counties that Big Bend belongs to were in the nation’s top 20 for most new cases per capita last week.

Known for its sprawling national park and the artist town of Marfa, Big Bend provides an extreme example of the danger that is unfolding across the country as the virus flares further and more furiously than ever, driving deaths to levels seen since spring and push many places into crisis at the same time. From California to Texas to Mississippi, hospitals and health officials in rural communities are increasingly concerned that they are alone.

“There is no neurologist, there is no long-term care specialist,” said Dr. JP Schwartz, Big Bend’s Presidio County health department and a doctor at a local clinic. “We don’t want to help them at all. There isn’t even a nursing home out here. “

Even with Texas hospitalizations and deaths near their summer peaks, local officials fear they have little power to intervene beyond the measures taken by Republican Governor Greg Abbott.

“My hands are tied,” said Eleazar R. Cano, the Brewster County judge, who said he was advised against issuing a stay at home order or other stricter measures that could violate the governor’s order. Mr. Cano, a Democrat, likened governing during the pandemic to driving his truck through the desert with an empty gas tank without a cell phone operator calling for help.

“It’s helpless, frustrating, almost panicking,” he said.

On the long miles between the sparsely populated cities of Big Bend, it’s hard to fathom how a virus that thrives on human contact can flare up in a place so vast. Falcons rule in the great blue sky. Cell phone service is spotty. Christmas decorations along the street are not in people’s homes, but on the gates of their ranch.

But somehow new cases have exploded in the past few weeks.

In Brewster County, a sprawling giant of 9,200 residents in an area of ​​6,000 square miles, more than half of the 700+ known cases were identified last month. In neighboring Presidio County of 6,700 people near the Mexico border, cases have quadrupled from less than 100 to more than 470 in the past two months. Both communities are older, with 65 and over making up about a quarter of the population.

“The numbers are rising at this point,” said Malynda Richardson, the presidio city ambulance director, who coughed sporadically as she recovered from the freezing chills and knockout exhaustion of Covid-19.

There are a number of reasons for the spike.

The area is so remote that local residents have to travel to El Paso or Odessa to schedule a doctor’s appointment and buy essentials at Walmart. With cases popping up across west Texas, the virus may have come back with them. Officials also cited border traffic from Mexico, cases among young people at Sul Ross State University, and an increase in tourists who were not deterred by the pandemic.

Big Bend National Park visitor numbers rose 20 percent in October, park officials said, and so many cars clogged the park over Thanksgiving weekend that it jammed. In the liberal artist outpost of Marfa, young people from Austin and Dallas roam the city, sipping on almond milk and photographing murals that ask existential questions such as, “Is austerity an illusion?” A recent art installation caused a stir during the pandemic with an obvious message against tourism: “Everyone here hates you.”

However, it turns out that tourism isn’t the biggest part of the problem.

The limited contact tracing in the region shows greater local penetration – in bars, in multi-generational homes, and by people who ignore positive test results and continue to work and socialize as usual.

In Alpine, the largest city with 5,900 residents, residents wear masks with their cowboy hats to shop at Porter’s grocery store, but remove them to eat inside at local restaurants. There is no general consensus on whether masks are necessary and effective. In a sign of the controversy that has played out on social media and off-social media, the county was left without a local health authority when the doctor in the position, a volunteer pediatrician, resigned this fall after being told by local residents who opposed, had been pushed back mask orders and other restrictions.

Brewster County, which also includes Alpine, has already ordered bars to shut down and reduce food in indoor restaurants from 75 percent to 50 percent, as the governor’s order for counties with a high percentage of Covid-19 hospital stays prescribes. However, enforcement is incomplete, and the governor has prohibited local officials from imposing stricter rules than his own.

Because of the scarcity of resources, local health clinics are a prime option for testing, but even then, the swabs must be driven to El Paso for three hours and flown out of Dallas for processing in Arlington. The National Guard also offers regular tests. In response to the growing crisis, new mobile test vehicles should arrive this week.

For those who get seriously ill, the hospital, the Big Bend Regional Medical Center in Alpine, only has 25 beds and a makeshift Covid ward where patients were confiscated at the end of the lonely, L-shaped hallway.

Dr. John Ray, a family doctor who works shifts at the hospital, said the hospital had received consecutive calls for incoming coronavirus patients on a final day. One of them had to be taken to a larger hospital in Odessa to receive special care.

Not long after that, said Dr. Ray, he saw the patient’s obituary in the newspaper.

“I don’t want to see Alpine like the pictures you see in New York, just people dying in hallways and waiting for a bed,” said Dr. Ray, 44, who grew up in the small town of Troup, East Texas, Wisconsin for his residency and then returned to Texas to settle in the Big Bend for Beauty and People area in 2013. He and his wife, also a doctor, usually treat a lot of sore throats, urinary tract infections, and pregnancy visits. Now he said: “It’s Covid, Covid, Covid.”

Higher-level hospitals are also full across West Texas. El Paso, which was recently so inundated with infection that it created mobile morgues, is still recovering from its own virus deluge. Lubbock recently had up to 50 percent of beds filled with Covid patients, and on a particularly bad day last week, the city reported that overall hospital capacity was depleted.

Dr. Ray fears there may be a day when critically ill patients who would normally be moved to another location run out of options. “To be very clear,” he said, “if you can’t go anywhere else, you will die here.”

A spokeswoman for Big Bend Regional Medical Center said the hospital has had room so far, adding ventilators, oxygen tanks and nurses to prepare for a surge. Of nine patients in the hospital on Wednesday, four had Covid-19.

Even so, many remain concerned. Simone Rubi, 46, graphic designer and musician who owns a café in Marfa, about 30 minutes by car from the Alpine hospital, hung a poster in front of her to-go window and summarized the precarious situation in four words: “Small town, no hospital . “

“There will be no place for us if we get sick – that’s the bottom line,” she said, sitting on a picnic bench outside her shop on a Saturday morning.

“We’d have to go to Dallas,” said her husband Rob Gungor, who said he had asthma and was resigned to making the nearly eight-hour drive to an Airbnb near a major hospital if he contracted the virus to get it to be around in case it turns bad. Like most people in Marfa, who accepted masks more easily than some other cities in Big Bend, he also wore a mask outdoors.

“Maybe Phoenix,” he added, “because it’s only a nine-hour drive.”

For those living in even more rural parts of West Texas, navigating the coronavirus spike has consequences that go well beyond the virus itself.

There is only one full-service ambulance covering 3,000 square miles in the border community of Terlingua. In some cases, paramedics had to drive coronavirus patients to Alpine hospital for three hours to clear the area for other serious emergencies.

“That has always been our draw – it’s an isolated, beautiful, pristine landscape,” said Sara Allen Colando, Terlingua District Commissioner. But as the cases rise, the wilderness is also its own peril.

“If you have to take someone to God with Covid, where, how long does it take to get this ambulance back up and running?” She said. “Who will be there to take the call?”

Mitch Smith contributed to coverage from Chicago.

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Health

Kids’s hospitals are pitching in to assist with the flood of grownup Covid-19 sufferers.

Children’s hospitals are pitching in to help with the flood of adult Covid-19 patients.

With Covid-19 patients on the rise threatening to overwhelm hospitals, U.S. public health officials are reaching for a safety valve the Northeast used in the spring: borrowing beds in children’s hospitals to care for adults.

U.S. hospital stays hit a record high of 104,600, according to the Covid Tracking Project, and the nation set a record for the most deaths in a seven-day period last week.

“When the fall came in and the second spike hit, we’re seeing a lot more of it now,” said Amy Knight, president of the Children’s Hospital Association, a national group that represents more than 200 US facilities.

According to Dr. Peter Jay Hotez, Professor of Pediatrics and Molecular Virology and Microbiology, it is rare in American children’s hospitals to admit adult patients or to relax their admission criteria. The fact that this is happening now speaks to the severity of the crisis at Baylor College of Medicine and co-director of Texas Children’s Hospital Center for Vaccine Development.

“I don’t even know if this happened during the first half of 2009, so I can’t think of too many modern precedents,” he said.

Since coronavirus infections appear to largely spare younger children compared to teenagers and adults, children’s hospitals and the children’s wards of general hospitals tended not to be flooded at the beginning of the pandemic.

“It was more like a trickle of children being hospitalized,” Ms. Knight said.

Since then, however, the number of children who become infected and need hospital care has risen sharply, and children’s hospitals may have less space and resources available if the need for pediatric beds due to influenza increases anyway.

“We are much less able to treat pediatric critical diseases across the country,” said Dr. Brian Cummings, who works in the intensive care unit at MassGeneral Hospital for Children in Boston. “Obviously we are overwhelming the capacity of the adult intensive care unit, and using an even scarcer resource affects all of us who care about children.”

Even so, children’s hospitals are helping with the rise in the coronavirus in a number of ways. The Association of Children’s Hospitals published guidelines in April for several possible approaches, including admitting pediatric patients from general hospitals to free up space in these facilities and increasing their maximum admission age.

St. Louis Children’s Hospital, part of BJC HealthCare, opened its doors to adult patients in November, and another St. Louis children’s hospital, Cardinal Glennon Children’s Hospital, has accepted transfers for adults without Covid-19. Oishei Children’s Hospital in Buffalo said it will temporarily raise the admission limit to admit patients up to 25 years of age.

During the first major surge in the northeast from April to June, the MassGeneral Hospital for Children admitted adult patients to its 14-bed intensive care unit. “When we saw how hospitals were overwhelmed, everyone wanted to do their part,” said Dr. Cummings.

The unit returned to normal in the summer, but with Massachusetts cases picking up again, he said, “We’re definitely worried we’ll have patients again in the next week or two.”