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Covid-19: F.D.A. Panel Offers Inexperienced Mild to Johnson & Johnson’s Vaccine

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Credit…Phill Magakoe/Agence France-Presse — Getty Images

Johnson & Johnson’s Covid-19 vaccine was endorsed on Friday by a panel of experts advising the Food and Drug Administration, clearing the last hurdle before a formal authorization expected on Saturday, according to two people familiar with the agency’s plans. The nation’s first shipments will go out in the days after that.

It will be the third shot made available to the United States in the year since the first surge of coronavirus cases began washing over the country, and it will be the first vaccine to require just one dose instead of two.

Johnson & Johnson’s formulation worked well in clinical trials, particularly against severe disease and hospitalizations, even though it did not match the sky-high efficacy rates of the first two vaccines made by Pfizer-BioNTech and Moderna.

The panel, made up of independent infectious disease experts, statisticians and epidemiologists, voted unanimously in favor of authorizing the vaccine.

“We’re dealing with a pandemic right now,” said Dr. Jay Portnoy, an allergist at Children’s Mercy Hospital in Kansas City, Mo., and a member of the board. “It’s great that we have this vaccine.”

During Johnson & Johnson’s presentation to the panel, Dr. Gregory Poland, a virologist at the Mayo Clinic and a paid external consultant for the company, noted the vaccine’s efficacy, ease of use and low rate of side effects. It “nearly checks all the boxes,” he said. “To me, it is clear that the known benefits vastly outweigh the known risks.”

The vaccine had an overall efficacy rate of 72 percent in the United States and 64 percent in South Africa, where a concerning variant emerged in the fall. The shot showed 86 percent efficacy against severe forms of Covid-19 in the United States, and 82 percent against severe disease in South Africa.

Those are strong numbers, but lower than the roughly 95 percent efficacy rates of Pfizer-BioNTech and Moderna’s vaccines against mild, moderate and severe cases of Covid.

Johnson & Johnson’s vaccine is a single dose and uses a different kind of technology than the authorized vaccines. And the scale and size of the Johnson & Johnson trial was vast, spanning eight countries, three continents and nearly 45,000 participants.

Although the vaccine works with one shot, studies are underway to determine if a second dose would increase its protective effects.

Dr. Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia and one of the panelists, pointed out on Friday that in early clinical trials that took place over the summer, Johnson & Johnson found that a second dose led to levels of coronavirus antibodies that were almost three times higher than those produced by one dose alone.

The results of Johnson & Johnson’s two-dose, late-stage clinical trial are not expected until July at the earliest. If those results turn out to be better than a single dose, Dr. Offit asked, “Does this then become a two-dose vaccine?”

Dr. Johan Van Hoof, the global head of vaccine research and development at Janssen Pharmaceuticals, the drug development arm of Johnson & Johnson, said that the company decided to pursue the one-shot strategy after its studies on monkeys last spring showed that a single dose was enough to provide strong protection against the disease.

“It’s clear that in a situation of an outbreak, in a raging epidemic, the big challenge is to get the epidemic under control,” he said. “The regimen is extremely well positioned to be used in outbreak situations.”

But Dr. Van Hoof also noted that it will be important to track volunteers who received a single dose to see if their immunity changes in the months to come. It might be necessary to deliver a booster shot for long-term protection. “The big question mark still is, how long does protection last?” he said.

After the vote, the F.D.A. told Johnson & Johnson that it “will rapidly work toward finalization and issuance of an emergency use authorization,” according to a statement. The F.D.A. also said that it had notified other government agencies “so they can execute their plans for timely vaccine distribution.”

United States › United StatesOn Feb. 26 14-day change
New cases 78,262 –29%
New deaths 2,266 –20%
World › WorldOn Feb. 26 14-day change
New cases 410,857 –5%
New deaths 9,468 –23%

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Decline in Coronavirus Cases ‘May Be Stalling,’ C.D.C. Director Warns

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said on Friday that a recent decline in coronavirus cases across the U.S. “may be stalling” and urged governors not to relax restrictions.

Over the last few weeks, cases in hospital admissions in the United States have been coming down since early January and deaths have been declining in the past week. But the latest data suggest that these declines may be stalling, potentially leveling off at still a very high number. We at C.D.C. consider this a very concerning shift in the trajectory. We are watching these concerning data very closely to see where they will go over the next few days. But it’s important to remember where we are in the pandemic. Things are tenuous. Now is not the time to relax restrictions. Although we’ve been experiencing large declines in cases and admissions over the past six weeks, these declines follow the highest peak we have experienced in the pandemic. We may be done with the virus, but clearly, the virus is not done with us. We cannot get comfortable or give in to a false sense of security that the worst of the pandemic is behind us. Not now, not when mass vaccination is so very close.

Video player loadingDr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said on Friday that a recent decline in coronavirus cases across the U.S. “may be stalling” and urged governors not to relax restrictions.CreditCredit…Josh Bell/The Sun News, via Associated Press

The federal government warned impatient governors against relaxing pandemic control measures on Friday, saying that a recent steep drop in U.S. coronavirus cases and deaths “may be stalling” and “potentially leveling off at still a very high number” — a worrisome development that comes as more cases of concerning new variants have been found and could suggest that a return to normalcy is not yet quite as near as many Americans had hoped.

“Things are tenuous,” Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said at a White House briefing on the pandemic. “Now is not the time to relax restrictions.”

Her warning was bolstered by Dr. Anthony S. Fauci, the government’s top epidemiologist, as the Biden administration scrambled to stay ahead of any new wave. President Biden himself flew to Houston to showcase the government’s latest mass vaccine site.

According to a New York Times database, virus cases across the United States appear to be leveling off from the steep decline that began in January, with figures comparable to those reported in late October. Cases have slightly increased week over week in recent days, though severe weather limited testing and reporting in Texas and other states the previous week, and not all states reported complete data on the Presidents Day holiday. The seven-day average of new cases was 77,800 as of Thursday.

While deaths tend to fluctuate more than cases and hospital admissions, Dr. Walensky said at the briefing on Friday, the most recent seven-day average is slightly higher than the average earlier in the week. The seven-day average of newly reported deaths was 2,165, as of Thursday.

“We at C.D.C. consider this a very concerning shift in the trajectory,” she said, adding, “I want to be clear: cases, hospital admissions and deaths — all remain very high and the recent shift in the pandemic must be taken extremely seriously.”

Dr. Walensky said some of the rise may be attributable to new variants of the coronavirus that spread more efficiently and quickly. The so-called B.1.1.7 variant, which first emerged in Britain, now accounts for approximately 10 percent of all cases in the United States, up from one to four percent a few weeks ago, she said. The U.S. ability to track variants is much less robust than Britain’s.

“I know people are tired; they want to get back to life, to normal,” she said. “But we’re not there yet.”

As cases had declined, some governors around the United States have begun to relax pandemic restrictions. States with Republican governors appeared to be more eager to make rollbacks, though New York, which has a Democrat as governor, has also been easing restrictions on a variety of activities.

On Friday, Gov. Henry McMaster of South Carolina, a Republican, announced that on Monday, restaurants would be able to serve alcohol past 11 p.m., and residents would not need to get approval from the state to hold events with 250 people or more. To try to limit the spread of the virus, the state last year ordered bars to stop serving alcohol after 11 p.m., which is three hours earlier than the late-night bar crowd was used to.

Brian Symmes, a spokesman for Mr. McMaster, said the governor “appreciates perspectives that differ from his own” but “respectfully disagrees” with Dr. Walensky’s assessment.

In Arkansas, Gov. Asa Hutchinson announced Friday that he’d be lifting restrictions around capacity limits for bars, restaurants, gyms and large venues, but extending the state’s emergency order and mask mandate until March 31. The current emergency order was set to expire February 27.

On Thursday, Gov. Greg Abbott of Texas said he was considering lifting a statewide mask mandate in place since July.

In Mississippi, Gov. Tate Reeves said he was also considering pulling back some restrictions, particularly mask mandates for people who have been fully vaccinated. As of Friday, 13 percent of the state’s population has received at least one shot, and 6.2 percent have received two, according to a Times database.

Dr. Fauci echoed Dr. Walensky’s warnings that more rollbacks at state or local levels would be unwise, noting that case levels remained at a “very precarious position.”

“We don’t want to be people always looking at the dark side of things, but you want to be realistic,” he said. “So we have to carefully look at what happens over the next week or so with those numbers before you start making the understandable need to relax on certain restrictions.”

In Oregon, Gov. Kate Brown extended the state’s emergency order until May 2. The state recorded a sharp decreases in daily cases, hospitalizations and deaths this week, but citing the new variants Ms. Brown said that “now is not the time to let up our guard.”

Eileen Sullivan Remy Tumin, Nicholas Bogel-Burroughs and Mitch Smith contributed reporting.

A trial site for treatments from Regeneron and Eli Lilly in Mesa, Ariz., last summer.Credit…Adriana Zehbrauskas for The New York Times

The federal government has agreed to buy 100,000 doses of a recently authorized Covid-19 treatment from Eli Lilly, increasing the supply of such drugs for patients who are high risk of becoming seriously ill but are not yet hospitalized.

Under the deal, announced on Friday, the government will pay $210 million and Eli Lilly will ship out the doses by the end of March. The government has the option to buy 1.1 million more doses of the treatment through November, but how many of those doses ultimately get ordered will depend in part on the course of the pandemic in the United States.

The treatment is a cocktail of monoclonal antibodies combining the Eli Lilly drug known as bamlanivimab — which was authorized last November and is in use for high-risk Covid-19 patients — with a second drug known as etesevimab. The combination received emergency authorization earlier this month from the Food and Drug Administration. Both drugs consist of artificial copies of the antibodies that are naturally generated when a person’s immune system fights off an infection.

The U.S. government previously agreed to buy nearly 1.5 million doses of bamlanivimab alone. Eli Lilly has delivered more than 1 million doses already, with the remainder to be delivered by the end of March. More than 660,000 doses of bamlanivimab have been shipped out to states and other jurisdictions.

Eli Lilly’s new combination therapy could offer an advantage over bamlanivimab alone if worrisome coronavirus variants — particularly B.1.351, the one first identified in South Africa — take off in the United States. While bamlanivimab alone was found in a lab study to be powerless against the B.1.351 variant, preliminary data suggest that the combination therapy may be better able to fight off variants. That’s because so-called escape mutations in the variants that may enable them to avoid one antibody may not work against the second.

Another monoclonal antibody cocktail, made by Regeneron, is also authorized in the United States. Nearly 100,000 doses of that therapy have been shipped out.

Antibody treatments got a publicity boost last fall when they were given to Donald J. Trump when he was infected in the last months of his presidency, and to other high-profile Republicans, but they were surprisingly underused in many places in their first months of availability. Overwhelmed hospitals did not prioritize the treatments, which are cumbersome and must be given via intravenous infusions. Many patients and doctors did not know to ask for them or how to find them.

In December, the federal government’s early data collected from hospitals suggested that they had given only about 20 percent of their supply to patients. But that picture is changing. Eli Lilly has seen usage of bamlanivimab alone rise to around 40 percent nationwide, with uptake much higher in some places, Janelle Sabo, who leads Eli Lilly’s work on Covid-19 antibodies, said in an interview earlier this week.

People over the age of 65 wait in line at a mobile Covid-19 vaccination site in the Chinatown neighborhood of Los Angeles.Credit…Philip Cheung for The New York Times

As more people in the United States learn of someone close to them who has received a Covid-19 vaccine, they are becoming more open to getting the vaccine themselves, according to the latest survey from the Kaiser Family Foundation, which has been monitoring attitudes since December.

Across most demographic groups, vaccine hesitancy, though still substantial, continues to abate. Fifty-five percent of adults now say they have either received one dose or will get it as soon as they can, up from 34 percent in December.

The so-called “wait and see” group is inching down, too, to 22 percent in February from 31 percent in January. But Black adults (34 percent) and Latino adults (26 percent) remain more inclined than white adults (18 percent) to take a wait-and-see approach.

About one in five Americans still refuses to get the shot, or said they would only do so if compelled by work or school.

Kaiser also took note of the political affiliation of its survey respondents. From December to February, the proportion of Democrats who had either gotten the shot or wanted to soared to 75 percent from 47 percent. Republicans remained more hesitant, but there was a notable increase in the amount who were vaccinated or hoped to be, to 41 percent from 28 percent.

Views of the vaccine were divided by age as well. People 65 and older, among the first demographic groups eligible for the shot, were among the most enthusiastic, an attitude that crossed racial lines. But while nearly half of older white people said they had already received at least one dose, only about one-third of older Black people said they had.

The survey also examined the most common reasons for hesitation. People were most concerned about side effects and also about the rapidity with which the vaccines were developed. They were also still gripped by misinformation, fearing they would have to pay for the vaccine (it is available at no cost) and that it would give them Covid (it does not).

The Centers for Disease Control and Prevention said on Friday about 47.2 million people in the U.S. have received at least one dose of a vaccine, including about 22.6 million people who have been fully vaccinated.

Alisa Haushalter, the director of the Shelby County Health Department in Tennessee, in March. The county’s mayor said Ms. Haushalter had submitted her resignation on Friday.Credit…Mark Weber/Daily Memphian, via Associated Press

The top health official in Memphis submitted her resignation after state health officials accused her department, which oversees the vaccine rollout in the state’s most populous county, of wasting thousands of doses, the mayor of Shelby County, Tenn., said on Friday.

The swift downfall of Alisa Haushalter, the Shelby County Health Department director, came hours after a news conference in which Dr. Lisa Piercey, Tennessee’s health commissioner, laid out a series of stunning accusations of mismanagement by Ms. Haushalter’s department, including episodes in which a volunteer may have stolen doses and another administered shots to two children.

State health officials have been investigating the department for at least a week after Ms. Haushalter first reported that vaccine doses had expired, Dr. Piercey said.

Investigators confirmed the expiration of 1,578 doses last week, but it was only this week that Shelby County health officials acknowledged that an additional 840 doses had expired on Feb. 15, bringing the total to more than 2,400.

And Dr. Piercey said that when she met with the mayor on Thursday, he said that he had heard a rumor about a volunteer possibly stealing vaccines on Feb. 3, but Dr. Piercey said the theft was never reported to any state or federal authorities. The state health department alerted the Federal Bureau of Investigation to the possible theft shortly after that conversation, she said. Dr. Piercey also said that a volunteer had wrongly vaccinated two children on Feb. 3.

The City of Memphis on Wednesday took over the responsibility of storing, transporting and allocating the vaccines.

A senior receives the coronavirus vaccine in Quebec on Thursday.Credit…Christinne Muschi/Reuters

Canada’s drug regulator authorized the AstraZeneca vaccine on Friday as well as a version of it developed by the Serum Institute of India. The vaccine, which was developed with Oxford University, has not yet been authorized for use in the United States but has been key to Britain’s rapid vaccination rollout.

The addition of a third vaccine, in addition to the offerings from Moderna and Pfizer-BioNTech, may help Canada alleviate a growing dissatisfaction about the sluggish pace of vaccination in the country.

“Vaccines will keep arriving faster and faster,” Prime Minister Justin Trudeau told a news conference. “We now have a third safe and effective vaccine.”

Mr. Trudeau said that the government expects to receive, within days, about 500,000 doses out of an order of two million doses of the Serum Institute version of the vaccine, known as Covishield. About 20 million doses will start arriving from AstraZeneca in the spring.

The AstraZeneca vaccine, the first virus vector-based inoculation for Covid-19 authorized in Canada, has had some stumbles. In trials in South Africa, where a more contagious virus variant has become dominant, it did not appear to protect people from mild or moderate illness, which led the country to halt its use of the vaccine.

Drug approval officials with Health Canada said on Friday that while some studies suggested that the AstraZeneca vaccine is less effective overall than others, the sample sizes used were not large enough to yield a clear conclusion. But in Germany, many people regard it as “second-class” compared to the vaccine developed by the German company BioNTech and Pfizer, and are avoiding AstraZeneca’s.

Downtown Chicago. Most scientists are optimistic that the worst of the pandemic is behind us.Credit…Lyndon French for The New York Times

Across the United States and the world, the coronavirus seems to be loosening its stranglehold. The curve of cases, hospitalizations and deaths has yo-yoed before, but never has it plunged so steeply and so quickly.

Is this it, then? Is this the beginning of the end?

The road ahead is potholed with unknowns: how well vaccines prevent further spread of the virus, whether emerging variants remain susceptible enough to the vaccines and how quickly the world is immunized, so as to halt further evolution of the virus.

And the greatest ambiguity is human behavior. Will Americans desperate for a return to pre-pandemic lifestyles continue to wear masks and distance themselves from family and friends? How much longer can communities keep businesses, offices and schools closed?

Covid-19 deaths are unlikely to again rise quite as precipitously as in the past, and the worst may be behind us. But if Americans let down their guard too soon and if the variants spread in the United States as they have elsewhere, another spike in cases may well arrive in the coming weeks.

Buoyed by the shrinking rates over all, governors are lifting restrictions across the United States and are under enormous pressure to reopen completely.

“Everybody is tired, and everybody wants things to open up again,” said Ashleigh Tuite, an infectious disease modeler at the University of Toronto. “Bending to political pressure right now, when things are really headed in the right direction, is going to end up costing us in the long term.”

Looking ahead to late March or April, the majority of scientists interviewed by The Times predicted a fourth wave of infections. But they stressed that it is not an inevitable surge if precautions are maintained for a few more weeks.

“Just hang in there a little bit longer,” Dr. Tuite said. “There’s a lot of optimism and hope, but I think we need to be prepared for the fact that the next several months are likely to continue to be difficult.”

President Biden is pushing hard for a $1.9 trillion economic rescue plan. Polls show that some Republican voters support the proposal, even if the party’s leaders do not.Credit…Doug Mills/The New York Times

In Washington, Republicans stand united in opposition to President Biden’s first major legislative proposal, a $1.9 trillion economic rescue plan that they have labeled a bloated, budget-busting “blue state bailout.”

But in rural Maine, Anthony McGill, a self-identified conservative Republican, describes the bill as something else entirely: “Most of it sounds like a good idea,” he said.

While Mr. McGill doesn’t agree with all the provisions, he supports the central thrust of the bill — another round of direct stimulus payments to nearly all Americans.

“There’s a lot of people that could use those checks. I don’t know about needing them, but we could all use them,” said Mr. McGill, 52, who voted for former President Donald J. Trump in November. “The debt is so far out of hand that it’s a fantasy number at this point. We might as well just blow it out till everything collapses.”

As Democrats prepare to vote as soon as Friday to pass the relief package in the House, Republican elected officials are struggling to overcome intraparty divides over whether to embrace the major pieces of the proposal — as well as to reconcile with the fact that many Republican voters support the plan. While Democrats are working swiftly to move their bill, Republicans are consumed by sideshows like false claims of voter fraud and what they call cancel culture, which are two major themes of the annual Conservative Political Action Conference, known as CPAC, starting on Friday in Orlando, Fla.

The lack of a unified Republican economic message reflects an unsettled party that is unable to agree on how to chart a path through a Democratic-controlled Washington. While congressional Republicans take a scattershot approach to try to undermine the legislation, mayors and governors in their party are pushing for the plan, saying their states and cities need the federal aid to keep police officers on their beats, reopen schools and help small businesses.

Polling shows a significant number of Republican voters agree: More than four in 10 Republicans back Mr. Biden’s aid package, according to polling from the online research firm SurveyMonkey for The New York Times. Over all, 72 percent of Americans said they supported the bill, a number that includes 97 percent of Democrats.

Global Roundup

A woman receiving her first injection of the Pfizer-BioNTech Covid vaccine in Pontoise, in the northwestern suburbs of Paris on Feb. 5.Credit…Andrea Mantovani for The New York Times

BRUSSELS — In vaccine-hungry, cash-rich Europe, the hunt for more doses has nations trading with each other, weighing purchases from Russia and China, and fielding offers from middlemen ranging from real to outright frauds.

Anger has been building over the European Union’s sluggish Covid vaccine rollout, which has left the E.U. member nations far behind several other wealthy countries, and many E.U. states are now looking beyond the bloc’s underwhelming joint purchasing strategy.

An immense black — or at least gray — market has arisen, with pitches from around the world at often exorbitant prices. Sellers have approached E.U. governments claiming to offer 460 million doses of vaccines, according to early results of an investigation by the bloc’s anti-fraud agency that were shared with The New York Times.

While they still plan to get vaccines from the bloc, some nations are also trying to negotiate directly with drug makers and eyeing the murky open market, where they are still unsure of the sellers and the products. Some have also agreed to swap vaccines with each other, deals some of them now have reason to regret.

The European Union last year was slow to make massive advance purchases from drug companies, acting weeks after the United States, Britain and a handful of other countries. This year, the bloc was blindsided by slower-than-expected vaccine production, and individual countries have fumbled the rollout.

About 5 percent of the E.U.’s nearly 450 million people have received at least one dose of a vaccine, versus almost 14 percent in the United States, 27 percent in Britain and 53 percent in Israel, as of earlier this week, according to the Our World in Data database and governments.

The stumbles by the world’s richest bloc of nations have turned vaccine politics toxic. Particularly galling to many Europeans is the sight of a former E.U. member, Britain, forging ahead with its vaccination and reopening plans, while many of their own societies remain under lockdown to contain a new surge of dangerous variants, their economies sinking deeper into recession.

In other international news on the pandemic:

  • The government in France has announced stricter border checks between Germany and the eastern Moselle region, one of several areas experiencing a spike in coronavirus infections. It is the latest pandemic measure to challenge the E.U.’s open borders. Officials said that starting Monday, those wanting to cross the border would have to present a negative coronavirus test from the past 72 hours. Cross-border workers in the area will be exempt.

  • President Emmerson Mnangagwa of Zimbabwe threatened this week to punish residents who do not take Covid vaccines. “You are not going to be forced to be vaccinated, but the time shall come when those who are not vaccinated won’t get jobs,” he said on Wednesday. The country of 15 million people received 200,000 donated doses from the Chinese company Sinopharm, and 600,000 more doses are expected in early March. Zimbabwe is also set to receive more than 1.1 million doses as part of the Covax distribution program for poor and middle-income countries.

  • North Korea’s borders have been closed for a year because of the pandemic, but some Russian diplomats and their families found a way home on a route that included a bus ride and a trip on a hand-pushed railroad trolley. Russia’s Foreign Ministry said on Friday that the journey by trolley was the only possible way for them to cross the border.

Vaccines are administered at the Andrew Jackson Community Center in the Bronx this month. Credit…James Estrin/The New York Times

Members of the Congressional Black Caucus and Dr. Anthony Fauci sought to reassure Black Americans that vaccine rollouts would be as equitable as possible and tried to quell anxieties over the safety of the inoculation among people of color during a televised forum Friday night.

Dr. Fauci, the government’s top infectious disease expert, said increasing pharmacies’ vaccine inventory and creating mobile units to get to hard-to-reach areas will help.

Experts say that Black and Latino Americans are being vaccinated at lower rates because they face obstacles like language barriers and inadequate access to digital technology, medical facilities and transportation. But mistrust in government officials and doctors also plays a role and is fed by social media misinformation. And in cities across the country, wealthy white residents are lining up to be vaccinated in low-income Latino and Black communities.

“It’s affecting us like no other disease, like no other epidemic has. That’s because for Black Americans, we were already behind,” Representative Barbara Lawrence, Democrat of Michigan, said during the forum on MSNBC’s “The Reid Out.”

“We’re looking at historic fear of vaccines and a fear of the health care industry because are they going to hurt us, harm us, ignore us or are they going to help us?” she said.

President Biden has said he wants to make racial equality a centerpiece of his vaccination rollout plan. He has begun shipping vaccines to federally qualified community health centers in Black and Latino communities.

While new data shows rates of vaccination in New York City’s Black and Latino communities are lower than rates in largely white communities and New York State’s Latino and Black residents were behind in vaccination totals, the absence of comprehensive national data on race and ethnicity makes it impossible to know just how equitable vaccine distribution is.

“This vaccine does not discriminate,” Ms. Lawrence said. “It hurts me when I see a line of people getting vaccines and my people are not represented but I’m invited to the funerals of those who have died. I have taken the vaccine. I believe in it. I need my people, my community, to step up.”

A Covid-19 vaccination at Howard University in Washington, D.C., in December 2020.Credit…Tasos Katopodis/Getty Images

The phone and online registration system set up by the District of Columbia for its residents to use to schedule Covid-19 vaccination appointments has been faltering after the city broadened the eligibility of prioritized residents who can make appointments on Thursday.

D.C. widened the criteria from people 65 and older to include residents with certain health conditions and those working jobs that require contact with multiple people.

But many complained on Thursday and Friday that the phone number listed for scheduling a jab was not in service, and that the website was returning error messages. Some people were able to secure an appointment, though it was not immediately clear why they were successful when others were not.

“In short … it did not go well,” one of the city’s council members, Charles Allen, said in an email to constituents on Thursday.

Mayor Muriel Bowser blamed the problems on the “high volume of traffic” on the city’s vaccination site and said in a tweet that the city was trying to fix the problems quickly. The mayor’s office did not immediately respond to a request for comment.

The city’s health department apologized for the problems and said the “technical review failure” on Thursday had been addressed. However, the problems persisted on Friday when the city released another 4,350 vaccine appointments.

As of Friday, nearly 11 percent of D.C. residents had received one dose of a vaccine, and nearly 5 percent had received two doses, according to a New York Times database.

President Jair Bolsonaro of Brazil at his official office at the Planalto Palace in Brasilia on Wednesday. Credit…Ueslei Marcelino/Reuters

RIO DE JANEIRO — The daily death toll of Covid-19 in Brazil hit a record high of 1,582 on Thursday, according to a news consortium’s survey of local health departments. The painful milestone came as President Jair Bolsonaro railed against face masks, despite compelling scientific evidence that they are effective at preventing infections.

A rise in coronavirus infections in several states in Brazil, which officials say is being driven by more contagious variants, has overwhelmed hospitals across the country.

While epidemiologists and health officials warn of a worsening crisis in the weeks ahead, Mr. Bolsonaro took aim at masks during his weekly address on Facebook Thursday. Citing an unspecified German study, the president said masks were bad for children and that wearing them could lead to headaches, difficulty concentrating and a “decreased perception of happiness.”

Mr. Bolsonaro has been criticized at home and abroad for his cavalier response to the coronavirus pandemic. He has questioned the use of quarantine measures, social distancing and has sowed doubts about vaccines, saying he does not intend to get a shot.

While new cases and deaths are dropping in a number of other countries that were hard hit by the pandemic, including the United States, Brazil is in the grip of a second wave that began in November and shows no sign of easing.

The country began vaccinating medical professionals and older people last month, but the campaign is off to a slow start because the government has struggled to procure enough doses to quickly inoculate its 212 million citizens.

This week, Brazil’s Covid death toll surpassed 250,000, which is second only to the U.S. count of more than 500,000 deaths. The Brazilian health minister, Eduardo Pazuello, said on Thursday that the country had entered a “new stage of the pandemic” as a result of variants that he said are three times more contagious than earlier strains of the virus. “That is the reality we’re living today in Brazil,” he said.

A doctor administering the Pfizer-BioNTech vaccine in Salisbury, England, last month.Credit…Neil Hall/EPA, via Shutterstock

For people who have had Covid-19, a single dose of the Pfizer vaccine is enough to provide robust protection from the coronavirus, according to two new studies from Britain that were published late Thursday in The Lancet, a prominent medical journal.

The studies, among the first fully vetted papers to weigh in on how to vaccinate people who have had Covid-19, added strong evidence to the case for inoculating people who already have antibodies against the virus — but only with one dose of the Pfizer vaccine.

One of the studies, led by researchers at University College London and Public Health England, described the benefits of that strategy.

“This could potentially accelerate vaccine rollout,” they said. And that in turn could forestall dangerous new mutations: “Wider coverage without compromising vaccine-induced immunity could help reduce variant emergence,” the paper said.

In recent weeks, several studies on the topic were posted online that were not yet published in scientific journals, showing that one dose of a coronavirus vaccine amplified people’s antibodies from an earlier infection.

People’s immune responses to being infected are highly variable: Most people make considerable and long-lasting antibodies, while others who had milder infections produce relatively few, making it difficult to know how protected they are from the virus.

Vaccines act as a sort of booster for those people’s immune responses, inducing enough antibodies to offer protection. But a single dose, rather than the full two-dose protocol, is enough for those who have been infected, a number of studies have suggested.

Some researchers in the United States are trying to persuade the Centers for Disease Control and Prevention to recommend giving only one dose to people who have recovered from Covid-19. The studies from Britain seem likely to put pressure on health officials there to consider the same approach.

More than 28 million people in the United States and four million people in Britain, along with many others whose illnesses were probably never diagnosed, have been infected so far.

One of the new studies — led by Charlotte Manisty, a professor at University College London, and Ashley D. Otter, a research scientist at Public Health England — tracked 51 health workers in London who have submitted to routine tests for antibodies and infection since March. That gave researchers an unusually detailed picture of any pre-existing protection from the virus.

Roughly half of the health workers had experienced a mild or asymptomatic infection. And a single dose of the Pfizer vaccine increased their antibody levels more than 140-fold from their peak levels before being inoculated, the study said. That appeared to give them better protection against the coronavirus than two doses of the vaccine did in people who had never been infected, the researchers wrote.

The study raised the idea of giving people blood tests in the weeks before they became eligible for a Pfizer vaccine to determine whether they already had antibodies. People’s immune responses to an infection are highly variable, making it difficult to predict without a blood test who can be fully protected with a single dose.

As a further benefit of the single-dose strategy, the researchers wrote that it would spare people who have already been infected from the unpleasant side effects that sometimes follow a booster shot in that group.

The second study, led by scientists at Imperial College London, measured the immune responses of 72 health workers who were vaccinated in late December. A third showed signs of having previously been infected.

For those people, one dose of the Pfizer vaccine stimulated “very strong” antibody responses, the study said, as well as “very strong T-cell responses,” referring to another arm of the immune system.

It is not clear how long the post-vaccine immune response will last in people who have previously been infected compared with those who have not.

Mark Machin, the chief executive of the Canada Pension Plan Investment Board, speaks at the Milken Institute Global Conference in Beverly Hills, Calif., in April 2019.Credit…Lucy Nicholson/Reuters

The head of Canada’s largest pension fund stepped down on Thursday evening after news broke that he had flown to the United Arab Emirates to receive a coronavirus vaccine, despite federal rules banning inessential travel and a long line of older and immunocompromised citizens across the country waiting for their shots.

The Canada Pension Plan Investment Board announced in a news release on Friday that it had accepted the resignation of its chief executive, Mark Machin, who had “decided to travel personally to the United Arab Emirates where he arranged to be vaccinated against Covid-19.” The board added: “We take that responsibility of leadership very seriously.”

At about $375 billion, the fund is Canada’s largest, with more than 20 million contributors and beneficiaries.

Mr. Machin, who last year earned about $4.2 million at the helm of the crown corporation, is the latest public figure in the country to be publicly sanctioned for traveling abroad for personal reasons, while much of the country is hunkered down during the pandemic’s second wave.

His trip was perceived as not just selfish, but as queue-jumping by many Canadians, who have grown increasingly impatient with the sluggish rollout of vaccinations across the country. Less than 4 percent of the country’s 38 million people have received a dose — far fewer than most Western nations.

The Canada Pension Plan Investment Board is an independent corporation, but the country’s finance minister appoints its directors. Through her spokeswoman, the deputy prime minister and finance minister, Chrystia Freeland, called Mr. Machin’s decision “very troubling” and said Canadians expect the organization to “be held to a higher standard.”

Mr. Machin’s trip was first reported by The Wall Street Journal on Thursday night. Soon after, he sent an internal memo to staff stating the trip was supposed to be “very private” and that he was disappointed it has become the focus of “expected criticism,” The Globe and Mail reported.

People walking in Charleston, S.C., at the end of January. A stubbornly high number of coronavirus cases farther away from the coast has kept the state’s case count relatively high in the last week.Credit…Cameron Pollack for The New York Times

Even as the overall number of coronavirus cases in South Carolina declines, the situation away from the state’s coastline has remained stubbornly dangerous, with some counties in the central and western parts of the state reporting some of the most dire case counts relative to their populations in the Southeast.

Those regions have kept the state’s case count from declining further, and over the last week, South Carolina has reported more cases per capita than any other state, as of Thursday.

The cases are staying high in a mix of small and large counties, including the metropolitan areas of Columbia, the state’s capital and second-largest city, and Spartanburg. Those two metro areas have reported more cases per capita over the last two weeks than all but three other metro areas in the United States, according to a New York Times database. And they are doing so even as cases in Charleston, the state’s largest city, have consistently fallen.

Gov. Henry McMaster cited the overall decline in U.S. cases on Friday in deciding to roll back several public health measures beginning next week. Starting Monday, there will no longer be an 11 p.m. curfew for alcohol sales at restaurants, and large gatherings can resume, though he encouraged people to voluntarily follow the guidelines that had been in place.

“With the spread of the virus consistently decreasing across the country and more of the most vulnerable South Carolinians being vaccinated every day, I believe these targeted and limited safety measures are no longer necessary,” Mr. McMaster said in a statement. “The virus is still among us and we all must continue to make responsible decisions to take care of ourselves and our loved ones, but those decisions are for South Carolinians to make.”

The move from Mr. McMaster came on the same day that Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, warned that the recent decline in cases may be stalling and said governors should keep public health measures in place. “Now is not the time to relax restrictions,” she said.

Brian Symmes, a spokesman for Mr. McMaster, said the governor “appreciates perspectives that differ from his own” but “respectfully disagrees” with Dr. Walensky’s assessment.

One day earlier, on Thursday, South Carolina’s top epidemiologist, Dr. Linda Bell, said in an interview with a local television station that while it was understandable that residents would be optimistic as vaccines rolled out, it was important for them to not forget that the situation was still severe in much of the state.

“We cannot say yet that we have passed the worst part of the pandemic,” Dr. Bell said on WIS-TV.

“I don’t want people to be too encouraged to the point that they stop doing the preventive measures, looking at the current decline in cases,” she added, “because we have declined to a level that has taken us to the height of cases that we were seeing after the Fourth of July, and I want to remind people that we were actually very alarmed.”

Mitch Smith contributed reporting.

Members of the Kansas State University marching band maintained social distance as they played before a college football game in October 2020.Credit…Charlie Riedel/Associated Press

Colleges and universities across the country are pledging to reopen more fully in the fall, with some administrators worried that students won’t return to campus if normality, or some semblance of it, isn’t restored by September.

Schools from large state institutions to small private ones have announced they are laying plans to bring students back to dormitories, deploy professors to teach most (if not all) classes in person and restart extracurricular activities, in stark contrast to the past academic year of largely virtual courses and limited social contact. The announcements of these changes coincide with the sending of acceptance letters to the class of 2025.

Some schools have taken a financial hit because of deferred admissions or lost room-and-board fees.

Bradley University, in Peoria, Ill., which has 5,600 undergraduate and graduate students, said earlier this month that it would return to “traditional residential education” in the fall, with in-person classes and activities on campus.

Kansas State University announced on Wednesday that it too is planning a “more normal” fall semester, with largely in-person classes, events and activities. Ohio State announced on Thursday that it plans to offer “robust” in-person activities and classes, allowing students to live in residence halls and fans to attend football games.

Katherine Fleming, New York University’s provost, told colleagues in an email on Tuesday of plans to have “all faculty teaching their classes in-person, in the classroom, in the fall 2021.” She conceded, however, that this would depend in part on whether enough professors were vaccinated by then.

Indeed, most school officials said that whether they can deliver on these promises hinges on factors like how much the virus can be suppressed, the availability of the vaccine — which is still in scarce supply, even for those who are eligible — and guidance from government authorities.

Despite their hopefulness about the fall, schools have struggled with keeping the virus in check. Positivity rates rose among college students, as among the general population, over the holidays, when people traveled. Administrators have put out many stern warnings that small parties and gatherings have been a source of infection. Many have noted, however, that the classroom itself has not proven to be a vector of infection, as long as students and teachers follow safety guidelines like wearing masks and social distancing.

More than 120,000 coronavirus cases have been linked to American colleges and universities since Jan. 1, and more than 530,000 cases have been reported since the beginning of the pandemic, according to a New York Times survey. The Times has identified more than 100 deaths, but the vast majority involved employees, not students.

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Biden Tours Texas Emergency Aid Centers After Winter Storms

President Biden spent the day in Houston touring a local food bank and other areas hit by recent snowstorms. Storm damage is expected to total $20 billion, according to the Insurance Council of Texas.

Mr. President, welcome. This is our emergency operations center, Harris County Emergency Operations Center. For me and these folks you see here, this has been our home away from home. Over fire, flood, Covid and now this winter weather event. These folks are the tip of the sphere. Thank you for What you are doing. All I did is I got a call and before you asked the question I just said yes. He did. He said yes before I even asked the question. Absolutely. It’s incredible. It’s an incredible place. They’re doing — and they have so many talented people here, not just volunteers, really talented people.

Video player loadingPresident Biden spent the day in Houston touring a local food bank and other areas hit by recent snowstorms. Storm damage is expected to total $20 billion, according to the Insurance Council of Texas.CreditCredit…Doug Mills/The New York Times

At an emergency response center in Houston, President Biden praised officials who’d slept in stairwells as they worked around the clock to answer the call of terrified residents who had no power or drinkable water when devastating snowstorms hit. At a food bank, Mr. Biden hugged a little girl who was volunteering. He then turned to a woman to discuss the death of his eldest son, plugging into the pain of people around him by accessing his own.

“Incredible,” Mr. Biden said as he surveyed what was happening around him. “It’s absolutely amazing, and we could do so much more.”

Infrastructure and coronavirus relief may be on the official agenda in Washington, but the overwhelming nature of grief was the unofficial theme of the week.

On Monday, Mr. Biden presided over a solemn observance of a grim pandemic milestone: more than 500,000 Americans dead. “While we have been fighting this pandemic for so long, we have to resist becoming numb to the sorrow,” he said during a speech at that White House that evening.

And when he traveled to Houston with Jill Biden, the first lady, the president for the first time used his new platform to show support for a community ravaged by twin crises of devastating snowstorms and the pandemic.

“You’re saving people’s lives,” Mr. Biden told a group of officials at an emergency operations center. “As my mother would say, you’re doing God’s work.”

Across Texas, the damage from the storms is extensive and the recovery is expected to be slow. The damage is expected to cost upward of $20 billion, according to the Insurance Council of Texas. Coronavirus vaccinations had all but stalled because of the storm, but are beginning to rebound — Mr. Biden was expected to visit a mass-vaccination site at a nearby stadium later Friday.

As soon as Mr. Biden hit the ground, the tone of his visit was different from what victims of natural disasters encountered when his predecessor, Donald J. Trump, would visit. Mr. Trump more than once threatened to withhold disaster funding if he had toxic political relationships with officials in those places.

Mr. Biden, who has been pushing a $1.9 trillion coronavirus relief package, was joined by Republicans who praised him for approving a major disaster declaration for Texas, ensuring the flow of federal resources to some 126 counties across the state that were hit by the storms — about half the number requested by Gov. Greg Abbott, who joined Mr. Biden on the trip.

“The governor and Senator Cruz and I asked for a declaration from the federal government which provides access to public and private assistance through FEMA,” said Senator John Cornyn, Republican of Texas and another participant on the trip, referring to the state’s junior senator, Ted Cruz. “That’s going to be important for our recovery.”

Mr. Cruz did not participate. He was in Florida, speaking at the Conservative Political Action Conference.

In Harris County, where Houston is, about 50 percent of 4.9 million residents lost power as the storms hit. Nearly two weeks later, about 10,000 residents are still boiling their water, according to county officials. More than 50,000 across the state still do not have access to safe water, according to officials with the Federal Emergency Management Agency.

During the visit to the food bank, Dr. Biden slipped cans of peaches into packages of food for students who rely on free school meals. Mr. Biden talked to children and told them about his own family.

It was a marked difference from Mr. Trump, who was criticized in 2018 for visiting a disaster relief center in Puerto Rico, only to throw paper towels at people who’d survived a Category 5 hurricane. “I was having fun,” Mr. Trump said afterward. “They were having fun.”

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F.D.A. Skilled Panel Endorses Johnson & Johnson’s Vaccine

Johnson & Johnson’s Covid-19 vaccine was approved on Friday by a group of experts advising the Food and Drug Administration and cleared the final hurdle before formal approval expected on Saturday, according to two people familiar with the agency’s plans are. The nation’s first shipments will run out in the days thereafter.

It will be the third shot made available to the United States in the year since the first wave of coronavirus cases washed across the country, and it will be the first vaccine to require just one dose instead of two.

The Johnson & Johnson formulation worked well in clinical trials, especially against serious illness and hospitalization, although it did not match the sky-high efficacy rates of the first two vaccines from Pfizer-BioNTech and Moderna.

The panel, made up of independent infectious disease experts, statisticians and epidemiologists, voted unanimously to approve the vaccine.

“We are dealing with a pandemic right now,” said Dr. Jay Portnoy, an allergist at Children’s Mercy Hospital in Kansas City, MO, and a board member. “It’s great that we have this vaccine.”

During Johnson & Johnson’s presentation to the panel, Dr. Gregory Poland, a virologist at Mayo Clinic and the company’s paid external consultant, noted the vaccine’s effectiveness, ease of use and low side effect rate. It “checks almost all the boxes,” he said. “It is clear to me that the known benefits far outweigh the known risks.”

The vaccine had an overall effectiveness rate of 72 percent in the US and 64 percent in South Africa, where a worrying variant emerged in the fall. The shot showed an effectiveness of 86 percent against severe forms of Covid-19 in the US and 82 percent against serious illnesses in South Africa.

These are strong numbers, but they are below the efficacy rates of Pfizer-BioNTech and Moderna’s vaccines against mild, moderate, and severe cases of Covid of around 95 percent.

The Johnson & Johnson vaccine is a single dose and uses a different technology from the approved vaccines. The scope and size of the Johnson & Johnson trial was huge, spanning eight countries, three continents, and nearly 45,000 participants.

Although the vaccine works with one shot, studies are currently being carried out to see if a second dose would increase the level of protection.

Dr. Paul Offit, a pediatrician at Philadelphia Children’s Hospital and one of the panellists, pointed out Friday that Johnson & Johnson found in early clinical trials that took place over the summer that a second dose resulted in levels of coronavirus antibodies that were almost three times higher than those produced by one dose alone.

The results of the Johnson & Johnson late-stage two-dose clinical trial are not expected until July at the earliest. If these results are found to be better than a single dose, Dr. Offit: “Will this be a two-dose vaccine?”

Dr. Johan Van Hoof, the global director of vaccine research and development at Janssen Pharmaceuticals, the drug development arm of Johnson & Johnson, said the company decided to pursue the one-shot strategy after its studies on monkeys last spring showed that a single dose was sufficient to provide strong protection against the disease.

“It is clear that in a situation of an outbreak, in a raging epidemic, the big challenge is getting the epidemic under control,” he said. “The regime is very well positioned to be used in outbreak situations.”

Dr. However, Van Hoof also noted that it will be important to track volunteers who have received a single dose to see if their immunity changes over the coming months. Firing a booster shot may be required for long-term protection. “The big question mark is still how long does the protection last?” he said.

Following the vote, the FDA told Johnson & Johnson that it “will work quickly towards completion and emergency clearance,” a statement said. The FDA also said it had notified other government agencies “so they can implement their plans for timely vaccine distribution”.

Sharon LaFraniere contributed to the coverage.

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Business

BET founder Robert Johnson on enhancing Black illustration in workforce

Robert Johnson, founder of BET, told CNBC on Monday that he believes that once it doesn’t affect their share price, companies will be more serious about addressing racial inequality within their workforce.

“Companies understand return on capital. They understand return on equity. They understand total return on shareholders,” Johnson told Closing Bell. “Link all of these factors to achieving employment opportunities for Black Americans at all levels. I think then you will see results because companies understand that. They respond to financial factors and market conditions.”

Johnson’s comments follow the release of a new report on the employment of blacks in the US private sector by consulting giant McKinsey & Company. The McKinsey report, based on data from 24 companies, which together have 3.7 million employees, found remarkable differences in the representation of blacks in management positions.

Black Americans make up 12% of the total private sector workforce, but for the companies that participated in the McKinsey report, it was only 7% of executive employees. According to the report, black representation at the senior manager, vice president, and senior VP level drops to 4% to 5%.

“It will take approximately 95 years, as we go now, for black workers to achieve talent parity (or 12 percent representation) at all levels of the private sector,” the report said.

Johnson said, in his opinion, the only way for companies to work seriously to fill the employment gaps, especially in senior positions, is to “hold companies accountable for not making a commitment to address the gaps” .

“I think there are ways to do this,” said Johnson, who founded Black Entertainment Television in 1980. A little over two decades later, in 2001, he became America’s first black billionaire when Viacom acquired BET’s holding company. He now sits on the board of Discovery and is the founder and chairman of RLJ Companies.

Johnson said one way to be accountable in eliminating racial differences in employment is to set it as a target in corporate deeds.

“Shareholders should hold them accountable as soon as they are in their articles of association,” said Johnson, adding that proxy advisory firms like Institutional Shareholder Services and Glass Lewis “could explore the whole concept of no to companies that do not commit this kind of racial parity or basically closing the employment gap. ”

Johnson said companies of all sizes should also commit to something similar to the NFL’s Rooney Rule, which the league expanded last year to add diversity to their coaching ranks.

Teams are now required to interview at least two outside minority candidates for head coaching jobs, up from at least one since its inception in 2003. Also, the rule has been expanded to require teams to interview at least one outside minority candidate for an open coordinator positions; So far there has been no diversity mandate for these roles.

NFL franchises could be fined for not complying with the Rooney Rule, Johnson noted. “I’m not sure we want to punish companies because they can easily pay the fine,” he warned. “I think there should be some kind of moral equivalent that if you don’t, you will be singled out and your inventory will be reported as a failure, causing certain people to become involved in this form of racial justice and equality believe their take investments in other places. ”

Last year, Nasdaq made a proposal to the Securities and Exchange Commission to improve diversity among company boards. The exchange operator’s proposal would require the majority of companies to have at least two different board members: a woman and a person who is LGBTQ or an under-represented minority.

According to the proposal, companies could ultimately be removed from the stock market if they do not publish board data. In December, when the proposal was published, over 75% of the roughly 3,200 companies listed on the Nasdaq failed to meet the requirement, according to the New York Times.

Johnson previously made proposals on how to close the racial wealth gap in the US. In a CNBC interview earlier this month, Johnson stressed the need to nurture black entrepreneurship in America through capital allocation programs.

“Black companies tend to hire black people as a whole, so if you create more black companies, more black jobs will be created,” Johnson said. “More black jobs mean more black people are paying to buy their homes, black people … are saving for retirement, black people are investing. In the end, we’re taking a big step towards closing the huge wealth gap.”

A Citigroup report last year found that racial inequality has cost the US economy $ 16 trillion over the past two decades.

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Health

UK PM Boris Johnson pronounces 100-day goal to develop new vaccines

UK Prime Minister Boris Johnson speaks during a press conference on Coronavirus (COVID-19) on Downing Street on January 15, 2021 in London, England.

Dominic Lipinski | Getty Images

LONDON – UK Prime Minister Boris Johnson will call on the leaders of the world’s largest economies to support efforts to accelerate the development of new vaccines.

Johnson, who will chair a virtual meeting with G-7 leaders on Friday, is expected to outline an ambition to cut the time it takes to develop new vaccines by two-thirds to 100 days.

A Downing Street statement said developing a coronavirus vaccine in around 300 days is a “great and unprecedented global achievement”.

“By further reducing the time it takes to develop new vaccines against emerging diseases, we can potentially prevent the disastrous health, economic and social effects of this crisis,” the government said.

The Coalition for Innovations to Prepare for Epidemics first proposed this 100-day goal earlier this year.

“The development of viable coronavirus vaccines offers the tempting prospect of a return to normal, but we must not rest on our laurels,” Johnson said ahead of the meeting.

“As leaders of the G7 today we have to say never again,” he added, calling on the coalition of leaders to use “collective ingenuity” to ensure that “vaccines, treatments and tests are ready to fight future health threats”. “”

Johnson has asked UK Government Chief Scientific Advisor Patrick Vallance to work with international partners including the World Health Organization and CEPI, along with industry and science experts, to help the G-7 accelerate the development of vaccines, treatments and tests to advise.

At Friday’s session, Johnson will also confirm the UK will share the majority of all future excess coronavirus vaccine doses with Covax. This is a global initiative jointly led by WHO and CEPI, among others, and aims to provide low-income countries with fair access to coronavirus vaccines.

On Friday, the EU announced that it would double its contribution to Covax to 1 billion euros (1.2 billion US dollars), while Germany pledged a further 900 million euros for the initiative, according to a statement by the European Commission, the EU’s executive branch.

Unequal guidelines for Covid vaccines

A Lancet paper released late last month highlighted that the 2 billion doses of vaccine allocated to low-income countries under the Covax Accelerator Program in 2021 represented only 20% of the vaccine needs of the countries participating in the program.

The paper followed a warning from the World Health Organization’s top official that the world was on the verge of “catastrophic moral failure” due to unequal Covid vaccine policies.

Dr. Tedros Adhanom Ghebreyesus on Jan. 18 condemned what he called the “first-me” approach from high-income countries, saying it was self-destructive and endangered the world’s poorest and most vulnerable.

Almost all high-income countries have prioritized the distribution of vaccines to their own populations. The international aid group Medecins Sans Frontieres has described what we are seeing today in terms of global access to vaccines as “far from an image of justice”.

The meeting on Friday will be the first in the UK’s “G-7 Presidency” in 2021. It will also be President Joe Biden’s first major multilateral engagement.

Johnson had drawn up a five-point plan to prevent future pandemics at the United Nations General Assembly last year. This will be the focus of the UK G7 Presidency on Friday.

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World News

Covid-19 World Reside Updates: AstraZeneca and Johnson & Johnson Vaccines

Here’s what you need to know:

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Fauci Warns New Virus Mutations Are a ‘Wake-Up Call’

On Friday, Dr. Anthony S. Fauci warned that new virus variants, despite the global vaccine distribution, should offer a wake-up call to the continuing dangers of the pandemic.

We’re all aware of the variance that we knew dominated — the U.K. B.1.1.7 , the B.1.351 in South Africa and other variants, such as the P.1. in Brazil. When these variants were first recognized, it became clear that we had to look at, in vitro, in the test tube, whether the antibodies that were induced by the vaccines that we had available would actually neutralize these new mutants. Antigenic variation, i.e. mutations that lead to different lineage do have clinical consequences because as you can see, even though the long-range effect in the sense of severe disease is still handled reasonably well by the vaccines, this is a wake-up call to all of us that we will be dealing as the virus uses its devices to evade pressure, particularly immunological pressure, that we will continue to see the evolution of mutants. So that means that we as a government, the companies, all of us that are in this together, will have to be nimble to be able to just adjust readily to make versions of the vaccine that actually are specifically directed towards whatever mutation is actually prevalent at any given time.

On Friday, Dr. Anthony S. Fauci warned that new virus variants, despite the global vaccine distribution, should offer a wake-up call to the continuing dangers of the pandemic.CreditCredit…Doug Mills/The New York Times

Dr. Anthony S. Fauci warned Friday that new clinical trial results from Johnson & Johnson, showing that its vaccine is less effective against a highly infectious variant of the coronavirus circulating in South Africa, were a “wake up call.” He said the virus will continue to mutate, and vaccine manufacturers will have to be “nimble to be able to adjust readily” to reformulating the vaccines if needed.

Dr. Fauci’s warning, at the White House briefing on the virus, comes amid increasing concern about new and more infectious variants of the virus that are emerging overseas and turning up in the United States. This week, officials in South Carolina reported identifying two cases of the variant circulating in South Africa, and officials in Minnesota announced they had found a case of the variant that was first detected in Brazil.

Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, who was also at the briefing, said another variant, first identified in Britain, has now been confirmed in 379 cases in 29 states. She said officials remained concerned about the variants and were “rapidly ramping up surveillance and sequencing activities” to closely monitor them. Unlike Britain, the United States has been conducting little of the genomic sequencing necessary to track the spread of the variants.

Dr. Walensky also issued a plea to Americans to continue wearing masks and practice social distancing, and to avoid travel. Earlier this month, the C.D.C. warned that the variant circulating in Britain could become the dominant source of infection in the United States and would likely lead to a surge in cases and deaths that could overwhelm hospitals. And given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States.

“By the time someone has symptoms, gets a test, has a positive result and we get the sequence, our opportunity for doing real case control and contact tracing is largely gone,” she said. “We should be treating every case as if it’s a variant during this pandemic right now.”

Friday’s briefing, the second in what the Biden White House has promised will be thrice-weekly updates on the pandemic, came just hours after Johnson & Johnson reported that while its vaccine was 72 percent effective in the United States, the efficacy rate was just 57 percent in South Africa, where a variant has been spreading.

Public health officials including Dr. Fauci and Dr. Walensky say the emergence of these variants is heightening the urgency of vaccinations. Dr. Fauci also said Friday that children under 16, who are not currently eligible for the vaccine, will likely start getting vaccinated “by late spring or early summer” if small-scale clinical trials show that it is safe and effective to do so.

He noted that the Johnson & Johnson vaccine is 85 percent effective against severe disease, and called the results “very encouraging,” even though the vaccine is not as effective as those by Pfizer and Moderna, which have emergency approval from the Food and Drug Administration. Johnson & Johnson will now seek its own emergency approval.

“This really tells us that we have now a value-added additional vaccine candidate,” he said.

But Dr. Walensky offered a far more sobering observation. While the daily number of new virus cases has been declining, the figures were still much higher than a period last summer, and deaths currently remain worrisome.

According to data compiled by The New York Times, new virus cases have averaged about 160,000 a day in recent days, compared to about 40,000 new cases a day around early September. As of Thursday, the seven-day average of new deaths was more than 3,200 a day, still near peak levels. The daily death toll has topped 4,000 deaths six times in the United States, including twice this week.

At Wednesday’s briefing by the Biden virus team, Jeffrey D. Zients, Mr. Biden’s coronavirus response coordinator, said the United States is lagging far behind other countries in sequencing the genomes of the new variants — a delay he called “totally unacceptable.” Dr. Walensky said she is working to change that.

“We have scaled up surveillance dramatically just in the last ten days, in fact, but our plans are more than what we’ve done so far,” Dr. Walensky said, adding that the C.D.C. is now asking every state to track for worrisome variants and sequence at least 750 samples from patients per week. In addition, she said, the agency has seven collaborations with universities to scale up surveillance to cover thousands of samples per week.

United States › United StatesOn Jan. 28 14-day change
New cases 165,264 –34%
New deaths 3,868 –2%
World › WorldOn Jan. 28 14-day change
New cases 603,392 –22%
New deaths 16,817 +4%

U.S. vaccinations ›

Where states are reporting vaccines given

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E.U. Plans to Halt Vaccine Exports Until Supply Contracts Are Met

The European Union announced a plan that would effectively stop AstraZeneca from shipping Covid-19 vaccine doses manufactured in the bloc to other countries until its E.U. supply contracts are met.

The commission has adopted a strictly targeted measure that will allow us to gather accurate information about the production of vaccines and where manufacturers intend to ship them. The measure is time-limited and specifically applies to those Covid-19 vaccines that were agreed by advance purchase agreements. The measure is intended to run until the end of March. The aim is to provide us immediately with full transparency, transparency that until now has been lacking, and what Europeans expect. And if needed, it also will provide us with a tool to ensure vaccine deliveries.

Video player loadingThe European Union announced a plan that would effectively stop AstraZeneca from shipping Covid-19 vaccine doses manufactured in the bloc to other countries until its E.U. supply contracts are met.CreditCredit…Dinuka Liyanawatte/Reuters

BRUSSELS — The European Union on Friday announced plans to effectively halt any attempt by AstraZeneca to move vaccine doses manufactured in the bloc to other countries unless it first meets its supply obligations to the bloc’s 27 member states.

The move, the latest escalation in a dispute between the bloc and the pharmaceutical company over reduced supplies, came as the European Union’s drug regulator authorized AstraZeneca’s coronavirus vaccine for use across its member states.

AstraZeneca said this month that it would significantly cut its promised delivery supply of the jab to the European Union as of mid-February. That pitted the bloc against Britain, a former member, which has been receiving a steady flow of vaccine doses from AstraZeneca since approving it well ahead of the E.U., in early December.

The AstraZeneca vaccine was developed in cooperation with Britain’s University of Oxford. The European Union accused the pharmaceutical company of using its promised doses to serve Britain, despite having paid the company about $400 million in October to help it scale up its capabilities and produce doses ahead of authorization.

The policy announced by the European Commission on Friday, presented as a “transparency tool,” will ask all pharmaceutical companies manufacturing coronavirus vaccines in factories within the bloc — currently Pfizer and AstraZeneca — to submit paperwork alerting the European authorities of any intention to move their products to non-E.U. countries. It will be in place until the end of March and will not apply to exports to poorer countries.

The Commission said it reserved the right to block such exports if it determined that the pharmaceutical companies were not meeting their contractual obligations with the E.U. first.

The measure could theoretically also affect Pfizer clients, but the Commission has said it is happy with how that company has handled a supply disruption in its Belgian factory that is setting back deliveries. The company has spread the pain among its clients, which include the E.U., Britain and Canada.

The Commission said that AstraZeneca’s decision to maintain delivery volumes to Britain while slashing its deliveries to the E.U., after a problem arose in a Belgium-based plant, was in bad faith and breach of the company’s contractual obligations.

The company’s chief executive responded that he regretted the situation, but that his company had not committed to a specific schedule, but rather to a vow to make its “best effort.”

The Commission dismissed the claim, and published a heavily redacted version of the contract with AstraZeneca. The contract affords the company many standard protections in case it fails to deliver, but includes some clauses that could be seen as favoring the E.U. interpretation that AstraZeneca is obligated to turn to other factories, including in Britain, to fulfill its delivery promises.

The matter is further complicated by regulation issues: The European drug regulator, the European Medicines Association, received an application for authorization from AstraZeneca on Jan. 12, nearly two weeks after the company received emergency authorization in Britain. The E.U. agency was expected to announce approval of use of the vaccine later on Friday.

The dispute with AstraZeneca is occurring against a backdrop of severe shortages of doses at vaccination centers across Europe. French and German regions have reported that they are nearly running out, and the Madrid region of Spain has suspended its rollout for at least two weeks until fresh deliveries arrive.

The E.U. regulator stopped short of imposing an age cap on the use of the vaccine, despite concerns about a paucity of data on the vaccine’s efficacy in people age 65 and older.

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N.Y.C. Indoor Dining to Reopen on Valentine’s Day

On Friday, Gov. Andrew M. Cuomo announced that indoor dining in New York City could resume at up to 25 percent capacity starting on Valentine’s Day.

New York City restaurants, on our current trajectory, we can reopen indoor dining at 25 percent on Valentine’s Day. The restaurants want a period of time so they can notify workers. They can get up to speed for indoor dining, order supplies, etc. So we’re saying indoor dining. 25 percent on Valentine’s Day. Going forward, we are very excited about the possibility of reopening venues with testing. Restaurants are opened on Valentine’s Day. You could make a reservation now or plan dinner on Valentine’s Day, you propose on Valentine’s Day. And then you can have the wedding ceremony March 15, up to 150 people. People will actually come to your wedding because you can tell them with the testing, it will be safe. Everybody there will be tested, and everybody will be safe.

Video player loadingOn Friday, Gov. Andrew M. Cuomo announced that indoor dining in New York City could resume at up to 25 percent capacity starting on Valentine’s Day.CreditCredit…Clay Williams for The New York Times

Indoor dining will resume with limited capacity in New York City restaurants next month, Gov. Andrew M. Cuomo announced on Friday, more than a month after he had banned it to combat a second wave of the coronavirus.

Starting on Feb. 14, the city’s restaurants can seat customers indoors at 25 percent maximum capacity, he said.

The announcement was a source of hope for the restaurant industry, an important driver of the city’s economic engine, which has been decimated by ever-changing virus-induced restrictions that have forced many restaurants and bars to go out of business and caused thousands of workers to lose their jobs.

After shutting down restaurants in March, Mr. Cuomo allowed the city’s indoor dining to restart in late September. He prohibited it again in mid-December as holiday travel threatened to increase transmission of the virus and overwhelm hospitals.

Restaurants and bars that have stayed afloat have relied on takeout and delivery, as well as outdoor dining, an increasingly untenable option as the frigid winter advances.

Starting March 15, wedding receptions with up to 150 attendees will be allowed in the state, the governor said, as long as the venues are at no more than 50 percent capacity. The gatherings would have to be approved in advance by a local health department, and all attendees will have to be tested.

“We want to use testing as the key to reopening events,” Mr. Cuomo said.

The governor’s decisions come at an incredibly precarious phase in the state’s battle against the virus, which has killed more than 42,500 people in New York State, a one-time center of the pandemic.

Yankee Stadium will open its doors as a mass vaccination site, Mr. Cuomo said, pointing to high positivity rates in the Bronx. He did not specify a time frame.

Participating in a Johnson & Johnson vaccine trial at the Desmond Tutu H.I.V. Foundation Youth Center near Cape Town last month.Credit…Joao Silva/The New York Times

Johnson & Johnson said on Friday that its one-dose coronavirus vaccine provided strong protection against Covid-19, offering the United States a third powerful tool in a race against a worldwide rise in virus mutations.

But the results came with a significant cautionary note: The vaccine’s efficacy rate dropped from 72 percent in the United States to 57 percent in South Africa, where a highly contagious variant is driving most cases. Studies suggest that this variant also blunts the effectiveness of Covid vaccines made by Pfizer-BioNTech, Moderna and Novavax.

The variant has spread to at least 31 countries, including two cases documented in the United States this week.

Johnson & Johnson said it planned to apply for emergency authorization of its vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February.

“This is the pandemic vaccine that can make a difference with a single dose,” said Dr. Paul Stoffels, the company’s chief scientific officer.

The company’s announcement comes as the Biden administration is pushing to immunize Americans faster even as vaccine supplies tighten. White House officials have been counting on Johnson & Johnson’s vaccine to ease the shortfall. But the company may have as few as seven million doses ready when the vaccine is authorized, according to federal health officials familiar with its production, and no more than 32 million doses by early April.

The variant from South Africa, known as B.1.351, could make the vaccine push tougher. Given the speed at which the variant swept through that country, it is conceivable that it could make up a large fraction of infections in the United States by April and therefore undermine the effectiveness of available vaccines.

The two vaccines approved by the U.S. government have been found to be less effective against the B.1.351 variant in clinical trials, a development that has unsettled federal officials and vaccine experts.

Many researchers say it is imperative to vaccinate people as quickly as possible. Lowering the rate of infection could thwart the more contagious variants while they are still rare.

“If ever there was reason to vaccinate as many people as expeditiously as we possibly can with the vaccine that we have right now, now is the time,” said Dr. Anthony S. Fauci, the government’s top infectious disease expert. “Because the less people that get infected, the less chance you’re going to give this particular mutant a chance to become dominant.”

A pregnant woman being vaccinated in Tel Aviv. Credit…Jack Guez/Agence France-Presse — Getty Images

The World Health Organization on Friday changed its guidance for pregnant women considering a Covid-19 vaccine, abandoning opposition to immunization for most expectant mothers unless they were at high risk.

The change followed an outcry to the W.H.O.’s previous stance, which stated that the organization did “not recommend the vaccination of pregnant women” with the vaccines made by Pfizer-BioNTech and Moderna.

Several experts had expressed disappointment on Thursday with the W.H.O.’s earlier position. The experts noted that it was inconsistent with guidance on the same issue from the U.S. Centers for Disease Control and Prevention, and would confuse pregnant women looking for clear advice.

The vaccines made by Pfizer-BioNTech and Moderna, while they have not been tested in pregnant women, have not shown any harmful effects in animal studies. And the technology used in the vaccines is generally known to be safe, experts said.

The W.H.O.’s new phrasing reflects this information:

“Based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.” The recommendation is now closely aligned with the C.D.C.’s stance.

Experts praised the shift, welcoming agreement between the world’s leading public health organizations on this important issue.

“I was very pleased to see that W.H.O. changed their guidance regarding offering the Covid-19 vaccine to pregnant women,” said Dr. Denise Jamieson, an obstetrician at Emory University and a member of the Covid expert group with the American College of Obstetrics and Gynecology. The association was among the many women’s health organizations that had urged Pfizer and Moderna to speed up vaccine tests in pregnant women.

“The more permissive W.H.O. language provides an important opportunity for pregnant women to get vaccinated and protect themselves from the severe risks of Covid-19,” Dr. Jamieson said. “This impressively rapid revision by W.H.O. is good news for pregnant women and their babies.”

Pregnant women have traditionally been excluded from clinical trials, leaving a dearth of scientific data on the safety of drugs and vaccines in women and their unborn children. Vaccines are generally considered to be safe, and pregnant women have been urged to be immunized for influenza and other diseases since the 1960s, even in the absence of rigorous clinical trials to test them.

Pfizer will test its vaccine in pregnant women over the next few months, according to a spokeswoman for the company. And Moderna plans to establish a registry to observe side effects in women who were immunized with its vaccine.

Border police at the international airport in Frankfurt, Germany.Credit…Thomas Lohnes/Getty Images

Germany on Friday announced its plans to restrict incoming travel from a handful of countries, including Britain and Ireland, in an attempt to curb the spread of infectious coronavirus variants, going beyond the measures recommended by the European Union.

“It’s about stopping the entry of a highly infectious virus,” Horst Seehofer, Germany’s interior minister, said on Thursday, a day before the federal cabinet approved the restrictions.

Under the new travel ban — which also applies to passengers coming from Portugal, Brazil, South Africa, Lesotho and Eswatini (formerly known as Swaziland) — German residents will be able to return home, but non-German residents from the areas in question will be refused entry, even with a negative coronavirus test.

While multiple known infectious variants have been found in Germany, including the B.1.1.7 variant at a hospital in Berlin, which then had to go into lockdown, health authorities believe they can still prevent variants from spreading and driving new infections.

The change will go into effect over the weekend and will be in place until at least Feb. 17. It follows a temporary halt in travel for all passengers coming from the United Kingdom and South Africa, which was lifted a few days after it was enacted. All nonessential travel remains discouraged.

After more than six weeks of a strict lockdown — during which restaurants, bars, nonessential shops and most schools have been shuttered — Germany is starting to show slight improvement in its daily case numbers. On Thursday, health authorities reported 14,022 infections in a 24-hour period, nearly 4,000 less than the amount registered one week earlier.

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Canadian Airlines Suspend Flights to the Caribbean and Mexico

Prime Minister Justin Trudeau of Canada announced on Friday that major airlines have agreed to suspend flights to sunny vacation spots as new coronavirus quarantine measures are put into place.

The government and Canada’s main airlines have agreed to suspend service to some destinations right away. Air Canada, WestJet, Sunwing and Air Transat are canceling air service to all Caribbean destinations and Mexico starting this Sunday up until April 30. Starting next week, all international passenger flights must land only at the following four airports: Vancouver, Calgary, Toronto and Montreal. In addition to the pre-boarding test we already require, as soon as possible in the coming weeks, we will be introducing mandatory P.C.R. testing at the airport for people returning to Canada. Travelers will then have to wait for up to three days at an approved hotel for their test results, at their own expense, which is expected to be more than $2,000. We will also, in the coming weeks, be requiring non-essential travelers to show a negative test before entry at the land border with the U.S. And we’re working to stand up additional testing requirements for land travel.

Video player loadingPrime Minister Justin Trudeau of Canada announced on Friday that major airlines have agreed to suspend flights to sunny vacation spots as new coronavirus quarantine measures are put into place.CreditCredit…Blair Gable/Reuters

Prime Minister Justin Trudeau of Canada announced Friday that flights between the country and several sunny vacation spots will be suspended, as new testing and quarantining measures are put in place for most air travelers entering Canada.

After previously requiring that air travelers coming to Canada for nonessential purposes show evidence of a negative coronavirus test result from within 72 hours before being allowed on planes, Mr. Trudeau said that they will now also be tested when they land upon their return to Canada. Travelers will have to wait for the results of that second test for three days in a government hotel at their own expense under the new measures.

“Now is just not the time to be flying,” Mr. Trudeau said at an outdoor news conference. “By putting in place these tough measures now, we can look forward to a better time when we can all plan those vacations.”

During most of the pandemic, international flights leaving and entering Canada have been limited to four airports. The flights that are canceled under the new order mainly service resort areas in Mexico and the Caribbean. Airlines are making arrangements to return Canadians who are already in those areas, Mr. Trudeau said.

In December, Canada temporarily stopped air travel to and from the United Kingdom following the appearance there of a new variant of the coronavirus.

Mr. Trudeau estimated that the mandatory three-day stay would cost travelers about 2,000 Canadian dollars, or about $1,570. Travelers with a negative test result will then need to quarantine for 11 more days at their homes. Those with positive test results will be sent to government facilities.

Travelers entering Canada on nonessential trips at land border crossings will also soon be tested, Mr. Trudeau said. They have long been required to quarantine for two weeks.

The premiers of Ontario and Quebec, the country’s two most populous provinces, have been pressuring Mr. Trudeau to introduce testing upon arrival at airports and introduce further flight restrictions. Several Canadian politicians and officials have also come under severe criticism and, in some cases, resigned their positions for traveling outside of the country for vacation.

Mr. Trudeau acknowledged that the percentage of Covid-19 cases in Canada linked to foreign travel is “extremely low.” But he said that the new restrictions should limit the risk posed by new variants of the virus.

“These variations represent a very real challenge,” Mr. Trudeau said.

Columbia University has mostly offered online instruction during the pandemic, and allowed only a sliver of students to live on campus or attend in-person classes. Credit…Mark Lennihan/Associated Press

Over 1,100 undergraduate and graduate students at Columbia University have pledged to withhold their tuition for the spring semester to demand a discount for what they see as a lost spring term.

While some universities have brought students back to campus, Columbia has mostly offered online instruction for students and allowed only a sliver of them to live on campus or attend in-person classes.

In response, students are asking the university to reduce their total costs — including tuition, fees, and room and board — by at least 10 percent, following suit of several schools including Georgetown University, Princeton University and Williams College. Columbia College, the university’s undergraduate school, can cost more than $80,000 a year for students not receiving financial aid.

Strike organizers said that both graduate and undergraduate students were participating; the university has more than 31,000 students.

“It’s a reasonable demand,” said Matthew Gamero, 19, a sophomore who is one of the strike organizers. “This is about the university providing an education of its worth, and to have it online is certainly not what we’re paying for.”

“This is a moment when an active reappraisal of the status quo is understandable, and we expect nothing less from our students,” the university said in a statement. “Their voices are heard by Columbia’s leadership, and their views on strengthening the University are welcomed.”

A tuition discount is only one of a series of demands made by strikers. They have also called on the university to reduce funding for campus policing, improve working conditions for graduate students and provide aid for the surrounding West Harlem community.

The tuition strike was officially kicked off after the spring term bill was due last Friday. For undergraduates, the university could impose a $150 late fee and prevent them from registering for summer or fall classes. The university could also penalize seniors by withholding their diplomas until their balance is paid.

People walk near the Eiffel Tower in Paris the day after Christmas. France will shut its borders to nonessential travel from countries outside the European Union on Sunday.  Credit…Michel Euler/Associated Press

France said on Friday that it would close its borders to non-European Union countries as cases rise and the government struggles to avoid a new lockdown.

Jean Castex, the French prime minister, said that all travel between France and nations outside of the E.U. would be banned starting on Sunday, with exceptions made only for urgent matters. All travelers from E.U. countries, except for cross-border workers, will have to present a negative coronavirus test to enter the country, Mr. Castex added.

Speculation about new restrictions had been growing in France over the past week, with a flurry of conflicting and often confusing information from officials, and many were expecting President Emmanuel Macron to replace the current 6 p.m. to 6 a.m. curfew with a new lockdown.

Speaking after a special cabinet meeting in Paris, Mr. Castex acknowledged France faced a “strong risk of acceleration of the epidemic” because of the more contagious British and South African variants of the virus, and said debates over a new nationwide lockdown were “legitimate.”

“But we all know the very heavy toll it has on the French, on all counts,” he said of a lockdown. “This evening, we consider that in view of the numbers over the past few days, we can still give ourselves a chance to avoid one.”

The variants that emerged in Britain and South Africa have both been detected in France, and the country’s vaccination campaign has slowed amid disruptions in the E.U. supply chain. The number of new cases has continued to rise in France over the past few weeks, with nearly 23,000 new cases reported on Friday, though they have not skyrocketed like they have for some of France’s neighbors.

Britain, which has faced record numbers of cases and deaths, tightened its travel restrictions on Wednesday, requiring British citizens arriving from 22 high-risk countries to quarantine in hotels for 10 days at their own expense. England entered its latest lockdown at the start of January.

The European Commission, the executive arm of the European Union, recommended on Monday restricting nonessential travel in a bid to prevent blanket border closures, which can obstruct trade and the movement of cross-border workers.

“We need to keep safe and discourage nonessential travel,” Ursula von der Leyen, the president of the commission, wrote on Twitter, citing the danger of new variants circulating.

Mr. Castex also announced the closure of the country’s largest malls that do not sell groceries, starting on Sunday, and increased police checks on curfew violations and establishments like restaurants that open illegally. Companies will be further encouraged to have their employees work from home, he said.

“Our goal is to do everything to avoid a new lockdown, and the next few days will be decisive,” Mr. Castex said.

A woman walks past a sorority house on the University of Michigan campus, where more than a dozen cases of a coronavirus variant were found.Credit…Shannon Stapleton/Reuters

Fourteen students at the University of Michigan have contracted a highly contagious variant of the coronavirus, leading health authorities to issue a stay-at-home recommendation for students living on and off campus.

Students were advised to not leave their residences until Feb. 7, except to attend classes, seek medical treatment or run essential errands.

The outbreak of the variant, first detected in Britain and known as B.1.1.7, appears to have started with a student who traveled to the United Kingdom over the winter break, according to Susan Ringler-Cerniglia, a spokeswoman for the Washtenaw County Department of Health.

The first case on the university’s campus was identified on Jan. 16 after the student tested positive and notified officials that he or she had traveled to an area where the variant was prevalent. That prompted additional sequencing that identified the student was infected with the variant, Ms. Ringler-Cerniglia said.

Since then an additional 13 students who are positive with the same variant have been identified. One of them had visited a local indoor mall and a grocery store before testing positive, leading authorities to issue a public notice to people who had visited those locations, asking them to seek testing.

Rick Fitzgerald, a spokesman for the university, said that all the infected students were in isolation with mild symptoms.

The stay-at-home recommendation announced by the Washtenaw County Health Department this week applies to the Ann Arbor campus but not to the broader community.

“More stringent, mandatory actions may be imposed if this outbreak continues to grow and additional variant clusters are identified,” the health department said in a memo to university officials on Wednesday.

Michigan athletics also imposed a two-week pause in competitions and practice, citing the emergence of the variant as the reason. Five of the cases involved individuals connected to the athletic program.

The variant is regarded as 50 percent more transmissible than the standard form of the virus but it isn’t more dangerous, and the vaccines that are currently on the market appear to be effective against it.

Since Michigan’s winter session began Jan. 19, the university has identified a total of 175 coronavirus cases, including the 14 cases of the variant.

Cardinal Timothy Dolan blessed the crowds from the steps of St. Patrick’s Cathedral in Manhattan after Easter Mass in 2016.Credit…Kathy Willens/Associated Press

Cardinal Timothy M. Dolan, the leader of the Roman Catholic Archdiocese of New York, was in quarantine on Friday after he interacted last week with a person who later tested positive for the coronavirus, according to a spokesman.

In a statement, the archdiocese said the cardinal “has not tested positive, feels fine, and has no symptoms.” Joseph Zwilling, a spokesman for the archdiocese, said the cardinal is tested regularly, had tested negative since the interaction, and would be tested again “in a few days.” He did not specify what kind of tests were used nor the timing of when he cardinal was tested after the interaction.

Tests taken too soon after exposure may return false negative results, because the virus has not yet had time to build up to detectable levels. People are thought to carry the largest quantity of virus around the time their symptoms appear, if they experience symptoms at all.

The cardinal’s quarantine had not previously been announced by the archdiocese. Mr. Zwilling said the cardinal had been in quarantine since Wednesday but that no announcement had been made because the infected individual had not received the results of their coronavirus test until Thursday.

“He did not have any public events, and all of his meetings were via Zoom, etc.,” Mr. Zwilling said in an email, referring to the cardinal. “We are announcing today because the exposure was confirmed, and the first public events — Mass tomorrow evening and Sunday morning — were coming up, and he will obviously not be present for those events.”

The cardinal will “continue to follow health and safety protocols as instructed by medical professionals, as will others on his staff who also had close contact with this individual,” the statement said.

Cardinal Dolan is one of the most influential figures in American Catholicism, and the Archdiocese of New York is the second-most populous in the United States, with more than 2.8 adherents living in a territory that stretches from Staten Island into the Hudson Valley.

He had celebrated Mass last Sunday at Saint Patrick’s Cathedral and interacted with other priests and parish personnel, all wearing masks, at that time, according to online video of the service.

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W.H.O. Delivers Update on China Visit

On Friday, the World Health Organization reviewed the details of its investigation into the origin of the coronavirus in China, and what it hopes to learn from the visit.

There is a very long list of site visits planned and face-to-face meetings continue. The — the visits will include the Wuhan Institute of Virology, other labs, the Wuhan markets, early responders, hospitals in which the first clusters of cases occurred. We continue to be hopeful that all of the data and all of the meetings that they need will be had. And and just to reconfirm that all hypotheses are on the table, and we’re looking forward, hopefully, to a successful conclusion of the mission. Success in the case of animal human interface investigations is not measured necessarily in absolutely finding a source on the first mission. This is a complicated business, what we need to do is gather all of the data, all of the information, summarize all of these discussions and come to an assessment as to how much more we know about the origins of the disease, and what further studies may be needed for the release of.

Video player loadingOn Friday, the World Health Organization reviewed the details of its investigation into the origin of the coronavirus in China, and what it hopes to learn from the visit.CreditCredit…Hector Retamal/Agence France-Presse — Getty Images

After months of delays, a team of World Health Organization scientists tracing the pandemic’s origin began its field work on Friday in Wuhan, the Chinese city where the coronavirus was first detected.

The W.H.O. said its team of 15 experts planned to visit hospitals, laboratories and a live animal market over the next several weeks in Wuhan, a city of 11 million, where the virus was detected in late 2019.

“As members start their field visits on Friday, they should receive the support, access and the data they need,” the W.H.O. said on Twitter. “All hypotheses are on the table as the team follows the science in their work to understand the origins of the #COVID19 virus.”

The Chinese government had repeatedly sought to delay the inquiry, apparently out of concern that the experts would draw attention to the government’s early missteps in handling the outbreak. But it relented under mounting global pressure.

The W.H.O. experts were first asked to undergo 14 days of quarantine in Wuhan, which ended on Thursday.

They plan to speak with some of the first patients to show symptoms of Covid-19, as well as with medical workers and Chinese scientists, according to the W.H.O. Their fieldwork will include a visit the Huanan Seafood Wholesale Market, where some of the first cases were detected.

They will also visit the Wuhan Institute of Virology and a laboratory operated by Chinese Center for Disease Control and Prevention.

The question of the pandemic’s origin has caused friction between China and the United States, with officials in each country at times blaming the other for unleashing the virus on the world.

Jen Psaki, the White House press secretary, said on Wednesday that the United States hoped for a “robust and clear” international investigation.

Chinese officials, in response, defended the country’s handling of the inquiry.

“We hope the U.S. side will work with China, take on a responsible attitude and respect facts, science and the diligent work of W.H.O. experts,” Zhao Lijian, a spokesman for the Chinese foreign ministry, said at a news conference in Beijing on Thursday.

  • Chinese officials said on Friday that several passengers traveling to China from the United States had falsified coronavirus test results so they could gain entry to the country. The Chinese consulate in San Francisco said the passengers had “changed their test results from positive to negative” and that other travelers had lied about test results. The consulate did not provide details about the passengers or the punishments they might face. China maintains strict border control rules, including a requirement that travelers present results from antibody and nucleic acid tests before they fly. The consulate said the passengers had violated public health laws. “The way they put others at risk is odious,” the statement said.

  • Vietnam recorded nine more coronavirus cases on Friday, including one in the capital, Hanoi, as a new outbreak spread beyond the two northern provinces where infections had first been detected a day earlier. Officials put the number of cases from the latest outbreak at 93 as of Friday afternoon but said that it could reach 30,000, nearly 20 times the number of cases that Vietnam detected during the entire first year of the pandemic. Vietnam has been among the most successful countries in containing the virus, with strict border controls, mask-wearing, contact tracing and isolation of infected people. The latest outbreak comes as officials from the governing Communist Party meet to select the country’s new leaders, an event held once every five years.

  • Hungary’s medicine authority has approved the coronavirus vaccine developed by the Chinese company Sinopharm. “This means that in addition to Pfizer, Moderna, Sputnik and AstraZeneca, we can also count on Sinopharm,” said Dr. Cecilia Muller, the country’s chief medical officer. “We trust that these vaccines will be readily available in large quantities and the immunization process will be completed in larger numbers in less time.” The country’s foreign minister later announced that it had purchased five million doses of the vaccine. Regarding the options, Prime Minister Viktor Orban expressed enthusiasm for the Chinese vaccine on Friday. “I will wait for the Chinese vaccine,” he said. “I trust that one the most.”

  • Spain’s first case of the South African variant of Covid-19 was detected in the port city of Vigo, in the northwestern region of Galicia. Health authorities in Galicia said a 30-year old man who works in the shipping industry returned from a recent work trip to South Africa and tested positive for the variant earlier this month. He had light symptoms and was not hospitalized, they said.

Registered nurses demonstrated against unsafe staffing practices at Good Samaritan Hospital in San Jose, Calif., in December. Credit…Sarahbeth Maney for The New York Times

The unions representing the nation’s health care workers have emerged as increasingly powerful voices during the still-raging pandemic.

With more than 100,000 Americans hospitalized and many among their ranks infected, nurses and other health workers remain in a precarious frontline against the coronavirus and have turned again and again to unions for help.

Nurses across the country from various unions are participating in dozens of strikes and protests. National Nurses United, the country’s largest union of registered nurses, held a “day of action” on Wednesday with demonstrations in more than a dozen states and Washington, D.C., as it starts negotiations at hospitals owned by big systems like HCA, Sutter Health and CommonSpirit Health.

“It’s so overwhelming. It’s unlike anything I’ve ever seen before,” said Erin McIntosh, a nurse at Riverside Community Hospital in Southern California, a part of the country that has been among the hardest hit by a surge in cases. “Every day I’m waist-deep in death and dying.”

Hospitals said the unions are playing politics during a public health emergency and say they have no choice but to ask more of their workers.

But health care workers say they have been bitterly disappointed by their employers’ and government agencies’ response to the pandemic. Dire staff shortages, inadequate and persistent supplies of protective equipment, limited testing for the virus and pressure to work even if they might be sick have left many workers turning to the unions as their only ally. The virus has claimed the lives of more than 3,300 health care workers nationwide, according to one count.

Credit…Joshua Lott/Reuters

“We wouldn’t be alive today if we didn’t have the union,” said Elizabeth Lalasz, a Chicago public hospital nurse and steward for National Nurses United.

Despite the decades-long decline in the labor movement and the small numbers of unionized nurses, labor officials have seized on the pandemic fallout to organize new chapters and pursue contract talks for better conditions and benefits. National Nurses organized seven new bargaining units last year, compared to four in 2019. The Service Employees International Union, which represents Mrs. McIntosh, also says it has seen an uptick in interest.

Tyler Perry in 2019.Credit…Frederic J. Brown/Agence France-Presse — Getty Images

With the pandemic exposing racial disparities in the United States — Black people have died of Covid-19 at nearly three times the rate of white people, according to the Centers for Disease Control and Prevention — health officials have been working to promote vaccinations in Black communities, and to combat doubt.

So doctors in Atlanta turned to Tyler Perry — a popular and prolific actor, director and studio head — to spread the word to Black audiences that the vaccine was harmless. He agreed to interview the experts, turning it into a TV special that aired Thursday night on BET. On the show, he peppered doctors from Grady Health System with questions about the safety of the vaccine, how it was developed, how it was tested and how it works.

At the end of the interview, with his sleeve pulled up, Perry got the jab as cameras rolled.

Perry is one of the most powerful people in the entertainment industry. He built his fortune portraying the character of Madea, a tart-tongued and irreverent matriarch, onstage and onscreen, before retiring her in 2019 to concentrate on other projects, which include running his 330-acre studios in Georgia.

Skepticism about the Covid-19 vaccine among Black people has been deeply concerning to health officials. A recent study by the Kaiser Family Foundation found that one in three Black people was hesitant about vaccine. A recent CNN analysis found that Black and Latino Americans were getting the vaccine at significantly lower rates than white people — rates attributed to, among other factors, lack of access to health care for many Black people, but also to an entrenched mistrust about the medical establishment.

On the BET special, Perry spoke of episodes in history that have led to a lack of faith in the medical establishment and the government, among them the Tuskegee Syphilis Study, in which doctors allowed syphilis to progress in Black men by withholding treatment from them, and the case of Henrietta Lacks, a Black woman who died of cervical cancer in 1951, whose cells were used in research without her knowledge or consent.

“We as Black people have healthy hesitation when it comes to vaccinations and so on and so forth, and even disease,” he said.

Perry said he didn’t want people getting vaccinated just because he had. “What I want to do is give you the information, the facts,” he said. “There’s a lot of misinformation out there.”

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New York City Sets ‘Aggressive Goal’ of 5 Million Vaccinations by June

Mayor Bill de Blasio said the city is aiming to vaccinate 5 million New Yorkers against Covid-19 by June. He also announced plans to bring city workers back to offices in May and reopen schools for all students in September.

We’re going for an aggressive goal, five million New Yorkers vaccinated by June. I am absolutely certain we can do it so long as we have the vaccine. And I am more and more confident because the actions the Biden administration, because the Johnson Johnson vaccine is coming, more and more confident that we will have what we need. I’m going to push hard on the federal government to get every pharmaceutical company in America into this work because they’re not right now. The federal government needs to ensure that they are required to produce vaccine, whether they’re the originator of the vaccine or not. So long as we have the supply, we can reach five million new Yorkers in June, get to a point of community immunity. And we’re going to bring back our city workforce in May and after, because obviously so many are on the job right now. But the folks who work in our offices and do so much important work, we want them back. We want to send a signal to this whole city. We’re moving forward. We want to see the private sector bring workforces back. We are going to have an entirely different situation as we proceed into the spring. By the end of the spring, I think you’re going to see something very different. And we’re going to a great group of folks out there, our vaccine for all core leading the way. Now, a lot of different pieces matter, and one of the most crucial ones that matters to us for today, for our parents, for our families, for our future, tomorrow — our schools, one of the things that says most clearly, we are back is our schools. And so in September, our schools come back fully. We focus on helping kids overcome that Covid achievement gap. Our 2021 student achievement plan focuses on the academic side, but also the emotional side, the mental health needs of our kids after everything they’ve been through.

Video player loadingMayor Bill de Blasio said the city is aiming to vaccinate 5 million New Yorkers against Covid-19 by June. He also announced plans to bring city workers back to offices in May and reopen schools for all students in September.CreditCredit…James Estrin/The New York Times

In his final State of the City address, Mayor Bill de Blasio offered a sprawling vision of New York City’s recovery from a pandemic that has taken tens of thousands of lives and destroyed the city’s economy.

The mayor committed to accelerating the city’s vaccination efforts and set a goal of inoculating five million New Yorkers by June.

“We’re going for an aggressive goal,” Mr. de Blasio said at a news conference on Friday morning, adding that “I am absolutely certain we can do it, so long as we have the vaccine.”

On Friday, Mr. de Blasio said that, given an adequate supply of the vaccine, the city could vaccinate half a million people per week, and that he planned to reopen vaccination sites that had closed as more vaccine became available.

Johnson & Johnson announced on Friday that their vaccine was very effective at preventing the virus, but that its efficacy dropped steeply against a more contagious variant in South Africa. White House officials have been counting on Johnson & Johnson’s vaccine, to ease the shortfall of vaccine supply. Unlike the federally authorized vaccines made by Pfizer and Moderna, Johnson & Johnson’s vaccine is effective after only one dose. But the company may only have about seven million doses ready when the F.D.A. decides whether to authorize it, according to federal health officials familiar with its production, and about 30 million doses by early April.

Mr. de Blasio also noted on Friday that the citywide seven-day average rate of positive test results was 8.63 percent, and city data show that in more than 30 city ZIP codes the rate is above 10 percent.

During the State of the City address, the mayor also said he would begin in May to bring back to offices the thousands of city employees who have been working remotely, and would safely reopen schools for all students in September.

“New York City’s vaccination effort is the foundation of a recovery for all of us,” the mayor’s 18-page recovery plan says. “With every vaccine shot, New York City moves closer and closer to fully reopening our economy, restoring the jobs we lost and ensuring equality in our comeback.”

If the federal government provides enough stimulus dollars to the city, Mr. de Blasio said, he will create a City Cleanup Corps of 10,000 temporary workers to focus on beautifying the city — an idea he compared to President Franklin D. Roosevelt’s Works Progress Administration during the Great Depression.

Mr. de Blasio also proposed two plans to help small businesses: a $50 million “recovery tax credit” program for businesses that have faced hardships from the pandemic, and a $100 million “recovery loan” program to help shops stay open. The city will provide low-interest loans of up to $100,000 to roughly 2,000 small businesses, according to the mayor’s plan.

But Mr. de Blasio has also warned that the city is facing major budget cuts and layoffs. He recently announced that the city’s property tax revenues are projected to decline by $2.5 billion next year, driven by a drop in the value of office buildings and hotel properties that have emptied out during the pandemic.

Gov. Andrew M. Cuomo announced on Friday that restaurants in New York City, major drivers of its economy that have struggled under pandemic restrictions, could reopen for indoor dining at 25 percent capacity starting on Feb. 14. Mr. Cuomo closed them last month as virus numbers ticked up.

Mr. de Blasio and Mr. Cuomo have expressed optimism that President Biden, along with a Democratic-led Congress, will bring substantial assistance to the city. Mr. de Blasio also called for higher taxes on wealthy New Yorkers in his speech — a policy he has pushed for years, but that Mr. Cuomo has opposed.

Mr. de Blasio noted that more than 100 billionaires in the state increased their net worth by billions of dollars during the pandemic and called again for a redistribution of wealth.

“There is clearly enough money in New York to invest in a fair and fast recovery — it’s just in the wrong hands,” he said.

A protest outside the Denver office of the Occupational Safety and Health Administration last year after hundreds of workers at a Colorado meatpacking plant developed Covid-19, six fatally.Credit…David Zalubowski/Associated Press

The federal occupational safety agency on Friday posted new guidance for employers on reducing the spread of Covid-19 in the workplace, just over one week after President Biden signed an executive order directing it to do so.

The move by the Occupational Safety and Health Administration, part of the Labor Department, includes only recommendations, not requirements. But the agency said it was exploring a rule mandating certain protective measures.

The agency declined to issue such a rule, known as an emergency temporary standard, during the Trump administration. But Mr. Biden indicated support for a standard during the campaign.

The new guidance makes fewer distinctions than the Trump administration’s version based on the exposure risk of different workers. “Everyone should be protected, not some more protected than others,” Ann Rosenthal, a senior adviser to the agency, said on a video call with reporters.

The document issued on Friday also uses less equivocal language than the agency did under President Donald J. Trump. For example, it says the most effective prevention programs “ensure that absence policies are nonpunitive.” During the Trump administration, the agency advised employers to “ensure that sick leave policies are flexible and consistent with public health guidance.”

Meatpacking and meat processing have been a particular source of concern, accounting for an outsized portion of Covid-19 infections nationally.

In late December, a state judge in California issued a temporary restraining order in a lawsuit involving workers at a local poultry plant, requiring a variety of safety protocols such as providing masks and requiring workers to wear them, as well as face shields, where social distancing isn’t possible.

The court announced Friday that it would issue a preliminary injunction to the same effect, giving workers an ongoing ability to force compliance if the company backs off the protocols. It cited evidence submitted by the plaintiffs that “regulatory agencies are overwhelmed by the issues raised by the Covid-19 pandemic and are unable to inspect with the same regularity as was the practice prior to the pandemic.”

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Johnson & Johnson’s Vaccine Provides Sturdy Safety however Fuels Concern About Variants

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Johnson & Johnson announced on Friday that its one-dose coronavirus vaccine provided strong protection against Covid-19, potentially offering the United States a third powerful tool in a desperate race against a worldwide rise in virus mutations.

But the results came with a significant cautionary note: The vaccine’s efficacy rate dropped from 72 percent in the United States to 57 percent in South Africa, where a highly contagious variant is driving most cases. Studies suggest that this variant also blunts the effectiveness of Covid vaccines made by Pfizer-BioNTech, Moderna and Novavax. The variant has spread to at least 31 countries, including the United States, where two cases were documented this week.

Johnson & Johnson said that it planned to apply for emergency authorization of the vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February.

“This is the pandemic vaccine that can make a difference with a single dose,” said Dr. Paul Stoffels, the chief scientific officer of Johnson & Johnson.

The Johnson & Johnson vaccine was 85 percent effective in preventing severe disease, regardless of what variant caused it, the company said. While less effective than the Moderna and Pfizer vaccines, Johnson & Johnson’s is still considered a strong vaccine by scientists. Annual flu vaccines, for example, are typically 40 to 60 percent effective.

The company’s announcement comes as the Biden administration is pushing to immunize Americans faster even with a tight vaccine supply. White House officials have been counting on Johnson & Johnson’s vaccine to ease the shortfall. But the company may only have about seven million doses ready when the F.D.A. decides whether to authorize it, according to federal health officials familiar with its production, and about 30 million doses by early April.

The variant from South Africa, known as B.1.351, could make things even worse for the vaccine push. Given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States.

The fact that four vaccines backed by the federal government seem to be less effective against the B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.

“If ever there was reason to vaccinate as many people as expeditiously as we possibly can with the vaccine that we have right now, now is the time,” Dr. Anthony S. Fauci, the government’s top infectious disease expert, said in an interview. “Because the less people that get infected, the less chance you’re going to give this particular mutant a chance to become dominant.”

As the United States scrambles to get enough vaccines, the country is turning into something of an evolutionary experiment. The B.1.351 variant is one of several that have arrived in the country or originated here, all with the ability to spread faster than other variants.

“The pandemic is a lot more complicated now than it was a couple months ago,” said Dr. Dan Barouch, a virologist at Beth Israel Medical Center in Boston.

Vaughan Cooper, an evolutionary biologist at the University of Pittsburgh, said that all the new variants were likely evolving quietly for months before bursting on the scene. “I think we’re going to see many stories like this,” he said.

Federal regulators are also still waiting on data from Johnson & Johnson’s new manufacturing facility in Baltimore that prove it can mass-produce the vaccine. The company is counting on that factory to help reach its contractual pledge to the federal government of 100 million doses by the end of June.

If Johnson & Johnson can deliver vaccines quickly enough to the United States, it might be able to help drive down cases before variants make things worse. Since the vaccine requires only a single shot — unlike the Moderna and Pfizer-BioNTech vaccines, which require two — that delivery would translate into full coverage for 100 million people.

Johnson & Johnson’s vaccine has another advantage that might help speed up the rollout. It can stay viable in a refrigerator for three months, while the two authorized vaccines have to be kept frozen. That gives the company an edge not just in reaching more isolated parts of the United States, but in getting the vaccine to remote areas of the world that could otherwise seed more aggressive mutants.

“I hope this vaccine gets approved as soon as possible to reduce disease burden around the world,” said Akiko Iwasaki, immunologist at Yale University. She pointed out that the shot greatly reduced the number of severe Covid cases, even those caused by the variant. “This is a really great result.”

Still, Johnson & Johnson and other vaccine makers must prepare for the B.1.351 variant or another one surging to dominance and demanding new vaccines. “You’ve got to be nimble enough to be able to adapt by upgrading our vaccines that match the dominant strain,” Dr. Fauci said.

Exactly when to make that switch will be a difficult decision, because the viruses are spreading unpredictably, and manufacturing new doses will be a huge undertaking.

“The implications of that are big. You would not take that choice lightly,” said John D. Grabenstein, an epidemiologist with the Immunization Action Coalition, a nonprofit organization that disseminates information about vaccines. “It’s not doomsday. It’s just that we are going to need a bigger boat.”

Johnson & Johnson’s announcement came one day after Novavax said an early analysis of its 15,000-person trial in Britain had revealed that the two-dose vaccine had an efficacy rate of nearly 90 percent there. But in a small trial in South Africa, the efficacy rate dropped to just under 50 percent.

Johnson & Johnson presented only a summary of findings of its clinical trial. The vaccine was 85 percent effective in preventing severe disease in all three regions where the trial was run: the United States, Latin America and South Africa. After 28 days, none of the vaccinated participants who developed Covid-19 had to be hospitalized.

The company reported that the vaccine’s protective effect seems to increase with time. But without long-term data on immunity, scientists and regulators do not yet know whether the vaccine’s efficacy peaks at some point before dropping.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

Am I eligible for the Covid vaccine in my state?

Currently more than 150 million people — almost half the population — are eligible to be vaccinated. But each state makes the final decision about who goes first. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring or early summer. The vaccine hasn’t been approved in children, although studies are underway. It may be months before a vaccine is available for anyone under the age of 16. Go to your state health website for up-to-date information on vaccination policies in your area

Is the vaccine free?

You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a health department vaccination site or a local pharmacy once the shots become more widely available.

Can I choose which vaccine I get?How long will the vaccine last? Will I need another one next year?

That is to be determined. It’s possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year. We have to wait to see how durable the protection from the vaccines is. To determine this, researchers are going to be tracking vaccinated people to look for “breakthrough cases” — those people who get sick with Covid-19 despite vaccination. That is a sign of weakening protection and will give researchers clues about how long the vaccine lasts. They will also be monitoring levels of antibodies and T cells in the blood of vaccinated people to determine whether and when a booster shot might be needed. It’s conceivable that people may need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.

Will my employer require vaccinations?Where can I find out more?

Dr. Stoffels said the company was still waiting for more data on whether the vaccine can protect against asymptomatic infection.

The company is preparing a lengthy briefing document it will submit to the F.D.A. in its application for authorization. The agency’s scientists will review the raw data from the trial and present their own analysis.

Unlike the messenger RNA vaccines made by Pfizer-BioNTech and Moderna, Johnson & Johnson uses an adenovirus, which normally causes the common cold. While adenovirus-based vaccines have been investigated for some three decades, they have yet to be licensed for use in the United States.

Johnson & Johnson’s Ebola vaccine became the first approved adenovirus-based vaccine for any disease when European regulators gave it the green light last July. Astra-Zeneca and the University of Oxford used a different adenovirus for their coronavirus vaccine, which is now authorized in Britain and other countries. Russian scientists created their Sputnik V vaccine from adenoviruses as well.

Johnson & Johnson received $456 million from Operation Warp Speed to support its research. In July, the government agreed to purchase 100 million doses for $1 billion if it proved safe and effective.

That same month, the company moved into clinical trials, which found that a single shot produced a strong immune response, consistent with experiments done on monkeys. Johnson & Johnson began the final “Phase 3” trial in September, again using a single dose. It recruited volunteers in the United States, South Africa and Latin America.

Half of the volunteers received the vaccine, and half received a placebo. The company then had to wait. Only when enough people in the trial got Covid-19 would an independent board of advisers look at the results to see how many sick volunteers were vaccinated — a process known as unblinding.

Late last year, surges of coronavirus infections accelerated the trial toward unblinding. In December, Johnson & Johnson decided it would not need to recruit 60,000 volunteers as it originally planned. It capped the trial at 45,000.

Like other vaccine developers, Johnson & Johnson was required by the F.D.A. to also record information about adverse events experienced by the volunteers for the first few months after vaccination.

Dr. Barouch, who led the team that designed the vaccine and tested it on animals last year, had to wait for months for the unblinding. “I’m thinking a lot about it,” he said in a Jan. 11 interview. “But, no, I don’t have champagne ready to go.”

After he learned the results, Dr. Barouch said he was delighted. “I think this vaccine will have a public health benefit throughout the world,” he said.

Johnson & Johnson is also moving forward with other trials of the vaccine to see how it can be improved. In December it began a trial with two doses. Dr. Fauci was optimistic that people who get a so-called prime boost may enjoy even more protection.

“If they get a prime boost, it’s entirely conceivable that they can get up to 90-plus percent,” he said.

In addition, Dr. Stoffels said that Johnson & Johnson was tailoring a version of its vaccine with a protein patterned after the B.1.351 variant. It could potentially deploy it in countries where that version of the virus was a threat.

“Pretty much all vaccine developers now are having that conversation,” said Dr. Peter J. Hotez, a vaccine expert with the Baylor School of Medicine and the creator of a different coronavirus vaccine.

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Johnson & Johnson JNJ earnings This autumn 2020 beat estimates

Johnson & Johnson on Tuesday reported fourth quarter earnings and sales that exceeded Wall Street expectations. The company also said it would “soon” release important details about its coronavirus vaccine.

According to Refinitiv’s average estimates, J&J has fared compared to Wall Street expectations as follows:

  • Adjusted earnings per share: $ 1.86 per share versus $ 1.82 expected.
  • Revenue: $ 22.48 billion versus $ 21.67 billion expected.

“I am incredibly proud of our Johnson & Johnson teams around the world who are committed to meeting stakeholder needs,” said CEO Alex Gorsky in a press release. “We are continuing to develop our COVID-19 vaccine candidate and look forward to publishing details from our Phase 3 study soon.”

J & J’s share price remained essentially unchanged in premarket trading after the report.

J & J’s pharmaceutical business, which is working on a coronavirus vaccine, had sales of $ 12.26 billion. This corresponds to an increase of 16% over the previous year as the demand for prescription drugs increased. The company’s consumer unit, which makes products like Listerine, had sales of $ 3.6 billion, up 1.4% year over year. The medical device unit generated $ 6.58 billion, down 0.7%.

The company forecast adjusted earnings of $ 9.40 to $ 9.60 per share and revenue of between $ 90.5 and $ 91.7 billion in 2021.

J&J is expected to release data from its Phase 3 study testing the Covid-19 vaccine this week.

US officials and Wall Street analysts are eagerly awaiting J & J’s nationwide approval of the vaccine, which could come as early as next month. Unlike the vaccines approved by Pfizer and Moderna, which require two doses three to four weeks apart, J&J only requires one dose. This means that patients don’t have to return for another dose, which simplifies logistics for healthcare providers.

Joseph Wolk, J & J’s chief financial officer, told CNBC Tuesday that the company expects the data from the Phase 3 study to be “robust.” He said it was possible that there were differences in results for people tested in places like South Africa, where there is a new, highly contagious strain of the virus.

Moderna said Monday it was working on a booster shot to protect against the strain seen in South Africa after it was found the current vaccine appeared to be less effective.

“It will be very comprehensive when it comes to specific ethnicities [such as] Blacks, Hispanics, and the elderly, “Wolk said on” Squawk Box. ” Because it is so diverse due to its geographical representation that it could provide many insights. ”

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Johnson & Johnson Expects Covid Vaccine Outcomes Quickly however Lags in Manufacturing

Johnson & Johnson expects to release critical results from its Covid-19 vaccine trial in as little as two weeks — a potential boon in the effort to protect Americans from the coronavirus — but most likely won’t be able to provide as many doses this spring as it promised the federal government because of unanticipated manufacturing delays.

If the vaccine can strongly protect people against Covid-19, as some outside scientists expect, it would offer big advantages over the two vaccines authorized in the United States. Unlike those products, which require two doses, Johnson & Johnson’s could need just one, greatly simplifying logistics for local health departments and clinics struggling to get shots in arms. What’s more, its vaccine can stay stable in a refrigerator for months, whereas the others have to be frozen.

But the encouraging prospect of a third effective vaccine is tempered by apparent lags in the company’s production. In the company’s $1 billion contract signed with the federal government in August, Johnson & Johnson pledged to have 12 million doses of its vaccine ready by the end of February, ramping up to a total of 100 million doses by the end of June.

Federal officials have been told that the company has fallen as much as two months behind the original production schedule and won’t catch up until the end of April, when it was supposed to have delivered more than 60 million doses, according to two people familiar with the situation who were not authorized to discuss it publicly. Carlo de Notaristefani, lead manufacturing adviser for Operation Warp Speed, the federal vaccine development program, acknowledged a delay, but said the company might be able to catch up with initial production goals by March.

“I agree there was a problem,” Dr. de Notaristefani said. But he added, “Manufacturing of pharmaceuticals is not a black box where you turn the key and start counting.”

Any delay could be critical because the federal government has secured only enough vaccine doses to inoculate 200 million of the roughly 260 million eligible adults in the first half of this year. With the nation in the grip of its largest surge of the coronavirus to date and the death toll escalating to as high as 4,000 a day, Americans desperate to be vaccinated are lining the sidewalks outside vaccination centers.

Fears about the virus have only escalated with the scientific discovery last month that the country has been seeded with a new, highly contagious variant. On Tuesday, the Trump administration announced it would no longer hold back vaccine stocks for second doses in order to get more people at least partly vaccinated more quickly.

Dr. Paul Stoffels, Johnson & Johnson’s chief scientific officer, said he expected to see clinical trial data showing whether his company’s vaccine is safe and effective in late January or early February. But he declined to provide details about the company’s production capacity.

“We are not ready to release the numbers month by month at the moment, as we are in the discussion with the F.D.A.,” he said.

If the data is positive and the Food and Drug Administration authorizes the vaccine for emergency use, he added, “hopefully somewhere in March we’ll be able to contribute” to the nation’s vaccination drive.

That Johnson & Johnson’s timetable has slipped is not unusual given the frantic pace of vaccine development amid the worst pandemic in a century. But the delay also highlights the unrealistic promises of Operation Warp Speed.

The premise of the program was that the federal government would front the costs of development and manufacturing so that vaccine makers could mass-produce doses even before the vaccines were proved to work. Moncef Slaoui, chief scientific adviser for Warp Speed, said in December that Johnson & Johnson’s vaccine would be a “game changer” in the pandemic.

But at a Tuesday news conference, Dr. Slaoui said that instead of 12 million doses envisioned in the contract by the end of February, the company was likely to have in the “single-digit” millions. He also said the company was “trying to make that number get as close to a double-digit number as possible, and then a larger number in March and a much larger number in April.” Another person familiar with the company’s progress said it was poised to deliver only perhaps three million or four million doses of its vaccine by the end of next month.

In a statement, a Johnson & Johnson spokesman said, “We are confident we can meet our contractual obligations to supply our vaccine candidate to the U.S. government.”

Dr. de Notaristefani, Operation Warp Speed’s manufacturing chief, said the government’s contracts with vaccine makers were written at a time of great uncertainty, with the understanding that unforeseen obstacles could throw off the timetables. “Numbers are never cast in stone when you start a new process,” he said, adding that the company had to transfer its manufacturing from the Netherlands to a plant in Baltimore. “I really think that technically they couldn’t do it earlier.”

Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, said that state health officials were clearly excited about Johnson & Johnson’s one-dose vaccine.

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

If I live in the U.S., when can I get the vaccine?

While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.

When can I return to normal life after being vaccinated?

Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.

If I’ve been vaccinated, do I still need to wear a mask?

Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.

Will it hurt? What are the side effects?

The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.

Will mRNA vaccines change my genes?

No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

“You can get it and you’re done,” he said. “Everybody is eager to have it out there. It has a lot of potential.”

But even if Johnson & Johnson’s vaccine pans out, Dr. Plescia said, it won’t be enough. He predicted that state health departments would need a total of four vaccines in the next six months if they hope to reach their goals of offering a vaccine to every American who wants one.

“Or else the public is going to get very frustrated, because they’re ready for it to be opened up and there isn’t adequate supply to do that,” Dr. Plescia said.

Johnson & Johnson is by no means alone in its manufacturing delays. Dr. Albert Bourla, Pfizer’s chief executive, told investors last fall that his company had agreed to deliver 40 million doses of its vaccine to the federal government in 2020, assuming it proved successful in clinical trials. In the end, the company had only half that many ready to ship.

No one — including company executives — knows whether Johnson & Johnson’s vaccine will work. But Lynda Coughlin, a virologist at the University of Maryland School of Medicine who is not involved in the trial, said that the design of the vaccine and the results from early trials made her optimistic.

“Hopefully the results from Johnson & Johnson are just really going to knock it out of the park,” she said.

Johnson & Johnson’s Covid vaccine is fundamentally different from the authorized vaccines from Moderna and Pfizer-BioNTech. Those two consist of genetic molecules encased in oily bubbles. Johnson & Johnson built its vaccine from a virus that causes common colds, known as an adenovirus.

Testing the vaccine on monkeys, the researchers found that a single shot was enough to protect the animals from infection. When they tried out different formulations of the vaccine in early clinical trials, they were pleased to see that the vaccine prompted a strong antibody response with a single dose.

On Wednesday, Johnson & Johnson researchers and their colleagues published the full details of these early clinical trials in the New England Journal of Medicine. They reported that when they checked the blood of volunteers 71 days after receiving a single dose, their levels of coronavirus antibodies were still high. In some cases they were still increasing.

As results of the early clinical trials emerged over the summer, the company had to make a high-stakes decision: proceed with a clinical trial of two doses, which had the most likelihood of success, or try one with a single dose, which would be far more useful for getting shots to the masses — if it worked. The company decided to roll the dice with a single-shot trial.

“We know from vaccination campaigns that the simpler the logistics, the more successful the program,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center who pioneered adenovirus vaccines in the early 2000s and collaborated with Johnson & Johnson researchers on the trial.

If many people began developing immunity from a single-shot dose, it might become harder for the virus to move from person to person, bringing down the high rates of new cases and easing the burden of the pandemic.

“A vaccine that is one dose would have a tremendous, tremendous public health impact, of course for low-income countries, but also in high-income countries,” said Ruth Faden, a professor of biomedical ethics at Johns Hopkins University.

While other vaccine developers moved quickly into late-stage trials, Johnson & Johnson deliberately moved more slowly so it could focus on ramping up manufacturing of its vaccine. At a facility in the Netherlands, researchers grew cells in which their adenoviruses could multiply. Adjusting the chemistry in giant vats, the scientists found a recipe for producing the vaccine at a fast, reliable rate.

Johnson & Johnson also began working early with other companies to prepare to manufacture the vaccine across the world. In April, it announced a partnership with the Maryland-based Emergent BioSolutions to manufacture the vaccine for the United States. Researchers from Johnson & Johnson began visiting Emergent BioSolutions starting that month to help it prepare for producing the adenoviruses.

“It was much more than a paper exercise: ‘Here’s the recipe, follow this,’” said Remo Colarusso, vice president at Janssen Supply Chain. “This is complex manufacturing.”

By the fall, Emergent BioSolutions was growing cells that were spewing out new adenoviruses. When Johnson & Johnson announced the start of its final Phase 3 trial, executives began making aggressive projections. “We are now committed to make more than one billion doses during 2021, and more after that,” Dr. Stoffels said at a September news conference.

The company then secured more deals to provide the vaccine to countries around the world. In 2021, Johnson & Johnson has promised to supply 200 million doses to Covax, an international partnership seeking to distribute coronavirus vaccines to nations that would not otherwise be able to afford them. It will supply another 300 million to Covax in 2022.

Soon after Johnson & Johnson started its trial, cases surged around the world. All the Phase 3 clinical trials of Covid vaccines accelerated because trials end only after a specified number of volunteers — from both the placebo and vaccinated groups — get sick. In November, the Pfizer-BioNTech and Moderna vaccine trials both delivered impressive results, with efficacy rates around 95 percent.

The F.D.A. authorized both vaccines for the United States, and other countries soon followed suit. But these two vaccines had some major shortcomings that soon became impossible to ignore. Both vaccines have to be kept in a deep freeze to prevent them from degrading. Once they reach a hospital or clinic, they have to be used before they spoil. In New York City and elsewhere, unused vaccines have ended up in the trash.

Once data collection is complete at the end of January or early February, an advisory board will review the data and report its analysis on safety and efficacy to Johnson & Johnson. F.D.A. regulators are already evaluating manufacturing data weeks ahead of when Johnson & Johnson is expected to apply for emergency authorization. Hiccups as small as mold in part of a facility could spur further delays.

Katie Thomas contributed reporting.

Categories
Health

Johnson & Johnson Covid vaccine: Analysts are cautiously optimistic

Illustration of the Johnson & Johnson coronavirus vaccine

Given Ruvic | Reuters

LONDON – Health systems around the world are struggling to cope with the rising number of Covid-19 infections as they race against the clock to vaccinate the vulnerable.

The three vaccines currently approved for use in large Western economies all require two separate vaccinations. Given the limited supply, governments are considering controversial tactics such as increasing the time between doses in order to get at least one dose to as many people as possible.

A one-shot vaccine could vastly improve our ability to fight the virus – and we may have one soon.

J & J’s late trial

Johnson & Johnson is expected to deliver preliminary late-stage study results for its single-dose Covid vaccine candidate by the end of January. If the push turns out to be safe and effective, the company will aim to have at least 1 billion doses by the end of the year.

The J&J vaccine was developed by the company’s Belgian unit, Janssen Pharmaceutica, and is based on adenovirus viral vector technology, the same approach used to make the Oxford-AstraZeneca University vaccine. This type of shot is easier to scale than those developed by Pfizer-BioNTech and Moderna, which are based on messenger RNA technology.

Shore Capital health analyst Adam Barker said in an email to CNBC last week, “The J&J vaccine is more like the AstraZeneca vaccine, but uses only one dose. So we know this approach works (viral vector) and we know the goal will work. But we have to see what a dose does. “

The Morgan Stanley health team said in a research report released last week that J & J’s vaccine “offers unique elements and efficacy that could be positive compared to AstraZeneca, increasing confidence in pandemic response and recovery Strengthens the market “.

The investment bank is confident in the vaccine’s safety profile, given early trial data, “along with the previous success and safety profile demonstrated in its Ebola vaccine and research use in HIV, RSV and Zika”.

A report by the Tony Blair Institute for Global Change, founded by the former UK Prime Minister, calls the AstraZeneca and Johnson & Johnson jabs “the two workhorse vaccines” because they should be widely available and easier to administer than those mRNA shots.

With J & J’s technology, the vaccine is estimated to be stable for at least three months at normal refrigeration temperatures, so no new infrastructure is required for transportation.

Expected timeline

On December 17th, J & J completed the registration of its phase 3 clinical trial with 45,000 participants for its single-dose vaccine candidate. Preliminary data from the study is expected to be available by the end of the month.

If the data suggests the vaccine is safe and effective, the company is expected to file an application for approval for emergency use with the U.S. Food and Drug Administration in February. Other health regulatory applications around the world are expected to be paralleled.

Supply contracts

The company is committed to selling the vaccine on a non-profit basis for emergency use.

J&J entered into an agreement with the United States in August 2020 to supply 100 million doses of the vaccine after FDA approval or approval and the option to purchase up to 200 million additional doses under a subsequent agreement.

The UK negotiated a deal in August to purchase an initial 30 million doses of the J&J vaccine, with the option to purchase up to 22 million additional doses. The EU signed a contract with J&J in October to supply up to 400 million cans.

J & J has also agreed to provide up to 500 million doses of its vaccine to lower-income countries through COVAX under a fundamental agreement with The Vaccine Alliance (Gavi), which is responsible for equitable access to vaccines. These doses will be distributed through 2022, when the vaccine candidate is approved for use.

“If J & J’s Ad26 platform is able to achieve over 80% efficacy from a single dose, we would consider that a compelling result given the vaccine’s favorable handling requirements and significant manufacturing scale,” said Morgan Stanley.

Jonathan Reiner, Professor of Medicine and Surgery at the George Washington University School of Medicine and Health Sciences, argues, “The J&J vaccine is why we shouldn’t ditch the two-dose strategy for Pfizer-BioNTech and Moderna. We’ll probably have all the vaccines we need. We need to focus on getting the vaccines into our arms. “

Categories
Business

On Brexit and Coronavirus, Boris Johnson Leaves It Late

This undermined the government’s goal of curbing social contacts in the face of a new variant of the coronavirus that British officials said is spreading far faster than the original strain. In fact, the refugees from London are likely to spread the virus across the country, where 35,928 new cases were reported on Sunday.

It is more tactical when the Prime Minister pulls out a post-Brexit deal. With only 10 days to go before December 31st, there would be very little time for a review of an agreement in parliament, where pro-Brexit hardliners would keep a close eye on it. But with no margin for error, analysts say Mr Johnson may have to compromise to prevent an economically ruinous breakdown in talks.

“The outlines of a possible deal have been known at least since last March,” said Sam Lowe, trade expert at the Center for European Reforms. “But the prime minister’s approach is to take difficult decisions until the last minute in the hope that something better will happen – as his approach to Covid-19 shows.”

Tim Bale, Professor of Politics at Queen Mary University in London, said: “The price for this psychological flaw and its political consequences is paid in lost lives in the case of Covid. In Brexit, livelihoods could be lost if some companies go under due to the uncertainty caused by the delay in decision-making. “

With the UK less than two weeks away from leaving the single market and customs union, UK businesses still have no idea whether their goods will be subject to tariffs when they are exported to continental Europe or Ireland. That could make car factories unprofitable or put some farmers out of business.

Trade talks continued in Brussels on Sunday with no sign of a breakthrough. The two sides are mostly haggling over fishing rights, but there are signs that Mr Johnson is already bowing to the European Union’s broader demand for Britain to accept long-term restrictions on its competition policy and state aid to industry.

Regarding the pandemic, critics say Mr. Johnson’s scattershot policies have undermined public confidence in the government. He has ruled out bans repeatedly, only to reverse course on the claim that the scientific evidence has changed. The mixed messages have left many confused and cynical about the rules.

In the recent U-turn, Mr Johnson cited new evidence that the variant was up to 70 percent more transmissible than the original virus – data he said was presented to his cabinet on Friday. Independent scholars generally have concerns about the variant. But UK health officials said Sunday that they first identified the variant in October from a sample taken in September.

Updated

Apr. 20, 2020 at 2:37 am ET

The government first announced the variant last Monday – and feared it could spread faster – when it placed London and other parts of southern and eastern Britain in the then highest levels of restrictions. Two days later, Mr. Johnson reiterated his promise to relax the December 23-27 restrictions so families can get together for Christmas.

When the leader of the opposition Labor Party, Keir Starmer, proposed in Parliament that Mr Johnson reconsider this plan, the Prime Minister ridiculed him. “I wish he had the courage just to say what he really wanted to do,” said Mr Johnson, “which means canceling the plans people have made and canceling Christmas.”

Now, of course, the prime minister has done just that – only he waited three more days with more people making travel plans. On Sunday, the Netherlands, Belgium, Italy, France, Germany and Austria began banning flights from the UK while the European Union weighed a coordinated response.

Mr Starmer predictably faded into criticism, saying that Mr Johnson was “so afraid of being unpopular that he won’t be able to make difficult decisions until it’s too late”.

The Prime Minister had given a glimpse into his fears earlier this week when he alluded to Oliver Cromwell holding Christmas celebrations during the ascetic days of the Puritan movement in England in the mid-17th century. The British newspapers, which had set Cromwell’s precedent in recent weeks, wasted no time in tagging Mr. Johnson with it after announcing the Christmas ban.

Surprisingly, the tough measures themselves may not be unpopular. A poll by research firm YouGov following Mr Johnson’s announcement on Saturday found that 67 percent of those polled were in favor of additional restrictions. But 61 percent of people said the government handled the rollout poorly.

According to analysts, Mr Johnson has been pressured by the same lawmakers in his Conservative Party that are likely to oppose a trade deal with the European Union. In this respect, the pandemic and the Brexit talks have a connection.

Because his mismanagement of the lockdown rules has angered some conservative lawmakers, they could now calculate that he can’t afford any further backlash in parliament by concluding a trade deal with the European Union that would be unpopular with die-hard Brexiters.

Mr Johnson has navigated swarms like this during his political career. His deadline mentality, developed during his time as a newspaper reporter and columnist, has sometimes led to smart decisions.

For example, he wavered for weeks before endorsing Britain’s exit from the European Union and even writing essays discussing both sides of the subject. It was a roll of the dice that pays off if it gives him a path to Downing Street.

Overall, analysts continue to assume that Mr Johnson will come to terms with the European Union in the next few days. By leaving the final decision so late, the Prime Minister has increased the likelihood that, as with the Christmas lockdown, he will have no choice but to accept the offer on the table.

“Johnson’s technique for dealing with problems is to get them out of control and build them to a point of sufficient crisis where delay is no longer sustainable,” wrote Rafael Behr in a column for The Guardian. “That way, it becomes perversely easier to choose because there are fewer options.”