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CVS and Walgreens have an opportunity to make Covid vaccine rollout extra equitable

Dr. Virginia Banks, eine Spezialistin für Infektionskrankheiten, gehört zu einer Gruppe schwarzer Ärzte und Wissenschaftler, die sich auf Möglichkeiten zur Lösung von Disparitäten im Gesundheitswesen konzentrieren.

Dr. Virginia Banks

Dr. Virginia Banks sagt, wenn die USA die Pandemie wirklich beenden wollen, werden sie mobile Transporter mit Impfstoffen in Gegenden nehmen, in denen die Menschen keinen Transport haben – und sogar in Friseursalons und Friseurläden schießen.

Da Tausende von Apotheken diese Woche Dosenlieferungen erhalten und Impfungen in ihren Läden beginnen, unternimmt das Land einen bedeutenden Schritt, um mehr Amerikaner zu erreichen. Beamte und Anwälte des öffentlichen Gesundheitswesens sagen jedoch, dass dies in Gemeinden, in denen die Menschen am kranksten waren, nicht weit genug gehen wird.

Weitere schwarze und hispanische Amerikaner wurden ins Krankenhaus eingeliefert und starben an Covid-19. Sie sind oft auch mit größeren Hindernissen konfrontiert, um Impfstoffe zu erhalten: Mangel an Transportmitteln. Ein Jonglieren mit mehreren Jobs. Zögern wegen Misshandlung durch die medizinische Gemeinschaft in der Vergangenheit.

CVS Health und Walgreens werden eine größere Rolle bei den Bemühungen spielen, da ein Bundesprogramm Dosen an mehr ihrer Geschäfte und die anderer Einzelhandelsapotheken versendet. Die Erweiterung stellt eine Geschäftsmöglichkeit für die beiden größten Apothekenketten des Landes dar, da sie für jeden Impfstoff bezahlt werden und mehr Fußgängerverkehr in die Geschäfte bringen. Der Impfstoff-Rollout wird auch das Engagement der Unternehmen für die Ausweitung des Zugangs zur Gesundheitsversorgung in schwarzen und hispanischen Gemeinden testen.

Banks, ein Arzt für Infektionskrankheiten in Ohio, ist Teil einer Interessengruppe der Infectious Diseases Society of America, die sich aus schwarzen Ärzten, Wissenschaftlern und Beamten des öffentlichen Gesundheitswesens zusammensetzt, die sich mit der Beseitigung von Disparitäten im Gesundheitswesen befassen. Sie sagte, dass Gesundheitsdienstleister kreativ werden und Engagement zeigen müssen. Sie sagte, sie sollten Kliniken an vertrauten Orten wie Kirchen einrichten und “vertrauenswürdige Boten” wie Pastoren und Gemeindevorsteher gewinnen.

“Man muss sich aus kultureller Sicht ansehen, wo wir sind.” und komm zu uns “, sagte sie.

Mehr als Fairness

Die Einführung des Impfstoffs in den USA war langsam und komplex. Die Nachfrage nach Dosen hat die Anzahl der Schüsse, die zum Einstechen in die Arme zur Verfügung stehen, bei weitem überwogen. Online-Terminsysteme waren schwierig zu navigieren und wurden von starkem Verkehr blockiert. Bisher haben nur zwei Impfstoffe eine Notfallgenehmigung der Food and Drug Administration und müssen bei kalten und ultrakalten Temperaturen gelagert werden. Und nur einige Amerikaner qualifizieren sich für den Schuss, wobei jeder Staat leicht unterschiedliche Kriterien hat, um Faktoren wie Alter, Gesundheitszustand oder Arbeit einer Person abzuwägen.

Laut den Centers for Disease Control and Prevention wurden in den USA bis Freitag etwa 48,4 Millionen Impfstoffe verabreicht. Fast 12,1 Millionen Menschen haben beide Dosen des Impfstoffs erhalten – nur ein kleiner Teil der 331 Millionen Menschen, die in den USA leben

Das Ziel des Landes ist es, zwischen 70% und 85% der US-Bevölkerung – oder etwa 232 bis 281 Millionen Menschen – zu impfen, um eine Herdenimmunität zu erreichen, so Dr. Anthony Fauci, der Chefarzt des Präsidenten.

Personen ohne Termin stehen an, um möglicherweise eine Dosis des Pfizer-BioNTech Covid-19-Impfstoffs zu erhalten, nachdem alle Termine am Donnerstag, dem 11. Februar 2021, an der Impfstelle des Sun City Anthem Community Center in Henderson, Nevada, verabreicht wurden.

Roger Kisby | Bloomberg | Getty Images

Der chaotische Rollout hat dazu geführt, dass einige Aufnahmen gemacht haben und andere nicht. Laut einer CDC-Studie waren die meisten der fast 13 Millionen Menschen, denen innerhalb des ersten Monats nach der Verteilung der Medikamente mindestens ein Schuss eines Covid-19-Impfstoffs verabreicht wurde, Frauen im Alter von 50 Jahren oder älter und wahrscheinlich nicht spanisch und weiß.

Bei der Verteilung von Impfstoffen ist Gerechtigkeit nicht nur eine Frage der Fairness. Dies ist auch ein entscheidender Weg, um die Ausbreitung in Gemeinden zu verlangsamen, in denen Covid-19-Fälle, Krankenhausaufenthalte und Todesfälle häufiger auftreten. Schwarze und hispanische Amerikaner werden nach Angaben der CDC Ende November 3,7-mal und 4,1-mal häufiger aus Covid ins Krankenhaus eingeliefert als weiße Amerikaner. Beide Minderheiten sterben 2,8-mal häufiger an der Krankheit als weiße Amerikaner.

In einem stark betroffenen Viertel kann die Wirkung jedes Schusses noch größer sein – Menschen erreichen, die einem höheren Risiko ausgesetzt sind, wenn sie in Lebensmittelgeschäften oder an anderen Arbeitsplätzen an vorderster Front arbeiten oder in einer dichten Wohnung oder in Haushalten mit mehreren Generationen leben.

Das Zögern bei Impfungen ist auch bei Schwarzen und Braunen höher, was auf die Geschichte der medizinischen Gemeinschaft zurückzuführen ist, in der Minderheiten misshandelt und weniger Gesundheitspraktiken in ihrer Nachbarschaft eröffnet wurden. Eine von der Association for a Better New York durchgeführte Umfrage unter New Yorkern ergab, dass 78% der Einwohner von White den Impfstoff so schnell wie möglich einnehmen würden, verglichen mit 39% der Einwohner von Black, 54% der Hispanics und 54% der Asiaten .

“Setzen Sie ihr Geld, wo ihr Mund ist”

Für Anbieter wie CVS und Walgreens ist es eine Geschäftsmöglichkeit, mehr Dosen des Impfstoffs zu haben. Sie werden für jeden Impfstoff bezahlt und die Regierung übernimmt die Kosten, wenn eine Person nicht krankenversichert ist. Jefferies schätzte, dass jeder Schuss eine Bruttomarge von 13 bis 15 US-Dollar haben wird und im nächsten Jahr einen zusätzlichen Bruttogewinn von etwa 1 Milliarde US-Dollar für CVS bringen könnte.

Beide Drogerieketten haben ihre Strategie festgelegt, mehr Gesundheitsdienstleistungen von Kliniken für Grundversorgung zu Diabetes-Screenings hinzuzufügen. Sie haben auch ihre Verpflichtungen zur Beseitigung von Rassenungleichheiten als Reaktion auf George Floyds Mord und landesweite Proteste verstärkt. CVS plant, über einen Zeitraum von fünf Jahren fast 600 Millionen US-Dollar zu investieren, um politische Initiativen und interne Bemühungen zu unterstützen, z. B. die Betreuung schwarzer Mitarbeiter und kostenlose Gesundheitsuntersuchungen auf Blutdruck und Cholesterin in Geschäften.

Walgreens startete ein Pilotprojekt in der Region Chicago, das darauf abzielt, die Krankenhausaufenthaltsraten zu senken, indem es Patienten erleichtert wird, ihre Medikamente einzunehmen, kostenlose Verschreibungen zu erhalten und regelmäßiger mit Angehörigen der Gesundheitsberufe über ihren Gesundheitszustand in Kontakt zu treten. Das Unternehmen hat kürzlich den ehemaligen Chief Operating Officer von Starbucks, Roz Brewer, als nächsten CEO eingestellt. Wenn sie Mitte März in die Rolle eintritt, wird sie nur eine schwarze Frau sein, die ein Fortune 500-Unternehmen leitet.

Karyne Jones, Der CEO des National Caucus and Center on Black Aging in Washington, DC, sagte, die Ausweitung von Impfstoffen auf schwer betroffene Gemeinden sei eine Möglichkeit für CVS und Walgreens, “ihr Geld dort einzusetzen, wo ihr Mund ist”. Ihre Organisation ist Gründungsmitglied des Covid-19 Vaccine Education and Equity Project, einer Koalition von gemeinnützigen Organisationen und Handelsgruppen, die vom Impfstoffhersteller Pfizer unterstützt wird.

Jones sagte, sie würde gerne sehen, wie CVS und Walgreens rund um die Uhr Impfstellen öffnen und Zelte in Gegenden aufbauen, in denen die Menschen keinen Transport haben.

“Wenn Sie wirklich gute unternehmerische Verantwortung zeigen wollen, ist dies die Zeit zu sagen, dass wir Ressourcen einsetzen müssen, um diese Pandemie zu lindern”, sagte sie.

Wir haben Apothekenwüsten. Wir haben Wüsten für Lebensmittelgeschäfte. Wir haben keine kirchlichen Wüsten.

Dr. Virginia Banks

Spezialist für Infektionskrankheiten

Banks, der Arzt für Infektionskrankheiten, sagte, er werde über den Tellerrand hinaus Strategien verfolgen, wie beispielsweise die Umleitung von Buslinien zu Impfkliniken. Sie wies auf eine Anstrengung hin, bei der sich Apotheker mit Friseurläden zusammengetan hatten, um Bluthochdruck zu erkennen, als schwarze Männer einen Haarschnitt machten – eine klinische Studie, die half, den Zustand zu erkennen und früher einzugreifen.

Sie sagte, sie hoffe, dass der Johnson & Johnson-Impfstoff – der nur eine Dosis benötigt und leichter transportiert werden kann – die Verteilung verändern und es einfacher machen könnte, Schüsse dort abzugeben, wo sich Menschen befinden. Das Unternehmen hat letzte Woche bei der FDA eine Genehmigung für den Notfall beantragt.

“Wir haben Apothekenwüsten”, sagte sie. “Wir haben Wüsten für Lebensmittelgeschäfte. Wir haben keine Wüsten für Kirchen.”

Dosen in mehr Stadtteilen

Walgreens und CVS haben in Tausenden von Pflegeheimen und Einrichtungen für betreutes Wohnen Covid-Impfstoffe verabreicht. Sie haben in einigen Geschäften Schüsse verabreicht, nachdem sie Impfstoffdosen von Staaten erhalten hatten. Mit dem Bundesprogramm werden sie Aufnahmen in mehr Stadtteilen anbieten.

Walgreens hat Covid-Impfstoffe in Geschäften in 15 Bundesstaaten und zwei weiteren Gerichtsbarkeiten, New York City und Chicago. Im Rahmen des Bundesprogramms werden Aufnahmen in 1.800 Filialen gemacht – oder rund 20% der US-Filialen, sagte eine Unternehmenssprecherin.

CVS hat sie in 18 Staaten und Puerto Rico. Ab Freitag werden rund 420 der rund 9.900 Filialen die Aufnahmen mit Dosen eines staatlichen oder föderalen Programms machen, sagte ein Unternehmenssprecher.

Beide Apothekenketten gaben an, Geschäfte in Gegenden mit größerem Bedarf ausgewählt zu haben. Etwa die Hälfte der Geschäfte jedes Unternehmens mit Covid-Impfstoffen befindet sich in medizinisch unterversorgten Gebieten oder an Orten, die auf dem CDC-Index für soziale Anfälligkeit einen hohen Stellenwert haben. Dieser basiert auf Faktoren wie der Verbreitung von Armut, mangelndem Zugang zu Fahrzeugen und überfüllten Wohnungen.

Mit Walgreens können Personen auch Termine persönlich oder telefonisch vereinbaren, sodass Personen nicht ausgeschlossen werden, wenn sie kein Internet oder keinen Computer haben, sagte Rina Shah, Vizepräsidentin der Walgreens-Gruppe für Apothekenbetriebe. CVS hat eine 1-800-Nummer als Alternative zur Online-Buchung.

Walgreens ging eine Partnerschaft mit Uber ein, um Menschen, die in unterversorgten Teilen von Großstädten wie Atlanta und Chicago leben, kostenlose Fahrten zu Impfungen zu ermöglichen. Wohltätige Partner helfen bei der Identifizierung von Personen, die Transport benötigen.

CVS unternimmt proaktive Schritte, um sicherzustellen, dass die Einheimischen Impfstofftermine in ihrem nahe gelegenen Geschäft erhalten können, sagte Chris Cox, Senior Vice President für Pharmazie des Unternehmens. Er sagte, dass Mitarbeiter einige Kunden anrufen, um ihre Termine zu vereinbaren, insbesondere diejenigen, die ein niedrigeres Einkommen haben und älter sind.

Zusammen mit der Anwerbung von Apotheken wird die Biden-Regierung nächste Woche Dosen an kommunale Gesundheitszentren liefern, die Millionen von Amerikanern dienen, die unterhalb der Armutsgrenze leben und rassische Minderheiten sind.

Das Impfprogramm ermöglicht es CVS, eindringlich zu demonstrieren, wie es Gesundheitsversorgung an Orten anbieten kann, an denen es normalerweise nicht zugänglich ist, sagte Cox.

“Alles, was wir tun, ist wirklich mit der Absicht, Menschen auf ihrem Weg zu einer besseren Gesundheit zu helfen”, sagte er. “Diese Gelegenheit bietet uns wirklich, unseren Patienten und anderen Interessengruppen zu demonstrieren, was wir seit mehreren Jahren sagen. Das heißt, dass die Gemeinschaftsapotheke eine große Rolle im Gesundheitswesen spielt.”

Viele Patienten sehen ihre Apotheker häufiger als ihre Ärzte, da sie Bluthochdruckpillen oder andere Erhaltungsrezepte abholen müssen, sagte er. Diese häufigen Wechselwirkungen bedeuten, dass CVS eine größere Rolle dabei spielen kann, sicherzustellen, dass Menschen ihre Medikamente richtig einnehmen, oder vor möglichen Komplikationen eingreifen kann.

Da Walgreens mehr Angebot erhält, wird Shah seine Arbeitszeiten verlängern und an Wochenenden Aufnahmen für Leute anbieten, die keinen Arbeitstag auslassen können. Es wird Kliniken in Gemeindezentren eröffnen, wie es bei Grippeschutzimpfungen der Fall ist.

Shah sagte, dass seine Apotheker eine Schlüsselrolle bei der Aufklärung und Beantwortung von Fragen spielen können, so dass die Leute eher auf die Aufnahmen gespannt sind als besorgt. Aber sie sagte, das Unternehmen brauche letztendlich mehr Versorgung, um mehr Menschen in Minderheitengemeinschaften zu erreichen.

“Unsere größte Chance ist es, mehr Impfstoffe zu bekommen”, sagte sie.

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As Hundreds of thousands Get Covid Vaccine Pictures, F.D.A. Struggles With Security Monitoring

“It’s great for routine activities, but when it comes to security surveillance, size is all,” said Dr. Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins University and former federal vaccine officer. “The bigger it is, the faster you get an answer. At some point the VSD is going to get a really good answer – probably one of the best answers out there because they are so good at it. But in a pandemic, time is not on our side. “

Few serious problems have been reported through these channels to date and no deaths have been clearly linked to the vaccines. The 30-year initiative, known as the Vaccine Adverse Event Reporting System (VAERS), relies on self-reported cases from patients and health care providers.

Health officials say the two vaccines already approved for use appear to be reasonably safe so far. There have been some serious allergic reactions, including anaphylaxis, but they are treatable and are considered rare. The rate at which anaphylaxis has occurred to date – 4.7 cases per million doses for the vaccine from Pfizer and BioNTech and 2.5 cases per million for the vaccine from Moderna – is in line with other widely used vaccines.

Bruising and bleeding caused by decreased platelet counts have also been reported, although it is not known whether they are vaccine-related or accidental. A total of 9,000 adverse events were reported, of which 979 were classified as serious and the remainder classified as non-serious according to the latest available CDC report.

In interviews, public health experts, including current and former FDA and CDC officials, expressed the need to improve on the old “passive” surveillance that relies on self-reporting. They said funding shortages, turf wars and bureaucratic hurdles had slowed BEST, officially known as the Biologics Evaluation Safety Initiative, in preparation for monitoring Covid vaccines.

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Vaccine ramp up most likely not sufficient to handle UK virus variant

An increase in vaccinations in the coming weeks alone may not be enough to contain the spread of a coronavirus variant, which was first reported in the UK in December and has now emerged in the US, said Scott Gottlieb, former commissioner for food and drug delivery.

The emergence of variants could complicate efforts to reopen the economy in the United States, which, according to Johns Hopkins University, had at least 475,000 virus deaths more than any other country.

The UK first reported the strain known as B117 to the World Health Organization in December, and now there are 971 cases in 37 US states, according to the Centers for Disease Control and Prevention.

“Right now they are shipping 11 million cans a week in states. That will likely increase,” said Gottlieb, who served as FDA chief under former President Donald Trump from 2017 to 2019, in CNBC’s “The News with Shepard Smith”. on Thursday. “So we’re increasing the vaccination rate across the country. Well, will it be fast enough to get a backstop against B117 – probably not by itself.”

Gottlieb said he doesn’t think travel restrictions could stop the spread of the B117 variant because it can often be too late. A “seasonal setback” in the form of the arrival of spring and summer could help reduce the spread of B117, said Gottlieb, a director of Pfizer, whose Covid vaccine is sold in the United States

He said that hopefully a combination of this and increasing vaccinations will include the variant in most parts of the country, although there may be hotspots in southern parts of California and Florida.

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Stay World Covid-19 Pandemic and Vaccine Updates

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

U.S. vaccinations ›

Where states are reporting vaccines given

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Classes are being held remotely for the foreseeable future.

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

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

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

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

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

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

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

But some students remain undeterred by the penalties.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Daily Poster

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

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

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

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

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

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

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

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

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

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

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

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

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

And shortages of protective gear remain a chronic issue.

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

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

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

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

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

— Jill Biden (@FLOTUS) January 21, 2021

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Global Roundup

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

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

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

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

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

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

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

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

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

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

In other developments around the world.

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

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

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

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

Many were clever fakes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Categories
Business

How Merck’s Vaccine Misplaced the Covid Race

Founded in 1891, Merck has been in the vaccines business for more than 100 years and has developed some of the world’s most famous vaccines, including mumps, hepatitis A and chickenpox. In 2019, it became the first company to receive approval for an Ebola vaccine from the Food and Drug Administration.

However, as the coronavirus spread around the world, Merck was slow to announce plans for a vaccine. By the time details of two vaccine candidates became known in late May, most of the main competitors had already announced contracts, and Pfizer and Moderna had begun early clinical trials.

But Merck didn’t have to be the first to win. Executives decided to pursue two projects that they believed had advantages over competitors. A vaccine developed in partnership with the International AIDS Vaccine Initiative uses the same technology that is based on a harmless animal virus that led to their successful Ebola vaccine. The other, acquired through the purchase of Themis Bioscience, was based on an existing measles vaccine.

Both experimental Covid vaccines, the company said, would be tested with a single dose, and Merck was also looking to see if whoever used the cattle virus could be given orally – two big advantages over potential competitors, especially in developing countries.

In July, Kenneth C. Frazier, CEO of Merck, warned against acting too quickly. “I think if people tell the public that there will be a vaccine by the end of 2020, for example, they are doing the public a serious disadvantage,” Frazier said in an interview with a professor at Harvard Business School. Mr Frazier recently announced that he will be retiring as managing director later this year, a decision that has long been planned.

In an interview in August, Dr. Nicholas Kartsonis, Merck’s senior vice president of clinical research for vaccines and infectious diseases, said the company’s position as the leading vaccine manufacturer has given him the luxury of time. “We are a much bigger company. We’re not so obliged to be the first, ”he said.

Categories
Health

Major Care Docs Really feel Left Out of Vaccine Rollout

Despite their willingness to participate, only one in five GPs said they gave their patients the vaccine. This was found in a survey conducted in mid-January by the Larry A. Green Center with the nonprofit Primary Care Collaborative. Given the widespread supply shortages, many were unable to get the vaccine and a third of them said they had not had contact with their local health department.

Dr. Katelin Haley, a family doctor in Lewes, Delaware, is one of the lucky few who just received 240 doses of the vaccine and will immunize patients this week. Your employees had asked the state every day when they could expect a delivery. “The hunt for the vaccine was almost a full-time occupation,” she said.

While Dr. Haley, who also works with Aledade, agrees with the state’s struggle for adequate supplies of the vaccine, she believes practices like hers need some of the doses. “It’s a delicate balance to meet the needs of the state and the needs of the individual practice,” she said.

Some doctors, like Dr. Altman, have received small amounts of the vaccine but do not know when they may have enough to immunize all qualified patients. At the end of January, Dr. Despite the cold weather, Altman and his staff vaccinated 200 patients in the practice parking lot. “The patients were literally in tears, they were so grateful for our efforts,” he said.

The Trump administration left it up to states to determine how to distribute the vaccines, and states and even local communities are taking different approaches. “So much of whether primary care is used effectively depends on the state,” said Ann Greiner, executive director of the Primary Care Collaborative.

Although demand for vaccines is currently outstripping supply, it is important to rely on family doctors to vaccinate the public when supply exceeds demand later in the year, said Dr. Asaf Bitton, a family doctor who is the general manager of Ariadne Labs, is at Brigham and Women’s Hospital and the Harvard TH Chan School of Public Health. Your involvement will be crucial in overcoming vaccine hesitation and achieving herd immunity.

As some conversations begin, “they should have started six months ago,” he said.

Categories
World News

Chirlane McCray, N.Y.C.’s first woman, will get a vaccine shot and says ‘there actually is nothing to be afraid of.’

New York first lady Chirlane McCray was given a Covid-19 vaccine at Kings County Hospital in Brooklyn Tuesday afternoon as New York health officials attempt to eradicate severe racial inequality in the introduction of the vaccine.

Ms. McCray, who is 66 years old, meets the state’s current age requirements that allow New Yorkers over 65 to receive the vaccine. Her husband, Mayor Bill de Blasio, who is 59 years old, does not.

So far, residents of Black and Latino have received far fewer doses of vaccine than residents of White, although color communities are hardest hit by the virus. The city’s demographics are incomplete, but the latest data available shows that of the nearly 375,000 city residents who received a vaccine dose and whose race was recorded, about 46 percent were white, 16 percent Latin American, 16 percent Asian, and 12 percent black.

Latino and Black residents were particularly underrepresented: the city’s population is 29 percent Latinos and 24 percent black.

The city health department has been working to encourage New Yorkers Black and Latino to get vaccinated in hopes of addressing vaccine hesitation, given the history of unethical medical research in the US. But Mr de Blasio said last week that he and his wife, who is black, would not receive the vaccine until they met state approval criteria, citing a desire to reassure New Yorkers that the process was fair and equitable .

“People need to see that people they know, trust and respect are getting the vaccine,” de Blasio said at a press conference. “You also need to know that priorities are respected and those who need them most get them first.”

After Ms. McCray received her shot, the Eligible New Yorker encouraged her to sign up for vaccine appointments – although access to those appointments, which are listed on dozen of different websites, was one of the barriers to the fair distribution of the vaccine.

“There’s really nothing to worry about,” Ms. McCray said of the vaccination. “We want to do this for our families, we want to do it for our loved ones, and of course we want to do it for our city.”

As of Tuesday, New York City had given more than a million doses of the vaccine. Mr de Blasio had hoped to give so many doses in January alone, but blamed a lack of supply for the slower pace.

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May a Single Vaccine Work In opposition to All Coronaviruses?

The invention of the Covid-19 vaccine will be remembered as a milestone in the history of medicine, creating in a few months what had previously taken up to a decade. Dr. However, Kayvon Modjarrad, director of the Emerging Infectious Disease Division at the Walter Reed Army Institute of Research in Silver Springs, Md., Is not satisfied.

“It’s not fast enough,” he said. More than 2.3 million people around the world have died, and many countries won’t have full access to the vaccines for a year or two: “Fast – really fast – got it on the first day there.”

There will be more coronavirus outbreaks in the future. Bats and other mammals abound in strains and species of this abundance Family of viruses. Some of these pathogens will inevitably cross the species barrier and cause new pandemics. It’s only a matter of time.

Dr. Modjarrad is one of many scientists who has been calling for a different type of vaccine for years: one that can work against all coronaviruses. These calls were largely ignored until Covid-19 showed how catastrophic coronaviruses can be.

Now researchers are starting to develop prototypes of what is known as a pancoronavirus vaccine, some of which show promise, albeit early. Results of animal experiments. Dr. Eric Topol, professor of molecular medicine at the Scripps Research Institute in San Diego, believes scientists should team up immediately on another major vaccine-making project.

“We have to find real workers to accelerate this so we can have it this year,” he said. Dr. Topol and Dennis Burton, a Scripps immunologist, called for this project on comprehensive coronavirus vaccines in Nature magazine Monday.

After coronaviruses were first identified in the 1960s, they weren’t a high priority for vaccine manufacturers. For decades, it seemed like they caused only mild colds. However, in 2002, a new coronavirus called SARS-CoV emerged, causing fatal pneumonia called SARS (Severe Acute Respiratory Syndrome). Scientists have been trying to make a vaccine for it.

Since no one had made a coronavirus vaccine for humans before, there was a lot to learn about its biology. Ultimately, the researchers chose a target for immunity: a protein on the surface of the virus called a spike. Antibodies sticking to the tip can prevent the coronavirus from entering cells and stop infection.

However, public health officials in Asia and elsewhere did not wait for the invention of a SARS vaccine to come to work. Their quarantines and other efforts have proven remarkably effective. Within a few months, they wiped out SARS-CoV with only 774 deaths.

The threat from coronavirus became even more apparent in 2012 when a second type of bat overflowed and caused another deadly respiratory disease called MERS. The researchers started working on MERS vaccines. However, some researchers wondered whether making a new vaccine for each new coronavirus – which Dr. Modjarrad called “One Bug, One Drug Approach” – the smartest strategy was. Wouldn’t it be better, they thought, if a single vaccine could work against SARS, MERS, and any other coronavirus?

That idea went nowhere for years. MERS and SARS caused relatively few deaths and were soon dwarfed by outbreaks of other viruses such as Ebola and Zika.

In 2016, Maria Elena Bottazzi, a virologist at Baylor College of Medicine, and her colleagues applied for assistance from the American government to develop a pancoronavirus vaccine, but were not given it. “They said there was no interest in pancorona,” recalled Dr. Bottazzi.

Their team even lost funding to develop a SARS vaccine after showing that it works in mice, is non-toxic to human cells, and can be manufactured on a large scale. A coronavirus that had disappeared from view just wasn’t a top priority.

Without enough money to start clinical trials, the scientists stored their SARS vaccine in a freezer and moved on to other research. “It was a fight,” said Dr. Bottazzi.

Dr. Matthew Memoli, a virologist at the National Institute for Allergies and Infectious Diseases, views these decisions as a huge mistake. “It’s a failure of our science system,” he said. “Funders tend to chase after shiny objects.”

Three years later, a third dangerous coronavirus emerged: the SARS-CoV-2 strain that causes Covid-19. Although this virus has a much lower death rate than its cousins ​​that cause SARS and MERS, it spreads far better from person to person, resulting in and still increasing in more than 106 million documented cases around the world.

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Apr. 9, 2021, 4:25 p.m. ET

All of the lessons researchers learned about coronaviruses helped them quickly manufacture new vaccines for SARS-CoV-2. Dr. Bottazzi and her colleagues used the technology they developed to make SARS vaccines to make one for Covid-19, which is currently in early clinical trials.

Other researchers used even newer methods to move faster. The German company BioNTech has developed a genetic molecule called messenger RNA that codes for the spike protein. Working with Pfizer, the companies received US government approval for their vaccine in just 11 months. The previous record for a vaccine against chickenpox was four years.

Although the Covid-19 pandemic is far from over, a number of researchers are calling for preparations for the next deadly coronavirus.

“It’s happened three times,” said Daniel Hoft, a virologist at Saint Louis University. “It will most likely happen again.”

Researchers at VBI Vaccines, a Cambridge-based company, took a small step towards a pancoronavirus vaccine last summer. They created virus-like shells that were studded with spike proteins from the three coronaviruses that caused SARS, MERS and Covid-19.

When the researchers injected this three-spike vaccine into mice, the animals made antibodies that were effective against all three coronaviruses. Interestingly, some of these antibodies could also bind to a fourth human coronavirus that causes seasonal colds – although the spike proteins from this virus were not in the vaccine. The scientists have published this data, but have not yet published it in a scientific journal.

David Anderson, chief scientist for the VBI, said it was not clear why the vaccine worked this way. One possibility is that an immune cell that is presented with multiple versions of a protein at the same time will not make antibodies against just one. Instead, a compromise antibody is made that works against all.

“You train it,” said Dr. Anderson, although he warned that this was speculation for now.

Last month, Pamela Bjorkman, a structural biologist at Caltech, and her colleagues published a more in-depth experiment with a universal coronavirus vaccine in Science magazine. The researchers only attached the tips of spike proteins from eight different coronaviruses to a protein core known as nanoparticles. After injecting these nanoparticles into mice, the animals produced antibodies that could attach to all eight coronaviruses – and to four other coronaviruses that the scientists hadn’t used in the vaccine.

Dr. Modjarrad leads a team at Walter Reed that is developing another vaccine based on a nanoparticle filled with protein fragments. They expect to begin clinical trials on volunteers next month. Although the vaccine currently only uses protein fragments from SARS-CoV-2 spikes, Dr. Modjarrad and his colleagues are preparing to convert it as a pancoronavirus vaccine.

Dr. Hoft at Saint Louis University is working on a universal vaccine that does not rely on antibodies to the spike protein. Working with Gritstone Oncology, a California-based biotech company, he developed a vaccine that prompts cells to make surface proteins that could alert the immune system as if a coronavirus – any coronavirus – was present. They are currently preparing a clinical trial to determine if it will be effective against SARS-CoV-2.

“We are interested in developing a third generation vaccine that is on the shelf and ready for the future outbreak,” said Dr. Court.

Dr. Topol believes that scientists should investigate another strategy as well: looking for the pancoronavirus antibodies that our own bodies make during infections.

Researchers studying HIV and other viruses have discovered rare types that act against a variety of related strains amid the billions of antibodies produced during infection. It might be possible to develop vaccines that will induce the body to make plenty of these largely neutralizing antibodies.

Coronaviruses are similar enough to each other, said Dr. Topol that it may not be that difficult to develop vaccines that make largely neutralizing antibodies. “This is an easy-to-remove family of viruses,” he said.

Finding a pancoronavirus vaccine may take longer than Dr. Topol’s sunny expectations. But even if it took a few years, it could help prepare the world for the next coronavirus to cross species boundary.

“I think we can have vaccines to prevent such pandemics,” said Dr. Memoli. “None of us want to go through that again. And we don’t want our children to go through this again, or our grandchildren or our descendants in 100 years. “

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Biden administration to start transport Covid vaccine doses to group well being facilities

People wait outside a COVID-19 vaccine distribution center at the Kedren Community Health Center on January 28, 2021 in Los Angeles, California.

Mario Tama | Getty Images

The White House will begin delivering doses of Covid-19 vaccine doses directly to state-qualified community health centers next week in an effort to extend reach to traditionally underserved communities, Jeff Zients, White House Response Coordinator for Covid-19, announced Tuesday .

Along with other initiatives such as government-sponsored mass vaccination centers and mobile clinics, the new program aims to ensure fair adoption of the vaccine, said Zients.

“Justice is at the core of our strategy to move out of this pandemic, and justice means reaching out to everyone, especially those in underserved and rural communities,” Zients said. “But we cannot do this effectively at the federal level without our partners at the state and local levels sharing the same commitment to justice.”

Dr. Marcella Nunez-Smith, Chair of the White House’s Covid-19 Health Equity Task Force, noted that there are more than 1,300 community health centers across the country serving nearly 30 million people.

“Two-thirds of their patients live at or below the federal poverty line, and 60% of patients in community health centers identify as racial or ethnic minorities,” she noted. “Justice is our north star here. These efforts, which focus on direct referral to community health centers, are really about connecting with hard-to-reach populations across the country.”

When the program launches, the White House plans to send cans to at least one center in each state, with 1 million split between 250 centers over the coming weeks, Nunez-Smith said. She noted that the government is also working to increase public confidence in vaccines, “which we know are lower than the national average in underserved communities”.

The community health center program will be announced after the launch of the retail pharmacy program, where the federal government will begin shipping cans directly to a few hundred pharmacies across the country. Nunez-Smith said the Centers for Disease Control and Prevention are working with participating pharmacy companies to ensure they reach “socially vulnerable areas”.

The government also announced that it will again increase the number of doses it sends to states each week. The federal government will now ship 11 million cans to states every week, up from the 8.6 million it sent three weeks ago, Zients said.

“That’s a 28% increase in vaccine delivery in the first three weeks,” he said.

When asked whether there is an inevitable trade-off between equity and speed of vaccine distribution, Zients said, “I do not accept that premise at all.”

“I think we can do this in a fair, equitable and efficient way,” he said. “So efficiency and equity are at the heart of everything we do, and I don’t see any compromise between the two that I think go hand in hand.”

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Fb says it plans to take away posts with false vaccine claims.

Facebook said Monday that it plans to remove posts with false claims about vaccines from its platform, including repealing claims that vaccines cause autism or that it is safer for people to contract the coronavirus than vaccinations receive.

The social network has increasingly changed its content policies over the past year as the coronavirus has risen sharply. In October, the social network banned people and companies from buying advertisements containing false or misleading information about vaccines. In December, Facebook announced it would remove posts with claims exposed by the World Health Organization or government agencies.

Monday’s move goes even further by targeting unpaid posts to the website and, in particular, to Facebook pages and groups. Rather than just aiming at misinformation about Covid-19 vaccines, the update includes incorrect information about all vaccines. Facebook said it had consulted with the World Health Organization and other leading health institutes to come up with a list of false or misleading claims regarding Covid-19 and vaccines in general.

In the past, Facebook had announced that it would only “rank down” or push down on people’s news feeds, leading to misleading or false claims about vaccines, making it harder to find such groups or posts. Now posts, pages and groups that contain such untruths will be completely removed from the platform.

“Building trust in these vaccines is critical, so we’re launching the world’s largest campaign to help public health organizations share accurate information about Covid-19 vaccines and encourage people to get vaccinated as soon as possible they have vaccines available, “said Kang-Xing Jin, director of health at Facebook, in a company blog post.

The company said the changes were in response to a recent decision by the Facebook Oversight Board, an independent body that reviews decisions made by the company’s policy team and determines whether they are fair. In a decision, the board said Facebook needed to create a new standard for health-related misinformation because its current rules were “inappropriately vague”.

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Apr 8, 2021, 7:52 p.m. ET

Facebook also announced that it would provide US $ 120 million in advertising loans to ministries of health, non-governmental organizations and United Nations agencies to help spread reliable Covid-19 vaccines and preventative health information. As vaccination centers became more prevalent, Facebook would help point people to places to get the vaccine.

Mark Zuckerberg, the founder and CEO of Facebook, has been proactive against false information related to the coronavirus. He has Dr. Anthony Fauci, the nation’s leading infectious disease expert, often hosted on Facebook for live video updates on America’s response to coronavirus. In his private philanthropy, Mr. Zuckerberg has also vowed to “eradicate all diseases” and pledge billions to fight viruses and other diseases.

However, Mr Zuckerberg was also a staunch advocate of free speech on Facebook and previously hesitated to contain most falsehoods, even if they were potentially dangerous. The exception was Facebook’s policy of not tolerating statements that could lead to “immediate, direct physical harm” to people on or outside the platform.

Facebook has been criticized for this stance, including for allowing President Donald J. Trump to stay on the platform until after the January 6 uprising in the U.S. Capitol.

Public health advocates and outside critics have questioned Facebook’s refusal to remove false or misleading claims about vaccines for years. This has resulted in an increase in false vaccine information, often by people or groups spreading other harmful misinformation on the website. Even when Facebook tried to update its guidelines, it often left loopholes that were exploited by misinformation spreaders.

Facebook announced on Monday that it was also changing its search tools to post relevant, authoritative results on coronavirus and vaccine information while making it harder to find accounts that are preventing people from getting vaccinated.