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

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

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

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

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

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

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

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

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World News

Covid-19 Vaccine, Instances Reside Updates: The Newest International Information

Here’s what you need to know:

Credit…Christopher Occhicone for The New York Times

The Trump administration, in a major policy shift aimed at accelerating lagging distribution of the coronavirus vaccine, announced on Tuesday that it would release all available doses and instructed states to immediately begin vaccinating every American 65 and older, as well as tens of millions of adults with health conditions that put them at higher risk of dying from the virus.

The announcement, by Health Secretary Alex M. Azar II and other top federal health officials, came amid continuing complaints about the pace of the vaccine rollout. Mr. Azar warned that states will lose their allocations if they don’t use up doses quickly, and that starting in two weeks, how many each state receives will be based on the size of its population of people 65 and older.

Precisely how that will work is unclear; in two weeks, President-elect Joseph R. Biden Jr. will already have been sworn in as president. Mr. Azar said the incoming Biden administration would be briefed on the changes, though he added that Americans “operate with one government at a time, and this is the approach that we believe best fulfills the mission.”

The new distribution plan, first reported Tuesday morning by Axios, is a reversal for the administration, which had been holding back roughly half of its vaccine supply — millions of vials — to guarantee that second doses would be available. Mr. Azar said the administration always expected to make the shift when it was confident in the supply chain. Both vaccines authorized in the United States so far require two doses: 21 days apart for the one developed by Pfizer and BioNTech, and 28 days apart for the one from Moderna.

“This next phase reflects the urgency of the situation we face,” he said.

Just days ago, Mr. Azar and officials from Operation Warp Speed, the administration’s fast-track vaccine initiative, criticized aides to Mr. Biden for announcing a similar plan. Mr. Azar said at the time that releasing nearly all of the doses, as the Biden team proposed, would jeopardize the “system that manages the flow, to maximize the number of first doses, but knowing there will be a second dose available.”

He called any proposed changes an “untenable position.”

Health officials also recommend that the vaccines be given to all adults with pre-existing conditions that make them more likely to develop serious illness from the virus, such as diabetes, chronic lung or heart disease, high blood pressure and cancer. Before the change, the vaccines were largely being distributed to people in the highest-risk categories, including frontline health care workers and older people in nursing homes.

In addition to the eligibility changes, health officials are also adding more community centers and pharmacies to the list of places where people can be vaccinated.

Mr. Azar’s new directive threatens to create more confusion in states that had already articulated different plans for who should receive the vaccine next. As of Monday, about 9 million people have received at least one dose of a Covid-19 vaccine, according to the Centers for Disease Control and Prevention, far short of the federal government’s original goals. At least 151,000 people in the United States have been fully vaccinated, as of Jan. 8, according to a New York Times survey of all 50 states. More than 375,000 people have died related to the virus and in recent days, the number of daily deaths in the country has topped 4,000.

Instead of holding back vaccine doses all existing doses will be now sent to states to provide initial inoculations. Second doses are to be provided by new waves of manufacturing.

The idea of using existing vaccine supplies for first doses has raised objections from some health workers and researchers, who worry that frontloading shots will raise the risk that second injections will be delayed. Clinical studies testing the vaccines showed the shots were effective when administered in two-dose regimens on a strict schedule. And while some protection appears to kick in after the first shot, experts remain unsure of the extent of that protection, or how long it might last without the second dose to boost its effects.

But others have vocally advocated for explicit dose delays, arguing that more widely distributing the partial protection afforded by a single shot will save more lives in the meantime.

The new recommendations come after some states have already begun vaccinating people 65 and older, leading to long lines and confusion over how to get a shot. Health experts and officials have faced difficult choices as they decided which groups would be prioritized in the vaccine rollout. While the elderly have died of the virus at the highest rates, essential workers have borne the greatest risk of infection, and the category includes many poor people and people of color, who have suffered disproportionately high rates of infection and death.

Despite the bumpy rollout, Gov. Ron DeSantis of Florida, who prioritized people 65 and older from the start, said he believed making all older people eligible was always the right thing to do.

The initial guidelines “would have allowed a 20-year-old healthy worker to get a vaccine before a 74-year-old grandmother,” he said on Tuesday at a news conference in the sprawling retirement community of The Villages. “That does not recognize how this virus has affected elderly people.”

In New York, which began vaccinating people 75 and older and more essential workers this week, Gov. Andrew M. Cuomo said that the state will accept the new federal guidance to prioritize those 65 and older, though he criticized the administration for not clearly defining who should be considered “immunocompromised.”

The new guidance will make more than 7 million New Yorkers eligible for the vaccine, Mr. Cuomo said, though the state only receives 300,000 doses a week.

“The federal government didn’t give us an additional allocation,” he said. “At 300,000 per week, how do you effectively serve 7 million people, all of whom are now eligible, without any priority?”

New Yorkers 65 and older are immediately able to schedule appointments on the state’s website, according to Melissa DeRosa, a top Cuomo aide, who added that the state was working with the C.D.C. on who is considered immunocompromised.

New guidelines released on Monday by the Centers for Disease Control and Prevention now note that while people should get their second shots “as close to the recommended 3-week or 1-month interval as possible,” there is “no maximum interval between the first and second doses for either vaccine.”

The update perplexed experts, who said that while other, previously licensed vaccines that involve multiple doses can be administered months or even years apart, no evidence yet exists to clearly support this strategy for Covid-19. “They will need to back this up with data,” said Marion Pepper, an immunologist at the University of Washington.

Dr. Leana Wen, an emergency physician at the George Washington School of Public Health, echoed the call for an explanation. With skepticism of vaccines already hindering the rollout of some shots, “the last thing we want to do is give the impression that there are shortcuts being taken in the approval process.”

Health officials in Britain are now allowing intervals between the first and second doses of Pfizer’s vaccines of up to 12 weeks. Last week, the World Health Organization said the injections could be given up to six weeks apart. The agency’s Strategic Advisory Group of Experts on Immunization “considers the administration of both doses within 21 to 28 days to be necessary for optimal protection,” said Saad Omer, a vaccine expert at Yale University who helped draft the WHO’s position on the matter.

In response to queries about dose delays, representatives from Pfizer and Moderna have repeatedly pointed to the company’s clinical trials, which tested dosing regimens of two shots, separated by 21 days for Pfizer, and 28 days for Moderna.

“Two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 percent,” Steven Danehy, a spokesman for Pfizer, said earlier this month. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

United States › United StatesOn Jan. 11 14-day change
New cases 222,902 +37%
New deaths 2,048 +48%
World › WorldOn Jan. 11 14-day change
New cases 625,815 +32%
New deaths 10,307 +28%

Where cases per capita are
highest

A coronavirus testing site in a shopping center parking lot in southern Los Angeles last week.Credit…Philip Cheung for The New York Times

California is trying to speed up its vaccination efforts, which have lagged amid the state’s struggle with a weekslong deluge of coronavirus cases that has led to some of the most dire consequences in the country.

Emergency rooms have had to shut their doors to ambulances for hours at a time. Nearly one in 10 people has tested positive for the virus in Los Angeles County, the nation’s most populous. And a surge of hospitalizations has caused problems for the oxygen delivery and supply system used by medical facilities.

Over the past week, an average of 480 people daily have died of Covid-19 in the state, according to a New York Times database.

Gov. Gavin Newsom said on Monday that California would employ an “all-hands-on-deck approach” to ramp up vaccinations.

The approach includes transforming Dodger Stadium from one of the nation’s biggest and most visible Covid-19 testing sites into a mass vaccination center. Petco Park, where the San Diego Padres play, and the state fairgrounds in Sacramento are also being set up as vaccination sites, the governor said.

The Orange County board of supervisors said on Monday that the county’s first of five planned “super” vaccination sites would open this week at the Disneyland Resort in Anaheim, which has been closed for much of the pandemic. Vaccinations will be available by appointment to everyone in “Phase 1a,” which includes frontline health care workers, paramedics, dentists and pharmacists.

Los Angeles County opened vaccine eligibility to a wider group of health care workers on Monday, allowing workers in facilities like primary care clinics, Covid-19 testing centers, laboratories, pharmacies and dental offices, as well as those who work with people who are homeless, to be vaccinated.

Previously, workers in hospitals and long-term-care facilities were prioritized. But as The Los Angeles Times reported, large numbers of health care workers in Los Angeles and Riverside Counties were declining to be inoculated.

And relatively few people in California have gotten vaccine doses, compared with other places: Only 2 percent of the state’s population has received a vaccine, according to a New York Times database; 782,638 doses out of the more than 2.8 million that the state has received have been administered.

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Newsom Broadens Who Can Administer Vaccines

Gov. Gavin Newsom of California described an “all-hands-on-deck approach” that will allow a wider range of health care workers, including pharmacists and dentists, to administer the coronavirus vaccine.

We are sending an urgent call across the spectrum, our health care partners, our legislative partners, as well as labor and business partners up and down the state, this notion of an all-hands-on-deck approach to accelerate the equitable and safe distribution of vaccines. Again, we’re not losing sight of the issue of equity. We’re not losing sight of the imperative to prioritize the most vulnerable and the most essential. So that’s why we talk about our special efforts to vaccinate the vaccinators as part of an all hands on deck — the slide that represents the number of categories of individuals and groups that can currently vaccinate. And you can see the myriad of different registered nurses, physician assistants and the like. But we recognize more folks need to have that ability. And that’s why you recall a week or so ago, we talked about our efforts on pharmacists and pharm techs. We’re seeing more and more paramedics partnering with the counties. Local health officers are encouraging this and we are very supportive of EMTs as this local option for additional vaccinators to help administer these vaccines faster.

Video player loadingGov. Gavin Newsom of California described an “all-hands-on-deck approach” that will allow a wider range of health care workers, including pharmacists and dentists, to administer the coronavirus vaccine.CreditCredit…Alex Welsh for The New York Times

Dr. Mark Ghaly, California’s secretary of health and human services, said at a news conference on Monday that the state was working to distribute vaccines to those who need them and want them — without allowing wealthy people to cut the line.

Mr. Newsom said the state was allowing a broader range of workers to administer vaccines, including pharmacists and dentists, and was rolling out a public awareness campaign in 18 languages.

“People have said, ‘Well, what about sending in the National Guard?’” he said of the groups administering vaccines. “Well, we have the National Guard out there.”

He also said there were urgent efforts to “vaccinate the vaccinators.”

Representative Brad Schneider, Democrat of Illinois, speaking in Washington last year.Credit…Samuel Corum/Getty Images

Three Democratic members of Congress have tested positive for the coronavirus, and say they believe their infections are linked to their time spent in a secure location with colleagues who did not wear masks during last week’s siege of the U.S. Capitol.

Representative Brad Schneider, Democrat of Illinois, said he received a positive test result Tuesday morning after driving home to Illinois, and that he did not have symptoms. Like Representatives Bonnie Watson Coleman of New Jersey and Pramila Jayapal of Washington, two Democrats who had announced positive tests on Monday, he directly blamed a group of House Republicans who refused to wear masks while sheltering in a secure location during the Capitol siege.

“Today, I am now in strict isolation, worried that I have risked my wife’s health and angry at the selfishness and arrogance of the anti-maskers who put their own contempt and disregard for decency ahead of the health and safety of their colleagues and our staff,” Mr. Schneider said.

He called for lawmakers who ignore public health guidance to be sanctioned “and immediately removed from the House floor by the Sergeant-at-arms for their reckless endangerment of their colleagues.”

Capitol Hill has long struggled to contain the spread of the virus, and within hours of the beginning of the 117th Congress on Jan. 3, lawmakers began announcing positive test results.

Now lawmakers, aides, police officers and reporters who fled to secure locations during the siege have been warned that they might have been exposed to the virus while sheltering from the mob.

On Sunday, Representative Chuck Fleischmann, Republican of Tennessee, who was also in protective isolation at the Capitol during the siege, said that he had tested positive for the virus after being exposed to his roommate, Representative Gus Bilirakis of Florida, also a Republican.

Mr. Fleischmann told the local news station WRCB that he was notified Wednesday that Mr. Bilirakis had tested positive, but did not receive the notification amid the riot. He said he did not know how many other lawmakers he had come in contact with.

Democrats, already frustrated by resistance from their Republican colleagues to wearing masks, accused maskless Republicans in the secure House location of reckless indifference.

“It angers me when they refuse to adhere to the directions about keeping their masks on,” Ms. Watson Coleman said in an interview. “It comes off to me as arrogance and defiance. And you can be both, but not at the expense of someone else.”

Ms. Jayapal said on Twitter that she had tested positive “after being locked down in a secured room at the Capitol where several Republicans not only cruelly refused to wear a mask but recklessly mocked colleagues and staff who offered them one.”

Ms. Jayapal, who said she had begun quarantining immediately after the siege on the Capitol, also said that any member of Congress who did not wear a mask should be removed from the floor by the sergeant-at-arms and fined.

“This is not a joke,” she said in a statement. “Our lives and our livelihoods are at risk, and anyone who refuses to wear a mask should be fully held accountable for endangering our lives because of their selfish idiocy.”

Dustin Johnson teeing off the 17th tee during round two at the Masters golf tournament in Augusta, Ga., in November.Credit…Doug Mills/The New York Times

This year’s Masters tournament in April will be attended by a limited number of spectators, the Augusta National Golf Club announced Tuesday. The club, which prohibited fans from the event two months ago, did not specify how many fans would be allowed in 2021, adding that spectators would be permitted if “it can be done safely.”

The 2020 Masters was postponed from its usual April date to November because of the coronavirus pandemic and was contested with protocols that included virus testing before the event for all players, caddies, club members, staff and other personnel, including a reduced number of media members.

Fred Ridley, the club chairman, said in a statement issued Tuesday that similar health standards would be instituted for this year’s tournament, which is scheduled to be contested from April 8 to 11. The club, based in Augusta, Ga., made the announcement as the state reported 16 new coronavirus deaths and 7,957 new cases on Jan. 11. Over the past week, there has been an average of 9,604 cases per day, an increase of 55 percent from the average two weeks earlier.

“Following the successful conduct of the Masters Tournament last November with only essential personnel, we are confident in our ability to responsibly invite a limited number of patrons to Augusta National in April,” Ridley said. “As with the November Masters, we will implement practices and policies that will protect the health and safety of everyone in attendance.”

The Augusta National statement said the club was in the process of communicating with all ticket holders and that refunds will be issued to those patrons not selected to attend.

Commuters at Shinjuku station in Tokyo last week.Credit…Noriko Hayashi for The New York Times

Another new coronavirus variant has been detected in four people who traveled to Japan from Brazil.

Japan’s health ministry said that the people who arrived this month at Tokyo’s Haneda Airport had tested positive for the coronavirus and that it was a separate variant with similarities to those detected in Britain and South Africa. It is also distinct from another variant recently identified in Brazil, according to experts who have analyzed the data.

Makoto Shimoaraiso, an official with Japan’s Cabinet Secretariat and Office for Covid-19 Preparedness and Response, said on Tuesday that the country was consulting with the World Health Organization.

It is not unusual for viruses to accumulate mutations or for new variants to emerge. But scientists are calling for greater surveillance of variants, particularly after those from Britain and South Africa proved to be more contagious.

Mr. Shimoaraiso said epidemiologists were not sure whether the variant identified in Japan was more infectious or likely to cause more severe illness.

According to Japan’s health ministry, one of the passengers infected with the new variant, a man in his 40s, was admitted to a hospital after having breathing difficulties. Of the other cases, a woman in her 30s and a teenage boy are experiencing sore throats and fever, and a teenage girl is asymptomatic.

London last week. A coronavirus variant that emerged in Britain has been found in about 50 countries.Credit…Andrew Testa for The New York Times

In recent weeks, scientists have raised concerns about a coronavirus variant first detected in December in South Africa, noting that this version of the virus may spread more quickly than its cousins, and perhaps be harder to quash with current vaccines.

Their worries are compounded by skyrocketing Covid-19 cases in the United States and another highly infectious new variant that is driving a surge in Britain.

Scientists still have a lot to learn about these variants, but experts are concerned enough to warn people to be extra-vigilant in masking and social distancing. Here’s what you need to know:

  • The British variant has been found in about 50 countries, including the United States, where dozens of cases have been identified. The South African variant has spread to about 10 countries but has yet to be detected in the United States.

  • Both variants carry genetic changes in the virus’s spike protein — the molecule used to unlock and enter human cells — that could make it easier to establish an infection. Researchers estimate that the British variant is about 50 percent more transmissible than its predecessors. Julian Tang, a virologist at the University of Leicester, said that researchers didn’t yet have a good estimate for how much more contagious the South African variant is.

  • There is no evidence that any of the new variants are more deadly on their own, but an uptick in the spread of any virus creates ripple effects as more people become infected and ill. That can strain already overstretched health care systems and undoubtedly lead to more deaths.

  • It is unlikely that either variant will completely evade the protective effects of the new Covid vaccines. A recent study, not yet published in a scientific journal, found that the Pfizer-BioNTech vaccine is still effective against a virus carrying a mutation common to both new variants.

    The South African variant does carry genetic changes that could make vaccines less effective: One mutation appears to make it harder for antibodies produced by the immune system to recognize the coronavirus, which means they may be less effective at stopping the variant. But it is “important to note that doesn’t mean vaccines won’t be functionally protective,” said Angela Rasmussen, a virologist affiliated with Georgetown University.

    Vaccines use multifaceted immune responses, and while some antibodies may be confused by the variant, others probably won’t be. In addition, antibodies are only one sliver of the complex cavalry of immune cells and molecules that battle infectious invaders.

    Also, if the virus accumulates more genetic changes, many of the authorized vaccines, including Pfizer’s and Moderna’s, can be adjusted fairly quickly.

Transportation emissions dropped sharply in 2020 as millions of people stopped driving to work and lockdowns were in place.Credit…Lucy Nicholson/Reuters

America’s greenhouse gas emissions from energy and industry plummeted more than 10 percent last year, reaching their lowest levels in at least three decades as the pandemic slammed the brakes on the nation’s economy, according to an estimate published Tuesday by the Rhodium Group.

The steep drop was the result of extraordinary circumstances, however, and experts say the United States still faces enormous challenges in getting its planet-warming pollution under control.

“The most significant reductions last year were around transportation, which remains heavily dependent on fossil fuels,” said Kate Larsen, a director at Rhodium Group, a research and consulting firm. “But as vaccines become more prevalent, and depending on how quickly people feel comfortable enough to drive and fly again, we’d expect emissions to rebound unless there are major policy changes put in place.”

Transportation, the nation’s largest source of greenhouse gases, saw a 14.7 percent decline in emissions in 2020 as millions of people stopped driving to work and airlines canceled flights. Although travel started picking up again in the second half of the year as states relaxed lockdowns, Americans drove 15 percent fewer miles last year than in 2019.

Over all, the fall in emissions nationwide was the largest one-year decline since at least World War II, the Rhodium Group said. It put the United States within striking distance of one of the major goals of the Paris climate agreement, a global pact by nearly 200 governments to address climate change.

As part of that agreement, President Barack Obama had pledged that U.S. emissions would fall 17 percent below 2005 levels by last year. President Trump withdrew the country from the Paris accord, and before last year, it appeared that the United States would miss the emissions target. But America’s industrial emissions are now roughly 21.5 percent below 2005 levels.

Scientists say that even a big one-year drop is not enough to stop climate change. Until humanity’s emissions are essentially zeroed out and nations are no longer adding greenhouse gases to the atmosphere, the planet will continue to heat up. As if to underscore that warning, European researchers announced last week that 2020 was probably tied with 2016 as the hottest year on record.

Global roundup

Coronavirus testing at a clinic outside Kuala Lumpur, Malaysia, on Monday.Credit…Fazry Ismail/EPA, via Shutterstock

Malaysia’s king declared a national state of emergency on Tuesday to stem a surge in coronavirus cases, suspending Parliament, closing nonessential businesses and locking down several states and territories, including the largest city, Kuala Lumpur.

The emergency declaration could last until Aug. 1, and some critics said the main beneficiary would be the prime minister, Muhyiddin Yassin, the head of an unelected government who for months has barely maintained his hold on power.

Mr. Muhyiddin, who asked the king to issue the declaration, went on television to assert that the emergency measure was necessary to contain the virus — and that it was not about extending his political career.

“Let me assure you, the civilian government will continue to function,” he said. “The emergency proclaimed by the king is not a military coup.”

Mr. Muhyiddin promised to hold a general election after the virus was brought under control.

Malaysia was mostly successful in containing the virus for much of last year, but the number of infections began rising in October and reached a daily peak of more than 3,000 new cases on Thursday. The surge was caused in part by an election campaign in the state of Sabah and by an outbreak among migrant workers. The government reported a total of more than 141,000 cases and 559 deaths as of Tuesday.

Mr. Muhyiddin came to power in March after the previous government collapsed. He formed a new coalition and the king appointed him prime minister without a parliamentary vote. Opponents have since questioned whether he has the support of a majority of Parliament’s 222 members.

Now, the king’s declaration means that no parliamentary vote or general election can be held for more than six months, as long as the virus persists.

James Chin, professor of Asian studies at the University of Tasmania, said the declaration gave Mr. Muhyiddin extraordinary powers, including the authority to pass laws that override existing ones and to use the military for police work.

“Politically he will benefit the most from this Covid emergency,” he said. “This will give him what he wants without any scrutiny from Parliament.”

Other global developments:

  • Taiwan on Tuesday reported two locally transmitted coronavirus infections: a doctor and a nurse at a hospital in the northern part of the island that treats coronavirus patients. They are Taiwan’s first locally transmitted cases since Dec. 22, when it reported the first such case since April.

  • The European Union’s top drug regulator said it would assess the coronavirus vaccine developed by AstraZeneca and Oxford University “under an accelerated timeline,” after receiving an application for emergency authorization of the drug.

  • The leader of the German state of Bavaria has urged health care workers to do their “civic duty” by getting vaccinated, and called on the government to consider making coronavirus vaccinations for medical personnel mandatory in some cases. And about half of the staff at Charité, Germany’s largest research hospital, has refused to receive vaccine shots, according to Dr. Andrej Trampuz, a department head at the facility.

  • Because of high infection numbers, Berlin residents will be restricted from traveling more than about 9 miles outside the city, under new rules agreed to by German lawmakers. The distance of travel within Berlin is not being limited.

  • A couple who were out walking on Saturday night in Sherbrooke, Quebec, told the police that they were in compliance with a new overnight curfew because the wife was walking her crawling husband on a leash like a dog, CTV News reported. People walking their dogs are excluded from the province’s curfew, which is in effect from 8 p.m. to 5 a.m., as are essential workers and those seeking medical care. The pair were fined 1,500 Canadian dollars each. The province’s leader, François Legault, said on Monday that 740 people were fined over the weekend for violating the curfew, the first of its kind in Canada.

Dr. Rochelle P. Walensky is President-elect Joseph R. Biden Jr.’s nominee to lead the Centers for Disease Control and Prevention.Credit…Hilary Swift for The New York Times

Dr. Rochelle P. Walensky, chief of the infectious diseases division at Massachusetts General Hospital and a professor at Harvard, has been nominated by President-elect Joseph R. Biden Jr. to be director of the Centers for Disease Control and Prevention. In a column for The New York Times Opinion section, excerpted here, she writes about her plans for the agency.

On Jan. 20, I will begin leading the C.D.C., which was founded in 1946 to meet precisely the kinds of challenges posed by this pandemic. I agreed to serve as C.D.C. director because I believe in the agency’s mission and commitment to knowledge, statistics and guidance. I will do so by leading with facts, science and integrity — and being accountable for them, as the C.D.C. has done since its founding 75 years ago.

I acknowledge that our team of scientists will have to work very hard to restore public trust in the C.D.C., at home and abroad, because it has been undermined over the last year. In that time, numerous reports stated that White House officials interfered with official guidance issued by the C.D.C.

As chief of the infectious diseases division at Massachusetts General Hospital, I and many others found these reports to be extremely disturbing. The C.D.C.’s science — the gold standard for the nation’s public health — has been tarnished. Hospitals, doctors, state health officials and others rely on the guidance of the C.D.C., not just for Covid-19 policies around quarantine, isolation, testing and vaccination, but also for staying healthy while traveling, strategies to prevent obesity, information on food safety and more.

Restoring the public’s trust in the C.D.C. is crucial. Hospitals and health care providers are beyond tired, beyond stretched. I know because I have stood among them, on the front lines of the Covid-19 response in Massachusetts. We also face the need for the largest public health operation in a century, vaccinating the population — twice — to protect ourselves and each other from a surging pandemic. Because the impact of Covid-19 does not fall equally on everyone, we must redouble our efforts to reach every corner of the U.S. population.

The research and guidance provided by the civil servants at the C.D.C. should continue regardless of what political party is in power. Novel scientific breakthroughs do not follow four-year terms. As I start my new duties, I will tell the president, Congress and the public what we know when we know it, and I will do so even when the news is bleak, or when the information may not be what those in the administration want to hear.

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Gorillas Test Positive for Coronavirus at San Diego Zoo

Officials at the zoo’s Safari Park said that several gorillas had tested positive for the virus and that they believed an asymptomatic staff member infected the animals.

They’re doing OK, they’re experiencing some mild symptoms. And we continue to observe them. But they’re drinking, they’re eating and they’re interacting with one another. So we suspect that the gorillas got this virus from an asymptomatic team member. And that’s despite all of the precautions that we take. We follow C.D.C. guidelines. We follow San Diego County health guidelines. The team wears P.P.E. around all of our wildlife. And so even with all those precautions, we still have an exposure that we think happened with that team member. This virus has been very, very tricky. We’ve done everything we can to respond to it and make sure that we’re taking all the precautions and following all the guidelines that we can. But as we see it evolving everywhere around the world right now, we know that it is, it is, it’s evolving. It’s changing. And the best that we can do for humans and wildlife is just to ensure that we stay up to date on any protocols, that we remain nimble so that we can respond accordingly and make sure that we’re doing the very best we can to protect both our team, our guests and wildlife.

Video player loadingOfficials at the zoo’s Safari Park said that several gorillas had tested positive for the virus and that they believed an asymptomatic staff member infected the animals.CreditCredit…Ken Bohn/San Diego Zoo Global/Via Reuters

Several gorillas at the San Diego Zoo Safari Park have tested positive for the coronavirus, becoming what federal officials say are the first known apes in the United States to be infected.

Zoo officials said on Monday that they believed the gorillas were infected by an asymptomatic staff member who had been following safety recommendations, including wearing personal protective equipment when near animals.

Veterinarians are closely monitoring the troop, which is made up of eight western lowland gorillas. The infected animals are expected to make a full recovery, officials said.

“Aside from some congestion and coughing, the gorillas are doing well,” Lisa Peterson, the Safari Park’s executive director, said in a statement.

Three animals are exhibiting symptoms, officials said. And because gorillas live together in troops, “we have to assume,” the zoo said, “that all members of the family group have been exposed.”

The total number of western lowland gorillas, which can be found in central Africa, has declined more than 60 percent over the past two decades, according to the World Wildlife Fund.

Zoo officials learned that at least two gorillas had been infected with the coronavirus after the animals were observed on Wednesday “coughing and showing other mild symptoms,” the zoo said in the statement.

The zoo’s Safari Park has been closed since Dec. 6 amid a lockdown, and the primate habitat where the gorillas are housed poses “no public health risk,” officials said. Last year, as the pandemic spread across the country, the zoo installed additional barriers to ensure that more than six feet of space separated visitors from “susceptible species,” officials said.

The gorillas are among the latest animals in the country to become infected with the coronavirus. In April, the first case of human-to-cat transmission was detected in a tiger at the Bronx Zoo in New York City. In August, minks on two farms in Utah tested positive. In December, a coronavirus infection in a snow leopard was detected at the Louisville Zoo in Kentucky.

VideoVideo player loadingMayor Bill de Blasio of New York City announced on Tuesday that CitiField, the Mets’ home stadium in Queens, will be a “24/7 mega-vaccination site” starting the week of Jan. 25.CreditCredit…Ryan Christopher Jones for The New York Times

Mayor Bill de Blasio of New York City announced on Tuesday that CitiField, the Mets’ home stadium in Queens, will be a mass vaccination site starting the week of Jan. 25. The site will operate around the clock, seven days a week, with the capacity to vaccinate 5,000 to 7,000 people a day, Mr. de Blasio said. The location is ideal, the mayor said, because it is right next to a subway and railroad station and has plenty of parking.

“It’s going to be big, and it’s going to be a game changer,” Mr. de Blasio said at a news conference on Tuesday.

Large sports venues across the country have been used as sites for mass coronavirus testing, and more recently for vaccination, including the home stadiums of the Los Angeles Dodgers and San Diego Padres baseball teams, the Arizona Cardinals of the N.F.L. and the San Antonio Spurs of the N.B.A. Testing and vaccination efforts at Hard Rock Stadium in Miami were temporarily suspended on Monday to allow the college football championship game between Alabama and Ohio State to be played there.

The pool of people eligible for the vaccine in New York has recently expanded to include teachers and a range of other essential workers, as well as any resident who is 65 or older. At first, the vaccine was limited to frontline health care workers and nursing home residents.

The CitiField location is part of New York City’s initiative to establish mass inoculation sites in each of the city’s five boroughs. Vaccination centers opened in Brooklyn and the Bronx this week; locations in Manhattan and Staten Island have not yet been announced.

More than 26,000 vaccine doses were administered in the city on Monday, according to Mr. de Blasio, who is trying step up the pace of inoculations. The mayor has said his goal is to have one million doses administered by the end of January.

Mr. Cuomo, a third-term Democrat, said on Tuesday that the state intended to set up a series of rapid testing sites in areas where restrictions have closed indoor dining and arts events, and closed offices. Some of these sites would be located in vacant retail spaces or shuttered businesses, he said, promising hundreds of “pop-up” testing sites.

At the same time, Mr. Cuomo wants to reopen office buildings — a major element of New York City’s economy, both for their tenants and developers — saying he had received assurances from their owners that they could ramp up testing for workers. “Bringing workers back safely will boost ridership on our mass transit, bring customers back to restaurants and stores, and return life to our streets,” he said.

A coronavirus testing site in Los Angeles on Monday. The United States was one of the poorest-performing countries in a study of responses to the pandemic.Credit…Alex Welsh for The New York Times

How well a country has responded to Covid-19 is not explained by the country’s economic power or scientific capacity, but by how its people relate to one another and their government, according to preliminary findings of a research study.

“Countries with traditions of acting in concert against social problems, and countries with histories of deference to public authorities, fared better on compliance than countries lacking either or both,” the researchers wrote.

Investigators compared characteristics of 23 countries on six continents, considering outcomes related to disease burden, economic impact and disparities. In the United States, rated as one of the poorest-performing countries, “the virus ‘exploited’ pre-existing weaknesses” in public health, the economy and politics.

Before the pandemic, numerous reports and congressional testimony “recognized vulnerabilities that became apparent during Covid-19,” another study found, including threats of viruses emerging from animals, economic disruption, inadequate stockpiles and vulnerability to global supply shortages. For that study, researchers compiled more than 1,200 pre-pandemic records in an expanding online library that was introduced on Tuesday — Health Security Net — in the hopes that it will “inform future planning and response efforts.”

Another team, studying five countries in Africa, found that national leaders there had quickly recognized the threat from the virus and imposed measures to limit its importation and spread. “That managed to at least curtail the outbreak,” said Wilmot James, a Columbia University research scholar who was one of the study’s principal investigators, “but the impacts on the economies were quite devastating.”

The Africa Centers for Disease Control and Prevention, a four-year-old institution modeled in part on its U.S. counterpart, was unique in providing technical assistance for an entire continent.

The research reports were released Tuesday in conjunction with a two-day symposium, the Futures Forum on Preparedness, supported by Schmidt Futures and the Social Science Research Council.

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Health

BioNTech CEO says vaccine is efficient towards new strains

The CEO of German pharmaceutical company BioNTech remains confident that the company’s Covid vaccine, developed in partnership with Pfizer, will be effective against the highly infectious variants of the virus discovered in the UK and South Africa.

“We are confident that based on the mechanism of our vaccine, although there are mutations, we believe that the immune response induced by our vaccine could also treat (a) mutated virus,” said Dr. Ugur Sahin, co-founder and CEO of BioNTech, said CNBC’s Meg Tirrell on Monday.

“Last week we reported another mutation that is present in both the UK and South African variants. This mutation is believed to be important as it could structurally alter the protein. However, it appears that the immune response to our vaccine does also neutralizes mutation. “

His comments were based on research published Thursday showing that Pfizer-BioNTech’s Covid-19 vaccine appeared to be effective against a key mutation in the more infectious variants of the virus discovered in the UK and South Africa.

The study, carried out by US pharmaceutical giant Pfizer and not yet peer-reviewed, suggested that the vaccine neutralized the so-called N501Y mutation. This mutation has been reported in the coronavirus variants discovered in the UK and South Africa.

The variants, which emerged separately, both share a genetic mutation of the so-called spike protein, which the virus uses to penetrate the cells of the body.

Doctors tentatively welcomed the results of the study last week, but cautioned that the research focused only on the N501Y mutation found in both new variants.

BioNTech’s Sahin said the company will be able to present more data in the coming days examining the full set of mutations.

The new vaccine could be ready “within six weeks”.

Pfizer-BioNTech’s Covid vaccine uses messenger RNA or mRNA technology, like Moderna’s. In practice, the US Centers for Disease Control and Prevention says this “teaches our cells how to make a protein – or even a piece of a protein – that will trigger an immune response in our bodies.”

The resulting immune response produces antibodies that protect people from becoming infected with the virus.

Ugur Sahin, co-founder and CEO of Biontech, is on the company premises. Biontech is a biotechnology company that researches vaccines against the coronavirus, among other things. (Photo by Andreas Arnold / Image Alliance via Getty Images)

Andreas Arnold | Image alliance via Getty Images

When asked how fast BioNTech could turn if the existing Covid vaccine were found to be ineffective against new variants, Sahin said “a key benefit” of mRNA technology is that the company is adapting the vaccine relatively quickly could. “”

“We can change the order of the vaccine in a matter of days and, in principle, deliver a new vaccine within six weeks. This is technically possible and if necessary we would go for it,” he said, noting that it is is would also require discussions with regulators such as the Food and Drug Administration.

“We are therefore confident that the technology with which we can react to a mutation or a virus variant with different problems will react extremely quickly,” said Sahin.

Public health experts have raised concerns that the new mutant strains could pose a threat to vaccination efforts. In recent weeks, optimism about the mass adoption of Covid vaccines has been tempered by the resurgent rate of virus spread around the world.

To date, more than 90.3 million people worldwide have contracted the coronavirus, with 1.93 million deaths, according to data from Johns Hopkins University.

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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. “

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‘It Turned Kind of Lawless’: Florida Vaccine Rollout Turns Right into a Free-for-All

MIAMI — Linda Kleindienst Bruns registered for a coronavirus vaccine in late December, on the first day the health department in Tallahassee, Fla., opened for applications for people her age. Despite being 72, with her immune system suppressed by medication that keeps her breast cancer in remission, she spent days waiting to hear back about an appointment.

“It’s so disorganized,” she said. “I was hoping the system would be set up so there would be some sort of logic to it.”

Phyllis Humphreys, 76, waited with her husband last week in a line of cars in Clermont, west of Orlando, that spilled onto Highway 27. They had scrambled into their car and driven 22 miles after receiving an automated text message saying vaccine doses were available. But by 9:43 a.m., the site had reached capacity and the Humphreys went home with no shots.

“We’re talking about vaccinations,” said Ms. Humphreys, a retired critical care nurse. “We are not talking about putting people in Desert Storm.”

Florida is in an alarming new upward spiral, with nearly 20,000 cases of the virus reported on Friday and more than 15,000 on Saturday. But the state’s well-intended effort to throw open the doors of the vaccine program to everyone 65 and older has led to long lines, confusion and disappointment.

States across the country, even as they race to finish vaccinating health care employees, nursing home residents and emergency workers, are under pressure from residents to reach a broader section of the public. Florida, which has already prioritized a large swath of its population to receive the vaccine, illustrates the challenges of expanding a vaccination program being developed at record speed and with limited federal assistance.

“How do you do something this huge and roll it out?” said Dr. Leslie M. Beitsch, the chairman of the behavioral sciences and social medicine department at Florida State University. “It’s not in any way surprising — to anyone who followed it closely, for sure — that there would be halting kind of progress and missteps getting something of this magnitude underway initially, whether we’re talking about Florida or the entire country.”

Guidelines from the Centers for Disease Control and Prevention recommend giving the next priority after the earliest groups to essential workers and people 75 and older. Some states, including Florida, Texas, Oklahoma and Hawaii, decided to vaccinate people 65 and older, even before essential workers, and other states are following suit.

But with states and counties left to largely sort out logistics by themselves, the rollout has gone anything but smoothly.

People camped out overnight in the Florida winter chill in Fort Myers and Daytona Beach for vaccines administered on a first-come-first-served basis, a spectacle that made national headlines. Health department offices in Sarasota and several other counties, unequipped to schedule vaccine appointments on their own websites, resorted to using Eventbrite, a service usually associated with invitations to dinner parties and art exhibitions.

Palm Beach County was accepting vaccine requests only by email, said the county’s health administrator, Dr. Alina Alonso, after the county’s phone system “absolutely died.” People in the queue were warned that they might have to wait months for an appointment. In the meantime, some wealthy people with connections to health care facilities have been able to get the vaccine more easily.

Adding to the complications, the Florida Division of Emergency Management announced on Sunday that its coronavirus testing and vaccination site at Hard Rock Stadium in Miami Gardens — the recent scene of long lines of people awaiting vaccination — would be shut down for much of Monday to make way for the College Football Playoff national championship game.

Experts say Florida is an example of what happens when officials attempt to distribute a vaccine that is still in very limited supply to a broad spectrum of the population. In a state with about 4.4 million people 65 and older, more than 402,000 doses had been administered as of Friday, according to federal data, the fourth-highest total in the nation. But Florida has used only about 30 percent of the vaccine doses it has received, behind 29 other states.

Some people have been successful, including Janice and Walter Greer, who were in the same line as the Humphreys in Clermont on Wednesday. Ms. Greer had called Lake County repeatedly, hoping to get information about vaccine availability.

Mr. Greer has a brother in Ohio with Covid-19. “I couldn’t go and see him,” he said softly, welling up with tears. “He has pneumonia.”

But while the Greers got in line early enough to receive shots, many more people left without one and were quite upset.

“My heart is beating 100 miles a minute,” said Shirley LaBoy, 65, of Polk County, who got to the recreation center only to see a line of cars and a digital road sign saying “NO VACCINES TODAY.”

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.

“I found myself on the computer all day. I feel, emotionally, all stressed out,” said Ms. LaBoy, who has been unable to see her children for fear of contracting the virus. “We are tired of being locked in. Then I get an opportunity to get the vaccine, and I can’t even get that.”

Aaron Kissler, the health administrator for Lake County, said officials wanted to get shots in arms quickly, even without a more organized appointment system available. “Right now, we just wanted to get out as much as possible,” he said.

In Texas, about 527,000 residents had received at least the first vaccine dose as of Friday, according to the Texas Department of State Health Services. About 107,000 of them were 65 or older, out of more than 3.7 million Texans eligible in that age range. But there have been problems similar to Florida’s.

Dr. Bob Kelly, a 77-year-old retired veterinarian in Austin, said he made 20 or more phone calls searching for a vaccine before he finally connected one night at 3 a.m. on a hospital internet link that offered an appointment for several days later.

He and his wife drove 25 miles to the appointment, only to be told that supplies were so limited that the vaccine would only be given to people with aggravating health conditions. So they are back to where they started, with their names on five waiting lists at pharmacies, chain hospitals and a doctor’s office.

“That’s what’s going on,” Dr. Kelly said. “The rollout is slow, the method of administration is not efficient and who gets it is kind of arbitrary.”

In Florida, Gov. Ron DeSantis, a Republican, has acknowledged that the initial rollout has been bumpy.

But he has steadfastly defended the state’s decision to open the door to all seniors, saying he could not in good conscience see a 20-something who bags groceries getting vaccinated before a grandparent, not in a state where of the more than 22,000 people killed by the coronavirus, 83 percent have been 65 or older.

The plurality of vaccine doses have gone so far to people between the ages of 65 and 74, not to people 75 and older who are the most vulnerable to the virus.

Some of the lag in numbers may be a result of older people who are being extra cautious about getting a new vaccine developed in record time. But older seniors may also be at a disadvantage because the process has often required a degree of computer proficiency and has generally not been clear or consistent, Dr. Beitsch said.

“Each of our 67 counties seems to be taking a slightly different pathway — and that’s remarkable, because we have a single department of health that is supposed to cover the entire state,” said Dr. Beitsch, whose 71-year-old tech-savvy brother got vaccinated in Orlando after filling out a request form that took him about 40 minutes.

The Florida Department of Health is working on an online appointment system for all counties, but it is not yet ready, though the DeSantis administration says it has been preparing for the vaccine rollout since July. It stockpiled millions of supplies and enrolled more than 270 providers to receive the shots once they became available.

Mr. DeSantis said his administration moved more aggressively than other states, getting teams of health workers and National Guard members to nursing homes the week before CVS and Walgreens pharmacies began vaccinating those residents. Florida is also distributing doses to Publix supermarkets and churches to increase community access.

“We’re going to be there for our parents,” he said in a news conference on Sunday. “We’re going to be there for our grandparents. And that will do more than anything else we can do to reduce mortality and change the scope of how this virus behaves in the state of Florida.”

The lucky vaccine recipients have been thrilled.

“Everything was great,” Susan Hacker said after getting her shot on Thursday at the Century Village retirement community in Boca Raton.

The state has no residency requirement for people to get the vaccine in their home county — or to be Florida residents at all. News reports in Argentina have recounted how wealthy people vacationing in Miami managed to get vaccinations.

More worrying to officials have been private institutions distributing the vaccine to people who are not in any of the priority groups. MorseLife Health System, a nursing home and assisted living facility in West Palm Beach, is under investigation by the Florida inspector general and the health department after The New York Post and The Washington Post reported that it steered vaccines to rich donors.

In an interview on Tuesday, Hong Chae, the organization’s chief financial officer, said that a number of the nursing home’s board members and volunteers were offered the vaccine in case facility managers became incapacitated by the virus and board members needed “to come in and chip in,” he said.

Some hospitals in Miami have vaccinated board members as well, according to local doctors and patients.

One of them, Rosario Rico Toro, posted news of receiving the Pfizer vaccine to Facebook friends on Dec. 30. “Baptist vaccination day!!” she wrote alongside an image of her Covid-19 vaccination record.

In an interview, Ms. Rico Toro, a onetime Miss Bolivia who now does charitable work for hospitals, said she had received the vaccine as a result of her donations and volunteer work for Baptist Hospital in Miami. When one of the hospital’s doctors canceled an appointment to get the shot, the hospital offered her the spot.

“They called and said, ‘As a board member, would you like to get it?’” she recalled.

The hospital did not respond to requests for comment.

Ms. Rico Toro, who is 49 and in good health, said she initially hesitated. But the hospital gave her the impression that if she turned down the vaccine, it would be offered to another board member or possibly not even be used, so she took it. “My question is, why not?”

Dr. Perri Young, an internist in Miami, said that the distribution process has been shambolic and ineffective. Even as a doctor, she said, her access to information is minimal.

“It’s crazy here,” she said. “It became sort of lawless.”

By the end of week, Ms. Kleindienst Bruns in Tallahassee had gotten some good news: Her internist had received vaccine doses. Would she like one?

She got it on Saturday. “It was so easy,” she said.

Patricia Mazzei reported from Miami, Eric Adelson from Clermont, Fla., and Kate Kelly from New York. David Montgomery contributed reporting from Austin, Texas; Neil Reisner from Coconut Creek, Fla., and Boca Raton, Fla.; and Rachel Abrams from Los Angeles.

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Israel’s large vaccine drive is not maintaining with new circumstances — particularly amongst youthful victims

For the first time since the pandemic began, Israel says more than a quarter of the most serious Covid-19 cases requiring hospitalization occur in patients under the age of 60.

The Israeli Ministry of Health blames a new strain first discovered in the UK last month.

Dr. Itamar Grotto, Deputy Director General of the Israeli Ministry of Health, said: “This is because the new British variant is more contagious, especially among young people and children.”

The news that Israel’s hospitals now have a record number of serious Covid cases came within 24 hours of Israel launching a “second dose”. Prime Minister Benjamin Netanyahu was the first to get his second shot yesterday.

Israel has been commended by the global health community for moving to vaccination so quickly. So far, nearly two million Israelis have received their first shot from around 9 million people. Israel has a highly centralized health system in which everyone has to register in a digital system, which makes it easier for the Ministry of Health to organize the vaccination campaign across the country.

Israeli Prime Minister Benjamin Netanyahu will receive the second dose of the vaccine against the coronavirus disease (COVID-19) on January 9, 2021 at the Sheba Medical Center in Ramat Gan near the coastal city of Tel Aviv.

MIRIAM ALSTER | AFP | Getty Images

Despite its success on the vaccine front, Israel is currently in its third nationwide lockdown due to the virus spreading. Without downplaying concerns about the rising percentage of younger people hospitalized with serious infections, epidemiologist Grotto points out that nearly 70% of Israelis over the age of 60 received their first shot, which gives them some immunity.

CNBC employee and former FDA chief Dr. Scott Gottlieb has been keeping an eye on trends in Israel and Europe since the pandemic started a year ago, and used them as a possible model for what could happen in the US, including the relatively newly discovered British variant.

“If we can use the vaccine, we can probably fight it off,” Gottlieb said, referring to the more dangerous, faster-spreading strain.

He believes the recent and alarming surge in cases in the United States is more related to vacation travel and gatherings, “but the bottom line is that we don’t have a good enough surveillance system to know for sure,” said Gottlieb.

The British variant officially only accounts for 0.2% of the US cases. Gottlieb also warned U.S. health officials that they are not yet looking so carefully for the increasingly dangerous burden ravaging an overstretched South African health system.

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Health

Coronavirus Vaccine Demand Has Well being Officers Turning to Eventbrite

In the early stages of a global effort to distribute the coronavirus vaccine to those who need it most – a process that has so far been both hectic and slow – some health officials turned to an unexpected tool: the Eventbrite ticketing website .

Before the pandemic, the platform was a place to book tickets for performances, art shows or pub crawls. Now public health officials are using it to schedule vaccination appointments.

Mai Miller, 48, of Merritt Island, Fla., Scoured Eventbrite last week looking for a place for her mom. She flipped through pages with dates and times, updated the website repeatedly, looking for blue booking buttons to show availability.

She found a few, but she didn’t seem to be clicking fast enough. “It was just a mess,” she said. “Like musical chairs with 20 chairs and 4,000 people.”

Ms. Miller couldn’t find an appointment, but others were lucky. Eventbrite has been used to schedule vaccinations in several Florida counties, Vice reported, and mentions of Eventbrite vaccination cards have surfaced elsewhere – such as the websites of Sevier County, Tennessee, and the city of Allen, Texas.

Even healthcare providers in the UK have used the platform.

This has raised accessibility concerns: not everyone has internet access or knows how to use Eventbrite. Those who do will be more fortunate to be able to get online at the right time – whenever there are tons of tickets available – which could put people with slower connections or key employees maneuvering around scheduled shifts at a disadvantage.

And some reports have raised alarms about possible scams. The Pinellas County, Florida Department of Health warned that appointments made through a “fraudulent Eventbrite site” were not valid, and the Tampa Bay Times reported that Eventbrite was used to bill people for vaccination slots, which turned out to be a fake.

In a statement, Eventbrite said it had investigated the unofficial entries and found that they were due to user error, not malice. “We understand that this has caused confusion and we continue to monitor and take action to remove these entries,” he added.

These deployment difficulties are part of a much larger problem: Coronavirus vaccine distribution in the U.S. and elsewhere is an unprecedented project with enormous operational challenges.

Federal officials have confirmed that the rollout was slower than expected. They also left many details of the vaccine distribution process, such as planning and staffing, to overstretched local health authorities and hospitals struggling with a lack of resources.

“It’s stressful for my people,” said Greg Foster, the emergency management director for Nassau County, Florida who works with health department officials to give the vaccine. “We get a lot of angry people who contact us because they can’t get the vaccine and I understand why they’re upset.”

Eventbrite was a useful tool because the county’s websites and phone lines did not have the bandwidth to meet demand – let alone limited supply. “We have tens of thousands of people trying to get 850 vaccines,” said Foster.

Covid19 vaccinations>

Answers to your vaccine questions

If I live in the US, when can I get the vaccine?

While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.

When can I get back to normal life after the vaccination?

Life will only get back to normal once society as a whole receives adequate protection against the coronavirus. Once countries have approved a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible that people spread the virus without knowing they are infected because they have mild symptoms or no symptoms at all. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.

Do I still have to wear a mask after the vaccination?

Yeah, but not forever. The two vaccines that may be approved this month clearly protect people from contracting Covid-19. However, the clinical trials that produced 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 with the coronavirus can spread it without experiencing a cough or other symptoms. Researchers will study this question intensively when the vaccines are introduced. In the meantime, self-vaccinated people need to think of themselves as potential spreaders.

Will it hurt What are the side effects?

The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection is no different from the ones you received before. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. However, some of them have experienced short-lived symptoms, including pain and flu-like symptoms that usually last a day. It is possible that people will have to plan to take a day off or go to school after the second shot. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system’s encounter with the vaccine and a strong reaction that ensures lasting immunity.

Will mRNA vaccines change my genes?

No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given moment, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can hold for a few days at most before it is destroyed.

In Brevard County, Florida, health department officials administered hundreds of doses daily. “Our staff, complemented by an Incident Management strike team consisting of National Guards and paramedics, are incredible,” said Anita Stremmel, deputy director of the county’s health ministry.

But the logistics weren’t easy. “Initial efforts to make appointments over the phone resulted in phone outages and disconnections,” she said. When officials there saw other counties using Eventbrite, they decided to follow suit.

To avoid fraud, people should only access the Eventbrite site through the Department of Health’s website, Ms. Stremmel said.

Ms. Miller, who lives in Brevard County, said someone posted her a link to Eventbrite vaccination bookings last week. “My first reaction was that it doesn’t look real,” she said.

But she was determined to help her mother Chut Agger, 68, get an appointment. A visit to the county website confirmed the Eventbrite link was real, so Ms. Miller tried her luck. She knew the platform because she had used it before – to buy concert tickets – but she still couldn’t secure a seat.

“I couldn’t imagine my mother, who is not at all tech-savvy, trying to make the appointment herself,” Ms. Miller said.

Ms. Agger agreed that she was unfamiliar with the art of Eventbrite booking. Their preferred medium was the telephone. Before her daughter tried to get an appointment online, Ms. Agger called the district health department for hours to make an appointment. She used two phones at the same time and hit the redial button hundreds of times. It never reached anyone.

Ms. Agger recalled news reports where other Floridians stood outside for hours asking for vaccinations, which were given based on availability. “All the elderly stand in line and sit there overnight – that’s just not right,” she said. She has no plans to try this tactic herself.

“No,” she said. “I’ll just wait.”

In a statement, Eventbrite, which describes itself as a “self-service ticketing and experience platform,” said anyone using the platform to register for coronavirus-related events should direct their questions to local health authorities.

“We are actively investigating how our platform can best support efforts to improve access to vaccines,” it said.

The company did not answer questions about protecting the privacy of people who booked vaccination appointments on the platform.

Using Eventbrite to process proprietary medical information could violate the privacy policy of the Health Insurance Portability and Accountability Act (HIPAA), said Kayte Spector-Bagdady, assistant director at the University of Michigan Center for Bioethics and Social Sciences in Medicine.

However, she stressed that local officials appear to be using whatever resources they have at their disposal to make the vaccine available to as many people as possible, adding that better planning and coordination by state and federal officials would have helped them.

“Now each county and institution really needs to catch as much as they can – try to vaccinate the population fairly while they try to get more government products into the states and then use whatever products they have” says Professor Spector. Said Baghdady. “It’s extraordinarily complex, so I have nothing but sympathy for these health care workers who are trying to get shot in the arms.”

For now, it seems that regulators won’t get in their way. The Civil Rights Office at the Department of Health and Human Services “is not interested in imposing HIPAA penalties on providers who do their best to vaccinate people quickly,” said its director Roger Severino.

Ms. Miller said she wasn’t particularly concerned about privacy when she used Eventbrite to find a vaccination appointment for Ms. Agger. Her main focus, she said, was keeping her mother safe from Covid-19.

“Now there is this vaccine and it seems almost out of reach,” she said. “It’s there, but we can’t get it. There has to be a better way. “

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Health

Pfizer Says Its Vaccine Works In opposition to Key Mutation in Contagious Variants

Pfizer and BioNTech announced on Friday that their Covid vaccine is effective against one of the mutations in the new contagious variants in the UK and South Africa.

Independent experts said the results were good news, but warned that each of these coronavirus variants have several different potentially dangerous mutations that have not yet been studied. So it’s possible that one of these mutations could affect the effectiveness of the vaccine.

“It’s the first step in the right direction,” said Dr. John Brooks, the chief medical officer of the Covid-19 emergency department at the Centers for Disease Control. “I hope the additional work that comes out in the future matches this insight.”

The new variant, known as B.1.1.7, first gave cause for concern in December when British researchers found it was rapidly becoming more common in people with Covid-19. Since then, it has appeared in 45 countries.

Subsequent research has confirmed that it has the ability to spread more easily from person to person. On Friday, Public Health England published a new study on B.1.1.7 in which researchers estimated that the variant is 30 to 50 percent more transmissible than other forms of the virus.

The viral line that leads to B.1.1.7 has accumulated 23 mutations. Of particular concern to scientists are eight mutations that affect the gene for a protein called spike on the surface of coronaviruses. That’s because the viruses use the spike protein to capture human cells. It is possible that one or more of them will help B.1.1.7 enter cells more successfully.

One of these mutations, known as N501Y, is of particular concern. Experiments have shown that it allows the virus to bind more tightly to cells. And it has appeared in other lines of the coronavirus as well, including a variant identified in South Africa in December. This variant, named B.1.351, quickly spread across the country and has so far expanded to a dozen other countries.

In the new study, which went online Thursday and has not yet undergone a formal scientific review, researchers from the University of Texas Medical Department conducted an experiment to see if the Pfizer BioNTech vaccine was against viruses with the N501Y mutation works. They found that in cells in the laboratory, the mutated virus could not infect human cells mixed with antibodies from vaccinated people. The antibodies clung to the coronaviruses, preventing them from entering cells. Despite the N501Y mutation, the experiment showed that the antibodies produced by the vaccine were still able to bind to the viruses.

“This indicates that the key N501Y mutation found in the emerging variants in the UK and South Africa does not create resistance to the immune responses induced by the Pfizer BioNTech vaccine,” the companies said in a press release .

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UK regulator approves Moderna Covid vaccine

CSL staff will be working in the laboratory on November 08, 2020 in Melbourne, Australia, where they will begin manufacturing the AstraZeneca-Oxford University’s COVID-19 vaccine.

Darrian Traynor | Getty Images

The UK regulator has approved Moderna’s coronavirus vaccine for use in the country, the Ministry of Health said on Friday.

It is the third Covid shot approved for use in the UK following previous vaccine approvals from Pfizer and BioNTech, as well as Oxford and AstraZeneca universities.

In a press release, the department announced that the Moderna vaccine met the “stringent standards for safety, efficacy and quality” set by the drug and health product regulator.

It added that the UK had ordered an additional 10 million doses of the vaccine, bringing the total to 17 million. They are expected to be available from spring.

This is a developing story and will be updated shortly.

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Health

EU broadcasts 300 million extra doses of Pfizer-BioNTech covid vaccine

European Commission President Ursula von der Leyen holds a press conference in Brussels, Belgium on December 13, 2020 after speaking to British Prime Minister Boris Johnson on the phone.

Olivier Hoslet | Reuters

LONDON – The European Union doubles its inventory of Pfizer BioNTech coronavirus vaccines as concerns about adoption mount across 27 member states.

The vaccine developed with German biotechnology was the first to be approved by European regulatory authorities. It has been administered across the region since December 27th. However, the rollout was inconsistent and the European Commission was criticized for not buying more vaccine.

The Commission has argued that, at the request of Member States, it has a diversified portfolio of vaccination contracts, totaling up to 2.3 billion doses of “the most promising candidates”.

“As you know, we currently have access to 300 million doses of the BioNTech-Pfizer vaccine. Now the good news is: we have now agreed with BioNTech-Pfizer to renew this contract. With the new agreement, we could buy more in total another 300 million cans, “said the President of the Commission, Ursula von der Leyen, at a press conference on Friday.

This would mean the EU is on track to receive 600 million doses of this vaccine. Speaking to CNBC in December, Pfizer’s CEO pledged to produce a total of 1.3 billion cans in 2021, which would mean Europe would get almost half of its annual output.

75 million cans of the new order will be available in the second quarter of 2021. The rest will be delivered in the third and fourth quarters.

The Netherlands only started vaccinating its citizens this week and the bureaucracy has reportedly made France one of the biggest stragglers in distributing the shock.

According to the European Center for Disease Prevention and Control, more than 15 million cases of coronavirus have been reported in the region to date.

European regulators approved a second coronavirus vaccine on Wednesday. Moderna’s candidate is expected to be available to European citizens in the coming days.

“Europe will have more than enough vaccines within a reliable timeframe, and this shows that the path that we have taken in the European Union is the right one,” said von der Leyen on Friday, rejecting the criticism.