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U.S. ought to push to get extra folks vaccinated earlier than Covid variants unfold, physician says

Dr. Peter Hotez told CNBC’s “The News with Shepard Smith” that people in the US shouldn’t get complacent about dropping Covid cases, especially in the face of new reports of a new variant, B.1.526, hitting New York spread.

“We’re all running high because the numbers are falling, and I say we are in the eye of the hurricane and the next big wave is coming,” said Hotez, co-director of the vaccine development center at Texas Children’s Hospital.

According to a CNBC analysis of the Johns Hopkins data, the average daily cases of coronavirus in the United States have decreased by about 57%. However, some states don’t see such a sharp decline. Vermont is only down 22% averaging daily falls, New York is down about 45%, Oregon is down nearly 47%, and Florida is down 48% averaging daily. Hotez recognized Florida for distributing a highly transmissible variant of Covid in the state, which was first found in the UK

“The only state that really intrigues me, not necessarily in a good way, is Florida because we hear that about 10% of Florida-derived virus isolates are the UK-derived B.117 variant.” said Hotez in an interview on Wednesday night.

Hotez urged that now is the time for the US to really take a vaccination boost, especially before more variants of Covid spread. While AstraZeneca reported that it expects its vaccine to be approved in the US in April, Hotez said, “I think sometimes we have to think about making the beep” and should approve it sooner.

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Covid-19 World Information: Dwell Updates on Variants, Instances and Deaths

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Boris Johnson Maps Out Plan to Lift Virus Lockdown

Prime Minister Boris Johnson of Britain outlined a plan to remove lockdown measures as a path toward “freedom” for the region.

We cannot escape the fact that lifting lockdown will result in more cases, more hospitalizations and sadly, more deaths, and this would happen whenever lockdown is lifted, whether now or in six or nine months, because there will always be some vulnerable people who are not protected by the vaccines. This roadmap should be cautious, but also irreversible. We’re setting out on what I hope and believe is a one-way road to freedom, and this journey is made possible by the pace of the vaccination program. In England, everyone in the top four priority groups were successfully offered a vaccine by the middle of February. The sequence will be driven by the evidence. So outdoor activity will be prioritized as the best way to restore freedoms while minimizing the risk. At every stage, our decisions will be led by data, not dates.

Prime Minister Boris Johnson of Britain outlined a plan to remove lockdown measures as a path toward “freedom” for the region.CreditCredit…Pool photo by Geoff Caddick

LONDON — Prime Minister Boris Johnson of Britain said Monday that schools in England would reopen on March 8 and that people would be allowed to socialize outdoors starting on March 29, the tentative first steps in a long-awaited plan to ease a nationwide lockdown prompted by a highly contagious variant of the coronavirus.

Mr. Johnson’s “road map” was intended to give an exhausted country a path back to normalcy after a dire period in which infections skyrocketed and hospitals overflowed with patients. At the same time, Britain rolled out a remarkably successful vaccination program, injecting 17 million people with their first doses.

That milestone, combined with a decline in new cases and hospital admissions, paved the way for Mr. Johnson’s announcement. But the prime minister emphasized repeatedly that he planned to move slowly in reopening the economy, saying that he wanted this lockdown to be the last the nation had to endure.

Under the government’s plan, pubs, restaurants, retail shops, and gyms in England will stay closed for at least another month — meaning that, as a practical matter, daily life will not change much for millions of people until the spring.

“We’re setting out on what I hope is a one-way journey to freedom,” Mr. Johnson said in a statement to the House of Commons. “This journey is made possible by the success of the vaccine program.”

The specific timetable, Mr. Johnson said, will hinge on four factors: the continued success of the vaccine rollout; evidence that vaccines are reducing hospital admissions and deaths; no new surge in cases that would tax the health service; and no sudden risk from new variants of the virus.

“At every stage,” the prime minister said, “our decisions will led by data, not dates.”

Mr. Johnson was scheduled to present the plan to the nation in an evening news conference, along with data that he said showed that the two main vaccines — from Pfizer and AstraZeneca — both reduced severe illness.

Mr. Johnson’s appearance in Parliament ended days of speculation about the government’s timetable. But it is likely to kindle a new round of debate about whether Mr. Johnson is easing restrictions fast enough.

With pubs and restaurants not allowed to offer indoor service until May, some members of Mr. Johnson’s Conservative Party are likely to revive their pressure campaign to lift the measures more quickly.

Mr. Johnson, however, appears determined to avoid a repeat of his messy reopening of the economy last May after the first phase of the pandemic.

Then, the government’s message was muddled — workers were urged to go back to their offices but avoid using public transportation — and some initiatives, like subsidizing restaurant meals to bolster the hospitality industry, looked reckless in hindsight.

Under Mr. Johnson’s plan, the current coronavirus restrictions would be lifted in four steps, with a gap of five weeks between steps. That way, the government would have four weeks to analyze the impact of each relaxation and another week’s notice of the changes to the public and businesses.

All the moves would be made throughout England, with no return to the regional differences in rules that applied last year, depending on local infection rates. The government warned that the dates specified are the earliest at which the restrictions would be lifted, and that the steps may happen later.

When students go back to school, they will be regularly tested for the virus while older pupils will be required to wear face masks. Those living in nursing homes will be allowed one regular visitor, but few other restrictions will be lifted.

Starting on March 29, up to six people would be allowed to meet outdoors, including in gardens. Outdoor sports will be permitted and though people will be urged to stay in their areas, they will not be urged to remain in their homes.

Then, no earlier than April 12, retail shops will reopen, along with hairdressers, beauty salons, gyms, museums, and libraries, while people will be able to eat and drink outside in pub and restaurant gardens in small groups.

Starting on May 17, up to six people, and groups drawn from two households, will be able to meet indoors, including in pubs and restaurants. Hotels will also be able to reopen and spectators will be allowed into sporting events in limited numbers.

Restrictions on foreign travel could also be eased, though that will be addressed by one of several policy reviews being launched by the government. These will also focus on the possible use of vaccine passports to help open up the economy, and on guidance and rules on social distancing measures such as the use of face masks.

United States › United StatesOn Feb. 21 14-day change
New cases 55,195 –44%
New deaths 1,247 –32%
World › WorldOn Feb. 21 14-day change
New cases 292,003 –20%
New deaths 5,729 –25%

U.S. vaccinations ›

Where states are reporting vaccines given

When movie theaters reopen in New York City, masks will be mandatory, and theaters must assign seating to patrons to guarantee proper social distancing.Credit…Angela Weiss/Agence France-Presse — Getty Images

Movie theaters in New York City will be permitted to open for the first time in nearly a year on March 5, Gov. Andrew M. Cuomo announced at a news conference on Monday.

The theaters will only be permitted to operate at 25 percent of their maximum capacity, with no more than 50 people per screening. Masks will be mandatory, and theaters must assign seating to patrons to guarantee proper social distancing. Tests for the virus will not be required.

Movie theaters were permitted to open with similar limits in the rest of the state in late October, but New York City was excluded out of concern that the city’s density would hasten the spread of the virus there.

The virus has battered the movie theater industry. In October, the owner of Regal Cinemas, the second-largest cinema chain in the United States, temporarily closed its theaters as Hollywood studios kept postponing releases and cautious audiences were hesitant to return to screenings. AMC, the world’s largest movie theater chain, has increasingly edged toward bankruptcy.

The economic effects of the pandemic have been particularly felt in New York City, one of the biggest movie markets in the United States. Theaters in the city closed in mid-March, as the region was becoming an epicenter of the pandemic in the country.

While other indoor businesses, including restaurants, bowling alleys and museums had been allowed to open in the city, Mr. Cuomo had kept movie theaters closed out of concern that people would be sitting indoors in poorly-ventilated theaters for hours, risking the further spread of the virus.

Theaters that open will be required to have enhanced air filtration systems. Public health experts say when considering indoor gatherings, the quality of ventilation is key because the virus is known to spread more easily indoors.

Mr. Cuomo’s announcement was applauded by the National Association of Theater Owners.

“New York City is a major market for moviegoing in the U.S.; reopening there gives confidence to film distributors in setting and holding their theatrical release dates, and is an important step in the recovery of the entire industry,” the association said in a statement.

The move came just days after Mr. Cuomo said that indoor family entertainment centers and places of amusement could reopen statewide, at 25 percent maximum capacity, on March 26. Outdoor amusement parks will be allowed to open with a 33 percent capacity limit in April.

The governor also said that the state was working on guidelines to allow pool and billiards halls to reopen after the state lost a lawsuit from pool hall operators. Those establishments will be allowed to reopen at 50 percent capacity with masks required, he said.

Cases in New York remain high despite climbing down from its January peak. Over the last seven days, the state averaged 38 cases per 100,000 residents each day, as of Sunday. That is the second-highest rate per capita of new cases in the last week in the country, after South Carolina.

Preparing a dose of the Moderna vaccine this month at a community center in the Bronx.Credit…James Estrin/The New York Times

The Food and Drug Administration said on Monday that vaccine developers would not need to conduct lengthy randomized controlled trials to evaluate vaccines that have been adapted to target concerning coronavirus variants.

The recommendations, which call for small trials more like what’s required for annual flu vaccines, would greatly accelerate the review process at a time when scientists are increasingly anxious about how the variants might slow or reverse progress made against the virus.

The guidance was part of a slate of new documents the agency released on Monday, including others addressing how antibody treatments and diagnostic tests might need to be retooled to respond to the virus variants. Together, they amounted to the federal government’s most detailed acknowledgment of the threat the variants pose to existing vaccines, treatments and tests for the coronavirus and come weeks after the F.D.A.’s acting commissioner, Dr. Janet Woodcock, said the agency was developing a plan.

“We want the American public to know that we are using every tool in our toolbox to fight this pandemic, including pivoting as the virus adapts,” Dr. Woodcock said in a statement Monday.

Most of the vaccine manufacturers with authorized vaccines or candidates in late-stage trials have already announced plans to adjust their products to address the vaccine variants. The Moderna and Pfizer-BioNTech vaccines use mRNA technology that the companies have said can be used to alter the existing vaccines within six weeks, although testing and manufacturing would take longer.

Moderna has already begun developing a new version of its vaccine that could be used as a booster shot against a virus variant that originated in South Africa, known as B.1.351, which seems to dampen the effectiveness of the existing vaccines.

A fast-spreading coronavirus variant first observed in Britain has also gained a worrisome mutation that could make it harder to control with vaccines. That variant with the mutation was found in the United States last week.

Still, the guidance did not appear to be written with the assumption that new vaccines were imminent, or would be needed at all. Despite the recent indications that some variants — and particularly B.1.351 — make the currently authorized vaccines less effective, the shots still offer protection and appear to greatly reduce the severity of the disease, preventing hospitalizations and death.

An updated Covid-19 vaccine can skip the monthslong process of a randomized clinical trial that would compare it with a placebo, the agency said. But a tweaked vaccine will still need to go undergo some testing. In trials proposed by the F.D.A., researchers will draw blood from a relatively small group of volunteers who have been given the adapted vaccine. Scientists will then observe what percentage of volunteers’ samples produce an immune response to the variants in the lab, and how large that response is. The vaccines will be judged acceptable if they produce an immune response that is relatively close to what is prompted by the original vaccines.

The volunteers will also be monitored carefully for side effects. The agency said the testing can be done in a single age group and then extrapolated to other age groups.

The guidance also encouraged the use of animal studies to support the case for modified vaccines, in case immune response studies come up with ambiguous conclusions.

The F.D.A. acknowledged that many questions remain unanswered, such as what type of data would trigger the need for an adapted vaccine and who would make that decision. The agency also noted that scientists have not yet determined what level of antibodies in a vaccinated person’s blood would protect someone from the virus.

Some other vaccines are regularly updated in a similar way. Because the influenza virus evolves rapidly from one year to the next, vaccine developers have to come up with new recipes annually.

The newly tweaked Covid-19 vaccines would be authorized under an amendment to the emergency authorization granted to the original vaccine, regulators said.

Patricia Carrete, a nurse, during a night shift at a field hospital in Cranston, R.I., this month.Credit…David Goldman/Associated Press

The number of Americans hospitalized for Covid-19 is at its lowest since early November, just before the surge that went on to ravage the country for months.

There were 56,159 people hospitalized as of Feb. 21, according to the Covid Tracking Project. That’s the lowest since Nov. 7. It’s a striking decline for a nation that is approaching 500,000 total deaths and once had some of the world’s worst coronavirus hot spots.

On Monday evening, President Biden and Vice President Kamala Harris plan to have a moment of silence for the hundreds of thousands of Americans who have died from Covid-19.

While deaths remain high, because it can take weeks for patients to die from Covid-19, the number of U.S. hospitalizations has steadily and rapidly declined since mid-January, when the seven-day average reached about 130,000, according to a New York Times database. Experts attributed that peak to crowds gathering indoors in colder weather, especially during the holidays, when more people traveled than at any other time during the pandemic.

Experts have pointed to a variety of explanations for why the country’s coronavirus metrics have been improving over the past few months: more widespread mask use and social distancing after people saw friends and relatives die, better knowledge about which restrictions work, more effective public health messaging, and, more recently, a growing number of people who have been vaccinated. The most vulnerable, like residents of nursing homes and other elderly people, were among the first to receive the vaccine.

While scientists hope the worst is behind us, some warn of another spike in cases in the coming weeks, or a “fourth wave,” if people become complacent about masks and distancing, states lift restrictions too quickly or the more contagious variants become dominant and are able to evade vaccines.

The change can be felt most tangibly in intensive care units: Heading into her night shift in the I.C.U. at Presbyterian Rust Medical Center in Rio Rancho, N.M., Dr. Denise A. Gonzales, the medical director, said she had seen a difference in her staff.

“People are smiling. They are optimistic,” she said. “They’re making plans for the future.” During the worst of the crisis, “working in such a highly intense environment where people are so sick and are on so much support and knowing that statistically very few are going to get better — that’s overwhelming.”

Though the winter wave that hit her hospital system was “twice as bad” as the summer surge, she said it seemed more manageable because hospitals had prepared to move patients around, staff had more knowledge about P.P.E. and treatment therapies, and facilities had better airflow.

At the CoxHealth hospital system in Springfield, Mo., there was a “moment of celebration” as staff emptied the emergency Covid-19 I.C.U. wing built last spring. “We have not defeated this disease,” said Steve Edwards, the system’s chief executive. “But the closing of this unit, at least for now, is a tremendous symbolic victory.”

Staff members wearing biohazard suits and heavy-duty masks were pictured in a rare occasion of relief and joy that Mr. Edwards shared on Twitter.

This is a moment of celebration as we vacated the emergency Covid ICU. Our number of Covid patients at Cox South has dropped to 43, and only 5 critical. We are mindful of future worries, but for now, HERE COMES THE SUN! pic.twitter.com/57t2TvWweB

— Steve Edwards (@SDECoxHealth) February 18, 2021

Dr. Kyan C. Safavi, the medical director of a group that tracks Covid-19 hospitalizations at Massachusetts General Hospital in Boston, said the number of newly admitted patients has dropped sharply. The hospital is admitting about 10 to 15 new patients daily, a decline of about 50 percent from early January, Dr. Safavi said.

“Everybody’s physically exhausted — and probably a little bit mentally exhausted — but incredibly hopeful,” Dr. Safavi said.

Preparing a dose of the AstraZeneca-Oxford vaccine in Edinburgh this month.Credit…Pool Photo by Jane Barlow, via AFP–Getty Images

The first studies of Britain’s mass inoculation program showed strong evidence on Monday that the coronavirus vaccines were working as intended, offering among the clearest signs yet that the vaccines slash the rate of Covid-19 hospital admissions and may be reducing transmission of the virus.

A single dose of either the AstraZeneca vaccine or the one made by Pfizer could avert most coronavirus-related hospitalizations, the British studies found, though researchers said it was too early to give precise estimates of the effect.

The findings on the AstraZeneca shot, the first to emerge outside of clinical trials, represented the strongest signal yet of the effectiveness of a vaccine that much of the world is relying on to end the pandemic.

And separate studies of the Pfizer vaccine offered tantalizing new evidence that a single shot may be reducing the spread of the virus, showing that it prevents not only symptomatic cases of Covid-19 but also asymptomatic infections.

The findings reinforced and went beyond studies out of Israel, which has also reported that the vaccine developed by Pfizer and BioNTech offered significant protection from the virus in real-world settings, and not only in the clinical trials held last year. No other large nation is inoculating people as quickly as Britain, and it was the first country in the world to authorize and begin using both the Pfizer shot and the one developed by AstraZeneca and the University of Oxford.

The studies released on Monday — two on the Pfizer shot and one on it and the AstraZeneca injection — showed both vaccines were effective against the more infectious coronavirus variant that has taken hold in Britain and spread around the world.

“Both of these are working spectacularly well,” said Aziz Sheikh, a professor at the University of Edinburgh who helped run a study of Scottish vaccinations.

Still, the findings contained some cautionary signs. And even as British lawmakers cited the strength of the vaccines in announcing a gradual loosening of lockdown restrictions, government scientists warned that many more people needed to be injected to prevent cases from spreading into vulnerable, vaccinated groups and occasionally causing serious disease and death.

A boom in gym memberships is likely as soon as people are sure it’s safe.Credit…Alyssa Schukar for The New York Times

The U.S. economy remains mired in a pandemic winter of shuttered storefronts, high unemployment and sluggish job growth. But attention is shifting to a potential post-Covid boom.

Forecasters have always expected the pandemic to be followed by a period of strong growth as businesses reopen and Americans resume their normal activities. But in recent weeks, economists have begun to talk of something stronger: a supercharged rebound that brings down unemployment, drives up wages and may foster years of stronger growth.

There are hints that the economy has turned a corner: Retail sales jumped last month as the latest round of government aid began showing up in consumers’ bank accounts. New unemployment claims have declined from early January, though they remain high. And measures of business investment have picked up.

Economists surveyed by the Federal Reserve Bank of Philadelphia this month predicted that U.S. output would increase 4.5 percent this year, which would make it the best year since 1999. Some expect an even stronger bounce: Economists at Goldman Sachs forecast that the economy would grow 6.8 percent this year and that the unemployment rate would drop to 4.1 percent by December, a level that took eight years to achieve after the last recession.

“We’re extremely likely to get a very high growth rate,” said Jan Hatzius, Goldman’s chief economist. “Whether it’s a boom or not, I do think it’s a V-shaped recovery,” he added, referring to a steep drop followed by a sharp rebound.

The growing optimism stems from several factors. Coronavirus cases are falling in the United States. The vaccine rollout is gaining steam. And largely because of trillions of dollars in federal help, the economy appears to have made it through last year with less structural damage than many people feared last spring.

Consumers are also sitting on a trillion-dollar mountain of cash, a result of months of lockdown-induced saving and rounds of stimulus payments.

“There will be this big boom as pent-up demand comes through and the economy is opening,” said Ellen Zentner, chief U.S. economist for Morgan Stanley. “There is an awful lot of buying power that we’ve transferred to households to fuel that pent-up demand.”

Even if there is a strong rebound, however, economists warn that not everyone will benefit.

Standard economic statistics like the unemployment rate and gross domestic product could mask persistent challenges facing many families, particularly the Black and Hispanic workers who have borne the brunt of the pandemic’s economic pain. That could lead Congress to pull back on aid when it is still needed.

Gov. Philip D. Murphy of New Jersey will allow 10 percent seating capacity at indoor sports and entertainment venues with 5,000 or more seats, and 15 percent at outdoor venues.Credit…Mike Stobe/Getty Images

New Jersey, home to several major league sports teams, will allow a limited number of fans to attend sports and entertainment events at venues with 5,000 or more seats as soon as next week, Gov. Philip D. Murphy said on Monday.

Indoor venues will be limited to 10 percent of their seating capacity, while outdoor venues will be limited to 15 percent capacity, Mr. Murphy said in a radio interview on WFAN. The events can begin next Monday at 6 a.m.

Mr. Murphy’s announcement comes two weeks after a similar decision by New York’s governor, Andrew M. Cuomo, whose plan allowed fans at venues with 10,000 or more seats starting this week, provided that seating is limited to 10 percent of the venue’s capacity.

Mr. Cuomo’s announcement covered several New York City-area sports franchises, like the Nets, Knicks, Rangers and Islanders, which can begin to have fans in the stands as soon as Tuesday. Attendees in New York have to show proof of a negative P.C.R. test for the coronavirus taken within 72 hours of the event.

Mr. Murphy said that New Jersey would not require test results, but people at the venues will be required to wear face coverings at games and remain socially distanced. Public health experts say when considering indoor gatherings, the quality of ventilation is key because the virus is known to spread more easily indoors.

Cases in New Jersey, while still high, are now on the decline, nearing levels reported in early November. Over the last seven days the state averaged 33 cases per 100,000 residents each day, as of Sunday. That was the third-highest rate per capita of new cases in the last week, after New York and South Carolina.

The governor’s announcement will allow his state’s pro hockey team, the Devils, to play home games starting next Tuesday, the team’s first home game after the change takes effect.

“This is a day toward which our entire staff has been planning, working, and looking forward to for the past 11 months,” said the team’s president, Jake Reynolds, in a statement.

The state also has two pro football teams, the Giants and the Jets; a Major League Soccer team, the Red Bulls; and a National Women’s Soccer League franchise, Sky Blue F.C. Mr. Murphy said he hoped those teams would still be able to have fans when their seasons began later this year.

“I’ll be shocked if we’re not at a higher level of capacity for Jets, Giants, Rutgers football, you name it, as we get into the summer and fall,” Mr. Murphy said.

Several other states have already permitted sports fans inside venues during the pandemic, especially at outdoor stadiums for football and baseball. But Mr. Cuomo and Mr. Murphy had resisted until December, when Mr. Cuomo worked with the N.F.L. to allow a limited number of fans at a Buffalo Bills playoff game in their open-air stadium.

Mr. Murphy also said that New Jersey would start to allow parents and guardians to watch their children play both indoor and outdoor college sports, provided venues meet capacity limits, on Monday. The state reopened high school sports to parents earlier this month, with indoor attendance limited to 35 percent or 150 people.

New Jersey will also allow houses of worship and religious services to operate at 50 percent capacity effective Monday, the governor said. The limit is an increase from the previous cap of 35 percent maximum capacity up to 150 people.

Alison Saldanha contributed reporting.

Bernard Gonzalez, a regional official, announced new restrictions for the French Riviera on Monday. The area has the country’s highest infection rate.Credit…Valery Hache/Agence France-Presse — Getty Images

The French Riviera, the famed strip along the Mediterranean coast that includes jet-setting hot spots like Saint-Tropez and Cannes, will be locked down over the next two weekends in an attempt to fight back a sharp spike in coronavirus infections.

France has been under a nighttime curfew since mid-January and restaurants, cafes and museums remain closed, but the government of President Emmanuel Macron has resisted putting a third national lockdown in place.

It has been a calculated gamble, with Mr. Macron hoping that he could tighten restrictions just enough to stave off a new surge of infections without resorting to the more severe rules in place in many other European countries.

The strategy has largely worked, but infection rates remain at a stubbornly high level of about 20,000 new cases per day. Officials have made it clear that the existing national restrictions would not be loosened and that more local lockdowns could be enforced in the coming days.

The French Riviera, which includes the city of Nice, has the country’s highest infection rate, and officials have grown increasingly alarmed as they surged to 600 cases per week per 100,000 residents — about three times the national rate.

“The epidemic situation has sharply deteriorated,” Bernard Gonzalez, a regional official for the Alpes-Maritimes area, said on Monday as he announced the lockdown, which will affect the coastal area between the cities of Menton and Théoule-sur-Mer.

Officials said that controls at the border with Italy, in airports and on roads would be toughened and that the police would carry out random coronavirus tests. New measures also include a closure of all larger shops and an acceleration of the vaccination campaign.

Infection rates surged as many French people flocked to the coast, attracted by the temperate Mediterranean weather as they sought to escape gloomy cities like Paris.

“We will be happy to receive lots of tourists this summer, once we win this battle,” Christian Estrosi, the mayor of Nice, said last week. “But it is better to have a period while we say ‘Do not come here, this is not the moment.’”

President John Magufuli of Tanzania in 2016. Having cast doubt on coronavirus vaccines and other measures to curb the spread of the pandemic, he is now changing course.Credit…Thomas Mukoya/Reuters

NAIROBI, Kenya — Officially, Tanzania has not reported a single coronavirus case since April 2020. According to government data, the country has had only 509 positive cases and 21 deaths since the start of the pandemic.

Almost no one believes those numbers to be credible. But they fit with President John Magufuli’s declaration that the pandemic was “finished.”

Now, facing criticism from the World Health Organization and skepticism from the public as Tanzanians take to social media to voice concern about a growing number of “pneumonia” cases, Mr. Magufuli is changing course and asking people to take precautions against the coronavirus and wear masks.

Speaking during a church service in the port city of Dar es Salaam, the president asked congregants to continue praying for the disease to go away but also urged them to follow “advice from health experts.”

In a statement released by his office, Mr. Magufuli said his government had never barred people from wearing masks but urged them to use only those made in Tanzania.

“The masks imported from outside the country are suspected of being unsafe,” the statement said.

Mr. Magufuli’s comments come a day after the director-general of the World Health Organization urged the country to start reporting coronavirus cases and share data.

Mr. Magufuli, 61, who was re-elected last October, has derided social distancing, publicized unproven treatments as a cure for the virus, questioned the efficacy of coronavirus testing kits supplied by the Africa Centers for Disease Control and Prevention and said that “vaccines don’t work.”

Yet health experts, religious entities and foreign embassies have issued warnings about the rising number of cases — and as deaths follow, the reality is harder to dismiss.

The vice president of the semiautonomous island of Zanzibar, Seif Sharif Hamad, died last week after contracting the virus, according to his political party. The United States Embassy in Tanzania also said in a statement it was “aware of a significant increase in the number of Covid-19 cases” since January.

Lawmakers are increasingly asking the health authorities to explain why so many people were dying from respiratory problems.

Speaking on Friday at the funeral of a government official, however, Mr. Magufuli said that citizens should put God first and not be instilled with fear about the virus.

“It is possible that we wronged God somewhere,” he said. “So let’s stand with God, my fellow Tanzanians.”

In his statement, the W.H.O. chief, Dr. Tedros Adhanom Ghebreyesus, said he had spoken to “several authorities” in the country about their plans to mitigate the spread of the coronavirus but had yet to receive any response.

“This situation remains very concerning,” he said.

The Biden inauguration’s memorial for the 400,000 lives lost to the coronavirus in the United States. On the day after his inauguration, President Biden said that the memorial would not be the country’s last and projected that “the death toll will likely top 500,000” in February.Credit…Todd Heisler/The New York Times

President Biden and Vice President Kamala Harris plan to have a moment of silence during a candle lighting ceremony at the White House this evening to remember the nearly 500,000 people in the country who have died from Covid-19. They will ask Americans to join them.

Mr. Biden will also call for lowering federal flags to half-staff for the next five days, when the number of deaths is expected to pass the somber milestone. About 100,000 of these deaths have occurred since Jan. 18.

“Tonight’s events, including the president’s remarks, will highlight the magnitude of loss at this milestone marked for the American people and so many families across the country,” Jennifer Psaki, the White House press secretary, said during a briefing Monday afternoon. “It will also speak to the power of the American people to turn the tide on this pandemic by working together, following public health guidelines and getting in line to be vaccinated as soon as they are eligible.”

Even as the number of deaths each day remains high, there are signs of improvement across the country. Since mid-January, the number of U.S. hospitalizations has steadily and swiftly declined. And the number of new cases has decreased more than 40 percent over the past two weeks and is down 70 percent since its high point on Jan. 8, according to a New York Times database.

Experts credit the declines, in part, to widespread mask-wearing, social distancing and vaccinations. About 12 percent of people in the country have received at least one vaccine dose, and about 5 percent are fully vaccinated.

Originally from Lebanon, Tarek Wazzan is against any vaccines. He is the owner of Lebanese Eatery, a restaurant in Port Richmond. Before the pandemic, Wazzan refused to vaccinate his children and subsequently was not able to send them to school so they are home-schooled.Credit…Kirsten Luce for The New York Times

Around the United States, the vaccine rollout has reflected the same troubling inequalities as the pandemic’s death toll, leaving Black, Latino and poorer people at a disadvantage. In New York City, home to more than three million immigrants from all over the world, data released last week suggests that vaccination rates in immigrant enclaves scattered across the five boroughs are among the city’s lowest.

This month, The New York Times interviewed 115 people living in predominantly immigrant neighborhoods about the rollout and their attitudes toward the vaccines.

Only eight people said they had received a shot. The interviews revealed language and technology roadblocks: Some believed there were no vaccine sites nearby. Others described mistrust in government officials and the health care system. Many expressed fears about vaccine safety fomented by news reports and social media.

The broader public may find it difficult to understand why people in communities ravaged by the coronavirus would be reluctant to line up to get vaccinated, said Marcella J. Tillett, the vice president of programs and partnerships at the Brooklyn Community Foundation.

“This is where there has been a lot of illness and death,” said Ms. Tillett, whose foundation is distributing funds to social service organizations for vaccine education and outreach. “The idea that people are just going to step out and trust a system that has harmed them is nonsensical.”

To be sure, thousands of immigrant New Yorkers have gotten vaccinated, navigating the system with patience, if not ease. Others have relied on social service organizations. BronxWorks recently held a five-day vaccine pop-up on the Grand Concourse in the Bronx, administering hundreds of shots each day.

To increase participation in immigrant enclaves and communities of color, the city has opened vaccine mega-sites at Yankee Stadium in the Bronx and Citi Field in Queens, which offer vaccinations to eligible residents of each borough. (There have been reports of suburbanites coming in to claim doses.)

The state is holding online “fireside chats” in several languages, opening new sites in Brooklyn and Queens, and continuing to bring pop-up sites to neighborhood organizations.

On Monday, Gov. Andrew M. Cuomo said that the Metropolitan Transportation Authority would boost bus service to the two new vaccine sites from public housing projects and community centers in Brooklyn and Queens to better serve Black, Latino and poorer New Yorkers who are most vulnerable to the virus.

Still, obstacles remain.

Bottles of disinfectant sit on a table at Hickory Hills Elementary School in Marietta, Ga.Credit…Audra Melton for The New York Times

Coronavirus clusters at six elementary schools in Georgia resulted from poor social distancing and, to a lesser extent, inadequate mask use by students, public health officials reported on Monday.

Teachers played a role in transmitting the virus in all but one of the clusters, and two of the clusters probably involved teacher-to-teacher transmission that was followed by teacher to student transmission, the study found.

Researchers from the Centers for Disease Control and Prevention examined nine clusters of three or more linked infections involving teachers and students in Cobb County, Ga., between Dec. 1 and Jan. 22, a period when the county, in suburban Atlanta, was experiencing a surge in cases.

Some 2,600 elementary school students — about 80 percent of the district’s total — were going to school in person at the time, and some 700 staff members were working in person.

The researchers identified transmission clusters involving 13 educators and 32 students at six schools in the county; some schools had more than one cluster.

In four of the nine clusters, an educator was identified as the index patient, or original source of infection. One cluster had a student as the index patient, and the researchers could not determine who the index patient was in the rest.

The study was limited in many ways, the investigators conceded. They said it was “challenging” to try to distinguish between infections acquired at school and those that were acquired in the community.

Some clusters may have been missed, they said, because almost half the people who were identified through contact tracing as having possibly been exposed refused to be tested.

Because infected adults are more likely to have symptoms and be tested, teachers may have been identified more frequently than students as index cases, the researchers said, while instances of student-to-student or student-to-teacher transmission may have gone undetected.

Even so, the authors said, their findings were consistent with studies in other countries. One in Britain found that transmission at schools happened most often from teacher to teacher; a German study found that in-school transmission rates were three times as high when the cluster began with an educator, rather than a student.

The C.D.C. investigators urged teachers to follow precautions to prevent coronavirus infection when they are not in school, and to limit their interactions with colleagues at meetings and over lunch.

They also called for teachers to be vaccinated. “Although not a requirement for reopening schools, adding Covid-19 vaccination for educators as an additional mitigation measure, when available, might serve several important functions, including protecting educators at risk for severe Covid-19 associated illness, potentially reducing in school SARS-CoV-2 transmission and minimizing interruption to in-person learning,” the researchers said.

People waiting to receive the Moderna vaccine in San Diego last month.Credit…Ariana Drehsler for The New York Times

A coronavirus testing campaign in San Francisco has found more evidence that a variant first observed in California may be more contagious.

Looking at more than 600 cases in one of the city’s predominantly Latino communities, scientists found that the proportion of virus samples carrying this variant greatly increased from late November to late January.

Although the study was relatively small, and no one knows whether the variant affects the effectiveness of vaccines, “this is not the time to let down the guard,” said Joe DeRisi, the co-president of the Chan Zuckerberg Biohub and one of the scientists involved in the new study. A more contagious variant could threaten to reverse the decline in cases seen over the past couple of months in California and elsewhere.

The results were announced on Monday by the University of California at San Francisco, which carried out the research in collaboration with the ​Chan Zuckerberg Biohub, the Chan Zuckerberg Initiative, and the ​Latino Task Force for Covid-19. The data have not yet been published.

The variant first came to light on Jan. 17, when the California Department of Public Health reported that it had become noticeably common in several communities across the state. The variant, which has gone by several names, is now known as B.1.429.

The variant might have become common in one of two ways. It might be more contagious, or it might simply have gone through a superspreading event, fueling its spread. “Just by random chance, a bad wedding or choir practice can create a large frequency difference,” Dr. DeRisi said.

Soon after the announcement, researchers at the Cedars-Sinai Medical Center in Los Angeles reported that B.1.429 was rapidly becoming more common around that city. But those findings were based on a limited sample of just 185 coronavirus genomes that had been fully sequenced.

To get more samples, Dr. DeRisi and his colleagues focused their efforts on the predominantly Latino community in the Mission District neighborhood. There they have been running a community testing program since last April, called Unidos en Salud​.

Looking at their samples from late November, the researchers found that 16 percent of the coronaviruses belonged to B.1.429. By January, after sequencing 630 genomes, the team found 53 percent were B.1.429.

Because the researchers were running their tests in a community, they could investigate how the B.1.429 variant spread from person to person. In some cases, entire families came to get tested. In other cases, the researchers followed up on positive tests to ask if they could test other people in the same household. The researchers studied the spread of B.1.429 and other variants in 326 households.

The researchers found that B.1.429 was more likely to spread among people living in the same house than other variants were. People had a 35 percent chance of getting infected if someone else in their home was infected with the B.1.429 variant. If the person was infected with another variant, the rate was only 26 percent.

“What we see is a modest, but meaningful difference,” Dr. DeRisi said.

A vaccination center in Sofia, Bulgaria, on Monday. Officials said they had set a goal of administering 10,000 shots a day.Credit…Vassil Donev/EPA, via Shutterstock

When vaccines arrived this winter in Bulgaria, which had one of the highest excess mortality rates in Europe, the authorities hoped people would clamor for a shot.

Instead, they were greeted by many with a shrug and skepticism.

Just 1.4 percent of the nation’s seven million people have been inoculated with the first dose, according to the European Center for Disease Prevention and Control.

The rollout of mass vaccination programs has been slow in many parts of Europe, but Bulgaria is lagging even further behind.

In an effort to speed up progress, Prime Minister Boiko Borisov called for “green corridors” allowing anyone who wanted a vaccination to get one, regardless of whether they were in a priority group under the country’s vaccination plan.

The goal was to administer around 10,000 shots per day, he said. The reaction appears to be better than expected: The lines evoked the period of communist rule, when people would spend hours waiting to get basic supplies like oil or meat.

Since Friday, 30,000 people received their first vaccination, according to data provided by the health ministry.

In comparison, around 120,000 total doses have been administered since vaccination campaign began in December.

Apostol Dyankov, a 38-year-old environmental expert in Sofia, received his shot on Sunday.

“I spent the weekend, browsing Twitter to figure out where this was for real,” he said. “The news was so unexpected that I couldn’t believe it’s actually happening. The lines I saw on the news reminded me of socialist times, when a store would receive a shipment of bananas.”

Donka Popopa, an owner of a construction business, described a chaotic scene at a vaccination site in Plovdiv, the country’s second-largest city, where medical workers were vaccinating all comers.

“We waited for several hours, even though we were told to come in the morning,” she said, adding that it had been difficult to figure out whether and when her employees were eligible for vaccination.

The health minister, Kostadin Angelov, told reporters in Sofia on Sunday that the turnout was a triumph.

“I would like to thank all the people who believed in science,” he said. “To those who have not been vaccinated, I would like to say something loud and clear: Bulgarians, hope is in your hands, the decision is yours. Please, trust the science, trust the doctors.”

Officials acknowledge, however, that maintaining the early burst of enthusiasm will be a challenge.

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FDA says photographs for brand spanking new variants will not want giant medical trials

Erick Vazquez receives the Pfizer vaccine during an event to vaccinate approximately 500 healthcare workers and adults over 65 years of age against COVID-19 organized by Labor Community Services, the Los Angeles Federation of Labor, and the St. Johns Well Child and Family Center shaped work of love, in Pico Union, February 13, 2021 in Los Angeles, CA.

Dania Maxwell | Los Angeles Times | Getty Images

The Food and Drug Administration announced Monday that modified Covid-19 vaccines against new, emerging variants can be approved without the need for lengthy clinical trials.

The new guidelines, published in a 24-page document on the FDA’s website, would release the new vaccines as an amendment to a company’s originally approved emergency application, according to the FDA. The company would have to submit new data showing the modified vaccine produces a similar immune response and is safe, similar to annual flu vaccines.

“Preliminary reports from clinical trials evaluating COVID-19 vaccine candidates in several countries, including South Africa, have contributed to concerns that the vaccine may be less effective against variant B.1.351 than against the original virus,” the wrote Agency found in the document with reference to the strain in South Africa. “Therefore, there is an urgent need to initiate the development and evaluation of vaccines against these SARSCoV-2 variants.”

The updated guidelines come because U.S. health officials, including White House Chief Medical Officer Dr. Anthony Fauci, fear the virus could potentially mutate enough to evade the protection of current vaccines and reverse advances in the pandemic.

For the past few weeks, officials have urged Americans to get vaccinated as soon as possible before potentially new and even more dangerous variants of the virus emerge.

As of Sunday, the Centers for Disease Control and Prevention had identified 1,661 cases of variant B.1.1.7, which were first identified in the UK. The agency has identified 22 cases of the B.1.351 strain from South Africa and five cases of P.1, a variant first identified in Brazil.

The FDA approved Pfizer and Moderna’s emergency vaccines in December, and the two drug makers have since announced plans to change their vaccines to target new variants. The guidelines could speed up the regulatory review process for the vaccines.

Public health officials and infectious disease experts said there was a high chance that Covid-19 would become an endemic disease, meaning it will never go away completely, although it will likely spread at lower levels than it is now. Health officials must constantly look for new variants of the virus so scientists can make vaccines against them, medical experts say.

Richard Webby, director of a World Health Organization flu center at St. Jude Children’s Research Hospital, said the clearance process for modified Covid-19 vaccines may be very similar to the procedure for annual flu shots.

The U.S. and other nations need to step up their surveillance of new tribes and then make regular recommendations as to which variants to target, he said in a recent interview. “It’s not there for Covid at the moment.”

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C.D.C. Publicizes $200 Million ‘Down Cost’ to Observe Virus Variants

When lawmakers asked billions of dollars to fund the country’s efforts to prosecute coronavirus variants, the Biden government on Wednesday announced new efforts to advance that work, pledging nearly $ 200 million to help the emerging ones Better identify threats.

Calling it a “down payment,” the White House said the investment would result in a significant increase in the number of positive virus samples that labs could sequence. Laboratories, universities and public health programs run by the Centers for Disease Control and Prevention sequenced more than 9,000 genomes last week, according to the GISAID database. The agency hopes to increase its own contribution to 25,000 genomes per week.

“When we reach 25,000 depends on the resources we have and how quickly we can mobilize our partners,” said Dr. Rochelle Walensky, CDC director, at a press conference at the White House on Wednesday. “I don’t think this will be a light switch. I think it will be a dial. “

The program is the administration’s most significant effort to date to address the looming threat of more contagious variants of the virus. An affected variant, first identified in the UK, has infected at least 1,277 people in 42 states, though scientists suspect the actual number is significantly higher.

Variant B.1.1.7 developed in the UK, which doubles roughly every 10 days, threatens to slow down or reverse the rapid decline in new coronavirus cases. In addition, Dr. Walensky that the nation saw their first case of B.1.1.7, which received a particularly worrying mutation that was shown in South Africa to affect vaccine effectiveness.

Other worrisome variants have also surfaced in the US, including one first found in South Africa that weakens vaccines.

The FDA is preparing a possible redesign of vaccines to provide better protection against the new variants. However, this effort will take months. In the short term, experts say, it is important to increase the sequencing effort, which is too small and uncoordinated to adequately track where and how quickly variants are spreading.

Scientists welcomed the Biden administration’s new plans. “It’s a big step in the right direction,” said Bronwyn MacInnis, geneticist at the Broad Institute.

Dr. MacInnis said the “minimum gold standard” would sequence 5 percent of the virus samples. If cases continued to drop, 25,000 genomes per week would bring the country near that threshold, she said, “where we need to be to detect not only known threats but emerging threats as well.”

Trevor Bedford, evolutionary biologist at the Fred Hutchinson Cancer Research Center, said the national sequencing effort had made “significant gains” since December. Still, he said the CDC also needs to make improvements in collecting data about the genomes – for example, to tie it to contact tracing information – and then support the large-scale analysis on computers that is needed to quickly understand everything .

“There’s too much focus on the raw count that we’re sequencing rather than the turnaround time,” he said.

White House officials occupied the sequencing attempt as part of a wider effort to test more Americans for the virus. The Department of Health and Human Services and the Department of Defense on Wednesday announced significant new investments in testing, including $ 650 million for elementary and middle schools and “underserved community facilities” like homeless shelters. The two divisions are also investing $ 815 million to expedite test supplies production.

The CDC’s $ 200 million sequencing investment is dwarfed by a program proposed by some lawmakers as part of an economic bailout package that Democratic Congress leaders want to pass before mid-March. Senator Tammy Baldwin, Democrat of Wisconsin, passed legislation to improve his sequencing efforts. House lawmakers have allocated $ 1.75 billion to the effort.

In an interview, Ms. Baldwin suggested that the government sequence 15 percent of positive virus samples, a goal that goes well beyond what researchers believe is possible in the short term.

“This is to create the basis for a permanent infrastructure that enables us not only to monitor Covid-19 in order to discover new variants, but also to have this ability for other diseases.” she said of her proposal. “There are significant gaps in knowledge.”

In an interview, Carole Johnson, the new testing coordinator for the Biden administration, said the $ 200 million investment was a “down payment” and just the beginning of what is likely to be a much more aggressive campaign to track the variants.

Updated

Apr. 20, 2021, 9:30 a.m. ET

“Here we can take a look: What resources are currently available to us? What can we find to act quickly? ” She said. “But you know that going forward we need bigger investments and a systematic way to get this job done.”

Since 2014, the CDC Office of Advanced Molecular Detection has been using genome sequencing to track diseases such as influenza, HIV, and food-borne diseases. When the coronavirus pandemic hit the United States, the CDC was slow to adapt these tools to track the coronavirus. For weeks it just struggled to create a test for the virus.

In contrast, the UK launched a highly acclaimed sequencing program last March that leveraged the nationalized health system with a central genomics laboratory. It now sequences up to 10 percent of all positive coronavirus tests and provides a thorough, quick analysis of the results.

The CDC began increased surveillance efforts later in 2020, helping academic laboratories, commercial sequencing companies, and public health departments to collaborate and share knowledge. In November, the company invested in its own program called NS3 to analyze coronavirus genomes. Every two weeks, the agency asks state health departments to send at least 10 samples to their laboratory for sequencing.

In December it became clear that these efforts would not be enough. Researchers in the UK found a new variant called B.1.1.7 that was up to 50 percent more transmissible than other variants. Scientists now suspect that it’s probably more deadly too. In South Africa, another variant called B.1.351 was found not only to be more contagious, but also to be less susceptible to multiple vaccines.

CDC officials began to fear that B.1.1.7 had already spread widely in the United States, according to a senior federal health official. They started new efforts, including contracts with laboratory testing companies to run coronavirus testing.

Dr. Gregory Armstrong, the director of the Advanced Molecular Detection Program, said in an interview that his team concluded in January that sequencing from 5,000 to 10,000 samples per week was a good short-term goal.

“It’s the starting point,” said Dr. Armstrong. “The more we sequence about it, the faster we can identify these variants.”

At a press conference at the White House earlier this month, Jeffrey D. Zients, the White House’s Covid-19 response coordinator, recognized how difficult it would be to achieve that goal.

“We are 43rd worldwide in genome sequencing – totally unacceptable,” he quoted December data from the GISAID database. In a subsequent interview, he corrected himself and said that the US stands behind 31 other nations.

In the early days of administration, Dr. Walensky set an initial goal for the CDC to sequence 7,000 genomes per month. Since then, laboratories have not come close to that number.

The agency’s National Genomic Surveillance Dashboard showed that only 96 genomes were logged for the week of February 6th. The following week the number rose to 1,382 genomes. Dr. Walensky’s new goal of 25,000 genomes per week calls for a significant increase.

Caitlin Rivers, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said it was a welcome development to invest $ 200 million quickly in surveillance variants before hoping for longer-term improvements. “Time is of the essence,” she said. “An initial investment in expanding genome monitoring while the complementary funding package comes together is a smart move.”

However, she warned that the plan could not be implemented immediately. It can take a month for the basic improvements to be achieved. By then, B.1.1.7 could already dominate US cases and jeopardize the current decline.

The larger program in the stimulus package will be critical to managing the pandemic in the long term, said Dr. Rivers.

“We may not be able to get very far on B.1.1.7, but what’s the next, in three months or six months or next winter?” She asked. “It’s not always just what’s in front of you. It’s what’s coming around the corner. “

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7 Virus Variants Present in U.S. Carrying the Identical Mutation

While Americans are excited to see variants that were first distributed in the UK and South Africa in the US, scientists are finding a number of new variants that originated here. What is even more worrying is that many of these flavors are moving in the same direction and potentially becoming contagious threats themselves.

In a study published on Sunday, a team of researchers reported seven growing lineages of the novel coronavirus discovered in states across the country. All of them have developed a mutation in the same genetic letter.

“There is clearly something wrong with this mutation,” said Jeremy Kamil, a virologist at Louisiana State University’s Shreveport Health Sciences Center and co-author of the new study.

It’s unclear whether it makes the variants more contagious. However, since the mutation occurs in a gene that affects the entry of the virus into human cells, scientists are very suspicious.

“I think there is a clear signature for an evolutionary benefit,” said Dr. Kamil.

The history of life is full of examples of what is known as convergent evolution, in which different lines follow the same path. Birds were given wings when they evolved from feathered dinosaurs, for example, just as bats did when they evolved from furry, shrew-like mammals. In both cases, natural selection resulted in a pair of flat surfaces that could be fluttered to create lift. So bats and birds alike could soar in the sky and fill an ecological niche that other animals couldn’t.

Charles Darwin first recognized convergent evolution by studying living animals. In recent years, virologists have found that viruses can also develop convergently. For example, HIV emerged when several types of virus were passed from monkeys and monkeys to humans. Many of these lines of HIV received the same mutations that made them adapt to our species.

While the coronavirus is now branching into new variants, researchers observe Darwin’s theory of evolution in action every day.

Dr. Kamil stumbled upon some of the new variants while sequencing samples from coronavirus tests in Louisiana. At the end of January he observed an unfamiliar mutation in a series of samples.

The mutation changed the proteins that examine the surface of the coronavirus. Known as spike proteins, they are folded chains of more than 1,200 molecular building blocks called amino acids. Dr. Kamil’s viruses all shared a mutation that changed the 677th amino acid.

When Dr. Kamil examined these mutant viruses, he found that they all belonged to the same lineage. The earliest virus in the line dates back to December 1st. It became more common in later weeks.

On the evening of his discovery, Dr. Kamil uploaded the genomes of the viruses to an online database used by scientists around the world. The next morning he received an email from Daryl Domman of the University of New Mexico. He and his colleagues had just found the same variant in their condition with the same 677 mutation. Your samples are from October.

The scientists wondered if the line they discovered was the only one that had a 677 mutation. Dr. Kamil and colleagues examined the database and found six other lineages that independently received the same mutation.

It is difficult to answer even basic questions about the prevalence of these seven lineages because the United States sequences genomes from less than 1 percent of coronavirus test samples. The researchers found samples from the lineages that were scattered across much of the country. But they cannot tell where the mutations first originated.

Updated

Apr. 14, 2021, 3:56 p.m. ET

“At the moment I would be quite reluctant to give a place of origin for one of these lines,” said Emma Hodcroft, epidemiologist at the University of Bern and co-author of the new study.

It’s also hard to tell if the increase in variants is actually due to their being more contagious. They might have become more frequent simply because of all the travel during the holiday season. Or they exploded during superspreader events in bars or factories.

Still, scientists are concerned because the mutation could plausibly affect how easily the virus gets into human cells.

Infection begins when a coronavirus uses the tip of the spike protein to attach itself to the surface of a human cell. It then releases harpoon-like arms from the base of the spike, pulls toward the cell, and supplies its genes.

Before the virus can make this invasion, however, the spike protein must encounter a human protein on the surface of the cell. After this contact, the spike is free to rotate, exposing its harpoon tips.

The 677 mutation changes the spike protein next to where our proteins cut into the virus, which may make it easier to activate the spike.

Jason McLellan, a structural biologist at the University of Texas at Austin who was not involved in the study, called it “an important advance.” But he warned that the way the coronavirus unleashed its harpoons was still pretty mysterious.

“It’s hard to know what these substitutions do,” he said. “There really needs to be some additional experimental data added.”

Dr. Kamil and his colleagues begin these experiments in the hope that the mutation actually makes a difference to infections. If the experiments confirm their suspicions, the 677 mutation will join a small, dangerous club.

Convergent evolution has transformed several other locations on the spike protein as well. For example, the 501st amino acid is mutated in a number of lineages, including the contagious variants first seen in the UK and South Africa. Experiments have shown that the 501 mutation changes the tip of the tip. This change allows the virus to attach itself more tightly to cells and infect them more effectively.

Scientists believe that coronaviruses will converge on more mutations that will give them an advantage – not just against other viruses, but also against our own immune system. However, Vaughn Cooper, an evolutionary biologist at the University of Pittsburgh and co-author of the new study, said laboratory experiments alone could not reveal the extent of the threat.

To really understand what the mutations are doing, scientists need to analyze a much larger sample of coronaviruses from across the country. Currently, however, they can only look at a relatively small number of genomes collected from a patchwork of government and university laboratories.

“It is ridiculous that our country is not developing a national strategy for surveillance,” said Dr. Cooper.

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CDC revises faculty reopening steerage, warns that Covid variants might trigger points

The Centers for Disease Control and Prevention presented comprehensive new guidelines on Friday on how schools can be safely reopened for personal learning despite the spread of the coronavirus and highly contagious new variants.

The 35-page guide advises schools to implement their reopening plans based on the severity of the outbreak in their areas. It is recommended that schools adopt three “essential elements” for resuming personal learning, including wearing masks, exercising physical distancing, and monitoring the level of spread in the surrounding community.

According to the CDC, schools should also implement a testing program as an “additional layer” of Covid-19 prevention to identify and isolate infectious people and vaccinate teachers and staff “as soon as supplies allow”.

“Data suggests that it is possible for communities to eradicate cases of COVID-19 while keeping schools open for face-to-face classes,” the guidelines read. “In addition, models of consistent implementation of mitigation measures in schools have shown that it is effective in limiting outbreaks and infections in schools.”

However, the agency noted that the guidelines may need to be updated as new, more contagious variants of the coronavirus spread across the U.S.

“In the event of increased community transmission due to a variant of SARS-CoV-2, updates to these guidelines may be necessary,” said the agency.

The CDC said the first step in considering whether schools should reopen is to assess the rate of spread in the community. The agency recommended schools to monitor the total number of new cases per 100,000 residents in the community in the past seven days, as well as the percentage of positive tests in the past seven days, also known as the positivity rate.

According to the CDC, all schools can be safely reopened to full face-to-face learning if they follow appropriate protocols and are in communities that have reported fewer than 50 new cases per 100,000 residents in the past seven days and have a positivity rate below 8% lies . It is possible for schools in communities with higher prevalence in some days or with limited attendance and stricter infection prevention measures to reopen to face-to-face learning, according to the CDC.

“If municipalities implement mitigation strategies and strictly adhere to them, the level of transmission by the municipalities will be slowed down,” the new guidelines say. “This in turn will allow schools that are open to face-to-face learning to stay open and schools that have not yet reopened will help them return to face-to-face teaching.”

The CDC found that younger children may be less prone to Covid-19 than older middle and senior school aged children. It said schools should give priority to bringing back elementary school students who are the least likely to get Covid-19 and who appear to be less likely to spread the virus than teenagers.

And the CDC urged school administrators and local officials to “provide fair access to a healthy educational environment for all students and staff.” White House Covid-19 response officials said justice is the “north star” for federal response to the pandemic.

“The lack of personal educational opportunities can put children of all origins at a disadvantage, especially children in communities with limited resources who may be at an educational disadvantage,” the new guidelines state. “On the other hand, certain racial and ethnic groups have borne a disproportionate burden of disease and grave consequences from COVID-19.”

The agency said school districts should take an active role in helping underserved families, “including parents / guardians of color students, low-income students, students with disabilities, English learners, students with homelessness and students in foster care”.

CDC director Dr. Rochelle Walensky and Donna Harris-Aikens, senior policy and planning advisor at the Department of Education, announced the new guidelines in a conference call with reporters.

The new guide comes after Walensky said last week that schools can safely reopen even if teachers haven’t been vaccinated. The White House quickly distanced itself from the comment. Press secretary Jen Psaki said it was not an “official guide” from the CDC.

President Joe Biden has made reopening the country’s schools for personal teaching a top priority. He promised in December that he would resume face-to-face tuition in most schools in the country for the first 100 days of taking office, but Biden did not define what it means for a school to “reopen”.

In January, he said the target only applies to schools teaching students through eighth grade. Earlier this week, the White House further clarified that schools are considered open as long as they teach in person at least one day a week. Psaki said Wednesday the target is part of the White House’s “bold, ambitious agenda”, adding that it is a floor the government hopes to cross.

“His goal is for the majority of schools, more than 50%, to be open by the 100th day of his presidency,” she said. “And that means some lessons in classrooms. So at least one day a week. Hopefully it’s more.”

In-person education came to an abrupt halt across the country in March as schools switched to distance learning to protect students, teachers and parents from the coronavirus. However, education experts and public health groups, including the World Health Organization, have warned of the permanent consequences of keeping students out of the classroom. Economists have also warned of the impact on working parents, especially mothers, who have lost record numbers of jobs during the pandemic.

Former President Donald Trump urged governors and local officials to reopen schools for personal learning, saying in July that closing schools will likely cause “more deaths”. However, under his administration, the CDC gave little guidance on how and when to safely reopen, saying instead that the decision should be made by local and state officials.

In the USA the problem is controversial. Some say the risk of the coronavirus for children is lower than the consequences of missing school. While children and young adults in general are less likely to get seriously ill and die of Covid-19, the risk is increased if the person has an underlying condition that affects their immune system. According to the CDC, more than 120 people under the age of 20 died of Covid-19 in September in the United States.

Instead of a previously clear federal approach, state, local and school officials have all set their own course on how and when schools should reopen. Data from Burbio, a service tracking school opening plans, recently reported that nearly 65% ​​of K-12 students are already learning some degree in person.

This story will be updated during the day.

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Germany set to increase lockdown on issues over new coronavirus variants

Chancellor Angela Merkel wears a protective face mask when leaving the country after speaking to the media at her annual summer press conference in Berlin on August 28, 2020 during the coronavirus pandemic.

Anadolu Agency | Anadolu Agency | Getty Images

Chancellor Angela Merkel will announce that Germany will extend its lockdown until March 14, amid concerns about new strains of the coronavirus.

A draft document appeared early Wednesday setting out plans between Merkel and state officials to maintain the lockdown and urge citizens to maintain socially distant rules, but gradually lift some restrictions in the coming weeks.

The reopening of schools is a priority for the German leadership, although due to the federal system of the country the individual federal states can be expected to be able to decide how to do this. Stores and hotels could start reopening next month in areas where infection rates are also low. The restrictions should end on February 14th.

There are concerns in Germany about the spread of more contagious variants of the virus, particularly the mutation that was first discovered in the UK last fall. However, the daily number of new infections in Germany has fallen as public life continues to be blocked across the country.

The Robert Koch Institute, a public health institution, reported 8,072 new coronavirus cases and 813 deaths on Wednesday. This brought the total number of infections to around 2.3 million and the death toll to 62,969.

German lawmakers reportedly described the situation as “very fragile” on Wednesday.

Slow rollout of the EU

The slow introduction of coronavirus vaccines in Germany and the rest of the EU is a problem for the federal government, which is an important pillar of the bloc. The EU has been slower than the UK and US to order vaccines from major drug manufacturers and has faced supply shortages.

The longer the introduction of vaccinations, the longer the economic damage is expected from lockdowns. According to the GDP data published in January for the full year (gross domestic product), the German economy contracted by 5% in 2020.

Ludovic Subran, Allianz’s chief economist, told CNBC on Wednesday that the slow roll-out of vaccinations could seriously hurt the EU’s growth prospects in 2021.

“I’m getting a little nervous and we are only in February that we miss the boat here, that the vaccination is the best investment and we should put all our forces (efforts) there,” he told CNBC’s “Street Signs Europe”.

“Our projections show that Europe won’t return to pre-crisis (growth) levels until 2022. Then we saw the vaccination chaos and started thinking, ‘OK, we’re really jeopardizing the recovery here’ … the problem is we’re vaccinating four times here slower than the UK and US, “he said, adding,” This is really a big problem as it will make or break the 2021 GDP recovery for Europe. “

—CNBC’s Annette Weisbach contributed to this article.

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Faculties vowed a safer spring, however then college students, and variants, arrived.

With nearly a year of coronavirus experience, executives at many universities across the United States have ushered in the new phrase of pledging not to repeat the mistakes of last year as infection rates rose at the sites and in the surrounding communities.

While most schools have committed to increasing the number of tests, it is an expensive proposition at a time when many are struggling financially and not all students test as often as recommended by public health experts.

Plans to keep the virus under control, for example at the University of Michigan, which had more than 2,500 confirmed cases by the end of the fall semester, included increasing testing, more online classes, restricting dorms to one inmate, and offering none Tolerance for rule violations. The school has announced more than 1,000 new virus cases since January 1.

Other universities across the country have also encountered obstacles to a smooth springtime, including the unexpected challenge of emerging variants that have been held in recent days at the University of Texas at Austin, the University of Miami, Tulane University in New Orleans, and the University of California were discovered. Berkeley – and the more common problem of unruly students.

At Vanderbilt University in Nashville, students returning after the winter break had to be tested on arrival and were then asked to avoid social interactions while waiting for results. But some had other ideas.

“We have identified a group of positive Covid-19 cases associated with students who do not adhere to the rules for arriving on site,” reported a campus-wide email on January 23, in which two student organizations for the violation of protocols was held responsible. “More than 100 students are now in quarantine.”

The foundation of most spring semester university plans is on reinforced testing to identify infected students before they show symptoms and then place them in isolation. The test spike has increased since July, when a study recommended testing students twice a week to better identify asymptomatic infections.

The American College Health Association later adopted the idea and issued guidelines in December. “For spring, we strongly recommend that all students be tested on arrival and twice a week if possible thereafter,” said Gerri Taylor, co-chair of the organization’s Covid-19 task force.

Ms. Taylor said her organization didn’t know what percentage of schools had accepted the recommendations, and a survey of colleges across the country found a variety of requirements ranging from voluntary testing to mandatory testing twice a week.

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Physician predicts one other Covid surge amid presence of latest variants

Dr. Nahid Bhadelia, medical director of the Special Pathogens Unit at Boston Medical Center, told CNBC’s “The News with Shepard Smith” that she expects Covid infections to rise further as the new variants of the virus emerge in the US

“If I run into someone who has any of these variants, the more likely I will get the infection from them, and then again, much more likely that I will transmit it, which means we may have a lot.” more infections, “said Bhadelia during an interview on Monday evening.” And so you could see more infections in February, which then lead to more hospitalizations and deaths in March. “

The director of the Centers for Disease Control (CDC), Dr. Rochelle Walensky said Monday that the dangerous new variants of Covid “remain a major problem” even though cases are falling across the country. At least 32 states have reported cases of new strains of Covid discovered in the UK, Brazil and South Africa, according to the CDC. Health officials in Maryland reported the first case of the South African variant by the state over the weekend, making it the third known case of the strain in the United States

Dr. Anthony Fauci said Monday that vaccines are the best way to tackle the variants.

“Viruses can’t mutate if they can’t duplicate,” said Fauci.

Bhadelia, a medical worker for NBC News, said that while the vaccines are less effective than the new variants, they can protect people from more severe cases of the virus and overwhelming health systems.

“After 49 days, Johnson & Johnson still has 100% protection, 100% protection from major illness and hospitalization,” said Bhadelia. “Any vaccine that turns a disease from fatal to mild will keep people out of hospitals.”

The US vaccination efforts are slowly picking up speed, according to the CDC. In the past seven days, the number of people fully vaccinated in the US has increased 79%, and as of January 31, approximately 1.8% of all Americans were vaccinated.

In addition to vaccinations, the Biden government is working to make home testing more widely available to help slow the spread of Covid. Andy Slavitt, Senior Advisor to the White House’s Covid-19 Response Team, announced Monday that the country’s first over-the-counter Covid test at home will be available soon. “The test is conducted by a company called Ellume and is on a test platform developed as part of the NIH RADx initiative,” he said.

Bhadelia told host Shepard Smith that readily available rapid tests could have a significant impact in fighting the virus.

“People can be clear about whether or not they will get infected, and they could stay home, hopefully not travel, and all of these are ways we could prevent one person from transmitting to another,” Bhadelia said . “I think it will make a difference.”

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World News

World Covid-19 Reside Updates: Information on Vaccine, Variants, Stimulus and Circumstances

Here’s what you need to know:

Credit…Rory Doyle for The New York Times

Vaccinations in the United States are slowly picking up speed as the Biden administration pushes to accelerate inoculations and blunt the spread of more contagious virus variants.

The United States has administered about 30 million doses, and, as of Sunday, is averaging more than 1.3 million doses administered over the past seven days, compared with an average of less than one million per day two weeks earlier, according to a New York Times vaccine tracker.

President Biden, under pressure to speed up coronavirus vaccinations, has recently suggested the nation could soon reach an average of 1.5 million shots a day.

But just as there are signs of progress, another problem has taken root: the spread of the variants, which scientists warn must be contained before they become dominant. Several hundred cases of the more contagious variant discovered in Britain, which experts have said could be the dominant form in the United States by March, have already been confirmed.

The country has also recorded its first two cases of the variant spreading rapidly in South Africa, which has proved to reduce the effectiveness of vaccines.

“If we didn’t have these variants looming,” we would be in a good place, said Dr. Peter Hotez, a vaccine scientist and pediatrician at Baylor College of Medicine in Houston. If those variants take over by spring, “as many of us are predicting,” he said, “it changes everything. Now, we really have to vaccinate the American population by late spring, early summer.”

Two key challenges in the weeks ahead are “increasing the supply of vaccines” and “speeding up the time it takes to administer them,” Andy Slavitt, a White House adviser, said in a news briefing on Friday. Many experts have pushed for bringing other vaccine options out and releasing the first doses more widely.

The most effective state programs, said Dr. Ashish Jha, the dean of the Brown University School of Public Health, are “very simple, age-based, not a lot of complex rules. They focus on getting the vaccines out.”

Here is a snapshot of how five of the best-performing states are doing:

  • West Virginia has given at least one dose to 10.7 percent of its population, second only to Alaska, and leads the nation in the percentage of its population that has received two doses (3.7 percent). Early on, the state got a head start because it opted out of a federal program to vaccinate people in nursing homes and other long-term care facilities. While other states chose the federal plan, which teamed with Walgreens and CVS, officials decided the idea made little sense in West Virginia, where many communities are miles from the nearest chain store, and about half of pharmacies are independently owned. Instead the state created a network of pharmacies, pairing them with about 200 long-term care facilities.

  • According to health officials in Alaska, there are several reasons behind the state’s relatively high vaccination rate, The Anchorage Daily News has reported. Those factors include: the state’s having received a high number of doses through the Indian Health Service; the decision to receive doses monthly, versus weekly, as most states do; and declining virus caseloads, which has allowed health care workers to focus on inoculations. The state has vaccinated 13 percent of its population, according to a Times database.

  • North Dakota has used 91 percent of the vaccines distributed to the state, according to the Times vaccine tracker. It is the only state above 90 percent; more populous states like California (58 percent) and New York (64 percent) have used less, proportionally. North Dakota was among the first states to lower the minimum age eligible for vaccination, from 75 to 65.

  • In a recent interview with the American Medical Association, health officials in New Mexico attributed part of the state’s success to its “data-oriented and science-oriented” governor, Michelle Lujan Grisham, and to an app that allowed easy registration and close coordination among hospitals and providers. The state has given 9.8 percent of residents at least one shot, and has used 83 percent of its doses.

  • Connecticut got mass vaccination sites up and running early, and uses an inventory system that allocates unused doses to places that need them. But older residents have complained about long waits.

United States › United StatesOn Jan. 31 14-day change
New cases 111,478 –32%
New deaths 1,875 –5%
World › WorldOn Jan. 31 14-day change
New cases 389,735 –21%
New deaths 8,093 +2%

U.S. vaccinations ›

Where states are reporting vaccines given

A shopping mall in Cergy-Pontoise, near Paris, on Sunday. France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed.Credit…Andrea Mantovani for The New York Times

PARIS — Public frustration with lockdowns is palpable across Europe, with pensioners protesting this weekend in Vienna, restaurateurs taking to the streets in Budapest and demonstrators clashing with the police in Belgium, prompting dozens of arrests. The Dutch authorities fined more than 10,000 people last week for violating the national curfew.

While none of the protests resulted in the kind of violence seen in the Netherlands in recent weeks, they reflect a growing impatience as political leaders extend restrictions to guard against a resurgence of the virus fueled by new variants.

In France, President Emmanuel Macron has resisted a full lockdown, making a calculated gamble that his government can tighten the rules just enough to avoid a new wave of infections.

Prime Minister Jean Castex appeared in front of television cameras for an unexpected statement on Friday night, announcing a handful of new curbs, including strict border closures.

“Even if the path is very narrow, we must take it,” Mr. Macron was reported to have said at a cabinet meeting last week, according to the Journal du Dimanche, pushing back against the advice of several senior aides. According to the newspaper, he added: “When you are French, you have all you need to get by, as long as you dare to try.”

Polls in France have shown weariness with restrictions, and grumbling about the rules is growing in some quarters.

France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed. Schools and shops are open.

After a widely publicized breach of the rules at a restaurant in the southern city of Nice last week and a call to “civil disobedience” by some restaurant owners, the French economy minister, Bruno Le Maire, warned on Monday that any establishments that flouted the rules would be cut off from coronavirus aid.

In the French Alps, protesters blocked roads on Monday to demand that ski lifts reopen.

Critics say that Mr. Macron’s approach may simply be delaying the inevitable and that he could be forced to change course if cases started to surge.

“It’s a risk, I’m hoping it was a calculated risk,” Karine Lacombe, an infectious-disease specialist, told the French news channel LCI on Sunday.

Mr. Macron’s plan is rooted partly in the relative stability of the pandemic in France. The number of new daily cases has inched up only slowly and while hospitalizations remain high, there has been no sudden surge. More contagious variants of the virus have been registered in the country, but the authorities say they believe that their spread, so far, is under control.

“Everything suggests that a new wave could occur because of the variant,” Olivier Véran, the French health minister, told the Journal du Dimanche. “But perhaps we can avoid it thanks to the measures that we decided early and that the French people are respecting.”

Aurelien Breeden reported from Paris, and Marc Santora from London.

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N.Y.C. Snowstorm Delays Vaccinations

On Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.

The storm is disrupting our vaccination effort, and we need to keep people safe. We don’t want folks, especially seniors, going out in unsafe conditions to get vaccinated. We know we can reschedule appointments very quickly because, of course, we have supply. We’re going to use the supply we have. Our problem is lack of supply. So we can take the supply we have and distribute it very quickly in the days to come, and make sure everyone gets the appointments. But it’s not safe out there today. So vaccinations are canceled today. They’re also going to be canceled tomorrow. Based on what we are seeing right now, we believe that tomorrow, getting around the city will be difficult, it’ll be icy, it’ll be treacherous. We do not want seniors, especially, out in those conditions. So we’re going to have vaccinations off for today and tomorrow, come back strong on Wednesday. We’ll be able to catch up quickly because, again, we have a vast amount of capacity. We don’t have enough vaccine. So we’ll simply use the days later in the week. Crank up those schedules, get people rescheduled into those days.

Video player loadingOn Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.CreditCredit…James Estrin/The New York Times

Mayor Bill de Blasio of New York said on Monday that coronavirus vaccinations scheduled for Tuesday would be postponed because of the winter storm, the second day in a row that they have been delayed.

Heavy snow was also complicating vaccination efforts in Washington, Philadelphia, New Jersey and elsewhere.

At a news conference on Monday, Mr. de Blasio of New York City said he did not want older residents traveling to vaccine appointments amid blizzard-like conditions with gusty winds.

“Based on what we are seeing right now, we believe tomorrow, getting around the city will be difficult,” Mr. de Blasio said. “It will be icy, it will be treacherous.”

He said he believed the city could quickly make up the appointments later in the week.

“We have a vast amount of capacity; we don’t have enough vaccine,” he said. “We’ll simply use the days later in the week, crank up those schedules, get people rescheduled into those days.”

The storm will temporarily derail a vaccine rollout that has been plagued by inadequate supply, buggy sign-up systems and confusion over the New York State’s strict eligibility guidelines. The vaccine is available to residents 65 and older as well as a wide range of workers designated “essential.”

About 800,000 doses have been administered so far in the city, Mr. de Blasio said.

Vaccine appointments originally scheduled for Monday at several sites in the region — the Javits Center in Manhattan, the Aqueduct Racetrack in Queens, a drive-through site at Jones Beach in Long Island, SUNY Stony Brook and the Westchester County Center — would be rescheduled for this week, according to a statement from Melissa DeRosa, a top aide to Gov. Andrew M. Cuomo. “We ask all New Yorkers to monitor the weather and stay off the roads tomorrow so our crews and first responders can safely do their jobs,” she said.

Mr. Cuomo said at a news conference on Monday that New York’s seven-day average positive test rate was 4.8 percent, the 24th straight day it had declined.

Mr. Cuomo added that the state had administered about 1.96 million doses of the vaccine.

In the Philadelphia area, city-run testing and vaccine sites were closed on Monday. Connecticut, New Jersey, Rhode Island and parts of the Washington, D.C., area were following suit. Some areas away from the center of the storm were expected to remain open for vaccinations, including parts of Massachusetts and upstate New York.

A medical technician at a coronavirus testing site in Austin, Texas, last month.Credit…Tamir Kalifa for The New York Times

The past few weeks in the United States have been the deadliest of the coronavirus pandemic, and residents in a majority of counties remain at an extremely high risk of contracting the virus. At the same time, transmission seems to be slowing throughout the country, with the number of new average cases 40 percent lower on Jan. 29 than at the U.S. peak three weeks earlier.

Other indicators reinforce the current downward trend in cases. Hospitalizations are down significantly from record highs in early January. The number of tests per day has also decreased, which can obscure the virus’s true toll, but the positivity rate of those tests has also gone down, indicating that the slowed spread is real.

Still, the average reported daily death rate over the past seven days remains above 3,000, compared with less than 1,000 per day in September and October.

Experts say the decrease could mark a turning point in the outbreak after months of ever-higher caseloads. But new, more contagious variants threaten to upend progress and could even send case rates to a new high if they take hold, especially if the national vaccine rollout faces hurdles.

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Biden to Discuss Pandemic Relief Package With Republicans

President Biden will meet with 10 Republican senators on Monday who have proposed a much smaller Covid-19 relief package. Jen Psaki, the White House press secretary, told reporters that the Mr. Biden’s biggest concern is releasing a package that is too small.

The president has been clear since long before he came into office that he’s open to engaging with both Democrats and Republicans in Congress about their ideas. And this is an example of doing exactly that. So as we said in our statement last night, it’s an exchange of ideas, an opportunity to do that. This group obviously sent a letter with some outline, some top lines of their concerns and their priorities, and he’s happy to have a conversation with them. What this meeting is not, is a forum for the president to make or accept an offer. His view — it remains — what was stated in the statement last night, but also what he said on Friday, which is that the risk is not that it is too big, this package, the risk is that it is too small. And that remains his view, and it’s one he’ll certainly express today. But it’s important to him that he hears this group out on their concerns, on their ideas. He’s always open to making this package stronger. And he also, as was noted in our statement last night, remains in close touch with Speaker Pelosi with Leader Schumer, and he will continue that engagement throughout the day, and in the days ahead.

Video player loadingPresident Biden will meet with 10 Republican senators on Monday who have proposed a much smaller Covid-19 relief package. Jen Psaki, the White House press secretary, told reporters that the Mr. Biden’s biggest concern is releasing a package that is too small.CreditCredit…Doug Mills/The New York Times

White House officials offered a pointed, if polite, warning to 10 Senate Republicans planning to pitch a scaled-back coronavirus relief package to President Biden at the White House on Monday evening: Think bigger.

Jen Psaki, the White House press secretary, played down expectations of the meeting, a critical first test of Mr. Biden’s dueling commitments to bipartisanship and speeding pandemic aid, saying no deal would be done without further negotiations — a statement aimed at reassuring Democrats leery of a fast, weak deal.

“What this meeting is not is a forum for the president to make or accept an offer,” Ms. Psaki told reporters on Monday afternoon, repeating the president’s determination to push through a $1.9 trillion stimulus bill.

“The risk is not that it is too big, this package,” Ms. Psaki added. “The risk is that it is too small. That remains his view.”

A coalition of center-right Republican senators, led by Susan Collins of Maine, on Monday outlined a more limited $618 billion stimulus plan, which they are billing as a way for Mr. Biden to pass a pandemic aid bill with bipartisan support and make good on his inauguration pledge to unite the country.

With 10 Republicans on board, joining the Senate’s 50 Democrats, a bipartisan bill could overcome the chamber’s 60-vote filibuster rule. But Democrats have shown little enthusiasm for a measure that amounts to less than one third of what the president says is needed.

Still, after receiving a letter from the senators on Sunday requesting a meeting, Mr. Biden called Ms. Collins and invited her and the other signers to the White House. He also spoke with Speaker Nancy Pelosi of California and Senator Chuck Schumer of New York, the majority leader.

The Republican proposal is likely to be met with resistance from congressional Democrats, who are preparing this week to begin laying the groundwork for passing Mr. Biden’s plan through a process known as budget reconciliation, which would allow it to bypass a filibuster and pass solely with Democratic votes.

The proposal would include $160 billion for vaccine distribution and development, coronavirus testing and the production of personal protective equipment; $20 billion toward helping schools reopen; more relief for small businesses; and additional aid to individuals. The package would also extend enhanced unemployment benefits of $300 a week — currently slated to lapse in March — until June 30.

“We recognize your calls for unity and want to work in good faith with your administration,” wrote the Republican group, which includes Senators Lisa Murkowski of Alaska, Bill Cassidy of Louisiana and Mitt Romney of Utah.

The measure omits a federal minimum wage increase that Mr. Biden included in his plan. It would also whittle down his proposal to send $1,400 checks to many Americans, and limit it to lower-income earners.

The proposal calls for checks of up to $1,000 for individuals making $50,000 a year or less and families with a combined income of up to $100,000, with individuals earning less than $40,000 — and families earning less than $80,000 — receiving the full amount.

Previous rounds of direct payments were targeted to Americans earning less than $99,000 annually, with those earning less than $75,000 receiving the full amount.

Congress approved more than $4 trillion through a series of bills last year to address the coronavirus crisis and its economic fallout. Most recently, in December, lawmakers passed a $900 billion stimulus plan that included $600 direct checks to many Americans.

Mr. Biden received an important boost on Monday ahead of his meeting with the senators: Gov. Jim Justice of West Virginia, a close ally of former President Trump, said he supported a bigger relief package than the one that the center-right Republicans are proposing.

“If we actually throw away some money right now, so what?” said Mr. Justice, a former Democrat who switched parties to support Mr. Trump in 2017, told CNN.

A shuttered business in Los Angeles. It may take years to return to the pre-pandemic levels of employment.Credit…Kendrick Brinson for The New York Times

The American economy will return to its pre-pandemic size by the middle of this year, even if Congress does not approve any more federal aid for the recovery, but it will be years before everyone thrown off the job by the pandemic is able to return to work, the Congressional Budget Office projected on Monday.

The new projections from the office, which is nonpartisan and issues regular budgetary and economic forecasts, are an improvement from the office’s forecasts last summer. Officials told reporters on Monday that the brightening outlook was a result of large sectors of the economy adapting better and more rapidly to the pandemic than originally expected.

They also reflect increased growth from a $900 billion economic aid package that Congress passed in December, which included $600 direct checks to individuals and more generous unemployment benefits.

The budget office now expects the unemployment rate to fall to 5.3 percent at the end of the year, down from an 8.4 percent projection last July. The economy is expected to grow 3.7 percent for the year, after recording a much smaller contraction in 2020 than the budget office initially expected.

The rosier projections are likely to inject even more debate into the discussions over whether to pass President Biden’s $1.9 trillion economic rescue package. It could embolden Republicans who have pushed Mr. Biden to scale back the plan significantly, saying the economy does not need so much additional federal support and that another big package could “overheat” the economy.

But the report shows little risk of that happening. The economy is projected to remain below potential levels until 2025 on its current path. And big economic risks remain. The number of employed Americans will not return to its pre-pandemic levels until 2024, officials predicted, reflecting the prolonged difficulties of shaking off the virus and returning to full levels of economic activity.

The Federal Reserve chair, Jerome H. Powell, warned last week that the economy was “a long way from a full recovery” with millions still out of work and many small businesses facing pressure.

Budget officials said the rebound in growth and employment could be significantly accelerated if public health authorities were able to more rapidly deploy coronavirus vaccines across the population.

As it stands, the budget office sees little evidence of growth running hot enough in the years to come to spur a rapid increase in inflation. It forecast inflation levels below the Federal Reserve’s target of 2 percent for years to come, even with the Fed holding interest rates near zero.

Other independent forecasts, including one from the Brookings Institution last week, have projected that another dose of economic aid — like the $1.9 trillion package Mr. Biden has proposed — would help the economy grow more rapidly, topping its pre-pandemic path by year’s end.

Dr. Ricardo Cigarroa hugging a patient at the Laredo Medical Center in Laredo, Texas.Credit…Verónica G. Cárdenas for The New York Times

During January, the pandemic’s deadliest month, Laredo, Texas, held the bleak distinction of having one of the most severe outbreaks of any city in the United States. The death toll in the overwhelmingly Latino city of 277,000 now stands at more than 630 — including at least 126 in January alone.

When the virus made its way to the borderlands almost a year ago, Dr. Ricardo Cigarroa could have just hunkered down. He could have focused on his profitable cardiology practice, which has 80 employees. He could have kept quiet.

Instead, Dr. Cigarroa has become a top crusader and the de facto authority on the pandemic along this stretch of the U.S.-Mexico border.

On regional television stations, he calmly explains, in both English and Spanish, how the virus is evolving. Known for making Covid-19 house calls around Laredo in his old Toyota Tacoma pickup, he is interviewed so often that Texas Monthly called him “The Dr. Fauci of South Texas,” comparing him to Dr. Anthony S. Fauci, the country’s top infectious disease expert — though Dr. Cigarroa holds no official government portfolio.

Lately, Dr. Cigarroa has been losing his patience.

Looking exhausted in a video posted on Facebook, he blasted political leaders for allowing the virus to rampage through this part of South Texas. Dr. Cigarroa singled out Gov. Greg Abbott, a Republican, for refusing to allow Laredo to impose stricter mitigation measures.

“To the governor: It’s OK to swallow your pride,” Dr. Cigarroa said, stunning some viewers with a warning that the virus could kill 1 in 250 Laredoans by midyear. “It’s OK to say that you’re not going to do it, and then do it to save lives.”

Pleading with the people of Laredo to consider civil disobedience in the form of staying home from work if politicians fail to act, he added, “The only thing that will save lives at this point will be staying home and shutting down the city.”

Students waiting to be admitted at a public school in Brooklyn in December. In New York City, about 12,000 more white children have returned to classrooms than Black students.Credit…Victor J. Blue for The New York Times

Even as more districts reopen their buildings and President Biden joins the chorus of those saying schools can safely resume in-person education, hundreds of thousands of Black parents say they are not ready to send their children back. That reflects both the disproportionately harsh consequences the coronavirus has visited on nonwhite Americans and the profound lack of trust that Black families have in school districts, a longstanding phenomenon exacerbated by the pandemic.

It also points to a major dilemma: School closures have hit the mental health and academic achievement of nonwhite children the hardest, but many of the families that education leaders have said need in-person education the most are most wary of returning.

That is shifting the reopening debate in real time. In Chicago, only about a third of Black families have indicated they are willing to return to classrooms, compared with 67 percent of white families, and the city’s teachers’ union, which is hurtling toward a strike, has made the disparity a core part of its argument against in-person classes.

In New York City, about 12,000 more white children have returned to classrooms than Black students, though Black children make up a larger share of the overall district. In Oakland, Calif., just about a third of Black parents said they would consider in-person learning, compared with more than half of white families. And Black families in Washington, Nashville, Dallas and other districts also indicated they would keep their children learning at home at higher rates than white families.

Education experts and Black parents say decades of racism, institutionalized segregation and mistreatment of Black children have left Black communities to doubt that school districts are being upfront about the risks.

“For generations, these public schools have failed us and prepared us for prison, and now it’s like they’re preparing us to pass away,” said Sarah Carpenter, the executive director of Memphis Lift, a parent advocacy group in Tennessee. “We know that our kids have lost a lot, but we’d rather our kids to be out of school than dead.”

In many cities and districts, Latino and Asian-American families are also less likely than white families to send their children back. Asian-Americans have opted out of in-person classes at the highest rates of any ethnic group in New York City. Latino families in Chicago were most likely to say they would keep their children at home when schools reopened.

Still, the pattern is most consistent and pronounced with Black families, which have been particularly affected by decades of underinvestment. By one estimate, a $23 billion gap, or $2,226 per pupil, separates funding for predominantly white districts and nonwhite districts, and Jessica Calarco, a sociologist at Indiana University Bloomington who has studied reopening, said the pandemic had amplified that inequity.

“If you know your school doesn’t have hot running water, how would you feel about sending your child to that school knowing they can’t fully wash their hands before they eat lunch?” she asked.

GLOBAL ROUNDUP

Workers loading South Africa’s first coronavirus vaccine doses at OR Tambo airport in Johannesburg on Monday.Credit…Elmond Jiyane for GCIS, via Reuters

A million doses of the Oxford-AstraZeneca coronavirus vaccine arrived in South Africa on Monday, paving the way for the country to begin vaccinating its population of nearly 60 million. Health care workers will be the first to be offered the shots, officials said.

The country has reported by far the most cases and deaths from the coronavirus on the African continent. It has participated in clinical trials of several vaccines.

The plane delivering the eagerly awaited doses from the Serum Institute of India, which produced them, was met at the airport by President Cyril Ramaphosa. The president has come under criticism over the country’s lagging start to widespread vaccination, with many countries in Asia and the West able to start immunizing their populations weeks before South Africa could secure a supply.

South Africa experienced a surge in new cases around the turn of the year, fueled by the more transmissible variant of the virus that was first detected in the country. But the surge has begun to ease in recent weeks. Information has not yet been released on the AstraZeneca vaccine’s effectiveness against the variant, which is now predominant in the country.

Over the course of the pandemic, South Africa has reported about 1.45 million cases, and has lately been averaging about 5,800 new cases a day, according to a New York Times database.

In other developments around the world:

  • Seeking a better understanding of the pandemic’s origins, a team of 15 World Health Organization experts is visiting some of the places first hit by the coronavirus in the Chinese city of Wuhan, including a live animal market, a hospital and a disease control center. The inquiry is expected to take months to complete. Scientists initially believed the outbreak began at the Huanan Seafood Wholesale Market in Wuhan, but many experts now doubt that theory.

  • The European Union will get 75 million additional doses of vaccine in the next few months, the German pharmaceutical company BioNTech announced on Monday. The vaccine jointly developed by the company and Pfizer was the first to be authorized for use in the E.U., but supplies have been limited by production issues in the early going, and several countries, including Germany, are off to slower than expected starts in vaccinating their populations.

  • The police in China said they had broken up a criminal ring that manufactured and sold more than 3,000 fake coronavirus vaccine doses, the state-run Xinhua news agency reported on Monday. More than 80 people were arrested, the agency said. According to Xinhua, the police said that since September, the main suspect had been selling vials of “vaccine” that was really just saline solution.

Congressman Adriano Espaillat of New York at the Capitol this month.Credit…J. Scott Applewhite/Associated Press

The scattered reports from around the country can play like a cruel irony: Someone tests positive for the coronavirus even though they have already received one or both doses of a Covid-19 vaccine.

It’s happened to at least three members of Congress recently:

But it’s been reported in people in other walks of life too, including Rick Pitino, a Hall of Fame basketball coach, and a nurse in California.

Experts say cases like these are not surprising and do not indicate that there was something wrong with the vaccines or how they were administered. Here is why.

  • Vaccines don’t work instantly. It takes a few weeks for the body to build up immunity after receiving a dose. And the vaccines now in use in the U.S., from Pfizer-BioNTech and Moderna, both require a second shot a few weeks after the first to reach full effectiveness.

  • Nor do they work retroactively. You can already be infected and not know it when you get the vaccine — even if you recently tested negative. That infection can continue to develop after you get the shot but before its protection fully takes hold, and then show up in a positive test result.

  • The vaccines prevent illness, but maybe not infection. Covid vaccines are being authorized based on how well they keep you from getting sick, needing hospitalization and dying. Scientists don’t know yet how effective the vaccines are at preventing the coronavirus from infecting you to begin with, or at keeping you from passing it on to others. (That’s why vaccinated people should keep wearing masks and maintaining social distance.)

  • Even the best vaccines aren’t perfect. The efficacy rates for Pfizer-BioNTech and Moderna vaccines are extremely high, but they are not 100 percent. With the virus still spreading out of control in the U.S., some of the millions of recently vaccinated people were bound to get infected in any case.

Gov. Andrew M. Cuomo of New York has said that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials.Credit…Pool photo by Mary Altaffer

The deputy commissioner for public health at the New York State Health Department resigned in late summer. Soon after, the director of its bureau of communicable disease control also stepped down. So did the medical director for epidemiology. Last month, the state epidemiologist said she, too, would be leaving.

The high-level departures came as morale plunged in the Health Department and senior health officials expressed alarm to one another over being sidelined and treated disrespectfully, according to five people with direct experience inside the department.

Their concern had an almost singular focus: Gov. Andrew M. Cuomo.

Even as the pandemic continues to rage and New York struggles to vaccinate a large and anxious population, Mr. Cuomo has all but declared war on his own public health bureaucracy. The departures have underscored the extent to which pandemic policy has been set by the governor, who with his aides designed a vaccination program hampered by early delays.

The troubled rollout came after Mr. Cuomo declined to use the longstanding vaccination plans that the State Department of Health had developed in recent years in coordination with local health departments. Mr. Cuomo instead adopted an approach that relied on large hospital systems to coordinate vaccinations.

In recent weeks, the governor has repeatedly made it clear that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials, who he said had no understanding of how to conduct a real-world, large-scale operation like vaccinations. After early problems, in which relatively few doses were being administered, the pace of vaccinations has picked up and New York is now roughly 20th in the nation in percentage of residents who have received at least one vaccine dose.

“When I say ‘experts’ in air quotes, it sounds like I’m saying I don’t really trust the experts,” Mr. Cuomo said at a news conference on Friday, referring to scientific expertise at all levels of government during the pandemic. “Because I don’t. Because I don’t.”

His comments reflected a rift between the state’s top elected official and its career health experts of the sort that has occurred across different levels of government during the pandemic.

In Albany, tensions worsened in recent months as state health officials said they often found out about major changes in pandemic policy only after Mr. Cuomo announced them at news conferences — and then asked them to match their health guidance to the announcements.

That was what happened with the vaccine plan, when state health officials were blindsided by the news that the rollout would be coordinated locally by hospitals.

At least nine senior state health officials have left the department, resigned or retired in recent months. They include Dr. Elizabeth Dufort, the medical director in the division of epidemiology; and Dr. Jill Taylor, the head of the renowned Wadsworth laboratory — which has been central to the state’s efforts to detect virus variants — and the executive in charge of health data, according to state records.