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E.U. Begins Coronavirus Vaccination Rollout

Countries across the European Union on Sunday began administering the Pfizer-BioNTech coronavirus vaccine, signaling the official start of the bloc’s campaign to inoculate more than 450 million people.

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Countries across the European Union on Sunday began administering the Pfizer-BioNTech coronavirus vaccine, signaling the official start of the bloc’s campaign to inoculate more than 450 million people.CreditCredit…Laetitia Vancon for The New York Times

BERLIN — From nursing homes in France to hospitals in Poland, older Europeans and the workers who care for them rolled up their sleeves on Sunday to receive coronavirus vaccine shots in a campaign to inoculate more than 450 million people across the European Union.

The inoculations offered a rare respite as the continent struggles with one of its most precarious moments since the pandemic began.

Despite national lockdowns, restrictions on movement, shuttering of restaurants and cancellations of Christmas gatherings, the virus has stalked Europe into the dark winter months. The spread of a more contagious variant of the virus in Britain has raised such alarm that much of continental Europe rushed to close its borders to travelers coming from the country, effectively plunging the nation as a whole into quarantine.

“Today, we start turning the page on a difficult year,” Ursula von der Leyen, the European Commission president wrote on Twitter. “The #COVID19 vaccine has been delivered to all EU countries.”

For Prime Minister Giuseppe Conte of Italy, the vaccine’s arrival could not come soon enough. Italy’s suffering at the outset of the pandemic served as a warning for the world, and the current death toll is again among the worst in Europe.

“Today Italy reawakens. It’s #VaccineDay,” he wrote on Twitter after a 29-year-old nurse at Rome’s Spallanzani hospital was the first person to be inoculated. “This date will remain with us forever.”

The nurse, Claudia Alivernini, said she hoped the vaccination campaign would signal “the beginning of the end” of the pandemic.

In Spain, a 96-year-old great-grandmother, Araceli Rosario Hidalgo, was the first to receive the vaccine. The Los Olmos nursing home, where she lives, is in Guadalajara, a city that has a special storage facility where the first doses of the vaccine were delivered on Saturday, transported from Belgium.

Prime Minister Pedro Sánchez wrote on Twitter that the vaccinations marked “a hopeful new chapter.”

Similar scenes played out across the continent, although not every member of the bloc followed the rollout plans. In Germany, a nursing home in the eastern state of Saxony-Anhalt jumped the gun, inoculating dozens of residents and staff members on Saturday, hours after the doses arrived. Officials in the Netherlands said they planned to begin vaccinations on Jan. 8.

But all E.U. member nations now have a supply of vaccine on hand to distribute.

Early Sunday, dozens of minivans carrying coolers filled with dry ice to keep the doses of the Pfizer-BioNTech vaccine from rising above minus 70 degrees Celsius fanned out to nursing homes across the German capital. The rollout comes as Europe’s largest nation is confronting its deadliest period since the start of the pandemic.

With nearly 1,000 deaths recorded in Germany each day in the week before Christmas, a crematory in the eastern state of Saxony operated around the clock, straight through the holiday, to keep up.

“I’ve never had to see it this bad before,” said Eveline Müller, the director of the facility, in the town of Görlitz.

More than 350,000 people in the 27 nations that make up the European Union have died from Covid-19 since the bloc’s first fatality was recorded in France on Feb. 15. And for many countries, the worst days have come in recent weeks. In Poland, November was the deadliest month since the end of World War II.

The European Union’s member states made a show of solidarity by waiting for the bloc’s regulatory board to approve the vaccine before beginning coordinated national campaigns. But how those will play out in individual countries is likely to be disparate.

All of the member states have national health care systems, so people will be vaccinated free of charge. But just as hospitals in poorer member states like Bulgaria and Romania were overwhelmed in the latest wave of the virus, the networks in those countries will face challenges in distributing vaccines.

While each nation is determining how to carry out its campaign, in general the first phase will focus on people most at risk of exposure and those most likely to have serious health conditions — health care workers and the oldest citizens.

Most member states have said they expect the vaccine to reach the general public by spring.

As Prime Minister Kyriakos Mitsotakis of Greece got his shot on Sunday, he encouraged citizens to get one, too. “It’s the only way to take back control of our lives, to hug the people that we love,” he said.

Raphael Minder contributed reporting.

United States › United StatesOn Dec. 27 14-day change
New cases 152,102 –12%
New deaths 1,230 –9%


World › WorldOn Dec. 27 14-day change
New cases 447,539 –9%
New deaths 7,422 –6%

Where cases per capita are

A Covid-19 testing center in Eindhoven, the Netherlands, this month. The Dutch response to the pandemic has been criticized as erratic.
Credit…Ilvy Njiokiktjien for The New York Times

The European Union rollout of the coronavirus vaccine officially began on Sunday, but each nation is setting its own timeline. Germany, Greece France, Italy, Spain and Poland were among the first to offer inoculations. More nations are to follow on Monday and Tuesday. The Netherlands is likely to be the last to begin.

The first Dutch citizens are not expected to be vaccinated until Jan. 8.

Throughout the pandemic, the Dutch response has been criticized as erratic, with many wondering how one of Europe’s richest and best organized countries has not been able to do more to keep coronavirus infections down.

Two weeks ago, the Netherlands entered a second lockdown that is to last until Jan. 19. Hugo de Jonge, the Dutch health minister, said last week that vaccinating the country’s 17 million citizens “needs time” and should be done “with care” to ensure prevent further fatalities and ensure wide acceptance. He had to defend the plan from critics frustrated by the delay. “The success of a vaccine does not depend on starting a week earlier, it depends on being careful and safe,” he told local media outlets. “Caution makes an important contribution to people’s acceptance of vaccinations.’

First in line will be those 60 and older with pre-existing medical conditions, followed by older citizens without medical conditions — some 6.5 million people — the Health Council of the Netherlands said. Healthy people younger than 60 will not be eligible for vaccinations before August.

But many Dutch people — skeptical after government promises for national programs in the fight against the virus fell apart — are wondering whether the mass vaccination project will also go off the rails.

In a rare televised address announcing the second lockdown — which limited gatherings over Christmas to only three guests per household and forced all nonessential stores to close — Prime Minister Mark Rutte urged citizens to accept the limitations in an effort to save lives.

“Every day, on average, 60 people die of Covid-19. Every day around 9,000 new infections are registered,” Mr. Rutte said. “That’s an entire football stadium of people in less than six days.”

As he spoke, protesters outside his office shouted slogans against the lockdown and beat on pots and pans, before they were dispersed by the police for not having a permit to demonstrate.

Many Dutch had been flouting requests to maintain social distancing, with lines of shoppers outside stores in the university town of Leiden laughing at their own disobedience. Even once the lockdown took effect, the streets remained full of people out for walks, enjoying takeaway coffees.

President Trump played golf at the Trump International Golf Club in West Palm Beach on Sunday, before signing the pandemic relief bill.
Credit…Marco Bello/Reuters

WASHINGTON — President Trump abruptly signed a measure on Sunday providing $900 billion in pandemic aid and funding the government through September, ending last-minute turmoil over a possible government shutdown and an economic lifeline for millions of Americans.

The signing was a sudden reversal for the president, who last week appeared poised to derail the bill. But the move came after two critical unemployment programs lapsed, guaranteeing a delay in benefits for millions of unemployed people.

His last-minute resistance last week to signing the $2.3 trillion package caught lawmakers and White House officials by surprise. It raised fears that such a delay would exacerbate the economic toll of the pandemic.

The aid bill includes a revival of expanded and extended unemployment benefits, billions of dollars to help states with vaccine distribution, a replenished small-business loan program and relief money for airlines. It was passed along with a spending measure to keep the government funded for the remainder of the fiscal year.

Last week, about 24 hours after Congress overwhelmingly approved the measure, Mr. Trump emerged in a surprise video from the White House and called for direct payments to be more than tripled to $2,000 per adult. Hinting that he might veto the legislation, the president also lashed out at provisions in the funding bill that provided foreign aid.

Earlier, lawmakers criticized Mr. Trump for his refusal to sign the bill.

“None of us totally liked the bill — it’s the nature of legislating, you’re not going to end up with anything perfect — but we passed it because this was the agreed-upon number,” Representative Adam Kinzinger, Republican of Illinois, said on the CNN program “State of the Union.” “I don’t understand what’s being done, why, unless it’s just to create chaos and show power and be upset because you lost the election. Otherwise I don’t understand it because this just has to get done.”

Multiple lawmakers, including Senator Bernie Sanders, independent of Vermont, said that Mr. Trump should not delay signing the legislation and instead approve a separate bill providing for the $2,000 checks.

“What the president is doing right now is unbelievably cruel,” Mr. Sanders said on the ABC program “This Week.” “Given the terrible economic crisis facing this country, yes, we do need to get $2,000 out to every working-class individual in this country, $500 for their kid. But you can’t diddle around with the bill.”

Members of the bipartisan group that helped break the logjam over a stimulus deal issued a statement pressing Mr. Trump to either sign or veto the bill, and “allow those in favor to act before it is too late.”

Two governors also said that the time for negotiations had passed. On “State of the Union,” Gov. Gretchen Whitmer of Michigan, a Democrat, said that she had long supported stimulus checks of $2,000, but that it was too late in the process to be making those kinds of requests.

“Sign the bill, get it done, and then if the president wants to push for more, let’s get that done too,” said Gov. Larry Hogan of Maryland, a Republican who also appeared on the show.

Another governor, Jay Inslee of Washington, said that Mr. Trump “has chosen to hold the entire relief package hostage.”

Though they harshly criticized Mr. Trump, two progressive representatives-elect joined the president’s call for greater direct payments. On “State of the Union,” Jamaal Bowman, Democrat of New York, claimed that the president was “posturing to make himself, to bring himself back as the hero of the American people” after his defeat in November. But like Mr. Trump, he said Americans needed more relief.

“It needs to at least be $2,000, so he needs to talk to his Republican buddies and say, ‘Give the people the money,’” said Cori Bush, Democrat of Missouri, who also called the $600 figure a “slap in the face to people who are suffering.”

Democrats, who have long advocated increasing the amount of financial relief distributed across the country, plan to hold a vote on Monday to approve a stand-alone bill that would increase the payments to $2,000. It is unclear whether that legislation will stand a chance in the Senate, where Republicans have long been resistant to spending more than $1 trillion on pandemic relief.

Fritz Jackson, an emergency medical worker in Ohio, received a dose during the first phase of U.S. vaccinations.
Credit…Brian Kaiser for The New York Times

The federal Centers for Disease Control and Prevention recommends that the first shots of the coronavirus vaccines go to people in nursing homes and other long-term care facilities as well as to doctors, nurses and frontline health care workers, and there has been little disagreement over that guidance.

But who should get vaccinated next?

“There is a consensus of what we call the A1 group,” Ohio Gov. Mike DeWine said on CBS’s “Face the Nation” on Sunday. “People who are risking their lives every single day, as well as where we have taken the most losses, and that is in our nursing homes.”

“I think there will probably be more lack of consensus among people in general when you get beyond that first group,” Mr. DeWine said.

In guidelines based on recommendations from an expert panel, the C.D.C. lays out the next two rounds of vaccination, known as Phase 1b and Phase 1c. Phase 1b would include people 75 years and older and essential frontline workers not in health care, such as firefighters, police officers, postal workers, grocery store employees, public transit workers and teachers.

Phase 1c would include people from 65 to 74 years old, people 16 to 64 with underlying medical conditions and other essential workers in jobs like food service, construction and public health.

But not all governors are following along. Some have put a higher priority on certain people in the Phase 1c group and a lower priority on those in Phase 1b.

“The next wave is going to be different by state,” Adm. Brett P. Giroir, an assistant secretary for the Department of Health and Human Services who serves as the administration’s testing coordinator, said during an appearance on “Fox News Sunday.”

He noted that Gov. Greg Abbott of Texas planned to give priority to people over 65. “Because those are the people will go to the hospitals,” Adm. Giroir said. “It’s not the frontline 24-year-old worker who is at low risk of getting the infection and at very, very low risk of getting serious results from that, but over 65.”

Gov. Ron DeSantis of Florida is similarly giving priority to people over 70, Admiral Giroir said.

”I think that variability is critically important because as the hospitals fill up, the first priority really needs to be to save lives and to reduce the burden on hospitals,” the admiral said. “You’re seeing that in Texas and Florida, and you will probably see that in many other states.”

The C.D.C. places teachers and others working in education in Phase 1b, but Admiral Giroir suggested that most states would move them down unless they suffer from underlying health conditions.

“Young healthy teachers should be at no more risk than young healthy individuals in any other profession,” he said. “They’re probably going to be further down the priority scale, because we need to take care of those who are vulnerable — who will die, who will be hospitalized — first.”

The exterior of Parcare’s health care facility in the Willamsburg section of Brooklyn in New York on Sunday. Many of ParCare’s patients are Orthodox Jews, a population that has been hard-hit by the virus, and the clinics have worked with the city on contact-tracing efforts.
Credit…Kathy Willens/Associated Press

The coronavirus vaccine has finally arrived in New York, but only a select group of at-risk people are supposed to receive it first.

These rules have not deterred others from trying to get the vaccine, including unauthorized doctors at some hospitals. Now the state is investigating whether a network of health clinics in New York provided vaccinations to members of the public who were not members of groups prioritized by the state — the most at-risk health care workers and nursing home residents and employees.

The state’s health commissioner, Dr. Howard Zucker, announced an investigation into the clinics, which he said “may have fraudulently obtained Covid-19 vaccine, transferred it to facilities in other parts of the state in violation of state guidelines and diverted it to members of the public.”

The clinics are run by ParCare Community Health Network, which has locations in Brooklyn, Manhattan and Kiryas Joel, a village northwest of the city. The Rabbinical Alliance of America shared a photo on Twitter that claimed to show ParCare’s chief executive, Gary Schlesinger, receiving the vaccine.

The post has since been deleted, but a ParCare representative confirmed that Mr. Schlesinger had received the vaccine because he works in the clinics every day. The representative said in an emailed statement that it followed all state procedures for obtaining and distributing the Moderna coronavirus vaccine.

Advertisements for vaccines appeared on ParCare’s Twitter feed on Dec. 16, two days after the Pfizer vaccine was first administered in New York. The advertisement said that “the vaccines will be made available on a first come first serve basis,” and asked patients to register through a website or by scanning a QR code. More than 850 had been administered, the company representative said.

Then & Now


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CreditCredit…Bridget Bennett for The New York Times

As 2020 comes to a close, we are revisiting subjects whose lives were impacted by the pandemic. When Sabrina Tavernise first spoke with Valicia Anderson in April, the 45-year-old wife and mother had to think hard to come up with a single person she knew who was not recently unemployed.

In Las Vegas, the Anderson family is still hurting.

The Rio casino finally reopened on Dec. 22. But the restaurant inside the casino where Jovaun Anderson worked until March, Guy Fieri’s El Burro Burracho, did not reopen, and the family has not heard anything about when it might.

Valicia Anderson, Jovaun’s wife, said the family will lose their health insurance in February if Jovaun is still unemployed then. It is a frightening prospect, because their daughter, Nylah, needs frequent medical care.

In an email, Ms. Anderson said Jovaun has been submitting applications elsewhere, but has not found a job. They are still receiving food aid from food banks. In October, they had to choose between paying rent and making their car payment. They chose rent, she said, and as a consequence, their car was repossessed. They now take the bus to doctors for Nylah, and to food banks, and worry about catching the virus while riding.

Evidence of financial hardship isn’t hard to find anywhere, but the economic impact of the pandemic has been especially merciless in Las Vegas, where one-third of the local economy is in the leisure and hospitality industry. Most of those jobs cannot be done from home. Once the Vegas strip shut down, thousands of restaurant, hotel and casino workers found themselves out of work.

For the Andersons, it has been a hard year, and it was a very hard Christmas.

Ms. Anderson said they could not afford to buy Nylah gifts as in years past, and that it hurts. She said they have been following the news from Washington, and she worries that her husband’s unemployment benefits could end for good.

“The stress is unimaginable,” she said in the email. “The pandemic is not our fault. My husband and I were stable, our life was in order.”

She added: “I just want our life back.”

Nurses at Arrowhead Regional Medical Center administered coronavirus tests at the hospital’s drive-through testing site in Colton, Calif., this month.
Credit…Alex Welsh for The New York Times

With bubble-enclosed Santas and Zoom-enhanced family gatherings, much of the United States played it safe over Christmas while the coronavirus rampaged across the country.

But a significant number of Americans traveled, and uncounted gatherings took place, as they will over the New Year holiday.

And that, according to the nation’s top infectious disease expert, Anthony S. Fauci, could mean new spikes in cases, on top of the existing surge.

“We very well might see a post-seasonal — in the sense of Christmas, New Year’s — surge,” Dr. Fauci said on CNN’s “State of the Union.”

“We’re really at a very critical point,” he said. “If you put more pressure on the system by what might be a post-seasonal surge because of the traveling and the likely congregating of people for, you know, the good warm purposes of being together for the holidays, it’s very tough for people to not do that.”

On “Fox News Sunday,” Adm. Brett P. Giroir, the administration’s testing coordinator, noted that Thanksgiving travel did not lead to an increase of cases in all places, which suggested that many people heeded recommendations to wear masks and limit the size of gatherings.

“It really depends on what the travelers do when they get where they’re going,” Admiral Giroir said. “We know the actual physical act of traveling in airplanes, for example, can be quite safe because of the air purification systems. What we really worry about is the mingling of different bubbles once you get to your destination.”

Still, U.S. case numbers are about as high as they have ever been. Total infections surpassed 19 million on Saturday, meaning that at least 1 in 17 people have contracted the virus over the course of the pandemic. And the virus has killed more than 332,000 people — one in every thousand in the country.

Two of the year’s worst days for deaths have been during the past week. A number of states set death records on Dec. 22 or Dec. 23, including Alabama, Wisconsin, Arizona and West Virginia, according to The Times’s data.

And hospitalizations are hovering at a pandemic height of about 120,000, according to the Covid Tracking Project.

Against that backdrop, millions of people in the United States have been traveling, though many fewer than usual.

About 3.8 million people passed through Transportation Safety Administration travel checkpoints between Dec. 23 and Dec. 26, compared with 9.5 million on those days last year. Only a quarter of the number who flew on the day after Christmas last year did so on Friday, and Christmas Eve travel was down by one-third from 2019.

And AAA’s forecast that more than 81 million Americans would travel by car for the holiday period, from Dec. 23 to Jan. 3, which would be about one-third fewer than last year.

For now, the U.S. is no longer seeing overall explosive growth, although California’s worsening outbreak has canceled out progress in other parts of the country. The state has added more than 300,000 cases in the seven-day period ending Dec. 22. And six Southern states have seen sustained case increases in the last week: Tennessee, Alabama, Georgia, South Carolina, Florida and Texas.

Holiday reporting anomalies may obscure any post-Christmas spike until the second week of January. Testing was expected to decrease around Christmas and New Year’s, and many states said they would not report data on certain days.

On Christmas Day, numbers for new infections, 91,922, and deaths, 1,129, were significantly lower than the seven-day averages. But on Saturday, new infections jumped past 225,800 new cases and deaths rose past 1,640, an expected increase over Friday as some states reported numbers for two days post-Christmas.

Preparation of a vaccine in a laboratory at the Piacenza hospital in Piacenza, Italy, on Sunday.
Credit…Alessandro Grassani for The New York Times

Pope Francis, whose plans for being inoculated have not been made public by the Vatican, on Sunday welcomed the arrival of a coronavirus vaccine in Italy.

Speaking from a library in the Vatican instead of St. Peter’s Square, where he would usually greet the faithful on Sundays, the pope said his thoughts were with families who have suffered because of the pandemic.

He said his thoughts were also with “the doctors, nurses and health care professionals on the front lines, whose commitment to fight the coronavirus has had important repercussions on family life.”

The Vatican’s own vaccination campaign to inoculate its citizens, employees and their families, though not children under 18, is expected to kick off in January.

The first doses in Italy were given shortly after 7 a.m. on Sunday to three health care workers at Rome’s Spallanzani hospital for infectious diseases, prompting a round of applause.

“It’s the beginning of the end,” Claudia Alivernini, a nurse at the hospital, told Italy’s state news channel. She said she was “honored” and “grateful” to be part of a “day we will never forget.”

In all, nearly 10,000 doses were given on Sunday, and the Italian news media was filled with videos of people being given jabs in the nation’s hospitals, where frontline workers were given priority.

Domenico Arcuri, the official overseeing the logistics of Italy’s coronavirus response, said that 470,000 doses of the Pfizer vaccine would be arriving per week.

“Today is not a day of polemics. All the European countries will begin together, and will all arrive together,” he told reporters in Rome, responding to concerns that most Italians will not receive the vaccine for months.

Italian newspapers greeted the campaign’s start with enthusiasm but tempered expectations. “Vaccine, a Beginning for Few, the Real Campaign is in April,” read a front-page headline in the Roman daily Il Messaggero.

Italian officials say they hope that about 30,000 doses a day can be administered, seven days a week. The push has started with health care workers and nursing home residents, a process that officials estimate will take at least eight weeks.

Next in line will be Italy’s oldest citizens and other at-risk groups. By the end of February, colorful flower-shaped pavilions are expected to be installed in 1,500 public squares as part of the country’s vaccination campaign.

Vaccination teams leaving the former Tegel airport in Berlin to distribute doses on Sunday.
Credit…Lena Mucha for The New York Times

“Am I famous now?” Kurt Klingseisen, 90, asked as he and his wife, Helga, 83, rolled up their sleeves to receive injections of the BioNTech-Pfizer coronavirus vaccine on Sunday morning in the southern German state of Bavaria.

The couple, who live in a nursing home in Germering, were among the first to be inoculated in Germany, whose scientists played a lead role in developing the vaccine.

“This is a day of hope,” Dilek Kalayci, Berlin’s leading health official, said after the first residents in the capital received their jabs. “This vaccine is a stroke of luck. That we even have a vaccine after only 10 months is not to be taken for granted.”

Unlike some other European countries, where political leaders were first in line to receive the vaccine in an effort to raise public confidence, members of the German government said they would wait for their turn.

For days, doctors had been visiting the homes, explaining to residents what would happen on Sunday when the nationwide immunization program began. They secured residents’ willingness to accept the vaccine, which was developed in the western city of Mainz by the firm BioNTech and produced and distributed together with the U.S. pharmaceutical company Pfizer.

Semi-trucks carrying about 150,000 doses arrived in Germany under police escort and distributed them to 400 vaccination centers across the country. Teams of volunteer doctors are administering the jabs free of charge to the public.

Early Sunday, the first vaccinators fanned out to nursing homes across the country. Many of Germany’s 29,778 recorded deaths from Covid have been residents in such facilities. Based on a plan drawn up by government officials, medical experts and members of a national Ethics Council, people age 80 and older and their caregivers are being prioritized, followed by medical and other frontline workers.

Delays were reported in eight districts in the southeastern region of Bavaria, where the authorities said thermometer readings in the coolers used to transport doses showed that the temperature may have risen above the maximum 8 degrees Celsius, or 46 degrees Fahrenheit. Officials said they would consult with BioNTech over the safety of the roughly 1,000 doses involved before deciding whether they could be used.

By the end of the year, Germany expects to receive 1.3 million doses, and officials have said they hope the vaccine will be available to the wider public by the summer.

The next challenge will be to persuade people skeptical of the vaccine to be inoculated. About two-thirds of people in Germany are willing to be vaccinated, according to a recent survey by YouGov and the German news agency D.P.A.

“Everyone who participates is saving lives,” Jens Spahn, the health minister, said at the launch of the vaccine campaign. “The vaccine is the key to getting out of this pandemic.”

A nearly empty street before a curfew in Istanbul this month.
Credit…Chris Mcgrath/Getty Images

The coronavirus did not start Turkey’s economic ails, but it greatly worsened them.

The country had been grappling with a falling currency and double-digit inflation for two years when the pandemic hit in March, adding to a deep recession. Nine months in, as a second wave of the virus sweeps through Turkey, there are signs that a significant portion of the population is overwhelmed by debt and increasingly going hungry.

For President Recep Tayyip Erdogan, who drew attention this year at home and abroad with an aggressive foreign policy and military interventions, things suddenly came to a head in November.

The government admitted that it had been understating the extent of Turkey’s coronavirus outbreak by not recording asymptomatic cases, and new data revealed record infection levels in the country.

Hacer Foggo, founder of the Deep Poverty Network, a group that helps street traders and informal workers, said that in her nearly 20 years of working to alleviate urban poverty in Turkey she had never seen such distress.

Ms. Foggo laid the blame squarely on local and national governments for their lack of strategy for confronting growing poverty and failing to improve social services.

Indeed, the economic tailspin came after Mr. Erdogan tightened his reins on the country, including over the economy, by acquiring sweeping powers under a new presidential system inaugurated in 2018. International monitors cite those changes as a main reason for their alarm about the country’s economic plunge.

Waiting for free antigen testing in Paris last week.
Credit…Andrea Mantovani for The New York Times

Canada, France, Japan, Spain and Norway have found small numbers of infections involving a new, potentially more transmissible variant of the coronavirus, most linked to travel from Britain, where it was first detected.

The rapid spread of the variant led to the lockdown of London and southern England, prompted a temporary French blockade of the English Channel and resulted in countries around the world barring travelers coming from Britain. Because few countries have the level of genomic surveillance that Britain does, there is concern that the variant may have been traveling across the world undetected for weeks.

A recent study by British scientists found no evidence that the variant was more deadly than others but estimated that it was 56 percent more contagious.

The British variant has been diagnosed in seven people in Japan, the country’s health ministry said. All had either recently traveled to Britain or were in contact with someone who had.

The discovery in Japan prompted the country to close its borders to all new entry by nonresident foreigners. The ban will go into effect at midnight on Monday and last through the end of January, the public broadcaster NHK reported.

In Spain, the variant was found in the capital region, the local authorities said on Saturday. Antonio Zapatero, a regional health official, said that four cases had been confirmed in Madrid, while another three were being treated as suspicious. At least two of the cases involve people who had recently been to Britain and then tested positive in Madrid, as well as some of their relatives.

In France, the first case of the new variant was identified on Friday, according to the country’s health ministry. Officials said the patient was a French citizen living in Britain who had traveled from London to Tours, a city in central France, on Dec. 19, a day before the British government imposed a lockdown because of the variant.

Officials in Sweden said on Saturday that a case of the variant had been detected there after a traveler visited Sormland, near Stockholm, from Britain over Christmas, Reuters reported.

Health officials in Ontario, Canada, said on Saturday that they had confirmed two cases of the variant in the province. The two cases included a couple from Durham, about 90 miles northwest of Toronto. The couple had no known travel history, exposure or high-risk contacts, the province’s health ministry said.

And on Sunday, the Institute of Public Health in Oslo reported that two travelers from Britain who had entered Norway this month had the new variant, according to Reuters.

It is normal for viruses to mutate, and most of the coronavirus mutations have proved minor. The British variant has a constellation of 23 mutations, several of which might alter its transmissibility. Vaccine experts are confident that the available vaccines will be able to block the new variant, although that has to be confirmed by laboratory experiments that are now underway.

A few other concerning variants have also been identified, including one in South Africa and another in Nigeria. Britain said on Thursday that it would ban travel from South Africa after the health secretary, Matt Hancock, said two people were confirmed to have been infected with the variant that emerged there.

Germany, the Netherlands, Lebanon, Australia and Singapore have identified infections with the new variant. And Denmark, which has wider genomic surveillance than many other countries, detected 33 cases of it from Nov. 14 to Dec. 14, according to the Danish health authorities.

The United States has not yet reported any cases of the British variant. But the country will require all airline passengers arriving from Britain to test negative for the coronavirus within 72 hours of their departure, the Centers for Disease Control and Prevention said on Thursday. The rule will take effect on Monday.

Hisako Ueno and Mike Ives contributed reporting.

A nurse taking a coronavirus patient outside for fresh air and sunlight at the Daryeel hospital in Somaliland, a self-governing region of Somalia.
Credit…Samantha Reinders for The New York Times

PORT ELIZABETH, South Africa — When the pandemic began, global public health officials raised grave concerns about the vulnerabilities of Africa. But its countries over all appeared to fare far better than those in Europe or the Americas, upending scientists’ expectations.

Now, the coronavirus is on the rise again in areas of the continent, posing a new and possibly deadlier threat.

In South Africa, a crush of new cases that spread from Port Elizabeth is growing steeply across the nation. Eight countries, including Mali, Nigeria and Uganda, recently recorded their highest daily case counts all year.

“The second wave is here,” John N. Nkengasong, the head of the Africa Centers for Disease Control and Prevention, has declared.

When the virus was first detected, many African countries were considered particularly at risk because they had weak medical, laboratory and disease-surveillance systems and were already battling other contagions. Some were torn by armed conflict, limiting health workers’ access. In March, Tedros Adhanom Ghebreyesus, the first African director-general of the World Health Organization, cautioned, “We have to prepare for the worst.”

But many African governments pursued swift, severe lockdowns that — while financially ruinous, especially for their poorest citizens — slowed the rate of infection. Some deployed networks of community health workers. The Africa C.D.C., the W.H.O. and other agencies helped expand testing and moved in protective gear, medical equipment and pharmaceuticals.

The reported toll of the pandemic on the continent — 2.6 million cases and 61,000 deaths, according to the Africa C.D.C. — is lower than what the United States alone currently experiences in three weeks. But that accounting is almost certainly incomplete.

Evidence is growing that many cases were missed, according to an analysis of new studies, visits to nearly a dozen medical institutions and interviews with more than 100 public health officials, scientists, government leaders and medical providers on the continent.

“It is possible and very likely that the rate of exposure is much more than what has been reported,” Dr. Nkengasong said in an interview.

Gabriella Ortega, a respiratory therapist, speaks to a health care worker who is helping to treat a Covid-19 patient at Providence St. Mary Medical Center in Apple Valley, Calif., on Dec. 17.
Credit…Ariana Drehsler for The New York Times

California, the wealthiest and most populous state of the world’s wealthiest country, has long had a dearth of hospital beds — just 1.8 beds per 1,000 people, according to 2018 data compiled by the Kaiser Family Foundation. Now a record-shattering slew of coronavirus cases has wiped out intensive care unit capacity in a large swath of the state.

Southern California, its most populous region, and San Joaquin Valley, a central region, have 0 percent I.C.U. capacity, keeping them under a stay-at-home order until at least Dec. 28, the California Department of Public Health said on Saturday.

Intensive care units in the Bay Area region are at 11.3 percent capacity and the Greater Sacramento Region has 16.9 percent capacity. Both will likely remain under the order at least into the new year.

Before the pandemic, California’s ratio of hospital beds per person was only slightly higher than Washington State and Oregon, both of which ranked last in the nation. Many of the state’s hospitals kept their number of beds low in part to limit costs.

I.C.U. beds have been limited as well: California only had 2.1 beds per 10,000 people, more plentiful than just 10 other states, according to KFF’s 2018 data.

California is the first U.S. state to report more than 2 million coronavirus cases so far. On Friday, the weekly average of new cases per day in the state was 36,418, according to a New York Times database. That is a 21 percent increase from two weeks prior.

The situation is now out of control, officials and health care workers have warned. At Martin Luther King Jr. Community Hospital in South Los Angeles, resources are so stretched that gurneys have been placed in the gift shop and the lobby is being used to treat patients. And keeping health care facilities sufficiently staffed has been yet another hurdle.

Police officers checked documents of a driver at a police checkpoint in Tel Aviv after Israel imposed a third national lockdown.
Credit…Amir Cohen/Reuters

Israel entered its third nationwide lockdown Sunday afternoon after a jump in positive coronavirus test results over the past week.

The lockdown, which is expected to last at least two weeks, comes amid Israel’s effort to vaccinate a wide swath of its population in the next month.

Israelis are barred from traveling more than one kilometer (or 0.6 mile) beyond their homes save for a number of exceptions, including participating in protests, attending a legal proceeding, receiving a vaccination, among others, the Israeli government decided late last week.

Museums, malls, national parks, zoos, salons, clothing stores and many other places are not allowed to open, the government decision stipulated. Restaurants are permitted only to offer delivery.

While the lockdown came into effect on Sunday, the Knesset, which is required to vote on the restrictions, still has not made a decision on most of them.

On Sunday, however, the Parliament’s education committee overturned the government’s decision to only allow some schools to remain open. On Monday, most schools are expected to be open.

Israel has averaged 3,683 virus cases per day over the past week — a significantly higher number than the preceding seven days, according to a New York Times database.

On Sunday, Yuli Edelstein, the health minister, called on Israelis to take it upon themselves to abide by the lockdown.

“If we all act responsibly, we will see the large light at the end of the pandemic,” Mr. Edelstein said.

Israeli officials have emphasized that they hope the vaccine will enable the country to restore a sense of normalcy in the near future.

As of Sunday, health professionals had already administered more than 300,000 doses of the vaccine, making the country the most inoculated population per capita in the world.

In a recorded message released on Saturday, Prime Minister Benjamin Netanyahu said Israel was aiming to begin vaccinating 150,000 people per day within the coming week.


A doctor examining a coronavirus patient at at a hospital in Neave, just outside Port Elizabeth, South Africa, in late November.
Credit…Samantha Reinders for The New York Times

On Sunday, reported coronavirus infections in South Africa surpassed one million since the start of the pandemic.

The country has now recorded 1,004,413 cases and 26,735 deaths.

With one of the strictest initial lockdowns in the world, South Africa avoided the high death toll that many experts feared. As restrictions eased in the last quarter of the year, however, the death toll climbed steadily, beginning to spike as the holiday season approached.

Many South Africans also traveled from cities to more rural provinces to celebrate the holidays. Officials recorded a daily increase of more than 14,000 cases on Christmas Day and the two days before, though the number fell to 9,502 on Sunday.

Physicians and nurses described overwhelmed hospitals. “For many of the young doctors at the front line, it’s an incredibly traumatic experience, the moral trauma of having to, if you will, decide who lives and dies,” said Dr. Ntobeko Ntusi, chair and head of medicine at Groote Schuur Hospital, a large public institution in Cape Town.

Dr. Ntusi said there had been some patients who were “28, 32 years old” without other health conditions who had extremely low oxygen levels from Covid-19 pneumonia. But because of the overwhelming demand for resources, “We are not able to offer them the treatment that we know can save their lives.”

Some medical professionals urged the government to return to stricter lockdown measures and restrict gatherings. “There’s a huge problem regarding adequate staff, nurses as well as doctors,” Dr. Angelique Coetzee, the president of the South African Medical Association, told SABC News, the public broadcaster, on Sunday.

As the number of infections climbed, President Cyril Ramaphosa held an emergency meeting with the National Coronavirus Command Council and would be submitting their proposals to the country’s Cabinet, according to local news reports. Mr. Ramaphosa is expected to announce new measures soon.

Early in December, South Africa tried to curb the spread of infections in hot spots by imposing a curfew, banning the sale of alcohol on weekends and closing beaches. Masks were made mandatory at all gatherings.

Scientists from the Nelson R. Mandela School of Medicine at the University of KwaZulu-Natal discovered a variant of the virus that accounts for the vast majority of samples tested in the current wave. It has one change in common with a distinct variant recently discovered in Britain that has led to travel bans; scientists believe both new lineages may be more easily transmissible. So far there is no evidence that they are associated with more severe disease.

Doctors began noting an increased number of younger patients who had no vulnerabilities, or comorbidities, Zweli Mkhize, the minister of health, said in a statement announcing the discovery earlier this month. That may be at least in part related to large gatherings of young people, including student parties, that officials say have been amplifying the spread of the virus.

South Africa does not have access to any vaccines yet, but Mr. Ramaphosa has said that the country will have soon enough vaccines for 10 percent of the population. They will arrive via an agreement with Covax, an international body established to promote equitable access to vaccines. Unlike 92 low- and middle-income countries, which will be receiving support to make their purchases, as a higher-middle income country, South Africa will finance its doses.

In other developments around the world:

  • Indonesia will bar entry to international visitors for two weeks from New Year’s Day to stem the spread of new, potentially more contagious strains of the coronavirus, Reuters reported, with an exemption only for high-level government officials. The country barred travelers from Britain a few days ago, and tightened rules for those arriving from Europe and Australia, expanding on an earlier tourism ban.

  • South Korea has discovered three cases of the variant first detected in Britain, officials said on Monday. All were in members of a London-based family who arrived in the country on Dec. 22, according to the Korea Disease Control and Prevention Agency. All three have been in isolation since testing positive on arrival. South Korea, which is struggling to contain a third wave of infections, is among dozens of countries that have temporarily banned flights from Britain in response to the new variant. The country of about 50 million people reported 808 new cases on Monday, bringing the national total to 57,680, with 819 deaths.

  • Frontline workers in Sydney, Australia, will not be allowed to watch the New Year’s Eve firework display from the harbor as planned, Gladys Berejiklian, premier of the state of New South Wales, said Monday, citing a growing coronavirus outbreak in the city’s northern suburbs. “We’ll find another opportunity during the year to recognize what you’ve done,” Ms. Berejiklian said to the workers, about 5,000 of whom would have been invited. Other restrictions announced for Dec. 31 include lowering a limit on outdoor gatherings to 50 from 100 and barring people who live outside the central business district from entering unless they have a venue booking and an entry permit. The city reported five locally transmitted cases on Monday, bringing the total in the cluster to 126.

Demonstrators protested federal executions of death row inmates in front of the Justice Department this month. Lisa Montgomery’s scheduled execution remains in limbo.
Credit…Nicholas Kamm/Agence France-Presse — Getty Images

A judge’s ruling to delay the execution of the only woman on federal death row could push the new date into the early days of the administration of President-elect Joseph R. Biden Jr., who has vowed to work to end federal capital punishment.

The woman, Lisa Montgomery, was scheduled to be executed on Dec. 8, but that date was delayed after two of her lawyers tested positive for the coronavirus shortly after traveling to a federal prison in Texas to visit her in November.

Should Ms. Montgomery’s life be spared as a result of the delays from her lawyers’ infection, it would be a rare reprieve for a prisoner from a virus that has swept through prisons, infecting inmates crammed into shared spaces.

The Justice Department had rescheduled her execution for Jan. 12, but Judge Randolph D. Moss of the U.S. District Court for the District of Columbia ruled on Thursday that the January execution date had been unlawfully rescheduled because a stay order issued because of her lawyers’ illnesses was still in effect.

Ms. Montgomery, of Melvern, Kan., was convicted in 2008 of killing a pregnant woman and cutting a baby from her abdomen. She tried to pass off the baby as her own before admitting to the crime.

Ms. Montgomery’s lawyers have said that she has severe mental illness, which was inherited from both of her parents and worsened by abuse endured as a child, including being sex-trafficked by her mother and gang-raped by men.

The stay in Ms. Montgomery’s case barred the government from executing her before Dec. 31. How long the government will wait to execute her after that point remains unclear. Federal rules state that execution notices must be given to prisoners at least 20 days in advance, but when the rescheduled date is fewer than 20 days from the original date, the prisoner must be notified only “as soon as possible.”

Marie Fazio and Hailey Fuchs contributed reporting.

Michael Callaway working the door at the Cantab Lounge, a longtime establishment in Cambridge, Mass., in 2008. The lounge’s owner put it up for sale this year, ending its 50-year run.
Credit…Jodi Hilton for The New York Times


The Cantab: A dive bar that drew poets, too.

Before Cambridge, Mass., became a tech boomtown, the Cantab sat on a stretch of Massachusetts Avenue that was genuinely grungy. The bar took only cash. It was always sticky, and you wouldn’t want to use the bathroom.

But if you wandered in there on the right night, you could find a poetry slam or bluegrass night or Little Joe Cook and the Thrillers. Ben Affleck’s father used to work there, serving Budweisers to off-duty postal workers.

In July, when the Cantab’s owner, Richard Fitzgerald, announced that he was putting it up for sale after 50 years, a howl of distress went up from that old, scruffy bohemian Cambridge. Mr. Fitzgerald, known as Fitzy, hopes to find a new buyer to reopen the place in the summer — let’s hope in its old, sticky style. — Ellen Barry


The Cake Cafe and Bakery: Long mornings over crab omelets and cupcakes.

On Saturday and Sunday, mornings the line ran out the door. People waited for French toast, biscuits and gravy, and crab omelets the size of phone books; you could add a cupcake for a dollar.

The staff knew most of the customers on sight, except during carnival season when the tourists flocked. By that time, those in the know had already ordered a king cake, in competition with the best in the city. It closed in June. — Campbell Robertson


The Original Hot Dog Shop: It was never really about the hot dogs

The warnings about the fries were as legendary as the fries themselves.

The large is huge!

Order it with friends.

Seriously, you can’t eat it by yourself.

The Original Hot Dog Shop had “hot dog” right there in the name, but it was the fries — perfectly cut, fried twice in peanut oil to extra crispness, served in a huge pile in a paper basket, with side cups of beef gravy or cheese product — that people talked about.

The University of Pittsburgh’s student newspaper reported that when the O, as the hot dog shop was known, closed in April, the owners served up one more giant order of fries, donating 35,000 pounds of potatoes to charity. — Scott Dodd


The Ma’am Sir restaurant: A Filipino spot with a boisterous vibe.

Credit…Lisa Corson for The New York Times

When Charles Olalia decided to open a Filipino restaurant in Los Angeles’s hip Silver Lake district, he wished to “showcase my country’s food and vibe: beautiful, boisterous, loving” to a wide audience, he said.

Ma’am Sir opened in 2018 to rave reviews for its creative renditions of signature Filipino dishes, like sizzling pork sisig and oxtail kare-kare.

“Ma’am Sir was different,” said Cheryl Balolong, 41, who grew up visiting traditional Filipino cafeteria-style joints in strip malls. “It was a place where we felt proud to bring friends who weren’t from our culture.”

Then the pandemic struck. By August, Mr. Olalia had shut the place down. “Day after day, putting food in a box and seeing an empty dining room, I was getting farther and farther away from what the restaurant really was and why I built it,” he said. — Miriam Jordan

Saying goodbye at O'Hare International Airport in Chicago on Wednesday.
Credit…Scott Olson/Getty Images

With bubble-enclosed Santas and Zoom-enhanced family gatherings, much of the United States played it safe over Christmas while the coronavirus rampaged across the country. But, as during Thanksgiving, a significant number of Americans traveled, raising the prospect of a spike in infections on top of the current surge.

Many European countries are under restrictions, but Christmas is celebrated so broadly — and New Year’s festivities will follow shortly — that the concern of a post-holiday spike reaches far beyond a single country.

Case numbers remain about as high as they have ever been, both in the U.S. and throughout the world. Total U.S. infections surpassed 19 million on Saturday, while the world total passed the 80 million mark, according to a New York Times database.

For now, the U.S. is no longer seeing overall explosive growth, although California’s worsening outbreak has canceled out progress in other parts of the country. The state has added more than 300,000 cases in the seven-day period ending Dec. 22. And six Southern states have seen sustained case increases in the last week: Tennessee, Alabama, Georgia, South Carolina, Florida and Texas.

The country’s virus-related deaths in general have continued to climb. And hospitalizations are hovering at a pandemic height of about 120,000, according to the Covid Tracking Project.

More than 330,000 people in the United States have died since the pandemic began, and two of the four worst days for deaths so far have been during the past week. A number of states set death records on Dec. 22 or Dec. 23, including Alabama, Wisconsin, Arizona and West Virginia, according to The Times’s data.

Holiday reporting anomalies may obscure any post-Christmas spike until the second week of January. Testing was expected to decrease around Christmas, and many states said they would not report data on certain days. On Christmas Day, numbers for both new infections, 91,922, and deaths, 1,129, were significantly lower than the seven-day averages. On Saturday, the country had at least 225,900 new cases and at least 1,640 new deaths, an expected increase over Friday as some states reported two days’ worth post-Christmas.

The lessons learned from Thanksgiving are mixed. Case numbers and deaths have continued to rise since, but the patterns look more like a plethora of microspreads than a mass superspreader event.

Over all, experts have told The Times, areas of the U.S. that were improving pre-Thanksgiving — like the Midwest — continued to do well afterward, while regions that were seeing higher numbers before the holiday continued to worsen.

Only time will tell whether new infections will result from increased exposure during the late-December holidays — from seeing family, passing through airports or buying food for celebrations. More than one million people passed through Transportation Safety Administration travel checkpoints on each of four recent days — Dec. 18, 19, 20 and 23 — but that was less than half the number for those days last year, according to the agency’s data. Only a quarter of the number who flew on the day after Christmas last year did so on Friday, and Christmas Eve travel was down by one-third from 2019.

So, as with Thanksgiving, Christmas will produce “a continuing ramification” of whoever is infected over the winter holidays, said Catherine L. Troisi, an infectious-disease epidemiologist at the University of Texas’ School of Public Health in Houston, so it is crucial to keep up protective measures.

What the Ghost of Christmas Yet to Come will bring, Dr. Troisi said, “is up to us.”

Vaccines are produced in a variety of ways, either by weakening or inactivating the virus, using just part of the virus, or by providing the body with a bit of the virus’ genetic code. Moderna’s COVID-19 vaccine, for example, contains a bit of messenger RNA that codes for the spike protein found on the surface of the SARS-CoV-2 virus. When injected, the body’s muscle cells use that RNA to produce copies of the protein spikes. These in turn instigate an immune response from the body priming the immune system to respond faster the next time it encounters the COVID protein.

Any vaccine in development must first undergo rigorous safety testing before it is approved for use by the FDA. The treatment molecule is first modeled using computer algorithms to estimate how it will interact with the human immune system, then tested on cell cultures. The next stage involves testing the vaccine on animals. Should it prove effective in animals, the vaccine enters Phase I trials with a couple dozen volunteers participating.

Phase II can run for up to two years and involve several hundred patients. Data gathered from these trials “can be used to determine the composition of the vaccine, how many doses are necessary, and a profile of common reactions,” according to the CDC. Once proven safe and effective in phase II, the vaccine will be administered to hundreds or even thousands of patients as part of the multi-year phase III trials, which determine how effective the vaccine is in a large population. Only after the FDA is satisfied that the vaccine is safe can it be licensed for use by the general public.

CDC safety guidelinesCDC

Earning FDA approval can take years to complete, which is why the government is currently allowing drug makers to apply for Emergency Use Authorization instead. In an effort to accelerate the vaccine development process while maintaining stringent safety testing standards, President Trump launched Operation Warp Speed (OWS) in May, 2020. This $10 billion initiative is a public-private partnership tasked with producing and distributing 300 million COVID vaccine doses by January, 2021 as part of a broader federal effort to bring the pandemic under control.

“Rather than eliminating steps from traditional development timelines, steps will proceed simultaneously,” per the HHS, “such as starting manufacturing of the vaccine at industrial scale well before the demonstration of vaccine efficacy and safety as happens normally. This increases the financial risk, but not the product risk.”

Fourteen promising vaccine candidates were initially selected from a pool of hundreds for the Warp Speed program. Those have since been pared down to seven finalists, which are being developed in parallel at an unprecedented speed. No vaccine has ever been created in this little time before.



For example, Moderna’s mRNA-based vaccine, mRNA-1273, started out as a computer model in January but within three months had already rapidly progressed to human studies. By November, just four months after beginning phase III trials, the company demonstrated its vaccine to be 94 percent effective in preventing COVID infection. And among the participants who did contract COVID during the trial, none developed a serious case of the disease. The vaccine requires two injections spaced 28 days apart to maximize its efficacy — but be warned, the technology behind it is so new that researchers aren’t yet certain how long its conferred immunity will last.

Moderna filed for FDA approval on November 30th and the agency’s advisory board granted it emergency usage authorization on December 17th. It was the first time that an mRNA treatment has been approved for use against an infectious disease. But don’t go lining up for your shots just yet: The company will only have a few tens of millions of doses available before it can ramp up production next year.

Pfizer, working in partnership with Germany’s BioNTech, has shown similarly exciting results with its own recently authorized mRNA vaccine, BNT162b2, which earned FDA authorization on December 11th. Like Moderna’s candidate, Pfizer’s vaccine tricks the body into creating COVID protein spikes and uses the resulting immune response to confer immunity. Of the 44,000 participants in Pfizer’s phase III trials, which began in July, only 96 people contracted COVID. The clinical trial results are still preliminary — whether those 96 people were part of the vaccine or placebo groups has not been announced — but they do suggest that BNT162b2 could be more than 90 percent effective.

And the results are even more promising for vulnerable groups. As the LA TImes points out, BNT162b2 prevented 95 percent of COVID cases in both Latinos and non-Latinos, it prevented COVID in 100 percent of Black people, was 94 percent effective in people over the age of 56, 95 percent effective for people with an existing health condition that make them more susceptible to contracting the virus. That’s a tremendous result given that the FDA only required COVID vaccines be 50 percent effective when being submitted  for emergency authorization consideration.

Pfizer has already gained authorization in the UK, the MHRA and the EU’s EMA is set to announce its decision later in December. The company reportedly hopes to have 30 to 40 million doses available by the end of the year with initial deliveries arriving in the US on December 14th.

“Bringing it all together in a first-time, very large-scale operation, is no simple feat,” Pfizer  spokeswoman, Amy Rose, explained to the Washington Post. “It’s as complicated as the research-and-development piece.”

However, not every manufacturer’s efforts have gone as smoothly. Researchers at the University of Oxford had already been working on treatments for MERS, a close relative of the COVID virus, which made adapting to the new challenge a straightforward task, enabling the team to begin phase I trials in April. AstraZeneca subsequently signed on to handle licensing and manufacturing the tens of millions of needed doses. But in September, AstraZeneca ran afoul of US regulators after apparently failing to disclose to the FDA that the company had quietly halted trials worldwide just two days before requesting emergency authorization.

Less expensive to produce and more shelf stable than other COVID vaccines, the Oxford candidate was expected to constitute a large portion of the overall vaccine supply. But after dragging its feet for seven weeks in providing regulators with required documentation regarding the trial stoppages, AstraZeneca has fallen off the pace and has yet to finish enrolling people for its US trials — something the company repeatedly said it hoped to have ready by October. “The world bet on this vaccine,” Dr. Eric Topol, a clinical trial expert at Scripps Research, told the NYT in December. “What a disappointment.”

The search for additional vaccine candidates continues. A study published in the journal Nature in December has identified five genes linked with severe cases of COVID: IFNAR2, TYK2, OAS1, DPP9 and CCR2. These genes, which are involved in antiviral immunity and lung inflammation, could help explain why some folks come down with COVID but remain asymptomatic while others end up in the ICU. More importantly, this identification can help guide researchers in finding new treatments. To date, only the steroid dexamethasone and Gilead’s antiviral remdesivir have been approved to treat COVID patients.

“Our results immediately highlight which drugs should be at the top of the list for clinical testing,” Edinburgh University’s Kenneth Baillie, who co-led the research, told Reuters.

But developing effective vaccines is only half the challenge. Ensuring that the vaccine is distributed equitably and efficiently is of critical importance but, as the OWS handout below illustrates, the process involves a lot of moving parts depending on which company is making it.



To complicate the situation further, health officials around the country already anticipate a coming vaccine shortage struggle. The federal government has already announced it will stagger deliveries to states so that they can maintain a sufficient supply to administer the vaccine’s second dose 21 – 28 days later. And despite the White House’s repeated promises that a stockpile of 300 million doses would be assembled by the end of this year, the government is currently on pace to deliver only a tenth of that, around 30 – 40 million doses.

Officials in Maine, for example, were originally promised 36,000 doses but have since seen their allotment dwindle to only 12,675. Any potential shortages will hopefully be short lived and rectified come January and February as manufacturers ramp up production. Pfizer originally sought to produce 100 million doses by the end of the year but has had to revise that down to just 50 million in recent months. However the company aims to produce 1.3 billion doses in 2021.

There are a number of factors that have hindered distribution efforts, from shortages of raw materials to manufacturing setbacks and difficulties in scaling production to a high enough level. “There were a couple of our vaccine candidates that took significantly longer, in terms of failed batches, in terms of not having the purity we sought,” Paul Mango, HHS deputy chief of staff for policy, told the Washington Post. “We have cracked the code on these things but we’re two months behind on some of them.”

Moderna, on the other hand, has been hindered by supply bottlenecks for the specialized materials used to create the vaccine. “The swing factor between 500 million and 1 billion [doses] is raw materials,” Moderna CEO Stephane Bancel noted in a recent interview. He explains that the company has already scaled up production by a factor of 1,000 in 2020. “Some of our suppliers were not ready for that, of course,” he continued.

Despite these challenges, Operation Warp Speed chief adviser Moncef Slaoui remains optimistic that America will see a return to semi-normalcy by next Spring. “I think we may start to see some impact on the most susceptible people probably in the month of January and February, but on a population basis, for our lives to start getting back to normal, we’re talking about April or May,” Slaoui told a Face the Nation panel earlier this month.



Countering misinformation about the vaccine and convincing a skeptical public that it is indeed safe poses even more problems for health officials. A recently published study out of North Carolina State University suggests that our inflated opinions of our own ability to spot online misinformation better than other folks — known as the “third person effect” — plays a large part in misinformation’s resilience.

The third person effect “makes it harder to get people to participate in media literacy education or training efforts,” assistant professor of communication at NCSU, Yang Cheng, explained in a press release. “It suggests that most people think everyone else needs the training more than they do.”

Of course, the Trump administration hasn’t exactly done itself any favors on the topic of misinformation. The president has spent the weeks since November’s election making unfounded claims about election fraud rather than participating in the transition process, which would enable the incoming Biden administration to seamlessly take over the fight against COVID. But, as such, president-elect Biden and his team have been largely kept in the dark about the current administration’s pandemic response. It wasn’t until the second week of December that Biden first had an opportunity to meet with OWS’ Moncef Slaoui.

“We haven’t had any meetings yet. I know we have a meeting this coming week and we really look forward to it because actually things have been really very appropriately planned,” Slaoui said on Face the Nation earlier this month.

We plan to have all the ancillary material, the syringes, the needles, the swabs, everything co-localized with the vaccine. So, I think the plans are there,” he continued. “And I feel confident that once we will explain it, everything in detail, I hope the new transition teams will understand that things are well planned.”

In a separate interview with Fox News Sunday, Slaoui cautioned against getting complacent once the vaccine becomes available. “We all need to take our precaution, wear our masks, wash our hands, keep our distance, remain aware that this virus is a killer,” he warned adding that there is “light at the end of the tunnel, but we will not all have the vaccine in our arms before May or June, so we need to be very cautious and vigilant.”

A few weekends ago, while trying to convince my 4-year-old son that pants are still required for afternoon hikes, my pocket buzzed with a text message that canceled everything.

“COVID19 Community Tracing Collaborative: We have information about the status of your test. We need to speak with you and will call you back.”

Having written about efforts to trace people exposed to Covid-19, I knew what it meant. Sure enough, a few hours later, a contact tracer called to deliver the bad news: I’d tested positive. She told me I needed to isolate, and she asked for the names and phone numbers of those I’d been in close contact with so that they could be alerted.

Read all of our coronavirus coverage here.

It was worrying of course—but also baffling. I had no symptoms, to my knowledge I hadn’t been near anyone sick, and I’m always careful about mask-wearing, handwashing, and social distancing.

I’d barely left the house in weeks, in fact. As I explained to the tracer, the only interaction I’d had with anyone outside my family bubble in the past week was meeting an old friend, but that was outside, both of us wearing masks and staying at least 6 feet apart. My son is in daycare, and we’ve been in a “bubble” with another family whose child also attends. But his school has introduced all sorts of precautions, with teachers and parents voluntarily testing regularly, a new air filtration system, and countless cleaning and safe-distancing protocols. It all seemed like a shocking reminder of how sneaky the virus really is.

After a few days pacing my hotel room, however, I was less sure. By then, my wife and son had both received several negative results; my friend and the other family had too, along with about two dozen parents and kids at the daycare.

I took a second test three days after the first, and the results came back overnight: negative. At my doctor’s suggestion, I took a third, three days after that at a different location. That too came back all clear. As per the guidelines at the time from the Centers for Disease Control and Prevention, I remained in quarantine for two weeks. But increasingly it felt like maybe something had gone wrong.

I began to wonder what it means to test positive. A Covid test is not a binary thing. There is no single, standard way to detect the virus; different labs set their own thresholds for signaling a positive result. Some experts now think that the sensitivity of a test, and how much virus it detects, should be factored into behavioral guidelines and the public health response.

My initial test was at a drive-through site run by the city of Cambridge, Massachusetts. A swab from my nose went from there to the Broad Institute, a biomedical research center created by Harvard and MIT that converted its genomics lab into a Covid-19 testing facility in March.

The Broad uses a technique known as polymerase chain reaction (PCR) to detect viral genetic material in a sample. A PCR test typically takes a day or more to produce a result, but it is considered the gold standard of Covid testing, because it’s so good at picking up minuscule fragments of the virus. Rapid tests, which detect specific proteins on the surface of the virus, are cheaper and faster, but they are less accurate than PCR and work best when someone has high levels of the virus.

A PCR Covid test involves preparing a sample using chemical reagents to isolate fragments of RNA and enzymes to generate complementary strands of DNA. The lab then amplifies this DNA by adding compatible strands carrying fluorescent markers that break off and activate after binding. This process is repeated over and over. If the virus is present, then the chamber containing the sample should start to glow.

The number of cycles required to trigger a result is crucial. The more virus someone is carrying, the fewer cycles needed; more cycles mean the patient likely has only a low level of infection. Labs generally do not disclose the number of cycles required to get a result—only whether or not there is one. Broad uses 40 cycles as the limit for its tests, as recommended by the CDC. If the sample doesn’t glow by 40 cycles, the result is considered negative. But some other labs use different thresholds.

A volunteer in Oxford, England, last week received the vaccine made by AstraZeneca and the University of Oxford.
Credit…Andrew Testa for The New York Times

The drugmaker AstraZeneca announced on Monday that an early analysis of some of its late-stage clinical trials, conducted in the United Kingdom and Brazil, showed that its coronavirus vaccine was 70.4 percent effective in preventing Covid-19, suggesting that the world could eventually have at least three working vaccines — and more supply — to help curb the pandemic.

The British-Swedish company, which has been developing the vaccine with the University of Oxford, became the third major vaccine developer in this month to announce encouraging early results, following Pfizer and Moderna, which both said that their vaccines were about 95 percent effective in late-stage studies.

AstraZeneca’s results are a reassuring sign of the safety of the vaccine. It came under global scrutiny after AstraZeneca temporarily paused its trials in September to investigate potential safety issues after a participant in Britain developed a neurological illness.

Oxford and AstraZeneca said they would submit their data to regulators in Britain, Europe and Brazil and seek emergency authorization.

The company said its early analysis was based on 131 coronavirus cases. The trials used two different dosing regimens, one of which was 90 percent effective in preventing Covid-19 and the other of which was 62 percent effective.

The regimen that was 90 percent effective involved using a halved first dose and a standard second dose. Oxford and AstraZeneca also said that there were no hospitalized or severe cases of the coronavirus in anyone who received the vaccine, and that they had seen a reduction in asymptomatic infections, suggesting that the vaccine could reduce transmission.

AstraZeneca’s vaccine is expected to come with relatively simple storage requirements, which would be an asset once it gets rolled out. The company has said it anticipates the vaccine will require refrigeration, though it has not provided details about how long and at what temperature it can be kept. Moderna’s vaccine can be kept for up to a month at the temperature of an ordinary refrigerator. Pfizer’s can be kept for up to 5 days in conventional refrigerators, or in special coolers for up to 15 days, but otherwise needs ultracold storage.

AstraZeneca has said it aims to bring data from its studies of its vaccine being conducted overseas to the Food and Drug Administration — which would mean that the agency will likely review and authorize a vaccine before late-stage data are ready on how well the vaccine works in American participants. British regulators already have been conducting a so-called rolling review of the vaccine.

“Today marks an important milestone in our fight against the pandemic,” AstraZeneca’s chief executive, Pascal Soriot, said. “This vaccine’s efficacy and safety confirm that it will be highly effective against Covid-19 and will have an immediate impact on this public health emergency.”

Professor Andrew Pollard, the chief investigator of the Oxford Vaccine Trial, said that “these findings show that we have an effective vaccine that will save many lives.”

Performing surgery on a coronavirus patient in Houston in August. Medical workers are among the high-priority groups that would receive the vaccine first.
Credit…Erin Schaff/The New York Times

In the wake of results suggesting that two prospective coronavirus vaccines are remarkably effective, the official in charge of the federal coronavirus vaccine program explained on Sunday news shows how the vaccines might be distributed to Americans as early as next month.

Dr. Moncef Slaoui, head of the administration’s Operation Warp Speed, said that within 24 hours after the Food and Drug Administration approves a vaccine, doses will be shipped to states to be distributed. “Within 48 hours from approval,” the first people would likely receive injections, Dr. Slaoui said on ABC’s “This Week With George Stephanopoulos.”

Two companies, Pfizer and Moderna, announced this month that their vaccines were about 95 percent effective, and Pfizer formally submitted an application to the F.D.A. for emergency approval. Regulators at the agency will spend about three weeks reviewing the application. On Dec. 10, an outside advisory board on vaccines will meet to discuss the application, and the agency is expected to make a decision shortly after that meeting. Moderna is expected to submit its own application soon.

Even if the first vaccine is authorized in mid-December, officials and company representatives have estimated that there will only be enough doses available to treat about 22.5 million Americans by January. Each vaccine requires two doses, separated by several weeks.

Dr. Slaoui said vaccines would be shipped to states, proportioned according to their population, and that states would decide how and where to distribute the doses. He said that likely within a day after a vaccine receives F.D.A. authorization, a committee at the Centers for Disease Control and Prevention would issue recommendations for which groups should be first to receive a vaccine.

High-priority groups are likely to include frontline medical workers and residents of nursing homes. Dr. Scott Gottlieb, a former F.D.A. commissioner, said on the CBS show “Face the Nation” that those groups would likely be followed by other older adults and then expanded to younger adults in the spring. Both he and Dr. Slaoui estimated that tens of millions of adults could be vaccinated by sometime in May.

Immunizations for children would follow. Dr. Slaoui said on the CNN show “State of the Union” that the youngest participants in the clinical trials so far have been 12 to 14 years old and that approval for younger children and toddlers would likely not occur until late in 2021, after clinical trials for those age groups are conducted.

On “Face the Nation,” Larry Merlo, the chief executive of CVS Health, said that pharmacists and other medical staff from CVS plan to immunize residents of more than 25,000 long-term care facilities, beginning about 48 hours after a vaccine is approved. He said that for several years, CVS has been going to nursing homes to administer the seasonal flu vaccine, so “we have the systems, we have the processes, and we have built the logistics directly for the Covid vaccine.”

Mr. Merlo, whose company runs 10,000 pharmacies across the country, also said as the supply of the vaccines increase, they would be administered by CVS pharmacies and also by kiosks and mobile trailers that have been doing coronavirus testing in underserved communities.

Nurses picketed outside St. Mary Medical Center in Langhorne, Pa., last week, saying the hospital does not hire enough nurses or pay them competitive wages.
Credit…Jessica Griffin/The Philadelphia Inquirer, via Associated Press

Coronavirus patients are swamping U.S. hospitals in record numbers, straining the health care system much more widely than the first acute outbreaks did in the spring.

The total number of patients in hospitals with Covid-19 nationally has hit new highs every day since Nov. 11, when hospitalizations first exceeded the April peak. There were nearly 84,000 on Sunday, according to the Covid Tracking Project.

The surge comes as the Thanksgiving and the December holidays approach, when travel and family visits are expected to accelerate the spread of the virus and further strain hospitals.

With a week of November left to go, the United States has already had its highest monthly case total, reporting more than 3,075,000 new coronavirus cases since Nov. 1, according to a New York Times database. By the time the month is over, the tally could top four million, more than double the number in October.

November’s case total is nearly 2.9 million more than March’s total.

The landscape has changed markedly since March, when the virus was concentrated mainly in outbreaks on the East and West Coasts and in a few big cities like New Orleans and Detroit. In New York City, especially, when hospitals were flooded with patients in the spring, medical workers were flown in from across the nation to help, and the Navy deployed a hospital ship to the city.

Now, though, with the strain being felt nearly everywhere, few hospitals can spare anyone to help in other places, and the focus is on acute shortages of staff, more than of beds.

The explosion of cases in rural parts of Idaho, Ohio, South Dakota and other states has prompted local hospitals that lack such experts on staff to send patients to cities and regional medical centers, but those intensive care beds are quickly filling up.

After months of unrelenting stress from the pandemic, many workers are getting sick themselves, suffering from burnout or even retiring early. Hundreds of nurses near Philadelphia went on strike last week over the trauma of the pandemic, low pay and limited resources.

The military deployed medical crews to help overwhelmed hospitals in El Paso, and the Texas state government has been dispatching thousands of workers to assist in other hard-hit areas of the state. The traveling nurses that some hospitals depend on for crisis staffing are in high demand in many states, and their rates have shot up. Overall, about one-fifth of U.S. hospitals are now short-staffed, according to an NPR analysis of data from the Department of Health and Human Services.

Hospitals can set up more beds, but “where they’re going to get stretched is on personnel,” Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, said Sunday on the CBS program “Face the Nation.” “They just won’t have the people to staff them.”

Angelia Gower, a patient access manager in the SSM Health system in St. Louis, said she has seen the problem firsthand. She has been filling in on night shifts after several of her employees contracted Covid-19 and one lost a parent to the disease, creating both a logistical challenge and a morale crisis for her department.

“That takes a toll, on not just my employee and her life, but all of the staff that knows her,” Ms. Gower said.

Early in the pandemic, she said, her team was strained by furloughs brought on by the financial pressures that the coronavirus put on the hospital system. Those furloughs are over, she said, but “we are still working short-staffed.”

At Newark International Airport on Saturday. Up to 50 million people in the United States could be traveling for Thanksgiving this week, according to AAA.
Credit…Kena Betancur/Agence France-Presse — Getty Images

The nation’s health experts on Sunday pleaded with Americans to stay home over the Thanksgiving holiday and forgo any plans to travel or celebrate at large family gatherings, even as airports have recorded a significant rise in passengers.

Dr. Anthony S. Fauci, the country’s top infectious disease specialist, and other health experts relayed a clear message on Sunday morning news shows: with coronavirus cases surging to record levels across the country, turning nearly every state into a hot zone of transmission, the risk of getting infected, whether in transit or in even small indoor gatherings, is high.

Up to 50 million people could be traveling on roads and through airports in the United States over Thanksgiving this year, according to AAA, the biggest travel surge since the pandemic began, despite strong cautions from the Centers for Disease Control and Prevention and other health authorities. A video of a packed airport in Phoenix has been circulating widely on social media. As of Sunday, 47 states — all but Hawaii, Maine and Vermont — were considered high-risk zones for viral transmission, and nationwide hospitalizations were at a record 83,227.

“Please seriously consider decisions that you make,” Dr. Fauci said on the CBS show “Face the Nation.” Encountering large numbers of people in airports and on planes is particularly dangerous, he said. Although airlines have invested in air circulation and ventilation systems to minimize viral transmission, Dr. Fauci said, “sometimes when you get a crowded plane, or you’re in a crowded airport, you’re lining up, not everybody’s wearing masks — that puts yourself at risk.”

And gathering indoors, whether you travel or not, carries risk. “When you’re eating and drinking, obviously, you have to take your mask off,” Dr. Fauci said. “We know now that those are the kinds of situations that are leading to outbreaks.”

Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, said on Fox News on Sunday that because about half of infections are spread by people who don’t have any symptoms, “you can’t assume that you don’t have the virus, and you can’t assume that the people whose home you’re about to enter don’t have the virus, at this point in our pandemic.”

He recommended celebrating Thanksgiving only with the people you live with. People who choose to visit others’ homes should spend as much time as possible outdoors and “should be wearing masks indoors when they’re together, and only removing them when they’re eating.”

In Tulsa, Okla., Victory, a megachurch, canceled a “Friendsgiving” service on Sunday that had called on members to bring a friend after it prompted an outcry, instead opting to give away boxed meals, NBC News reported. The church did not respond to a request for comment regarding its planned “Thanksgiving Day Brunch,” which, according to its website, is set to be held on Thursday in the church’s cafeteria.

Dr. Fauci and others warned that Americans’ behavior over Thanksgiving would have critical implications for the coming weeks of the winter season, including risks to people gathering to celebrate Christmas and New Year’s, because the country is still months away from having wide access to vaccines and therapeutics and the cold weather drives more people indoors.

“We’re going to have to, you know, hunker down, reduce our interactions,” Dr. Scott Gottlieb, a former Trump administration Food and Drug Administration commissioner, said on “Face the Nation.”

As an example of the risk, he said that in a state like North Dakota, where case levels are high, there’s a 50 percent chance that someone in a group of 10 people has Covid-19. “That’s the kind of risk we’re facing individually right now,” he said. “And that’s only going to get worse.”

Workers gather for Covid-19 testing at Shanghai Pudong International Airport on Monday.
Credit…Associated Press

Since the pandemic erupted in China, the country has grown adept at swiftly smothering coronavirus flare-ups by ordering residents across entire cities to line up for nucleic acid tests that can pinpoint carriers. So officials snapped into action after a cluster of infections linked to Pudong International Airport in Shanghai grew over the weekend.

On Sunday, Pudong International Airport ordered cargo handlers and other potentially exposed workers to immediately undergo tests. But this time, the plan faltered badly.

The urgent order prompted a crush of hundreds of workers who merged on an airport parking garage that had been converted into a temporary test center, and video that spread first on Chinese social media showed guards in protective suits struggling to hold back a seething, anxious crowd trying to walk up a ramp. Other video shared by Shanghai residents appeared to show a worker who had fainted being carried out of the garage.

Shanghai authorities ordered the blitz of tests after testing confirmed five cases since Friday linked to the airport, including three workers and two of their spouses. The scenes of workers jammed together drew criticisms that the poorly organized testing only exposed them to greater risks of infecting each other, and the video quickly began to disappear from Weibo and WeChat, China’s two main social media platforms, as censors apparently stepped in.

“Even if the outbreak is urgent, there aren’t even the most basic safety and distancing measures,” said one comment widely shared on Weibo. “This can cause big problems.”

The government moved quickly to combat the anxiety about the cluster and scenes of mayhem. The Shanghai police issued pictures of airport workers in orderly lines, waiting to be tested in the garage — apparently after officials had restored control. “Currently everything is normal and there is an orderly queue for tests,” said The Paper, a news website based in Shanghai.

Chinese health officials appear likely to step up tests and disinfection at airports and other sites that handle imported goods. Earlier this month, tests revealed two infections among freight handlers at the Pudong Airport, and Chinese experts have repeatedly raised the theory that the virus may be carried on goods from abroad.

Hunter Mortensen, a longtime Breckenridge ski patroller, recently shaved for the first time in 10 years. He worked at the resort last week with his ski patrol dog, Huckleberry.
Credit…James Stukenberg for The New York Times

Tony Cammarata dreaded the news he had to deliver to his employees: They were losing their beards.

Mr. Cammarata, who oversees the ski patrol for an area in the Rocky Mountains west of Denver, had to clamp down on the facial hair so that the patrol could properly wear their N95 respirator masks.

But he knew this would be a tough measure for the men on his crew (47 of the resort’s 56 patrollers).

“You could tell people they’re not getting a merit increase, that you’re cutting their skiing privileges,” Mr. Cammarata said. “It’s not as bad as telling them they have to shave. The whole beard thing is ingrained in our culture.”

By and large, ski patrol members cutting their beards see it as a small inconvenience for the sake of safety and keeping the slopes active. But all the shaving has come with some peculiarities.

In ski areas like Arapahoe Basin, about 80 percent of the male patrollers have had to drastically change (or introduce) shaving regimens. A chart issued by the Centers for Disease Control and Prevention highlighting the variety of facial hairstyles permitted with a fitted respirator mask has become a go-to resource.

“It’s one of the funniest government-issued documents I’ve ever seen,” Mr. Cammarata said. “It’s a pictogram with 40-plus styles of facial hair.”

Bearded patrollers say their facial hair serves as protection against the elements — a warm layer in strong winds, blizzards and frigid temperatures.

Still, many patrollers are finding a silver lining. “Most of us look a lot younger and less weathered,” said Hunter Mortensen, a longtime Breckenridge ski patroller who recently shaved for the first time in 10 years.

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FILE PHOTO: The logo of Anglo American is seen on a jacket of an employee at the Los Bronces copper mine, in the outskirts of Santiago, Chile March 14, 2019 Picture Taken March 14, 2019. REUTERS/Rodrigo Garrido

LONDON (Reuters) – Global miner Anglo American (AAL.L) on Thursday stuck to its full-year guidance for metals, including copper and diamonds, as it posted lower second quarter output due to coronavirus lockdowns.

In the three months to end-June output in diamonds, platinum, palladium, iron ore, coal and manganese declined, while copper and nickel rose.

Reporting by Zandi Shabalala; Editing by Alex Richardson


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