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While the start of the U.S. mass vaccination campaign this week has brought desperately needed hope, health experts warned on Wednesday that it’s far too soon to abandon common-sense precautions that can halt the spread of the virus.
The first shots of a vaccine made by Pfizer and BioNTech were administered on Monday, and another vaccine, made by Moderna, is expected to receive emergency authorization from the Food and Drug Administration this week. Both were highly effective in preventing Covid-19 in clinical trials, but it will be months before a broad-enough swath of the population could receive doses, and officials are scrambling to combat skepticism about the vaccines.
And as the doses are distributed throughout the states, the virus continues to engulf the country. The death toll passed 300,000 in the United States on Monday, more than any other country, just as the first injections of the vaccine were going into the arms of frontline health care workers. Nearly 3,000 new deaths were reported on Tuesday, while new cases exceeded 200,000. The seven-day average of new cases is up 28 percent from two weeks ago.
“As wonderful as this is, because it’s been an extraordinary manifestation of the fruits of science done in a very rapid way, it’s also bittersweet,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said of that split-screen reality, on “CBS This Morning” on Wednesday.
“We should celebrate the fact that the science has come through, but it is not over yet. We have a ways to go. We have to abide by the public health measures that we talk about all the time.”
Those public health measures, of course, include social distancing, wearing masks, avoiding travel and indoor gatherings and frequent hand washing. Dr. Fauci called them “the bridge to get to the vaccine, which is going to get us out of this.”
Then there is the question of persuading people to take a vaccine. Dr. Fauci noted that some people are hesitant because of the speed with which the vaccines were developed. But he argued that the speed was a reflection of “extraordinary scientific advances in vaccine platform technology” and enormous investment.
“We hope that the overwhelming percentage of the population will accept the vaccine,” he said. (In an interview with the Vox podcast “Today, Explained” on Tuesday, Dr. Fauci said that he hoped that as many as 85 percent of Americans would get it.)
“If we do that, we will get a veil, or an umbrella, of herd immunity over the population that would dramatically diminish the dynamics of the outbreak. When we do that, then that would be the end of this outbreak. So it’s going to take months to do, but we certainly are on the right track.”
Adm. Brett P. Giroir, who heads up national testing efforts, also stressed the need to continue protective measures on Wednesday, urging Americans to wear masks and avoid travel and crowds over the holidays.
He noted that the Midwest appeared to have turned a corner as case rates improve. But outbreaks continue to escalate in the Northeast, the South and on the West Coast.
“We are still at a dangerous and critical part of this pandemic and tens of thousands of American lives are at stake really every week,” he said on CNN’s “New Day,” even as “the end of the pandemic is in sight.”
“But until we get a few more months down the road, do your best. Save lives, save American lives, save global lives, just by doing these simple measures. If you do that, we’re going to be in really good shape. But if you don’t, we’re going to have thousands of more casualties in this country that we can avoid.”
The Trump administration is negotiating a deal to use its power to free up supplies of raw materials to help Pfizer produce tens of millions of additional doses of its Covid-19 vaccine for Americans in the first half of next year, people familiar with the situation said.
Should an agreement be struck, it could at least partially remedy a looming shortage that the administration itself arguably helped create by not pre-ordering more doses of the vaccine Pfizer developed with its German partner, BioNTech. Pfizer agreed this summer to provide the United States with 100 million doses by the end of March, enough to inoculate 50 million people since its vaccine requires two shots.
The Pfizer vaccine is one of only two so far that have been proved to work. The Trump administration has locked in only enough doses of the two vaccines — the other, produced by Moderna, is on track to receive emergency authorization from the Food and Drug Administration this week — to cover 150 million people by the end of June, or less than half the nation.
The administration recently asked Pfizer to sell it enough doses to cover an additional 50 million Americans, but Pfizer said it had already found customers around the world for all the doses it can produce until around the middle of next year.
In recent days, however, Pfizer has indicated that it would be able to manufacture more doses if the administration orders the company’s suppliers to prioritize its purchase requests. The two sides are now negotiating a contract under which Pfizer would provide tens of millions more doses from April to the end of June.
According to one person familiar with the situation, Pfizer asked for that favored status with suppliers months ago. But before it was clear which vaccine trials would succeed, Trump administration officials were apparently worried about hindering other vaccine makers that had accepted billions of dollars in federal subsidies. Federal officials worked to prioritize orders for manufacturing supplies from those firms, including Moderna.
It is unclear whether the government’s concerns about squeezing the supply chain have now faded, or whether its interest in securing more of Pfizer’s vaccine has simply grown. Pfizer announced in November that clinical trials had shown that its vaccine was about 95 percent effective, and the firm was the first to win approval from the F.D.A. for emergency use of its vaccine.
After the company signed a contract last July pledging to sell the United States 100 million doses by the end of March, Pfizer officials suggested at least twice that the Trump administration reserve more doses, but were turned down, according to people familiar with the situation.
Alex M. Azar II, the secretary of health and human services, told “PBS News Hour” on Monday that in early October, the government resumed negotiations with Pfizer about delivering more doses. But he said Pfizer “resisted giving us any date by which they would do it.”
Moderna, a small Massachusetts-based firm that developed a similar vaccine, agreed last summer to provide the United States with 100 million doses by the end of March. It has now pledged to sell another 100 million doses by the end of June.
A health care worker in Alaska had a serious allergic reaction after getting Pfizer’s coronavirus vaccine on Tuesday and remained hospitalized on Wednesday morning under observation.
The middle-aged worker had no history of allergies, but had an anaphylactic reaction that began 10 minutes after receiving the vaccine at Bartlett Regional Hospital in Juneau, Alaska, a hospital official said. The reaction included flushing and shortness of breath.
Dr. Lindy Jones, the emergency department medical director at the hospital, said the reaction subsided soon after the worker was treated with epinephrine. He said the worker remained enthusiastic that she had received the vaccine and was set to be discharged later on Wednesday.
“She is healthy and she is doing well,” Dr. Jones said.
Government officials were scrambling on Wednesday to learn more about the case, according to three people familiar with their response.
With millions of Americans expected to be vaccinated by the end of the year, the incident is likely to prompt federal officials to be even more watchful for any sign of serious side effects. The Alaska recipient’s reaction was believed to be similar to the anaphylactic reactions two health workers in Britain experienced after receiving the Pfizer-BioNTech vaccine last week. Both of them recovered.
Pfizer’s trial in the United States involving more than 40,000 people did not find any serious adverse events caused by the vaccine, although many participants did experience aches, fevers and other side effects. Severe allergic reactions to vaccines are typically linked to the vaccine because of their timing.
A Pfizer representative did not immediately comment on the case.
After the workers in Britain fell ill, authorities there initially warned against giving the vaccines to anyone with a history of severe allergic reactions. They later clarified their concerns, changing the wording from “severe allergic reactions” to specify that the vaccine should not be given to anyone who has ever had an anaphylactic reaction to a food, medicine or vaccine. That type of reaction to a vaccine is “very rare,” they said.
Pfizer officials have said the two British people who had the reaction had a history of severe allergies. One, a 49-year-old woman, had a history of egg allergies. The other, a 40-year-old woman, had a history of allergies to several different medications. Both carried EpiPen-like devices to inject themselves with epinephrine in case of such a reaction.
Pfizer has said that its vaccine does not contain egg ingredients.
The British update also said that a third patient had a “possible allergic reaction,” but did not describe it.
In the United States, federal regulators issued a broad authorization for the vaccine on Friday to adults 16 years and older. Health care providers were warned not to give the vaccine to anyone with a “known history of a severe allergic reaction” to any component of the vaccine, which they said was a standard warning for vaccines.
But because of the British cases, F.D.A. officials have said they would require Pfizer to increase its monitoring for anaphylaxis and submit data on it once the vaccine comes into use. Pfizer also said that the vaccine is recommended to be administered in settings that have access to equipment to manage anaphylaxis. Last weekend, the Centers for Disease Control and Prevention said that people with serious allergies can be safely vaccinated, with close monitoring for 30 minutes after receiving the shot.
Anaphylaxis can be life-threatening, with impaired breathing and drops in blood pressure that usually occur within minutes or even seconds after exposure to a food or medicine, or even a substance like latex to which the person is allergic.
JERUSALEM — The number of severe Covid-19 cases in the blockaded Gaza Strip sharply increased over the past several days, raising concerns that hospitals could face overwhelming circumstances in the coming weeks.
The 200 intensive care beds at the two hospitals that the Hamas-run Health Ministry has tasked with treating coronavirus patients filled up earlier this week, forcing the authorities to transform parts of other medical institutions into Covid-19 wards.
“We are in a very dangerous situation,” said Rami al-Abadla, the director of the ministry’s infection control department, expressing concerns that virus cases in Gaza would surge even higher as the territory enters the thick of the winter.
In the past week, severe cases, which are typically when a patient’s oxygen level reaches 94 percent or less, have jumped from 103 to 190, according to ministry data. And critical cases have climbed from 32 to 39. Those patients could have respiratory failure, septic shock and/or multiple organ dysfunction.
And on Wednesday, the ministry announced that about 45 percent of the 2,088 virus test results it had received over the preceding 24 hours had come back positive — a single day record.
The increase in severe and critical cases in Gaza, which has an overwhelmingly young population, comes even as the authorities have stepped up restrictions, like instituting nightly closures and weekend lockdowns.
The primary concern, Dr. al-Abadla said, was if the amount of severe and critical cases continue to grow, hospitals would not have enough oxygen supply for both Covid-19 patients and those facing other illnesses like heart failure and chronic obstructive pulmonary disease.
He said a Norwegian organization was sending more oxygen tanks to Gaza, which could help about 23 more virus patients breathe, but he said it would likely take another two weeks before they arrive.
Hospitals in Gaza, devastated by years of conflict and war, were already dealing with challenging circumstances before the virus arrived in the territory.
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Stimulus Negotiations Have Made ‘Major Headway,’ McConnell Says
Senator Mitch McConnell, the majority leader, said congressional leaders are approaching agreement on a roughly $900 billion coronavirus relief package.
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The Democratic leader and I worked into the evening alongside the speaker of the House and the House Republican leader. We made major headway toward hammering out a targeted pandemic relief package that would be able to pass both chambers with bipartisan majorities. We committed to continuing these urgent discussions until we have an agreement. And we agreed we will not leave town until we’ve made law. The American people need more help. It’s that simple. Further targeted relief is now months overdue. We need vaccine distribution money. We need to re-up the Paycheck Protection Program to save jobs, we need to continue to provide for laid-off Americans. Congressional leaders on both sides are going to keep working until we get this done.
Senator Mitch McConnell, the majority leader, privately made the case to Republicans on Wednesday for a stimulus deal that includes another round of direct payments to struggling Americans, suggesting that delivering such help could boost the party’s hopes of hanging onto their majority in the Senate.
In a call on Wednesday afternoon, Mr. McConnell said that Senators Kelly Loeffler and David Perdue, who are both facing January runoffs that will determine which party controls the Senate, were “getting hammered” for Congress’s failure to deliver more pandemic aid to struggling Americans — particularly the direct payments — and that enacting the measure could help them. The Kentucky Republican also emphasized that the package could be signed by President Trump, who has pushed for another round of stimulus checks, and would help those devastated by the pandemic.
His comments, relayed by two people familiar with them who shared them on the condition of anonymity, came as congressional leaders closed in on an agreement on a coronavirus relief measure that could infuse the economy with as much as $900 billion, racing to complete both a pandemic aid package and a catchall federal spending measure before government funding lapses on Friday.
In an indication that a deal was imminent but not yet in hand, Mr. McConnell also warned senators to prepare to remain in Washington through the weekend as lawmakers and aides finalize the details and write legislative text.
Top Republicans and Democrats on Capitol Hill appeared to be nearing a compromise that would include both another round of direct stimulus payments to Americans and additional unemployment benefits, according to others familiar with the emerging plan who also described it on the condition of anonymity.
While the details were not yet final, the package was also expected to provide billions of dollars for vaccine distribution and support for schools and small businesses, but omit coronavirus liability protections long sought by Republicans and a dedicated funding stream for state and local governments insisted upon by Democrats — the two most contentious sticking points.
Senator John Thune of South Dakota, the No. 2 Republican, told reporters on Wednesday that the direct payments were likely to be $600 to $700 per person, about half the size of the checks included in the $2.2 trillion stimulus law enacted in March, which Democrats and some Republicans had pushed to replicate or exceed.
“Right now we’re going to do our best to get the $1,200, but this is a good start,” said Senator Bernie Sanders, the Vermont independent who joined forces with Senator Josh Hawley, Republican of Missouri, to lobby for the inclusion of the payments.
Senator Rand Paul, Republican of Kentucky and one of the fiercest opponents of government spending, said on Wednesday that he “will make a point to let people know that they’re giving away money they don’t have” but “won’t object to the time that it takes to do this.”
Negotiators were also still haggling over an expansion and extension of unemployment benefits and how long they would last. They were also discussing reinstituting federal supplemental jobless payments, which provided $600 per week until they lapsed over the summer but would likely be revived at a smaller amount. With the inclusion of another round of stimulus checks, there was some discussion that leaders would also cut the duration of the enhanced jobless payments in order to keep the measure’s overall cost below $1 trillion.
With Congress wrangling for months over aid proposals, New Mexico has stepped in and begun distributing one-time payments of $1,200 each to about 130,000 unemployed residents to help ease persistent economic hardship in the state.
The payments are going to people who qualify for unemployment benefits or whose benefits have expired. Democrats and Republicans in the State Legislature came together in a special session in late November to support the payments as part of a $330 million relief package.
Gov. Michelle Lujan Grisham, a Democrat, commended the bipartisan action in a statement after the legislation was approved, saying that the payments were needed because “the economic pain caused by the spread of the virus is felt in every corner of New Mexico.”
The downturn has weighed heavily on industries like tourism and oil production that are important in New Mexico, one of the country’s least wealthy states. In Albuquerque, the state’s largest city, a similar distribution of $2,000 checks ran out of funds in nine hours, after thousands more people applied for the relief than the program could accommodate.
The unemployment rate in New Mexico was 8.1 percent in October, compared with 4.8 percent in the same month a year earlier. Nationally, the rate was 6.7 percent in November.
Most of the money for the payments comes from funds allocated to New Mexico, but not yet spent, under the CARES Act, the federal stimulus legislation passed as the pandemic’s first wave surged in the spring. The state has until Dec. 30 to spend those funds.
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‘A Heroic Place:’ Elmhurst Hospital Workers Get Coronavirus Vaccine
Two staff members of Elmhurst Hospital in Queens, a public hospital hit hard during the city’s spring coronavirus crisis, became the first at the hospital to be vaccinated Wednesday.
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“We’re here at Elmhurst Hospital, a heroic place, a heroic place, a place where something extraordinary happened. One of the toughest battles anywhere in the United States of America against the coronavirus happened right here. But Elmhurst Hospital held, Elmhurst Hospital held the line. The men and women who worked here, the health care heroes, did an extraordinary job against all odds. That’s the story of Elmhurst Hospital. We’re celebrating such an important moment here, the first-ever vaccination at a New York City public hospital. And there’s no more fitting place than here. This is the place where it should be because this is the heroic place.” [applause] “Yeah, I feel very privileged to be one of the first to get the vaccine. I know there are people that are more front line and more deserving. So my message to the mayor and everybody, I hope that everybody can be vaccinated quickly. Quite frankly, I don’t know a health care worker in this hospital who doesn’t want this vaccine immediately.” “I hope everybody, you know, takes the shot, you know, so we can all get back together.”
At the height of the pandemic in New York City, as hospitals filled and deaths mounted, Elmhurst Hospital in Queens bore the brunt of the crisis. A public hospital near the neighborhoods hit hardest by the coronavirus in the spring, Elmhurst quickly became overrun with patients and ran short of beds, equipment and staff.
On Wednesday morning, the hospital entered a new, brighter phase, when two employees became Elmhurst’s first to receive a Covid-19 vaccine.
The employees — Veronica Delgado, a lead physician assistant in the hospital’s emergency department, and William Kelly, who works in environmental services — both said they were thrilled.
“I don’t know a health care worker in this hospital who doesn’t want the vaccine immediately,” Ms. Delgado, 65, said.
A room full of city employees and hospital workers applauded as the shots were administered.
“This is a standing ovation,” Mayor Bill de Blasio said as he looked on. “It doesn’t get better than this.”
Since the city’s first vaccinations outside a clinical trial took place at another Queens hospital, more than 1,600 health care workers have received a first dose, Mr. de Blasio said.
Gov. Andrew M. Cuomo said on Wednesday that the state had received 87,750 doses of the Pfizer vaccine so far, with 80,000 additional ones expected in the coming days for nursing home residents and employees. He said the state expected 346,000 doses of the Moderna vaccine once it was federally authorized.
Mr. Cuomo also said that he expected the state would likely move into its second phase of vaccine distribution, targeting essential workers and high-risk members of the public, by late January.
In preparation, the state would direct insurers to cover the costs of vaccination. Federal officials working as part of Operation Warp Speed — the multiagency effort to quickly make a coronavirus vaccine available to Americans — have also said their goal was to make vaccines free for all Americans.
“In New York State, no person will pay a penny for a vaccination,” Mr. Cuomo said.
Both Mr. Cuomo and Mr. de Blasio have cheered the vaccine as a positive development at a time when more people have been testing positive and growing ill in New York City, which both officials have warned could lead to another shutdown. However, Mr. Cuomo, not the mayor, has the power to impose a shutdown.
Mr. de Blasio said that over the last week, an average of 5.71 percent of the city’s coronavirus tests were coming back positive, a rate that was “higher than we want it to be.”
“Hospitalizations keep increasing, and I’m worried about that,” the mayor said on Wednesday.
Mr. Cuomo also said that the rise in hospitalizations was troubling, particularly in areas upstate. To address the issue, the state’s health commissioner sent a letter to hospitals directing them to start “crisis management mode” and directing overburdened hospitals to shift patients to facilities that have available beds. Statewide, hospitalizations topped 6,000, Mr. Cuomo said. The figure peaked in April when the state neared 19,000 hospitalizations.
The strategy was reminiscent of one needed in the city’s hospitals in the spring, when Elmhurst Hospital was reaching capacity but thousands of hospital beds were available in facilities elsewhere.
Officials maintained on Wednesday that the city’s hospitals were prepared to handle the surge, including at Elmhurst.
Dr. Mitchell Katz, the head of Health and Hospitals, the agency that oversees the city’s public hospitals, said there were just 280 patients in them now who have the virus, compared with nearly 4,000 patients at the peak in the spring.
Elmhurst was particularly hard hit. On one day in late March, it saw 13 virus-related deaths in 24 hours. Hundreds of patients were arriving seeking help; some of them were found dead in rooms. A medical worker at the hospital described the conditions as “apocalyptic.”
“One of the toughest battles anywhere in the United States against the coronavirus happened right here,” Mr. de Blasio said on Wednesday.
Dr. Katz said that he expected to have every employee at Elmhurst vaccinated within three weeks. Ms. Delgado, after receiving her shot, urged the mayor and city officials to make it happen quickly.
She also had a message to the public: Don’t be afraid of the vaccine, and don’t “get information off of Facebook.”
Since the pandemic began, a debate has raged both inside and outside of Sweden over how to curb the virus. As other countries went into lockdown in the spring, Sweden stayed open out of concern that keeping everyone holed up at home would have long-term detrimental effects on children and adults and could lead to depression, suicide, postponed health care and job losses.
Now, a second wave has brought a new surge in infections and Stockholm’s emergency services are overrun, forcing the authorities to recalibrate their approach. They imposed new restrictions at the end of November that bring the country’s response somewhat more in line with the rest of Europe. They include drastic cutbacks on the size of public gatherings and some school closures.
But with ski lifts, restaurants and bars all remaining open, Sweden’s tougher restrictions still pale in comparison to the rest of Europe and there are mounting concerns that not enough is being done.
On Monday, the Swedish prime minister, Stefan Lofven, said the country’s experts had underestimated the likelihood of a second wave. On Tuesday, a special commission concluded in an initial report that the government had failed to protect older people and was unprepared for the pandemic. During the first wave, deaths were high, especially among those in older age groups.
Since October, infection numbers and deaths have been rising steadily. By Tuesday, the country had reached a total of 320,098 cases since the beginning of the pandemic and its death toll reached 7,667. The country now has 74 deaths per 100,000 cases, less than the United Kingdom, with 97, but far more than its neighbor Norway, with seven.
“I was hoping this grave situation would change things, but yesterday they opened the ski lifts in Sweden,” said Fredrik Elgh, a professor of clinical virology at Umea University.
Mr. Lovfen’s government can only ask, not order, people to follow the recommendations. Under Swedish law, the government isn’t allowed to force people to stay home or fine those who flout them. And face masks aren’t recommended because the Public Health Authority says there isn’t enough scientific evidence that they work.
“We are the only democracy in the world that does not recommend the use of face masks. There are more than 170 countries in the world that recommend using masks. But here they are saying there is not enough science behind that. That is nonsense,” said Mr. Elgh.
Secretary of State Mike Pompeo is in quarantine after coming in contact with a person who tested positive for the coronavirus, the State Department said in a statement on Wednesday. Mr. Pompeo has so far tested negative, it said.
The statement did not identify the person who had contact with Mr. Pompeo, or when it happened, citing privacy concerns. It was not immediately clear what kind of test Mr. Pompeo had taken or when he was tested, nor whether he was showing any symptoms. Mr. Pompeo is being monitored by the State Department’s medical team, the statement said.
Tests taken too soon after exposure may return false negative results, because the virus has not yet had time to build up to detectable levels. People are thought to carry the largest quantity of virus around the time their symptoms appear, if they experience symptoms at all.
Mr. Pompeo has not traveled abroad since a 10-day trip to Europe and the Middle East last month. His last publicly reported meeting with a foreign official was in Washington last week with the Slovenian foreign minister, Anže Logar.
Even so, he has hosted hundreds of people at several State Department holiday parties in recent days. He was slated to attend one on Tuesday afternoon for family members of diplomats who are stationed abroad, but The Washington Post reported that he canceled the speech he had prepared to give to guests. It was not clear whether he appeared and did not speak, or just skipped the event entirely.
Mr. Pompeo is the latest of the Trump administration’s most senior national security officials to have contact with people who tested positive.
Last month, the Pentagon was notified that Lithuania’s defense minister had tested positive after meeting Christopher C. Miller, the acting defense secretary, and other top military officials. One of them, Anthony J. Tata, a senior Pentagon adviser who is performing the duties of undersecretary of policy, tested positive for the virus afterward.
At least 50 people with close links to the White House have contracted the virus, in addition to guests and others, and President Trump himself, who was hospitalized for a few days in early October after showing symptoms of Covid-19.
This spring, the Y.M.C.A. on Fort Bragg, the largest military base in the United States, saw a 40 percent increase in requests for groceries at its food pantry. During the same period, grocery requests to AmericaServes, a network that helps military families, jumped to the biggest service request in the organization’s history.
The story is much the same around the country, hunger groups say, for the lowest-income families in the military, who have a specific set of challenges, and different from civilians whose economic fortunes have also been damaged by the coronavirus pandemic.
Spouses of active-duty troops have lost jobs, but are often the least likely to be able to find new ones. And children — including those from military families — who rely on free or reduced meals at school no longer are receiving them.
While many poor civilian families have turned to federal food programs for support, military families often receive a housing allowance that renders them ineligible for food assistance, a quirk in the law that Congress has repeatedly failed to resolve And while military families make up a small portion of the 37 million Americans struggling with food insecurity, hunger experts say most Americans have no idea that people serving in the military often need to rely on help to eat.
“There is something that’s so unjust about it that the families who are making significant sacrifices for our country, and are not able to fully meet their basic needs,” said Josh Protas, vice president of public policy at Mazon, a Jewish group focused on hunger. “ I really think the Pentagon has really tried to sweep this under the rug.”
The Defense Department is working on a report to Congress on the topic, said Maj. César Santiago, a Pentagon spokesman.
Veterans are in a similar situation, hunger advocates and service organizations have found.
According to a recent study from the Institute for Veterans and Military Families at Syracuse University, nearly 40 percent of active-duty families had food and nutrition support needs since the pandemic hit.
SURAT, India — The crowds surged through the gates, fought their way up the stairs of the 160-year-old station, poured across the platforms and engulfed the trains.
It was May 5, around 10 a.m. Surat was beastly hot, 106 degrees. Thousands of migrant laborers were frantic to leave — loom operators, diamond polishers, mechanics, truck drivers, cooks, cleaners, the backbone of Surat’s economy.
Tens of millions of migrant workers were stranded without work or food after Prime Minister Narendra Modi imposed a national coronavirus lockdown in March. By spring and summer, these workers were so desperate that the government provided emergency trains to carry them back to their home villages. The trains were called Shramik Specials, because shramik means “laborer” in Hindi.
India has now reported more coronavirus cases than any country other than the United States. And it has become clear that the special trains operated by the government to ease suffering — and to counteract a disastrous lack of lockdown planning — instead played a significant role in spreading the coronavirus into almost every corner of the country.
The trains became contagion zones: Every passenger was supposed to be screened for Covid-19 before boarding but few if any were tested. Social distancing, if promised, was nonexistent, as men pressed into passenger cars for journeys that could last days. Then the trains disgorged passengers into distant villages, in regions that before had few if any coronavirus cases.
Global roundup
A little over a week after Britain kicked off its mass inoculation program, the first in the world to approve and begin distributing a fully tested vaccine, more than 137,000 people have received shots, the government minister in charge of the rollout wrote on Twitter on Wednesday.
Since the inoculations began last Tuesday, hospitals have distributed some 137,897 vaccines across the country, according to the minister, Nadhim Zahawi. He noted that the figure did not take into account shots administered by primary care doctors, the next phase of the rollout that is intended to reach a broader stretch of the population, which began on Monday.
The Pfizer-BioNTech shots are being prioritized in Britain for health care workers, those 80 years of age or older, and workers and residents at nursing homes. Those who have received the first dose require a second shot after 21 days to enjoy the full benefits of the vaccine.
Britain had an initial batch of 800,000 doses of the Pfizer-BioNTech vaccine, which is enough to vaccinate 400,000 people, but the vaccine’s complex cold storage requirements make it difficult to transport and store in smaller batches, so the rollout has been limited far.
Mr. Zahawi called the figures “a really good start” and said that the government would begin to publish weekly statistics starting next week. In the days since Britain began distributing the vaccine, the United States and Canada have also begun inoculation campaigns, and several other countries have approved the Pfizer-BioNTech shots for emergency use.
Emergency approval for the vaccine in the European Union could come as early as Dec. 21, when the European Medicines Agency meets. Ursula von der Leyen, the president of the European Commission, told the European Parliament on Wednesday that vaccinating enough of the population would be a “huge task.” She encouraged the 27 member states of the bloc to begin on the same day.
“As we have gone in unity through this pandemic, let us start the eradication of this horrible virus together and united,” she said.
Here’s what else to know from around the world:
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Germany entered a nationwide lockdown on Wednesday that saw schools and nonessential businesses close through at least Jan. 10, as the country battles to bring down record numbers of new infections and fatalities. There were 27,728 new cases of the coronavirus recorded on Wednesday and 952 additional deaths in the country, according to a New York Times database.
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South Korea reported a daily record of 1,078 new coronavirus cases on Wednesday, nearly all of them locally transmitted, the Yonhap news agency reported. The country’s health authorities were deciding whether to raise the national Covid-19 alert system to the highest of five tiers — a move that would shutter schools and reduce the maximum size of gatherings to 10, from 49. South Korea kept its caseload low for much of the year but has been grappling with a fresh wave of infections.
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Almost half of Singapore’s migrant workers, or 152,000 people, were infected with the coronavirus this year, new government data showed. By comparison, the rest of the population recorded fewer than 4,000 cases. The Singaporean economy is heavily dependent on migrant workers, and the virus spread rapidly through their crowded dormitories in the spring. The data released Monday by the Ministry of Health, which said it had tested all 323,000 migrant workers living in dormitories, showed more than 98,000 workers tested positive for coronavirus antibodies, and more than 54,000 workers had received positive coronavirus tests and had already been reported. The government has been criticized over its treatment of the workers, who continue to be mostly confined to their dormitories even as the rest of Singapore prepares to enter its final phase of reopening later this month.
In coming days, squads of CVS and Walgreens employees, clad in protective gear and carrying small coolers, will begin to arrive at tens of thousands of nursing homes and assisted-living facilities to vaccinate staff and residents against the coronavirus.
It promises to be a crucial milestone in America’s battle against a pandemic that has inflicted especially severe carnage on nursing homes. At least 106,000 residents and staff of long-term care facilities have died from the virus, accounting for 38 percent of the country’s Covid-related fatalities.
But even before it begins, the mass-vaccination campaign is facing serious obstacles that are worrying nursing home executives, industry watchdogs, elder-care lawyers and medical experts. They expect nursing homes to be the most challenging front in the mission to vaccinate Americans.
Some residents and staff are balking at taking the vaccine. Short-staffed facilities are concerned about workers calling in sick with side effects, straining resources just as some frail residents are likely to experience fever and fatigue from the shot. Most nursing home employees work in shifts; will it be possible to vaccinate everyone over the course of just a few visits from CVS and Walgreens?
With days to go before the vaccinations begin, there is also widespread confusion about how nursing homes will get consent to vaccinate residents who aren’t able to make their own medical decisions.
Pharmacists from Walgreens are scheduled to arrive next week at the 460-bed Gurwin Jewish Nursing & Rehabilitation Center in Commack, N.Y., to begin vaccinations. Employees, residents and their families have been peppering Stuart Almer, the home’s chief executive, with questions. Can residents and staff orally agree to receive the vaccine or will they have to sign something? What role, if any, will nursing home employees play in vaccinating residents?
Mr. Almer said he has spent hours on the phone with federal and state agencies but has few answers.
“We still don’t know very much,” he said.
https://www.nytimes.com/2020/12/16/business/covid-coronavirus-vaccine-nursing-homes.html
The actor Tom Cruise recently erupted at crew members on the set of “Mission: Impossible 7” over a breach of Covid-19 protocols. His expletive-laden rant was an apparent effort to prevent further disruptions to a film whose production has already been delayed by the pandemic.
“We are creating thousands of jobs,” Mr. Cruise, the star of the film, can be heard saying in a leaked audio clip. “I don’t ever want to see it again! Ever! And if you don’t do it, you’re fired!”
The recording was published on Tuesday by The Sun, a British tabloid, and its authenticity was confirmed by two sources close to the film. One source said that Mr. Cruise had been speaking to members of the “Mission: Impossible 7” crew about a breach in Covid-19 protocols on the set in London.
Mr. Cruise apparently became enraged after spotting two crew members standing together at a computer screen, in violation of an on-set rule requiring people to stand about six feet apart, The Sun reported.
Paramount Pictures declined to comment, and The Sun did not say when the recording of Mr. Cruise, 58, had been made. Reuters reported that the filmmakers for “Mission: Impossible 7” — the latest installment in the 24-year-old series — arrived in London this month.
In February, production on the film was shuttered in Venice, Italy, amid a raging coronavirus outbreak in that country, Reuters reported. Production resumed in September, and has since moved between Italy, Norway and Britain.
Production was paused again in October after 12 crew members on a set in Italy tested positive for the virus, Variety reported.
In the leaked clip, Mr. Cruise said he would not accept any apologies for what had happened on the set, an apparent reference to the breach in Covid-19 protocol.
“You can tell it to the people that are losing their homes because our industry is shut down,” he said, adding an expletive. “It’s not going to put food on their table or pay for their college education.”
The federal government should invest $42.5 billion to aggressively ramp up coronavirus testing capacity and use it to enable all of the country’s public schools to open for in-person instruction by March 1, the Rockefeller Foundation says in a report published on Wednesday.
Noting that it will be months longer before all teachers can be vaccinated, the foundation urges widespread and frequent surveillance testing to allow schools to open safely in the meantime.
With 300 million tests a month, the report says, the nation’s nearly 100,000 schools could test all students once a week and all teachers and other staff members twice a week. For the strategy to work, it says, the tests must be able to deliver results within 24 hours.
The report calls on the federal government to pay for the tests and testing supplies, and to make use of the more than 6,000 members of the Commissioned Corps of the U.S. Public Health Service to support the nation’s 13,000 school districts in setting up their testing systems.
If districts have an array of testing options, the report says, they should choose polymerase chain reaction (PCR) tests, and consider using pooled tests to reduce costs, though it describes rapid antigen tests as almost as good. Some experts argue that the rapid tests are actually more useful for this kind of surveillance testing, because they are very good at detecting people who are contagious, and can be acted on quickly.
Experts have been arguing for months that the country should hugely expand rapid testing capacity, and evidence from colleges has shown that frequent testing of all students and staff members can stop outbreaks from catching fire.
“A lot of the advice in this plan was available months ago, but there has been a lack of will to act upon it,” Dr. Bill Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, said in an email.
He added that testing must be accompanied by other mitigation measures. “They’re not an excuse for poor ventilation or a lack of masks, or even soap in the restrooms.”
Researchers in Peru announced on Wednesday that they would resume clinical trials for an experimental coronavirus vaccine manufactured by the Chinese company Sinopharm after concluding that a volunteer’s illness last week was unlikely to be related to the injection.
The trial participant had experienced a feeling of weakness in both legs that made walking difficult, prompting health officials to halt the study on Friday to investigate. It was not clear whether the volunteer had received a vaccine from Sinopharm, which contains a modified version of the coronavirus that cannot cause disease, or a placebo. Sinopharm is testing two such vaccines in Peru in the same trial of 12,000 people.
Experts have repeatedly stressed that such pauses are crucial for researchers to evaluate unexpected illnesses or side effects that occur in clinical trial volunteers. Such events could be tied to the vaccines being tested or they could be a coincidence, completely unrelated to the injection. On Saturday, Peru’s minister of health, Pilar Mazzetti, reiterated his country’s priority for safety in developing tools to combat the coronavirus.
Feelings of weakness in the limbs can sometimes be caused by Guillain-Barre syndrome, a rare condition in which the immune system attacks the nervous system that has occasionally been linked to vaccines.
But Dr. Germán Málaga, a physician at Cayetano Heredia University who is coordinating the Sinopharm trial, described the volunteer, 64, who fell ill as having chronic and poorly controlled diabetes. He added that the person more likely had experienced another ailment related to that condition.
Dr. Málaga added that Guillain-Barre syndrome had not yet been confirmed or ruled out as a diagnosis. The volunteer is “in good condition,” he said, and had not experienced “a serious episode.”
Sinopharm’s vaccines have been granted limited or full approval in several countries, including the United Arab Emirates, Bahrain and China, and are estimated to have been administered to about a million people. Some people receiving the injections have reported headaches, mild “skin secretions” and diarrhea, but side effects seem relatively rare.
Peru’s trial is slated to wrap up within a few weeks, Dr. Málaga said. Data on the vaccine’s efficacy is still pending and negotiations with Sinopharm continue. The country is expected to purchase several million doses of Sinopharm’s vaccines, with the first injections scheduled for next year.
As a powerful winter storm raced up the East Coast on Wednesday, several major cities planned to temporarily shut down Covid-19 testing facilities.
In Baltimore, the city health department postponed testing at two outdoor testing sites on Wednesday and Thursday. Testing at the indoor Baltimore City Convention Center Field Hospital — operated by the University of Maryland Medical System, Johns Hopkins Medicine and the Maryland Department of Health — remained open for “walk-up” testing.
“We would urge residents to remain safe while they travel to the testing site, and would encourage residents to dress warmly should they need to wait in line for a test,” the city department said in a written statement.
In Connecticut, Hartford HealthCare, which operates nine drive-through testing sites, said that they would all be closed on Thursday. Trinity Health of New England announced that three hospital testing sites would also be closed Thursday “due to the anticipated snowfall, accompanying winds, and timing of storm.”
In Rhode Island, Gov. Gina Raimondo warned residents that Covid-19 test scheduling on the state’s online portal would be “temporarily paused” for Thursday “to ensure the safety of Rhode Islanders.” Some outdoor sites may close, and some indoor or covered sites will stay open, she said, urging the public to use local media to check if their appointment would still be available.
In Boston, two city-sponsored mobile testing cites will be closed on Thursday.
But in Philadelphia, where the snowfall could reach up to eight inches, city testing clinics remained open on Wednesday, and officials expected that they would be open Thursday as well, said James Garrow, a spokesman for the city department of health.
Some “funded sites,” which are community testing programs that follow the city’s guidance but adhere to their own schedules, were closed Wednesday, Mr. Garrow said. “Our messaging for the next couple of days will stress the need to call ahead to make sure that folks’ local testing site is open,” he said.
An international team of 10 scientists named by the World Health Organization is expected to travel to China early in the new year to begin a wide-ranging investigation of the origins of the coronavirus that has caused a pandemic.
The team includes experts in viruses, ecology and public health from countries around the world. They will be working with Chinese scientists and public health officials.
Their task, according to a November description by the W.H.O. of the planned inquiry, will be to study how the outbreak in Wuhan began. All possibilities will be investigated, according to the organization, although the November document makes no mention of unsubstantianted suspicions about laboratory leaks, which Chinese scientists and officials have vigorously denied.
Reuters first reported the timing of the impending trip; the W.H.O. confirmed that the team is now making travel arrangements to go to China as soon as possible, with January the goal. EcoHealth Alliance, whose president, Peter Daszak, is one of the team members, also confirmed that the team planned to travel in January. Dr. Daszak is also the chairman of a 12-member task force on the origins of the virus organized by the The Lancet, a medical journal. The Lancet task force is not expected to travel to China.
Dr. Daszak has worked on surveillance of bat coronaviruses with the Wuhan Institute of Virology, which has been the target of some speculation about laboratory leaks. An EcoHealth Alliance grant to continue that work was canceled by the National Institutes of Health, in what many scientists took to be an exertion of political influence by the Trump administration. The cancellation prompted protest letters, including one from a group of Nobel Laureates.
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