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The United States begins the new year far behind schedule in its coronavirus vaccine rollout, having distributed shots to a mere fraction of the 20 million it had hoped to reach by this time, even as the nation hit a grim new milestone on New Year’s Eve: 20 million cases since the start of the pandemic.
According to the Centers for Disease Control and Prevention, about 2.8 million people have received their first dose, though that number may be somewhat low because of lags in reporting. Federal officials, who said that their goal was to have 20 million people receive their first shot by the end of 2020, said they do not fully understand the cause of the delays and have denied that they are to blame. Officials behind Operation Warp Speed, the federal effort to fast-track vaccines, have said that their job was to ensure that vaccines are made available and get shipped out to the states.
But state health officials and hospital leaders throughout the country pointed to several factors for the lag. States have held back doses to be given out to their nursing homes and other long-term care facilities, an effort that is just gearing up and expected to take several months. Across the country, just 8 percent of the doses distributed for use in these facilities have been administered, with two million yet to be given.
The holiday season has meant that people are off work and clinics have reduced hours, slowing the pace of vaccine administration. In Florida, for example, the demand for the vaccines dipped over the Christmas holiday and is expected to dip again over New Year’s, Gov. Ron DeSantis said on Wednesday.
Public health experts say that federal officials have left many of the details of the final stage of the vaccine distribution process, such as scheduling and staffing, to overstretched local health officials and hospitals. The result is a series of notable blunders.
In one case, 42 people in West Virginia who were scheduled to receive the coronavirus vaccine on Wednesday were instead mistakenly injected with an experimental monoclonal antibody treatment.
In another, a pharmacist at a Wisconsin hospital was arrested for allegedly removing hundreds of vaccine doses from refrigeration, intentionally spoiling them. As of Thursday, the pharmacist’s motive was unclear.
The task of administering thousands of vaccines in the United States is daunting for health departments that have already been overburdened by responding to the pandemic. In Montgomery County, Md., the local health department has recruited extra staff to help manage vaccine distribution, said Travis Gayles, the county health officer.
“While we’re trying to roll out vaccinations, we’re also continuing the pandemic response by supporting testing, contact tracing, disease control and all of those other aspects of the Covid response,” Dr. Gayles said.
The United States is not alone in its plight to distribute vaccines. President Emmanuel Macron of France also faced growing criticism for the sluggishness of France’s rollout. Fewer than 200 people have received doses there since Sunday, when the European Union officially began its campaign to distribute shots to its 410 million citizens. Germany has inoculated nearly 80,000 over the same period.
By contrast, the pace of Israel’s vaccination program is far outstripping the rest of the world. Nearly 10 percent of Israel’s population has received the first of two doses of the Pfizer/BioNTech vaccine after the program began there on Dec. 20.
In a news conference on Wednesday, Operation Warp Speed officials said they expected the pace of the rollout in the United States to accelerate significantly once pharmacies begin offering vaccines in their stores. The federal government has reached agreements with a number of pharmacy chains — including Costco, Walmart and CVS — to administer vaccines once they become more widely available. So far, 40,000 pharmacy locations have enrolled in that program.
Faced with a resurgence of Covid-19 infections, French authorities pulled out all the stops to ensure that France would step into 2021 in safety. An existing nationwide overnight curfew was enforced on New Years’s Eve by some 130,000 police officers; all public celebrations were banned and the government advised to limit private gatherings to six people.
That did not prevent some 2,500 partygoers from attending an illegal New Year rave near the city of Rennes, in northwestern France.
A statement from local authorities said that many of the revelers were still on the site of the illegal party on Friday morning and that police had failed to stop it. Paramedics were deployed around the site to distribute gel and masks in a bid to limit the risks of coronavirus contaminations and prosecutors announced that they opened an investigation into the illegal organization of the event.
Police officers tried to prevent the rave “but faced fierce hostility from many partygoers,” the statement read, adding that stones and bottles were thrown at them and that a police car was set on fire.
The rave near Rennes, and some other large-scale illegal parties throughout France that were broken up by the police, sparked concern about the spread of the coronavirus, as the country still suffers from the second wave of the pandemic.
With more than 2.6 million confirmed cases of coronavirus — the highest number of cases in Europe — and some 65,000 deaths, France has paid a heavy toll to the pandemic.
On Thursday, health authorities announced that a first case of a new coronavirus variant linked to South Africa had been reported in France, while the seven-day average of new daily infections cases has surpassed 13,000 — more than double the government’s daily target of 5,000 new infections to ease restrictions.
To fight back a rise in infections in parts of the country, French authorities on Friday announced that it would bring forward by two hours the nighttime curfew in 15 of France’s 101 departments, or administrative divisions. The curfew will being at 6 p.m. rather than 8 p.m., starting on Saturday.
With hospitals still struggling to cope with the second wave of the pandemic and while authorities fear that end-of-year holiday gatherings will result in a rebound of Covid-19 infections, the French government is under pressure to act.
In a note submitted to the government on Dec. 23 and made public on Tuesday, France’s scientific council — a government advisory body for the Covid-19 crisis — recommended to act swiftly in the face of a “possible” resumption of the pandemic that could soon be “out of control.”
The French government has for the moment ruled out a return to a full lockdown, despite pressure from some local authorities, but Olivier Véran, France’s health minister, warned that a relaxation of the restrictions that have forced bars, restaurants, museums and theaters to close is likely to be delayed.
“At this stage, and depending on the evolution in the coming days, it seems hardly conceivable to lift all the restrictions,” Mr. Véran said.
A highly contagious coronavirus variant first identified in Britain has been discovered in Florida, health officials said on Thursday.
The Florida Department of Health announced that a man in his 20s located in Martin County was the state’s first identified case of the variant. The man has no history of travel, officials said in a statement on Twitter.
“The Department is working with the C.D.C. on this investigation,” the statement reads. “We encourage all to continue practicing Covid-19 mitigation. At this time, experts anticipate little to no impact on the effectiveness of the Covid vaccine.”
Other cases of the variant have been identified this week in Colorado and California, and patients in those cases also did not report traveling outside of the United States. The variant, known as B.1.1.7, has not been known to lead to more severe cases of Covid-19, but it has been found to be more transmissible than previous forms, experts have said.
This means the new variant could bring more cases as well as casualties and hospitalizations, affecting an already frail health care system that has yet to see the full ramifications of holiday gatherings and travel amid the pandemic.
Mitigation efforts that have become staples of the pandemic — physical distancing, mask wearing and improved ventilation — will all need to remain a priority as the modes of transmission under the new variant have not changed.
This past week Florida saw an average of 10,246 coronavirus cases per day, according to a New York Times database. During a news briefing on Wednesday, Gov. Ron DeSantis said over 175,000 residents in the state have received a vaccine.
A more contagious form of the coronavirus is churning in the United States.
First identified in Britain, the variant already accounts for more than 60 percent of new coronavirus cases in London and its neighboring areas, and there’s worry the variant could further exacerbate cases in the U.S. and place greater strain on an already strained health care system.
A variant that spreads more easily also means that people will need to religiously adhere to precautions like social distancing, mask-wearing, hand hygiene and improved ventilation — unwelcome news to many Americans already chafing against restrictions.
We asked experts to weigh in on the evolving research into this new version of the coronavirus. Here’s what they had to say.
The new variant seems to spread more easily between people.
The new variant, known as B.1.1.7, seems to infect more people than earlier versions of the coronavirus, even when the environments are the same.
Scientists initially estimated that the new variant was 70 percent more transmissible, but a recent modeling study pegged that number at 56 percent. Once researchers sift through all the data, it’s possible that the variant will turn out to be just 10 to 20 percent more transmissible, said Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.
Even so, Dr. Bedford said, it is likely to catch on rapidly and become the predominant form in the United States by March.
The variant behaves like earlier versions.
So far, at least, the variant does not seem to make people any sicker or lead to more deaths. Still, there is cause for concern: A variant that is more transmissible will increase the death toll simply because it will spread faster and infect more people.
The routes of transmission — by large and small droplets, and tiny aerosolized particles adrift in crowded indoor spaces — have not changed.
Infection with the new variant may increase the amount of virus in the body.
Some preliminary evidence from Britain suggests that people infected with the new variant tend to carry greater amounts of the virus in their noses and throats than those infected with previous versions.
That finding offers one possible explanation for why the new variant spreads more easily: The more virus that infected people harbor in their noses and throats, the more they expel into the air and onto surfaces when they breathe, talk, sing, cough or sneeze.
With previous versions of the virus, contact tracing suggested that about 10 percent of people who have close contact with an infected person — within six feet for at least 15 minutes — inhaled enough virus to become infected.
“With the variant, we might expect 15 percent of those,” Dr. Bedford said. “Currently risky activities become more risky.”
Scientists are still learning how the mutations have changed the virus.
Each infected person offers opportunities for the virus to mutate as it multiplies. With more than 83 million people infected worldwide, the coronavirus is amassing mutations faster than scientists expected at the start of the pandemic.
The vast majority of mutations provide no advantage to the virus and die out. But mutations that improve the virus’s fitness or transmissibility have a greater chance to catch on.
At least one of the 17 new mutations in the variant contributes to its greater contagiousness. The mechanism is not yet known. Some data suggest that the new variant may bind more tightly to a protein on the surface of human cells, allowing it to more readily infect them.
Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government, said it’s important to look at evidence “as preliminary and accumulating.”
But one thing is for sure, mitigation efforts will need to remain a priority.
“We need to be much more careful over all, and look at the gaps in our mitigation measures,” said Dr. Cevik said.
A flurry of headlines this week flooded social media, documenting a seemingly concerning case of Covid-19 in a San Diego nurse who fell ill about a week after receiving his first injection of Pfizer’s coronavirus vaccine.
But experts said the sickness is nothing unexpected: The protective effects of vaccines are known to take at least a couple of weeks to kick in. And getting sick before completing a two-dose vaccine regimen, they said, should not undermine the potency of Pfizer’s product, which blazed through late-stage clinical trials with flying colors.
Reporting that a half-vaccinated person contracted the virus is “really the equivalent of saying someone went outside in the middle of a rainstorm without an umbrella and got wet,” said Dr. Taison Bell, a critical care physician at the University of Virginia. Dr. Bell received his first dose of Pfizer’s vaccine on Dec. 15, and will be getting his second shot soon.
The California nurse, identified as Matthew W., 45, in an ABC10 News report, received his first dose of Pfizer’s vaccine on Dec. 18. Six days later, according to the news reports, he began to feel minor symptoms, including chills, muscle aches and fatigue. He tested positive for the virus the day after Christmas.
Framing the nurse’s illness as news, said Dr. Megan Ranney, an emergency physician at Brown University, implied that it was a departure from the expected — and that there should have been protection about a week after the first vaccine dose. That’s not the case at all.
The timeline of the California nurse’s illness falls well within the window of post-vaccination vulnerability, Dr. Ranney said in an interview. It’s also very likely he caught the virus right around the time he got the shot, perhaps even before. People can start experiencing the symptoms of Covid-19 between two and 14 days after encountering the coronavirus, if they ever have symptoms at all.
A similar situation appears to have recently unfolded with Mike Harmon, the Kentucky state auditor, who this week tested positive for the virus the day after receiving his first dose of an unspecified coronavirus vaccine.
The nation’s courts have reacted nimbly to the coronavirus pandemic, Chief Justice John G. Roberts Jr. wrote in his year-end report on the state of the federal judiciary.
“For the past 10 months,” he wrote, “it has been all hands on deck for the courts, as our branch of government confronted the Covid-19 pandemic.”
“The last nationwide crisis came with the virulent outbreak of the Spanish flu in 1918, which led to cancellation of Supreme Court sessions,” he wrote. “But for more than a century, the courts have not had to respond to such a widespread public health emergency.”
It was an eventful year for Chief Justice Roberts, one that included presiding over the impeachment trial of President Trump, the death of Justice Ruth Bader Ginsburg and the arrival of Justice Amy Coney Barrett. The reconfigured court is a work in progress, but the addition of Justice Barrett will almost certainly diminish the chief justice’s power, as his vote is now no longer crucial when the justices are divided along ideological lines.
In reaction to the pandemic, the Supreme Court postponed arguments that had been scheduled for March and April, and in May it embarked on a bold experiment, hearing arguments by telephone and letting the public listen in, both firsts. The court has now heard some 40 arguments in the new format. Notwithstanding the occasional glitch, the proceedings were orderly and dignified if at times stilted and inert.
Chief Justice Roberts wrote that the new format allowed the court to function. “Although we look forward to returning to normal sittings in our courtroom,” the chief justice wrote, “we have been able to stay current in our work.”
By some measures, though, the court’s workload is dropping. An appendix to the chief justice’s report said the court issued only 53 signed opinions in argued cases in the term that ended in July. That is the smallest number since the 1860s. The current term seems poised to yield a similarly small number of opinions.
During the Spanish flu epidemic, in the term that started in 1918, the court decided 163 cases, or more than three times as many as the current court.
The world hit a few more pandemic milestones this week with the distribution of the coronavirus vaccines developed by Moderna and by Pfizer and BioNTech; the advancement of trials studying other experimental shots; and the approval or authorization of coronavirus vaccines in several countries. The welcome news comes as the number of known infections worldwide rises toward 83 million.
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Britain announced on Wednesday that it had granted emergency authorization to the Oxford-AstraZeneca vaccine. The vaccine is less expensive than others — $3 to $4 a dose — and can be stored in a normal refrigerator, unlike some of its freezer-bound counterparts, making it easier to transport and administer. The vaccine is meant to be given in two doses four weeks apart, but Britain plans to wait up to 12 weeks to give the second shot, freeing up more doses for first injections. Some early evidence suggests the delay might boost the vaccine’s ability to protect people from Covid-19, though experts have repeatedly cautioned that more data is needed.
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The state-owned Chinese company Sinopharm announced that one of its experimental vaccines, developed by the Beijing Institute of Biological Products, had an efficacy rate of 79 percent based on an interim analysis of Phase 3 trials, spurring the Chinese government to grant the shot full approval. The vaccine has also been approved in the United Arab Emirates and Bahrain. The company has yet to publish the detailed results of its late-stage clinical trials.
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Novavax, based in Maryland, announced on Monday the start of a late-stage clinical trial that will enroll about 30,000 people in the United States and Mexico. Two-thirds of the volunteers in the study will receive the company’s vaccine; the other 10,000 will get a shot of a saline solution as a placebo. Like many other vaccines, Novavax’s vaccine requires two doses. The vaccine can be kept stable in a normal refrigerator.
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The World Health Organization gave the Pfizer-BioNTech vaccine an emergency stamp of approval on Thursday, the first one granted to a Covid-19 vaccine. Placing it on the organization’s Emergency Use Listing will allow the vaccine to move more quickly through regulatory approval in countries around the world. The step will also allow the vaccine to be distributed through Unicef and the Pan-American Health Organization.
Denese Rankin, a 55-year-old retired bookkeeper and receptionist in Castleberry, Ala., did not want the Covid-19 vaccine. Her opinion toward the vaccine was like many Black, rural Americans: The vaccine had come about too quickly to be safe.
Her worry prompted her niece, Dr. Zanthia Wiley, to come to town. Dr. Wiley, who is an infectious disease specialist at Emory University in Atlanta, said one of her goals on her trip was to let her family hear the truth about vaccines from someone they knew, someone who is Black.
Across the country, Black and Hispanic physicians like Dr. Wiley are reaching out to Americans in minority communities who are suspicious of Covid-19 vaccines and often mistrustful of the officials they see on television telling them to get vaccinated. Many are dismissive of public service announcements, the doctors say, and of the federal government. The government’s long history of medical experimentation on Black people is also not helping the matter.
But it’s the assurance from Black and Hispanic doctors that can make all the difference.
“I don’t want us to benefit the least,” Dr. Wiley said. “We should be first in line to get it.”
Physicians across the U.S. are making themselves readily available to dispel myths and address concerns about Covid-19 vaccinations. Some have even gone as far to host video calls and post messages on social media.
“I think it makes a whole lot of difference,” said Dr. Valeria Daniela Lucio Cantos, an infectious disease specialist at Emory who has been running online town halls and webinars on the subject of vaccination.
Black and Hispanic communities have been disproportionately affected by the coronavirus, with Black and Hispanic Americans being three times more likely to be infected with the coronavirus compared to white people.
Many of the vaccine-hesitant are linchpins of health in their own families. Ms. Rankin, for example, helps care for Dr. Wiley’s grandmother, who is blind, and her grandfather, who cannot walk. Ms. Rankin looks in on Dr. Wiley’s mother, whose health is fragile. And she is the single mother of three girls, including a 14-year-old who still lives at home.
“If my aunt got infected, my family would be in tough shape,” Dr. Wiley said.
Dr. Virginia Banks, an infectious disease specialist in Youngstown, Ohio, who is Black, said she has seen too many people — and not all of them old — suffer and die in the pandemic. She often recites stories of her experiences dealing with those infected to people hesitant about getting vaccinated.
“We have to tell these stories” to Black Americans, she said. “And it has to come from someone who looks like them.”
“My friends and family say, ‘Even if the risk is one in a million, I am not taking it,’” she added. “I say, ‘I understand your mistrust, but this is beyond Tuskegee. This is beyond “The Immortal Life of Henrietta Lacks.” We are in a pandemic now. We have to put our faith in the science.’”
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