As U.S. Vaccine Drive Lags, Fast-Moving Coronavirus Variant Is Making Inroads

People waiting in line to be vaccinated at a library in Bonita Springs, Fla., on Tuesday.
Credit…Octavio Jones for The New York Times

A slower-than-expected vaccine rollout in the United States may be about to meet a fast-moving new variant of the coronavirus.

Officials in two states, Colorado and California, say they have discovered cases of the more contagious variant, which was first identified in Britain.

A day after Colorado reported the first known case of the variant in the United States, state officials on Wednesday reported a second one. Then later in the day, Gov. Gavin Newsom of California announced that his state, too, had a case in San Diego County.

There is no evidence that the new variant makes people any sicker, but it appears to be much more contagious than older forms. And that threatens to complicate what had seemed a hopeful, if halting, path to recovery from the pandemic in the United States.

The confirmation that the variant, which has upended Britain’s efforts to contain the pandemic, was in the United States came as U.S. officials acknowledged the vaccination drive has been lagging.

Federal health officials said in a news conference on Wednesday that they did not have a clear understanding as to why only a fraction of the doses that had been shipped out around the country have made it into arms.

As of Wednesday, more than 12.4 million doses of the Pfizer and Moderna vaccines had been sent out across the United States, up from 11.4 million on Monday morning. But just 2.8 million people had received their first dose, according to the Centers for Disease Control and Prevention.

“We agree that that number is lower than what we hoped for,” said Moncef Slaoui, scientific adviser of Operation Warp Speed, the federal effort to accelerate vaccine development and rollout. He added: “We know that it should be better, and we’re working hard to make it better.”

The 2.8 million administered doses reported by the C.D.C. is an underestimate of the true number because of lags in reporting. Still, it falls far short of the goal that federal officials put forward as recently as this month to have 20 million people vaccinated by the end of this year.

Gen. Gustave F. Perna, the logistics lead of Operation Warp Speed, said that the C.D.C. was gathering data to better understand the factors driving the slow uptake of vaccines that had been shipped out. “To have greater specificity at this time, after two weeks, I don’t think would be appropriate,” he said.

Still, General Perna pointed to a few possible contributing factors. In addition to the lags in reporting, the holiday season and winter weather have slowed uptake. Hospitals and other facilities administering the vaccines are still learning how to store the doses at very cold temperatures and properly administer them. And states have set aside many doses to be given out to their long-term care facilities, a drive that is just gearing up and expected to take several months.

So far, most vaccines administered have been given out at hospitals, clinics and nursing homes. Dr. Slaoui and General Perna both said they expected the pace of the rollout 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 in their stores and other locations once vaccines become more widely available. So far, 40,000 pharmacy locations have enrolled in that program, General Perna said.

“What we should be looking at is the rate of acceleration over the coming weeks,” Dr. Slaoui said, “and I hope it will be in the right direction.”

United States › United StatesOn Jan. 7 14-day change
New cases 280,028 +15{50531db320f8e8a316d79d6a285e47c71b6e4f6739df32858cb86474d7e720e9}
New deaths 4,111 +6{50531db320f8e8a316d79d6a285e47c71b6e4f6739df32858cb86474d7e720e9}

World › WorldOn Jan. 7 14-day change
New cases 840,193 +6{50531db320f8e8a316d79d6a285e47c71b6e4f6739df32858cb86474d7e720e9}
New deaths 15,632 Flat

Where cases per capita are

All the residents and most staff members at this nursing home have tested positive in recent weeks.
Credit…Matthew Staver for The New York Times

Simla, Colo., an isolated ranching community on the high plains, is the last place locals expect to be first for anything, especially a new, more infectious variant of the coronavirus.

But on Wednesday, state health officials announced that the first known case of the variant in the United States had been confirmed in a National Guard soldier sent to help with a Covid outbreak at the town’s Good Samaritan nursing home.

A second soldier at the nursing home has also tested positive for the coronavirus and may also have the variant, Dr. Emily Travanty, the interim director of the state public health laboratory, said in a conference call with reporters.

All 26 residents of the nursing home and 20 of its 24 regular employees have tested positive in recent weeks, and four residents have died.

It was not clear whether the two National Guard soldiers were infected at the nursing home or had picked up the virus before they came to Simla. They arrived on Dec. 23, after most of the cases at the facility had occurred, Dr. Herlihy said.

Simla seems an unlikely place for a virus variant only recently detected in the United Kingdom to turn up. For generations this windswept stretch of short grass prairie, perched at 6,000 feet about 80 miles southeast of Denver, has been shaped mainly by the timeless rhythms of raising cattle.

When the virus arrived in the United States at the beginning of the year, many of the roughly 600 residents of Simla went on with life, assuming that, like most things that sweep the country, the pandemic would pass them by.

The town’s feeling of isolation changed late this fall when a second wave of infections swept across Colorado and hit Simla and surrounding Elbert County particularly hard, sending it into the state’s “severe risk” threat level, where it remains today. Soon nearly everyone in this tightknit community knew someone who was sick.

On Wednesday, television news crews gathered in front of the modest, one-story nursing home while cleaning crews in hazmat suits discreetly passed in and out through a back door.

A day earlier, the state sent a team to the facility to collect new specimens from the residents and staff. Based on the samples tested so far, Dr. Herlihy said, it does not appear that the variant is circulating in the facility, but more samples were to be tested.

In Simla’s lone craft shop, on a dirt road where the only apparent customers were a half-dozen local cats lounging in the winter sun outside the front door, the owner, Carla Tracy, was in a state of disbelief.

“My gosh, this itty-bitty town most people can’t even find on a map,” she said. “And we thought we wouldn’t have much trouble with the virus.”

Travelers waiting for their luggage last week at Dallas-Fort Worth International Airport.
Credit…Yffy Yossifor/Star-Telegram, via Associated Press

Flights at Dallas-Fort Worth International Airport — one of the world’s busiest hubs — were grounded Wednesday after an air traffic control center was forced to close for several hours for cleaning after an unspecified number of employees tested positive for the coronavirus.

The disruption at the center, which handles high-altitude air traffic for most of North Texas, Northwest Louisiana and the southern parts of Oklahoma and Arkansas, caused ripples of delays and diverted flights across the country.

The Fort Worth Air Route Traffic Control Center suspended operations from 3 p.m. to 5:30 p.m. so that the facility could be disinfected, according to the Federal Aviation Administration. It did not say how many employees had contracted the virus.

Both Dallas-Fort Worth International Airport and Dallas Love Field Airport reported substantial disruptions to their operations.

“The F.A.A. has closed the airspace in and out of the DFW Airport until 5 p.m. Central Time,” a statement issued by the airport said. “This is due to a required sanitization cleaning of offsite F.A.A. facilities that control the airspace in DFW. This will result in flights being delayed or possibly canceled.”

The airport, which served about 75 million passengers last year before the pandemic, urged travelers to check with their airlines for changes to their flights.

Students at the Boys & Girls Club of Hollywood.
Credit…Jae C. Hong/Associated Press

Gov. Gavin Newsom of California unveiled a $2 billion plan on Wednesday to bring elementary school students back into classrooms starting in February, arguing that it was urgent to bring young students back to school and possible to do so safely even as the state is battling a devastating surge of coronavirus cases.

Many of California’s large school districts — including its largest, Los Angeles — have been operating remotely for the majority of students all fall. Even some cities that had the virus substantially under control earlier this fall, like San Francisco and Oakland, did not open schools, in part because of opposition from teachers’ unions.

Mr. Newsom’s plan would provide approximately $450 per student to districts offering in-person instruction, with more money going to districts serving low-income families, English language learners and foster children.

The state would, in turn, adopt a safety regimen, including regular testing for all school staff members and students, a mask requirement for all students and staff, and a contact tracing system as well as prioritized vaccinations for school workers. There will also be a state dashboard for tracking outbreaks.

“As a father of four, I know firsthand what parents, educators and pediatricians continue to say: In-person is the best setting to meet not only the learning needs, but the mental health and social-emotional needs of our kids,” the governor said in a statement.

Tony Thurmond, the state’s superintendent of public instruction, said at a news conference that the plan would be put in place alongside other measures aimed at helping students who will still be learning remotely.

“We moved into distance learning overnight,” he said. “We must address the lack of infrastructure and lack of broadband access across our state.”

The announcement comes as California grapples with its worst surge of the pandemic. There are more than 20,000 people hospitalized with Covid-19 in the state, and intensive care units across much of California are overwhelmed.

On Tuesday, officials formally extended stay-at-home orders for most of the state’s residents and pleaded with them to refrain from gathering with loved ones to ring in the new year.

But evidence has accumulated that elementary schools can open safely even when there are relatively high rates of community transmission, in part because young children appear to transmit the virus less easily than older ones and adults.

Linda Darling-Hammond, the president of the state’s board of education, said at the Wednesday news conference that evidence shows “it’s possible” to safely reopen schools even when the virus is prevalent in the surrounding communities.

Some California school districts have already said they will remain in remote learning mode for the entire year, and it is unclear whether they might reconsider, the education news outlet EdSource reported.

The superintendents of seven large districts — Los Angeles, San Diego, Long Beach, San Francisco, Oakland, Sacramento and Fresno — issued a statement saying they welcomed the administration’s efforts to make reopening schools a priority and would provide a thorough response to the governor’s plan before the State Legislature reconvenes on Jan. 11.

Pharmacists preparing vaccines for health care workers at the Ohio State University Wexner Medical Center.
Credit…Brian Kaiser for The New York Times

Although the vast majority of nursing home residents in Ohio are accepting a vaccine for Covid-19, the same cannot be said for the staff who work in these facilities, Gov. Mike DeWine said Wednesday.

Roughly 60 percent of Ohio nursing home workers offered a vaccine have refused to be inoculated, the governor announced at a news conference on Wednesday, citing anecdotal evidence.

Mr. DeWine, a Republican, urged people in high priority groups not to pass up an opportunity to get the vaccine, saying the vaccine’s benefits far outweighed any risks.

“We’re not going to make them, but we wish they had a higher compliance,” he said. “Our message today is: The train might not be coming back for a while.”

Nursing home residents and employees have made up one of the most vulnerable populations during the pandemic. About 40 percent of U.S. coronavirus deaths have been linked to nursing homes or long-term care facilities.

And so when vaccines arrived, nursing home residents were some of the first people in the U.S. to get them. They were inoculated after federal regulators gave emergency use authorization to vaccines from Pfizer-BioNTech and Moderna.

In Ohio, the state is also giving vaccine priority to other groups, among them frontline workers, E.M.S. workers, and residents and staff members at veterans’ homes and facilities that treat those with developmental disabilities and mental health disorders.

Adults working in schools will also soon have the option to receive a vaccine, Mr. DeWine said, although he did not give an exact date.

The state is set to receive over 500,000 doses of vaccine from Pfizer-BioNTech and Moderna. As of Wednesday, close to 94,000 Ohio residents have received a vaccine, the Ohio Department of Health reported.

Mr. DeWine said he had expected the numbers of those vaccinated to be higher. More broadly, U.S. officials have acknowledged that vaccine rollout has lagged throughout the country.

“I’m not satisfied with where we are in Ohio,” Mr. DeWine said. “We’re not moving fast enough, but we’re going to get there.”

A volunteer in the Oxford-AstraZeneca vaccine trial getting a shot in Oxford, England, in November.
Credit…Andrew Testa for The New York Times

A global push to accelerate vaccinations gathered steam on Wednesday, with new developments from Britain, China and Russia.

Britain became the first country to give emergency authorization to the coronavirus vaccine developed by AstraZeneca and the University of Oxford. The approval opens a path for a cheap and easy-to-store shot that much of the world will rely on to help end the pandemic. Indian officials met on Wednesday and were set to meet again on Friday to consider vaccine applications.

For Britain, where hospitals are overwhelmed by a new, more contagious variant of the virus, the regulator’s decision offered some hope of a reprieve. The health service is preparing to vaccinate a million people per week at makeshift sites in soccer stadiums and racetracks.

The Oxford-AstraZeneca shot is poised to become the world’s dominant form of inoculation. At $3 to $4 a dose, it is much less expensive than some other vaccines. And it can be shipped and stored at normal refrigeration temperatures for six months, rather than in the ultracold freezers required by the Pfizer-BioNTech and Moderna vaccines, making it easier to administer to people in poorer and hard-to-reach areas.

In a bold departure from prevailing strategies around the world, the British government also decided to begin giving as many people as possible a first vaccine dose, rather than holding back supplies for quick second shots, greatly expanding the number of people who will be inoculated. Clinicians in Britain will wait as long as 12 weeks to give people second doses, the government said.

The effects of delaying second doses as a way of giving more people the partial protection of a single dose are not fully known. Britain, which experts believe is the first country to undertake such a plan, will also delay second doses of the Pfizer-BioNTech vaccine, which has been in use in the country for several weeks and has been shown in clinical trials to have considerable efficacy after a single dose. Some participants in the clinical trial of the Oxford-AstraZeneca vaccine were given the two doses several months apart.

When given in two full-strength doses, AstraZeneca’s vaccine showed 62 percent efficacy in clinical trials — considerably lower than the roughly 95 percent efficacy achieved by Pfizer’s and Moderna’s shots. For reasons scientists don’t yet understand, AstraZeneca’s vaccine showed 90 percent efficacy in a smaller group of volunteers who were given a half-strength initial dose.

Here are other vaccine developments from around the world:

  • China said on Thursday that it had approved a homegrown coronavirus vaccine after an early analysis of clinical trial results showed that it was effective. The announcements sent a positive signal for the global rollout of Chinese vaccines but lacked crucial details.

    The manufacturer, a state-controlled company called Sinopharm, said a vaccine candidate made by its Beijing Institute of Biological Products arm had an efficacy rate of 79 percent based on an interim analysis of Phase 3 trials. Sinopharm said it had filed an application with Chinese regulators to allow the vaccine to be used broadly, and on Thursday the government said the vaccine had been granted conditional approval.

  • Russia secured an important outside vote of confidence in the safety of its vaccine, Sputnik V, with the start of mass inoculations in Belarus and Argentina. The vaccine had been dogged by criticism since President Vladimir V. Putin announced in August that it was ready for use even though clinical trials had not been completed.

    Large-scale clinical trials carried out since then have shown the vaccine, developed by the Gamaleya National Research Institute of Epidemiology and Microbiology, to be more than 91 percent effective, according to its Russian backers. A voluntary vaccination program using Sputnik V began in Russia this month, but a recent survey found that only 38 percent of Russians intended to get the vaccine.

  • Hungary, whose leader, Viktor Orban, has pointed to Russia as a beacon of his model of so-called illiberal democracy, was the first member of the European Union to receive a delivery of the Russian vaccine, though the shipment it received on Monday was only 6,000 vials. Doses of the Russian vaccine also arrived in Serbia, which is outside the union, on Wednesday.

  • Prime Minister Giuseppe Conte of Italy said on Wednesday that the country was aiming to immunize 10 million to 15 million people by late spring but that it would not make the vaccine obligatory.




Some Fans Can Attend Buffalo Bills Playoff Game, Cuomo Says

Gov. Andrew M. Cuomo of New York said about 6,700 fans will be allowed to attend the Buffalo Bills playoff game as part of a pilot plan for business reopening. Fans must test negative for Covid-19.

We’re piloting an expansive testing plan to give us an opportunity to reopen businesses safely and smartly, and we’re going to pilot the approach at the Buffalo Bills playoff game. A football playoff game, obviously is outdoors, which is a much better situation from Covid spread. And the stadium is a controlled venue. The agreement with the Department of Health, State of New York, Buffalo Bills will allow fans at the first playoff game that the Buffalo Bills are going to play. The agreement is for 6,700 fans, they’ll be socially distanced, masks required. But every fan will be tested before the game. Obviously, if they test positive for the virus, they won’t be attending the game, and they’ll get the treatment that they need. And then post-game, there will be contact tracing. So we’ll find out exactly what happened, was there any spread at the game, etc. The question is, rather than wait six, nine, 12 months to reopen the economy, can you start to reopen businesses safely, smartly by using rapid testing? That’s the question, because, again, we can’t wait. We can’t stay closed down.

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Gov. Andrew M. Cuomo of New York said about 6,700 fans will be allowed to attend the Buffalo Bills playoff game as part of a pilot plan for business reopening. Fans must test negative for Covid-19.CreditCredit…Adrian Kraus/Associated Press

Gov. Andrew M. Cuomo of New York announced on Wednesday that fans would be allowed at the Buffalo Bills game on the weekend of Jan. 9, the first move in a state plan to reopen some sectors of the economy before the state reaches herd immunity.

The change came as Mr. Cuomo said officials are hoping to launch an “expansive testing plan” to allow businesses to restart. The pilot will be in the world of sport.

In Buffalo, state officials, said up to 6,772 fans will be allowed at the team’s stadium.

“The question is: Rather than waiting six, nine, 12 months to reopen the economy, can you start to reopen businesses safely, smartly by using rapid testing?” Mr. Cuomo said. “You cannot afford on any level to keep the economy closed until the vaccine hits critical mass.”

Negative tests will be required for all attendees before the game, officials said, and contact tracing will be conducted afterward. Safety precautions like mask wearing and social distancing will also be enforced, and Mr. Cuomo urged fans to avoid attending tailgates or other large gatherings at the stadium.

At most, Bills Stadium will hit roughly nine percent of its capacity of more than 70,000 under the new provisions. But the development still comes as a win for fans who have not been allowed at professional sporting events for months — and as the team approaches its first home playoff match in more than two decades.

Across the state, more than 25 zones, among them parts of western New York, communities along the Pennsylvania border and areas of New York City, are under various levels of restrictions on businesses and dining.

Mr. Cuomo did not offer extensive details on how or when the state’s new approach might expand to other sectors, or whether it will be used again if the team advances in the playoffs and plays other games at the stadium.

But he did say that businesses and events that operate outdoors would be go first. “We haven’t even talked about indoors,” he said.

Still, the governor sounded a note of optimism.

“If it works there, could you do Madison Square Garden?” Mr. Cuomo asked. “Could you do a theater on Broadway? Could you do a certain capacity in a restaurant so restaurants could start to reopen safely? That is the road that we’re looking at.”

Reporters questioned Mr. Cuomo at a news briefing about why a football game was being given priority, particularly as the city’s positive test rate reaches its highest daily figure since May.

He said that if the state waited until it achieved herd immunity, which experts say is far off, businesses would be further devastated.

The game, he said, is a first step.

“If you wait until critical mass of the vaccine,“ the governor said, “you’re really going to have to be digging through the rubble.”

London on Wednesday. Three-quarters of England is now under the toughest virus limits.
Credit…Andrew Testa for The New York Times

On the same day that Britain’s regulators gave emergency approval to the coronavirus vaccine developed by AstraZeneca and the University of Oxford, millions more people in England were told they would be placed under the country’s tightest regulations starting Thursday.

Three-quarters of the country’s population will live under England’s toughest virus limits, Britain’s health secretary, Matt Hancock, announced in Parliament on Wednesday. The government stopped short of introducing a full national lockdown, but will effectively create one across almost all of the country, with northeastern England and large parts of northwestern, southwestern and central England set to join London and southern and eastern England under the tier four rules.

The return of high school and secondary school students after the winter break will be delayed until mid-January, the education secretary, Gavin Williamson, said on Wednesday. Universities will also be asked to reduce the number of students who return to campus next month.

Most primary schools for children 5 to 11 years old will return on Jan. 4 as previously planned, but some schools in areas with the highest infection rates will shift to remote learning for all students except those who are vulnerable or whose parents are essential workers. The government still hopes to introduce a mass testing program for all schools.

The measures were deemed necessary as Britain is fighting to contain the spread of an especially contagious strain of the coronavirus that has brought the country’s cases to record levels and pushed the National Health Service to its limits.

Britain reported 50,023 new lab-confirmed cases on Wednesday, and 981 deaths, the highest daily death toll since April. Frontline health care workers have been warning that hospitals are at a breaking point, with more patients admitted in England with Covid-19 than at the April peak. Some hospitals have already warned of shortages of bed space and oxygen supplies.

Shortly before Christmas, London and parts of southern England — where the new strain is most prevalent — were moved up to the strictest regulations. Those restrictions include: a ban on indoor socializing; people staying at home as much as possible; and gyms, nonessential shops and restaurants remaining closed, except for takeaway meals. Meeting one other person outdoors and open-air exercise are permitted.

The country’s approval of the homegrown AstraZeneca vaccine brought hope that the pandemic’s end could be near. “From the beginning, we’ve focused on the vaccine as a way out of this pandemic and now it is a reality,” Mr. Hancock said, adding that it was a day of “mixed emotions” as he acknowledged the new measures would place a significant burden on people and businesses. “We must all stick at it during the difficult weeks ahead,” he said.

Chris Long of Clarkston, Mich., has been in the hospital seven times since contracting the coronavirus.
Credit…Emily Rose Bennett for The New York Times

Nearly a year into the pandemic, it is clear that recovering from Covid-19’s initial onslaught can be an arduous, uneven journey. Now, studies reveal that a significant subset of patients are having to return to hospitals, sometimes repeatedly, with complications triggered by the disease or the body’s battle against it.

The routine of Chris Long, 54, used to include biking 30 miles three times a week and taking courses toward a Ph.D in eight-week sessions. But since getting sick with the coronavirus in March, Mr. Long has fallen into a distressing new cycle — one that so far has landed him in the hospital seven times.

Every few weeks since his initial five-day hospitalization, his lungs begin filling, he starts coughing uncontrollably and runs a low fever. Roughly 18 days later, he spews up greenish-yellow fluid, signaling yet another bout of pneumonia.

Soon, his oxygen levels drop and his heart rate accelerates to compensate, sending him to a hospital near his home in Clarkston, Mich., for several days, sometimes in intensive care.

Data on rehospitalization of coronavirus patients is incomplete, but early studies suggest that in the United States alone, tens or even hundreds of thousands could ultimately return to the hospital.

“It’s an urgent medical and public health question,” said Dr. Girish Nadkarni, an assistant professor of medicine at Mount Sinai Hospital, who, with another assistant professor, is studying readmissions of Covid-19 patients.

A study by the Centers for Disease Control and Prevention of 106,543 coronavirus patients, initially hospitalized between March and July, found that one in 11 was readmitted within two months of being discharged, with 1.6 percent of patients readmitted more than once.

Readmissions strain hospital resources, and patients can be exposed to new infections and develop muscle atrophy from being bedridden.

Some research suggests implications for hospitals currently overwhelmed with cases. A Mount Sinai Hospital study of New York’s first wave found that patients with shorter initial stays and those not sick enough for intensive care were more likely to return within two weeks.

Staff members at Redlands Community Hospital in Redlands, Calif., after being vaccinated on Dec. 18. Vaccine recipients should be observed for at least 15 minutes afterward in case they have an allergic reaction, health officials say.
Credit…Alex Welsh for The New York Times

Anyone who experiences a severe allergic reaction, like anaphylaxis, immediately after receiving the first dose of a coronavirus vaccine should not receive the second dose, federal health officials warned on Wednesday.

Though acute reactions to the vaccines are believed to be extremely rare, health care providers who administer the shots are being advised to observe all patients for at least 15 minutes afterward, just in case — and twice as long for people with a history of severe allergic reactions to other vaccinations or injections.

Officials from the Centers for Disease Control and Prevention said they updated their guidance on vaccine reactions Wednesday because the first people to be vaccinated against Covid-19 in the United States will soon be due to receive the second required dose.

People who have had allergic reactions to either of two chemicals — polyethylene glycol or polysorbate — are also being warned not to receive a vaccine.

Polyethylene glycol is an ingredient in both of the authorized Covid vaccine preparations. The vaccines do not contain polysorbate, which is used in some laxatives, oral preparations for colonoscopies and certain medications. But the chemical has cross reactivity with polyethylene glycol, meaning that if you are sensitive to one, you may have a similar allergic reaction to the other.

“No one really knows if polyethylene glycol is the culprit” causing the severe allergic reactions that have been seen so far, said Dr. Sarah Mbaeyi of the C.D.C.’s Covid-19 Response clinical guidelines team. “Everything is still under investigation.”

Even so, she said, polyethylene glycol is being singled out because most of the other components of the vaccines are not considered to be of concern. Though severe allergic reactions to polyethylene glycol are believed to be rare, some experts think they may have gone unnoticed or unrecognized in the past.

The C.D.C. urged that precautions be taken when vaccinating anyone who has had an immediate allergic reaction to any vaccine or injectable drug in the past. These people should undergo a risk assessment, and consider putting off getting the Covid-19 vaccine until they have consulted an allergist or immunologist, officials said.

But people with allergies to other things that are not in the vaccine — like foods, pets, insects or other medications — are not precluded from taking the Covid-19 vaccine, officials said.

So far, there have been very few severe allergic reactions to the new vaccines, officials said. At least two cases were reported in Britain earlier this month, and there were six cases reported in the United States among the more than 272,000 patients vaccinated through Dec. 19.

global roundup

A memorial in April for those who died of the coronavirus in Wuhan.
Credit…Roman Pilipey/EPA, via Shutterstock

A new study released by the Chinese Center for Disease Control has suggested that the number of coronavirus infections in Wuhan, the Chinese city where the outbreak was first discovered, may have been far higher than official data shows.

In Wuhan, a city of 11 million people, official tallies put the number of coronavirus infections at just above 50,000, with 3,869 deaths. But blood samples taken from residents after the pandemic’s first wave reveal that the number of infections could be as high as 500,000 — 10 times higher than the official count.

The study looked at samples from 34,000 people in Wuhan and other cities across China, including Beijing and Shanghai, as a way of estimating infection rates. More than 4 percent of the samples taken from Wuhan residents contained Covid-19 antibodies, a prevalence rate far higher than that found in other cities in the study. In other cities in Hubei Province, of which Wuhan is the capital, less than 1 percent of residents in the study had Covid-19 antibodies.

The results of the study were released on Monday by the Chinese Center for Disease Control. It concluded that the lower infection rates in other cities were evidence that China’s approach to controlling the coronavirus had been successful.

China has been criticized for its lack of transparency in its pandemic response and has been accused of hiding information that could cast the government in a negative light. But some experts said the discrepancy in case numbers suggested by the study released on Monday was evidence instead of the chaotic early days of the outbreak in Wuhan, when medical resources were scarce and little was known about the coronavirus.

“I don’t think this means that the authorities were hiding cases,” Tao Lina, a former immunologist at the Shanghai Center for Disease Control and Prevention, said in a phone interview. During the outbreak’s first weeks, Mr. Tao said, many people who were sick stayed home, treating their illness like a common cold. Others were turned away from hospitals because of a lack of space.

In other developments from around the world:

  • Saying a coronavirus variant in South Africa appears linked to a recent surge in infections, the World Health Organization urged all African countries on Wednesday to carry out “crucial investigations” to detect any new mutations and to help contain the virus’s spread. Rising infections in South Africa and increases in some other countries have led the continent to near a July peak.

  • The authorities in France said that an overnight curfew in place since mid-December would begin two hours earlier in several regions hard hit by the pandemic. The new curfew will be enforced on Saturday if the rise of Covid-19 infections has not been curbed by then. The health minister, Olivier Véran, said that the existing curfew, which lasts from 8 p.m. to 6 a.m., would start at 6 p.m. France has reported an average of 13,000 new cases per day for the past two weeks — more than double the 5,000 set as a target for the easing of restrictions. For now, the government has ruled out a full lockdown.

  • China announced new measures in Beijing and the northern city of Shenyang as officials moved to control two local outbreaks. Officials in the Shunyi District of Beijing said on Wednesday that they were tightening controls as they worked to track down one outbreak, according to Xinhua, the state-run news agency. Officials said an infected person without symptoms had visited multiple locations. Officials in the northern city of Shenyang said on Wednesday they had declared “wartime status,” signaling new limits after eight cases were confirmed there, according to state-run China Central Television. The city will restrict large-scale gatherings including group meals, training sessions and parties.

  • The authorities in Germany recorded 1,129 coronavirus deaths on Tuesday, the highest daily number since the start of the pandemic. While experts say the number is elevated because of delays in reporting during Christmas, it has led to headlines in a country that prided itself on a relatively low fatality rate early in the pandemic. “The numbers show just how brutally this virus is still striking,” the German health minister, Jens Spahn, said at a news conference on Wednesday. Although registered infections had dropped from a week earlier, health officials warned that these were probably underreported. A national lockdown, scheduled to run to Jan. 10, is likely to be extended, Mr. Spahn said, though he did not give details.

  • Hackers from Turkey have been accused of defacing the website of the Chinese coronavirus vaccine manufacturer Sinovac. On Wednesday, the site included a large image with the words “Turkish defacer.” A separate page included the flag of East Turkestan, an emblem long banned in China and generally used as a symbol of independence for the Uighurs, a Turkic Muslim minority group. The hack comes as Turkey began receiving the vaccine produced by Sinovac and as Turkey weighs ratifying an extradition treaty with China. A Sinovac spokesman did not immediately respond to questions about the hack.

  • People traveling to Sweden from Britain will need to show a negative test result for the virus before entering the country, the Swedish government said on Wednesday. The requirement will start Jan. 1 and will not apply to Swedish citizens, the country’s home affairs minister, Mikael Damberg, said at a news conference, Reuters reported.

    Correction: Dec. 30, 2020
    An earlier version of this article described incorrectly the recent surge in coronavirus infections in Africa. The surge is driven largely by increases in South Africa and some other countries, not 47 African countries.

Prisoners affected by the coronavirus in facilities like the Eastern Oregon Correctional Institution in Pendleton have the right to sue Oregon state officials over their handling of the pandemic, a federal judge has ruled.
Credit…Ricardo Nagaoka for The New York Times

Inmates in Oregon’s prisons, where coronavirus infections and deaths have been rising for months, have the legal right to sue state officials over their handling of the outbreaks, a federal court judge has ruled.

The ruling this month by Stacie Beckerman, a magistrate judge, is believed to be the first in the nation to allow state officials — including the governor and top prison officials — to be held accountable in court for failing to adequately protect prisoners from the virus.

If such lawsuits succeed, Oregon may ultimately be forced to pay damages, and prisoners in other states may follow the same legal road.

State prison officials around the nation have acknowledged that they have taken a trial-and-error approach to the pandemic, one that has failed to stop the virus from penetrating any state prison system in the nation, according to a New York Times database. As of Tuesday, there had been almost 265,000 confirmed infections and more than 1,600 Covid-19 deaths among inmates in state prisons, according to the database.

Indications that a prison took inadequate precautions might include anything from not requiring guards to wear masks to testing too few inmates, according to the court ruling.

In May, the Supreme Court denied a request from two inmates in a Texas geriatric prison to reinstate a trial judge’s order instructing officials to take steps to protect them from the coronavirus. But Juan Chavez, one of the lawyers representing prisoners in the Oregon lawsuit, said the Texas case was different.

The Texas prisoners were asking the court to order officials to act to prevent the spread of the virus, Mr. Chavez said. The Oregon lawsuit, however, includes a claim for money damages because the prisoners believe state leaders did too little to protect their health.

The Oregon Department of Corrections declined to comment on the lawsuit on Tuesday.

Advocacy groups and prisoners’ families have pressed the state to release many inmates to slow the spread of the virus, as some other states have done. But since March, only 247 people have had their sentences commuted, according to the department.

Bonnie Grady, whose son, Matthew Yurkovich, is incarcerated at the Snake River Correctional Institution in Ontario, Ore., said that prisoners slept within a few feet of one another and had limited access to cleaning supplies, and that guards did not always wear masks.

Ms. Grady said that in the spring, her son lost his sense of smell and taste, a symptom associated with the coronavirus, but that he was never tested. “If I did my job as poorly as the prison did their job with the virus, then I would have lost my job,” she said.

Nearly 2,200 prisoners and 500 correctional officers have been infected in Oregon state prisons, including more than 460 inmates at Snake River, according to state records. Twenty-one prisoners statewide have died. Coronavirus cases surged in the state prison system after wildfires in September forced the evacuation of several prisons.

Coronavirus: Then & Now

Valerie Brown waited for the No. 17 bus in April to get home after work in Detroit.
Credit…Emily Rose Bennett for The New York Times

As 2020 comes to a close, we are revisiting subjects whose lives were affected by the pandemic. John Eligon first spoke with Valerie Brown in April. She was a regular passenger on the No. 17 bus in Detroit, and worried that the crowds on the bus, including some riders without masks, would endanger her health.

When we last heard from Valerie Brown, her life was going the way of two face-slapping emojis, which she sent me in a text message.

“It’s never going to get better here,” she wrote in April, describing having to ride a packed bus to get to work in Detroit as the pandemic began cutting its fatal path across the city.

I met Ms. Brown, 22, during one of those rides on the No. 17 bus, which cuts east-west across the city. She had boarded a bus that was relatively empty that day, but it quickly became crowded. She was annoyed when a man sidled up in the seat right next to her when there were other empty seats available. Although most riders were wearing masks, they were not required in those days, so there were plenty of people without them.

As spring turned to summer, Ms. Brown said, the situation only grew worse. Buses became more and more packed. People ignored signs to stay out of certain seats, she said, and there were always a few riders who didn’t cover their faces. And cases of the coronavirus were increasing.

“I was definitely scared to get on public transportation,” Ms. Brown, who commuted by bus to her job at a fast-food restaurant, told me in an interview this week. “No one’s caring about the safety of public transportation. It was a complete disregard. It was kind of messed up.”

Sometimes the bus got so packed that riders were standing right over her, Ms. Brown said. In some of those instances, she said, she got off the bus and took a Lyft the rest of the way to work. Her breaking point came in October, she said, when a group of teenagers got on the bus, eating and drinking without masks.

“It was like, ‘At this point, do I need to go where I’m going?’” she said. “This is a joke to everybody.”

Ms. Brown was primarily concerned about bringing the virus home to her 43-year-old mother, who has battled pneumonia, as well as her father and three siblings. So far, fortunately, she has not caught it and neither have they.

After a while, things started to improve slightly on the bus. The city began requiring all riders to wear masks. Ms. Brown said she began seeing more transit police patrolling the bus, enforcing social distancing rules and making sure that people wore masks.

But real relief for Ms. Brown came a few weeks ago: She bought a car, which she had been saving up to purchase for about a year. She found a 2013 Chevrolet Cruze advertised on Facebook, and paid cash. It was a bit of a stretch for her to afford, but she said the peace of mind was worth it.

“I feel safer,” she said. “I feel like I’m more in control of who I’m around, knowing that I’m not around random people, who’ve been around random people, who’ve been around other random people.”

Luke Letlow in July. He said on Dec. 18 that he was isolating at home after testing positive for the coronavirus.
Credit…Melinda Deslatte/Associated Press

Luke Letlow, a Republican who was elected to the House of Representatives this month to represent Louisiana’s Fifth Congressional District, died Tuesday evening of complications from Covid-19, a spokesman said. He was 41.

Mr. Letlow was set to take office on Sunday. His death was confirmed by several politicians, including Representative Garret Graves of Louisiana, who said in a Facebook post that the death of his friend and “former co-worker” was “a huge loss to Louisiana and America.” Mr. Letlow died at the Ochsner L.S.U. Health medical center in Shreveport, La., said the spokesman, Andrew Bautsch.

Mr. Letlow said on Dec. 18 that he was isolating at home after testing positive for the coronavirus. He was hospitalized a day later in Monroe, La., before being transferred to the hospital in Shreveport on Dec. 22. Mr. Bautsch said on Dec. 23. that Mr. Letlow had been receiving the antiviral drug remdesivir and steroids to treat his infection.

On Dec. 21, while he was hospitalized in Monroe, Mr. Letlow urged people who had recovered from Covid-19 to donate plasma. “Your plasma is ESPECIALLY needed by those who are suffering,” he wrote in a tweet. “I cannot stress this enough. Please consider saving lives by going out and donating at your local blood bank.”

He did not have any underlying conditions that would have increased his chances of dying from Covid-19, Dr. G.E. Ghali, a doctor at the Shreveport hospital, told The Advocate in Baton Rouge, La.

In a runoff this month against another Republican, Mr. Letlow was elected to succeed Representative Ralph Abraham, whom Mr. Letlow had served as chief of staff.

Mr. Letlow is survived by his wife, Julia, and their two children, Jeremiah and Jacqueline.

Speaker Nancy Pelosi said in a statement, “Tonight, the United States House of Representatives sadly mourns the passing of Congressman-elect Luke Letlow.

“Congressman-elect Letlow was a ninth-generation Louisianian who fought passionately for his point of view and dedicated his life to public service,” she said.

Kevin McCarthy, the House minority leader, said, “Our hearts break tonight as we process the news of Congressman-elect Luke Letlow’s passing.”

Gov. John Bel Edwards of Louisiana said Tuesday evening that Covid-19 had “taken Congressman-elect Letlow from us far too soon.” Mr. Edwards, a Democrat, said he had ordered flags to be flown at half-staff on the day of Mr. Letlow’s funeral.

Representative Mike Johnson, a Republican who represents the state’s Fourth Congressional District, issued a statement on behalf of the state’s six-member Congressional delegation: “We are devastated to hear of Luke Letlow’s passing. Luke had such a positive spirit, and he had a tremendously bright future ahead of him. He was looking forward to serving the people of Louisiana in Congress, and we were excited to welcome him to our delegation where he was ready to make an even greater impact on our state and our nation.”

Bobby Jindal, the former governor of Louisiana whom Mr. Letlow had previously worked for when Mr. Jindal was a congressional candidate, representative and governor, said the congressman-elect “had talked in recent days about his excitement about the opportunity to serve” his district.

“I first met Luke when he was still a college student, and spent countless hours with him in his truck driving the back roads of Louisiana,” Mr. Jindal said. “His passion for service has been a constant throughout his life.”

According to Ballotpedia, Mr. Letlow is the first elected federal official to die from the coronavirus; the first member of the federal government to die from it was a judge.

Other elected officials to die from Covid-19 include several state legislators: a Republican state senator from Minnesota, New Hampshire’s new Republican speaker of the House of Representatives, and in North Dakota, David Dean Andahl, a Republican known as Dakota Dave, who was elected posthumously to the State House of Representatives after dying from the virus.

The Mexican Army set up a checkpoint in Celaya, Mexico, in August after an anti-drug operation.
Credit…EPA, via Shutterstock

Like a lot of businesses, the Sinaloa Cartel was knocked back on its heels as the coronavirus swept the globe and travel ground to a near halt.

Government measures to contain the virus had fouled up its operations, interrupting the supply of chemicals for manufacturing synthetic drugs like fentanyl and methamphetamine and cutting off trafficking routes across international borders.

But while many legitimate industries remain staggered by the pandemic, the cartel has adapted quickly, as have other organizations that dominate drug trafficking throughout the Americas, the source of nearly all of the world’s cocaine and most of the heroin consumed in the United States.

“The cartels have long demonstrated their resiliency,” said Scott Brown, the head of the Homeland Security Investigations office in Arizona. “They are going to continue to find new and innovative ways to try to move their product.”

The drug trafficking organizations have slashed payrolls and devised workarounds to traffic drugs and get them into the hands of consumers, according to interviews with sources close to the Sinaloa Cartel, law enforcement officials in the United States and Latin America, and security analysts.

During the year, some traffickers have increasingly relied on newer tools like drones and cryptocurrency and on creative uses of older approaches like underground tunnels and sea routes.

American officials have also detected a growing emphasis on the recruitment of impoverished or drug-addicted Americans to smuggle drugs in their body cavities.

The changes, sources said, have allowed the Sinaloa Cartel and the region’s other major drug trafficking groups to rebound quickly even as the pandemic continues to devastate economies.

And the challenges of getting drugs into the United States when travel routes shut down appears to have spurred the development of clandestine laboratories in the United States for the production of synthetic drugs, said Celina Realuyo, professor at the William J. Perry Center for Hemispheric Defense Studies at the National Defense University in Washington.

Law enforcement agencies around the world have also detected an acceleration in the use of cryptocurrency and the so-called dark web for drug transactions and money laundering during the pandemic, she said.

“They’re adjusting,” Ms. Realuyo said of the drug trafficking groups. “They already had kind of a wherewithal, and what they’re doing is they’re just adapting quicker to their context.”

Workers from Landmark Signs installed a panel of Waterford crystal triangles on the New Year’s Eve ball on Sunday.
Credit…Kathy Willens/Associated Press

Every December, the eyes of the world are drawn to New York City, where a glittering crystal ball in Midtown Manhattan marks a communal chance for a new beginning. But this past spring, when the pandemic ravaged New York City, photos of an eerily vacant Times Square became a grim meme, the deserted plaza an enduring image of the crisis.

And this New Year’s Eve, for the first time in decades, Times Square will be closed to the public. Only production workers and dozens of selected frontline workers and their families will be permitted near the stage.

On the guest list are a pediatrician at Elmhurst Hospital, a public hospital that was overwhelmed by the pandemic; a pizza delivery driver who became ill with the coronavirus; and Ronald Colbert, a Staten Island Ferry operator who will be attending his 40th Times Square ball drop.

“I am just so honored and happy,” said Mr. Colbert, 66, who worked through the pandemic.

The outdoor concert will be staged according to state and industry guidelines for safe media productions. This year’s musical guests include Gloria Gaynor singing “I Will Survive,” a disco classic resurfaced as a pandemic anthem.

The TV networks will project the image of a Times Square transformed by the pandemic, one without the throngs of revelers in glittering gear. The sweeping shots showing a blocks-long street party will be axed. Close-ups won’t show smiles, said Jeff Straus, the president of Countdown Entertainment, which co-produces the Times Square event, because faces will be covered.

“We want to show a physically distanced Times Square,” Mr. Straus said. “We want to show a Times Square that is wearing masks.”

Still, both Mr. Straus and Tim Tompkins, the president of the Times Square Alliance, said it was important to them that an audience of some kind be present if circumstances allowed.

“So much of the energy comes from the hordes of people,” said Mr. Tompkins, who has been involved with the ball drop since 2002. “And so there will definitely be a different energy in Times Square.”

“We want to show a city with a heartbeat,” said Mr. Straus. “And a city that’s alive.”

Credit…Marta Monteiro

My 12-year-old daughter, Audrey, told me recently on one of our many walks around the neighborhood that she would never forget this pandemic, and that she never wanted to take for granted having friends over, visiting extended family or hugging her grandparents again. She wondered, though, whether people would really live with new appreciation. Over time, would we all forget? Would a hug or a handshake become commonplace again?

“Write down how you feel,” I suggested. “Record it so your future self will remember.”

The next day, I spotted this letter on my daughter’s desk.

“Open on New Year’s Day or Eve, starting when you are in high school or even 8th grade maybe,” she wrote.

Here’s part of her letter.

Dear Audrey,

You are much older now, and hopefully wiser, although sometimes that’s not the case. You have probably forgotten about me.

I’m 12-year-old you struggling with anxiety, hating virtual learning, in this nightmarish pandemic.

I’ve come from 2020 to remind you not to forget. I am sitting on my bed right now, tears still on my face from a fight with my mom (I love her more than anything or anyone, but we’ve spent too much time together), and aware of the light blue masks hanging on the hooks next to the door in my kitchen. In a way, it still feels like March, when this whole crazy thing started. I’m sick of it.

I didn’t get to spend Thanksgiving with my beloved grandparents, when I’d been waiting so long to act normally with them and pod up. Now, it looks like I won’t be spending Christmas with them normally either. In America (where I live), the Coronavirus numbers are higher than they’ve ever been.

I am struggling and would do anything to get out of 2020 and this pandemic, to see my friends and family normally. You are able to do that. You have what I want so badly. So please, I urge you to enjoy your life, your friends, your family, your experiences.

Remember — everything is replaceable and unimportant, but people are the only true thing that matter in this modern-day world.

Love your life, and be filled with joy this year.


You, age 12, Audrey in 2020, the Pandemic Year.

Loretta Jones with her children, from left, Grenderline, 11, Christopher Michael, 4, and Frederick, 12. “By the grace of God, we’re making it through,” Ms. Jones said.
Credit…Cheriss May for The New York Times

Since the first coronavirus case was recorded in her neighborhood in Southeast Washington in the spring, 11-year-old Grenderline Etheridge has burst into tears many times for reasons she cannot explain. She has crawled into bed with her mother, something she had not done for a very long time.

Her siblings have also had trouble dealing with the pandemic: Her brothers, who are 12 and 4, have joined her in their mother’s bedroom, and the little one, who was nearly potty trained before his school shut down in March, recently went back to wearing diapers.

Grenderline’s mother, Loretta Jones, has tried over the past 10 months to keep the children focused on their studies and entertained with games, books and handprint art activities. In the early days of the pandemic, Ms. Jones often drove the family to a nearby park for exercise, but they stopped going once virus cases began rising again. A surge in gunfire this year in the neighborhood has also caused the family to stay mostly inside, confined to a crowded, three-bedroom apartment.

“By the grace of God, we’re making it through,” said Ms. Jones, 34, who has bipolar disorder and has had difficulty finding steady work.

As the virus advanced on the nation and spared not a single community, it also inflamed the difficulties that many families were already enduring in pre-pandemic times: gun violence, hunger, poverty.

The disruptions to daily life — and the associated stresses of lives on pause — have been perhaps most acutely felt by children from low-income families, experts said, many of whom live in predominantly Black and Latino neighborhoods that have been plagued by a rise in gun violence and disproportionately high coronavirus infection rates.

The pandemic has inflicted so much upheaval in Grenderline’s life — and the lives of many young people — that experts worry the devastating effects will be felt long after vaccines are distributed and some semblance of normalcy returns.