Israel’s Vaccination Results Point a Way Out of the Pandemic
New York State will begin allowing people with some chronic health conditions that put them at greater risk of severe illness from the coronavirus to receive a vaccine on Feb. 15, Gov. Andrew M. Cuomo said on Friday.
About 1.3 million people are now receiving a vaccine every day in the United States as the country pushes to accelerate inoculations before new, more contagious virus variants become dominant. New York is just the latest state to expand vaccine eligibility beyond the initial focus on health care workers and residents of long-term care facilities. Some teachers are being vaccinated in at least 25 states and Washington, D.C., a New York Times survey found.
Last month, many states heeded a federal appeal that all people over 65 should be prioritized. That was embraced by many older people, but it also caused a deluge of problems as people tried to figure out whether their state was now allowing them to get shots, how to sign up, and where to go.
In California, experts are still recommending that vaccines be administered only to people over 65 and residents and staff at long-term care facilities. But state officials launched a task force on Wednesday to sort out the logistics of expanding vaccine eligibility to people with disabilities and underlying health conditions.
Florida has introduced some discretion into its vaccination rollout; residents under 65 are eligible if they are “deemed to be extremely vulnerable” by hospital providers.
Some of the conditions that would qualify people to be eligible for the vaccine included cancer, heart conditions, lung diseases, liver disease, diabetes, obesity, diabetes and pregnancy, although the C.D.C.’s advisory committee has told pregnant women to consult with their doctors before receiving the vaccine.
Mr. Cuomo’s announcement came as he said that state health data showed that 75 percent of New York’s hospital workers had received at least one dose of the vaccine. The state will give hospitals one more week to inoculate remaining employees before it begins to reallocate vaccine doses to give them to people with comorbidities.
Across the state, more than 2.2 million doses of the vaccine have been given, Mr. Cuomo said. Virus-related hospitalizations stood at 7,937, the lowest number since Jan. 1.
The loosening of restrictions on vaccine eligibility came as a much-anticipated vaccination site opened at Yankee Stadium in the Bronx, which New York City and state health officials hope will boost inoculation rates among local people of color and battle the spread of the virus in the borough, which currently has the city’s highest positive test rates.
Health officials had hoped to prioritize these groups in the rollout but have struggled. Black and Latino people are more likely to contract the virus than white people, yet many communities of color have been hesitant or suspicious regarding the vaccine, particularly in light of the country’s history of unethical medical research.
Mr. Cuomo released data on Friday showing that the percentage of eligible Black New Yorkers who had received a dose of the vaccine lagged behind white ones. The governor did not provide raw totals, but said that 17 percent of the essential workers eligible to receive the vaccine were Black, compared to only 5 percent of those who received it. Among those eligible to receive the vaccine because they were over 65 years old, 13 percent were Black, but only 4 percent of those inoculated were Black.
The Yankees’ president, Randy Levine — who appeared at Mr. Cuomo’s news conference along with the manager, Aaron Boone, and the former pitcher Mariano Rivera — said that the team would offer Yankees “trinkets and gifts” to encourage people to come to the stadium for vaccinations.
Mayor Bill de Blasio said on Friday during an interview on WNYC that a mass vaccination site at Citi Field in Queens was “coming in a matter of days,” but he did not address the timetable for a planned location at the Empire Outlets on Staten Island. That borough was a hot spot for the virus last fall, and positive test rates have remained high.
In the same interview, Mr. de Blasio said that the policy that requires city school buildings to close when two or more coronavirus cases are reported within the same week is “being re-evaluated.” The rule has led to frequent temporary school closures.
The Covid-19 vaccine developed by AstraZeneca and the University of Oxford protected people against a new, more contagious coronavirus variant at similar levels to the protection it offered against other lineages of the virus, Oxford researchers said in a paper released on Friday.
The paper, which has not yet been peer-reviewed, said that the vaccine had 74.6 percent efficacy against the new variant, which was first detected in Britain and is known as B.1.1.7. That was similar to, though potentially slightly lower than, its efficacy against other lineages of the virus.
The encouraging, albeit preliminary, findings suggest that all five of the leading vaccines may offer at least some protection against new variants of the virus spreading around the globe. Still, the mounting evidence suggests that mutant viruses can diminish the efficacy of vaccines, increasing the pressure on countries to quickly vaccinate their populations and outrace the variants taking hold across the globe.
In clinical trials, the AstraZeneca-Oxford vaccine protected all participants against severe illness or death.
The Oxford scientists behind the vaccine took weekly swabs from the nose and throat of participants enrolled in their clinical trial in Britain. To determine the vaccine’s efficacy against the new variant, they sequenced the viral particles from several hundred swabs between Oct. 1 and Jan 14, a period when the new variant was known to be present in Britain.
The vaccine had 84 percent efficacy against other lineages of the virus, compared to 74.6 percent against the new variant, though the scientists did not have enough statistical confidence to know for sure if the vaccine was slightly less effective against the variant.
Andrew Pollard, the lead investigator of Oxford’s vaccine trial, said in a news conference that the new data show that the vaccine has “very similar” levels of efficacy against the original pandemic virus and the variant that has been rapidly in the U.K. and some other countries.
The researchers also conducted laboratory tests on blood samples from clinical trial participants who had been vaccinated. They found a nine-fold reduction in the activity levels of the vaccine-generated antibodies against the B.1.1.7 variant compared to another lineage of the variant. That’s a sign that the vaccine may have less power to neutralize the variant, though it appears to still be potent enough to be protective.
The variant first detected in Britain has since been reported in more than 70 other countries. Public Health England has estimated that the variant’s rate of infection is 25 percent to 40 percent higher than that of other forms of the coronavirus.
Preliminary data from lab tests of the vaccines from Pfizer and Moderna suggest that they offer good protection against the B.1.1.7 variant. Novavax, which sequenced testing samples from its clinical trial participants in Britain while the variant was circulating widely there, found that its vaccine was highly effective against the B.1.1.7 variant.
The paper released on Friday did not address the AstraZeneca vaccine’s protective power against another fast-spreading coronavirus variant, known as B.1.351, that was first identified in South Africa. Researchers are conducting similar lab tests to try to measure the effect of that variant on the vaccine’s potency.
AstraZeneca’s vaccine has been authorized in nearly 50 countries around the globe but not the United States, where the Food and Drug Administration is waiting on data from a clinical trial that enrolled more than 30,000 participants, mostly Americans. Results from that study are expected in March.
In the United States, the B.1.1.7 variant has been identified in 33 states, but the full extent of its spread is unknown because of the lack of a national surveillance program. Federal health officials have warned that it could become the dominant form of the virus in the United States by March.
Officials in two of America’s largest cities issued ultimatums to teachers on Friday, warning them that they risked discipline if they did not show up at school buildings on Monday.
In Chicago, where Mayor Lori Lightfoot and the teachers’ union have been locked in a battle over how to reopen schools during the coronavirus pandemic, prekindergarten and some special education teachers were expected to return on Monday, the mayor and the chief executive of the school system, Janice K. Jackson, said in a letter. Those who did not, they said, would be locked out of the district’s virtual teaching system at the end of the day.
In Philadelphia, prekindergarten through second-grade teachers were supposed to report to schools on Monday to prepare for students returning on Feb. 22. The district told those teachers in a message that they would be subject to discipline if they did not show up.
Teachers’ unions in both cities have been pushing back.
The president of the Philadelphia Federation of Teachers, Jerry Jordan, directed teachers to continue working remotely and said in a statement on Friday that “other than sheer cruelty and a callous disregard for the lives of educators and school staff, I can’t think of another reason to push forward with a reckless plan to reopen unsafe buildings.” The Chicago Teachers Union has told its members to refuse to report to schools until a reopening agreement is reached and has threatened to strike if the district retaliates against teachers who stay home.
The fight over reopening in Chicago, the nation’s third-largest district, has become one of the nation’s most contentious. On Friday, Ms. Lightfoot and Dr. Jackson said they had provided the union with their “last, best, and final offer” and had not yet received a formal response.
In letters to students’ families and staff, they said the offer included a phased timeline for reopening, under which prekindergarten and some special education students would return to school on Tuesday. Older grades would be brought into classrooms over the following weeks, with middle school students returning on March 1.
The Canadian government has extended a ban on cruise ships through February 2022, effectively docking tourism in Alaska’s southeastern region for another year.
The extension of the ban on Thursday — which was originally set to expire at the end of this month — will allow the country’s public health authorities to focus on vaccine rollouts and suppressing the spread of new variants of the virus, according to a statement by the Canadian government.
A United States maritime law prohibits foreign-registered ships from sailing between two American ports without stopping at a foreign port in between, which means that trips to Alaska typically make stops in Canada. Without access to Canadian shores, large ships can’t traverse the southeastern coast of the state, known as the Alaska Marine Highway.
According to The Associated Press, most of Alaska’s 1.3 million visitors in 2019 were cruise ship passengers visiting that part of the state. Last year, only 48 cruise ship passengers visited the state’s shores. A report put together in September by the Southeast Conference of Alaska, a regional economic development organization, showed that from April to July of last year the area lost 7,000 jobs, but tourism “was particularly devastated.”
“While many hoped that the tourism season could continue in a modified format, Canada’s prohibition of cruise ships effectively ended the regional tourism season before it began,” the report read.
Alaska’s congressional delegation, made up of Senators Lisa Murkowski and Dan Sullivan, and Representative Don Young, issued a statement condemning Canada’s decision. The announcement, they said, was made “without so much as a courtesy conversation,” and was “not only unexpected — it is unacceptable — and was certainly not a decision made with any consideration for Alaskans or our economy.”
The delegation also said it would look into ways “to ensure the cruise industry in Alaska resumes operations as soon as it is safe,” including making changes to existing laws.
New research published by the Centers for Disease Control and Prevention on Friday shows that statewide mask-wearing mandates were associated with a decline in the growth rate of Covid-19 hospitalizations. The study provides additional evidence that wearing of masks can help minimize transmission of the coronavirus.
The research, published in the Morbidity and Mortality Weekly Report by the agency, found that in three weeks or more following a mask mandate, Covid-19 hospitalization growth rates fell by 5.5 percent in people aged 18 to 64.
The research focused on 10 states — California, Colorado, Connecticut, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio and Oregon — that implemented mask mandates in the period from April to June of 2020. Hospitalization growth rates fell for adults 40 to 64 two weeks or more after the mandates were put into place, the research showed. There are currently 34 states with mask mandates.
Mask orders are “helping to protect people and helping the cases coming down,” said Dr. Rochelle Walensky, director for the C.D.C., in a briefing on Friday by the White House Covid-19 Response team. She added that the data remains somewhat open to interpretation in light of a multitude of changing factors taking place during the period these mandates were implemented.
The C.D.C.’s Morbidity and Mortality Weekly Report also published another study on Friday showing that college students appear to be doing an impressive job responding to the public health rallying cry to wear masks.
From September to November, observers at six universities, five universities in the South and one in the West, found that 85.5 percent of 17,200 people on campus wore masks, with nearly 90 percent wearing them correctly (“If the mask completely covered the nose and mouth and was secured under the chin.”). Proper mask-wearing rates were higher indoors, 91.7 percent, the research found.
The participating schools included five public universities with student populations ranging from 29,000 to 52,000, and one private university with 2,300 students. The rates of mask-wearing compliance were not specific by university; the research also noted that proper use of the masks varied by the type of covering: 96.8 percent or N95-type masks, 92.2 percent for cloth and 78.9 percent for “bandanas, scarves, and similar face coverings.”
The House gave final approval on Friday to a budget blueprint that included President Biden’s $1.9 trillion stimulus plan, advancing it over unanimous Republican opposition as Democrats pressed forward with plans to begin drafting the aid package next week and speed it through the House by the end of the month.
“Our work to crush the coronavirus and deliver relief to the American people is urgent and of the highest priority,” Speaker Nancy Pelosi wrote in a letter to Democrats shortly before the bill passed by a 219-to-209 margin.
President Biden, speaking just before the House acted, cited a weak jobs report in justifying the use of a procedural device, called reconciliation, to ram through the measure if Senate Republicans oppose his effort to speed aid to families, businesses, health care providers and local governments.
“It is very clear our economy is still in trouble,” Mr. Biden said during remarks at the White House — amping up the pressure on an upper chamber bracing for former President Donald J. Trump’s impeachment trial next week.
“I know some in Congress think we’ve already done enough to deal with the crisis in the country,” added Mr. Biden, who reiterated his commitment to fund $1,400 direct checks to low- and middle-income Americans. “That’s not what I see. I see enormous pain in this country. A lot of folks out of work. A lot of folks going hungry.”
Mr. Biden’s comments came as the Labor Department’s reported on Friday that the economy added only 49,000 jobs in January, and just 6,000 in the private sector. The labor market remains 10 million jobs below its pre-pandemic levels.
Hours earlier, as the sun rose over the Capitol dome, the Senate approved a fast-track budget measure, with Vice President Kamala Harris casting her first-ever tiebreaking vote after a grinding all-night session. The move, in theory, allows them to enact the package without any Republican votes.
Senate leaders could begin working on their own bill in hopes of delivering a final package to Mr. Biden’s desk before supplemental unemployment benefits are set to expire in mid-March.
Jen Psaki, the White House press secretary, cited poll numbers showing bipartisan support among American voters for the plan, brushing aside criticism the White House was sacrificing bipartisan solidarity for partisan celerity.
“He didn’t run on a promise to unite the Democratic and Republican Party into one party in Washington,” she said in her Friday briefing at the White House.
Still, Mr. Biden offered one olive twig on Friday, saying his plans could change to win over moderates in both parties, acknowledging that he favored restricting the direct payments to people earning less than $300,000.
“I’m not cutting the size of the checks,” he said on Friday. “They’re going to be $1,400, period.”
Still, there were warning signs the road ahead would not be entirely traffic-free.
The Senate agreed to a proposal by Senator Joni Ernst, Republican of Iowa, to prohibit any minimum wage increase during the pandemic — which could complicate Mr. Biden’s plan to raise the federal minimum wage to $15 per hour by 2025.
Democrats did not contest Ms. Ernst’s proposal, arguing that it was never their intention to increase the wage immediately, but their reticence to record a vote on the matter was a signal that the wage increase might ultimately lack the support to pass in an evenly split Senate, where at least one Democrat, Senator Joe Manchin III of West Virginia, is on record in opposition.
A curfew will be imposed in Havana on Friday night as Cuba tries to parry its biggest coronavirus spike since the beginning of the pandemic.
The Havana Tribune, a provincial newspaper of the Communist Party of Cuba, informed the capital’s population that a “total restriction of movement of people and vehicles” will be imposed from 9 p.m. to 5 a.m. and that the curfew “will remain in place until the epidemiological situation is favorable.”
The curfew is part of a package of measures applied in recent weeks to help curb the spread of the virus: Last month, schools were closed and public transport was cut back. Starting tomorrow, travelers entering the country will be forced to quarantine for five days — Cubans in state-run isolation centers at no cost, foreigners in hotels at their own expense. The number of flights from Covid-19 hot spots, including the United States, Colombia and the Dominican Republic, will be reduced as well.
Cuba is the first country in Latin America to develop, produce and test its own Covid-19 vaccines. Four vaccines are currently being tested in clinical trials. Sovereign II, the vaccine that has advanced the furthest, is expected to start Phase 3 testing in March and mass production in April. Cuba aims to vaccinate its entire population and produce 100 million doses this year. Surplus doses will be exported.
Health authorities say that tourists will be able to receive jabs during their stay, creating the prospect of health tourism once workers at package holiday destinations have been vaccinated. Tourism, one of the island’s main industries, has all but disappeared since the pandemic, leading to massive lines for groceries and even bread shortages. The prospect of a swift vaccination campaign and the return of tourist dollars by the high season in the fall may make the wait for basic goods and the curfew a little easier for the capital’s inhabitants.
Cuba reported only 12,225 confirmed cases and 146 deaths last year, but case numbers shot up during January. So far this month, the island has averaged around 900 confirmed cases per day, with over a third in Havana.
The Biden administration on Friday announced that it was sending 1,110 active-duty troops to five federal Covid-19 vaccination centers across the country, a significant escalation in its efforts to take more control of a chaotic and mostly state-led effort to administer the vaccines.
Five teams of 222 troops from the Air Force, Marine Corps, Navy and Army will deploy to the sites, which are run by the Federal Emergency Management Agency. Each team will include vaccinators, nurses, clinical staff and other operational positions, the Pentagon said.
At a White House news conference, Andy Slavitt, a pandemic adviser, said that Lloyd J. Austin III, the secretary of defense, had approved the request. Mr. Austin said at his confirmation hearings last week that he would increase military support for the federal government’s pandemic response.
Mr. Slavitt said that troops would arrive in California within 10 days, to begin operating around Feb. 15. Other assignments would be announced soon, he added.
“The military’s critical role in supporting sites will help vaccinate thousands of people per day, and ensure that every American who wants a vaccine will receive one,” Mr. Slavitt said.
FEMA, a part of the Department of Homeland Security, has said it hopes to set up roughly 100 vaccine sites nationwide as early as this month, and on Wednesday night requested that the Pentagon support the effort. The agency has said it would spend $1 billion on vaccine measures, including community vaccination sites.
The sites, and the use of the military within them, would require the approval of state governments, some of which have been openly hostile to the idea of the military assisting the efforts. The National Guard has already staffed large vaccination sites — over half of states and territories have used members to give shots — but the Pentagon’s role has been largely behind the scenes.
Federal officials also announced what they described were the administration’s first steps in activating a Korean War-era law, the Defense Production Act, to attempt to speed up the manufacturing of vaccines, test and supplies — what amounted at least in part to a continuation of a strategy deployed during the Trump administration.
Tim Manning, a former FEMA official and the White House’s supply chain coordinator, said the administration was using the law to ensure that suppliers of pumps and filtration units will prioritize orders from Pfizer so it can meet its production targets.
The Trump administration invoked the act to help Pfizer secure critical supplies in late December — months after Pfizer first asked for that support — and used it extensively to help other vaccine manufacturers. Mr. Manning said the latest moves would expand on that earlier effort to bolster Pfizer’s production. The law is used in part to allow federal contractors to jump ahead of other companies and secure supplies to meet the government’s needs.
The Trump administration used the law 18 times to hasten the production of vaccine supplies, Dr. Moncef Slaoui, the scientific lead of its vaccine development program, told Bloomberg News in a recent interview.
Mr. Manning also said that the government would begin building American plants to make raw materials for surgical gloves, and that the aim was for more than a billion nitrile gloves to be made every month to in the U.S. by the end of the year.
“We’re nearly 100 percent reliant on overseas manufacturers to export to us our country’s surgical gloves that protect health care workers. That’s unacceptable,” he said. “We’ll now make enough to satisfy half of all of the U.S. health care community demands right here on U.S. shores.”
They are called “vaccine hunters,” and they are creating an ethical dilemma for health officials across the country.
With overwhelming demand in the early months of the vaccine rollout and a patchwork of rules devised by local officials, thousands of Americans are crossing state lines in quest of a shot.
“The federal government has created this ‘Hunger Games’ scenario where people are out there doing everything they can to get to the front of as many lines as they possibly can,” said Dr. Francisco García, director of the Pima County Health Department in Tucson, Ariz.
So-called vaccine hunter groups scour the country for places where people can qualify for the vaccine, and then spread the word via social media. Many then show up far from home, with sleeves rolled up.
That has left public health officials grappling with how to respond.
Should strict rules be followed, and outsiders turned away? Or should as many shots be administered as possible, even if some may go to people who are not part of the community?
Some vaccine hunters say the flaws in the vaccine distribution process left them little choice but to take to the road.
“The idea of having to wait an unlimited amount of time in Louisiana to get a vaccine just didn’t work for us,” said Chanel Maronge, 37, a school librarian.
Ms. Maronge, who has hypertension, traveled from her home in Baton Rouge, La., to McComb, Miss., to receive a vaccine. Her husband, who has diabetes, and both her parents were able to get vaccinated, too.
Given the pressing need to vaccinate Americans as efficiently as possible, medical ethicists say it is fine to accept a vaccine out of priority order if offered one.
But cutting the line — or in this case, state lines — to jump ahead crossed not just a geographical boundary but an ethical one, said Nancy Berlinger, a bioethicist at the Hastings Center, an ethics research institute in Garrison, N.Y.
“When we jump the queue,” Dr. Berlinger said. “we’re not only putting ourselves literally in ahead of other people, we are actually working against the health of other people. Because some people came into this pandemic with higher risks.”
In the coming weeks and months, the issue may become less pressing. The picture has brightened as vaccines arrive across the country in growing numbers, though there is increasing concern about variants that are more resistant to the drug.
For people still waiting for vaccines, it can be frustrating to see people from outside their community manage to get one.
Lawrence Gretz, 66, a retired correctional transportation officer in Mesa, Ariz., said he had been incensed after seeing news reports that people from out of state, including people spending the winter in Arizona, were getting their shots before him and his mother.
“It’s just not right,” Mr. Gretz said, “and it’s ticking a lot of us off.”
Scientists have been sounding the alarm about new variants of the coronavirus that carry a handful of tiny mutations, some of which seem to make vaccines less effective.
But the novel coronavirus also has a propensity to mix large chunks of its genome when it makes copies of itself. Unlike the small mutations, which are like typos in the sequence, a phenomenon called recombination resembles a major copy-and-paste error in which the second half of a sentence is completely overwritten with a slightly different version.
A flurry of new studies suggests that recombination may allow the virus to shapeshift in dangerous ways.
The coronavirus mutations that most people have heard about, such as those in the B.1.351 variant first detected in South Africa, are changes in a single “letter” of the virus’s long genetic sequence, or RNA. Because the virus has a robust system for proofreading its RNA code, these small mutations are relatively rare.
Recombination, in contrast, is rife in coronaviruses.
Researchers at Vanderbilt University Medical Center recently studied how things go awry during replication in three coronaviruses, including SARS-CoV-2, which causes Covid. The team found that all three viruses showed “extensive” recombination in the laboratory.
Scientists worry that recombination might allow for different variants of the coronavirus to combine into more dangerous versions inside a person’s body. The B.1.1.7 variant first detected in Britain, for example, had more than a dozen mutations that seemed to appear suddenly.
Nels Elde, an evolutionary geneticist at the University of Utah, said that recombination may have merged mutations from different variants that arose spontaneously within the same person over time or that co-infected someone simultaneously. For now, he said, that idea is speculative: “It’s really hard to see these invisible scars from a recombination event.” And although getting infected with two variants at once is possible, it’s thought to be rare.
Russian news outlets connected to election disinformation campaigns in the United States have set their sights on a new target: convincing Spanish-speaking countries that Russia’s Sputnik V coronavirus vaccine works better than its American competitors, according to researchers and State Department officials.
The Russian campaign has focused on Latin American nations, including Mexico, which this week signed a deal to acquire millions of doses of Sputnik V, and Argentina, which last month began vaccinating its citizens with it.
Conducted on Spanish-language social media and reinforced by the official Twitter account of the Russian Embassy in Mexico City, the campaign signaled a new wrinkle in Russian influence operations, promoting Russian industry and scientific cachet over its competitors as governments around the world race to vaccinate their populations.
Sputnik V is considered less expensive and easier to transport than vaccines made by the American companies Pfizer and Moderna. But some researchers say the criticism in Russian outlets of the Western vaccines has been misleading.
For instance, media outlets backed by the Russian government posted to Facebook and Twitter hundreds of links to news stories that reported potential ties suggesting American vaccines may have had a role in deaths, the researchers said. The accounts left out follow-up reports that found the vaccines most likely played no role in the deaths.
“Almost everything they are promoting about the vaccine is manipulated and put out without context,” said Bret Schafer, a fellow with the Alliance for Securing Democracy, an advocacy group that tracks Russian disinformation. “Every negative story or issue that has come out about a U.S.-made vaccine is amplified, while they flood the zone with any positive report about the Russian vaccine.”
Researchers have tracked similar Russian efforts in Eastern European countries that are still negotiating with Russia to buy the vaccine. Disinformation researchers have also monitored Russia spreading similar narratives in a half-dozen languages, targeting countries in central and Western Africa.
Confronted with the possibility of coronavirus variants that may evade current vaccines, therapies and tests for the virus, the Food and Drug Administration is readying a plan for action in the next few weeks.
The Pfizer and Moderna vaccines have so far proven to be effective against known variants of the coronavirus, but they are less potent against the variant first identified in South Africa. That variant has only been confirmed in three people in the United States so far, but the country’s surveillance is thin and may be missing other cases.
As of Thursday, all but seven of the 618 coronavirus variant cases identified in the United States so far have involved a fast-spreading variant first observed in Britain, according to data from the Centers for Disease Control and Prevention.
“If variants emerge that are not prevented, that the vaccines have poor efficacy against, then we will need to rapidly change,” Janet Woodcock, the F.D.A.’s acting director, said in a call with reporters on Thursday. New versions of the vaccine would need to be rapidly manufactured, tested and distributed.
Officials at Pfizer and Moderna have said that they are prepared to tweak their vaccines as needed and that the process could be complete in as little as six weeks.
Dr. Woodcock declined to reveal any details about how the F.D.A. planned to evaluate the tweaked vaccines, but she said that the agency would probably require smaller and shorter trials than in the original trials run by Pfizer and Moderna.
“There are things short of doing full-fledged efficacy trials that we can use to shift or perhaps add components to the existing vaccines,” she said.
Dr. Woodcock said the plans will be released for comment from scientists before they are implemented.
The F.D.A. also plans to release guidance documents for monoclonal antibody treatments and for tests of the virus. The monoclonal antibody made by Eli Lilly and one of the two antibodies in the cocktail made by Regeneron are powerless against the variant circulating in South Africa, according to a recent study.
“We knew from the very beginning that monoclonals were vulnerable to this type of strain shift,” Dr. Woodcock said.
Johnson & Johnson on Thursday submitted to the Food and Drug Administration an application for emergency authorization for its one-dose coronavirus vaccine, putting the company on track to potentially begin shipping it by early March.
The agency has scheduled a meeting with its outside advisory panel, which will vote on Feb. 26 on whether the F.D.A. should authorize the vaccine, according to people familiar with the planning.
That leaves regulators about three weeks to pore over a large and complex application that includes clinical and manufacturing data. A decision on whether to authorize the vaccine could come within days of that meeting.
A similar timeline was used for the review of two-dose vaccines made by Pfizer-BioNTech and Moderna, which were authorized by the F.D.A. in December.
Dr. Paul Stoffels, Johnson & Johnson’s chief scientific officer, said in a statement that Johnson & Johnson was ready to ship the vaccine as soon as the F.D.A. cleared it.
Last week, the company announced promising results from its clinical trial, which showed that the vaccine was 85 percent effective in preventing severe disease in all three regions where the vaccine was studied: the United States, Latin America and South Africa. After 28 days, none of the vaccinated participants who developed Covid-19 had to be hospitalized.
But the results came with an ominous note: The vaccine’s efficacy rate was 72 percent in the United States, but only 57 percent in South Africa, where a highly contagious variant of the coronavirus is driving most cases.
There is also still uncertainty about how many doses Johnson & Johnson will be able to provide in the days and months after getting emergency clearance, when the company may have only about seven million ready, according to federal officials familiar with its production.
The company said on Thursday that it expected to supply the 100 million doses it has promised the United States by the end of June.
The idea makes sense, so much so that at least two governors, a national union leader and President Biden are behind it: extend this school year into the summer to help students make up for some of the learning they lost during a year of mostly remote school.
By summer, more teachers will be vaccinated against the coronavirus. Transmission rates might be significantly lower. And it will be easier in warm weather for students and educators to spend time in the open air, which is safer than being indoors.
Gov. Ralph Northam of Virginia promoted the idea on Friday, saying that schools should make summer classes an option for families. Gov. Gavin Newsom of California and Randi Weingarten, the powerful president of the American Federation of Teachers, have offered similar endorsements. Boston teachers and the district have started talking about summer options. And Mr. Biden is expected to ask Congress to approve $29 billion to fund summer programs and tutoring as part of his pandemic stimulus package.
Ms. Weingarten has said districts should use federal stimulus money to make the summer a “second second semester.” The focus should be on enrichment activities that “help kids get their mojo back,” she said, such as art, music and sports, in addition to core academics.
But if parents and students have learned anything during this crisis, it is that even simple, intuitive ideas are hard to pull off in a public education system that is simultaneously decentralized and highly bureaucratic. And though many policymakers like the idea, there is no consensus on what summer learning should look like.
Governors also have few ways to compel districts to expand summer offerings. Local contracts typically make it impossible to require teachers to work over the summer, and a recent poll of educators found that only 19 percent support a shorter summer vacation in 2021 or 2022.
Teachers who do agree to work over the summer would need to be paid at a time when districts are already stretching their budgets to cover costs such as updating ventilation systems, hiring school nurses and testing staff and students for the coronavirus.
Dan Weisberg, head of a nonprofit group that provides consulting services to districts, said it would be important to design a program specific to pandemic needs. Typical summer remediation offers fifth graders “third-grade math problems and has them sit in the corner,” said Mr. Weisberg, who is chief executive of TNTP, formerly the New Teacher Project. Instead, he said, students should be given intensive help on the most important concepts they have missed from earlier years so they can then tackle grade-level content.
“We know this plain fact: Children learn better in classrooms, and that’s where they need to be,” Mr. Northam said in a news conference Friday morning.
The report card for vaccination in long-term-care facilities, whose residents supposedly stood at the front of the line, shows a mixed performance.
Nationally, almost 3.4 million long-term-care residents and staff members have received at least one shot, the Centers for Disease Control and Prevention reported on Thursday; close to 800,000 had gotten two.
By mid-January, Medicare data showed that cases in long-term-care facilities had dropped by almost 46 percent compared with four weeks earlier, reflecting the decline in cases across the country but probably also the impact of vaccination.
But experts, noting that an estimated five million people live or work in long-term care, have expressed intense frustration at the slow initial rollout. “There’s been nothing warp speed about long-term care,” said David Grabowski, a health policy researcher at Harvard Medical School.
They also worry about the even more sluggish rate at assisted-living facilities, and about workers who are suspicious of vaccination. The C.D.C. reported that at nursing homes with clinics, only a median 37.5 percent of staff members were vaccinated in the first month.
“People who live in nursing homes would do just about anything to reconnect with the outside world and the people they love,” said Dr. Kathleen Unroe, a geriatrician at the Indiana University School of Medicine who also practices at Northwest Manor, a nursing home in Indianapolis.
One of her patients initially had doubts. “I didn’t want to be a guinea pig,” said Norma Ware, 86. “I’m not crazy about shots, anyway.” But after conversations with her family and “a very friendly nurse,” she received both doses and became a believer.
Last fall, the Trump administration contracted with the two big pharmacy chains to administer vaccinations, the pace of which has picked up substantially since December.
Company executives emphasized that while the Centers for Disease Control and Prevention prioritized long-term care for vaccinations, individual states determined when programs began. While nearly all states activated nursing home clinics on Dec. 21 or 28, most didn’t launch assisted living clinics until January, often weeks later.
The virus didn’t wait. Infections in long-term care reached a peak in December, according to a Kaiser Family Foundation analysis.
In the year since the coronavirus began its march around the world, China has done what many other countries would not or could not do. Using coercion and persuasion, it has mobilized its vast Communist Party apparatus to reach deep into the private sector and the broader population, in what the country’s leader, Xi Jinping, has called a “people’s war” against the pandemic — and won.
China is now reaping long-lasting benefits that few expected when the virus first emerged in the central city of Wuhan, positioned the country, economically and diplomatically, to push back against the United States and others worried about its seemingly inexorable rise. It has also emboldened Mr. Xi, who has offered China’s experience as a model for others to follow.
While officials in Wuhan initially dithered and obfuscated for fear of political reprisals, the authorities now leap into action at any sign of new infections. In Hebei this January, the authorities deployed their well-honed strategy to test millions and isolate entire communities — all with the goal of getting cases, officially only dozens a day in a population of 1.4 billion, back to zero.
China is the only major economy that has returned to steady growth. The government has poured money into infrastructure projects, its playbook for years, while extending loans and tax relief to support business and avoid pandemic-related layoffs.
The government offered land, loans and subsidies for new factories to make vaccines and fast-tracked approvals. Two Chinese vaccines are in mass production; more are on the way. While they have shown weaker efficacy rates than those of Western rivals, 24 countries have already signed up for them. The pharmaceutical companies have, at Beijing’s urging, promised to deliver them quickly.
“They were able to pull together all of the resources of the one-party state,” said Carl Minzner, a professor of Chinese law and politics at Fordham University. “This of course includes both the coercive tools — severe, mandatory mobility restrictions for millions of people — but also highly effective bureaucratic tools that are maybe unique to China.”
Among the Communist Party leaders, a sense of vindication is palpable. In the final days of 2020, the seven members of the Politburo Standing Committee, the country’s top political body, gathered in Beijing for the equivalent of an annual performance review.
Far from even hinting at any shortcomings — the rising global distrust toward China, for example — they exalted the party leadership.
“The present-day world is undergoing a great transformation of the kind not seen for a century,” Mr. Xi told officials at another meeting in January, “but time and momentum are on our side.”
The number of coronavirus tests administered daily in the United States has been trending downward for more than two weeks. And though experts say the trend is too fresh to set off major alarm bells, the decline raises the possibility that testing has reached a ceiling at a time when scientists say the nation should be conducting millions more tests per day to help stop the spread of the virus.
On Jan. 18, the seven-day average of daily new tests reached an all-time high of more than 2.1 million, according to the Covid Tracking Project. On Thursday, it was about 1.7 million. Maintaining a level of at least two million tests per day is considered an important threshold by public health experts, who say that it is a level of testing that will allow them to identify most people with symptoms, as well as two people with whom each sick person has been in close contact.
This dip coincides with a downturn in another important coronavirus metric: the seven-day average of new reported coronavirus cases, which was down 57 percent Thursday compared with its peak on Jan. 8.
When the number of tests performed and cases reported go down at the same time, public health experts want to know if the dip in new cases is tied to the fact that fewer tests are being performed — the theory being that “If you don’t test, you don’t find cases,” as Dr. Jodie Guest, an epidemiologist at Emory University, put it recently.
For now it seems the number of new cases is indeed falling, said Dr. Ashish Jha, dean of the Brown University School of Public Health, who noted that the percentage of positive tests is also on the decline. “That’s why I’m convinced the decline is real,” Dr. Jha said in an interview Friday night.
The decline, unfortunately, is also relative. Friday’s seven-day average of about 130,953 daily reported cases in the U.S. is still significantly higher than peaks in the spring and summer.
The Covid crisis is still with us. So why are the testing numbers going down?
Dr. Emily Martin, an associate professor of epidemiology at the University of Michigan, said that the recent dip in testing should come with “lots of caveats on what exactly it is we can take away” from the trend. It may be, she said, that testing spiked in January, possibly caused by people returning to jobs and schools after holiday breaks and being subjected to mandatory testing.
But Dr. Martin and other experts say that the numbers could also reflect a complacency about testing, as vaccine distribution is ramping up.
It is also possible that the dip reflects the burden on public health offices that are being asked to administer both vaccines and tests at the same time — and that vaccinations, in some cases, are taking precedence. The seven-day average of vaccinations has been on the rise, topping 1.3 million in recent days and approaching the Biden administration’s goal of 1.5 million doses per day.
“I do know that there are testing facilities that have been shifting their focus to vaccinations right now,” Dr. Guest said. “And I do wonder if the numbers we’re seeing go down are based on some shifting of priorities.”
And that is not particularly good news: Experts say that widespread testing must continue to be part of the fight against the virus, because scientists don’t know exactly how effective most of the vaccines are at slowing its spread. Vaccine trials, in the interest of speed, were intended primarily to study how effective the inoculations are against stopping the onset of severe Covid-19 disease and not whether they would prevent the transmission of the virus.
There was some progress on that front this week, with a study that showed that the vaccine developed by the University of Oxford and AstraZeneca has the potential to slow transmission, according to researchers at the university.
Dozens of times a day in Covid-19 wards across California, a scene like this plays out: A hospital chaplain watches as a death is announced by machine.
Kristin Michealsen, a hospital chaplain in Los Angeles, stood at a man’s bedside, holding his hand. His relatives gathered at their home just minutes from the hospital — they were not allowed into the hospital ward. The patient’s heart had just stopped. Ms. Michealsen, an ordained minister, had watched a computer monitor as she accompanied the man to the edge of his life. Eighty beats per minute. Sixty. Forty.
In the depersonalized math of the pandemic, there are two ways to view the ravages of the virus in California. As America’s most populous state, it has by far the most cases in the country — more than 3.4 million — and now the most deaths. But when adjusted for its large population, California has a lower death rate than 31 states and Washington, D.C.
With about 114 deaths per 100,000 people, the state has about half the rate of New York, New Jersey, Massachusetts or Mississippi. The disparity between New York and California could be even greater when taking into account the likelihood that New York undercounted deaths in the pandemic’s frenetic early stages because virus testing was so limited.
Yet these mitigating statistics mean little to the families of the more than 44,900 people killed by the virus in California. Nor do the numbers mean much to chaplains like Ms. Michealsen, who on that day in January when the picture was taken by an Associated Press photographer had already watched two other patients die. Often, she is the only other person in the room when death comes. Sometimes, a nurse holds the other hand of the dying patient.
“When we come into this world, we are immediately surrounded by people — we have human touch,” Ms. Michealsen said last week from the Providence Holy Cross Medical Center in Los Angeles. “I just think that when we leave this world, we should have the same.”
The pandemic has taken an uneven toll in California, with people in the south and agricultural Central Valley much harder hit than those in the north.
In San Francisco, where almost 350 people have died from the virus, the cruelty of the pandemic — the inability of families to surround their dying relatives, the interruption of age-old rituals of mourning — is wearing.
“I’ve never in 15 years experienced the multiple layers of loss that we are experiencing now,” said Naomi Tzril Saks, a chaplain at the University of California, San Francisco medical center. Like chaplains across the country, Ms. Saks and her colleagues have done what they can to remedy the cruel isolation of the disease.
“We’ve Zoomed in bands and people playing the violin,” Ms. Saks said. “We Zoomed in a person’s son who was incarcerated, and she hadn’t seen him for years before she died.”
Chaplains have gone on virtual retreats to avoid emotional burnout, Ms. Saks said. Some have joined national support groups.
“There are stories and experiences from this pandemic that will stay in my body for a very long time,” Ms. Saks said.
The coronavirus vaccines currently being distributed in Britain are as safe as predicted in clinical trials, the country’s medicine regulator reported on Friday as part of continuous monitoring of the inoculation campaign.
The latest data, released by the Medicines and Healthcare Products Regulatory Agency, an independent body, found that the vaccines “meet strict regulatory standards for safety” and noted that “the benefits continue to far outweigh any known side effects.”
Two vaccines — one from Pfizer-BioNTech and one from AstraZeneca — are in use in Britain, and the vast majority of reported side effects have been mild and short lasting, reflecting a normal immune response, according to the regulator. The safety update report is based on the analysis of data from the beginning of the rollout in December until Jan. 24.
By that date, 5.4 million people had received a first dose of the Pfizer-BioNTech vaccine and another 1.5 million had been given the AstraZeneca vaccine. About three people out of every 1,000 who received a shot reported side effects.
Britain has made huge strides in its vaccine campaign. If it continues at its current rate, the nation is on track to offer an inoculation to all adults by the end of June. As of this week, more than 15 percent of the population had been given at least one coronavirus vaccine shot.
“Vaccines are the most effective way to protect against Covid-19 and save lives and prevent serious complications from this terrible virus,” said June Raine, the chief executive of the regulatory agency in a statement released with the report. “The data we have collected provides further reassurance that the Covid-19 vaccines are safe and continue to meet the rigorous regulatory standards required for all vaccines. We remain confident that the benefits of these vaccines outweigh any risks.”
People with a previous history of severe allergic reactions to any ingredients of the vaccine should not receive it, the regulator noted, but that guidance had already been issued, and no new safety concerns were identified.
In the most extensive real-world test so far, Israel has demonstrated that a robust, rapid coronavirus vaccination program can have a quick and powerful impact, showing the world a plausible way out of the pandemic.
Cases of Covid-19 and hospitalizations dropped significantly among people who were vaccinated within just a few weeks, according to new studies in Israel. And early data suggests that the vaccines are working nearly as well in practice as they did in clinical trials.
But as the world races to curb the virus before more dangerous mutations spread, dire vaccine shortages may prevent other countries from replicating Israel’s success, or from stopping new variants from emerging.
And even Israel, which has outpaced every other nation in vaccinating its people, is far from out of the woods. The country extended its third nationwide lockdown on Thursday.
Still, researchers found hope in the vaccine’s ability to quickly drive down cases among Israelis getting the shots.
“I find this pretty persuasive that we are seeing actual effects of population-level vaccination,” said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health who was not involved with the Israeli study.
The new Israeli research looked at national health statistics for people 60 years and older, who received the Pfizer-BioNTech vaccine first because of their high risk. Analyzing data from six weeks into the vaccination campaign, when the majority of people that age had been vaccinated, they found that the number of new Covid-19 cases dropped by 41 percent compared to three weeks earlier.
That group also experienced a 31 percent drop in hospitalizations from the coronavirus, and a drop of 24 percent of those who became critically ill.
The results are all the more striking, experts said, because Israel is contending with a worrisome new variant of the coronavirus. The variant B.1.1.7, first identified in Britain, now accounts for up to 80 percent of the samples tested in Israel.
Despite its successes, Israel remains vulnerable. After a dip in new cases at the end of January, the average rate is climbing back up again. The contagiousness of the B.1.1.7 variant may be partly to blame, along with lower compliance with the current lockdown compared to previous ones. And all but a handful of Palestinians in the occupied territories are still waiting for vaccines, leaving them and Israelis less protected in any new surges.
In other news from around the world:
Prime Minister Igor Matovic of Slovakia said on Friday that the coronavirus variant first identified in Britain, known as B.1.1.7, was now the main cause of new infections in his country, Reuters reported. He said that examinations of all positive samples of PCR laboratory tests taken in the country on Wednesday showed that 74 percent involved the variant, a touch above the 71 percent in partial findings he had reported earlier in the day. “There is no country in Europe with a higher documented proportion of the British mutation,” Mr. Matovic said.
Portugal registered on Friday its highest number of Covid-19 patients in intensive care units, raising the pressure on hospitals that have recently been asking people to treat themselves at home, while transferring patients from overcrowded hospitals in Lisbon to other regions with more available beds. The health ministry said there were now 904 Covid-19 patients in I.C.U.s, a rise of 41 from Thursday. The Portuguese government also said on Friday that it was planning to send 10 patients to Austria, in response to an offer made last weekend by Vienna to help Portugal, which has recently also had the highest Covid-19 death rate in Europe.
The first knockout round of European soccer’s showpiece tournament, the Champions League, will have to be rearranged because of travel restrictions designed to prevent the spread of new variants of the coronavirus. Liverpool, the reigning English champion, was due to travel to Germany to face RB Leipzig on Feb. 16, but on Friday, the German government confirmed that it would not offer an exemption for elite sporting events from new legislation — in place until Feb. 17 at the earliest — barring entry to visitors from Britain.
The U.S. pharmaceutical giant Pfizer said on Friday that it had withdrawn its application for emergency-use authorization in India for the coronavirus vaccine that it developed with the German company BioNTech. Indian regulators require domestic clinical trials for foreign-made vaccines, and Pfizer had not undertaken any in India and did not intend to, according to minutes of a meeting Pfizer had with the regulators on Wednesday. India has begun one of the world’s largest vaccine campaigns using an Indian company’s vaccine and the AstraZeneca-Oxford vaccine, which is being produced at the Serum Institute of India.
New Zealand is resuming its refugee program, which was suspended last March when the country closed its borders in the pandemic. By the end of February, 35 refugees are expected to arrive. Since October, only 50 refugees — who arrived as part of an “emergency priority” program — have been permitted entry, the Immigration Department said in a statement.