Biden Moves to Take Charge as U.S. Virus Deaths Near 400,000

A pop-up coronavirus testing site in Berkeley, Calif., on Tuesday.
Credit…Jim Wilson/The New York Times

California’s terrifying coronavirus surge, which has overwhelmed hospitals and killed thousands, appears to be subsiding, one of the state’s top health officials said on Tuesday.

Covid-19 hospitalizations have decreased by 8.5 percent over the last two weeks, suggesting that a “surge on top of a surge” after the holidays hasn’t been as severe as was feared. The state’s overall transmission rate has decreased.

“These are rays of hope,” Dr. Mark Ghaly, California’s secretary for health and human services said in a virtual news conference.

But even as the cresting case numbers and hospitalizations started to recede, another variant of the virus — separate from the one that spread in Britain — was found throughout the state.

Although it is still unknown whether the variant is deadlier or more transmissible than other forms of the virus, it was found in more than half of samples researchers tested last week in Los Angeles, suggesting that it may be a driver of the region’s crisis.

At the same time, the state’s vaccine rollout has continued to be plagued by confusion.

After Gov. Gavin Newsom announced last week that the state would expand eligibility to anyone 65 and older, Californians who met the criteria scrambled to find appointments, quickly overwhelming county websites and jamming the phone lines of their health care providers.

In an email to members on Tuesday in response to a crush of inquiries, Kaiser Permanente, one of the state’s biggest health care providers, said that it cares for 1.5 million people who are 65 or older. Last week, the system received “just 20,000 first doses” of the vaccine.

“Our ability to expand and speed vaccine distribution depends on vaccine supply made available to our state,” the email said. “At the current rate, we’re looking at vaccine distribution that is much slower than any of us find acceptable.”

Experts have said that much of the chaos so far has arisen because California is relying on already overwhelmed county public health departments to manage much of the distribution of vaccines.

Each county has responded to the challenge differently, with evolving guidelines meant to address the tension between vaccinating as many people as quickly as possible and protecting the most vulnerable first.

In Los Angeles County, for example, officials at first said they planned to stick with strict priority rules, vaccinating thousands of health care workers first, before broadening eligibility.

But on Monday, Hilda Solis, chair of the powerful Los Angeles County Board of Supervisors, announced she was signing an executive order to make vaccination appointments available to anyone in the county 65 and older.

Ms. Solis said in an interview on Monday that it would be important in coming days and weeks to bring vaccines to clinics, pharmacies and schools in the county’s hardest hit communities, which are lower-income, predominantly Latino and home to many essential workers.

But, she said, the most urgent priority now is getting vaccines out the door.

Meanwhile, some state lawmakers have asked the governor to develop a program aimed specifically at inoculating farmworkers, who have been some of the state’s most critical — and at-risk — workers throughout the pandemic.

“Farmworkers are the fulcrum of the food chain, ravaged by Covid-19 with no available replacement labor pool,” the letter said.


United States › United StatesOn Jan. 28 14-day change
New cases 165,073 –34%
New deaths 3,862 –2%

World › WorldOn Jan. 28 14-day change
New cases 603,201 –22%
New deaths 16,811 +4%

U.S. vaccinations ›

Where states are reporting vaccines given

A Covid-19 testing site in Los Angeles earlier this month.
Credit…Alex Welsh for The New York Times

In late December, scientists in California began searching coronavirus samples for a fast-spreading new variant that had just been identified in Britain.

They found it, though in relatively few samples. In the process, the scientists made another unwelcome discovery: California had produced a variant of its own.

That mutant, which belongs to a lineage known as CAL.20C, seemed to have popped up in July but lay low till November. Then it began to quickly spread.

CAL.20C accounted for more than half of the virus genome samples collected in Los Angeles laboratories on Jan. 13, according to a new study that has not yet been published.

“We had our own problem that didn’t cross over from Europe,” said Jasmine Plummer, a research scientist at Cedars-Sinai Medical Center in Los Angeles, who worked on the study. “It really originated here, and it had the chance to start to emerge and surge over the holiday.”

There’s no evidence that CAL.20C is more lethal than other variants. And scientists have to conduct more research to determine whether CAL.20C is in fact more contagious.

But Eric Vail, the director of molecular pathology at Cedars-Sinai, said it was possible that CAL.20C was playing a large part in the surge of cases that has overwhelmed Southern California’s hospitals. “I’m decently confident that this is a more infectious strain of the virus,” Dr. Vail said.

Dr. Charles Chiu, a virologist at the University of California, San Francisco, said that across the state, he and his colleagues were finding the variant in roughly 20 percent to 30 percent of samples being sequenced. “It just popped up under our noses, and now it’s rising in multiple counties,” he said. “On the whole, it’s safe to say it’s going to spread outside of California.”

Researchers are also looking in other states for CAL.20C, Dr. Plummer said, and have so far found it in Arizona, Connecticut, Maryland, New Mexico, Nevada, New York, Texas, Utah, Washington and Wyoming, as well as the District of Columbia. It’s not clear yet how common it is outside California.

A spokesman for the Centers for Disease Control and Prevention said the agency was working with California to learn more about the new variant. “Currently, it’s not known whether this variant is any different from other SARS-CoV-2 viruses, whether those differences may have contributed to its emergence, or whether this emergence was merely a random event,” he said.

Outside scientists are concerned about the findings, but say it’s still unclear whether the California variant’s mutations are giving it an edge — or whether it’s showing up so much just by chance.

There might be a bias in the samples that scientists are looking at, for example. It’s also possible that CAL.C20 happened to become more common thanks to some big super-spreader events.

Dr. Chiu and his colleagues are now growing the variant in cells to see how quickly they multiply compared with other variants. The researchers are also going to observe how well antibodies produced by vaccines work against CAL.C20.

Other scientists are also looking more closely at the rise in frequency of the variant in California. They’re searching for evidence that could determine whether biology or chance is to blame.

“That’s the work that needs to be done,” said Dr. Vail. “We just don’t have that information.”

A woman whose parents died of Covid-19 placed flowers on their grave near Fort Yates, N.D., last month.
Credit…Victor J. Blue for The New York Times

More than 400,000 people in the United States who had the coronavirus have died, according to data compiled by The New York Times on Tuesday, as the anniversary of the country’s first known death in the pandemic approaches.

The pace at which Americans have been dying accelerated through the fall and into the winter, exploding to record levels in January. During some weeks this month, the average deaths per day exceeded 3,300, more than the number of people killed in the Sept. 11 terrorist attacks. Tuesday’s harrowing milestone came a day after the United States surpassed 24 million total cases.

The single deadliest day of the pandemic so far was Jan. 12, when more than 4,400 deaths were reported. Unlike in the early days of the outbreak in the United States, which was centered in a handful of big, mostly Northeastern cities, this surge is widespread. As of Monday, Arizona, California, South Carolina, New York and Oklahoma had reported the most new cases per capita over the previous week. Much of the latest surge has been attributed to people gathering over the holidays, from Thanksgiving to New Year’s Eve.

The length of time it has taken to log each 100,000 deaths has decreased dramatically since the country’s first known Covid-19 death, which occurred in Santa Clara County, Calif., on Feb. 6, 2020. The first 100,000 U.S. deaths were confirmed by May 27; it then took four months for the nation to log another 100,000 deaths; the next, about three months; the latest, just five weeks.

Public health experts do not expect mortality rates to peak until the end of the month. By the end of February, the death toll might hit 500,000, a number that would have seemed unthinkable a year ago. Dr. Anthony S. Fauci, the country’s top infectious disease expert, estimated last March that up to 240,000 Americans might lose their lives, an enormous figure that still fell far short of reality.

The United States has had more total virus-related deaths than any other country in the world. In total, New York alone has recorded more than 40,000 known deaths. In all, more than two million people have died with the virus worldwide, a number that is almost certainly an undercount.

The blame for the enormous loss of American life, many experts say, lies in a failure of leadership by President Trump, whose administration politicized the use of masks and left states to implement a patchwork of inconsistent measures that did not bring the virus under control.

“It wasn’t that he was just inept,” said Jeffrey Shaman, a Columbia University professor of environmental health sciences who has modeled the virus’s spread. “He made something that could have very easily turned into a point of patriotism, pride and national unity — protecting your neighbors, protecting your loved ones, protecting your community — into a divisive issue, as is his wont, and it cost people’s lives.”

By comparison, Vietnam, a nation of 97 million people, has confirmed just 35 virus-related deaths, Dr. Shaman added.

President-elect Joseph R. Biden Jr., who is set to be inaugurated on Wednesday, has called for an aggressive national strategy to beat the virus, including ramping up the availability of Covid-19 vaccines, though he has not committed to a federal mask mandate.

“You have my word that we will manage the hell out of this operation,” Mr. Biden said on Friday, noting the disproportionate deadly outcomes of the virus for Black, Latino and Indigenous Americans. “Our administration will lead with science and scientists.”

With the virus rampaging everywhere for so many months, hospitals have been stretched. In rural areas, doctors have at times been unable to transfer gravely ill patients to larger medical centers for more sophisticated treatment.

As of Monday, the seven-day average of cases across the United States was 200,000 a day, though it has started to decline from recent weeks. Hospitalizations also have finally begun to level off and on Sunday reached their lowest level since Jan. 2. In the Midwest, hit by its worst surge in the fall, case numbers have fallen sharply in recent weeks, but that progress seems to be slowing.

However, new variants of the virus, some of which make it more transmissible, could soon spread throughout and threaten to make infections rise again.

“There’s no clear end in sight anytime in the near future,” said Ira M. Longini Jr., a biostatistics professor at the University of Florida.

The variants have made it even more urgent to administer the coronavirus vaccines developed at record speed that brought so much hope to people when they started to become available last month.

But at the slow rate that shots are being administeredabout 10.6 million people had received at least the first dose as of Friday — Dr. Shaman warned, it could take more months than expected to reach enough of a critical mass of vaccinated people for the inoculations to make a dent in the pandemic.

Video

transcript

transcript

Biden: ‘To Heal, We Must Remember’

On Tuesday, the eve of his inauguration as the 46th president of the United States, President-elect Joseph R. Biden Jr. led a national mourning for the 400,000 Americans who have died from the coronavirus pandemic.

To heal, we must remember. It’s hard sometimes to remember, but that’s how we heal. It’s important to do that as a nation. That’s why we’re here today. Between sundown and dusk, let us shine the lights in the darkness along this sacred pool of reflection and remember all we lost. [bells ringing]

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On Tuesday, the eve of his inauguration as the 46th president of the United States, President-elect Joseph R. Biden Jr. led a national mourning for the 400,000 Americans who have died from the coronavirus pandemic.CreditCredit…Todd Heisler/The New York Times

President-elect Joseph R. Biden Jr. arrived in Washington on Tuesday and led a national mourning for Americans killed by the coronavirus pandemic as the death toll topped 400,000, a gesture to the tragedy the country had endured even as he pledged that light would pierce the darkness.

On the eve of his inauguration as the 46th president of the United States, Mr. Biden flew to the capital from his home in Wilmington, Del., and headed to the Lincoln Memorial, where he presided over a brief ceremony paying tribute to those who had died from Covid-19 in the past year.

“To heal, we must remember,” Mr. Biden said, standing in front of the Reflecting Pool, which was surrounded by 400 lights to commemorate the 400,000 victims of the virus. “It’s hard sometimes to remember. But that’s how we heal. It’s important to do that as a nation. That’s why we’re here today. Between sundown and dusk, let us shine the lights in the darkness along the sacred pool of reflection and remember all whom we lost.”

As he spoke, the bells at Washington National Cathedral began to chime, and the Empire State Building in New York and the Space Needle in Seattle were lit. Cities from Miami to San Diego also planned to light buildings for the occasion while Mr. Biden’s inaugural committee encouraged Americans to light candles in their windows in a show of national solidarity. Events were also planned for Mr. Biden’s hometowns, Wilmington and Scranton, Pa.

Mr. Biden is assuming the role of mourner in chief and projecting an air of command of the issue that has vexed the Trump administration for the past year. He has declared getting control of the pandemic the central issue of his administration, and has been highly critical of how his predecessor handled the worst public health crisis in more than 100 years.

On Monday night, as President Trump ordered an end to the ban on travelers from Europe and Brazil that had been aimed at stopping the spread of the coronavirus to the United States, Mr. Biden’s aides said he would rescind the move when he takes office on Wednesday, before it was scheduled to go into effect.

Mr. Trump’s order was issued at a time of heightened anxiety over the coronavirus and what Mr. Biden has warned will be a “dark winter.” The country has experienced a post-holidays surge in cases that has overwhelmed some hospitals and led to record numbers of deaths. The national vaccination rollout has been slow and chaotic. And a more contagious virus variant is spreading, while others are being discovered.

The somber remembrance on Tuesday kicked off two days of in-person and virtual events in Washington as Mr. Biden takes the oath of office on Wednesday at a time of economic struggle and cultural upheaval after President Trump’s four tumultuous years in the White House.

Somber in his demeanor and brief in his remarks, Mr. Biden was joined by his wife, Jill Biden, as well as Vice President-elect Kamala D. Harris and her husband, Doug Emhoff. Cardinal Wilton D. Gregory, the archbishop of Washington, delivered the invocation while two acclaimed gospel singers, Yolanda Adams and Lori Marie Key, performed.

Students waited outside Sleepy Hollow Middle and High School before they took the SAT in Sleepy Hollow, N.Y., in September.
Credit…Hilary Swift for The New York Times

The College Board, which administers the SAT college entrance examination and has seen its business battered by the coronavirus pandemic, said Tuesday that it will drop the optional essay section from the SAT and stop administering subject-matter tests in the United States.

“The pandemic accelerated a process already underway at the College Board to simplify our work and reduce demands on students,” the organization said in a statement, adding that it would also continue to develop a version of the SAT test that could be administered digitally — something it tried and failed to do quickly with an at-home version last year after the pandemic shut down testing centers.

The board gave no time frame for when a digital version of the SAT, which would be administered at testing centers by live proctors, might be introduced, but said it would provide more information in April.

The changes to the SAT come as more and more colleges are dropping the requirement that students take the test, as well as its competitor the ACT, a trend driven in part by concerns about equity that received a boost during the pandemic.

Critics of the College Board said the decision was almost certainly driven by financial considerations. The SAT has in the past represented a substantial portion of the College Board’s more than $1 billion in annual revenue.

“The SAT and the subject exams are dying products on their last breaths, and I’m sure the costs of administering them are substantial,” Jon Boeckenstedt, the vice provost of enrollment management at Oregon State University, said in an email.

At the same, he said, the College Board was likely to try to use the elimination of the subject tests to try to convince elite high schools to offer more Advanced Placement courses, whose tests the College Board also administers, as a way to burnish their students’ transcripts. But because A.P. tests have to be taken at the end of a student’s junior year or earlier for their scores to be considered in admissions decisions, more focus on A.P. scores in the admissions process would likely only increase pressure on students.

“Overall, it’s good for College Board, and probably not so good for students,” Mr. Boeckenstedt said. “In other words, par for the course.”

Indeed, in its announcement, the board said that A.P. courses provided students “rich and varied opportunities to showcase their knowledge and skills” and that the “expanded reach of A.P. and its widespread availability for low-income students and students of color” made the subject tests no longer necessary.

David Coleman, the chief executive officer of the College Board, said the organization’s goal was not to get more students to take A.P. courses and tests, but to eliminate redundant exams, thereby reducing the burden on high school students applying to college.

“Anything that can reduce unnecessary anxiety and get out of the way is of huge value to us,” he said.

VACCINE ROUNDUP

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, receiving his first dose of the coronavirus vaccine at the National Institutes of Health, in Bethesda, M.D., last month.
Credit…Pool photo by Patrick Semansky

Dr. Anthony S. Fauci, the government’s top infectious disease expert, received his second dose of Moderna’s coronavirus vaccine on Tuesday morning at the National Institutes of Health’s vaccination center, a Department of Health and Human Services spokeswoman confirmed, drawing him closer to full protection against Covid-19.

Joining Dr. Fauci were Alex M. Azar II, the health and human services secretary, and Dr. Francis Collins, the N.I.H. director, who also received their second shots. Scientists are still working to determine how long protection from Moderna’s second dose — which follows the first after 28 days — will last. In a recent study, the company found that volunteers were still making high levels of antibodies three months after the second dose. But it is unknown what levels are needed to maintain immunity.

Dr. Fauci’s second dose came at a time when the country is struggling — with a limited supply — to get every available dose of Moderna’s and Pfizer’s vaccines into the arms of health workers and older Americans.

Scientists at N.I.H. and Moderna are now analyzing data to see if they can double the supply of the vaccine by cutting doses in half.

Dr. Fauci and other government scientists have repeatedly emphasized the importance of the second dose as a way to achieve long-term immunity. At an event sponsored by the Harvard Business Review on Tuesday afternoon, he reiterated that, but said protection that people might get from a first dose is insufficient for providing fuller immunity.

He also struck an optimistic note, saying that the U.S. may have enough protection against the virus to achieve “some form of normality” by the fall. To get there, he warned that the country would need to adhere much more closely to public health measures and to successfully implement a vaccine program that can reach the vast majority of Americans.

Tuesday functioned as something of a wind-down for the Trump administration’s top health officials who will leave their roles on Wednesday, when President-elect Joseph R. Biden Jr. is sworn in. Mr. Azar delivered a final “state of the department” address in the morning, listing what he viewed as the administration’s accomplishments in funding and developing vaccines and tests for the virus, and thanking the department’s employees for working long hours and weekends during the pandemic.

On Tuesday afternoon, Vice President Mike Pence was scheduled to oversee his final meeting with the White House coronavirus task force, which Mr. Azar and Dr. Fauci are members of. Dr. Fauci will cross over into the next administration as the chief medical adviser to Mr. Biden.

As of Friday, about 10.6 million people in the United States had received at least one dose of a Covid-19 vaccine, and about 1.6 million people had been fully vaccinated, according to the Centers for Disease Control and Prevention. That is far short of the goal set by federal officials to give at least 20 million people their first shots before the end of 2020.

In other news about the vaccines:

  • In Michigan on Tuesday, officials said that 21 shipments containing 11,900 doses of the Moderna vaccine were disposed of after they were transported at the improper temperature. The matter was under investigation by McKesson, the distributor, and an additional six shipments were held back to inspect for issues, delaying vaccinations at six sites, the state said.

  • Gov. Henry McMaster urged South Carolina hospitals to administer vaccines “as quickly as you can,” saying that some hospitals in the state had been administering only about half of their doses, ostensibly saving the remainder for the required second shot. “Don’t delay,” he said. “If you run out, that’s OK. There’ll be another shipment right behind it.”

  • Officials at U.S. prisons and jails are running into widespread unwillingness among prisoners to consent to be vaccinated. To combat it, some are turning to offering incentives like free snack bags, extra visiting time and even a little time off sentences. While many prison systems around the nation have yet to receive any vaccine doses or offer them to prisoners, those that have tend to provide little or no educational material about the vaccines, inmates say.

  • New York City expects to exhaust its supply of coronavirus vaccine on Thursday, and will then have to cancel inoculation appointments at many city inoculation sites, according to Mayor Bill de Blasio. New York City received 53,000 doses this week, the mayor said, and had a total of 116,000 doses in inventory Tuesday morning. But Mr. de Blasio said that was not nearly enough to keep up with the pace at which New Yorkers are being inoculated, adding that the city is not currently scheduled to receive any more doses until next Tuesday.

  • Vaccinations began on Tuesday in Umariaçu, a remote indigenous community in Brazil’s Amazon rainforest, Reuters reported, where the Brazilian military flew in medical personnel and 1,000 doses of a vaccine by China’s Sinovac.

  • Canada will not receive any vaccine shipments from Pfizer next week, but that should not affect the government’s plan to administer six million doses of the Pfizer and Moderna vaccines by the end of March, officials said Tuesday.

  • As of Monday in New York State, about 37 percent of the more than 130,000 people working in “skilled nursing” facilities in the state have been vaccinated, according to the governor’s office. But, 32 percent of the workers have declined to be vaccinated, raising concerns about vaccine hesitancy among those who are in contact with some of the individuals at highest risk of a severe infection.

Bryan Pietsch, Ann Hinga Klein, Juliana Kim and Ian Austen contributed reporting.

Gov. Andrew M. Cuomo of New York, unveiling a budget proposal, said the state was facing a $15 billion shortfall.
Credit…Pool photo by Hans Pennink

Gov. Andrew M. Cuomo on Tuesday warned that New York State was facing an enormous $15 billion deficit as he unveiled a 2022 budget proposal laden with urgency and uncertainty caused by the coronavirus pandemic, and raised the possibility of increasing the state income tax for top earners.

The governor pleaded with leaders in Washington to deliver $15 billion in emergency pandemic relief, but the precariousness of the situation led Mr. Cuomo to lay out two different budget possibilities: one assuming a federal aid package of $6 billion, and another with the full $15 billion.

If the state were to receive $6 billion, a doomsday plan would include a temporary wealth tax that would apply to taxable income above $5 million, under the governor’s proposal. The state would tax that income at 10.82 percent rate, up from 8.82 percent.

Mr. Cuomo said that in this scenario, the state would also have to cut about $2 billion in school funding, $600 million in Medicaid funding and $900 million in other across-the-board reductions.

There were other question marks in the governor’s budget proposal, primarily a lack of clarity about how much money the state would have on hand because of diminished tax revenues, which Mr. Cuomo said were expected to drop by $39 billion over the next four years.

“This budget is really the economic reconciliation of the Covid crisis, the cost of the Covid crisis,” Mr. Cuomo said during a virtual address from the State Capitol’s Red Room in Albany.

In crafting a budget for the next fiscal year, which begins April 1, state officials face similar challenges as last year, when the pandemic devastated the economy and upended one of the nation’s largest budgets.

But the political climate in Washington is certainly different: Senator Chuck Schumer, who will take over as majority leader in Washington this week, has promised “better days ahead out of Washington for New York,” though he has stopped short of promising a complete bailout.

Last week, Mr. Schumer announced that the city and state would receive $2 billion in emergency funding related to expenses incurred as part of the coronavirus response. Mr. Schumer has also said that money for mass transit would be one of his “top priorities.

The Metropolitan Transportation Authority, which serves the greater New York metro area, said on Sunday that it would postpone a planned 4 percent fare increase for at least several more months, anticipating more federal aid. Officials are hoping for an additional $8 billion relief, which is the size of the agency’s budget deficit through 2024.

The fare hike was part of a regularly scheduled increase to help fill that budget hole after the pandemic drained the system of riders and starved it of nearly all its revenues. Transit advocates and a growing number of state and city elected officials had argued that raising fares would further strain essential workers, who tend to be lower-income people of color.

The incoming Biden administration is promising $350 billion in direct aid to states and local municipalities, as part of a $1.9 trillion Covid response plan. Even so, Mr. Cuomo has maintained that without a substantial infusion of cash from Washington, the state would need to resort to a mix of tax increases, spending cuts and borrowing.

“We don’t know what level of aid we will get,” Mr. Cuomo said on Tuesday, adding, “New Yorkers deserve and demand fairness.”

The Aurora Medical Center in Grafton, Wis., where Steven R. Brandenburg, a pharmacist, is accused of deliberately removing vials of the Moderna vaccine from a refrigerator.
Credit…Mark Hoffman/Milwaukee Journal-Sentinel, via Associated Press

A Wisconsin pharmacist accused of purposefully spoiling doses of Covid-19 vaccines pleaded not guilty on Tuesday to a misdemeanor charge of attempted criminal damage to property.

The count was less serious than initially had been expected because officials have yet to determine whether the vaccine doses involved were actually spoiled, Adam Gerol, the prosecutor for Ozaukee County, said.

The pharmacist, Steven R. Brandenburg, 46, of Grafton, has admitted removing more than 50 vials of the Moderna vaccine in late December from a refrigerator at the hospital where he worked the night shift. The vaccines need to be kept at a low temperature.

Credit…Ozaukee County Sheriff, via Associated Press.

According to a criminal complaint, Mr. Brandenburg told police that he had attempted to “intentionally destroy the vials of vaccine” by removing them from a refrigerator at different points. The police said Mr. Brandenburg had admitted to deliberately removing the vials because he is a “conspiracy theorist” who believed the vaccine could harm people.

The hospital, Aurora Medical Center, part of the Advocate Aurora Health Care system, has since fired Mr. Brandenburg, and the Wisconsin Pharmacy Examining Board has suspended his pharmacy license.

In a hearing on Tuesday, Mr. Gerol told the court that the vaccine doses were being sent to Moderna for further testing and “if something should come up, the charges could change.”

The prospect of more serious charges had been based on a presumption that the doses were ruined, he said, adding, “We were working off the assumption that the vaccine at issue in this case was damaged, but the best evidence at this point is that the vaccine remains viable.”

Jennifer Garrett, a spokeswoman for the state of Wisconsin Pharmacy Examining Board, said that Mr. Brandenburg’s license remains suspended pending the outcome of criminal proceedings, as well as the outcome of the board’s own disciplinary case, which was initiated in response to three complaints it received regarding the vaccine tampering actions.

Skylar Mack, the 18-year-old Georgia college student who was sentenced to two months in prison for violating coronavirus restrictions in the Cayman Islands, was released on Friday after a month behind bars.
Credit…ABC News

Skylar Mack, the American college student who was released from a prison in the Cayman Islands last week for violating coronavirus restrictions, said in an interview that she “deserved it.”

In a segment that aired on ABC’s “Good Morning America” on Tuesday, Ms. Mack, 18, apologized for breaking the rules and said that any anger toward her was justified, adding that if she had gotten someone sick, she would not have been able to live with herself.

She was released on Friday after spending more than a month behind bars.

“I deserved it,” she said. “I was like, ‘You know what, I made this mistake, and it sucks, you know, but you did it to yourself.’”

After finishing the semester at Mercer University in Georgia in late November, Ms. Mack flew to the Cayman Islands to watch her boyfriend, Vanjae Ramgeet, 24, compete in the islands’ Jet Ski racing national championship.

She arrived on a Friday and tested negative for the coronavirus. While the British territory’s laws required her to remain in her hotel room for 14 days, on Sunday, the day of the championship, she slipped the electronic monitoring bracelet from her wrist. She went to the beach and cheered on Mr. Ramgeet as he won first place.

In mid-December, a Cayman Islands court sentenced Ms. Mack and Mr. Ramgeet to four months in prison. After an outcry that the punishment was too harsh, a panel of judges reduced the sentence to two months. Her release after a little more than half that time was in line with what her lawyer expected. Mr. Ramgeet was also released on Friday, according to Ms. Mack’s family.

Thousands of others around the world have been similarly punished for breaching quarantine restrictions. Extensive travel restrictions have failed to stop the virus from spreading, with some people viewing themselves as above the rules.

Global roundup

The government district in Berlin this month. Chancellor Angela Merkel was meeting with state governors on Tuesday about new lockdown rules.
Credit…Lena Mucha for The New York Times

On Tuesday Chancellor Angela Merkel and state governors announced an extension and tightening of Germany’s lockdown rules, partially in response to the highly infectious variant of the coronavirus that is currently causing a spike in infections in Britain and elsewhere.

“Now is the time to prevent the danger that lies in this mutated virus,” said Ms. Merkel. “It’s all a matter of precaution.” Although the new variant has been detected in Germany, it is not yet believed to have spread widely.

The current lockdown rules will be extended to at least mid-February, mask rules will stipulate that “medical” grade masks must be worn on public transport or in the few shops allowed to remain open, and working from home will be mandated where possible. Schools will generally remain closed, although some states will continue to offer voluntary in-person classes and most will provide emergency child care for parents working in essential service jobs.

Even without the risk of the new variant, Germany’s recent infection figures, now at 132 per 100,000 people over a week, is much higher than the goal of 50 per 100,000, which authorities say is the rate at which lockdown rules can be suspended.

As of Monday, the seven-day average number of cases in the country was 16,886, according to a New York Times database, slightly higher than when the national lockdown began at the beginning of November.

Separately, some German states are planning guarded mandatory quarantine centers for the very few who repeatedly disobey quarantine rules, according to an investigation by Die Welt am Sonntag, a national Sunday paper.

States like Schleswig-Holstein in the north, Brandenburg around Berlin and Baden–Württemberg in the southwest are preparing such mandatory quarantine sites in hospitals, refugee centers and a youth detention center.

However, since there are very few known cases of people who repeatedly flout quarantine and isolation rules and fines — which are imposed because someone either has Covid, has had close and prolonged contact with an infected person, or has come back from a high-risk foreign country — the states are only planning for a few sites.

Among the other developments around the world:

  • Rwanda announced restrictions on movement and businesses in the capital, Kigali, on Monday, as coronavirus cases continued to surge across the country. The authorities closed all places of worship, shut down public transportation, banned travel between the capital and other parts of the country, and ordered all workers other than those providing essential services to work from home. Farming can continue, and businesses selling food, medicine, fuel or cleaning products may operate but must close by 6 p.m. Funeral gatherings are permitted but cannot exceed 15 people.

  • Officials in Hong Kong said on Tuesday that current social distancing measures, which include a ban on dine-in service after 6 p.m., would be extended for at least another week, a day after the number of new coronavirus cases returned to the triple digits for the first time this year. They also said they would bar entry to travelers who had spent more than two hours in Ireland or Brazil in the past 21 days — the same rule as applied to Britain and South Africa, where two more transmissible variants of the virus were first detected.

  • Starting Jan. 26, everyone flying to New Zealand will have to show proof before departure that they have tested negative for the virus, the government said on Tuesday, unless they are coming from Australia, Antarctica or most Pacific islands. Two weeks of quarantine continues to be mandatory for all travelers to New Zealand, which last recorded a locally transmitted case in November. Last week, the country began requiring predeparture tests for passengers from the United States and Britain.

  • Japan’s southernmost prefecture, Okinawa, declared a state of emergency after a spike in cases, Reuters reported. Okinawa Governor Denny Tamaki said emergency measures include asking restaurants and bars to close by 8 p.m. and residents to refrain from non-urgent outings after 8 p.m. The emergency is scheduled to last until Feb. 7.

  • A survey about coronavirus cases in Britain from the Office for National Statistics estimates that one in eight people in England — about 5.4 million people over the age of 16 — had antibodies against the virus in December, suggesting they were infected in the past. The report suggests about one in 10 people across Britain had such antibodies. Excess deaths were at the highest level since last May, the analysis found, and in England the Covid-19 mortality rate in the most deprived areas last month was more than twice that in the least deprived.

  • Britain’s health secretary, Matt Hancock, said on Tuesday that he would isolate at home for the next six days after a notification from the National Health Service coronavirus app told him he had been in close contact with someone who tested positive. Mr. Hancock, a key figure in country’s virus response, appeared in a televised coronavirus briefing Monday evening and tested positive himself in March.

  • Scotland’s lockdown will be extended to mid-February and its schools and kindergartens will remain closed until then, First Minister Nicola Sturgeon said on Tuesday. Early in January, people were asked to stay at home for all but essential purposes, and most students returned to remote learning, as the country tried to clamp down on the more transmissible British variant of the coronavirus.

People wait in line to receive the Sputnik V coronavirus vaccine at the State Department Store GUM in Moscow.
Credit…Sergey Ponomarev for The New York Times

The Russian government is considering issuing coronavirus health certificates that could ease travel and commerce for people who have been vaccinated or who have antibodies from surviving the disease, while sharply limiting the liberties of others — an idea that has also been floated in the European Union and by private companies.

Proponents say that such documents, often called Covid passports, could ease airline travel and hasten the reopening of theaters, cruise lines and other settings where people congregate.

Opponents fear a dystopic system that would limit the rights of people who have been careful to avoid infection and are unable or unwilling to be vaccinated. Russia has a grim history rooted in the Soviet era of controlling citizens’ movements, through a residency permit system that was never fully abolished.

Internationally, airlines have already tested electronic certificates showing negative test results for passengers. Those systems could be expanded to show the status of those with some immunity.

The head of the Russian Parliament’s committee on public health, Dmitri Morozov, said on Tuesday that a Covid passport was “very important and needed.”

Collecting people’s Covid health status in a government system, he said, could also provide important data for public health officials. “This is great, this is the new world,” he said. Mr. Morozov did not specify what kinds of information a Covid passport would display.

A regional governor in Russia, Radi Khabirov, proposed on Monday that Covid passport holders receive discounts at stores, as an incentive for people to obtain the certificate.

President Vladimir V. Putin’s spokesman, Dmitri S. Peskov, said on Tuesday that the government is considering issuing Covid passports, perhaps in digital form, but that Russia wanted to coordinate with other countries to agree on standards for them.

Stella Kyriakides, the European Union’s health commissioner, speaking during a plenary session on E.U. global strategy on coronavirus vaccinations at the E.U. parliament in Brussels on Tuesday.
Credit…Pool photo by John Thys

The European Union’s executive arm on Tuesday set ambitious Covid-19 vaccination goals for its 450 million citizens, after a sluggish start to its inoculation efforts.

The European Commission said that the bloc’s 27 member states should aim to have at least 80 percent of their citizens over the age of 80, as well as at least 80 percent of their health care workers, vaccinated by March, and at least 70 percent of the whole population vaccinated by this summer.

“We are racing against time, but not against each other,” said Stella Kyriakides, the bloc’s health commissioner. “And we’re all racing together as one team.”

The commission’s call comes as E.U. countries face a resurgence of coronavirus cases, turbocharged by emerging new variants, as well as the grim reality of prolonged lockdowns. E.U. leaders are due to meet by teleconference on Thursday to endorse the Commission’s proposals.

The commission also urged the bloc’s national governments to update their testing strategies, which remain the competence of member states, and urged them to genome sequence more positive coronavirus test results: 10 percent of them, up from the current rate of below 1 percent. Genome sequencing helps quickly identify new variants, while also keeping track of the progress of known ones.

“If we do not act now with determination, we might not be able to contain the risk of a potentially harsh third wave,” warned Ms. Kyriakides. “The numbers are already worrying across the E.U., and hospitals are under a lot of pressure. We cannot be complacent.”

In order to salvage border-free travel across the bloc, the commission also opened the debate over using so-called vaccination certificates, which could permit easier travel for people who’ve been vaccinated. The concept has been advocated by Greece and other smaller states, which heavily depend on tourism, but opposed by several larger E.U. countries such as France.

The bloc intends to determine a common approach by the end of January. For the moment, the commission recommended that all nonessential travel be strongly discouraged. Traveling restrictions, as well as testing and quarantine rules, are currently the prerogative of national governments, and have resulted in a patchwork of chaotic measures across the continent.

Coronavirus testing in Austin on Monday, when new cases in Texas were averaging over 20,000 a day.
Credit…Tamir Kalifa for The New York Times

The persistently rapid spread of the coronavirus in Texas, the second most populous state in the U.S., is threatening the gradual progress the country has been making toward flattening the curve of new cases.

Counties along the Mexican border in particular have seen steep spikes. The city of Laredo sent residents an emergency cellphone alert over the weekend — the second in three days — warning that local hospitals were near capacity.

“Our medical professionals and hospitals are overwhelmed with the surge in Covid-19 cases,” the message read. “The current situation is at its most critical level, and lives are at stake. We are asking you to stay home unless it is absolutely necessary.”

New cases in Texas were averaging more than 20,000 a day on Monday. The state has seen a steady increase in new cases since October, when there were approximately 4,000 a day on average, according to a New York Times database.

Since the start of the pandemic, Texas has reported more than 2.1 million cases, the second highest total in the country after California, which in recent weeks has been in the throes of a devastating flood of cases that has pushed hospitals to the brink.

Federal health officials have acknowledged that the vaccine rollout has had a slower-than-expected start. In the United States, about 14.3 million people have received at least one dose of a Covid-19 vaccine, and about 2.2 million people had been fully vaccinated, according to data reported on Wednesday by the federal Centers for Disease Control and Prevention. Federal officials had set a goal of giving at least 20 million people their first dose by the end of 2020.

The United States as a whole has been averaging more than 200,000 new virus cases a day since Jan. 2, with California and Texas fueling that surge. Arizona, Oklahoma and South Carolina have been swept by high numbers of cases for days, and New York now has the country’s fourth worst outbreak, though deaths per day in the state have not come close to the tragic levels seen in the spring.

On Monday, Texas reported 111 deaths, bringing the total number of people lost to the virus in the state to more than 32,000 — a sizable portion of the more than 400,000 total deaths reported in the United States.

For more than a month, Laredo has had 35 to 40 percent of its hospital beds filled with Covid-19 patients, a higher ratio than anywhere else in the state, a city spokeswoman said. On Tuesday, she added, the figure was nearing 50 percent.

In Del Rio, another border town, Dr. Laura Palau of the Val Verde County Health Authority said officials were still seeing cases emerge from maskless family gatherings and parties over the holidays. An alarming 30 percent of coronavirus tests performed in the city are coming back positive, she said. The sheriff’s office is issuing quarantine orders to people who test positive.

Dr. Palau said she was worried about the way deaths are rising.

“The people that were hospitalized in December or early January are starting to expire,” she said.

Texas has received more than 1.7 million doses of the coronavirus vaccine, and administered 1.3 million, Gov. Greg Abbott said on Tuesday. More than 800,000 more doses were expected this week, he said.

But Clay Jenkins, the top elected official in Dallas County, warned that a new, more transmissible variant of the virus, which is circulating in the United States after forcing Britain to lock down again, could make any progress in taming the pandemic fleeting.

“January and February will be our toughest months here in North Texas,” he said. “Right now, we just need everyone to avoid crowds, wear their mask, forgo get-togethers. Really think about ways to make patriotic sacrifices to protect the community.”

David Montgomery contributed reporting.

Andrew Yang announced that he was running for mayor last week in Manhattan’s Morningside Park.
Credit…James Estrin/The New York Times

Less than a week after his vigorous launch into the New York City mayor’s race, Andrew Yang said on Tuesday that he was halting in-person events and quarantining because a campaign staffer had tested positive for the coronavirus.

Mr. Yang, the former presidential candidate, had been seemingly everywhere in recent days, meeting with elected officials across the city and riding the subway and bus to campaign events. His whirlwind appearances were in sharp contrast to the mostly virtual campaigns that his rivals have been conducting.

Now Mr. Yang will enter quarantine for at least eight days, his campaign said in a statement.

“This morning, we learned that a member of the campaign staff received a positive result on a rapid Covid test,” the statement said. “Since that time, Andrew has tested negative and is not experiencing any symptoms.”

On Monday, Mr. Yang attended an event at the Rev. Al Sharpton’s headquarters in Harlem to commemorate Martin Luther King Jr.’s Birthday. He spoke without a mask before a large crowd that included many of the other mayoral candidates.

Denise Saylor, right, taking a selfie as Lara Comstack gave her the Modern vaccine at the Callen-Lorde Community Health Center in Manhattan this month.
Credit…James Estrin/The New York Times

New York City expects to exhaust its supply of coronavirus vaccine on Thursday, and will then have to cancel inoculation appointments at many city inoculation sites, according to Mayor Bill de Blasio.

“We will literally have nothing left to give as of Friday,” Mr. de Blasio said at a news conference Tuesday.

New York City received 53,000 doses this week, the mayor said, and had a total of 116,000 doses in inventory Tuesday morning. But Mr. de Blasio said that was not nearly enough to keep up with the pace at which New Yorkers are being inoculated. The mayor, who raised concerns last week about a coronavirus vaccine shortage after an initially sluggish rollout, said the city is not currently scheduled to receive any more doses until next Tuesday.

Mr. de Blasio and Gov. Andrew M. Cuomo have urged the federal government to send more vaccine to New York, now that the state’s eligibility pool has been expanded to include anyone 65 or older.

Statewide, more than 835,000 people have received the first of the two doses of a vaccine — both federally authorized vaccines are two-dose vaccines — and nearly 84,000 have received the second dose, Mr. Cuomo said in a statement on Tuesday. Even so, pressure is mounting to speed up vaccinations as hospitalizations across the state surpassed 9,000, according to Mr. Cuomo on Tuesday, for the first time since early May.

The supply issue threatens the success of the mass vaccination sites the city has been setting up in each of the five boroughs, Mr. de Blasio said. Sites at CitiField, the Mets’ home stadium in Queens, and at the Empire Outlets shopping center in Staten Island are scheduled to open next week. “This is not the way it should be,” the mayor said. “We have the ability to vaccinate a huge number of people. We need the vaccine to go with it.”

The city’s vaccination program has run into several obstacles since eligibility was expanded. Buggy websites and complex sign-up systems have made it difficult for many New Yorkers to schedule appointments. Mr. de Blasio said the city expects to have administered 500,000 doses by the end of Wednesday. The city had previously set a goal of one million doses by the end of January.

Officials in Delaware are offering a variety of incentives to encourage prisoners to consent to being vaccinated. The James T. Vaughn Correctional Center is in Smyrna, Del.
Credit…Suchat Pederson/The News Journal, via Associated Press

Officials at U.S. prisons and jails are running into widespread unwillingness among prisoners to consent to be vaccinated. To combat it, some are turning to offering incentives like free snack bags, extra visiting time and even a little time off sentences.

Incarcerated people are at much greater risk from Covid-19 than the general public: Studies have shown that they are four times as likely to become infected, and twice as likely to die. But many say they are wary both of the vaccines and of the prison medical staff members who administer them.

A recent survey at a jail in Billerica, Mass., found that only 40 percent of the inmates would volunteer for a vaccination, even though there had been more than 130 infections at the jail.

Many prison systems around the nation have yet to receive any vaccine doses or offer them to prisoners. Those that have tend to provide little or no educational material about the vaccines, inmates say.

At the Allenwood federal prison complex in Pennsylvania, inmates said medical workers arrived without any prior notice on Jan. 6, carrying clipboards and pushing carts containing vaccine doses.

“They didn’t give us any information beyond, basically, ‘Hey, this is safe, and you don’t have any worries taking it,’” said Domingo Ramirez, who is incarcerated there.

At the same prison, Andres Azner said that more than half of the inmates in his unit had refused vaccination when it was offered, including him.

“They didn’t give me enough time to think about it,” he said. “They didn’t give me enough information to make a solid, sound, prudent decision. They kind of just tried to force it upon me. And, no, no, I’m not taking it.”

The Bureau of Prisons did not respond to a request for comment.

The Delaware state prison system is trying to overcome the skepticism with incentives to receive the shot, and the North Carolina system is considering doing the same.

Delaware is offering credits that shorten sentences by a few days, as well as a 30-minute video visit with loved ones and either a free commissary snack bag or a “special meal.”

The idea is not unprecedented. In November, Kansas state prisons began offering inmates $5 to get a flu shot. The prisons have not yet received coronavirus vaccines to offer to prisoners, and officials declined to say whether the same policy would apply when they do.

Lauren Brinkley-Rubinstein, a professor at the University of North Carolina School of Medicine, said that a “very dark history of experimentation on prisoners” was responsible for fostering mistrust — and that certain incentives, involving expanded visitation privileges, were ethically questionable.

Brant Addison, an inmate at the Wake Correctional Center in North Carolina, described a string of sleepless nights as he weighed whether to receive the vaccine. Mr. Addison, who is African-American, cited the infamous Tuskegee syphilis study, and said that two of his relatives who are nurses shared his concerns.

He said he might feel safer receiving the vaccine after more people have taken it, including those outside prison walls.

“I have such a short time left, just a few months,” he said, referring to his sentence. “And I want to be able to walk out of here with a sound mind and body.”

 Timothy F. Geithner, left, and Henry M. Paulson Jr., two former Treasury secretaries, in 2018. Both support Janet Yellen’s confirmation as the new Treasury secretary.
Credit…Win Mcnamee/Getty Images

Janet L. Yellen won the endorsement on Tuesday of eight former Treasury secretaries, who called for her speedy Senate confirmation so that she can assume the job under President-elect Joseph R. Biden Jr.

The letter of support was released shortly ahead of Ms. Yellen’s testimony at her confirmation hearing before the Senate Finance Committee. The group said that any delay would pose an unnecessary risk to the economy at a critical time.

“With millions of Americans out of work, long-term unemployment rising, and activity stalled in large sectors of the economy, daunting challenges will face the incoming administration. Addressing these pressing issues will require thoughtful engagement by the Department of the Treasury,” they wrote. “Any gap in its leadership would risk setting back recovery efforts.”

They added that a delay in confirming Ms. Yellen would also sow confusion among American allies, who traditionally rely on the United States for global economic leadership in times of crisis.

The letter was signed by George P. Shultz, James A. Baker III, Robert E. Rubin, Lawrence H. Summers, John W. Snow, Henry M. Paulson, Jr., Timothy F. Geithner and Jacob J. Lew. That all-male crew reflects the significance of Ms. Yellen’s nomination — if confirmed, she would be the first woman to lead the Treasury in its 231-year history.

The former secretaries said that Ms. Yellen, a former Federal Reserve chair, was uniquely qualified for the job because of her experience and knowledge.

Ms. Yellen is expected to have a smooth path to confirmation. An acting Treasury secretary is expected to fill the void at the Department between when Treasury Secretary Steven Mnuchin departs on Wednesday at noon and when Ms. Yellen is confirmed.

A CVS pharmacist preparing a Covid-19 vaccination for residents of a nursing home in Harlem on Friday. Nearly a third of nursing home workers in New York State have declined to be vaccinated.
Credit…Yuki Iwamura/Associated Press

The number of nursing home workers in New York State who have declined the coronavirus vaccine rivals the number who have been inoculated, raising concerns about vaccine hesitancy among those who are in contact with some of the individuals at highest risk of a severe infection.

As of Monday, about 37 percent of the more than 130,000 people working in “skilled nursing” facilities in the state have been vaccinated, according to the governor’s office.

But 32 percent of the workers have declined to be vaccinated.

In some parts of the state, staff members who have declined outnumber those who have been vaccinated. On Long Island, 46 percent declined while 34 percent have been vaccinated.

Officials cautioned that the vaccination process for long-term-care facilities was still in its early stages — the first of three inoculation phases concluded on Sunday, and many workers have not had the chance to get vaccinated. They said they hoped the proportion of staff members declining would decrease as they saw their colleagues getting vaccinated safely.

Gov. Andrew M. Cuomo said at a news conference on Monday that the state had earmarked 225,000 doses for residents and workers in long-term care facilities and that 105,000 had been used. Of the 120,000 unused doses, 15,000 will be reserved for residents and 40,000 for staff members; the remainder will be reallocated to the main vaccination program, Gareth Rhodes, a top aide to Mr. Cuomo, said Tuesday.

The vaccination rate among residents was higher: 67 percent have been inoculated, while 16 percent have declined. Workers and residents who are medically able to get the vaccine but had previously declined will still be able to get a shot if they decide to.

The state health department has done online events and other educational outreach with nursing homes, largely to address vaccine hesitancy.

Many of the workers are lower-income and people of color, communities that tend to have higher rates of vaccine hesitancy. In a speech on Monday marking Martin Luther King’s Birthday, Mr. Cuomo said he understood their distrust, citing the decades-long Tuskegee experiment in which government researchers withheld treatment from Black men infected with syphilis.

“No one can ameliorate or justify the victimization and discrimination the Black community has endured,” Mr. Cuomo said.

But, he said, “We have had New York’s doctors, the best on the planet, review the vaccine, and they vouch for it. I will take it as soon as I am eligible.”

By Health News

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