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Covid-19 Live Updates: Scientists Are Studying Whether Moderna Supply Can Be Doubled By Cutting Doses in Half - The New York Times

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A medical worker receiving one of the first doses of the Moderna Covid-19 vaccine at Christ Hospital in Jersey City, N.J., last month.
Bryan Anselm for The New York Times

Scientists at the National Institutes of Health and the drugmaker Moderna are analyzing vaccine research data to see if they can double the supply of the company’s coronavirus vaccine by cutting doses in half, a move that would help alleviate vaccine shortages as the country surpassed more than 21 million virus cases.

The research, which also involves scientists from Operation Warp Speed, the government’s vaccine initiative, could take about two months, Dr. John Mascola, the director of the Vaccine Research Center at the N.I.H., said in an interview Tuesday.

The data analysis, which Dr. Mascola said has been long planned as part of the vaccine research effort, comes amid a broader scramble to increase vaccine supply. Late last month, the Trump administration sealed a deal with Pfizer to increase that company’s vaccine supply by 100 million doses.

“It’s important to do these analyses that we’re doing, and have all that data in our pocket in the event that there’s a need to use it,” Dr. Mascola said.

The vaccine rollout has been troubled from the start. For the moment, the problem is not a shortage of vaccine, but rather that state and local governments are having trouble distributing the vaccine doses they already have.

The prospect of doubling the supply of Moderna doses was first raised on Sunday by Dr. Moncef Slaoui, the head of Operation Warp Speed, who said on the CBS program “Face the Nation” that data from Moderna’s clinical trials demonstrated that people between the ages of 18 and 55 who received two 50-microgram doses showed an “identical immune response” to the two 100-microgram doses.

That is true, said both Dr. Mascola and Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases, which includes the vaccine research center. But Dr. Slaoui also went one step farther, and said federal officials and Moderna were discussing possibly halving each of Moderna’s two doses — a remark that prompted pushback from the Food and Drug Administration, which would have to approve any change in the dosing regimen.

In a statement posted on its website Monday night, the F.D.A. said a proposal for half-doses of the Moderna vaccine was “premature and not rooted solidly in the available science.” The finding Dr. Slaoui cited came from an early Phase II clinical trial, which involved hundreds of people and was designed to test only for immune response, and not for the effectiveness of the vaccine, Dr. Fauci said. It compared the immune response in people given 50 micrograms against those given 100 micrograms.

The larger Phase III trial that found the vaccine effective involved 30,000 people, half of whom were given the 100-microgram dose and half of whom were given placebo.

In order to provide the F.D.A. with the kind of data it would need to approve a change in dosing, scientists must first study blood samples from patients who participated in the Phase III trial to determine precisely what immune response correlates with protection against Covid-19.

Then, Dr. Mascola said, researchers would have to either look back at patients from the Phase II trial, or conduct a new one, to demonstrate that patients who received the 50 milligram dose developed the threshold immune response. If the results looked promising, he said, “all this then needs to be put together as a data package for review and discussion with F.D.A.”

On Tuesday, Dr. Jerome Adams, the U.S. surgeon general, urged states not to stick rigidly to the Centers for Disease Control and Prevention guidelines about whom to vaccinate first. He said states should “move quickly to other priority groups” if fewer health care workers agree to be vaccinated.

Asked about Dr. Adams’s remarks, a C.D.C. spokeswoman said the agency had made clear in written guidance that states did not need to vaccinate everyone in a priority group before moving on to the next group.

Dr. Jerome Adams, the surgeon general, left, elbow-bumps Demetrius Mcalister, an emergency room technician, after Mr. Mcalister received the Pfizer-BioNTech vaccine at Saint Anthony Hospital in Chicago last month.
Pool photo by Youngrae Kim

Acknowledging that coronavirus vaccination around the United States was going slowly, Dr. Jerome Adams, the surgeon general, urged the states on Tuesday not to stick rigidly to the Centers for Disease Control and Prevention guidelines about whom to vaccinate first.

If fewer health care workers are agreeing to be vaccinated, he said, states should “move quickly to other priority groups,” such as people older than 75 and essential workers.

“Your headline today really should be, ‘Surgeon General tells states and governors to move quickly to other priority groups,’” Dr. Adams said on NBC’s “Today” show. “If the demand isn’t there in 1a, go to 1b and continue on down. If the demand isn’t there in one location, move those vaccines to another location.”

“The problem really is that we need to continue to do a better job of matching up supply and demand at the local level,” he said.

An advisory committee to the C.D.C. recommended last month that nursing home residents and health care workers who are especially at risk of being exposed to the virus should be the first group (“1a”) to get the vaccine, followed by other people 75 and older and certain other essential workers (“1b”). The C.D.C. endorsed and published the recommendations, but they are not binding. Each state sets its own priority list, with some following the federal guidelines exactly and others not.

Nearly all states have made getting health care workers and nursing home residents immunized a top priority. But the effort, now three weeks old, has been slower than many governors and public health officials hoped.

The federal government has shipped more than 15 million vaccine doses to states, but only 4.5 million people have received them so far. There are 21 million health care workers nationwide, and three million residents of nursing homes and other long-term care facilities.

Some states, like Texas and Florida, have already begun offering shots to people 65 and older who are not nursing home residents, and to those of any age with medical conditions that raise their risk of dying if they contract Covid-19.

Dr. Adams said in some cases, health officials “feel beholden” to the C.D.C. priority recommendations, resulting in a lot of vaccine sitting unused in freezers.

An effort to have the C.V.S. and Walgreens drugstore chains manage the vaccination of most nursing home residents and employees around the country has been slow to get off the ground. And anecdotally, health care workers are turning down the vaccine, sometimes in large numbers.

Asked about Dr. Adams’s remarks, a spokeswoman for the C.D.C. said the agency had made clear in written guidance that states did not need to vaccinate everyone in a priority group before moving on to the next group.

But some officials, including Gov. Andrew M. Cuomo of New York, have said poor execution by hospitals is largely to blame for the slow start. Mr. Cuomo, for one, is resisting calls to start offering shots to lower-priority groups just yet.

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Speaking at a news conference, Prime Minister Boris Johnson of Britain said that 1.3 million people had already been vaccinated, and that he hoped that the most vulnerable could be protected by the vaccine within about six weeks.Andrew Testa for The New York Times

As England re-entered lockdown on Tuesday, new figures showed that one in 50 people had been infected with the virus, and officials warned that some restrictions on daily life could still be needed next winter.

Speaking at a news conference, Prime Minister Boris Johnson promised to focus government efforts on rolling out a mass vaccination program intended to prevent a surge in infections of a highly transmissible variant of the virus from overwhelming the health service.

With more than a million people, or 2 percent of the population, having been infected, the country is in a race against time to distribute vaccines.

Mr. Johnson was speaking on a day when the government said more than 60,000 new cases were recorded for the first time. Standing alongside him, Professor Chris Whitty, England’s chief medical officer, said that the number of daily deaths, now averaging around 530, was expected to rise and that if people did not observe a lockdown order to stay at home, the risk was “extraordinarily high.”

He also warned that Britons might face some restrictions well into the future.

“We might have to bring a few in, in the next winter for example — that is possible — because winter will benefit the virus,” Professor Whitty said.

Mr. Johnson said that 1.3 million people had already been vaccinated and that he hoped that the most vulnerable, a group including the elderly and numbering around 13 million, could be protected by the vaccine within about six weeks, turning the tide in the battle against the virus.

“We in government are now using every second of this lockdown to put that invisible shield around the elderly and the vulnerable in the form of vaccinations,” he said.

Mr. Johnson also said he was planning a new system to ensure that those traveling to Britain had a negative coronavirus test before arrival. But he was forced to defend himself against charges that he moved too slowly to order the lockdown, and showed poor judgment by insisting over the weekend that many schools in England should reopen after the winter holiday on Monday — only to reverse that decision on Monday night.

Los Angeles paramedics gave oxygen to a potential Covid-19 patient on the sidewalk before taking him to a hospital in Hawthorne, Calif. on Dec. 29.
Apu Gomes/Agence France-Presse — Getty Images

California’s daily coronavirus case tallies remain around four times what they were during the state’s summer surge, and officials predict that the aftereffects of a December surge linked to holiday gatherings will worsen as the winter drags on.

After new infections — driven by Thanksgiving travel and gatherings, then Christmas festivities — resulted in a surge unlike any the state had yet seen, the trajectory of its new cases has leveled off somewhat in the early days of 2021.

But there are more than twice as many Covid-19 patients in California hospitals now as there were a month ago, and many intensive care units in the state have been overflowing. At least six people in the state have also been found to be infected with the new, more transmissible variant of the virus first identified in Britain.

The state is also facing an oxygen shortage for patients, and it has deployed the U.S. Army Corps of Engineers and the California Emergency Medical Services Authority to help deliver and refill oxygen tanks.

In a sign of how dire that shortage is, Marianne Gausche-Hill, the medical director for Los Angeles County’s E.M.S. agency, issued guidelines to emergency workers on Sunday for administering the “minimum amount of oxygen necessary” to keep patients’ oxygen saturation level at or just above 90 percent. (A level in the low 90s or below is a concern for people with Covid-19.)

In the pandemic’s brutal logic, more cases inevitably translates to more suffering and deaths. As of Monday night, 4,258 people with Covid-19 had died in the preceding two weeks, compared with 3,043 in the two weeks before that.

“This is a deadly disease, this is a deadly pandemic,” Gov. Gavin Newsom told reporters on Monday. “It remains more deadly today than at any point in the history of the pandemic.”

There has been some progress. California’s daily average of 38,086 cases per day over the past week represents a decrease of 11 percent from the average two weeks earlier, for example. And although Covid-19 hospitalizations have increased by 18 percent over the past two weeks, to 20,618, Governor Newsom said that represents a slight flattening of the curve.

But the state’s last major Covid-19 surge, over the summer, only produced around 10,000 infections on its worst days. And in Los Angeles County, the latest crisis has stretched the health care system so thin that incoming patients at one hospital were recently being instructed to wait in an outdoor tent.

Mayor Eric Garcetti of Los Angeles said on Sunday that the county’s latest surge was infecting a new person every six seconds, and that many transmissions were occurring in private settings.

“It’s a message for all of America: We might not all have the same density as L.A., but what’s happening in L.A. can and will be coming in many communities in America,” he said.

The worst of the state’s outbreak is concentrated in Southern California and the San Joaquin Valley, where intensive care units are at zero percent capacity. Officials are now working to bring in extra nursing staff to care for the flood of patients; Governor Newsom said that 90 patients were being kept at “alternate care sites” outside hospitals to help ease the burden.

More inoculations would help ease California’s burden, but Governor Newsom said vaccinations were only just ramping up after facing some early challenges. So far, he said, the state has only administered about 35 percent of the coronavirus vaccine doses it has received.

“That’s not good enough,” he said. “We recognize that.”

In the meantime, said Dr. Mark Ghaly, the state’s secretary of health and human services, Californians should be extra cautious about gathering with people outside their household now that the virus is so prevalent.

“The same activities that you did a month ago, today are just so much more risky than they were from a Covid transmission perspective,” he said.

Billie Eilish with multiple Grammy awards in 2020. The 2021 Grammys will be postponed due to the the surge in coronavirus in Southern California.
Chris Pizzello/Invision

The 63rd annual Grammy Awards, set to be presented this month, have been delayed as the coronavirus spreads rapidly in the Los Angeles area, according to a spokeswoman for the Recording Academy, which presents the awards.

The delay comes less than four weeks before the ceremony was to be held, on Jan. 31, although the academy had so far announced few details about the show.

A new date for the event, which is broadcast by CBS, is planned for March but has not been announced.

In an interview in November, when nominations were announced, Harvey Mason Jr., the chairman and interim chief executive of the academy, said that an event was planned for a small audience, but that many other details were still being worked out. Trevor Noah, from “The Daily Show,” was to be the host.

The news came as unions and entertainment industry groups have called to suspend in-person television and film production in Los Angeles, citing the danger of overwhelmed hospitals, and as several late-night shows moved back to remote formats. The academy was expected to issue a formal announcement about the delay later on Tuesday. The postponement was first reported by Rolling Stone.

Curative’s walk-up kiosk testing site for Covid-19 in Seattle on Saturday.
Ted S. Warren/Associated Press

The Food and Drug Administration has raised concerns about the accuracy of a coronavirus test used by lawmakers, congressional staff and reporters, potentially muddling the already fraught effort to stem the spread of the virus on Capitol Hill.

In a notice published on Monday, the F.D.A. warned of the risk of false results, particularly false negative results, with the Curative SARS-Cov-2 test, which in the Capitol is a self-administered nasal swab and typically produces a result within 12 hours. The warning outlined multiple risks to a patient with a false negative result, including “delayed or lack of supportive treatment, lack of monitoring of infected individuals and their household or other close contacts for symptoms resulting in increased risk of spread of Covid-19 within the community.”

Curative’s test is based around a laboratory technique called polymerase chain reaction, or P.C.R. — typically considered the gold standard of coronavirus diagnostics. P.C.R.-based tests carry a reputation for high accuracy, making the problems with Curative’s product somewhat unusual. Other tests, such as rapid antigen tests, which can run in just minutes, are typically more prone to returning incorrect results.

The F.D.A. notice did not specify the rate at which Curative’s test was delivering false negatives. It did, however, note that samples that come from nasal swabs and oral fluid specimens should only be taken from people with Covid-19 symptoms.

After months without testing on Capitol Hill, Curative has been providing the tests to hundreds of lawmakers and staff who work in the building since at least November. The testing was implemented in part to help lawmakers who travel across the country twice a week comply with Washington’s quarantine requirements after travel.

Dr. Brian P. Monahan, Congress’s attending physician, acknowledged the warning about the test in a memo, which was first obtained by Politico, but wrote that it was “the most accurate available” and that all tests carry the risk of a false result.

“This is not unique to this test,” Dr. Monahan wrote. “It is a problem for all the coronavirus tests. We expect to have additional information in the coming days from the FDA and our expert consultants with regard to any concerns about the ongoing use of this test for the Capitol community.”

The warning about the tests, which are used by several lawmakers, aides and reporters, on days when Congress is in session, comes as lawmakers are still struggling to implement coronavirus protocols and prevent the virus from spreading through their ranks. Congressional leaders initially resisted providing testing in the Capitol despite the amount of traveling lawmakers do to vote in person because of a nationwide shortage and concerns about appearing to jump the line.

Representative Kay Granger, Republican of Texas, reported a positive test after spending time on the House floor Sunday for the swearing-in of the 117th Congress, where hundreds of lawmakers had to vote in person. It is unclear whether any lawmakers are quarantining as a result of that exposure.

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Experts advising the World Health Organization have recommended that the Pfizer-BioNTech Covid-19 vaccine be administered as recommended by its manufacturer, adding that countries with limited supplies of the vaccine could delay the second dose.Adriana Zehbrauskas for The New York Times

A group of international experts advising the World Health Organization has recommended that the Pfizer-BioNTech Covid-19 vaccine be administered as recommended by its manufacturer, in two doses given three to four weeks apart. However, it concluded that countries that have limited supplies of the vaccine and are concerned about the level of transmission of the virus could delay the second dose for up to six weeks.

That delay would help “maximize the number of individuals benefiting from a first dose,” the group’s chairman, Dr. Alejandro Cravioto, said at a news conference on Tuesday.

“We have to be a bit open to these types of decisions that countries need to make according to their own epidemiological situations,” he added.

The decision followed what Katherine O’Brien, director of the W.H.O.’s Department of Immunization, Vaccines and Biologicals, referred to as a “very robust discussion” about the trade-offs between risks, including the risk that the vaccine may not work as well as anticipated if it is not given in the way it was tested.

The group, known as the Strategic Advisory Group of Experts on Immunization, also recommended that the vaccine be given only in situations where health workers are able to treat rare severe allergic reactions, known as anaphylaxis.

The experts also concluded that while there is not yet enough safety data to be able to recommend the Pfizer vaccine for pregnant women, there are “situations where the benefit of vaccination of a pregnant woman outweighs the potential risks, such as health workers at high risk of exposure,” Dr. Cravioto said.

He also said that the vaccine should be offered regardless of whether a person has previously been infected by the virus. However, in situations of limited vaccine supply, people whose infections have been documented may choose to delay getting vaccinated until close to six months after their infections, in order to make the vaccine more available to others.

At the news conference, the W.H.O.’s director general, Tedros Adhanom Ghebreyesus, also revealed that a separate team of international experts who were expected to go to Wuhan, China this week to conduct a long-awaited investigation into the origins of the pandemic had been delayed; two of the members had already departed their home countries.

“Today we learned Chinese officials have not yet finalized the necessary permissions for the team’s arrival in China,” he said. “I’m very disappointed with this news.”

He added that he had been in contact about the matter with senior Chinese officials who assured him, he said, that the country “is speeding up internal procedures for the earliest possible deployment.”

Chicago has been wrestling for months over plans to reopen its public schools, including Frederic Chopin Elementary on the city’s West Side. 
Taylor Glascock for The New York Times

Just over half of the teachers who were expected to report to school buildings in Chicago on Monday, as the first step in the district’s reopening plan, did not show up, the district said on Tuesday. The absences were part of a long-running clash between teachers and administrators that is complicating the district’s efforts to resume in-classroom instruction for the first time since March 2020.

Chicago Public Schools, the nation’s third largest district with some 340,000 students, is planning to welcome prekindergarten students and some special education students back to schools next week, followed by kindergarten through eighth-grade students on Feb. 1. The students’ families can choose to have them return or to continue with remote learning; about 37 percent have chosen to return.

The district’s plan has run into relentless opposition from the Chicago Teachers Union, which argues that virus transmission remains too high in many neighborhoods and that the district’s safety measures are inadequate. A majority of the City Council signed a letter opposing the plan and demanding that the district negotiate with the union over the conditions for reopening.

The district, which is under the control of Mayor Lori Lightfoot, indicated on Tuesday that it was determined to press forward with its reopening plans.

The district’s chief executive, Janice K. Jackson, said that overall, some 60 percent of school-based employees — including teachers and paraprofessionals — who were expected to return to schools on Monday did so, “which is significant,” she said, “considering the fact that they were pressured by the union not to return.”

For comparison, she said, about 83 percent of employees reported for work in the first two days following winter break last year, “which is what we typically expect around this time.”

“We are optimistic that more staff will report to work in the coming days,” Dr. Jackson said, adding that employees who continued to stay away would be subject to progressive disciplinary actions, up to dismissal.

The head coach of the Cleveland Browns, Kevin Stefanski, during an game against the Pittsburgh Steelers on Sunday.
David Richard/Associated Press

Cleveland Browns head coach Kevin Stefanski, two other coaches and two players tested positive for Covid-19, the team said on Tuesday, putting the team’s championship aspirations in doubt.

All five people will miss the Browns matchup against the Pittsburgh Steelers on Sunday night, Cleveland’s first postseason game in nearly two decades. Special teams coordinator Mike Priefer will take over as head coach in Stefanski’s absence.

The N.F.L. said there was no change to the status of the game, and the league and team continue “to conduct standard contact tracing to identify any possible high-risk close contacts.”

Stefanski and the other coaches and players must be isolated from the team for a minimum of 10 days. If any players or personnel are found to have had close contact with them, they would need to remain apart from the team for five days, after which they would be eligible to return to the team and play in the game.

Offensive lineman Joel Bitonio is one of the two players who tested positive. Bitonio has been with the Browns his entire seven-year career, which has included the 2016 and 2017 seasons, when the team went 1-15 and 0-16.

Stefanski gave Bitonio, the longest tenured player on the team, the game ball after Sunday’s win. Now Bitonio will miss his first chance to play in a postseason game.

During their 24-22 victory on Sunday over the Steelers, the Browns had six players on the Covid-19 reserve list who had either tested positive or had close contact with someone who had. The previous week, the Browns had played without any of their best wide receivers because of an outbreak on the team.

The number of N.F.L. players, coaches and staff who tested positive picked up noticeably starting in November as the virus raged through communities around the country.

In the week that ended Jan. 2, the N.F.L. said there were 34 new confirmed positive tests among players and 36 new confirmed positives among other personnel. The 70 combined cases was up from 58 positive tests the week before and 45 cases the week before that.

Prime Minister Boris Johnson of Britain watches as Jennifer Dumasi receives a dose of the Oxford-AstraZeneca vaccine in London’s Chase Farm Hospital on Monday.
Pool photo by Stefan Rousseau

As England enters a strict new national lockdown and other European nations extend restrictions to try to slow the spread of the coronavirus, political leaders have pointed to the promise of mass vaccination campaigns to bring an end to the suffering.

But in the race to beat the virus, the virus is still way out in front.

Around the world, inoculation efforts in many countries are rolling out slower than promised, even as the count of new infections soars and record numbers flood hospitals, placing a double burden on health care providers who have also been tasked with leading the vaccination push.

And a more contagious variant spreading widely in England and detected in dozens of other countries threatens to give the virus an even greater advantage.

Prime Minister Boris Johnson said that England would be locked down until inoculations reached the four most vulnerable groups: residents in nursing homes and those who care for them, everyone over the age of 70, all frontline health and social care workers, and everyone who is clinically extremely vulnerable.

“If we succeed in vaccinating all those groups, we will have removed huge numbers of people from the path of the virus,” he said.

That goal, he added, could be achieved by the middle of February.

But to do that, the pace of vaccinations will need to increase drastically.

The four groups that the prime minister cited include 13.9 million people in England, according to Nadhim Zahawi, the minister overseeing the vaccine effort.

Since the campaign started on Dec. 8, fewer than 800,000 people in England had been vaccinated as of Dec. 27, the last date when data was available.

But with the introduction on Monday of the first doses of a vaccine developed by the University of Oxford and AstraZeneca — shots that are easier to transport and do not need to be stored at very cold temperatures — British officials said that the campaign could now be ramped up.

To meet Mr. Johnson’s target, some two million doses need to be given every week.

According to Mr. Johnson, England is outpacing many countries in the European Union, where vaccination campaigns did not kick off until just before Christmas.

Data from 19 of the bloc’s 27 member states, including France, Germany and Italy, show that about 500,000 vaccinations have been carried out so far.

In Germany, where the government was poised to extend lockdown measures through January, nearly 265,000 people received a first shot as the nationwide drive entered its second week, according to health officials. At the moment, Germany and other European Union countries are relying on the BioNTech-Pfizer vaccine, which requires another booster shot weeks later to reach full efficacy. England has decided to delay that second shot and other countries are exploring doing the same.

The Italian government said that as of Monday, 151,606 people had been vaccinated. A majority, 134,255, were health care professionals.

The vaccination drives in Germany and Italy are moving much faster than in France, where only about 500 people received the vaccine during the previous week.

And the campaign in the United States, the world’s leader in new infections, is off to a much slower start than promised.

About 4.5 million people in the United States have received a dose of a Covid-19 vaccine, according to the Centers for Disease Control and Prevention, far short of the goal that federal officials set to give at least 20 million their first shots before the end of December.

The small number of vaccine recipients is particularly striking in New York City, where roughly 110,000 people — in a city of more than eight million — have received the first of two doses necessary to help prevent serious cases of the disease. That is about a quarter of the total number received by the city.

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Chancellor Angela Merkel of Germany announced on Tuesday that the country would extend the nationwide lockdown until the end of January amid the surge of coronavirus cases and the fear that the more contagious variant of the virus could spread.Lena Mucha for The New York Times

Chancellor Angela Merkel and state governors in Germany agreed on Tuesday to extend the nationwide lockdown by three weeks, until at least the end of January, and to tighten restrictions amid high rates of coronavirus cases and deaths and the fear that a more contagious variant of the virus could spread in Germany.

“The measures we have adopted today are drastic,” Ms. Merkel said in a news conference after the meeting. “They are not just a continuation of what we did before Christmas. Given the situation, they are tougher.”

Under the extended lockdown rules, members of a household cannot meet more than one person from another household; schools, child care centers, cultural sites and all but essential shops are closed. Ms. Merkel and the governors also agreed to limit movement to 15 kilometers from home for people living in areas in which there are more than 200 new infections a week per 100,000 people. It is the first such rule in effect across Germany since the pandemic began.

After the failure of lighter lockdown measures in November — under which both schools and most shops had remained open — the German authorities had set stricter rules in mid-December. Those restrictions, which were set to expire Jan. 10, cut short the pre-Christmas shopping period, discouraged family gatherings over the festive season and curtailed celebrations for New Year’s Eve.

In a recent YouGov poll, two thirds of German respondents said that they approved of an extension to the lockdown. About 24 percent also said that they thought the restrictions should be tightened, according to the poll, commissioned by the German news service DPA.

On Monday, the health authorities in Germany registered 11,897 new infections and 944 deaths. According to a New York Times database, there were 17,526 new infections per day on average during the last seven days, comparable to the number of daily infections registered at the beginning of November, when authorities started the lockdown.

Since the pandemic began, only one in five prisoners in Mississippi’s correctional facilities has been tested, according to state records.
Rogelio V. Solis/Associated Press

The Mississippi Department of Corrections has reported that 108 people died in its prisons in 2020, a toll that was significantly higher than a year earlier. But as of Monday, the department had not disclosed whether any of those deaths were caused by the coronavirus, though more than 1,400 inmates have been infected since the pandemic’s start, according to state data.

Grace Fisher, a spokeswoman for the prison system, did not respond to email and phone inquiries about how the state prison system determines, records and makes public the causes of inmate deaths. A spokeswoman for Gov. Tate Reeves did not respond to an email and phone call seeking comment.

Many states report Covid-19 cases and deaths in online dashboards. Others report them in news releases or when requested.

Mississippi’s prison system has touted its handling of the virus, saying in a news release in December that its prisons “remain among the safest in the nation from the Covid-19 virus.”

Burl Cain, the state’s prison commissioner, said in May that the prison system had successfully managed the virus by restricting inmate transfers, suspending family visits and using increased cleaning and disinfection practices.

Advocates of greater transparency from prison authorities say it is unclear whether Mississippi’s prisons are opting not to disclose coronavirus deaths or if officials are uncertain of a full count because deaths are not being fully investigated.

Cliff Johnson, the director of the University of Mississippi School of Law’s MacArthur Justice Center — which filed a Freedom of Information request to obtain the number of prison deaths — said the lack of information about the causes of prison deaths represented a public safety threat.

All but three states have reported Covid-19 deaths in their prison systems. Vermont has recorded no prisoner deaths from the virus, a representative for that system said. Wyoming has not disclosed any deaths. But Mississippi’s prison system is far larger, with about 16,350 inmates, compared with just 3,200 in Wyoming and Vermont combined.

In New Jersey, whose prisons house about 15,000 inmates, at least 53 have died from Covid-19, according to state data.

The rate of coronavirus testing in Mississippi’s prisons is among the lowest in the nation. Since the pandemic began, only one in five prisoners has been tested, according to state records.

GLOBAL ROUNDUP

An employee in December at the Global Halal Center near Jakarta, Indonesia, where the coronavirus vaccine made by the Chinese company Sinovac was analyzed.
Ulet Ifansasti for The New York Times

The one-sentence letter didn’t say much. The coronavirus vaccine was “manufactured free of porcine materials,” Sinovac, the Chinese vaccine maker, wrote to Indonesia’s state-owned vaccine manufacturer in July.

While the letter was promising, Indonesian clerics needed more details. A vaccine laced with the smallest amount of pork DNA could dissuade some followers of Islam from inoculation in Indonesia, the country with the world’s largest Muslim population. Sinovac took months to provide more information, which came only this week.

The Chinese company’s delayed response has been yet another challenge in Indonesia’s already fragile vaccine rollout. With the highest number of coronavirus infections in Southeast Asia, the country is eager to drum up support for its goal of inoculating 181.5 million adults within 15 months. But looming questions about the safety of the Sinovac vaccine and whether it is halal, or allowed under Islam, are complicating the government’s efforts.

“There shouldn’t be any concern about whether this vaccine is halal or not halal,” President Joko Widodo has said. “We are in an emergency situation because of the Covid pandemic.”

Indonesia has recorded nearly 800,000 infections and more than 23,000 deaths, staggering numbers in a region where virus cases have remained relatively low. Inoculations are set to begin with health workers, soldiers and police officers in the coming weeks, once the health authorities are satisfied that the Sinovac vaccine is safe and effective.

Islamic authorities in other countries where Muslims make up a sizable share of the population, including Malaysia and the United Arab Emirates, have already ruled that coronavirus vaccines are permissible, even if they contain pork gelatin, which is used to stabilize many inoculations.

The Ulema Council, an influential group of Muslim clerics that decides which products are halal in Indonesia, is expected to issue a decree, or fatwa, authorizing the use of the Sinovac vaccine in the coming weeks. But the nature of its findings could affect how widely it is accepted in Indonesia, especially among the country’s many conservative Muslims.

In other developments across the world:

  • A senior official in Singapore said on Monday that the country’s police force could legally use data from the government’s coronavirus contact-tracing program for criminal investigations. A privacy statement on the program’s website had said that the information would be used only for contact tracing, local news media reported. But Desmond Tan, the home affairs minister, said in Parliament on Monday that officers could use the data for criminal investigations “and for the purpose of the safety and security of our citizens.”

  • Japan’s top-ranked sumo wrestler, Hakuho, has tested positive for the virus after losing his sense of smell, the country’s national broadcaster reported on Tuesday. The Mongolian-born athlete had been scheduled to compete next week in the New Year Grand Tournament, a major sumo event.

Eric Ettinger was first on line before a pop-up vaccination site opened in Manhattan, New York, on Tuesday morning.
James Estrin/The New York Times

As New York tries to confront lagging coronavirus vaccinations, Gov. Andrew M. Cuomo on Tuesday said that he would not immediately expand the pool of people eligible to receive the vaccine in the state, after repeated pleas from Mayor Bill de Blasio of New York City to do just that.

Mr. Cuomo maintained that health care workers should be the first to receive the vaccine, and that the state’s supply was not yet sufficient to expand distribution to other categories. He said that only 900,000 doses had been distributed so far, and there were 2.1 million health care workers in the state’s highest priority group.

At the rate the state was receiving vaccine shipments it would be about four weeks before the vaccination effort could move on from health care workers, the governor said.

Mr. Cuomo’s comments came on the same day Dr. Jerome Adams, the U.S. surgeon general, urged states not to stick rigidly to the Centers for Disease Control and Prevention guidelines about whom to vaccinate first. He said that states should “move quickly to other priority groups” if fewer health care workers agree to be vaccinated.

Asked about Dr. Adams’s remarks, a C.D.C. spokeswoman said the agency had made clear in written guidance that states did not need to vaccinate everyone in a priority group before moving on to the next group.

City officials said that at least a third of health care workers in city hospitals were hesitant about receiving the vaccine because they were concerned about its safety and efficacy.

Mr. Cuomo blamed hospital management for the slow pace of vaccine distribution and said he doubted that health care workers were not agreeing to be vaccinated in large numbers. He noted out of the 194 public and private hospitals statewide distributing the vaccine, some were working quickly. And he said for those that were not, the state could take back the doses and instead use hospitals that are moving faster.

“Why are they slow? A variety of reasons,” he said. “These are 194 hospitals, some of them frankly operate better than others. It’s like anything else in life.”

Mr. de Blasio had asked to add people over 75 years old and essential workers to those in the pool approved for vaccinations. As of Tuesday morning, New York City data showed that just over 118,000 people had been vaccinated, a sliver of a population of more than 8 million.

In a news conference on Tuesday, Mr. de Blasio also called for federal officials to provide more vaccines for the city on a clearer schedule, and to allow vaccine providers to pre-fill syringes to create a vaccination “assembly line.”

“The largest vaccination campaign in recent history is underway in New York City and New York State, as we make the final push in the battle against Covid-19,” Mr. de Blasio wrote in a letter addressed to Vice President Mike Pence . “But the speed and success of these efforts depend on seamless, coordinated delivery of this life-saving resource at every level of government.”

On Monday, Mr. Cuomo said that he planned to fine hospitals and potentially strip them of their right to distribute the vaccines if they did not do so rapidly as a way to speed up the process, an approach Mr. de Blasio described as motivated by “arrogance” on “Inside City Hall” on NY1 that night.

“This is a moment for cooperation, this is a moment for trust, this is a moment for partnership,” Mr. de Blasio said on Tuesday, adding that he thought the last thing health care workers needed was a punitive approach from the state.

“What they don’t need is to be shamed, what they don’t need is more bureaucracy, what they don’t need is the threat of fines,” Mr. de Blasio said on Tuesday, adding, “that just paralyzes people. Why don’t we stop talking about fines, and start talking about the freedom to vaccinate?”

Regarding his remarks on Monday night, the mayor said later during his news conference on Tuesday that “I let my emotions get the better of me.”

“I believe that when the governor and I talk about things we find a lot of common ground,” he added.

At his own news conference on Tuesday shortly after Mr. de Blasio’s, Mr. Cuomo doubled down on his approach, saying, “For those hospitals that have it already, use it or lose it, you wont get any more and you can be fined.”

Mr. Cuomo said the state was also looking to ramp up vaccination from places other than hospitals. He said essential workers like police officers, firefighters and transit workers should look to use their own networks to distribute the vaccine, once they are eligible to do so.

He said there would eventually be more than 3,700 sites across the state, including pharmacies and urgent care clinics, where people could get a vaccine.

Statewide, there were 8,590 reported hospitalizations, he said Tuesday, up from around 400 in early September.

In the city, Mr. de Blasio said five new vaccination centers, one in each of the five boroughs, will operate day and night with the aim of distributing 100,000 doses of the vaccine per week. He said that virus statistics for the city remained discouraging, with a seven-day average positive test rate of 9.03 percent.

On Monday, the governor announced the first confirmed case of a more infectious variant of the coronavirus in Saratoga Springs, N.Y.

The appearance of the variant led Mr. de Blasio on Tuesday to call for the federal government to institute a travel ban between the U.S. and the United Kingdom, where the variant was first discovered. In December, the United States began requiring all airline passengers arriving from Britain to test negative for the virus within 72 hours of their departure.

“It’s time to stop the half measures,” Mr. de Blasio said.

Mr. Cuomo also called for a greater focus on travel, saying that people flying into the United States from abroad should be required to take a test, either before they get on a plane or after they land.

The variant has already been detected in states like Colorado, Florida and California, and it is unclear whether a travel ban would be useful in containing it. Mr. Cuomo said on Monday that though only one case had been confirmed in New York, “I think it is much more widespread than people know.”

There were 7,048 sales of co-ops and condos in Manhattan in 2020, compared with 10,048 in 2019, representing a nearly 30 percent drop.
Mike Segar/Reuters

The pandemic’s effect on the 2020 real estate market has come into sharp relief. And in Manhattan, the year in home sales was predictably grim, even though there have been recent signs of improvement, according to new industry statistics.

There were 7,048 sales of co-ops and condos in Manhattan in 2020, compared with 10,048 in 2019, representing a nearly 30 percent drop, according to the brokerage Douglas Elliman. Co-op and condo sales were down about equally.

But prices don’t seem to have collapsed to the same extent, with the median of $1.05 million down only slightly, by a fluctuation of 4 percent, since the start of the coronavirus crisis. (The average sale price, which is often skewed by high-end transactions, was practically unchanged, at $1.94 million.)

In a pattern that suggests a widening socioeconomic divide, affluent buyers continued to snap up expensive apartments, reports from several brokerages show, while entry-level buyers, who are more likely to be unemployed because of Covid-19, were practically absent.

Along the same lines, the high-end bracket — homes listed for $5 million to $20 million — was the only one to enjoy an increase in values last year, and a large one, of more than 20 percent.

“Prices aren’t really rising,” said Jonathan Miller, an appraiser and the author of a year-end report for Douglas Elliman that was released on Tuesday. “There was just less activity at the bottom and more activity at the top.”

Sharing a meal at a hot pot restaurant in Beijing in November.
Greg Baker/Agence France-Presse — Getty Images

While many countries are still reeling from Covid-19, China — where the pandemic originated — has become one of the safest places in the world. The country reported fewer than 100,000 infections for all of 2020. The United States has been reporting more than that every day since early November.

China resembles what “normal” was like in the pre-pandemic world. Restaurants are packed. Hotels are full. Long lines form outside luxury stores. Instead of Zoom calls, people are meeting face to face to talk business or celebrate the new year.

The country will be the only major economy to have grown this past year. While such forecasts are often more art than science, one outfit is predicting that the Chinese economy will surpass that of the United States in 2028 — five years earlier than previously expected.

Citizens of China don’t have freedom of speech, freedom of worship or freedom from fear — three of the four freedoms articulated by President Franklin D. Roosevelt — but they are able to move around and lead a normal day-to-day life. In a pandemic year, many of the world’s people would envy that.

But China’s freedom of movement comes at the expense of nearly every other kind. The country is roughly the most surveilled in the world. The government took extreme social-control measures at the beginning of the outbreak to keep people apart — approaches that are beyond the reach of democratic governments.

“There are actually a lot of parallels between how the Chinese government treats a virus and how they treat other problems,” said Howard Chao, a retired lawyer in California who invests in start-ups on both sides of the Pacific.

“It’s kind of a one-size-fits-all approach: Just completely take care of the problem,” he said. “So when it comes to a virus, maybe that’s not too bad a thing. When it comes to certain other problems, maybe not such a good thing.”

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