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Coronavirus Cases Surge in Arizona

Arizona has recorded the highest number of new coronavirus cases per capita in the country. A medical official said the hospital systems are under “immense pressure” to keep up with the amount of Covid-19 patients.

Arizona, for weeks, has remained one of the states with the highest Covid-19 infection rates in the country. A conservative estimate suggests that about one in 10 Arizonans is currently infected with the virus. Cases, hospitalizations and deaths in our state continue to climb. This week, the total number of Covid-19 deaths in Arizona surpassed 10,000. Our reproduction rate remains above 1.0, which means the virus is spreading faster than is desired. Hospitals in the state are under immense pressure as we continue to expand capacity and adjust operations to accommodate a much higher volume and acuity of patients. Currently, 58 percent of hospital beds in Arizona are occupied by Covid-19 patients.

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Arizona has recorded the highest number of new coronavirus cases per capita in the country. A medical official said the hospital systems are under “immense pressure” to keep up with the amount of Covid-19 patients.CreditCredit…Max Whittaker for The New York Times

Deaths from the coronavirus are skyrocketing in the United States, reaching levels never before seen, largely fueled by relentless surges in California and Arizona.

As the national death toll nears 400,000, weekly deaths in Maricopa County, Ariz., and in Los Angeles and Fresno Counties in California have reached new highs, according to data compiled by The New York Times.

The virus has been raging for weeks in California — especially in Los Angeles County, where Covid-19 has claimed one life about every eight minutes — although state officials said on Wednesday that they were seeing some encouraging signs.

In Arizona over the past week, state officials have recorded the highest number of new coronavirus cases per capita in the country.

Dr. Marjorie Bessel, chief clinical officer for the Banner Health hospitals in Arizona, warned on Wednesday that unless elected leaders and residents did more to stop the spread of the virus, five large health systems risked becoming overwhelmed with patients. More than two-thirds of the state’s intensive care units were full as of Monday, and the hospitals were preparing for a surge of 25 to 50 percent.

“We hope we do not get there,” Dr. Bessel said, adding, “We’re asking you — we’re imploring you — today to help us avoid that.”

She urged officials to adopt a statewide mask mandate and to ban indoor restaurant dining. Certain cities and counties, such as Maricopa and Pima, have full mask mandates, but Gov. Doug Ducey, a Republican, has resisted calls for a statewide order.

Nationwide, the numbers largely remained grim on Wednesday, though in the Northern Plains, cases this week were at about a quarter of their peak in mid-November, when the region was among the hardest hit in the country. There were at least 3,900 virus deaths in the United States reported on Wednesday, a day after the country hit a daily record of more than 4,400.

Earlier in the pandemic, cities bore the brunt of the virus. But now, although metropolitan areas are still suffering, rural communities are, too. Data compiled by The Times shows that deaths have spiked in less populous places, among them Butler County, Kan.; Sevier County, Tenn., and Etowah County, Ala.

“It’s taken a little while, but this highly contagious virus has now spread not only to the suburbs, but also to rural areas,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “In Tennessee, we have some very rural counties, and there’s no county that’s unaffected.”

The geographic diversity of the deaths makes clear that the virus has crushed the health care system in the state, Dr. Schaffner said. On Monday, nearly 90 percent of Tennessee’s intensive care units were full.

Yet it is still common in many rural areas to see people gather in large numbers, often not wearing masks. Some wind up in the hospital.

In regular circumstances, patients in rural areas who require a more sophisticated level of care — as gravely ill Covid-19 patients do — are sent to bigger hospitals in cities. But not all of those transfers are possible now.

“Now we can’t take referrals, because we’re full,” Dr. Schaffner said. “No wonder mortality is going up.”

Airlines, workplaces and sports stadiums may soon require people to show their coronavirus vaccination status on their smartphones before they can enter.

A coalition of leading technology companies, health organizations and nonprofits — including Microsoft, Oracle, Salesforce, Cerner, Epic Systems and the Mayo Clinic — said on Thursday that they were developing technology standards to enable people to obtain and share their immunization records through health passport apps.

“For some period of time, most all of us are going to have to demonstrate either negative Covid-19 testing or an up-to-date vaccination status to go about the normal routines of our lives,” said Dr. Brad Perkins, the chief medical officer at the Commons Project Foundation, a nonprofit in Geneva that is a member of the vaccine credential initiative.

That will happen, Dr. Perkins added, “whether it’s getting on an airplane and going to a different country, whether it’s going to work, to school, to the grocery store, to live concerts or sporting events.”

Vaccine passport apps could fill a significant need for airlines, employers and other businesses. In the United States, the federal government has developed paper cards that remind people who receive coronavirus vaccinations of their vaccine manufacturer, batch number and date of inoculation. But there is no federal system that people can use to get easy access to their immunization records online and establish their vaccination status for work or travel.

A few airlines, including United Airlines and JetBlue, are trying Common Pass, a health passport app from the Commons Project. The app enables passengers to retrieve their virus test results from their health providers and then gives them a confirmation code that allows them to board certain international flights. The vaccination credentialing system would work similarly.

The U.S. vaccination program has been stymied by logistical hurdles as states scramble to set up new systems for booking appointments. Demand is high, but the rollout has been progressing far more slowly than hoped, marred by crashing servers, busy signals and confusion.

The federal Centers for Disease Control and Prevention said on Thursday that about 11.1 million people have received at least one dose of a Covid-19 vaccine, far short of the goal federal officials set to give at least 20 million people their first shots before the end of 2020.

At least 541,000 people in the United States have been fully vaccinated as of Jan. 12, according to a New York Times survey of all 50 states.

Experts from the World Health Organization at the airport in Wuhan, China, on Thursday.
Credit…Ng Han Guan/Associated Press

More than a year after a new coronavirus first emerged in China, a team of experts from the World Health Organization arrived on Thursday in the central city of Wuhan to begin hunting for its source.

But in a sign of Beijing’s continuing efforts to control the investigation, the team of scientists and W.H.O. employees almost immediately ran into obstacles. Two scientists were unable to enter China at the last minute and remained in Singapore because they had tested positive for coronavirus antibodies, the W.H.O. said on Twitter.

The Chinese authorities required the remaining 13 experts to undergo two weeks of quarantine in Wuhan, where the virus first emerged in late 2019.

The investigation, which aims to gain an understanding into how the virus jumped to humans from animals, is a critical step so that another pandemic can be avoided. But getting answers is likely to be difficult.

Here’s what to know about the investigation.

China set up hurdles and pushed for control.

Apparently worried about drawing renewed attention to the country’s early mistakes in handling the pandemic, Chinese officials have used a variety of tactics over the past year to hinder the W.H.O. investigation.

After resisting demands from other countries that it allow independent investigators onto its soil to study the origin of the pathogen, China let two W.H.O. experts visit in July to lay the groundwork. They were not allowed to visit Wuhan, where the virus first emerged.

For months, China delayed approving a visit by a full team of experts, frustrating the health agency’s leaders. When the visit seemed to be finalized this month, it fell apart when Beijing declined to provide visas for the visitors, according to the health agency.

Now that the investigators have arrived, critics say Beijing’s desire for control means the inquiry will probably be more political than scientific.

Tracing the virus will be a painstaking task.

The team that has come to Wuhan will face a city radically transformed from when the virus first emerged, in late 2019. The city, which went into lockdown on Jan. 23 last year and became a symbol of the virus’s devastation, has since been held up by Chinese officials as a success story in vanquishing the virus.

The W.H.O. experts have decades of experience plumbing the depths of viruses, animal health and disease control. But tracing the source of the virus that as of Thursday had killed almost two million people worldwide and infected more than 92 million will be painstaking. While experts believe the virus originated naturally in animals, possibly bats, little else is known.

How much access the team gets in China will be critical, public health experts say.

The team will have to sidestep attempts to politicize its inquiry.

The pandemic has hurt China’s reputation, with many foreign governments still angry that Beijing did not do more to contain the crisis in its earliest stages. So Chinese propagandists are trying to use the W.H.O. inquiry to help shore up China’s image and portray the country as a mature superpower.

Complicating that effort could be new virus flare-ups in recent weeks that have prompted fresh lockdowns in China. In all, more than 22 million people have been ordered to remain inside their homes — double the number affected a year ago in Wuhan. On Thursday, China’s National Health Commission reported a coronavirus death in the mainland for the first time since May.

“The major concern here is the origin of the outbreak has been so politicized,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “That has really narrowed the space for the W.H.O. to have an independent, objective and scientific investigation.”

President-elect Joseph R. Biden Jr. will detail his plans, which he and his economic team have been honing for weeks, in an evening speech in Delaware.
Credit…Kriston Jae Bethel for The New York Times

President-elect Joseph R. Biden Jr. is expected to outline proposals on Thursday for trillions of dollars in government spending to combat the pandemic and its effects on the economy, with an initial focus on large-scale expansions of vaccinations and virus testing capacity.

The efforts will cover the pandemic, the economy, health care, education, climate change and other domestic priorities, Brian Deese, the incoming director of the National Economic Council, said at the Reuters Next conference on Wednesday.

Mr. Biden will detail his plans, which he and his economic team have been honing for weeks, in an evening speech in Delaware. Top Democrats in Congress have said in recent days that they are preparing for the initiatives to span two bills.

“At this moment the president-elect feels that we need to move aggressively on both rescue and recovery,” Mr. Deese said.

Money to complete $2,000 direct payments to individuals and aid to small businesses and local and state governments, components that Mr. Biden has stressed in recent weeks, will be part of the initial package, Mr. Deese said. Others briefed on Mr. Biden’s thinking said he would also call for the first piece of legislation to include an extension of supplemental federal unemployment benefits, which are set to expire in March for many workers, and more help for renters.

Plans for the first package also include a significant increase in spending on vaccine deployment, testing and contact tracing, Mr. Deese said, and Mr. Biden will seek enough money to allow most schools to open.

“We need to get the schools open,” Mr. Deese said, “so that parents, and particularly women, who are being disproportionately hurt in this economy, can get back to work.”

Transition team officials would not say on Wednesday how expensive Mr. Biden’s proposals were likely to be or whether he would announce a cost estimate on Thursday. Last week, Mr. Biden said he expected that his full agenda would cost trillions of dollars.

 Alex M. Azar II, the secretary of health and human services, criticized China’s handling of the pandemic at a Heritage Foundation forum on Thursday. 
Credit…Stefani Reynolds for The New York Times

The U.S. secretary of health and human services, Alex M. Azar II, excoriated China on Thursday for its “bullying of international experts and scientists” and acknowledged for the first time that a top official at the Centers for Disease Control and Prevention was correct when she warned in February that the novel coronavirus might cause a severe disruption to American lives.

The official, Dr. Nancy Messonnier, was muzzled for nine months after issuing the Feb. 25 warning, which threw the stock market into a nosedive and infuriated President Trump, who was on his way back from India at the time. But she was merely repeating what she had learned from a White House Task Force meeting days earlier, Mr. Azar recalled.

“She got a little ahead of the briefing of the president and the official announcement,” Mr. Azar said. “But she and we were correct.”

Mr. Azar made his comments to the Heritage Foundation, during an online seminar that was billed as a talk about “lessons learned” from the pandemic. He spent much of it describing how China rebuffed offers of help from the United States — and thwarted American efforts to learn more about the virus that has now claimed more than 380,000 American lives.

The United States got its first hint of the novel virus — a case of an unusual pneumonia in Wuhan, China, on Dec. 30, 2019 — from monitoring news reports and through a notification from Taiwan. While American officials tried various tacks to get them to cooperate — including praising China in public as they “pressed them very hard and very firmly in private,” they were unsuccessful, he said.

“Our teams were also pressing for the Chinese government to send us viral isolates from patients there. And China has still, one year later, failed to provide the first-generation viral isolates,” Mr. Azar said, describing events in late January.

It was not until Feb. 16, he said, that an international team including American experts was allowed into China to investigate. “By this time,” he said, “Chinese intransigence meant that the window of opportunity had passed. Outbreaks had been seeded around the world.”

On Thursday, a team of experts from the World Health Organization finally arrived in the central city of Wuhan to begin hunting for the source of the coronavirus.

But in a sign of Beijing’s continuing efforts to control the investigation, the team of scientists and W.H.O. employees almost immediately ran into obstacles. Two scientists were unable to enter China at the last minute and remained in Singapore because they tested positive for coronavirus antibodies, the W.H.O. said. The Chinese authorities required the remaining 13 experts to undergo two weeks of quarantine in Wuhan.

The investigation is a critical step in understanding how the virus jumped to humans from animals so that another pandemic can be avoided. Getting answers will most likely be difficult.

Representative Adriano Espaillat speaking in Washington last year. Mr. Espaillat announced on Thursday he had tested positive for the coronavirus.
Credit…Pool photo by Jacquelyn Martin

Representative Adriano Espaillat, Democrat of New York, announced on Thursday he had tested positive for the coronavirus, as concerns continue to mount on Capitol Hill that efforts to corral lawmakers into secure locations during last week’s siege by Trump supporters may have led to a super-spreader event.

Mr. Espaillat, 66, who received his second dose of the Pfizer vaccine last week, said he was not experiencing any symptoms and that he was isolating at home. In a statement, he said he understood that it took time for the vaccine to be fully effective and that he had continued to take all necessary precautions. Guidelines from the Centers for Disease Control and Prevention state that people who test positive for the virus should isolate for at least 10 days after their symptoms start.

The two vaccines cleared for emergency use in the United States, made by Pfizer and Moderna, were shown in clinical trials to be about 95 percent effective at preventing symptomatic cases of Covid-19. But neither vaccine is perfect, and researchers remain unsure of how well the shots curb the ability of the virus to silently infect people. Both the Pfizer and Moderna vaccines require two injections, separated by three or four weeks, and they aren’t believed to fully kick in until about a week or two after a person receives the second shot.

Capitol Hill has long struggled to control the spread of the pandemic within its marble walls, a haphazard effort exacerbated last week as hundreds of maskless Trump supporters stormed the building and forced lawmakers to shelter in confined secure locations across the Capitol complex. Lawmakers, aides and reporters who took shelter in two separate rooms on both sides of the Capitol have been warned about possible exposure to the coronavirus.

Though cases have continued to emerge since the 117th Congress was sworn in nearly two weeks ago, House Democrats have blamed a group of their Republican colleagues who refused to wear masks during the attack while waiting in a secure location for law enforcement to regain control of the building.

Representatives Bonnie Watson Coleman, Democrat of New Jersey, Pramila Jayapal, Democrat of Washington, and Brad Schneider, Democrat of Illinois, have all tested positive in the aftermath of the attack and cited the Republican refusal to wear masks during the siege. Representative Ayanna S. Pressley, Democrat of Massachusetts, is in isolation after her husband, who was with her in the room, tested positive, and in a statement said the diagnoses were a consequence of “my callous Republican colleagues” who refused to wear masks.

In response to those accusations and concerns about the spread of the virus on Capitol Hill, the House earlier this week approved a fine system for members who refuse to adhere to a mask mandate on the floor.

It was unclear whether Mr. Espaillat took shelter in the secure room. But on Wednesday, he was among the lawmakers who spoke on the House floor — while wearing a mask — before voting to impeach President Trump for the second time.

Mr. Espaillat noted that the colleagues who had tested positive in recent days “collectively occupy a range of gender, ages, races and ethnicities.”

“Covid-19 does not discriminate,” he said. “It is incumbent on each of us to prioritize social distancing from one another — even if that poses a temporary inconvenience — and wear a face mask. There is no singular panacea and we must adjust our daily habits and practices for our own health and safety as well as the health and safety of those around us and throughout our communities.”

Students boarding a school bus after school let out at Eneida M. Hartner Elementary School in Miami, Fla., on Monday, Nov. 30, 2020.
Credit…Scott McIntyre for The New York Times

When a more contagious coronavirus variant first surfaced in early December, some researchers initially suggested that unlike with previous versions of the virus, children might be just as susceptible to the new variant as adults.

Recent research from Public Health England may put those fears to rest.

Based on detailed contact-tracing of about 20,000 people infected with the new variant — including nearly 3,000 children under 10 — the report showed that young children were about half as likely as adults to transmit the variant to others. That was true of the previous iteration of the virus, as well.

“There was a lot of speculation at the beginning suggesting that children spread this variant more,” said Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government. “That’s really not the case.”

But the variant does spread more easily among children, just as it does among adults. The report estimated that the new variant is about 30 percent to 50 percent more contagious than its predecessors — less than the 70 percent researchers had initially estimated, but high enough that the variant is expected to pummel the United States and other countries, as it did Britain.

Adolescents and teenagers between ages 10 and 19 were more likely than younger children to spread the variant, but not as likely as adults. Over all, though, the variant was more contagious in each age group than previous versions of the virus. The mutant virus will result in more infections in children unless schools shore up their precautions, experts said.

“The variant is not necessarily affecting children particularly, but we know that it’s adding on more transmissibility to all age groups,” Dr. Cevik said. “We need to find ways to return these kids back to school as soon as possible; we need to use this time period to prepare.”

Prime Minister Boris Johnson of Britain had promised last year to do all he could to keep schools open. But he changed course in the face of soaring infections and buckling hospital systems, and ordered schools and colleges to move to remote learning. Other European countries put a premium on opening schools in September and have worked to keep them open, though the variant already has forced some to close.

In the United States, the mutant virus has been spotted only in a handful of states but is expected to spread swiftly, becoming the predominant source of infections by March. If community prevalence rises to unmanageable levels — a likely proposition, given the surge in most states — even elementary schools may be forced to close.

But that should be a last resort, after closures of indoor restaurants, bars, bowling alleys and malls, several experts said.

“I still say exactly what many people have said for the past few months — that schools should be the last thing to close,” said Helen Jenkins, an infectious disease expert at Boston University. Keeping schools open carries some risk, but “I think it can be reduced substantially with all the mitigations in place,” she said.

Students at a school near Paris in September. France is ramping up its efforts to test schoolchildren in order to stop a coronavirus variant from spreading.
Credit…Martin Bureau/Agence France-Presse — Getty Images

France strengthened border controls and extended a curfew to the entire country on Thursday to keep the coronavirus in check, but authorities warned that new restrictions were possible in the coming days if the epidemic worsened.

Starting next Monday, all travelers coming to France from countries outside of the European Union will have to present proof of a negative virus test that is no older than 72 hours, and will have to pledge to isolate for seven days before getting tested again, although it is unclear how that measure will be enforced. France will work with other European Union countries in the coming weeks on a coordinated protocol for travel from member states, according to Jean Castex, the French prime minister.

Mr. Castex praised the French for following distancing rules over the winter holidays, noting that health authorities had not recorded an “epidemic flare-up” tied to Christmas or New Year’s Eve celebrations. But he also said authorities were concerned about new variants of the virus, especially the more contagious one first identified in Britain.

“We must do everything to prevent it from rapidly spreading,” Mr. Castex said.

The average number of daily cases in France is at about 16,000, Mr. Castex said — far less than at the peak of the second wave last fall, but still over three times the target set by the government to loosen restrictions. Hospitalizations have stabilized at a high plateau, with nearly 25,000 Covid-19 patients. Nearly 70,000 people have died because of the virus.

An 8 p.m. curfew was already in place in most of France and had been tightened to 6 p.m. in some areas. Starting on Saturday and for at least 15 days, barring certain exceptions, everyone will have to be home by 6 p.m., Mr. Castex said, and shops will have to close by then. The government vowed to continue providing furlough programs, subsidies, loan guarantees and tax breaks to struggling businesses.

Schools, however, will remain open with stricter health protocols, by preventing classes from mixing in cafeterias, for instance, and by suspending all indoor physical activity. Additionally, France said on Thursday that it planned to test up to a million school children and teachers every month for the virus.

Olivier Véran, France’s health minister, said tests would be carried out “everywhere where it makes sense” and would include schoolchildren age 6 and older.

“What we know so far is that indeed the virus seems more contagious among children,” Mr. Véran told reporters. Mr. Véran said the government was “closely” watching the spread of the variant, which was reported in about 1 percent of all positive virus tests in France over two days last week, according to the health authorities.

France has also ramped up its vaccination rollout after a sluggish start, with some 318,000 people vaccinated so far. The campaign had focused on health workers and residents of nursing or retirement homes, but Mr. Castex said it would accelerate on Monday as vaccines will be made available to people over 75 and to those considered at risk because of serious illnesses. Some 700 vaccination centers will be opened to handle the influx of new patients.

“The priority of priorities to exit this crisis is the use of vaccination,” Mr. Castex said. “But we must collectively show patience and responsibility, because vaccination will not protect us sufficiently until several more months.”

A TAP Air Portugal check-in desk at Heathrow Airport in London last month. Britain has banned travelers from Portugal and Latin America, citing concern about a new variant of the coronavirus.
Credit…Niklas Halle’N/Agence France-Presse — Getty Images

Britain said on Thursday that it would ban arrivals from Latin American countries and Portugal over fears of a coronavirus variant discovered in Brazil.

In recent weeks, British authorities have already struggled to contain the spread of a different coronavirus variant discovered in Britain that is more contagious than its predecessors.

At least two coronavirus variants are currently circulating in Brazil, and at least one has slipped its borders, traveling to Japan.

Japanese authorities found one of those variants in four people traveling from Brazil earlier this week. The variant contains a mutation that has been linked with higher contagiousness, similar to the variant found in Britain and another in South Africa.

Like the variant found in South Africa, the one exported from Brazil to Japan also carries a mutation that may weaken the efficacy of vaccines. This same mutation has also been identified in the other coronavirus variant recently discovered in Brazil.

Experts have cautioned, however, that it would be very difficult for new variants of the coronavirus to evade vaccines entirely.

The British ban is set to come into effect on Friday at 4 a.m., the transportation secretary Grant Shapps said on Twitter. “Travel from Portugal to the U.K. will also be suspended given its strong travel links with Brazil,” Mr. Shapps added, although truck drivers transporting essential goods from Portugal will be exempted.

Britain has already banned flights from South Africa. Brazil banned flights from Britain on Christmas Day.

British authorities have come under criticism from opposition lawmakers for delaying a travel ban from Latin America, but they have argued that implementing such measures takes time, and that travelers coming from these countries had to quarantine for 10 days upon arrival.

“What we need to ensure is that when we make these very, very important decisions that have a huge impact on people’s personal lives, but also businesses, we have got to have a little bit of time,” the Home Office junior minister Victoria Atkins said on Sky News.

In the past week, Britain has faced some of its deadliest days since the beginning of the pandemic, and health authorities have warned that the country’s health care system was on the brink of collapse. Authorities have warned that they may tighten nationwide lockdown measures if the public doesn’t stay at home.

Britain has reported nearly 85,000 deaths, the heaviest death toll in Europe.

Health workers preparing vaccinations in Rockaway, N.J.
Credit…Sarah Blesener for The New York Times

Anxious about taking a new vaccine and scarred by a history of being mistreated, many frontline workers at hospitals and nursing homes are balking at being inoculated against the coronavirus.

But hospitals and nursing homes, worried about their patients’ health and scarred by many thousands of deaths in the past year, are desperate to have their employees vaccinated.

These opposing forces have led to unusual measures: In addition to educating workers about the benefits of the vaccines, employers are dangling incentives like cash, extra time off and even Waffle House gift cards for those who get inoculated, while, in at least a few cases, threatening to fire those who refuse.

Officials at two large long-term care chains in the United States, Juniper Communities and Atria Senior Living, said they were requiring their workers, with limited exceptions, to be vaccinated if they want to keep their jobs.

“For us, this was not a tough decision,” said Lynne Katzmann, Juniper’s chief executive. “Our goal is to do everything possible to protect our residents and our team members and their families.”

Critics say it is unethical to strong-arm low-paid workers into being vaccinated.

“This is a population of people who have been historically ignored, abused and mistreated,” said Dr. Mike Wasserman, a geriatrician and former president of the California Association of Long Term Care Medicine. “It is laziness on the part of anyone to force these folks to take a vaccine. I believe that we need to be putting all of our energy into respecting, honoring and valuing the work they do and educating them on the benefits to them and the folks they take care of in getting vaccinated.”

A survey of about 5,900 employees at Jackson Health System in Miami found that only half wanted to get a vaccine immediately, a hospital spokeswoman said. Others said they would consider it later.

In Ohio, Gov. Mike DeWine said last month that roughly 60 percent of nursing home workers had declined vaccination. In New York City, at least 30 percent of health care workers said no to the shot in the first round, Mayor Bill de Blasio said on Monday.

Nursing home residents in Reims, France, received the Covid-19 vaccine last week. The World Health Organization is concerned about the spread of a new variant throughout Europe.
Credit…Andrea Mantovani for The New York Times

Europe has reached a tipping point as it grapples with the spread of new coronavirus variants, the World Health Organization’s top official in the region said on Thursday, calling for tighter public health controls to slow their transmission.

The new variants have been identified in 25 of the European region’s 53 nations, Hans Kluge, the W.H.O.’s regional director, told a virtual news conference.

“We were prepared for challenging times in 2021, and it has been just that,” he said.

The region had 26 million confirmed coronavirus infections last year and more than 580,000 related deaths, he said, and in the past week alone recorded 1.8 million new cases.

He said that the health authorities could not yet assess the full extent of a surge in infections resulting from increased social gatherings and relaxed precautions over the year-end holidays, because testing and reporting also dropped.

But he said that the availability of vaccines offered hope for the months ahead. “2021 will be another year with the virus, but it will be more manageable and more predictable,” Mr. Kluge said.

As the year began, over 280 million people in Europe were living under national lockdowns, and several countries are set to add new measures in the hope of reducing new infections and easing the pressure on strained health facilities.

In Switzerland, where the number of new Covid-19 infections has fallen in recent days, the authorities announced new restrictions that take effect next week because of the threat posed by the highly transmissible variants.

Restrictions on businesses and social life in the country had been limited, and ski resorts have been allowed to remain open in a bid to minimize the impact on the economy.

Switzerland is also keeping its schools open. But starting Monday, all shops selling nonessential goods will have to close, the limit on private gatherings has been cut to five people from 10, and the required closing of bars, restaurants, cultural centers and sports facilities has been extended until the end of February.

A casket sat in an empty room at a funeral home in Los Angeles on Sunday.
Credit…Alex Welsh for The New York Times

Deaths from all causes rose sharply during the second quarter of 2020 as the pandemic took hold in the United States, reaching levels last seen 75 years ago, according to provisional figures released on Thursday by the National Center for Health Statistics.

Over all, the unadjusted death rate for all Americans rose to 1,033.7 per 100,000 in the second quarter of 2020, up from 850.8 per 100,000 Americans during the second quarter of 2019.

The last time the death rate exceeded that figure was in 1945, the year World War II ended, when there were 1,058 deaths for every 100,000 Americans. Rates had steadily declined since then, said Robert Anderson, chief of the mortality statistics branch of the center.

The overall death rate attributed specifically to Covid-19, the disease caused by the coronavirus, was 136.2 deaths per 100,000 Americans during the three months of April, May and June of 2020.

But deaths from several other leading causes, including diabetes, stroke, heart disease and hypertension, also increased. Since March, at least 400,000 more Americans have died than would have in a normal year. Deaths related to cancer, which have been declining for some time, continued to drop.

The new figures also highlight the unique threat that Covid-19 poses to men. Men died of Covid-19 at far higher rates than women during the second quarter of last year, with 148.1 deaths per 100,000, compared to 124.6 per 100,000 for women.

When the figures were adjusted to account for the age differences between the sexes, the disparities were even more stark: the Covid-19 death rate for men was 133.9 per 100,000 during the second quarter of 2020, compared with 86.9 per 100,000 for women.

The center has collected data on racial and ethnic disparities in death rates, but has not yet published the research. Another paper published on Thursday, in the Proceedings of the National Academy of Sciences, calculated that Covid-19 has reduced life expectancy for all Americans by about a year on average, but found that the impact differs dramatically by race.

While the life expectancy of white Americans has been shortened by less than a year, to 77.84 years on average, life expectancy among Black and Hispanic Americans has been reduced by two years and three years, respectively, to 72.7 years and to 78.7 years. (Hispanic Americans live longer on average than white or Black people.) The reduction represents the single largest single drop in life expectancy in 40 years.

The N.C.H.S. report is not the first to show that the pandemic has increased deaths from a variety of causes. In addition to the nearly 200,000 American deaths caused directly by Covid-19 from Jan. 26 to Oct. 3, another roughly 100,000 so-called excess deaths from other causes were recorded, the Centers for Disease Control and Prevention recently reported. The greatest rate of excess deaths was found among young adults and people of color.

Calculations of the death toll from injuries — a category that includes suicide, homicide, drug overdoses and firearm deaths — were not included in the new data, as reporting on these deaths frequently lags.

But a separate N.C.H.S. provisional report on drug overdose deaths during the 12-month period ending in June 2020 found an 18 percent increase over the previous year to 79,251 deaths, up from 67,821 deaths during the previous 12-month period ending in June 2019.

In total, there have been more than 384,000 known virus-related deaths in the United States. As of Wednesday, the seven-day average was 3,346 deaths a day, according to a New York Times database.

Giving a vaccine shot to a nursing home resident in the Bronx.
Credit…James Estrin/The New York Times

Laura Engle, 78, lives alone in an apartment in Midtown Manhattan. She uses a walker and has a chronic lung disease. She is exactly the kind of person who most needs a coronavirus vaccine.

Yet she has found it impossible to make an appointment and has become lost in the confusing system set up by the city and the state.

Computer-literate, she navigated New York City’s vaccine finder page on Monday, found the closest provider and sent an email with her name and phone number to set up an appointment. When no one called, she reached out to the urgent care’s corporate office, which told her to wait.

She wanted to register at the new Javits Center megasite, which she had heard about on the news, but couldn’t figure out how.

“I’m willing to wait my turn,” she said, frustrated, “but I would like to have some feeling that I have a turn.”

Millions of older New Yorkers started the week with optimism that they would finally gain access to a vaccine after months of fearing they would fall victim to the coronavirus. But the reality of actually getting the shots has proved maddening.

Buggy websites, multiple sign-up systems that act in parallel but do not link together and a lack of outreach is causing exasperation and exhaustion among older New Yorkers and others trying to set up vaccination appointments. It is also stymying New York’s efforts to get the vaccine to many of the city’s most vulnerable, creating a situation that risks exacerbating the inequalities that Covid-19 has already laid painfully bare.

The race to vaccinate millions of New Yorkers has reached a critical point, as officials on Wednesday announced that two cases of a more contagious variant of the virus first detected in Britain had been found in New York City, one in Manhattan and one in Queens.

The state has used 35 percent of its available vaccine, in line with the national average in a rollout that has gone far slower than expected nationwide. New York City has distributed 38 percent of its shots, with 491,000 available doses as of Thursday.

But in the race to get shots in arms, some say the bigger picture about exactly whose arms should be prioritized has been lost.

“Here we are, facing a global pandemic, with thousands of New Yorkers who have lost their lives, and who is again the forgotten group of people? The very people who need help the most,” said Mark Treyger, a city councilman from Brooklyn who said his office had been inundated with calls from family members trying to get appointments for their parents.

Global Roundup

A usually busy highway near Lebanon’s capital, Beirut, on Thursday as the country entered its first day of a strict lockdown.
Credit…Joseph Eid/Agence France-Presse — Getty Images

Lebanon began its strictest lockdown of the pandemic on Thursday, imposing a 24-hour curfew, shutting nearly all businesses and allowing grocery stores to serve customers only by delivery.

The lockdown, scheduled to last until Jan. 25, is intended to curtail a sharp rise in infections since the holidays that has outstripped the abilities of the health sector in the small Mediterranean country.

Thirty-five people died on Wednesday after falling ill with Covid-19, a new daily record, and nearly 5,000 new cases were reported. Lebanon, with a population of nearly six million, has recorded more than 231,000 infections and 1,740 deaths since the start of the pandemic, according to a New York Times database.

The caretaker health minister, Hamad Hassan, tested positive on Wednesday and was taken to a hospital. The state-run news media said his condition was “good.”

Lebanon’s response to the pandemic has been hampered by an acute economic crisis. The country’s currency has fallen in value by about two-thirds. On top of that, a huge explosion in the port of Beirut in August killed about 200 people, destroyed four hospitals and damaged a large swath of the city.

To leave home during the lockdown, people must obtain a one-hour permit — even to buy bread or medicine or go to the airport, hospital or doctor’s office — or risk a fine. The caretaker prime minister, Hassan Diab, has called on the security forces to be strict with violators.

In other developments around the world:

  • President Recep Tayyip Erdogan of Turkey received a Covid-19 vaccination in Ankara on Thursday, hoping to alleviate public concerns as the country’s mass vaccination program gets started. Photos of Mr. Erdogan receiving the shot were posted on social media, instead of him getting inoculated on live television, as expected. Senior members of Mr. Erdogan’s political party have also received vaccines. Turkey is currently using the vaccine developed by Sinovac, a Chinese company, but it expects shipments of the vaccine developed by Pfizer and BioNTech, a German company owned by two Turkish emigrants. The country is concentrating first on health care workers; the health ministry reported that almost 300,000 had received shots the first day.

  • King Abdullah II of Jordan and two other members of the Jordanian royal family received coronavirus vaccines on Thursday. The country also began the first vaccination campaign for a major refugee operation against the virus, drawing praise from the United Nations. At the Zaatari refugee camp, home to around 120,000 fugitives from the war in Syria, 43 refugees were vaccinated Thursday. Jordan had shown “exemplary leadership” integrating refugees into its public health response to the pandemic, the U.N. refugee agency chief Filippo Grandi said, “proving how it should be done if we are to keep everyone safe.”

  • Regulators in the Philippines granted emergency use authorization to the Pfizer-BioNTech coronavirus vaccine on Thursday, making Pfizer the first foreign company to receive permission to distribute its Covid-19 vaccine in the country.

  • One region of Spain — Castile and León, north and west of Madrid —  asked the national government on Thursday to put it under a stay-at-home order, and the leader of another region — Andalusia, the country’s most populous — asked residents to stay home voluntarily. The national health ministry reported more new coronavirus cases on Wednesday than on any previous day since the pandemic began, and hospitalizations in the country are rising sharply.

  • The Vatican said on Thursday that Pope Francis, 84, and Pope Emeritus Benedict XVI, 93, had each received the first dose of a coronavirus vaccine “as part of the vaccination program of the Vatican City State.” Francis has called being vaccinated “an ethical action.”

  • New Zealand, which has kept its borders tightly controlled while largely vanquishing the coronavirus, will let 1,000 international students back into the country starting in April, Chris Hipkins, the education minister, announced on Thursday. The move applies to students already enrolled in an undergraduate or postgraduate course who were locked out of New Zealand when border restrictions were imposed.

  • Andy Murray, the former top-ranked tennis player, has reportedly tested positive for the virus, putting in doubt his participation in next month’s Australian Open. He had planned to fly to Melbourne this week to begin a two-week quarantine required by the tournament, which begins Feb. 8, three weeks later than usual because of the pandemic.





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