Covid-19: U.S. to Require Negative Virus Tests From International Air Travelers – The New York Times

International passengers entering into the United States will need to show proof of a negative coronavirus test.
Credit…Brittainy Newman for The New York Times

Before boarding their flights, all international passengers headed to the United States will first need to show proof of a negative coronavirus test, according to a new federal policy going into effect on Jan. 26.

“Testing does not eliminate all risk,” Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, said in a statement describing the new policy.

“But when combined with a period of staying at home and everyday precautions like wearing masks and social distancing, it can make travel safer, healthier, and more responsible by reducing spread on planes, in airports, and at destinations.”

Dr. Redfield is expected to sign the order detailing the new rules on Tuesday.

The new policy requires all air passengers, regardless of vaccination status, to get a test for current infection within the three days before their flight to the United States departs, and to provide written documentation of their test results or proof of having recovered from Covid-19.

Proof of immunization will not be sufficient, because the vaccines have only been shown to prevent serious illness, said Jason McDonald, a spokesman for the C.D.C. Vaccinated people may still become infected, in theory, and transmit the virus on a flight.

The agency will not require further testing in the three months after a positive test, so long as the traveler has not had any symptoms. In this situation, a passenger may travel with documentation of the positive test result and a letter from a health care provider or a public health official stating that the traveler now has been cleared for travel.

Airlines must confirm the negative test result for all passengers or the documentation of recovery before they board. If a passenger does not provide proof of a negative test or recovery, or chooses not to take a test, the airline must deny boarding to the passenger, the agency said.

“Testing before and after travel is a critical layer to slow the introduction and spread of Covid-19,” agency officials said in a statement. “With the U.S. already in surge status, the testing requirement for air passengers will help slow the spread of the virus as we work to vaccinate the American public.”

The policy expands on a similar rule, implemented in late December, that required travelers from Britain to show proof of a negative result on a test for the virus. The Trump administration introduced that restriction following reports that a more contagious variant of the coronavirus had become the source of the majority of infections in much of that country.

That variant has since been detected in several American states and is likely to have spread even more widely, scientists have said. The United States genetically sequences only a tiny proportion of its virus samples, however — too few to have an accurate estimate for the variant’s spread in this country.

The new travel policy comes on the heels of an announcement by the Japanese government on Tuesday that four travelers from Brazil had imported another new variant of the virus into Japan. Two other so-called variants of concern are said to be circulating in South Africa and in Brazil.

The White House coronavirus task force and federal agencies, including the C.D.C., have been debating the expanded requirements for weeks.

The C.D.C. currently recommends that all air travelers, including those flying within the United States, get tested one to three days before travel, and again three to five days after the trip is complete.

Many airlines offer optional testing for passengers, but mandate it only when destinations require them to do so. But last week, a group representing major U.S. airlines backed a policy that would require all passengers to get tested.

In a statement Tuesday, the group, Airlines for America, said it supports a national testing standard set by the federal government.

“Since the onset of this crisis, U.S. airlines have relied on science to help guide decisions as they continuously reevaluate and update their processes, procedures and protocols,” the group said in a statement. “Recognizing that this regime will provide an additional layer of safety in the travel journey, we encourage the administration to move forward with recommendations to concurrently lift existing entry restrictions on travelers from Europe, the United Kingdom and Brazil.”

Niraj Chokshi contributed reporting.

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Trump Administration Expands Vaccine Eligibility

The Trump administration announced on Tuesday that it would release all available doses and instructed states to immediately begin vaccinating every American 65 and older.

“Over the last several days, we’ve averaged around 700,000 reported vaccinations each day. And we are on track to hit one million per day in a week to 10 days time. In total, we have more than nine million first vaccinations already given, far more than any Western country. By the end of next week, 95 percent of long-term care facilities will have had their first visit with vaccine doses.” “To echo what the secretary said, and strongly recommend the vaccination now be expanded to those individuals 65 or over and those individuals between 16 or 18, depending on the vaccine being used to 64 that have a comorbidity with medical documentation of such.”

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The Trump administration announced on Tuesday that it would release all available doses and instructed states to immediately begin vaccinating every American 65 and older.CreditCredit…Christopher Occhicone for The New York Times

The Trump administration, in a major policy shift aimed at accelerating distribution of the coronavirus vaccine, announced on Tuesday that it would release all available doses and instructed states to immediately begin vaccinating every American 65 and older, as well as tens of millions of adults with health conditions that put them at higher risk of dying from the virus.

The announcement, by Health Secretary Alex M. Azar II and other top federal health officials, came amid continuing complaints about the pace of the vaccine rollout. Mr. Azar warned that states will lose their allocations if they don’t use up doses quickly, and that starting in two weeks, how many each state receives will be based on the size of its population of people 65 and older.

It also comes during the country’s worst days of the pandemic. On Tuesday, more than 4,100 deaths were reported, a record, according to a New York Times database. Hospitalizations are at a near-record high of 131,326, according to the Covid Tracking Project. More than 375,000 people in the United States have died from Covid-19.

Precisely how the altered distribution would work is unclear; in two weeks, President-elect Joseph R. Biden Jr. will already have been sworn in as president. Mr. Azar said the incoming Biden administration would be briefed on the changes, though he added that Americans “operate with one government at a time, and this is the approach that we believe best fulfills the mission.”

The new distribution plan, first reported Tuesday morning by Axios, is a reversal for the administration, which had been holding back roughly half of its vaccine supply — millions of vials — to guarantee that second doses would be available. Mr. Azar said the administration always expected to make the shift when it was confident in the supply chain. Both vaccines authorized in the United States so far require two doses: 21 days apart for the one developed by Pfizer and BioNTech, and 28 days apart for the one from Moderna.

The administration has secured commitments for enough doses to cover 200 million Americans by the end of July from Pfizer and Moderna, the only two firms that so far have won emergency use authorization.

“This next phase reflects the urgency of the situation we face,” he said. “Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost or one more hospital bed occupied.”

Just days ago, Mr. Azar and officials from Operation Warp Speed, the administration’s fast-track vaccine initiative, criticized aides to Mr. Biden for announcing a similar plan. Mr. Azar said at the time that releasing nearly all of the doses, as the Biden team proposed, would jeopardize the “system that manages the flow, to maximize the number of first doses, but knowing there will be a second dose available.”

He called any proposed changes an “untenable position.”

Health officials also recommend that the vaccines be given to all adults with pre-existing conditions that make them more likely to develop serious illness from the virus, such as diabetes, chronic lung or heart disease, high blood pressure and cancer. Before the change, the vaccines were largely being distributed to people in the highest-risk categories, including frontline health care workers and older people in nursing homes.

In addition to the eligibility changes, health officials are also adding more community centers and pharmacies to the list of places where people can be vaccinated.

As of Monday, about 9 million people have received at least one dose of a Covid-19 vaccine, according to the Centers for Disease Control and Prevention, far short of the federal government’s original goals. At least 151,000 people in the United States have been fully vaccinated, as of Jan. 8, according to a New York Times survey of all 50 states.

Instead of holding back vaccine doses, all existing doses will be now sent to states to provide initial inoculations. Second doses are to be provided by new waves of manufacturing.

On Tuesday, Mr. Azar said that even if there were “glitches” in production, supplies would be prioritized to ensure people get their second dose. “The way this would work is new production on the production lines would go first and foremost towards fulfilling the second dose obligation,” he said.

The idea of using existing vaccine supplies for first doses has raised objections from some health workers and researchers, who worry that frontloading shots will raise the risk that second injections will be delayed. Clinical studies testing the vaccines showed the shots were effective when administered in two-dose regimens on a strict schedule. And while some protection appears to kick in after the first shot, experts remain unsure of the extent of that protection, or how long it might last without the second dose to boost its effects.

But others have vocally advocated for explicit dose delays, arguing that more widely distributing the partial protection afforded by a single shot will save more lives in the meantime.

The new recommendations come after some states have already begun vaccinating people 65 and older, leading to long lines and confusion over how to get a shot. Health experts and officials have faced difficult choices as they decided which groups would be prioritized in the vaccine rollout. While the elderly have died of the virus at the highest rates, essential workers have borne the greatest risk of infection, and the category includes many poor people and people of color, who have suffered disproportionately high rates of infection and death.

Anthony Lopes, security guard at Mount Sinai Medical Center in Miami, receives a Pfizer-BioNtech COVID-19 vaccine shot on December 16, 2020.
Credit…Saul Martinez for The New York Times

Amid a nationwide struggle to vaccinate even limited groups of people, the Trump administration’s announcement on Tuesday — that it would release all available vaccine doses and instruct states to immediately vaccinate every American 65 and older — threatens to create more confusion, particularly for the state and local leaders who had already laid out different plans for who should receive the vaccine next.

As part of the shift, the federal government will send all available doses to states to provide the first of the two doses required by both vaccines authorized in the United States. Previously, the Trump administration had been reserving roughly half of the vaccine supply to provide the second inoculations. Now, second doses are to be provided by new waves of manufacturing.

Health officials also recommend that the vaccines be given to all adults with various pre-existing conditions.

Gov. Ron DeSantis of Florida, who prioritized people 65 and older from the start, said he believed making all older people eligible was always the right thing to do.

The initial guidelines “would have allowed a 20-year-old healthy worker to get a vaccine before a 74-year-old grandmother,” he said on Tuesday at a news conference in the sprawling retirement community of The Villages. “That does not recognize how this virus has affected elderly people.”

In New York, which began vaccinating people 75 and older and more essential workers this week, Gov. Andrew M. Cuomo said that the state will accept the new federal guidance to prioritize those 65 and older, though he criticized the administration for not clearly defining who should be considered “immunocompromised.”

The new guidance will make a total of more than 7 million New Yorkers eligible for the vaccine, Mr. Cuomo said, though the state only receives 300,000 doses a week.

“The federal government didn’t give us an additional allocation,” he said. “At 300,000 per week, how do you effectively serve 7 million people, all of whom are now eligible, without any priority?”

But earlier this week — after reports from medical providers that they had been forced to throw out doses because of difficulties finding patients who matched precisely with the state’s strict vaccination guidelines — Mr. Cuomo loosened vaccine restrictions, allowing medical providers to administer the vaccine to any of their employees who interact with the public if there are extra doses in a vial and no one from “the priority population can come in before the doses expire.” A pharmacy’s “store clerks, cashiers, stock workers and delivery staff” could qualify, the guidelines said. California last week took a similar step.

New Yorkers 65 and older are immediately able to schedule appointments on the state’s website, according to Melissa DeRosa, a top aide to the governor, who added that the state was working with the C.D.C. on who is considered immunocompromised.

In New York City, Mayor Bill de Blasio expressed concern of the possibility that there might not be enough supply of the second dose as the pool of eligibility widens.

“So long as we have the supply, we intend to keep both efforts going, first dose and second dose,” Mr. de Blasio said at a news conference on Tuesday.

Credit…Adriana Zehbrauskas for The New York Times

The Trump administration is abandoning its policy of reserving roughly half of its vaccine supply to guarantee that second doses would be available, instead opting to release all available doses in an effort to ramp up slow and complicated vaccine efforts across the country.

The announcement on Tuesday raised some concerns — including from Mayor Bill de Blasio of New York City — that the move could cause a delay in administering the required second dose for those who had already received the first shot. (New waves of manufacturing will provide enough supply for the second doses, the administration said.)

New guidelines released on Monday by the Centers for Disease Control and Prevention now note that while people should get their second shots “as close to the recommended 3-week or 1-month interval as possible,” there is “no maximum interval between the first and second doses for either vaccine.”

The update perplexed experts, who said that while other, previously licensed vaccines that involve multiple doses can be administered months or even years apart, no evidence yet exists to clearly support this strategy for Covid-19. “They will need to back this up with data,” said Marion Pepper, an immunologist at the University of Washington.

Dr. Leana Wen, an emergency physician at the George Washington School of Public Health, echoed the call for an explanation. With skepticism of vaccines already hindering the rollout of some shots, “the last thing we want to do is give the impression that there are shortcuts being taken in the approval process.”

On Tuesday afternoon, Kristen Nordlund, a spokeswoman for the C.D.C., defended the agency’s guidance as allowing “flexibility” as the vaccine rollout continues. The guidance, she said, was intended to deter people from seeking out unnecessary doses of the vaccine if they don’t get their second injections on schedule. “We are not trying to promote delays of the second dose as a strategy to get more people vaccinated with the first dose,” Ms. Nordlund said.

Health officials in Britain are now allowing intervals between the first and second doses of Pfizer’s vaccines of up to 12 weeks. Last week, the World Health Organization said the injections could be given up to six weeks apart. The agency’s Strategic Advisory Group of Experts on Immunization “considers the administration of both doses within 21 to 28 days to be necessary for optimal protection,” said Saad Omer, a vaccine expert at Yale University who helped draft the WHO’s position on the matter.

In response to queries about dose delays, representatives from Pfizer and Moderna have repeatedly pointed to the company’s clinical trials, which tested dosing regimens of two shots, separated by 21 days for Pfizer, and 28 days for Moderna.

“Two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 percent,” Steven Danehy, a spokesman for Pfizer, said earlier this month. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

Coffins holding the bodies of people killed by the coronavirus were stored in preparation for burial or incineration in an underground parking lot at a funeral home in Barcelona in April.
Credit…Samuel Aranda for The New York Times

Countries in Europe that quickly implemented stringent measures to control the spread of the new coronavirus saw lower death rates through June 2020 than those imposing such policies later, according to a new report by the Centers for Disease Control and Prevention.

The study, published on Wednesday, is the latest volley in a continuing debate among researchers and public health officials over which containment measures are effective and when should they be put in place. The question is not easy to answer: Every analysis contains assumptions, and it can be difficult to compare one state or country with another.

The C.D.C. analysis involves data from 37 countries that instituted measures like closing nonessential businesses, canceling public events, closing schools, restricting the size of gatherings and asking people to stay at home. The countries differed in how many of these measures they implemented and when.

To assess how rigorously countries attempted to control the spread of the virus, the C.D.C. researchers used the Oxford Stringency Index, which includes nine policies thought to prevent the virus’s spread. The index is weighted to account for the strictness of each policy, like closing businesses or limiting the size of gatherings.

Stringent measures prevented thousands of deaths, despite the severe costs in unemployment and social isolation, the study concluded. In 26 countries, more than 70,000 deaths might have been averted if the most stringent measures had been implemented when the pandemic began.

Most of the preventable deaths were in the United Kingdom, France and Spain.

A member of the military during a media tour of the detention center at Guantanamo Bay in 2019.
Credit…Doug Mills/The New York Times

The first 100 members of the prison staff at Guantánamo Bay, Cuba, have received initial vaccines against the coronavirus, the U.S. military disclosed Tuesday evening, declining to say whether any of the 40 wartime prisoners at the detention center were offered or received vaccines.

Capt. Garrett Kasper, a Navy spokesman at the prison, said in a statement that a shipment of Moderna vaccines arrived at the base on Friday, and 100 people assigned to the detention operation with 1,800 staff members were vaccinated the next day.

More vaccinations were scheduled to take place Wednesday morning inside a ballroom adjacent to the base’s Irish pub, O’Kelly’s, according to an announcement posted by the base’s small community hospital on Tuesday evening. Recipients were to include emergency room and urgent care workers as well as some other emergency workers described as “first responders.”

About 6,000 people live at the base but the detention center apparently received a separate supply of the vaccines for its personnel.

The military did not say whether the first 100 people to receive the vaccine included civilian workers in the prison zone, such as translators, or were given exclusively to U.S. forces, such as National Guard troops on temporary assignment as prison guards and Navy medics who care for the detainees in the cellblocks.

Captain Kasper said the prison headquarters was expected to receive a second shipment of Moderna vaccines later this week “and our medical personnel are prepared to swiftly administer the vaccines in an organized fashion.”

Both the prison spokesman and a spokesman for the U.S. Southern Command, which supervises detention operations, declined to disclose if any prison personnel were offered but refused the vaccine on Saturday. The current Pentagon policy makes vaccination voluntary because the Food and Drug Administration has only has authorized the use of the Pfizer-BioNTech and Moderna vaccines on an emergency basis.

The spokesmen also declined to say whether any of the prisoners had been vaccinated, or were offered the shots. They referred the question to the public affairs division of the Office of the Acting Secretary of Defense, Christopher C. Miller, whose spokesmen did not respond to a query on Tuesday night.

In the first months of the pandemic, Guantánamo disclosed that two service members had tested positive for the virus and were isolated. It provided no further updates on cases because the Pentagon banned base-by-base disclosures.

Most legal visits and military commission proceedings involving the prisoners — including Khalid Shaikh Mohammed and four other men accused of conspiring in the Sept. 11, 2001 attacks — have come to a standstill during the pandemic. Troop rotations have continued and some base families have traveled to and from Guantánamo on military leaves and vacations.

To control any possible spread, people arriving on the base are required to individually quarantine for two weeks before having contact with other residents. The commissary, gym, church compound, 245-pupil school system and Irish pub are all open, the last with a 50-patron limit and a requirement that waiters and waitresses wear masks.

President Donald Trump speaks near the construction of the southern border wall near Alamo, Texas, on Tuesday.
Credit…Doug Mills/The New York Times

The U.S.-Mexico border region in Texas, where President Trump traveled to on Tuesday, is struggling with a spike in coronavirus infections.

Mr. Trump was not in the state to discuss the virus, though. He was there to visit and show his support for the partially built border wall in Alamo, along the Rio Grande in southern Hidalgo County.

The county, however, was devastated by the virus last summer. Now, the border towns of Del Rio, Eagle Pass and Laredo, in other counties, are seeing major spikes as Texas nears two million total coronavirus cases, according to a New York Times database.

“South Texas has been one of the hardest hit areas of the country all year,” said Dr. Peter J. Hotez, a vaccine scientist at the National School of Tropical Medicine at Baylor College of Medicine.

The virus has disproportionately hurt Hispanic communities. “A perfect storm of tragedy” has been created by the fact that many communities in the region are made up of low-income essential workers who often do not have adequate access to health care or testing, Dr. Hotez said.

Thirty-five percent of Covid-19 deaths in the Hispanic community in Texas have been people under the age of 65, he added. “It’s really hitting mothers and fathers and brothers and sisters,” he said.

In Hidalgo County, hospitals have experienced an uptick in patients but nothing like the awful crush of infections and deaths from last summer, said Richard F. Cortez, the county’s top elected official.

“Our medical people are doing a better job of caring and managing the disease — or the disease isn’t affecting our people as severely as before,” said Mr. Cortez, 77, who caught the virus last month. He has since recovered.

Still, Mr. Cortez, a Democrat, said he would have advised the president against visiting.

“It brought people from other parts of Texas to this area, supporters that he had,” he said. “We don’t know what those people brought. We don’t know the care that they were taking. It presented some potential risk for us. What was the benefit to the general public for him to come here?”

Ambulance crews transported a patient into City Hospital in Birmingham, England, on Tuesday.
Credit…Jacob King/Press Association, via Associated Press

More people died in Britain last year than in any year in the past century, surpassing even the toll during the 1918 pandemic, the government’s statistical agency reported on Tuesday. And with around 90,000 more deaths than expected, it was the highest number of excess fatalities recorded since World War II.

But as terrible as the toll has been, officials are warning that the worst is yet to come.

As a new, more contagious variant of the coronavirus continues to tear through Britain — with an estimated one in 30 people in London currently infected — hospitals are on the verge of being overwhelmed, even as authorities struggle to convince the public of the urgency of the moment.

Prime Minister Boris Johnson — who came under criticism Tuesday for cycling seven miles from his home despite orders that people stay close to where they live — met with his cabinet on Tuesday to discuss ways to tighten what are already some of Europe’s most sweeping restrictions.

All pubs, restaurants and retail stores are already closed, school reopenings have been delayed and public gatherings are forbidden. People have been told they should leave their homes only for essential reasons like food shopping and exercise.

Police have said they have issued some 45,000 fines and will increase enforcement.

Even now, mask wearing in Britain is far from universal. It is not required outdoors and is not always enforced indoors.

“The next few weeks are going to be the worst weeks of this pandemic in terms of numbers into the N.H.S.,” England’s chief medical officer, Chris Whitty, said Monday, referring to the National Health Service.

Ambulance crews are stretched to the breaking point. Hundreds of police and firefighters have been diverted to their ranks to keep the services running.

Exhausted health care workers are struggling to cope with the surge in patients at the same time as they are being asked to help carry out the most ambitious vaccination campaign in the nation’s history.

There has been one recent encouraging sign. After rising steeply for weeks, the number of infections has begun to drop. Around 45,000 were reported on Tuesday — significantly less than the recent peak of more than 80,000.

Still, officials warned that the full effects of gatherings held around the Christmas holiday had yet to be felt, and as hospitalizations continue to rise, the crisis in the hospitals is growing more acute by the hour.

Inspecting vials containing the CoronaVac vaccine at the Butantan Institute in São Paulo. A trial conducted in Brazil found the Chinese-made vaccine had an efficacy rate of just over 50 percent.
Credit…Amanda Perobelli/Reuters

Scientists in Brazil on Tuesday provided a markedly less enthusiastic assessment of the efficacy of a Chinese coronavirus vaccine that they hailed as a major triumph last week.

Officials at the Butantan Institute in São Paulo said a trial conducted in Brazil showed that the CoronaVac vaccine, manufactured by Beijing-based Sinovac, had an efficacy rate of just over 50 percent. That rate was far lower than the 78 percent efficacy rate announced last week.

Officials have since clarified that the higher figure pertained to the protection the vaccine offered against developing symptoms of Covid-19 significant enough to require medical treatment. While officials had asserted last week that the vaccine provided absolute protection against moderate to severe symptoms, they acknowledged on Tuesday that the data underpinning that claim was not statistically significant.

The 50 percent efficacy rate is just over the threshold the World Health Organization and the Food and Drug Administration use to assess the efficacy of vaccines.

Scientists and world leaders regard CoronaVac as a potential game-changer in fighting the pandemic because it could be rapidly produced and distributed in countries in the developing world. Unlike other vaccines, it does not require storage in freezing temperatures.

Natalia Pasternak, a microbiologist and the president of Instituto Questão de Ciência, told reporters on Tuesday that the results of the trial meant it will not be a panacea.

“It is not the best vaccine in the world,” she said at the news conference during which the efficacy rate was disclosed. But she called it a “perfectly acceptable vaccine” that would reduce the number of patients who develop serious cases or die from the virus.

Brazil’s health regulatory agency, Anvisa, is reviewing data from the trial, which relied on volunteers who are health care professionals. If Anvisa approves emergency use of CoronaVac, officials hope to start giving out shots in Brazil late this month.

Dimas Covas, the director of Butantan Institute, called the vaccine an “excellent” tool “waiting to be used in a country where currently 1,000 people are dying per day.”

President Jair Bolsonaro has spoken derisively about CoronaVac, fueling an growing anti-vaccination movement in Brazil, where more than 200,000 people have died from Covid-19. The vaccine has been championed by the São Paulo governor João Doria, who is widely expected to run for president in 2022 and is among the president’s most vocal critics.

Denise Garrett, a Brazilian-American epidemiologist and vaccine expert, said there was no reason to doubt the vaccine’s safety, adding that the data presented so far suggests it will provide a satisfactory level of protection. But Dr. Garrett said the vague and at times misleading manner in which information about the vaccine has been presented to the public stands to shake people’s confidence in its reliability and fuel the political battle over the vaccine.

“The lack of transparency really damages people’s trust,” she said. “They’ve just reinforced the narrative that this vaccine is not good.”

Commuters at Shinjuku station in Tokyo last week.
Credit…Noriko Hayashi for The New York Times

Another new coronavirus variant has been detected in four people who traveled to Japan from Brazil.

Japan’s health ministry said that the people who arrived this month at Tokyo’s Haneda Airport had tested positive for the coronavirus and that it was a separate variant with similarities to those detected in Britain and South Africa. It is also distinct from another variant recently identified in Brazil, according to experts who have analyzed the data.

Makoto Shimoaraiso, an official with Japan’s Cabinet Secretariat and Office for Covid-19 Preparedness and Response, said on Tuesday that the country was consulting with the World Health Organization.

It is not unusual for viruses to accumulate mutations or for new variants to emerge. But scientists are calling for greater surveillance of variants, particularly after those from Britain and South Africa proved to be more contagious.

Mr. Shimoaraiso said epidemiologists were not sure whether the variant identified in Japan was more infectious or likely to cause more severe illness.

According to Japan’s health ministry, one of the passengers infected with the new variant, a man in his 40s, was admitted to a hospital after having breathing difficulties. Of the other cases, a woman in her 30s and a teenage boy are experiencing sore throats and fever, and a teenage girl is asymptomatic.

Dustin Johnson teeing off the 17th tee during round two at the Masters golf tournament in Augusta, Ga., in November.
Credit…Doug Mills/The New York Times

This year’s Masters tournament in April will be attended by a limited number of spectators, the Augusta National Golf Club announced Tuesday. The club, which prohibited fans from the event two months ago, did not specify how many fans would be allowed in 2021, adding that spectators would be permitted if “it can be done safely.”

The 2020 Masters was postponed from its usual April date to November because of the coronavirus pandemic and was contested with protocols that included virus testing before the event for all players, caddies, club members, staff and other personnel, including a reduced number of media members.

Fred Ridley, the club chairman, said in a statement issued Tuesday that similar health standards would be instituted for this year’s tournament, which is scheduled to be contested from April 8 to 11. The club, based in Augusta, Ga., made the announcement as the state reported 16 new coronavirus deaths and 7,957 new cases on Jan. 11. Over the past week, there has been an average of 9,604 cases per day, an increase of 55 percent from the average two weeks earlier.

“Following the successful conduct of the Masters Tournament last November with only essential personnel, we are confident in our ability to responsibly invite a limited number of patrons to Augusta National in April,” Ridley said. “As with the November Masters, we will implement practices and policies that will protect the health and safety of everyone in attendance.”

The Augusta National statement said the club was in the process of communicating with all ticket holders and that refunds will be issued to those patrons not selected to attend.

The federal prison complex in Terre Haute, Indiana.
Credit…Michael Conroy/Associated Press

A federal judge in Washington, D.C. has halted the executions of the last two men scheduled to die under the Trump administration — both of whom tested positive for the coronavirus last month — citing their risk of suffering “a sensation of drowning akin to waterboarding” with the government’s lethal injection protocol.

U.S. District Judge Tanya S. Chutkan issued a preliminary injunction until March 16, postponing any new execution dates for the two inmates — Corey Johnson and Dustin John Higgs — until well into the Biden administration. If the ruling remains in effect, the order could effectively stop their executions altogether; President-elect Joseph R. Biden has said he would work to eliminate the federal death penalty as part of his criminal justice platform.

But the government has already appealed the order, and a higher court could overturn it, as has been done in the cases of previous inmates executed under the Trump administration.

Mr. Johnson and Mr. Higgs, two men convicted of numerous federal crimes, including multiple counts of murder, contracted the coronavirus in December, amid an outbreak on federal death row in Terre Haute, Ind. At least 22 of the roughly 48 men held on death row there have tested positive, according to lawyers for the men and others with knowledge of the cases, although that number may be much higher.

Their lawyers had claimed that they would risk suffering excruciating pain from the lethal injection protocol — which uses a single drug, pentobarbital — given the complications caused by the coronavirus.

Judge Chutkan concluded that the prisoners would undergo “the effects of flash pulmonary edema one to two seconds after injection and before the pentobarbital has the opportunity to reach the brain.” The resulting sensation, caused by the rapid accumulation of fluid in the lungs, will resemble waterboarding, she added. The court order purports to give enough time for the prisoners to recover from the virus.

The judge said she was “deeply concerned” about the government’s intent to execute two prisoners who suffered from the coronavirus and underscored the dangers of conducting executions for those performing and witnessing them in a facility with an active outbreak. The Bureau of Prisons has reported 108 active coronavirus cases among inmates at the Terre Haute complex.

In statements, lawyers for Mr. Johnson and Mr. Higgs maintained that the recent spate of executions, which draws witnesses, Bureau of Prisons staff, lawyers and others to the prison complex, caused their clients’ infections. Shawn Nolan, a lawyer for Mr. Higgs, called the events “super-spreader executions” and added that Mr. Higgs continues to suffer from “debilitating symptoms.”

London last week. A coronavirus variant that emerged in Britain has been found in about 50 countries.
Credit…Andrew Testa for The New York Times

In recent weeks, scientists have raised concerns about a coronavirus variant first detected in December in South Africa, noting that this version of the virus may spread more quickly than its cousins, and perhaps be harder to quash with current vaccines.

Their worries are compounded by skyrocketing Covid-19 cases in the United States and another highly infectious new variant that is driving a surge in Britain.

Scientists still have a lot to learn about these variants, but experts are concerned enough to warn people to be extra-vigilant in masking and social distancing. Here’s what you need to know:

  • The British variant has been found in about 50 countries, including the United States, where dozens of cases have been identified. The South African variant has spread to about 10 countries but has yet to be detected in the United States.

  • Both variants carry genetic changes in the virus’s spike protein — the molecule used to unlock and enter human cells — that could make it easier to establish an infection. Researchers estimate that the British variant is about 50 percent more transmissible than its predecessors. Julian Tang, a virologist at the University of Leicester, said that researchers didn’t yet have a good estimate for how much more contagious the South African variant is.

  • There is no evidence that any of the new variants are more deadly on their own, but an uptick in the spread of any virus creates ripple effects as more people become infected and ill. That can strain already overstretched health care systems and undoubtedly lead to more deaths.

  • It is unlikely that either variant will completely evade the protective effects of the new Covid vaccines. A recent study, not yet published in a scientific journal, found that the Pfizer-BioNTech vaccine is still effective against a virus carrying a mutation common to both new variants.

    The South African variant does carry genetic changes that could make vaccines less effective: One mutation appears to make it harder for antibodies produced by the immune system to recognize the coronavirus, which means they may be less effective at stopping the variant. But it is “important to note that doesn’t mean vaccines won’t be functionally protective,” said Angela Rasmussen, a virologist affiliated with Georgetown University.

    Vaccines use multifaceted immune responses, and while some antibodies may be confused by the variant, others probably won’t be. In addition, antibodies are only one sliver of the complex cavalry of immune cells and molecules that battle infectious invaders.

    Also, if the virus accumulates more genetic changes, many of the authorized vaccines, including Pfizer’s and Moderna’s, can be adjusted fairly quickly.

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New York City to Open Mass Vaccination Site

Mayor Bill de Blasio of New York City announced on Tuesday that CitiField, the Mets’ home stadium in Queens, will be a “24/7 mega-vaccination site” starting the week of Jan. 25.

We have won the freedom to vaccinate, and we’re reaching thousands and thousands of people already — our seniors over 75 and over, our first responders, our essential workers, our teachers and school staff, we’re reaching them all, right now. We’re going to have a 24/7 mega-vaccination site at CitiField. This is going to be fantastic. This is going to help so many people to get vaccinated. Now, I want to tell you, the Mets organization has stepped up to the plate to help us out. And I am so grateful for that. I really appreciate the fact that the Mets wanted to do this. They wanted to be part of solving this problem, and helping the Queens community and helping all of New York City. So this site will be run by our city health and hospitals. They’ll — our professionals will be out there at CitiField. Tremendous capacity — we’ll be able to do between 5,000 and 7,000 vaccinations a day. And I want to be clear: We welcome Queens residents. We welcome all New Yorkers. We even welcome Yankees fans.

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Mayor Bill de Blasio of New York City announced on Tuesday that CitiField, the Mets’ home stadium in Queens, will be a “24/7 mega-vaccination site” starting the week of Jan. 25.CreditCredit…Ryan Christopher Jones for The New York Times

Mayor Bill de Blasio of New York City announced on Tuesday that CitiField, the Mets’ home stadium in Queens, will be a mass vaccination site starting the week of Jan. 25. The same day, Gov. Andrew M. Cuomo announced efforts to reopen office buildings and revive the arts scene, looking ahead even as the city rushes to meet its inoculation goals.

The vaccination site at CitiField will operate around the clock, seven days a week, with the capacity to vaccinate 5,000 to 7,000 people a day, Mr. de Blasio said. The location is ideal, the mayor said, because it is right next to a subway and railroad station and has plenty of parking.

“It’s going to be big, and it’s going to be a game changer,” Mr. de Blasio said at a news conference on Tuesday.

Not to be outdone, Yankee Stadium may soon become a second site. De Blasio spokesman Bill Neidhardt told The New York Post on Tuesday, “We confirm that we’re working with the Yankees organization to turn Yankee Stadium into a vaccination site.”

Large sports venues across the country have been used as sites for mass coronavirus testing, and more recently for vaccination, including the home stadiums of the Los Angeles Dodgers and San Diego Padres baseball teams, the Arizona Cardinals of the N.F.L. and the San Antonio Spurs of the N.B.A. Testing and vaccination efforts at Hard Rock Stadium in Miami were temporarily suspended on Monday to allow the college football championship game between Alabama and Ohio State to be played there.

The pool of people eligible for the vaccine in New York has recently expanded to include teachers and a range of other essential workers, as well as any resident who is 65 or older. At first, the vaccine was limited to frontline health care workers and nursing home residents.

The CitiField location is part of New York City’s initiative to establish mass inoculation sites in each of the city’s five boroughs. Vaccination centers opened in Manhattan, Brooklyn and the Bronx earlier this week; and a site in Staten Island will launch on Friday.

More than 26,000 vaccine doses were administered in the city on Monday, according to Mr. de Blasio, who is trying step up the pace of inoculations. The mayor has said his goal is to have one million doses administered by the end of January.

Mr. Cuomo, a third-term Democrat, said on Tuesday that the state intended to set up a series of rapid testing sites in areas where restrictions have closed indoor dining and arts events, and closed offices. Some of these sites would be located in vacant retail spaces or shuttered businesses, he said, promising hundreds of “pop-up” testing sites.

At the same time, Mr. Cuomo wants to reopen office buildings — a major element of New York City’s economy, both for their tenants and developers — saying he had received assurances from their owners that they could ramp up testing for workers. “Bringing workers back safely will boost ridership on our mass transit, bring customers back to restaurants and stores, and return life to our streets,” he said.

Mr. Cuomo also said that bringing back art and culture was crucial — not just to help artists, who have suffered some of the worst unemployment in the nation, but to keep New York City a vital, exciting center where people will want to live and work.

Mr. Cuomo said that the state would begin a public-private partnership to offer a series of statewide pop-up concerts featuring artists such as Amy Schumer, Chris Rock, Renée Fleming and Hugh Jackman; begin a pilot program exploring how socially distant performances might be held safely in flexible venues whose seating is not fixed; and work in partnership with the Mellon Foundation to distribute grants to put more than 1,000 artists back to work and provide money to community arts groups.

A coronavirus testing site in Los Angeles on Monday. The United States was one of the poorest-performing countries in a study of responses to the pandemic.
Credit…Alex Welsh for The New York Times

How well a country has responded to Covid-19 is not explained by the country’s economic power or scientific capacity, but by how its people relate to one another and their government, according to preliminary findings of a research study.

“Countries with traditions of acting in concert against social problems, and countries with histories of deference to public authorities, fared better on compliance than countries lacking either or both,” the researchers wrote.

Investigators compared characteristics of 23 countries on six continents, considering outcomes related to disease burden, economic impact and disparities. In the United States, rated as one of the poorest-performing countries, “the virus ‘exploited’ pre-existing weaknesses” in public health, the economy and politics.

Before the pandemic, numerous reports and congressional testimony “recognized vulnerabilities that became apparent during Covid-19,” another study found, including threats of viruses emerging from animals, economic disruption, inadequate stockpiles and vulnerability to global supply shortages. For that study, researchers compiled more than 1,200 pre-pandemic records in an expanding online library that was introduced on Tuesday — Health Security Net — in the hopes that it will “inform future planning and response efforts.”

Another team, studying five countries in Africa, found that national leaders there had quickly recognized the threat from the virus and imposed measures to limit its importation and spread. “That managed to at least curtail the outbreak,” said Wilmot James, a Columbia University research scholar who was one of the study’s principal investigators, “but the impacts on the economies were quite devastating.”

The Africa Centers for Disease Control and Prevention, a four-year-old institution modeled in part on its U.S. counterpart, was unique in providing technical assistance for an entire continent.

The research reports were released Tuesday in conjunction with a two-day symposium, the Futures Forum on Preparedness, supported by Schmidt Futures and the Social Science Research Council.

Thousands of Alabama fans crowded onto the streets, forming a massive crowd in Tuscaloosa after the Crimson Tide football team won the national championship game on Monday night.
Credit…Charity Rachelle for The New York Times

About 5,000 football fans packed a popular boulevard in Tuscaloosa after the University of Alabama won its 18th college football national championship on Monday night, ignoring the city’s pleas before the game to stay home and inflaming worries about an influx of coronavirus cases in a city already straining to contain the pandemic.

The scene on the street of bars and restaurants known as the Strip was precisely what health officials wanted to avoid after the Crimson Tide routed Ohio State, 52-24. Fans, many not wearing masks, could be seen bumping into one another, tossing beer bottles and reveling as if the pandemic did not exist.

Mayor Walt Maddox of Tuscaloosa said 14 people were arrested after fights broke out in the crowd.

The city reached a critical point in the pandemic, Maddox said last week, with just four intensive care unit rooms available at the city’s main hospital and a police force limited to about 69 percent because of the number of officers who had either contracted or been exposed to the virus.

The city had urged fans to not create a “block party environment” if Alabama won. Cases in Alabama had already increased 30 percent over the past week compared to two weeks ago, according to a New York Times database.

Now, health officials are preparing for a post-championship spike.

“A surge on top of a surge, like most places in the country, can have devastating consequences,” Maddox said.

Pre-kindergarten students listening as their teacher reads a story at Dawes Elementary in Chicago on Monday.
Credit…Pool photo by Ashlee Rezin Garcia

As millions are inoculated against the coronavirus, and the pandemic’s end finally seems to glimmer into view, scientists are envisioning what a post-vaccine world might look like — and what they see is comforting.

The coronavirus is here to stay, but once most adults are immune — following natural infection or vaccination — the virus will be no more of a threat than the common cold, according to a study published in the journal Science on Tuesday.

The virus is a grim menace now because it is an unfamiliar pathogen that can overwhelm the adult immune system, which has not been trained to fight it. That will no longer be the case once everyone has been exposed to either the virus or the vaccine.

Children, on the other hand, are constantly challenged by pathogens that are new to their bodies, and that is one reason they are more adept than adults at fending off the coronavirus. Eventually, the study suggests, the virus will be of concern only in children younger than 5, subjecting even them to mere sniffles — or no symptoms at all.

In other words, the coronavirus will become “endemic,” a pathogen that circulates at low levels and only rarely causes serious illness.

“The timing of how long it takes to get to this sort of endemic state depends on how quickly the disease is spreading, and how quickly vaccination is rolled out,” said Jennie Lavine, a postdoctoral fellow at Emory University in Atlanta, who led the study.

“So really, the name of the game is getting everyone exposed for the first time to the vaccine as quickly as possible.”

Global roundup

Coronavirus testing at a clinic outside Kuala Lumpur, Malaysia, on Monday.
Credit…Fazry Ismail/EPA, via Shutterstock

Malaysia’s king declared a national state of emergency on Tuesday to stem a surge in coronavirus cases, suspending Parliament, closing nonessential businesses and locking down several states and territories, including the largest city, Kuala Lumpur.

The emergency declaration could last until Aug. 1, and some critics said the main beneficiary would be the prime minister, Muhyiddin Yassin, the head of an unelected government who for months has barely maintained his hold on power.

Mr. Muhyiddin, who asked the king to issue the declaration, went on television to assert that the emergency measure was necessary to contain the virus — and that it was not about extending his political career.

“Let me assure you, the civilian government will continue to function,” he said. “The emergency proclaimed by the king is not a military coup.”

Mr. Muhyiddin promised to hold a general election after the virus was brought under control.

Malaysia was mostly successful in containing the virus for much of last year, but the number of infections began rising in October and reached a daily peak of more than 3,000 new cases on Thursday. The surge was caused in part by an election campaign in the state of Sabah and by an outbreak among migrant workers. The government reported a total of more than 141,000 cases and 559 deaths as of Tuesday.

Mr. Muhyiddin came to power in March after the previous government collapsed. He formed a new coalition and the king appointed him prime minister without a parliamentary vote. Opponents have since questioned whether he has the support of a majority of Parliament’s 222 members.

Now, the king’s declaration means that no parliamentary vote or general election can be held for more than six months, as long as the virus persists.

James Chin, professor of Asian studies at the University of Tasmania, said the declaration gave Mr. Muhyiddin extraordinary powers, including the authority to pass laws that override existing ones and to use the military for police work.

“Politically he will benefit the most from this Covid emergency,” he said. “This will give him what he wants without any scrutiny from Parliament.”

Other global developments:

  • Taiwan on Tuesday reported two locally transmitted coronavirus infections: a doctor and a nurse at a hospital in the northern part of the island that treats coronavirus patients. They are Taiwan’s first locally transmitted cases since Dec. 22, when it reported the first such case since April.

  • The European Union’s top drug regulator said it would assess the coronavirus vaccine developed by AstraZeneca and Oxford University “under an accelerated timeline,” after receiving an application for emergency authorization of the drug.

  • The leader of the German state of Bavaria has urged health care workers to do their “civic duty” by getting vaccinated, and called on the government to consider making coronavirus vaccinations for medical personnel mandatory in some cases. And about half of the staff at Charité, Germany’s largest research hospital, has refused to receive vaccine shots, according to Dr. Andrej Trampuz, a department head at the facility.

  • Because of high infection numbers, Berlin residents will be restricted from traveling more than about 9 miles outside the city, under new rules agreed to by German lawmakers. The distance of travel within Berlin is not being limited.

  • A couple who were out walking on Saturday night in Sherbrooke, Quebec, told the police that they were in compliance with a new overnight curfew because the wife was walking her crawling husband on a leash like a dog, CTV News reported. People walking their dogs are excluded from the province’s curfew, which is in effect from 8 p.m. to 5 a.m., as are essential workers and those seeking medical care. The pair were fined 1,500 Canadian dollars each. The province’s leader, François Legault, said on Monday that 740 people were fined over the weekend for violating the curfew, the first of its kind in Canada.

A coronavirus testing site in a shopping center parking lot in southern Los Angeles last week.
Credit…Philip Cheung for The New York Times

California is trying to speed up its vaccination efforts, which have lagged amid the state’s struggle with a weekslong deluge of coronavirus cases that has led to some of the most dire consequences in the country.

Emergency rooms have had to shut their doors to ambulances for hours at a time. Nearly one in 10 people has tested positive for the virus in Los Angeles County, the nation’s most populous. And a surge of hospitalizations has caused problems for the oxygen delivery and supply system used by medical facilities.

Over the past week, an average of 480 people daily have died of Covid-19 in the state, according to a New York Times database.

Gov. Gavin Newsom said on Monday that California would employ an “all-hands-on-deck approach” to ramp up vaccinations.

The approach includes transforming Dodger Stadium from one of the nation’s biggest and most visible Covid-19 testing sites into a mass vaccination center. Petco Park, where the San Diego Padres play, and the state fairgrounds in Sacramento are also being set up as vaccination sites, the governor said.

The Orange County board of supervisors said on Monday that the county’s first of five planned “super” vaccination sites would open this week at the Disneyland Resort in Anaheim, which has been closed for much of the pandemic. Vaccinations will be available by appointment to everyone in “Phase 1a,” which includes frontline health care workers, paramedics, dentists and pharmacists.

Los Angeles County opened vaccine eligibility to a wider group of health care workers on Monday, allowing workers in facilities like primary care clinics, Covid-19 testing centers, laboratories, pharmacies and dental offices, as well as those who work with people who are homeless, to be vaccinated.

Previously, workers in hospitals and long-term-care facilities were prioritized. But as The Los Angeles Times reported, large numbers of health care workers in Los Angeles and Riverside Counties were declining to be inoculated.

And relatively few people in California have gotten vaccine doses, compared with other places: Only 2 percent of the state’s population has received a vaccine, according to a New York Times database; 782,638 doses out of the more than 2.8 million that the state has received have been administered.

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Newsom Broadens Who Can Administer Vaccines

Gov. Gavin Newsom of California described an “all-hands-on-deck approach” that will allow a wider range of health care workers, including pharmacists and dentists, to administer the coronavirus vaccine.

We are sending an urgent call across the spectrum, our health care partners, our legislative partners, as well as labor and business partners up and down the state, this notion of an all-hands-on-deck approach to accelerate the equitable and safe distribution of vaccines. Again, we’re not losing sight of the issue of equity. We’re not losing sight of the imperative to prioritize the most vulnerable and the most essential. So that’s why we talk about our special efforts to vaccinate the vaccinators as part of an all hands on deck — the slide that represents the number of categories of individuals and groups that can currently vaccinate. And you can see the myriad of different registered nurses, physician assistants and the like. But we recognize more folks need to have that ability. And that’s why you recall a week or so ago, we talked about our efforts on pharmacists and pharm techs. We’re seeing more and more paramedics partnering with the counties. Local health officers are encouraging this and we are very supportive of EMTs as this local option for additional vaccinators to help administer these vaccines faster.

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Gov. Gavin Newsom of California described an “all-hands-on-deck approach” that will allow a wider range of health care workers, including pharmacists and dentists, to administer the coronavirus vaccine.CreditCredit…Alex Welsh for The New York Times

Dr. Mark Ghaly, California’s secretary of health and human services, said at a news conference on Monday that the state was working to distribute vaccines to those who need them and want them — without allowing wealthy people to cut the line.

Mr. Newsom said the state was allowing a broader range of workers to administer vaccines, including pharmacists and dentists, and was rolling out a public awareness campaign in 18 languages.

“People have said, ‘Well, what about sending in the National Guard?’” he said of the groups administering vaccines. “Well, we have the National Guard out there.”

He also said there were urgent efforts to “vaccinate the vaccinators.”

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