U.S. regulators could decide within weeks whether Moderna, the developer of one of two state-approved Covid-19 vaccines, can increase the number of doses in its vials – which could speed up the country’s vaccination rate.
Moderna hopes to increase the number of doses in its vials from the current 10 to 15, a potential increase of 50 percent. The proposal reflects the fact that the company has ramped up production of its vaccine to the point where the final stage of manufacture, where it is bottled, capped and labeled, has been found to be an obstacle to expanding its distribution.
If the change takes place, it could be extremely welcome news for Americans desperate to contain a pandemic that has killed more than 440,000 people in the United States. In a statement late Monday, Ray Jordan, a Moderna spokesman, said limiting the dosage per vial was limiting the production of Moderna.
The Moderna proposal is part of a broader effort by the Biden government to accelerate vaccine distribution, including removing barriers to the “fill and finish” phase of manufacturing. Although this stage of the nuts and bolts receives less attention than vaccine development, it has been identified for years as a restriction on vaccine production.
Moderna has discussed the possible change with the Food and Drug Administration but has not yet provided manufacturing data for support, according to those familiar with the discussions. Federal regulators may be receptive to the idea of more doses in each vial, but may oppose the idea of a 50 percent increase.
The industry standard has long been 10 doses per vial, and federal regulators may fear that the extra punctures of the vial’s rubber cover and the time it takes to extract more doses increases the risk of bacterial contamination of the vaccine could increase.
At some point, too much liquid can cause a vial to break. Moderna has tested what happens when additional doses are added and found that the limit is 15 people, according to people familiar with the company’s business and not allowed to speak publicly. Moderna’s proposal to the F.D.A. for the dose increase was first reported from CNBC.
Possibly packing more vaccine in each Moderna vial is one of several options the White House and health officials are considering to ramp up production before spring, when authorities anticipate a renewed spike in infections from emerging variants of the virus. Some proposals have already been considered and rejected, including a proposal to combine dose fractions remaining in vials.
The manufacturer of the other federally approved vaccine, Pfizer, cannot increase the amount of vaccine in its vials because its manufacture is geared towards a specific vial size that can only hold about six doses. However, the Moderna bottle is large enough to hold even more than the 10 doses that are now permitted.
When asked about Moderna’s proposal, a White House spokesman said Monday that “all options are on the table”.
Prashant Yadav, who studies healthcare supply chains at the Washington Center for Global Development, said Moderna could potentially make more of its vaccine “relatively quickly” if it was given the green light to add doses to each vial.
But he said it wasn’t an instant change. “I don’t think Moderna has a surplus,” he said.
Mr. Yadav said the finish-and-fill process is highly automated, dedicated to defending against contamination, and accurate to the microgram. It can fill up to 1,000 vaccine bottles per minute at top speed, he said.
He said that having a 15-dose vial involves a compromise: if healthcare professionals run out of people to get vaccinated and the rest of the doses have to be thrown away, it could lead to more wasted doses. But amid a raging pandemic, experts say, that could be a risk federal health officials would take.
In a study published online Monday, researchers found that Covid survivors had far higher levels of antibodies after both the first and second doses of the vaccine and may only need one shot.
“I think one vaccination should be enough,” said Florian Krammer, virologist at the Icahn School of Medicine on Mount Sinai and author of the study. “It would also save people from unnecessary pain when they received the second dose, and it would release additional doses of the vaccine.”
While some scientists agree with his logic, others are more cautious. E. John Wherry, director of the Institute of Immunology at the University of Pennsylvania, said before pushing for a policy change he would like to see data showing that these antibodies were able to stop the virus from replicating. “Just because an antibody binds to part of the virus doesn’t mean it will protect you from infection,” he said.
The study also found that people who had previously been infected with the virus were more likely to report fatigue, headache, chills, fever, and muscle and joint pain after the first shot than those who had never been infected.
Side effects after vaccination are fully to be expected. The clinical trials of Pfizer and Moderna’s approved vaccines, which each had more than 30,000 participants, suggest that most people experience the worst side effects after the second shock. And in the Moderna study, people who were previously infected actually had fewer side effects than those who hadn’t.
But anecdotally, researchers hear of a growing number of people who felt sick after being shot.
This is in line with what Dr. Krammer and his colleagues found in their new study, which has not yet been published in a scientific journal. The researchers rated symptoms after vaccination in 231 people, of whom 83 were previously infected and 148 were not. Both groups widely reported pain at the injection site after the first dose. But those who had previously been infected were more likely to report fatigue, headaches, and chills.
The team also looked at how the immune systems responded to the vaccine in 109 people – 68 of whom were previously uninfected and 41 – and found a more robust antibody response in the latter group. The numbers are small, however, and so the study’s conclusions need to be further explored with more research, experts said.
Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Monday that the United States’ ability to detect new, more contagious variants of coronavirus has increased ten-fold, even if those efforts are well below the levels suggested by experts stay behind required.
Speaking at a Covid-19 briefing at the White House, she said the labs wanted to sequence 7,000 samples of the virus per week, a significant increase from the week of January 10 when she said only 251 samples had been sequenced. Last week, 2,238 samples were sequenced for the virus mutations, she said.
The CDC’s system of sequencing the virus to detect mutations nicknamed “NS3” was expanded with large commercial lab partners analyzing 3,000 samples per week and committed to analyzing 6,000 per week by the middle of this month, said Dr. Walensky.
However, these numbers still seem insufficient to understand how far and quickly the variants will spread if they threaten to sweep the nation. With around one million coronavirus cases per week in the US, experts say that at least 1 percent of samples should be sequenced for variants and that 5 percent is preferable, with the 6,000 figure below what some consider to be the bare minimum .
Jeffrey D. Zients, the White House’s Covid-19 response coordinator, said last week that the country’s global position with its sequencing efforts was “totally unacceptable”.
As of Sunday, 471 cases of variants, first identified in the UK, South Africa and Brazil, had been in the US, of which 467 were found in the UK, said Dr. Walensky on Monday.
She said the increase in sequencing activity is a “good start” but “more resources and capacity are needed to increase our country’s sequencing surveillance and outbreak analysis capacity to the levels required by this crisis.”
Andy Slavitt, a White House pandemic advisor, announced at the briefing Monday that the Department of Health, Human Services and Defense had signed a $ 232 million contract with Australian company Ellume for its over-the-counter coronavirus antigen testing at home , which received emergency clearance from the Food and Drug Administration in December.
The company has ramped up production and plans to ship 100,000 test kits per month to the U.S. from February through July, Slavitt said, and could produce 19 million test kits per month by the end of the year, with 8.5 million guaranteed to go to the nation . The Department of Defense said in a press release that the deal will increase domestic production of the tests by 640,000 tests per day through December 2021.
The nasal swab test detects parts of coronavirus proteins called antigens and is slightly less sensitive than laboratory tests that look for genetic material for coronavirus using a technique called the polymerase chain reaction, or P.C.R. It takes about 15 minutes and the results are reported on a smartphone app.
The cost of the test, around $ 30 each, could still be prohibitive for some Americans who want to use it regularly, a challenge Mr. Slavitt recognized.
Dr. Marcella Nunez-Smith, Chair of the Biden government’s Covid-19 Health Justice Task Force, also spoke at the briefing, showing a table with a significant gap in the race and ethnicity data collected for previously vaccinated Americans. 47 percent of the vaccinations were missing this data as of January 30th.
“We cannot ensure a fair vaccination program without data to guide us,” she said.
She added that lack of federal coordination and uneven adoption of the vaccine, without sufficient emphasis on fair vaccination, “hurts not only our statistics, but also the communities that are most at risk and hardest hit”.
Blacks and Latinos are more likely to be affected by the virus than whites, and many color communities have hesitated or suspected of taking the vaccine amid unethical medical research in the United States. Officials have emphasized the importance of making vaccines available to underserved communities.
A fast-spreading variant of the coronavirus, first observed in the UK, has received a new mutation that could potentially make it difficult to control with vaccines, Public Health England reported Monday. It is the latest evidence that the virus is in worrying development around the world.
The variant known as B.1.1.7 was first presented in December. The researchers found that within a few months it had rapidly become more common in the UK.
Experiments in test tubes suggest that some of its mutations allow the coronavirus to hold the cells tighter.
Since B.1.1.7 was discovered in the UK, the variant has been reported in 72 other countries. The United States confirmed its first case of B.1.1.7 on December 29th. Since then, the Centers for Disease Control and Prevention has collected 467 samples of the variant in 32 states.
In its latest analysis, Public Health England estimated that the infection rate of the variant is 25 to 40 percent higher than that of other forms of the coronavirus. Some preliminary evidence suggests it can cause more deaths as well.
There are several indications that vaccines are effective against B.1.1.7. On Thursday, vaccine maker Novavax announced that its UK study had found no evidence that B.1.1.7 could escape the vaccine’s defense.
In South Africa, where a variant called B.1.351 has gained importance, the vaccines Novavax and Johnson & Johnson were less effective in studies.
This variant has been reported in 31 countries so far. In the United States, it has appeared in South Carolina and Maryland.
Whenever these variants infect a new host and multiply, there is a small chance that they will receive another mutation. Most mutations are of minor importance, but scientists feared that mutating these already dangerous variants could evolve into more terrifying forms.
Even if a mutation changes one coronavirus variant, this is no guarantee that it will have the same effect in another variant. The effect of each new mutation depends on all other mutations carried by the virus.
Public Health England said the worrying mutation known as E484K appears to have appeared more than once in the B.1.1.7 coronavirus variants in the UK. It was also discovered that two variants in Brazil independently received the same mutation.
Moderna and other companies are already preparing to develop vaccines against the E484K mutation. Kristian Andersen, a virologist at the Scripps Research Institute in La Jolla, Calif., Said that while the mutation known as E484K was not good, it was still impossible to say whether it would make these coronaviruses not only more contagious but also more resistant to vaccinations. “We have to wait for dates,” he said.
Last week, scientists checked all coronavirus genomes sequenced in the UK. They discovered 11 coronavirus variants that belong to the B.1.1.7 line and also carried the worrying mutation.
Why the E484K mutation occurs so often remains a mystery. Nicholas Davies, a math biologist at the London School of Hygiene and Tropical Medicine, said it was possible the coronavirus could evade antibodies that had arisen from previous infections from other variants. “E484K may well provide a fitness benefit in immunity environments,” he said.
However, he warned that the 11 variants of over 200,000 samples are extremely rare and that without the mutation they could actually lose to other B.1.1.7 viruses. “I think it may be worrying, but it’s hard to see from the report what it means,” he said.
A federal regulation requiring passengers and crew members to wear masks on most modes of transport in the U.S. – including planes, trains, ferries, buses, and other public transportation – goes into effect at 11:59 p.m. Monday. Eastern Time as part of the Biden government’s broader effort to stop the spread of the coronavirus.
However, the comprehensive ordinance issued by the Centers for Disease Control and Prevention can only serve as a sort of exclamation point for mask mandates that already exist in large parts of the transport sector. For example, US airlines last spring demanded that passengers wear masks in flight.
Nevertheless, in mid-January, a week before he was sworn in, the industry group Airlines for America asked President Biden for a mask mandate from the federal government. The letter found that thousands of passengers were not complying with airline regulations – they wore masks on airplanes and were therefore banned from flying by individual airlines.
A federal mandate, the group said, “would strengthen the ability of our flight crews to enforce requirements in order to achieve universal compliance.”
In the regulation of the C.D.C. It should be noted that it is often difficult to maintain social trains on trains, planes and buses. The mask mandate also applies to transport hubs such as train stations, bus stops and airports.
The Transportation Security Administration announced that its officers would be involved in carrying out the order, which could result in civil penalties if not followed. In a press release, the T.S.A. Attention was drawn to the fact that all passengers who appear to be over 2 years of age must wear a mask “throughout the security clearance process”.
As part of the airline’s security checkpoints, officials are “asked to temporarily lower their mask to verify their identity” and added, “Passengers who refuse to wear a mask are not allowed to enter the airport security area.” including the terminal and gate area. “
As a presidential candidate, Mr Biden called for a “national mask mandate” but eventually quashed the idea, which would likely have faced major legal challenges. Instead, his new administration issued a number of coronavirus-related instructions, including one requiring the wearing of masks and social distancing on all federal estates, as well as the wearing of masks by all federal employees while on the job. Various federal agencies are responsible for taking steps to enforce these requirements.
Mr Biden has also urged all Americans to wear masks in public, even if there is no mandate where they live.
New data from the Centers for Disease Control and Prevention confirm what individual reports from nursing home administrators across the country have been suggesting for weeks: a significant number of their employees reject the Covid-19 vaccine, at least when it is originally offered to them.
The C.D.C. reported Monday that among 11,460 nursing homes where CVS and Walgreens pharmacists held vaccination clinics between mid-December and mid-January, an average of 78 percent of residents were vaccinated, but only 37.5 percent of staff.
The federal government hired the two pharmacy chains to deliver shots to residents and workers in most of the country’s long-term care facilities. To date, the companies have given more than 3.1 million first doses and nearly 600,000 second doses.
Typically, they make three visits to each nursing home and assisted dormitory, and some report that employees who did not get vaccinated on the first visit agree to the second.
Vaccinating people who live and work in long-term care facilities is particularly urgent, as Covid-19-related deaths in facilities account for nearly 40 percent of the country’s pandemic deaths.
Vaccinations in the US are slowly picking up pace as the Biden government presses to speed up vaccinations and curb the spread of contagious variants of the virus.
The United States has given approximately 30 million doses and, as of Sunday, an average of more than 1.3 million doses given in the past seven days, compared to an average of less than a million a day two weeks earlier, according to a New York Times Vaccine tracker.
President Biden, under pressure to hasten coronavirus vaccinations, recently suggested that the nation could soon hit an average of 1.5 million shots a day.
But just as there are signs of progress, another problem has set in: the spread of the variants that scientists are warning of must be contained before they become dominant. Hundreds of cases of the contagious variant discovered in the UK, which experts said could be the dominant form in the United States by March, have already been confirmed.
The country has also recorded its first two cases of the rapidly spreading variant in South Africa, which has been shown to reduce the effectiveness of vaccines.
“If we didn’t have these variations, we would be in a good place,” said Dr. Peter Hotez, vaccine scientist and pediatrician at Baylor College of Medicine in Houston. If those variants get the upper hand by spring, “as many of us predict,” he said, “everything will change. Now we really need to vaccinate the American people by late spring and early summer.”
Two major challenges in the coming weeks are “increasing the vaccine supply” and “reducing the time it takes to administer them,” said Andy Slavitt, White House adviser, in a news conference on Friday. Many experts have pushed for other vaccine options to be launched and the first doses to be continued.
The Most Effective Government Programs, said Dr. Ashish Jha, the Dean of Brown University School of Public Health, are “very simple, age-dependent, not many complex rules. They focus on getting the vaccines out. “
Here is a snapshot of how five of the best performing states are doing:
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West Virginia has given at least one dose to 10.7 percent of its population, the second largest after Alaska, and leads the nation for the percentage of its population that received two doses (3.7 percent). The state got a head start early on by deregistering from a federal program to vaccinate people in nursing homes and other long-term care facilities. While other states chose the federal plan that worked with Walgreens and CVS, officials decided the idea made little sense in West Virginia, where many communities are miles from the nearest chain store and about half of the pharmacies are independently owned. Instead, the state created a network of pharmacies that were combined with about 200 long-term care facilities.
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According to health officials in AlaskaAccording to The Anchorage Daily News, there are several reasons for the state’s relatively high vaccination rate. These factors include: The state has received large numbers of doses through the Indian Health Service. the decision to be dosed monthly or weekly, as most states do; and declining virus case numbers, which has allowed health care workers to focus on vaccinations. According to a Times database, the state has vaccinated 13 percent of its population.
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North Dakota According to the Times’ vaccine tracker, 91 percent of vaccines distributed to the state were used. It is the only state over 90 percent; more populous states like California (58 percent) and New York (64 percent) have consumed proportionally less. North Dakota was among the first states to lower the minimum vaccination age from 75 to 65.
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In a recent interview with the American Medical Association, health officials asked in New Mexico attributed part of the state’s success to its “data-driven and science-driven” Governor Michelle Lujan Grisham and an app that enabled easy registration and close coordination between hospitals and providers. The state gave at least one shot to 9.8 percent of residents and used 83 percent of its cans.
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Connecticut put mass injection sites up and running early and uses an inventory system that assigns unused cans to the places they need. However, older residents have complained of long waiting times.
Transcript
Transcript
N.Y.C. Snow storm delays vaccinations
On Monday, New York City Mayor Bill de Blasio postponed coronavirus vaccinations to prevent elderly residents from traveling to appointments in blizzard-like conditions.
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The storm is disrupting our vaccination efforts and we need to keep people safe. We don’t want people, especially seniors, who go out in unsafe conditions to be vaccinated. We know that we can reschedule appointments very quickly because of course we have supplies. We will take advantage of the offer that we have. Our problem is insufficient supply. In this way we can take up the stock we have very quickly in the coming days and make sure that everyone gets the dates. But it’s not safe outside today. Therefore, vaccinations are canceled today. They will also be canceled tomorrow. Based on what we are currently seeing, we believe that tomorrow it will be difficult to find your way around the city, it will be icy, it will be treacherous. We don’t want seniors to be outside in these conditions. So we will have vaccinations today and tomorrow and be strong again on Wednesday. We will be able to catch up quickly because we have enormous capacity again. We don’t have enough vaccine. So we just use the days later in the week. Raise these schedules and get people into these days.
With snow continuing into the evening and a winter storm warning extended into early Tuesday, New York officials said Monday that coronavirus vaccinations scheduled for Tuesday at government-run locations would be extended by a second day Episode would be postponed.
Heavy snowfall also hampered vaccination efforts in Washington, Philadelphia, New Jersey and elsewhere. New Jersey planned to close six state vaccination centers on Tuesday.
Speaking at a press conference Monday, New York City Mayor Bill de Blasio said he did not want elderly residents traveling in slippery conditions with gusty winds to get vaccinations on slippery streets and sidewalks.
“Based on what we are seeing now, we believe that tomorrow it will be difficult to find your way around the city,” said de Blasio. “It will be icy, it will be tricky.”
He said he believed the city could make up for the appointments later in the week.
“We have an enormous capacity. We don’t have enough vaccine, ”he said. “We’re just going to use the days later in the week, turn up those schedules, and move people into those days.”
The delays caused by the storm were another problem with vaccine rollouts, plagued by inadequate supplies, faulty registration systems, and confusion over New York state’s strict licensing policies. The vaccine is available to residents aged 65 and over and a large number of workers classified as “essential”.
By Monday, around 800,000 doses had been administered in the city, said de Blasio.
In a similar move, Governor Andrew M. Cuomo’s office announced later Monday that several state vaccination sites were in and around the city – including the Jacob K. Javits Convention Center in Manhattan; Aqueduct Racetrack in Queens; Jones Beach and Stony Brook University on Long Island; and the Westchester County Center in White Plains – would be closed for a second straight day on Tuesday.
Mr Cuomo said at a news conference Monday that New York’s average positive test rate was 4.8 percent for seven days, the 24th straight day it had declined. He added that the state had given about 1.96 million doses of the vaccine.
Urban testing and vaccination sites in the Philadelphia area were closed on Monday. Connecticut, New Jersey, Rhode Island, and parts of the Washington area followed suit. Some areas outside of the center of the storm were expected to remain open for vaccination, including parts of Massachusetts and New York state.
GLOBAL ROUNDUP
Eine Million Dosen des Oxford-AstraZeneca-Coronavirus-Impfstoffs kamen am Montag in Südafrika an und ebneten dem Land den Weg für die Impfung seiner fast 60 Millionen Einwohner. Gesundheitspersonal wird das erste sein, dem die Schüsse angeboten werden, sagten Beamte.
Das Land hat bei weitem die meisten Fälle und Todesfälle durch das Coronavirus auf dem afrikanischen Kontinent gemeldet. Es hat an klinischen Studien mit mehreren Impfstoffen teilgenommen.
Das Flugzeug, das die mit Spannung erwarteten Dosen vom Serum Institute of India lieferte, das sie produzierte, wurde am OR Tambo International Airport in Johannesburg von Präsident Cyril Ramaphosa abgeholt. Der Präsident ist in die Kritik geraten, dass das Land mit der weit verbreiteten Impfung nur schleppend begonnen hat. Viele Länder in Asien und im Westen können Wochen vor der Sicherung der Impfstoffversorgung durch Südafrika mit der Immunisierung ihrer Bevölkerung beginnen.
Gesundheitsbeamte sagten, dass es bis zu zwei weitere Wochen dauern könnte, bis das Land mit der umfassenden Verabreichung der am Montag eingetroffenen Dosen beginnt.
Südafrika erlebte um den Jahreswechsel einen Anstieg neuer Fälle, der durch eine übertragbarere Variante des Virus ausgelöst wurde, das erstmals im Land entdeckt wurde. Aber der Anstieg hat in den letzten Wochen begonnen, nachzulassen. Es wurden noch keine Informationen über die Wirksamkeit des AstraZeneca-Impfstoffs gegen die derzeit im Land vorherrschende Variante veröffentlicht.
Im Verlauf der Pandemie hat Südafrika laut einer Datenbank der New York Times etwa 1,45 Millionen Fälle gemeldet und in letzter Zeit durchschnittlich 5.800 neue Fälle pro Tag gemeldet.
In anderen Entwicklungen auf der ganzen Welt:
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Die palästinensischen Gebiete erhielt am Montag 2.000 Dosen des Coronavirus-Impfstoffs, die erste größere Lieferung von voraussichtlich 5.000 Dosen aus Israel, berichtete die Jerusalem Post. Eine Lieferung von 100 Dosen wurde vor zwei Wochen als einmalige humanitäre Geste aus Israel in das Westjordanland und in den Gazastreifen geschickt, sagte ein israelischer Beamter gegenüber dem Wall Street Journal. Palästinensische Beamte teilten der New York Times Anfang letzten Monats mit, dass sie Israel um 10.000 Dosen gebeten hätten, Israel dies jedoch abgelehnt habe. Die Vereinten Nationen haben Israel aufgefordert, den Palästinensern den gleichen Zugang zum Impfstoff zu gewähren.
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Um die Ursprünge der Pandemie besser zu verstehen, besucht ein Team von 15 Experten der Weltgesundheitsorganisation einige der Orte, die zuerst vom Coronavirus in der Pandemie betroffen sind Chinesische Stadt Wuhan, einschließlich eines Marktes für lebende Tiere, eines Krankenhauses und eines Krankheitskontrollzentrums. Die Anfrage wird voraussichtlich Monate dauern. Wissenschaftler glaubten zunächst, dass der Ausbruch auf dem Huanan Seafood Wholesale Market in Wuhan begann, aber viele Experten bezweifeln diese Theorie jetzt.
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Nach der Einführung einer harten Sperre im Dezember haben die Gesundheitsbeamten in Dänemark Reuters berichtete am Montag, dass die Schulen des Landes am kommenden Montag für Schüler der ersten bis vierten Klasse geöffnet werden.
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The Europäische Union will get 75 million additional doses of vaccine in the next few months, the German pharmaceutical company BioNTech announced on Monday. The vaccine jointly developed by the company and Pfizer was the first to be authorized for use in the E.U., but supplies have been limited by production issues in the early going, and several countries, including Germany, are off to slower than expected starts in vaccinating their populations.
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The police in China said they had broken up a criminal ring that manufactured and sold more than 3,000 fake coronavirus vaccine doses, Xinhua, the state-run news agency, reported on Monday. More than 80 people were arrested, the agency said. According to Xinhua, the police said that since September, the main suspect had been selling vials of “vaccine” that was really just saline solution.
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Officials in Spain’s Madrid region said they would loosen coronavirus restrictions this week, allowing groups of six to gather for outdoor dining, up from four, Reuters reported. A 10 p.m. curfew may be extended to midnight.
PARIS — Public frustration with lockdowns is palpable across Europe, with retirees protesting this weekend in Vienna, restaurateurs taking to the streets in Budapest and demonstrators clashing with the police in Belgium, prompting dozens of arrests. The Dutch authorities fined more than 10,000 people last week for violating the national curfew.
While none of the protests resulted in the kind of violence seen in the Netherlands in recent weeks, they reflect a growing impatience as political leaders extend restrictions to guard against a resurgence of the virus fueled by new variants.
In France, President Emmanuel Macron has resisted a full lockdown, making a calculated gamble that his government can tighten the rules just enough to avoid a new wave of infections.
Prime Minister Jean Castex appeared in front of television cameras for an unexpected statement on Friday night, announcing a handful of new curbs, including strict border closures.
“Even if the path is very narrow, we must take it,” Mr. Macron was reported to have said at a cabinet meeting last week, according to The Journal du Dimanche, pushing back against the advice of several senior aides. According to the newspaper, he added: “When you are French, you have all you need to get by, as long as you dare to try.”
Polls in France have shown weariness with restrictions, and grumbling about the rules is growing in some quarters.
France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed. Schools and shops are open.
After a widely publicized breach of the rules at a restaurant in the southern city of Nice last week and a call to “civil disobedience” by some restaurant owners, the French economy minister, Bruno Le Maire, warned on Monday that any establishments that flouted the rules would be cut off from coronavirus aid.
In the French Alps, protesters blocked roads on Monday to demand that ski lifts reopen.
Critics say that Mr. Macron’s approach may simply be delaying the inevitable and that he could be forced to change course if cases started to surge.
“It’s a risk, I’m hoping it was a calculated risk,” Karine Lacombe, an infectious-disease specialist, told the French news channel LCI on Sunday.
Mr. Macron’s plan is rooted partly in the relative stability of the pandemic in France. The number of new daily cases has inched up only slowly and while hospitalizations remain high, there has been no sudden surge. More contagious variants of the virus have been registered in the country, but the authorities say they believe that their spread, so far, is under control.
“Everything suggests that a new wave could occur because of the variant,” Olivier Véran, the French health minister, told The Journal du Dimanche. “But perhaps we can avoid it thanks to the measures that we decided early and that the French people are respecting.”
Aurelien Breeden reported from Paris, and Marc Santora from London.
Mayor Lori Lightfoot of Chicago and the city’s teachers’ union declared a 48-hour “cooling off period” Monday evening in what has been a tense confrontation over the city’s plan to reopen school buildings.
The city had planned to welcome thousands of students from kindergarten through eighth grade back to classrooms on Monday for the first time since March. But the union opposes the plan as unsafe and had instructed its members to refuse to report to work in person until the union’s concerns were addressed.
On Sunday night, with the district and union still at an impasse, the district postponed the start of in-person instruction for those students by a day. Still, the mayor said that teachers were expected to report to school buildings and warned that those who did not would be locked out of the district’s virtual teaching system and stop being paid until they came to work in person. The union, for its part, had threatened that retaliation against teachers for staying home would trigger a strike.
But on Monday, the two sides de-escalated. The mayor and the chief executive of the school system, Janice K. Jackson, said in a statement that the sides had made “substantial progress” in talks and were now “calling for a 48-hour cooling off period that will hopefully lead to a final resolution on all open issues.”
As a result of the progress, they said, and “as a gesture of good faith,” teachers would for now retain access to the virtual teaching systems. In the meantime, all students would continue learning remotely through Wednesday.
The union’s president, Jesse Sharkey, called the district’s decision to continue negotiating “heartening.”
The fight in Chicago, the nation’s third-largest school district, has been one of the most intense battles over school reopening anywhere in the United States. The majority of the district’s mostly Black and Hispanic families have chosen to keep their children learning virtually for now, while white parents have mostly opted to send their children back at high rates, a fact the union has cited in arguing that reopening does not serve the interest of the city’s most disadvantaged students.
Gov. Pete Ricketts of Nebraska will complete a seven-day quarantine after he was in “close contact” with a person who has since tested positive for the coronavirus, his office said on Monday.
The exposure, which was “work-related,” occurred on Saturday, according to a statement from his office; Mr. Ricketts had not shown any symptoms.
Mr. Ricketts “will get tested at the appropriate time,” the statement said. It was not immediately clear when he began to quarantine and when he will be tested. A spokesman for Mr. Ricketts did not specify, but referred to the statement released by his office.
The Centers for Disease Control recommends that a person who has been exposed should ideally get tested five to six days after a potential exposure to give the virus the opportunity to build up to detectable levels in the body.
C.D.C. guidelines also include recommendations that people should quarantine for at least seven days after a possible exposure and receive a negative test result before returning to normal activity.
“It really is a good reminder for all of us, that we want to make sure that we’re taking all the steps we can to slow down the spread of the virus,” Mr. Ricketts said at a news conference, speaking from a video screen. He urged people to continue wearing masks and practicing social distancing even though hospitalizations and positivity rates in Nebraska have dropped.
Mr. Ricketts has been outspoken about his opposition to mask mandates in the past. In July he threatened to withhold $100 million in federal relief funds to municipalities that mandated mask wearing in government offices. In November, a video spread on social media that appeared to show him taking pictures with people in a restaurant while not wearing a mask.
This is the second time Mr. Ricketts has quarantined after possible exposure.
Mr. Ricketts joins other governors who have quarantined after possible exposure, including Gov. Gavin Newsom of California, who quarantined twice last year. Others, including Gov. Tom Wolf of Pennsylvania and Gov. Henry McMaster of South Carolina, have tested positive, part of a fast-growing list of federal and local officials. Governors Kevin Stitt of Oklahoma, Mike Parson of Missouri and Ralph Northam of Virginia also tested positive last year.
The past few weeks in the United States have been the deadliest of the coronavirus pandemic, and residents in a majority of counties remain at an extremely high risk of contracting the virus. At the same time, transmission seems to be slowing throughout the country, with the number of new average cases 40 percent lower on Jan. 29 than at the U.S. peak three weeks earlier.
Other indicators reinforce the current downward trend in cases. Hospitalizations are down significantly from record highs in early January. The number of tests per day has also decreased, which can obscure the virus’s true toll, but the positivity rate of those tests has also gone down, indicating that the slowed spread is real.
Still, the average reported daily death rate over the past seven days remains above 3,000, compared with less than 1,000 per day in September and October.
Experts say the decrease could mark a turning point in the outbreak after months of ever-higher caseloads. But new, more contagious variants threaten to upend progress and could even send case rates to a new high if they take hold, especially if the national vaccine rollout faces hurdles.
A coalition of 10 Republican senators took a stimulus counterproposal to the White House on Monday evening, urging President Biden to scale back his ambitions for a sweeping $1.9 trillion pandemic aid package in favor of a plan less than one-third the size that they argued could garner the bipartisan consensus the new president has said he is seeking.
After a two-hour closed-door meeting, Senator Susan Collins of Maine, the leader of the Republican group, said the discussion had been excellent, though “I wouldn’t say that we came together on a package tonight.” She said Mr. Biden and the senators had agreed to continue their talks.
The discussions took place as Democrats prepared to push forward on Mr. Biden’s plan with or without Republican backing, and as the president faced a test of whether he would opt to pursue a scaled-back measure that could fulfill his pledge to foster broad compromise, or use his majority in Congress to reach for a more robust relief effort enacted over stiff Republican opposition.
At the end of a lengthy statement hailing a “substantive and productive” meeting, Jen Psaki, the White House press secretary, indicated that the president would not be giving much ground.
Mr. Biden reiterated, she said, “that he will not slow down work on this urgent crisis response, and will not settle for a package that fails to meet the moment.”
Still, the president appeared eager to signal an openness to negotiating, telling Ms. Collins that he was “anxious” to hear what the senators had to say as they chatted in the Oval Office before the beginning of what both sides described as a cordial and productive session.
“All of us are concerned about struggling families, teetering small businesses, an overwhelmed health care system, getting vaccines out and into people’s arms, and strengthening our economy and addressing the public health crisis that we face,” Ms. Collins said.
There was scant evidence, for now, that any Democrats were seriously considering embracing a proposal as limited as the one the Republicans have laid out. And the Republicans, too, were facing a test of whether they could hold together and forge a compromise that would ultimately be seen as a sufficient response to the public health and economic toll of the pandemic.
The Republicans’ $618 billion proposal would include many of the same elements as Mr. Biden’s plan, with $160 billion for vaccine distribution and development, coronavirus testing and the production of personal protective equipment; $20 billion to help schools reopen; more relief for small businesses; and additional aid to individuals. But it differs in ways large and small, omitting a federal minimum wage increase or direct aid to states and cities.
It would slash the direct payments to Americans, providing $1,000 instead of $1,400 and limiting them to the lowest income earners, excluding individuals who earned more than $50,000. It would also pare back federal jobless aid, which is set to lapse in March, setting weekly payments at $300 through June instead of $400 through September.
This groundhog day won’t be like the others at all.
As early as 1900, the New York Times traditionally referred to this annual “superstition”.
Like clockwork, the event draws the curious and worldwide attention. Will a fat marmot named Punxsutawney Phil see his shadow? The feeling that this could never change was hastened by a popular 1993 film starring Bill Murray as the weather man “inexplicably living the same day over and over” when talking about the annual festival in Punxsutawney, a bucolic neighborhood to the west of Pennsylvania, about 300, reported miles west of midtown Manhattan.
Change is not easy in this part of the world. Until the coronavirus pandemic.
The event will proceed on Tuesday in Punxsatawney, but it will be held virtually. The event’s organizers, the Punxsutawney Groundhog Club, said in a recorded message that “no personal participation or guests are allowed on-site”.
As for the massive snowstorm burying parts of the Northeast, organizers are, for now, forging ahead. Gobbler’s Knob, the groundhog’s home turf, will be closed on Monday at 5 p.m. but will reopen on Tuesday at 9 a.m. The live stream starts at 6:30 a.m. that day.
That dispatch was, itself, a hybrid of modernity and antiquity. Es wurde auf Instagram gepostet. But the words were printed on a sign, held by a man.
The scattered reports from around the country can play like a cruel irony: Someone tests positive for the coronavirus even though they have already received one or both doses of a Covid-19 vaccine.
Notable examples
It’s happened to at least three members of Congress recently:
But it’s been reported in people in other walks of life too, including Rick Pitino, a Hall of Fame basketball coach, and a nurse in California.
How can that happen?
Experts say cases like these are not surprising and do not indicate that there was something wrong with the vaccines or how they were administered. Here is why.
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Vaccines don’t work instantly. It takes a few weeks for the body to build up immunity after receiving a dose. And the vaccines now in use in the U.S., from Pfizer-BioNTech and Moderna, both require a second shot a few weeks after the first to reach full effectiveness.
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Nor do they work retroactively. You can already be infected and not know it when you get the vaccine — even if you recently tested negative. That infection can continue to develop after you get the shot but before its protection fully takes hold, and then show up in a positive test result.
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The vaccines prevent illness, but maybe not infection. Covid vaccines are being authorized based on how well they keep you from getting sick, needing hospitalization and dying. Scientists don’t know yet how effective the vaccines are at preventing the coronavirus from infecting you to begin with, or at keeping you from passing it on to others. (That’s why vaccinated people should keep wearing masks and maintaining social distance.)
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Even the best vaccines aren’t perfect. The efficacy rates for Pfizer-BioNTech and Moderna vaccines are extremely high, but they are not 100 percent. With the virus still spreading out of control in the U.S., some of the millions of recently vaccinated people were bound to get infected in any case.
