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Racing to ramp up Covid-19 vaccinations, states have opened mass inoculation sites and expanded eligibility. But a big problem remains: The supply isn’t increasing fast enough.
The United States, facing a growing threat from more contagious and possibly deadlier virus variants, is gradually administering more doses every day, now up to an average of about 1.7 million, according to a New York Times database.
But states are also steadily widening access beyond the most vulnerable groups, frontline health care workers and nursing home staff and residents. Now, some state officials say they are ready to administer thousands more shots every day — if they can get them.
Last week, California announced that it would soon become one of just a handful of states to expand vaccine access to people of any age with underlying health issues or severe disabilities. But it has already used 72 percent of its doses and has shortages in some areas.
The mass vaccination site at Dodger Stadium shut over the weekend because Los Angeles had exhausted its supply, Mayor Eric Garcetti said. He said the city received just 16,000 doses last week — roughly a day’s worth.
“When vaccines do get to Los Angeles, we know how to administer them,” Mr. Garcetti told reporters. “We have a great infrastructure set up, of amazing people, and we will give them to folks efficiently and safely. But the problem is, we still aren’t receiving enough doses soon enough.”
Officials in Georgia say constrained supply is getting in the way of opening up eligibility. When the Atlanta Board of Education called on Gov. Brian Kemp earlier this month to start allowing teachers to be vaccinated, the governor said the state was not getting enough doses for residents who were already eligible.
Many districts around Atlanta, he said, had stopped scheduling new vaccine appointments because federal deliveries were falling so far short of the demand.
Experts say expanding eligibility requires a delicate balance of prioritizing those most at risk and ensuring no dose goes to waste.
“I don’t think anyone would want to be the person to receive the vaccine at the expense of someone else who is higher risk,” said Dr. Sarita Shah, an epidemiologist at Emory University in Atlanta.
Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said expanding lists too quickly could backfire. “People are going to be angry when they are promised a second dose and don’t get it on time,” he said.
Some experts, like Dr. Robert Murphy, the director of Northwestern’s Institute for Global Health, have called for more flexibility for places that have already vaccinated their most vulnerable residents.
“I think the dangerous thing is some places are too regimented with the current rules,” Dr. Murphy said. “If you’ve got an extra 50 vials, that’s 500 doses, and nobody is coming, and this thing is going to expire in a matter of days or weeks — give it out.”
New York State has used 90 percent of its initial doses, Gov. Andrew M. Cuomo said on Saturday, but is forging ahead to expand eligibility to anyone with underlying health issues. He, too, said his state could be vaccinating faster if it had more doses.
On Sunday, the first day that appointment sign-ups opened for New Yorkers with chronic health conditions, tens of thousands flooded websites and many were left waiting for openings.
People flying into England from South Africa, Brazil and 31 other countries deemed by Britain to be hot spots for coronavirus variants will be required starting Monday to complete a 10-day quarantine in a government-sanctioned hotel, costing nearly $2,500 for a single adult. Travelers from elsewhere are required to quarantine at home for 10 days.
Scotland is requiring all international air passengers, no matter where from, to isolate on arrival in a government-sanctioned hotel.
The compulsory quarantined hotel stays, which include meals, security guards and virus testing, bring Britain in line with similar requirements in some of the countries that have been praised for their virus response, such as Australia, New Zealand, Hong Kong and Singapore.
Britain, by contrast, has suffered one of the world’s worst coronavirus outbreaks in terms of deaths per capita. The country is under a monthslong lockdown to tame a huge surge in cases caused by a virus variant, first detected in southeastern England, which is more transmissible and potentially deadlier than others. But it has not shown the diminished response to some vaccines associated with the variants first found in South Africa and Brazil.
Britain is vaccinating rapidly, with first doses already given to more than a fifth of the population.
The new quarantine requirement applies to British citizens and residents and Irish citizens who fly into England from any of the 33 nations on the British government’s “red list” of high-risk locations, which does not include the United States. Foreign nationals from those destinations who are not residents of Britain were already barred from entering the country.
Those who fail to comply face fines of up to 10,000 pounds (about $14,000), but concerns have been raised about Britain’s ability to safely handle the influx of passengers.
Heathrow, Britain’s busiest airport, warned over the weekend that the extra checks needed at border control could create long delays. The Times of London also reported fears that a lack of protocols for limiting interaction between travelers from high-risk countries and others on planes and in some parts of airports could lead to safety compromises.
“We’ve got the right balance — robust measures, but targeted measures,” Britain’s foreign secretary, Dominic Raab, said in an interview with the broadcaster Sky News on Sunday.
KANSAS CITY, Mo. — Cold weather and the nation’s homeless crisis have long been a fatal mix that community advocates and public officials have struggled to address. But this winter, the coronavirus has added a dangerous new complication as cities and community groups wrestle with how to shelter members of a vulnerable population from the elements while not exposing them to an airborne virus that spreads most easily indoors.
The calculation has taken on greater urgency in recent days as arctic weather freezes a large swath of the middle of the country, from Minnesota to Texas, with wind chills expected to dip as low as minus 60 degrees Fahrenheit in some places.
Officials in Ramsey County, Minn., which includes St. Paul, have set up shelters in a vacant hospital and a vacant seminary dormitory so that they can better distance homeless residents from one another.
Chicago officials have used former school buildings as well as Salvation Army and Y.M.C.A. locations to give service providers more space for shelter beds.
New Life Center, a nonprofit rescue mission in Fargo, N.D., outfitted an abandoned warehouse to expand its shelter capacity.
And in Kansas City, where the forecast calls for a low of minus 14 degrees on Monday, officials have converted the downtown convention center — the size of eight football fields — into a shelter.
With public spaces like libraries and the dining rooms of many fast food restaurants closed, people experiencing homelessness have fewer places to warm up during the day or use the bathroom. Traditional shelters have had to reduce their capacity for social distancing.
Kansas City typically spends $1.5 million a year on homeless services, according to a city spokesman. But this year, with the help of federal relief funds, it plans to spend $8.5 million on programs that include paying for hotel rooms to house families and providing financial assistance to prevent evictions.
At the urging of local activists, city officials opened a temporary shelter, with a capacity of 65 people, at a community center in mid-January. The number who showed up quickly exceeded that, and city leaders had a difficult call to make.
“We made a collective decision to say, ‘Look, if any one of these people had to spend the night in the street, it’s likely a death sentence,’” said Brian Platt, the city manager. “If they come inside and there’s a possibility of spreading or catching the Covid virus, there’s a greater chance that they could live through that.”
Global Roundup
Italy reversed course on a plan to open its ski slopes, pushing back a reopening that was set for Monday back to March 5 at the earliest.
The Health Ministry announced the decision on Sunday, citing concerns about new variants. Italy closed its slopes early last year as it was fighting Europe’s first major coronavirus outbreak, and about a month ago set Feb. 15 as a reopening date.
“There are not the conditions for further relaxation of the current containment measures including those for amateur skiing,” the board of scientific advisers to the government wrote in a report on Friday, adding that the more transmissible virus variant first found in Britain now represented nearly one in five cases in Italy.
More than 10,000 new cases and 200 deaths in Italy were reported on Sunday.
In the release announcing a new decree, the government promised economic relief for the ski sector. But the government’s sudden reversal upset owners of ski facilities and local authorities in mountainous regions near Switzerland, which has had slopes open for months.
In recent days, Luca Mantovani, the chief executive of a cable car company in Vigezzo, in Italy’s northern region of Piedmont, had already dispatched snowcats to groom slopes and hired waiters and cooks.
“What am I going to tell these guys now?” he said in a telephone interview. “You can’t just change your mind 24 hours before I am supposed to open.”
On Monday, Mr. Mantovani opened the slopes anyway, defying government orders. He said his company had lost 90 percent of its revenue this year and hasn’t received any government subsidies. A decree that contained some financial relief for the sector was halted by Italy’s government crisis.
Walter Ricciardi, a scientific adviser to the health minister, argued that the country’s level of contagion was high enough to warrant not just the closing of ski slopes but a nationwide lockdown. He said that skiers in Switzerland had contributed to the spread of the British variant across Europe.
“We have known since October that ski slopes could not be reopened,” he said on television on Sunday. “Politicians are reluctant to tell the truth, which is that we will have to fight.”
In other developments around the world:
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The president of Zimbabwe, Emmerson D. Mnangagwa, said Monday that Zimbabwe would begin vaccinations this week. China donated 200,000 doses of its Sinopharm vaccine, on top of the 600,000 doses that Zimbabwe purchased.
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The government of Rwanda said Sunday that it had begun vaccinating health care workers and other high-risk groups, making it the first country in East Africa to start its inoculation campaign. Rwanda, a country of about 13 million people, has recorded more than 17,000 cases and 239 deaths, according to a New York Times database. Last week, officials eased a lockdown in the capital, Kigali, that had been imposed in mid-January amid a second wave of infections. But movement within the country is restricted and a nighttime curfew is in effect.
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Thirteen countries in the Middle East have reported cases of at least one of three new, more transmissible variants, the World Health Organization said Monday, according to The Associated Press. The situation in the Middle East remains critical, although case numbers in certain parts of the region are stabilizing, the W.H.O. said.
Back in the summer, Dr. Michael Mina made a deal with a cold storage company. With many restaurants closed, the firm had freezers to spare. And Dr. Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, had a half-million vials of human blood plasma coming to his lab from across the country, samples dating to the carefree days of January 2020.
The vials, now in three hulking freezers outside Dr. Mina’s lab, are at the center of a pilot project for what he and his collaborators call the Global Immunological Observatory. They envision an immense surveillance system that can check blood from all over the world for the presence of antibodies to hundreds of viruses at once.
That way, when the next pandemic washes over us, scientists will have detailed, real-time information on how many people have been infected and how their bodies responded.
It might even offer some early notice, like a tornado warning. Although this monitoring system will not be able to detect new viruses or variants directly, it could show when large numbers of people start acquiring immunity to a particular kind of virus.
The human immune system keeps a record of pathogens it has met before, in the form of antibodies that fight against them and then stick around for life. By testing for these antibodies, scientists can get a snapshot of which flu viruses you have had, what that rhinovirus was that breezed through you last fall, even whether you had a respiratory syncytial virus as a child.
Although the observatory would not have been able to identify the new coronavirus, it would have revealed an unusually high number of infections from the coronavirus family, which includes those that cause colds. It might also have shown that the virus was interacting with immune systems in unexpected ways, resulting in telltale markers in patients’ blood.
After a bitter fight, the Chicago Public Schools reached a deal with its teachers’ union last week to reopen elementary and middle schools amid the pandemic. By early March, students who have been learning remotely for 10 months will be back in classrooms.
The agreement speeds up vaccinations for teachers, provides expanded accommodations for educators with medically vulnerable relatives and sets virus thresholds that would trigger a return to remote learning.
With other big cities across the United States, particularly on the West Coast, locked in conflict with teachers’ unions, the deal is a potential road map for how local officials can have children return to the classrooms and help President Biden achieve his goal of reopening most schools within the first 100 days of his administration.
In an interview with The New York Times, Mayor Lori Lightfoot, a Democrat, spoke frankly about her acrimonious relationship with the Chicago Teachers Union and how she plans to rebuild trust with students’ parents. Despite campaigning to restore an elected school board, she now says that she believes reopening would not have been possible without mayoral control of schools — something that mayors in Los Angeles, San Francisco and Portland, where schools remain closed, lack.
Mayor Lightfoot said that it is “important for us to talk about what’s happened to our children during this.” Their social life, she noted, had been torn away. “Our 3-, 4-, 5-year-olds?” she said. “Their social-emotional learning is absolutely central to their growth, and yet we see them learning on screens. We know that’s not the best way for them to learn.”
Yes, I miss going out to restaurants and concerts, and traveling, but above all I miss going to a friend’s house and hanging out. I miss browsing through someone else’s cluttered bookshelf, or admiring their décor. Of all the layers of life that have been stripped away by this pandemic, the loss of casual intimacy — time with a friend that’s not masked and outdoors and crowded with worry — takes a toll.
Now that vaccines are rolling out, the prospect of a post-pandemic life has started to become worth imagining. When will we readily have house guests again without worrying about contributing to the spread of this disease? What might those visits look like?
Perhaps we will quickly return to our old habits. Or maybe a new normal will take shape, one influenced by the troubling new variants of the virus that threaten to undermine vaccination efforts.
I spoke with historians and health experts to learn when we might be able to safely spend a weekend with friends again, and what that get-together will look like.
“By the time we get into late spring, summer, I fully expect, with a large proportion of adults vaccinated, things will be dramatically better,” said Dr. Ashish K. Jha, the dean of the Brown University School of Public Health.
“We’re not done by a long shot, and if everything goes well, and I mean everything,” then we may see normalcy resume by the end of 2021, said Dr. Ingrid Katz, an assistant professor at Harvard Medical School and an infectious-disease specialist. She sees the summer as more of a test case for the fall. She anticipates that gatherings will still happen mostly outside, but masks might come down more readily.
After the 1918 influenza pandemic, Americans went shopping, traveled, and attended sporting events, movies and concerts. Christopher Nichols, an associate professor of history at Oregon State University who studies that period, anticipates that Americans could go big after this pandemic, too.
Initially, our gatherings may be about “going small,” he said — a dinner party for four, a weekend trip with your best friend. “I suspect we’ll be taking baby steps” back to a normal social life.
When the pandemic struck late last winter, it devastated a retail sector that had been battered for at least a decade. Vacancy mounted upon vacancy, bankruptcy upon bankruptcy. By May, with hundreds of thousands of people living in pajamas, staffing at clothing stores was down 40 percent from the previous year.
Yet a chicly homey stretch of stores along well-traveled Atlantic Avenue in Brooklyn has maintained the vitality of an alternate world. These shops are an unlikely bright spot in a devastating year, when as many as one-third of businesses in New York City have failed or been severely constrained.
The monuments to corporate branding — the Guccis and Pradas — that line so many of the desolate retail corridors in Manhattan are essentially absent here. In the 1980s and ’90s, this part of Atlantic Avenue was given over to modest antiques stores serving a new population of first-time homeowners restoring brownstones in Boerum Hill.
The newcomers brought with them not only money, but also the locavore values of liberal affluence.
They were happy to shop in places that distinguished their tastes as artful. “Through all of this, the neighbors have been so aware of how important it is to support us,” said Michele Varian, who moved her interior design store from SoHo to Atlantic Avenue in January 2020.
The intimacy extends, crucially, to landlords, who in several cases have held these properties for decades.
“In March I called my landlord, freaking out,” Eva Dayton told me. Ms. Dayton, who owns Consignment Brooklyn, a vintage clothing store, has had the same landlord for 17 years. “He is like my dad,” she said. “His response when I called him was ‘I am here to help you be successful.’” He forgave three months of rent.
Just before the pandemic, she had started a text group for 12 like-minded women who own stores on the block.
“We went through all of Covid together, texting each other every day about 500 things — P.P.P. loans, snow shoveling,” Ms. Dayton said. “We talk about everything. ‘You guys are having a sale? Maybe we’ll have a sale.’”
In December, the Center for an Urban Future, a policy organization, issued its 13th annual study of national retailers in New York City. It found by far the biggest overall decline in the number of chain stores; more than 1,000 of them, or approximately one out of seven, had disappeared during the preceding 12 months.
The lessons would seem obvious — that neighborhoods do best when they evolve organically in sync with the people who live in them. They cannot be manufactured as if real life were Minecraft. And in the micro sense there are hopeful signs: landlords tying rents to percent of sales, banks slowly becoming more flexible in their financing.
Dr. Anthony S. Fauci, the veteran director of the National Institute of Allergy and Infectious Diseases and the public face of the battle against the pandemic in the United States, was the recipient of a $1 million Dan David Prize, an award headquartered at Tel Aviv University and dedicated this year to outstanding contributions in public health.
The prize awards a total of $3 million a year to individuals and organizations for their achievements in three categories: expanding on knowledge of the past, enriching society in the present and promising to improve the future of the world. The theme of the prize varies from year to year. Previous laureates include cellist Yo-Yo Ma, former Vice President Al Gore, novelist Margaret Atwood and Dr. Demis Hassabis, an artificial intelligence researcher, neuroscientist and entrepreneur.
Dr. Fauci, 80, won in the “Present” category for his scientific contributions, including his research and his efforts to inform the public about the pandemic. He “leveraged his considerable communication skills to address people gripped by fear and anxiety and worked relentlessly to inform individuals in the United States and elsewhere about the public health measures essential for containing the pandemic’s spread,” the organizers of the Dan David Prize said in a statement.
It added, “He has been widely praised for his courage in speaking truth to power in a highly charged environment,” a reference to Dr. Fauci’s testy relations with former President Donald J. Trump and his supporters, who came to treat him as a villain.
The other Dan David Prize awards were shared this year by health and medicine historians Dr. Alison Bashford, Dr. Katharine Park and Dr. Keith A. Wailoo in the Past category; and Dr. Zelig Eshhar, Dr. Carl June and Dr. Steven Rosenberg, pioneers of an anti-cancer immunotherapy, in the Future category.
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