Gov. Andrew M. Cuomo of New York wrote the book on pandemic leadership, literally. He won an International Emmy for his TV briefings during the outbreak’s early months. Now, his self-created image as America’s Covid-19 governor may be threatened by his efforts to protect it.
Mr. Cuomo conceded on Monday that his administration’s lack of transparency about how it counted coronavirus-related deaths in the state’s nursing homes had been a mistake.
The pandemic has ravaged nursing homes across the country. But as recently as late January, New York was reporting only about 8,500 nursing-home fatalities, excluding virus-related deaths that occurred outside those facilities, such as in hospitals. Now, with those included, more than 15,000 residents of New York’s nursing homes and long-term care facilities are known to have died from Covid-19.
The spike came after the state’s attorney general, Letitia James, accused the Cuomo administration of severely undercounting deaths connected to nursing homes. The state quickly updated those numbers, adding thousands. A court order has since led to more updates and an even higher number.
Speaking Monday in the State Capitol, Mr. Cuomo made his first remarks since a top aide to the governor, Melissa DeRosa, privately told some state lawmakers last week that the state had withheld data from the Legislature. She said it had feared that the Trump administration would use the information to begin a federal investigation into the state’s handling of nursing homes.
The governor echoed Ms. DeRosa’s comments and acknowledged that by failing to answer questions from state lawmakers, the public and the news media, the state created a void that was “filled with skepticism, cynicism and conspiracy theories which furthered confusion.”
The revelation that data was withheld from lawmakers has prompted accusations of a cover-up and calls from lawmakers in both parties for the Democratic governor to be investigated and stripped of the emergency powers that he has exercised during the pandemic.
President Trump’s Justice Department never formally opened an investigation. But the episode has cast a shadow on the governor’s record on nursing homes, darkening his carefully cultivated image as a competent executive beholden to facts. In October, Mr. Cuomo published a memoir, “American Crisis,” offering “leadership lessons” from his approach to the pandemic, which has killed more than 45,000 people in New York.
The nursing-home revelations are “really potentially politically problematic” for Mr. Cuomo, who plans to run for a fourth term in 2022, said Patrick Egan, a political-science professor at New York University. But he added that if the governor successfully pushes for the vaccinations of large numbers of New Yorkers, his transgression “may be long forgotten.”
New York ranks 38th among states in vaccinating its population with at least one shot, according to a New York Times database.
The governor has been eager to expand vaccine access, most recently to millions of New Yorkers with chronic health conditions. He did so knowing that New York had already used about 85 percent of its supply.
New Yorkers lined up to receive the vaccine at sites around the city on Monday, a day after people inundated a state website and call center and found a shortage of appointments.
Last month, state officials scrambled to loosen vaccine eligibility restrictions after medical providers said they had to throw out vaccine doses because they were struggling to find patients who fit the guidelines.
Vaccination bottlenecks “could very quickly resolve themselves,” Dr. Egan said, but Mr. Cuomo’s reputation as a pandemic leader could lose its luster if investigations brought damaging revelations.
“We just don’t know if it’s going to metastasize into a bigger problem,” he said. “Are there more things that the government withheld?”
The winter storm stretching across much of the country is disrupting the distribution of coronavirus vaccines. Clinics have closed and shipments have been stalled as snow and ice grounded flights and made highways dangerously slick.
The cancellations are just the latest hurdle in the U.S. vaccine rollout, which has been accelerating despite difficulties, delays and confusion: An average of about 1.7 million people are getting a shot daily, according to a New York Times database. Several states, including New York and California, have expanded eligibility despite a limited supply.
Many of the closures and cancellations have been in the South, where the storm was particularly fierce — and where several states have lagged the national average in pace of vaccination. On Monday, vaccine appointments were rescheduled or canceled from Texas to Alabama to Kentucky.
The storm’s impact on vaccine distribution reached across the country. Health officials in Washington State, where the storm has come and gone, say they are dialing back vaccination plans later this week because they expect delays in the delivery of doses. Gov. Mike Parson of Missouri said the weather was likely to interfere with vaccine shipments to his state as well.
The interruptions appear likely to grow as the storm continues on its path. More closures are being announced. Power outages, some intentional to protect the electrical grid, have affected millions of people in Texas, Oregon, Virginia, Kentucky and elsewhere.
In Missouri, Mr. Parson said on Monday that vaccination distribution run by the state would be brought to a halt through the rest of the week.
“Missouri is experiencing severe winter weather that makes driving dangerous and threatens the health and safety of anyone exposed to the cold,” he said in a statement.
In Alabama, hospitals have closed vaccination clinics, as have more than two dozen county health departments. In New Hampshire, state officials said vaccination appointments on Tuesday would be rescheduled or canceled.
Last week, the Biden administration announced it had secured enough vaccine to inoculate every American adult, with 200 million more doses of the Pfizer and Moderna vaccines lined up by the end of summer for a total of 600 million. Both require two doses per person.
Many Americans still won’t have been vaccinated by then, President Biden said, because of logistical hurdles such as overburdened local health departments.
GLOBAL ROUNDUP
North Korea has tried to steal Covid-19 vaccine and treatment technology by attempting to hack the computer systems of international pharmaceutical companies, including Pfizer, a South Korean lawmaker said on Tuesday after a briefing by government intelligence officials.
The North, which has a decrepit public health system, claims officially to be free of Covid-19. It sealed its borders early last year.
The South Korean lawmaker, Ha Tae-keung, who is affiliated with the opposition People Power Party, spoke to reporters after he and other lawmakers were briefed by senior officials from the National Intelligence Service in a closed-door session on Tuesday.
Mr. Ha provided no further details, and the service declined to corroborate his remarks, citing a policy of not confirming information from such briefings. Pfizer did not immediately respond to a request for comment.
Western officials have long accused North Korea of stealing technology and cash from the outside world through hacking. Last week, the Reuters news agency reported that a preliminary United Nations inquiry into the theft of $281 million worth of assets from a cryptocurrency exchange last September “strongly suggests” links to North Korea.
In other developments around the world:
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Colombia, which will start vaccinations on Wednesday, is kicking off its campaign in a rural part of the country to signal that the vaccines will be available for everyone, not just those in major cities, President Iván Duque said. Colombia has had the second worst coronavirus outbreak in Latin America, and is beginning vaccinations weeks after neighboring countries like Chile and Argentina.
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A court in the Netherlands ruled that the country’s 9 p.m. curfew to curb the spread of the coronavirus must end immediately, saying there was no “special urgency” to justify it. The court called the curfew, which the government instituted without input from the Parliament, a “far-reaching violation of the right to freedom of movement and privacy.” Last month, after the curfew went into effect, violent demonstrations erupted across the country for multiple nights on end, in which people looted stores and threw rocks at the police.
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Germany plans to provide free, rapid-turnaround tests for coronavirus antigens starting on March 1, Jens Spahn, the country’s health minister, said on Twitter. They will be administered in pharmacies or test centers, he said. Currently, German health insurers pay for tests for those with symptoms or who have had contact with infected people, although rules vary across the country.
Doctors across the United States have been seeing a striking increase in the number of young people with Multisystem Inflammatory Syndrome in Children, or MIS-C. Even more worrisome, they say, is that more patients are now very sick than during the first wave of cases, which alarmed doctors and parents around the world last spring.
The reasons are unclear. The surge follows the overall spike in Covid-19 in the United States after the winter holidays, and more cases may simply mean more chances for severe disease to emerge. So far, there’s no evidence that recent coronavirus variants are responsible, and experts say it is too early to speculate about any impact of variants on the syndrome.
The condition remains rare. The latest numbers from the Centers for Disease Control and Prevention show 2,060 cases in 48 states, Puerto Rico and the District of Columbia, including 30 deaths. The median age was 9, but infants to 20-year-olds have been afflicted. The data, which is complete only through mid-December, shows the rate of cases has been increasing since mid-October.
While most young people, even those who became seriously ill, have survived and gone home relatively healthy, doctors are uncertain whether any will experience lingering heart issues or other problems.
“We really don’t know what will happen in the long term,” said Dr. Jean Ballweg, the medical director of pediatric heart transplant and advanced heart failure at Children’s Hospital & Medical Center in Omaha, which treated about two hospital cases a month from April through October, about 30 percent of them in the I.C.U. That rose to 10 cases in December and 12 in January, with 60 percent needing I.C.U. care — most requiring ventilators.
Symptoms of the syndrome can include fever, rash, red eyes or gastrointestinal problems. Those can progress to heart dysfunction, including cardiogenic shock, in which the heart cannot squeeze enough to pump blood sufficiently. Some patients develop cardiomyopathy, which stiffens the heart muscle, or abnormal rhythm.
Hospitals say most patients test positive for Covid-19 antibodies that indicate previous infection, but some patients also test positive for active coronavirus infection. Many children were previously healthy and had few or no symptoms from their initial infection. Doctors are uncertain which factors predispose children to the syndrome.
Sixty-nine percent of reported cases have affected Latino or Black young people, which experts believe stems from socioeconomic and other factors that have disproportionately exposed those communities to the virus.
But Omaha’s hospital, where early cases were largely among children of Latino parents working in the meatpacking industry, is now “seeing a much more broad spectrum and every ethnicity,” Dr. Ballweg said.
Covid-19 arrived in Cambodia a year ago, on Jan. 23, when a Chinese national flew in from Wuhan, the city where the illness was first detected, and soon fell sick with a fever. A P.C.R. test came back positive.
For Cambodia, a developing country with a rudimentary health care system and multiple direct flights from Wuhan, the new disease presented an especially high risk.
Dr. Jessica Manning, a public health researcher with the National Institute of Allergy and Infectious Diseases who had been working in Cambodia for years, also saw an opportunity: helping the country join the global effort to watch for new diseases.
In those early days of Covid-19, researchers did not know how accurate the P.C.R. tests were or whether the virus was spawning new strains with potentially different properties. The Cambodian report helped confirm the accuracy of the P.C.R. test, and it revealed that only minor changes in the sequences were appearing. The virus did not seem to be mutating substantially — an indication that the disease would be easier to test for, treat and vaccinate against.
For Dr. Manning, the exercise was proof that even a small research outpost in the developing world could successfully detect new or unexpected pathogens and glean important information about them. As such, her lab and others like it could serve as an early-warning system for the next potential pandemic.
Watching for novel pathogens in Southeast Asia has recently become an important part of the global effort to understand the pandemic. In late January, a group of researchers, most at the Pasteur Institute in Cambodia, announced that it had used metagenomic sequencing to discover a coronavirus closely related to the one that causes Covid-19 in a bat captured in Cambodia in 2010.
“This is what we were looking for, and we found it,” Dr. Veasna Duong, the leader of the study, told Nature in November. “It was exciting and surprising at the same time.”
That finding has drawn attention from researchers who want to better understand how and when viruses cross between species.
Dr. Duong is looking in particular at places where people come near fruit bats. “This kind of exposure might allow the virus to mutate, which might cause a pandemic,” he told the BBC last month.
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, has been awarded a $1 million prize from the Dan David Foundation and Tel Aviv University that is 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 the cellist Yo-Yo Ma, former Vice President Al Gore, the 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 Prizes were shared this year by the 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.
Subways in New York will soon resume running longer into the night, transit officials announced on Monday, marking a step toward the full reopening of city life.
Starting next Monday, the system will close for cleaning only from 2 a.m. to 4 a.m., instead of from 1 a.m. to 5 a.m., officials said during a news conference. They described the move as the beginning of a “phased reopening,” although they did not say when trains would again operate around the clock.
“New York is starting to return to normalcy,” said Sarah Feinberg, interim president of the New York City Transit Authority, which manages the subways.
The regular overnight closure — the first in the system’s history — began last May, as the pandemic ripped through New York. Under Gov. Andrew M. Cuomo, the Metropolitan Transportation Authority, which oversees transit in New York City, mandated the nightly closures of the famously 24-hour subway system to allow the entire system to be disinfected, a move Mr. Cuomo said was needed to reduce the spread of the virus.
The nightly cleaning of the trains will continue during the abbreviated closures, officials said.
The pandemic has decimated the finances of cities across the country and hollowed out their transit agencies — in some smaller cities, fledgling systems could be forced to shut completely. In Minneapolis, commuter rail ridership was down more than 98 percent last May compared with the previous year, according to the city’s transit agency.
On Monday, Washington’s Metrorail reduced its frequency of service for three lines during rush hour to “better match customers’ travel patterns during the pandemic” and to manage costs, the transit agency said in a statement. Its operating hours will remain unchanged, it said, though ridership on the Metrorail has declined nearly 90 percent from pre-pandemic levels.
In New York, Mr. Cuomo and other officials had previously said the subway would fully reopen only at the pandemic’s end. The phased opening appeared to signal a new approach.
In recent months, the governor has come under mounting criticism from transit activists who have argued the closure was hurting thousands of essential workers who travel at night.
About 80 percent of overnight subway riders are people of color, and a third are low-income, activists and several New York City Council members noted in a news release last week urging Mr. Cuomo to restore service.
As freezing weather has gripped the city this winter, supporters of homeless New Yorkers have also voiced concerns.
For decades, the city’s sprawling subway system has offered a shelter of last resort for thousands of homeless New Yorkers who are wary of the city’s often crowded and sometimes violent shelters.
Now, homeless people living on the streets are confronting a dangerous mix of winter weather and a lack of indoor public spaces, such as subway stations, trains and fast-food restaurants, that once offered a respite each night.
Critics of the nightly closures also have noted that scientists long ago concluded that the coronavirus spreads primarily through inhaled droplets, not via contaminated surfaces.
