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Covid-19 Live Updates: Moderna Is Working on Vaccine Booster for New Variant

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Credit…Jim Wilson/The New York Times

Moderna’s vaccine is effective against new variants of the coronavirus that have emerged in Britain and South Africa, the company announced on Monday. But it appears to be less protective against the variant discovered in South Africa, and so the company is developing a new form of the vaccine that could be used as a booster shot.

“We’re doing it today to be ahead of the curve should we need to,” Dr. Tal Zaks, Moderna’s chief medical officer, said in an interview. “I think of it as an insurance policy.”

He added, “I don’t know if we need it, and I hope we don’t.”

Moderna reported findings from a study that used blood samples from eight people who had received two doses of the vaccine, and two monkeys that had also been immunized.

The variant found in Britain had no effect on the levels of neutralizing antibodies — the type that can disable the virus — produced after vaccination. But with the form from South Africa, there was a sixfold reduction in those levels.

Even so, the company said, those antibodies “remain above levels that are expected to be protective.”

Moderna collaborated on the study with the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

The results have not yet been published or peer-reviewed, but have been submitted to bioRxiv, which posts preliminary studies online.

The company’s action is part of a race to control a shape-shifting virus that has already created global havoc and now threatens to mutate in ways that will make it even harder to fight.

In other vaccine news:

  • Australia on Monday approved the Pfizer-BioNTech vaccine for use among people 16 and older, the country’s first coronavirus vaccine approval. Vaccinations are expected to start late next month. The announcement came one year to the day after Australia reported its first coronavirus case.

  • After delays, Turkey received 6.5 million more doses of a Chinese-produced coronavirus vaccine Monday morning, the state-run news agency, Anadolu, reported. Turkey was expecting to receive at least 10 million doses of the vaccine in December, and 20 million more in January. But the batches were delayed and the number of doses remained below expectations, an apparent blow to China’s vaccine diplomacy. Turkey has given more than 1. 2 million inoculations, according to Health Ministry data, using the CoronaVac shot from the Chinese company Sinovac. Almost 2.5 million people in Turkey are infected with the coronavirus and more than 25,000 people have died, government data shows.

Livia Albeck-Ripka contributed reporting.


United States › United StatesOn Jan. 24 14-day change
New cases 129,527 –33%
New deaths 1,815 –5%

World › WorldOn Jan. 24 14-day change
New cases 449,163 –20%
New deaths 8,808 +8%

Where cases per capita are
highest

Credit…Tom Mihalek/Agence France-Presse — Getty Images

Merck announced on Monday that it was abandoning a pair of Covid-19 vaccines in clinical trials.

The news came as a disappointment at a time when the United States and other countries are struggling to accelerate their sluggish vaccination campaigns and new coronavirus variants threaten to bring surges over the next few months.

The two projects are the second and third vaccines to be abandoned in clinical trials. The University of Queensland in Australia abandoned its own effort in December. Sanofi and other vaccine makers have paused some projects after getting disappointing initial results but are now regrouping to move forward.

Merck was slower than other companies to get into the Covid-19 vaccine race. In June, it acquired the Austrian firm Themis Bioscience to develop a vaccine originally designed at Institut Pasteur, based on a weakened measles virus. Researchers began a Phase 1 trial in August. In a second effort, Merck partnered with IAVI, a nonprofit scientific organization that develops vaccines and treatments, on another vaccine. For that one, they used the same design that they successfully employed to make a vaccine for Ebola.

Merck and IAVI were awarded $38 million for their vaccine research, but neither of Merck’s projects earned the lavish support that Operation Warp Speed showered on other efforts from companies such as Moderna and Johnson & Johnson. In its announcement, Merck said that both vaccines looked safe in early clinical trials. But neither produced a strong response from the immune system. They decided that it was not worth going forward with large-scale trials that would demonstrate whether the vaccines protected people from Covid-19.

“We are grateful to our collaborators who worked with us on these vaccine candidates and to the volunteers in the trials,” Dr. Dean Y. Li, the president of Merck Research Laboratories, said in a statement.

Merck will instead focus its Covid-19 efforts on an experimental antiviral drug known as molnupiravir. Originally designed for influenza, it has shown promising effects in studies on animals and in early clinical trials. The trial is set to finish by May, although preliminary results could come out as early as March.

IAVI said it would continue searching for Covid-19 vaccines. “Our scientists will continue to evaluate other candidates to see if other routes of administration or changes to the construct could lead to improved immune response,” said Karie Youngdahl, senior director and head of global communications at IAVI.

Salisbury Cathedral, which is being used as a vaccination site in Salisbury, England. Lockdowns across Britain are expected to be prolonged.
Credit…Tom Jamieson for The New York Times

As scientists and government officials wrestle with variants of the coronavirus that were first detected in Britain and South Africa, Prime Minister Boris Johnson of Britain is expected to announce an extension and tightening of lockdown rules in England, while President Biden plans to bar travel by noncitizens into the United States from South Africa.

A White House official, citing concern over the variants, said on Sunday that the South Africa ban would go into effect on Jan. 30 and that a ban would be extended on noncitizen travelers from Europe and Brazil — the same ban that former President Donald J. Trump, on his last full day in office, tried to eliminate.

The variants are just two of several emerging across the globe that have scientists asking how well coronavirus vaccines will hold up. Studies published last week show that the variant identified in South Africa is less susceptible to the antibodies created by natural infection and by the vaccines made by Pfizer-BioNTech and Moderna, which have both been authorized for emergency use in the United States, the European Union and elsewhere. Those vaccines can be altered in a matter of weeks, but experts warn that it would be difficult to update them constantly.

The vaccines held up against the British-affiliated variant in one study. But at a news briefing in London on Friday, Mr. Johnson said that the variant was not only more contagious but may also be more deadly.

He is expected to announce that schools may stay closed until Easter, which this year falls on April 4, while travelers arriving in Britain could be required to quarantine in hotels for 10 days.

While scientists agree that the evidence of the so-called British variant’s greater lethality is preliminary, inconclusive and based on limited data, they said it nonetheless served the government’s purposes in the debate over lockdowns, in which Mr. Johnson, pulled between science and politics, has often shown an aversion to taking hard steps.

“It’s odd to be making such an announcement, which has serious implications and is clearly concerning for the general public, without having a full data set and a more thorough analysis,” said Lawrence Young, a virologist at Warwick Medical School. “I wonder whether it was about reinforcing the tough message about needing to stick to lockdown and justifying increased border controls.”

Despite signs of a slowdown in new cases, British hospitals are crushed and deaths are soaring. As of Sunday evening, almost 100,000 people in the country had died.

The Centers for Disease Control and Prevention recently warned the so-called British variant could become the dominant source of infection in the United States by March and would very likely lead to further surges in cases and deaths.

The agency announced a new policy that requires all arriving international air passengers, regardless of vaccination status, to be tested for the coronavirus within three days of their departure for the United States, and to provide written documentation of their test results or proof of having recovered from Covid-19, the disease caused by the coronavirus.

Mr. Biden, despite vowing to quickly re-engage with the world and retracting a decision by the Trump administration to withdraw from the World Health Organization, has now been forced to seal the country off from much of it.

Francisca Alves Xavier, 102, receiving China’s Sinovac vaccine in Brasília last week.
Credit…Eraldo Peres/Associated Press

China’s coronavirus vaccines were supposed to deliver a geopolitical win that showcased the country’s scientific prowess and generosity. Instead, in some places, they have set off a backlash.

Officials in Brazil and Turkey have complained that Chinese companies have been slow to ship the doses and ingredients. Disclosures about the Chinese vaccines have been spotty. The few announcements that have trickled out suggest that China’s vaccines, while considered effective, cannot stop the virus as well as those developed by Pfizer and Moderna, the American drugmakers.

In the Philippines, some lawmakers have criticized the government’s decision to purchase a vaccine made by a Chinese company called Sinovac. Officials in Malaysia and Singapore, which ordered doses from Sinovac, have had to reassure their citizens that they would approve a vaccine only if it has been proven safe and effective.

At least 19 countries, most of them low and middle income, signed deals with the Chinese vaccine companies because they offered access at a time when richer nations had claimed most of the doses made by Pfizer and Moderna. But the delays in getting the Chinese vaccines and the fact that the vaccines are less effective mean that those countries may take longer to vanquish the virus.

Beijing officials who had hoped the vaccines would burnish China’s global reputation are now on the defensive. The state news media has started a misinformation campaign against the American vaccines and promoting the Chinese vaccines as a better alternative. They have also distributed online videos that have been shared by the anti-vaccine movement in the United States.

The vaccines are also meant to prove that China has become a scientific and diplomatic powerhouse. It remains on par with the United States in the number of vaccines approved for emergency use or in late-stage trials. Sinopharm, a state-owned vaccine maker, and Sinovac have said they can produce up to a combined two billion doses this year, making them essential to the global fight against the coronavirus.

Unlike the Pfizer and Moderna vaccines, their doses can be kept at refrigerated temperatures and are more easily transported, making them appealing to the developing world.

China’s campaign has been plagued with doubts, however. A YouGov survey this month of roughly 19,000 people in 17 countries and regions showed that most were distrustful of a Covid-19 vaccine made in China. The misinformation campaign surrounding Western vaccines could further undermine its image.

President Andrés Manuel López Obrador of Mexico said he would continue to carry out his official duties.
Credit…Marco Ugarte/Associated Press

Mexico’s president, Andrés Manuel López Obrador, said Sunday that he had contracted the coronavirus and was undergoing “medical treatment” for what he described as mild symptoms.

Mr. López Obrador, writing on Twitter, said he would continue to carry out his official duties, including holding a call with President Vladimir V. Putin of Russia that is set for Monday.

“As always, I am optimistic,” he said.

The Mexican leader has consistently played down the pandemic, questioning the value of wearing masks and refusing to wear one himself in most public appearances.

On Friday, he posted a photo of himself indoors, again without a mask, conducting a call with President Biden. He was accompanied by Marcelo Ebrard, the foreign minister, and Alfonso Romo, a former top aide — and neither was wearing a mask. And on Saturday, the president met with local business leaders in Monterrey.

Hours before disclosing that he had contracted the virus, Mr. López Obrador, who flies commercial on all official trips, sat in coach on a flight from San Luís Potosí to Mexico City, according to local media reports.

As late as June, Mr. López Obrador was still sounding dismissive. He said that having a clean conscience would help fight off the virus. “No lying, no stealing, no betraying, that helps a lot to not get coronavirus,” he told reporters.

And for months, the president has repeatedly insisted that the end of the pandemic’s devastation was just around the corner.

“The worst is ending,” he said this month, as deaths surged. “We are coming out of it.”

In the spring, The New York Times reported that the Mexican government had failed to record hundreds, possibly thousands, of deaths in Mexico City, dismissing officials who had tallied more than three times as many fatalities in the capital than the government had publicly acknowledged.

Then in December, federal officials, loath to damage the economy still further, reassured the public that Mexico City had not reached the level of contagion that would require a full lockdown. In fact, the government’s own numbers showed that the capital had surpassed that threshold, an analysis by The Times found.

Some public health experts said they were little surprised that Mr. López Obrador had become infected, given his preference for going mask free, even in situations where the risk of exposure was high.

“One even expected or assumed, because of his way of exposing himself to so many people and not wearing a mask, that he would have been infected earlier,” said Carlos Magis Rodríguez, professor of medicine at the National Autonomous University in Mexico. “In all the public appearances of López Obrador, except for when he went to visit Trump, we saw him without a face mask.”

He said there was reason for concern about the prognosis for Mr. López Obrador, who is 67 and had a heart attack in 2013. “He’s at greater risk than a young person,” Dr. Magis said.

Mr. López Obrador has told reporters that he will wait to get vaccinated with the rest of his age group, most likely in mid-March.

The news came as Mexico is confronting its worst moment since the pandemic began, with deaths hitting horrific highs. On Thursday, Mexico confirmed 1,803 new coronavirus deaths, surging past the previous record of more than 1,500 set days earlier.

And while the president is already being treated, many Mexicans are struggling to get medical care. The country’s hospitals are overrun, and close to 90 percent of beds in Mexico City, the epicenter of the national outbreak, are occupied.

Mexico has intentionally kept testing low throughout the pandemic, which has obscured the true extent of the virus’s reach across the country. But it is undeniable that Mr. López Obrador has presided over one of the worst outbreaks in the world.

To date, the country has recorded more than 1.7 million coronavirus infections and nearly 150,000 deaths, the fourth-highest global death toll.

Official numbers severely underestimate the true toll of the pandemic. As of December, the country had recorded 250,000 more deaths than expected, an excess mortality rate that suggests the pandemic has been far deadlier than official numbers suggest.

Kirk Semple and Elda Cantú contributed reporting.

Dr. Anthony S. Fauci with President Donald Trump during a White House coronavirus briefing in April.
Credit…Doug Mills/The New York Times

An adviser to seven presidents and the nation’s top infectious disease expert for decades, Dr. Anthony S. Fauci has weathered many crises.

But in 2020, as one of the most familiar, trusted faces of the nation’s public health community, Dr. Fauci, 80, faced a year like no other when the coronavirus pandemic unfolded in the final months of the Trump administration amid an extremely divisive election season.

In an hourlong conversation with The New York Times over the weekend, Dr. Fauci described some of the difficulties, and the toll, of working with President Donald J. Trump.

The Chicago Teachers Union said on Sunday that its members had voted to defy an order to return to the classroom before they were vaccinated against the coronavirus.
Credit…Anthony Vazquez/Chicago Sun-Times, via Associated Press

In his first 48 hours in office, President Biden sought to project an optimistic message about returning the nation’s many homebound students to classrooms. “We can teach our children in safe schools,” he vowed in his inaugural address.

The following day, Mr. Biden signed an executive order promising to throw the strength of the federal government behind an effort to “reopen school doors as quickly as possible.”

But with about half of American students still learning virtually as the pandemic nears its first anniversary, the president’s push is far from certain to succeed. His plan is rolling out just as local battles over reopening have, if anything, become more pitched in recent weeks.

Teachers are uncertain about when they will be vaccinated. With alarming case counts across the country and new variants of the coronavirus emerging, unions are fighting efforts to return their members to crowded hallways.

The Chicago Teachers Union told members to defy orders to return to the classroom on Monday and to begin working remotely. The teachers say the district has not done enough to keep students and teachers safe during the pandemic. Students are supposed to come back to classrooms on Feb. 1.

Given the seemingly intractable health and labor challenges, some district officials have begun to say out loud what was previously unthinkable: that schools may not be operating normally for the 2021-22 school year. And some labor leaders are seeking to tamp down the expectations Mr. Biden’s words have raised.

“We don’t know whether a vaccine stops transmissibility,” said Randi Weingarten, president of the American Federation of Teachers, the nation’s second-largest teachers union.

Some virus experts, however, have said there is reason to be optimistic on this question.

Ms. Weingarten said a key to returning teachers to classrooms in the coming months would be promises to allow those with health conditions, or whose family members have compromised immune systems, to continue to work remotely; the collection of centralized data on the number of coronavirus cases in specific schools; and assurances from districts that they would shut down schools when cases occur.

Fights over those very demands have slowed and complicated reopenings across the country.

Mr. Biden’s executive order directs federal agencies to create national school reopening guidelines, to support virus contact tracing in schools and to collect data measuring the impact of the pandemic on students. The White House is also pushing a stimulus package that would provide $130 billion to schools for costs such as virus testing, upgrading ventilation systems and hiring staff members.

Research has pointed to the potential to operate schools safely before teachers and students are vaccinated, as long as practices like mask wearing are adhered to, and especially when community transmission and hospitalization rates are controlled.

A parking lot of the State Farm Stadium in Glendale, Ariz., which has been turned into a mass vaccination site.
Credit…Juan Arredondo for The New York Times

An 8-year-old girl in Missouri is getting an earful from frustrated Arizonans who are trying to get inoculated against Covid-19 and mistakenly calling her instead.

Sophia Garcia of Sullivan, Mo., who used to live in Arizona, has been receiving dozens of calls from people in the state on her hand-me-down phone, whose Phoenix number is just one digit different from the Arizona health department’s vaccine help line.

“Every five minutes my phone keeps ringing,” she told Phoenix’s CBS affiliate, KPHO/KTVK. Callers have been complaining about scheduling difficulties and asking how to book an appointment, her family said. In response, Sophia has recorded a voice mail message directing callers to the appropriate number.

Her story offers a glimpse of the struggles and at times desperation of people seeking vaccination in Arizona and elsewhere. People across the United States have complained of their second dose appointments being canceled after vaccination sites ran out of supplies. And there are concerns that President Biden’s goal of 100 million shots in 100 days may not be ambitious enough.

Arizona, which has the worst infection rate in the country, is speeding up vaccinations after a slow start, with the Department of Health Services announcing on Sunday that more than 400,000 doses had been administered. Over 61,000 people have received both doses, the health department said. A New York Times tracker monitoring the vaccine rollout in each state places Arizona in the top 20 for doses administered.

After earlier glitches and staff shortages, the state attributes the turnaround partly to round-the-clock use of the State Farm Stadium in Glendale, a suburb of Phoenix, as a site for inoculations in the past few weeks. “The success of our State Farm Stadium vaccination site has made it clear that Arizona can efficiently and effectively administer vaccine to large numbers,” Dr. Cara Christ, director of the Arizona Department of Health Services, said in a statement.

Another vaccination site at the Phoenix Municipal Stadium is set to open next week.

State officials said the federal government had denied a request for an additional 300,000 doses each week. “Now the federal government has to step up its game and provide additional vaccine to support Arizona’s proven momentum,” Dr. Christ said.

In the meantime, Arizonans who inadvertently call Sophia in Missouri will get this firm but encouraging message: “Hopefully, if you try carefully, you could get the right number.”

Members of a vaccine task force met this month in West Virginia’s command center in Charleston.
Credit…Kristian Thacker for The New York Times

Carolyn Zain had heard horror stories about the nation’s coronavirus vaccine rollout: long waits, clunky websites, people being turned away. So when her health department announced it was expanding appointments, she armed herself with two phones and held her breath.

Within 20 minutes, she secured a slot for the next day. She arrived for her 2 p.m. appointment and was resting in a chair, a fresh shot in her arm, by 2:21 p.m.

“It went wonderfully,” said Ms. Zain, 79, who, after a year spent mostly home alone, wore a sequined face mask that shimmered like confetti for her appointment at a Charleston clinic last week.

Since the United States began distributing vaccines more than a month ago, it has moved far more slowly than officials had hoped. But West Virginia has stood out for its success in getting people vaccinated. About 9 percent of all West Virginians have received a first dose of the coronavirus vaccine, a larger segment than in every state but Alaska and double the rate of some.

No state has given a larger share of its residents second doses, a crucial step to securing the best chance at immunity.

While many states are struggling to hand out the shots that the federal government has provided to them, West Virginia has given out 83 percent of its doses, by far among the highest. Many states so far have struggled to give even half of their allotted vaccines.

“West Virginia is about at the top of the charts,” said Dr. Mark McClellan, a former commissioner of the U.S. Food and Drug Administration. “We need to get more states to the point that they have the vaccination capacity of West Virginia.”

The state also provides a glimpse at a fundamental problem that looms for the country: Even the most efficient state vaccine operations do not have enough shots for all who want them.

Dr. Clay Marsh, the state coronavirus czar, estimated that West Virginia had the capacity to handle 125,000 doses a week, but was getting just 23,600.

Early on, the state got a significant head start because it initially opted out of a federal program to vaccinate people in nursing homes and other long-term care facilities.

The federal plan teamed up with Walgreens and CVS to inoculate people in nursing homes around the country, but many communities in West Virginia are far from the nearest big box store, and about half of pharmacies are independently owned.

West Virginia created a network of pharmacies in the state, pairing them with about 200 long-term care facilities. As a result, West Virginia finished its first round of vaccinations at nursing homes last month, while many states were just getting started.

Central to the state’s strategy, too, is putting the National Guard at the helm of vaccine operations.

Officials say they have also learned what not to do, including not promising shots they do not yet have. In Charleston, appointments are not made until county officials have that week’s allotment of vaccines on hand, sitting in their own freezer.

Global Roundup

Workers moving goods at warehouse in  in Changchun, China, that stores and disinfects imported cold-chain products.
Credit…CNSPHOTO, Via Reuters

An official in the northeastern Chinese city of Tonghua, where residents are barred from leaving their homes amid a strict lockdown, apologized to residents who said they had not been receiving enough food.

Tonghua, an industrial city of about two million people in Jilin Province, went into lockdown on Jan. 20 after the number of recent cases grew to nearly 100. Since then the local outbreak has been largely brought under control, with just two new symptomatic cases reported on Saturday.

As China observes the first anniversary of the lockdown in Wuhan, the central city where the virus was first discovered, other parts of the country are confronting smaller outbreaks. The government has responded with mass testing and citywide lockdowns that at one point affected more than 28 million people, almost three times the size of the population that was initially locked down in Wuhan.

On Monday, China reported 124 new cases in the previous 24 hours, including 117 local cases and seven among travelers in quarantine after returning from overseas. That is an increase from 80 cases reported a day earlier, though still vastly lower than other large countries. Mainland China, which has a population of 1.4 billion people, has recorded a total of about 100,000 coronavirus cases and 4,635 deaths, according to a New York Times database.

In Tonghua, the tough restrictions on movement have led to widespread complaints, with residents taking to social media to vent and seek help. Jiang Haiyan, a deputy mayor, acknowledged the problems on Sunday, saying that a lack of personnel had hindered the distribution of supplies.

“At present, there are problems of untimely and inadequate distribution of household materials for citizens, which has caused great inconvenience to everyone’s lives,” Ms. Jiang said.

The city’s Communist Party committee and local government “express their sincere apologies to everyone,” she added.

The city had since recruited a large number of community workers and volunteers to ensure adequate supply distribution, Ms. Jiang said.

But on the social media accounts for The People’s Daily, the Communist Party’s main newspaper, some people continued to express dissatisfaction with the situation.

“Before the residents weren’t treated humanely, they didn’t tell us anything and in one night went from house to house sealing everything up,” read one popular reply. “Now grass-roots officials and volunteers are treated inhumanely, and in one night all the food must be distributed door to door.”

Livia Albeck-Ripka, Christopher F. Schuetze, and Lin Qiqing contributed reporting.

In other developments around the world:

  • Officials in New Zealand confirmed on Monday a case of the South African variant of the coronavirus in a returned traveler a week after she left hotel quarantine. Officials have said the 56-year-old, who had tested negative twice before being allowed to return home, was probably infected by a fellow returned traveler while in quarantine. People who were at the same hotel have been urged to self-isolate immediately. It is the first case New Zealand has recorded outside quarantine since November. The government in Australia responded on Monday by suspending its travel bubble with New Zealand for at least 72 hours, saying all travelers from the country must quarantine on arrival.

  • A Berlin hospital was forced to lock down and put its entire staff in quarantine, after 20 cases of the new British variant of the coronavirus were found among patients and hospital workers. The hospital, Vivantes Humboldt-Klinikum, in the northwestern neighborhood of Reinickendorf, stopped taking new patients on Friday night and has put its entire staff — as many as 1,700 nurses, doctors, caregivers, support staff and administrators — under quarantine. Those required to come to work who do not have private means of transportation are using specially organized ride-hailing services to avoid coming into contact with the population at large.

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Video by City of New Orleans, courtesy of Crista RockCreditCredit…Crista Rock

With the snap of the snare drums, New Orleanians take joyous turns high-stepping and chicken strutting, dressed in the finery of their social clubs and krewes. The celebration, shown on a 30-second public service announcement, is one of numerous efforts around the country to persuade people to get inoculated against the coronavirus. But its homegrown approach, using neighborhood personas and invoking local Carnival culture, may make it particularly effective, say experts in vaccine hesitance and behavioral change.

“I’m getting the vaccine so we can have Mardi Gras, y’all!” shouts Jeremy Stevenson, a Monogram Hunter Mardi Gras Indian, also known as Second Chief Lil Pie, as he sways in a 12-foot tower of turquoise feathers and beading.

Other locals prance forth to offer their own reasons, concluding: “Sleeves Up, NOLA!”

“I teared up several times and also just laughed out loud with delight. The sense of community is contagious,” said Alison M. Buttenheim, the scientific director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania. “Vaccination is framed as a collective action that everyone can contribute to in order to bring back things the community values and cherishes.”

Although national vaccine hesitation rates are falling, surveys show that antipathy to the new shots is still widespread among some demographic groups. But there has been little consensus around ways to build confidence in the shot.

In November, New Orleans put together a coalition of public health doctors, clergy, leaders from Black, Latino and Vietnamese communities, and heads of the city’s large social clubs. The group identified cultural icons that would appeal widely to residents.

Rather than focusing messaging on the miseries wrought by the pandemic, it decided to emphasize an aspirational and inviting tone, a core insight derived from behavioral change research.

“I’m getting my shot so I can visit my 92-year-old mom and we can eat in our favorite restaurants,” says Julie Nalibov of the Krewe of Red Beans.

The spot will be shown on local TV stations and saturate social media. Photographs will adorn citywide billboards.

“I hope state and local health departments around the country can get resources to develop more hyperlocal campaigns,” Dr. Buttenheim said. “Imagine similar spots from Philly, or Boise, or Hawaii, or the Cherokee Nation.”

Protesters clashed with the police during a demonstration against coronavirus restrictions in Eindhoven, the Netherlands, on Sunday.
Credit…Rob Engelaar/Agence France-Presse — Getty Images

Prime Minister Mark Rutte of the Netherlands said on Monday that anyone involved in riots over the weekend protesting the country’s coronavirus measures had engaged in “criminal violence” and warned that perpetrators would be treated accordingly.

Hundreds of people were detained during unrest in Amsterdam, Eindhoven and at least eight other cities after the start of a 9 p.m. curfew on Saturday, the police said. Officers used tear gas, attack dogs and water cannons to disperse crowds in the southern city of Eindhoven, where shops were looted and cars set on fire. In Urk, a staunchly protestant fishing village young people burned down a Covid test facility.

“This has nothing to do with protest or fighting for freedom,” Mr. Rutte, told reporters on Monday. “This is criminal violence, and we will treat it as such.”

His caretaker government implemented harsh new lockdown measures last week, vetted by Parliament, to curb the spread of the coronavirus. Flights to Britain, South Africa and most of South America were halted on Saturday. It also implemented a nationwide curfew, the first since World War II.

The mayor of Eindhoven, John Jorritsma, was visibly upset when he spoke to reporters about the violence in the city. He called the rioters “scum of the earth” and said he feared the Netherlands, normally one of the quietest countries in the European Union, was “on a path of civil war.”

A spokesman for the Dutch police union said the group feared that the illegal protests and riots were just the start of the curfew-related unrest. “I hope it was a one-off, but I’m afraid it was a harbinger for the coming days and weeks,” the spokesman, Koen Simmers, said, according to the public broadcaster NOS. “We haven’t seen so much violence in 40 years,” he added.

The protesters also gathered last week in Amsterdam after calls on social media to “resist” the lockdown rules and the government’s policies overall. Mr. Rutte is one of the longest-serving European leaders. Elections in the Netherlands are scheduled for March.

Protests also erupted over the weekend in Denmark. Five people were arrested on Saturday during an anti-lockdown demonstration in Copenhagen, local news outlets reported. Around 1,000 protesters gathered to demonstrate against what they said were limitations of their freedoms, after a call for protest by a Facebook group. Protesters tied an effigy of Prime Minister Mette Frederiksen to a pole and burned it, Danish channel TV2 reported. A sign was hung around the effigy’s neck saying, “She must and should be killed.”

Outside a cafe in Kyiv, Ukraine, on Monday, the first day after lockdown restrictions were lifted.
Credit…Gleb Garanich/Reuters

Ukraine reopened schools, restaurants and movie theaters on Monday after testing showed the coronavirus was spreading less rapidly after just one week of a strict lockdown.

The health minister, Maksym Stepanov, pointed to the improving statistics as a clear indication that a strict lockdown, even if brief, can tamp down numbers. The rate of new infections declined about a third after the first seven days of closures, he said.

The cumulative number of infections nationwide last week was just over 30,000, nearly 14,000 less than the week before, Mr. Stepanov said. “The statistics are relatively optimistic and point to an improvement in the situation,” he said, local media reported.

Mr. Stepanov also pointed to a decline in hospitalizations, which typically trail infections by several weeks, suggesting that the downward trend had begun before the lockdowns and that New Year celebrations had not shifted the dynamic.

President Volodymyr Zelensky quickly imposed lockdowns last spring before easing them over the summer. The country retained a system that can close businesses in cities or regions with flare-ups.

Though the government lifted some restrictions on Monday, not all businesses can open. Nightclubs and sports stadiums remain closed. Schools are not allowed convene large gatherings of students, such as for performances or schoolwide meetings.

Ukraine, which aspires to join the European Union but is not in the bloc, has struggled to find vaccines and may not be able to inoculate its population until well into the year, forcing it to rely on quarantines, lockdowns and other restrictions until then.



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