The drugmaker AstraZeneca announced on Monday that an early analysis of some of its late-stage clinical trials, conducted in the United Kingdom and Brazil, showed that its coronavirus vaccine was 70.4 percent effective in preventing Covid-19, suggesting that the world could eventually have at least three working vaccines — and more supply — to help curb the pandemic.
The British-Swedish company, which has been developing the vaccine with the University of Oxford, became the third major vaccine developer in this month to announce encouraging early results, following Pfizer and Moderna, which both said that their vaccines were about 95 percent effective in late-stage studies.
AstraZeneca’s results are a reassuring sign of the safety of the vaccine. It came under global scrutiny after AstraZeneca temporarily paused its trials in September to investigate potential safety issues after a participant in Britain developed a neurological illness.
Oxford and AstraZeneca said they would submit their data to regulators in Britain, Europe and Brazil and seek emergency authorization.
The company said its early analysis was based on 131 coronavirus cases. The trials used two different dosing regimens, one of which was 90 percent effective in preventing Covid-19 and the other of which was 62 percent effective.
The regimen that was 90 percent effective involved using a halved first dose and a standard second dose. Oxford and AstraZeneca also said that there were no hospitalized or severe cases of the coronavirus in anyone who received the vaccine, and that they had seen a reduction in asymptomatic infections, suggesting that the vaccine could reduce transmission.
AstraZeneca’s vaccine is expected to come with relatively simple storage requirements, which would be an asset once it gets rolled out. The company has said it anticipates the vaccine will require refrigeration, though it has not provided details about how long and at what temperature it can be kept. Moderna’s vaccine can be kept for up to a month at the temperature of an ordinary refrigerator. Pfizer’s can be kept for up to 5 days in conventional refrigerators, or in special coolers for up to 15 days, but otherwise needs ultracold storage.
AstraZeneca has said it aims to bring data from its studies of its vaccine being conducted overseas to the Food and Drug Administration — which would mean that the agency will likely review and authorize a vaccine before late-stage data are ready on how well the vaccine works in American participants. British regulators already have been conducting a so-called rolling review of the vaccine.
“Today marks an important milestone in our fight against the pandemic,” AstraZeneca’s chief executive, Pascal Soriot, said. “This vaccine’s efficacy and safety confirm that it will be highly effective against Covid-19 and will have an immediate impact on this public health emergency.”
Professor Andrew Pollard, the chief investigator of the Oxford Vaccine Trial, said that “these findings show that we have an effective vaccine that will save many lives.”
In the wake of results suggesting that two prospective coronavirus vaccines are remarkably effective, the official in charge of the federal coronavirus vaccine program explained on Sunday news shows how the vaccines might be distributed to Americans as early as next month.
Dr. Moncef Slaoui, head of the administration’s Operation Warp Speed, said that within 24 hours after the Food and Drug Administration approves a vaccine, doses will be shipped to states to be distributed. “Within 48 hours from approval,” the first people would likely receive injections, Dr. Slaoui said on ABC’s “This Week With George Stephanopoulos.”
Two companies, Pfizer and Moderna, announced this month that their vaccines were about 95 percent effective, and Pfizer formally submitted an application to the F.D.A. for emergency approval. Regulators at the agency will spend about three weeks reviewing the application. On Dec. 10, an outside advisory board on vaccines will meet to discuss the application, and the agency is expected to make a decision shortly after that meeting. Moderna is expected to submit its own application soon.
Even if the first vaccine is authorized in mid-December, officials and company representatives have estimated that there will only be enough doses available to treat about 22.5 million Americans by January. Each vaccine requires two doses, separated by several weeks.
Dr. Slaoui said vaccines would be shipped to states, proportioned according to their population, and that states would decide how and where to distribute the doses. He said that likely within a day after a vaccine receives F.D.A. authorization, a committee at the Centers for Disease Control and Prevention would issue recommendations for which groups should be first to receive a vaccine.
High-priority groups are likely to include frontline medical workers and residents of nursing homes. Dr. Scott Gottlieb, a former F.D.A. commissioner, said on the CBS show “Face the Nation” that those groups would likely be followed by other older adults and then expanded to younger adults in the spring. Both he and Dr. Slaoui estimated that tens of millions of adults could be vaccinated by sometime in May.
Immunizations for children would follow. Dr. Slaoui said on the CNN show “State of the Union” that the youngest participants in the clinical trials so far have been 12 to 14 years old and that approval for younger children and toddlers would likely not occur until late in 2021, after clinical trials for those age groups are conducted.
On “Face the Nation,” Larry Merlo, the chief executive of CVS Health, said that pharmacists and other medical staff from CVS plan to immunize residents of more than 25,000 long-term care facilities, beginning about 48 hours after a vaccine is approved. He said that for several years, CVS has been going to nursing homes to administer the seasonal flu vaccine, so “we have the systems, we have the processes, and we have built the logistics directly for the Covid vaccine.”
Mr. Merlo, whose company runs 10,000 pharmacies across the country, also said as the supply of the vaccines increase, they would be administered by CVS pharmacies and also by kiosks and mobile trailers that have been doing coronavirus testing in underserved communities.
Coronavirus patients are swamping U.S. hospitals in record numbers, straining the health care system much more widely than the first acute outbreaks did in the spring.
The total number of patients in hospitals with Covid-19 nationally has hit new highs every day since Nov. 11, when hospitalizations first exceeded the April peak. There were nearly 84,000 on Sunday, according to the Covid Tracking Project.
The surge comes as the Thanksgiving and the December holidays approach, when travel and family visits are expected to accelerate the spread of the virus and further strain hospitals.
With a week of November left to go, the United States has already had its highest monthly case total, reporting more than 3,075,000 new coronavirus cases since Nov. 1, according to a New York Times database. By the time the month is over, the tally could top four million, more than double the number in October.
November’s case total is nearly 2.9 million more than March’s total.
The landscape has changed markedly since March, when the virus was concentrated mainly in outbreaks on the East and West Coasts and in a few big cities like New Orleans and Detroit. In New York City, especially, when hospitals were flooded with patients in the spring, medical workers were flown in from across the nation to help, and the Navy deployed a hospital ship to the city.
Now, though, with the strain being felt nearly everywhere, few hospitals can spare anyone to help in other places, and the focus is on acute shortages of staff, more than of beds.
The explosion of cases in rural parts of Idaho, Ohio, South Dakota and other states has prompted local hospitals that lack such experts on staff to send patients to cities and regional medical centers, but those intensive care beds are quickly filling up.
After months of unrelenting stress from the pandemic, many workers are getting sick themselves, suffering from burnout or even retiring early. Hundreds of nurses near Philadelphia went on strike last week over the trauma of the pandemic, low pay and limited resources.
The military deployed medical crews to help overwhelmed hospitals in El Paso, and the Texas state government has been dispatching thousands of workers to assist in other hard-hit areas of the state. The traveling nurses that some hospitals depend on for crisis staffing are in high demand in many states, and their rates have shot up. Overall, about one-fifth of U.S. hospitals are now short-staffed, according to an NPR analysis of data from the Department of Health and Human Services.
Hospitals can set up more beds, but “where they’re going to get stretched is on personnel,” Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, said Sunday on the CBS program “Face the Nation.” “They just won’t have the people to staff them.”
Angelia Gower, a patient access manager in the SSM Health system in St. Louis, said she has seen the problem firsthand. She has been filling in on night shifts after several of her employees contracted Covid-19 and one lost a parent to the disease, creating both a logistical challenge and a morale crisis for her department.
“That takes a toll, on not just my employee and her life, but all of the staff that knows her,” Ms. Gower said.
Early in the pandemic, she said, her team was strained by furloughs brought on by the financial pressures that the coronavirus put on the hospital system. Those furloughs are over, she said, but “we are still working short-staffed.”
The nation’s health experts on Sunday pleaded with Americans to stay home over the Thanksgiving holiday and forgo any plans to travel or celebrate at large family gatherings, even as airports have recorded a significant rise in passengers.
Dr. Anthony S. Fauci, the country’s top infectious disease specialist, and other health experts relayed a clear message on Sunday morning news shows: with coronavirus cases surging to record levels across the country, turning nearly every state into a hot zone of transmission, the risk of getting infected, whether in transit or in even small indoor gatherings, is high.
Up to 50 million people could be traveling on roads and through airports in the United States over Thanksgiving this year, according to AAA, the biggest travel surge since the pandemic began, despite strong cautions from the Centers for Disease Control and Prevention and other health authorities. A video of a packed airport in Phoenix has been circulating widely on social media. As of Sunday, 47 states — all but Hawaii, Maine and Vermont — were considered high-risk zones for viral transmission, and nationwide hospitalizations were at a record 83,227.
I'm an ER doctor in Arizona and our hospitals are being overwhelmed with COVID19. 7.4 million people & only 174 ICU beds left with healthcare workers calling out sick. Our pleas for help have fallen on selfish deaf ears - this is Phoenix airport @dougduceypic.twitter.com/7iLbngxHNp
— Cleavon MD (@Cleavon_MD) November 21, 2020
“Please seriously consider decisions that you make,” Dr. Fauci said on the CBS show “Face the Nation.” Encountering large numbers of people in airports and on planes is particularly dangerous, he said. Although airlines have invested in air circulation and ventilation systems to minimize viral transmission, Dr. Fauci said, “sometimes when you get a crowded plane, or you’re in a crowded airport, you’re lining up, not everybody’s wearing masks — that puts yourself at risk.”
And gathering indoors, whether you travel or not, carries risk. “When you’re eating and drinking, obviously, you have to take your mask off,” Dr. Fauci said. “We know now that those are the kinds of situations that are leading to outbreaks.”
Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, said on Fox News on Sunday that because about half of infections are spread by people who don’t have any symptoms, “you can’t assume that you don’t have the virus, and you can’t assume that the people whose home you’re about to enter don’t have the virus, at this point in our pandemic.”
He recommended celebrating Thanksgiving only with the people you live with. People who choose to visit others’ homes should spend as much time as possible outdoors and “should be wearing masks indoors when they’re together, and only removing them when they’re eating.”
In Tulsa, Okla., Victory, a megachurch, canceled a “Friendsgiving” service on Sunday that had called on members to bring a friend after it prompted an outcry, instead opting to give away boxed meals, NBC News reported. The church did not respond to a request for comment regarding its planned “Thanksgiving Day Brunch,” which, according to its website, is set to be held on Thursday in the church’s cafeteria.
Dr. Fauci and others warned that Americans’ behavior over Thanksgiving would have critical implications for the coming weeks of the winter season, including risks to people gathering to celebrate Christmas and New Year’s, because the country is still months away from having wide access to vaccines and therapeutics and the cold weather drives more people indoors.
“We’re going to have to, you know, hunker down, reduce our interactions,” Dr. Scott Gottlieb, a former Trump administration Food and Drug Administration commissioner, said on “Face the Nation.”
As an example of the risk, he said that in a state like North Dakota, where case levels are high, there’s a 50 percent chance that someone in a group of 10 people has Covid-19. “That’s the kind of risk we’re facing individually right now,” he said. “And that’s only going to get worse.”
Concerned over the increasing likelihood that the economy is headed for a “double-dip” recession early next year, aides to President-elect Joseph R. Biden are pushing for Democratic congressional leaders to reach a quick compromise stimulus agreement, according to people familiar with the discussions.
Until now, Mr. Biden, Speaker Nancy Pelosi of California and Senator Chuck Schumer of New York, the Democratic leader, have insisted that Republicans agree to a spending bill of $2 trillion or more, while Senator Mitch McConnell of Kentucky, the majority leader, wants a much smaller package. The resulting impasse has threatened to delay additional economic aid until after Mr. Biden’s inauguration on Jan. 20.
Many of the president-elect’s advisers have become convinced that deteriorating economic conditions from the renewed surge in Covid-19 infections and the looming threat of millions of Americans losing jobless benefits in December amid a wave of evictions and foreclosures require more urgent action before year’s end, Jim Tankersley and Emily Cochrane report. That could mean moving at least part of the way toward Mr. McConnell’s offer of a $500 billion package.
Mr. Biden’s team is also considering a range of other policy options for fighting a renewed downturn and the prospect of rising unemployment when he takes office, according to the people familiar with his plans. Some of them, like a sweeping spending bill that includes all or large parts of his campaign proposals for infrastructure, could depend on Democrats’ winning Senate control in two special elections in Georgia in January.
Others would not require Congress. Mr. Biden’s aides have weighed having the president-elect announce in the coming weeks that he will sign executive orders on his first day in office extending moratoriums on evictions and foreclosures, and deferrals of some student loan payments that are set to expire at the end of the year, the people familiar with the discussions said.
Such orders could lessen or avoid an economic cliff of expiring protections for renters, homeowners and some borrowers, which experts fear could hasten an economic contraction.
Since the pandemic erupted in China, the country has grown adept at swiftly smothering coronavirus flare-ups by ordering residents across entire cities to line up for nucleic acid tests that can pinpoint carriers. So officials snapped into action after a cluster of infections linked to Pudong International Airport in Shanghai grew over the weekend.
On Sunday, Pudong International Airport ordered cargo handlers and other potentially exposed workers to immediately undergo tests. But this time, the plan faltered badly.
The urgent order prompted a crush of hundreds of workers who merged on an airport parking garage that had been converted into a temporary test center, and video that spread first on Chinese social media showed guards in protective suits struggling to hold back a seething, anxious crowd trying to walk up a ramp. Other video shared by Shanghai residents appeared to show a worker who had fainted being carried out of the garage.
Shanghai authorities ordered the blitz of tests after testing confirmed five cases since Friday linked to the airport, including three workers and two of their spouses. The scenes of workers jammed together drew criticisms that the poorly organized testing only exposed them to greater risks of infecting each other, and the video quickly began to disappear from Weibo and WeChat, China’s two main social media platforms, as censors apparently stepped in.
“Even if the outbreak is urgent, there aren’t even the most basic safety and distancing measures,” said one comment widely shared on Weibo. “This can cause big problems.”
The government moved quickly to combat the anxiety about the cluster and scenes of mayhem. The Shanghai police issued pictures of airport workers in orderly lines, waiting to be tested in the garage — apparently after officials had restored control. “Currently everything is normal and there is an orderly queue for tests,” said The Paper, a news website based in Shanghai.
Chinese health officials appear likely to step up tests and disinfection at airports and other sites that handle imported goods. Earlier this month, tests revealed two infections among freight handlers at the Pudong Airport, and Chinese experts have repeatedly raised the theory that the virus may be carried on goods from abroad.
When Britons first faced tough coronavirus restrictions in March, compliance was high as millions stayed at home, emerging only to shop for food, to exercise briefly or — once a week — applaud health care workers.
Current restrictions are less stringent than in March (schools and universities are open), but in a country with one of Europe’s highest Covid-19 death rates, Prime Minister Boris Johnson has said they are vital to prevent the National Health Service from being overwhelmed.
Midway through the new lockdown in England, though, support is more patchy and the consensus is fragmenting. Many gym owners are among those resisting the new restrictions.
The resistance is not confined just to gyms, which are supposed to be closed to adults until the scheduled end of the current lockdown on Dec. 2. In recent weeks fines have been issued to hundreds of Britons, including people partying on a moored boat in Liverpool and seven women caught traveling in a stretch limousine in the West Midlands.
Rebel gym owners say they are staying open on principle and to help people stay healthy, rather than for financial reasons.
According to one set of official figures, gyms rank below secondary schools, pubs and restaurants, and supermarkets (but above care homes and universities) as places identified as a possible source of infection. Fitness centers vary hugely in terms of available space and ventilation, though participants in martial arts classes are unlikely to observe social distancing.
In the United States, gyms in many areas have been allowed to remain open, although some states have placed limits on their operations.
In England, because responsibility for enforcing the lockdown is split between local municipalities and the police — and Covid-19 regulations give neither an automatic right to enter property — some gyms have played a cat-and-mouse game with the authorities, keeping them at bay and disputing legal orders.
Some have overplayed their hand, however, perhaps spurred by social media posts erroneously suggesting that they can cite common law or even Magna Carta of 1215 (the medieval document that inspired protections for cherished liberties) to resist the power of the state.
Tony Cammarata dreaded the news he had to deliver to his employees: They were losing their beards.
Mr. Cammarata, who oversees the ski patrol for an area in the Rocky Mountains west of Denver, had to clamp down on the facial hair so that the patrol could properly wear their N95 respirator masks.
But he knew this would be a tough measure for the men on his crew (47 of the resort’s 56 patrollers).
“You could tell people they’re not getting a merit increase, that you’re cutting their skiing privileges,” Mr. Cammarata said. “It’s not as bad as telling them they have to shave. The whole beard thing is ingrained in our culture.”
By and large, ski patrol members cutting their beards see it as a small inconvenience for the sake of safety and keeping the slopes active. But all the shaving has come with some peculiarities.
In ski areas like Arapahoe Basin, about 80 percent of the male patrollers have had to drastically change (or introduce) shaving regimens. A chart issued by the Centers for Disease Control and Prevention highlighting the variety of facial hairstyles permitted with a fitted respirator mask has become a go-to resource.
“It’s one of the funniest government-issued documents I’ve ever seen,” Mr. Cammarata said. “It’s a pictogram with 40-plus styles of facial hair.”
Bearded patrollers say their facial hair serves as protection against the elements — a warm layer in strong winds, blizzards and frigid temperatures.
Still, many patrollers are finding a silver lining. “Most of us look a lot younger and less weathered,” said Hunter Mortensen, a longtime Breckenridge ski patroller who recently shaved for the first time in 10 years.
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