Covid-19 Live News and Updates

Covid-19 Live News and Updates

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Credit…Jae C. Hong/Associated Press

California’s intensive care units could be overloaded by the middle of December, and its hospitals could be dangerously close to full by Christmas, according to sobering projections that Gov. Gavin Newsom presented on Monday.

And the strain could be even worse in the hardest-hit areas, like the San Joaquin Valley, which was projected to reach 83 percent of its hospital capacity by Dec. 24.

“If these trends continue, California will need to take drastic action,” Mr. Newsom said during a virtual briefing, adding that more severe restrictions, including full stay-at-home orders, could come within the next few days.

California is one of several states that had appeared to have gained control of the virus, only to see it spread rapidly throughout the fall. On Sunday it became the first state to record over 100,000 cases in just a week, according to a New York Times database.

A University of Arizona Covid-19 modeling team recently urged the state of Arizona to take action to stem hospitalizations or else “risk a catastrophe on a scale of the worst natural disaster the state has ever experienced.”

And in New York, Gov. Andrew M. Cuomo said the state will take a series of emergency actions as it faces a new “nightmare of overwhelmed hospitals.”

Already, 99 percent of California’s residents are under a curfew that bans them from leaving their homes to gather or to go to nonessential businesses after 10 p.m. Los Angeles County health leaders have gone even further, announcing a ban on all gatherings in public or at private homes that goes into effect on Monday.

Officials had spent the weekend talking with local leaders and health care providers about their concerns, said Dr. Mark Ghaly, the state’s secretary of health and human services, who also spoke during the Monday briefing.

“Everything is on the table, in terms of how we guide the state through this,” he said. “And we want to make sure what we do is impactful and as time-limited as possible.”

But unlike early in the pandemic, when just a few coastal states bore the brunt, the governor noted that the tidal wave of cases slamming the entire country has limited the likelihood of aid from the federal government or other states.

The total number of coronavirus cases in the United States for November surpassed four million on Saturday, more than double the record set in October of 1.9 million cases. And the sharp escalation is likely to continue after Americans traveled by the millions for the long Thanksgiving weekend.

By contrast, after three weeks of lockdown in England, the number of new cases has fallen 30 percent, according to new data. And after strict measures throughout Europe, a drop in new cases there helped drive down newly reported cases globally for the first time since September, according to Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization.

Mr. Newsom emphasized that California will be able to build on work that the state began earlier this year, including a registry of retired or otherwise nonpracticing health care workers who would be willing to return to work. Eleven surge health care facilities could be prepared quickly to receive patients.

“We don’t anticipate this,” the governor said, referring to the alarming hospitalization figures. “I want folks to know we intend to bend this proverbial curve.”

Credit…Cody O’Loughlin for The New York Times

As the drugmaker Moderna said it applied to the Food and Drug Administration on Monday to authorize its coronavirus vaccine for emergency use, the health secretary Alex M. Azar II reiterated that distribution would begin quickly after the expected approvals of the Moderna and Pfizer vaccines vaccine.

“We could be seeing both of these vaccines out and getting into people’s arms before Christmas,” he said on “CBS This Morning” on Monday.

If its vaccine is approved, Moderna said that injections for Americans could begin as early as Dec. 21. The company also announced highly encouraging results, saying that complete data from a large study show its coronavirus vaccine to be 94.1 percent effective, a finding that confirms earlier estimates.

Stéphane Bancel, the company’s chief executive, said in an interview that it was “on track” to produce 20 million doses by the end of December, and from 500 million to a billion in 2021. Each person requires two doses, administered a month apart, so 20 million doses will be enough for 10 million people.

Asked about the role of states in the distribution process, Mr. Azar said that doses would be shipped out through normal vaccine distribution systems, and governors would be “like air traffic controllers” determining which hospitals or pharmacies receive shipments. While governors will determine which groups are prioritized, he said he hoped that they would follow the federal recommendations.

The first shots of the two vaccines are likely to go to certain groups, including health care workers; essential workers like police officers; people in other critical industries; and employees and residents in nursing homes. More than 100,000 Covid deaths have occurred in U.S. nursing homes and other long-term care centers.

On Tuesday, a panel of advisers to the Centers for Disease Control and Prevention will meet to determine how to allocate initial supplies of vaccine.

Mr. Azar said that C.D.C. experts will base their recommendations on the latest data on virus cases around the country.

But generally, “Be thinking people in nursing homes, the most vulnerable, be thinking health care workers who are on the front lines,” he said.

Even though some of the largest outbreaks have occurred in the nation’s prisons, the C.D.C. advisory committee has prioritized correctional officers and others who work in jails and prisons — but not inmates.

Now several groups, including the American Medical Association, are calling for coronavirus vaccines to be given to inmates and employees at prisons, jails and detention centers, citing the unique risks to people in confinement — and the potential for outbreaks to spread from correctional centers, straining community hospitals.

Shares of Moderna surged nearly 18 percent, to $149.50, by early afternoon, after the company’s announcement. The stock is up roughly 117 percent in November. Moderna’s gains have far outpaced those of other vaccine developers, in part because it is a far smaller company, and in part because the announcement could help it generate actual profits for the first time.

Moderna is the second vaccine maker to apply for emergency use authorization; Pfizer submitted its application on Nov. 20. Pfizer has said it can produce up to 50 million doses this year, with about half going to the United States. Its vaccine also requires two doses per person.

The hopeful news arrives at a particularly grim moment in the U.S. health crisis. Coronavirus cases have surged and overwhelmed hospitals in some regions, and health officials have warned that the numbers may grow even worse in the coming weeks because of travel and gatherings for Thanksgiving.

The new data from Moderna show that its study of 30,000 people has met the scientific criteria needed to determine whether the vaccine works. The findings from the full set of data match an analysis of interim data released on Nov. 16 that found the vaccine to be 94.5 percent effective. It also showed that the vaccine was 100 percent effective at preventing severe disease from the coronavirus.

The White House moved quickly on Monday to take credit for the Moderna vaccine’s development.

“President Trump’s Operation Warp Speed is rapidly advancing on a trajectory of success to save millions of American lives — five times faster than any other vaccine in history,” Michael Bars, a spokesman for President Trump, said in an emailed statement.

The hopeful news arrives at a particularly grim moment in the U.S. health crisis. Virus cases have surged and overwhelmed hospitals in some regions, and health officials have warned that the numbers may grow even worse in the coming weeks because of Thanksgiving travel and gatherings. In November alone, there have been more than four million new cases and 25,500 deaths.

More than 70 vaccines are being developed around the world, including 11 that, like Pfizer’s and Moderna’s vaccines, are in large-scale trials to gauge effectiveness.

Moderna’s application for emergency use authorization included data from its Phase 3 study of 30,000 people. F.D.A. scientists will examine the information, and the application is likely to undergo a final review on Dec. 17 by a panel of expert advisers to the agency, Mr. Bancel said, adding that he expected the advisers to make a decision within 24 to 72 hours. The F.D.A. usually follows the recommendations of its advisory panels.

Officials at Operation Warp Speed, the government’s program to accelerate vaccine development, have said vaccinations could begin within 24 hours after the F.D.A. grants authorization.

Mr. Bancel said that Moderna had not yet begun shipping vaccines across the country, and would not do so until the emergency authorization is granted.

The government has arranged to buy vaccines from both Moderna and Pfizer and to provide it to the public free of charge. Moderna has received a commitment of $955 million from the U.S. government’s Biomedical Advanced Research and Development Authority for research and development of its vaccine, and the United States has committed up to $1.525 billion to buy 100 million doses.

The federal government will also begin a publicity campaign to encourage vaccinations, with ads on radio this week and on TV soon, he said.

In response to a question about how officials can guard against people using money or connections to jump the proverbial line, Mr. Azar vowed to “call out any inequities or injustices that we see.”

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Cuomo Announces New Phase in ‘War Against Covid’

Gov. Andrew M. Cuomo of New York announced on Monday a series of emergency measures to combat rising hospitalizations and coronavirus case numbers.

It’s a new phase in the war against Covid — the war against Covid because I think of this as a war, you know, it’s a war of attrition. It’s a war in terms of preparation and mobilization. We have five strategies that we’re announcing today and that we are putting in place. First, we’re going to shift the focus to the number of hospitalizations and hospital capacity. We’re going to add to our zone designations — the yellow, orange, red. The hospitalization rate — we know by address where people are coming from who are going into the hospital. Today, New York City Department of Health is going to initiate emergency hospital measures. No. 1, every hospital has to identify retired nurses and doctors now. We’re already experiencing staff shortages. It is mandatory as of today that they balance the load within their system. They balance patient load so you distribute the patients among your hospitals in your system. The nightmare we went through last time was a hospital would be overwhelmed, but that system had other hospitals that had capacity. Well then, why didn’t you shift patients from the overwhelmed hospital to the hospitals that had capacity in your own system?

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Gov. Andrew M. Cuomo of New York announced on Monday a series of emergency measures to combat rising hospitalizations and coronavirus case numbers.CreditCredit…Mike Groll/Office of Governor Andrew M. Cuomo, via Associated Press

As he warned that New York State had entered a new phase in fighting the spread of coronavirus, Gov. Andrew M. Cuomo announced on Monday a new series of emergency measures to combat rising hospitalizations and case numbers statewide.

Among other steps, Mr. Cuomo urged hospitals to form plans in case of staff shortages, develop emergency field protocols and prepare to add 50 percent of bed capacity. In Erie County in Western New York, all elective surgeries will be stopped on Friday and similar protocols could be enacted in other areas of the state.

“It’s a new phase in the war against Covid,” Mr. Cuomo said at a news conference in Manhattan. “It’s a war in terms of preparation and mobilization.”

Mr. Cuomo said that the strength of the virus’s second wave has forced the state to rely less on test positivity rates as the determinant for restrictions, and focus more on hospital capacity. On Monday, the governor announced that hospitalizations topped 3,500 over the weekend, a level not seen since May. The governor also raised the possibility that a “critical hospitalization situation” could trigger a regional return of the most stringent measures enacted in the spring, which led to the closure of all nonessential businesses statewide.

“We are not going to live through the nightmare of overwhelmed hospitals again,” he said. “If a hospital does get overwhelmed, there will be a state investigation.”

Mr. Cuomo has warned that the holidays and indoor social gatherings during the winter season could trigger a further resurgence of the virus, a concern shared in neighboring New Jersey. Gov. Philip D. Murphy said Monday that the state will limit all outdoor gatherings to 25 people in an attempt to stem an ongoing surge of cases — and an expected spike after the Thanksgiving holiday.

The new limit on outdoor gatherings, which takes effect on Dec. 7, will sharply reduce the permitted number of people from 150. Religious and political gatherings will be exempt, as will funerals, memorial services and wedding ceremonies, Mr. Murphy said at a news conference.

New Jersey will also suspend all indoor youth and adult sports, including practices and competitions, starting Saturday and extending through Jan. 2. College and professional sports will be exempt from the ban, which Mr. Murphy said he hoped would only be temporary.

Despite rising rates of positive test results, Mr. Cuomo has resisted implementing the kind of widespread shutdowns seen in March, when hundreds of New Yorkers began to die every week, and much of New York’s economic activity ground to a complete halt.

Rather, Mr. Cuomo’s strategy has been to utilize targeted restrictions on individual areas — known as his “micro-cluster initiative” — which has now expanded to nearly 30 locations around the state, including in all five boroughs of New York City, its suburban counties, and major upstate population centers.

On Monday, he said new statistics — including hospitalization rates, death rates and available hospital beds — would be used to determine lockdown levels under the state’s color-coded restriction system. The state will evaluate how virus metrics change following Thanksgiving — the effects of which could be delayed because the incubation period for the virus is up to 14 days — before deciding how those restrictions would be determined, he added.

Hospital networks across the state should also better prepare for a surge in patients than they did in the spring, and plan to spread out patients between individual sites, Mr. Cuomo said. The hope is to avoid an overwhelming number of patients at any one site, as happened in the spring at hospitals at the center of the pandemic in New York City. “That has always been my nightmare,” he said, referring to Elmhurst Hospital Center in Queens, where beds were filled in March and refrigerated trucks sat outside to hold the dead.

As virus cases continue to rise across the county, hospitals have also begun to face crisis-level shortages of staff in addition to beds. Mr. Cuomo said on Monday that he was “very worried” about those potential issues in New York, urging hospitals to identify retired nurses and doctors in case of a need. “We can build beds, we can’t create more staff,” he said.

He added that further increasing and better distributing testing across the state, as well as establishing ongoing testing in schools with a focus on elementary school, middle school and special education students at all levels were also top priorities.

Still, the governor was hopeful that the situation in New York was “manageable” and said the state was better prepared than in the spring to curb the spread of the virus.

“I think we’re going to be fine here on all of this,” Mr. Cuomo said. “But we have our work cut out for us. You can’t just sit by and let this happen.”

Credit…Giannis Papanikos/Associated Press

The head of the International Federation of Red Cross and Red Crescent Societies, Francesco Rocca, warned on Monday that misinformation and mistrust could hinder efforts to distribute a coronavirus vaccine around the world, even as countries scramble to secure doses for their populations.

Speaking at a virtual news conference ahead of a United Nations meeting on the virus this week, Mr. Rocca argued that since the start of the pandemic, high levels of mistrust of health authorities “clearly facilitated transmission of the virus at all levels.”

For example, many people refused to wear face masks or practice social distancing.

The same dynamics could create a disaster if vaccine distribution is not handled properly, he said. The challenge is compounded by growing hesitancy about vaccines in general.

For that reason, Mr. Rocca said, his organization shared the widespread sense of relief and optimism that has come with the progress in vaccine development , but with “a dose of caution.”

“To beat this pandemic, we also have to defeat the parallel pandemic of distrust,” he said.

Mr. Rocca also called for greater efforts to ensure the equitable distribution of vaccines around the world — and criticized the “vaccine nationalism” of wealthy countries that bought up massive quantities of vaccines in exclusive deals with pharmaceutical companies. He called on all governments — including the incoming administration of President-elect Joseph R. Biden Jr. — to join a global immunization effort known as Covax.

“I would like to repeat here our urgent warning to all governments: None of us are safe until all of us are safe,” he said.

Credit…Justin Sullivan/Getty Images

With coronavirus vaccine distribution expected to start as early as this month, public health officials are scrambling to develop guidelines for the equitable allocation of limited supplies. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention will meet on Tuesday to make initial determinations about who gets the first shots.

There is broad consensus that health care workers who treat Covid-19 patients should be first in line. Other high-priority groups include residents and employees of long-term care facilities, essential workers whose jobs keep people fed and society running, and medically vulnerable and older adults — roughly in that order.

Prison inmates are not ranked in the top tiers, however, even though some of the largest outbreaks have occurred in the nation’s prisons. Instead, the C.D.C. advisory committee has prioritized correctional officers and others who work in jails and prisons for the first phase of immunizations — but not inmates. The federal prison system will set aside its initial allotment for such employees, according to documents obtained by The Associated Press.

Now several groups, including the American Medical Association, are calling for coronavirus vaccines to be given to inmates and employees at prisons, jails and detention centers, citing the unique risks to people in confinement — and the potential for outbreaks to spread from correctional centers, straining community hospitals.

“We aren’t saying that prisoners should be treated any better than anybody else, but they shouldn’t be treated any worse than anybody else who is forced to live in a congregate setting,” said Dr. Eric Toner, co-author of a report on vaccine allocation published by the Johns Hopkins Center for Health Security.

There is also a powerful public health argument to be made for prison vaccination: Outbreaks that start in prisons and jails may spread to the surrounding community. “Prisons are incubators of infectious disease,” Dr. Toner said.

“It’s a fundamental tenet of public health to try and stop epidemics at their source,” he added.

Credit…Jonah Markowitz for The New York Times

While many in the United States celebrated a muted Thanksgiving over Zoom, millions of people traveled instead, rejecting the advice of public officials.

According to Transportation Safety Administration data, about 800,000 to one million people passed through T.S.A. checkpoints each day in the days before and after the holiday — far lower than the same period last year, but likely far higher than epidemiologists had hoped to see.

A United Airlines spokeswoman, Annabelle Cottee, said the week of Thanksgiving was “the busiest since March” for the carrier.

Americans also took to the roads. AAA predicted significant declines in bus, train and cruise travel, but predicted only a modest drop in car travel.

For several days leading up to Thanksgiving, as case numbers and hospitalizations across the country grew exponentially, political leaders and medical experts warned of the dangers of compounding the virus spread by being with others. In November alone, there have been more than 4.1 million cases and more than 25,500 deaths.

There were 91,635 current hospitalizations as of Nov. 28, according to the Covid Tracking Project, almost twice as many as there were on Nov. 1, and triple the number on Oct. 1.

Aware of the emotional resonance of the holiday, experts tried to thread a narrative from these numbers that would convince people of the danger. Their warnings were direct — sometimes stern, sometimes impassioned pleas.

“Keep the gatherings, the indoor gatherings as small as you possibly can,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on “Good Morning America” last week. By making that sacrifice, he said, “you’re going to prevent people from getting infected.”

The Centers for Disease Control and Prevention was also urging people not to travel. “All Americans want to do what they can to protect their loved ones,” Dr. Henry Walke, a Covid-19 incident manager at the C.D.C., said at a news briefing.

And though it would have been unrealistic to expect a public that is restive from months of restrictions to universally abide by such recommendations, the aftermath of those decisions will begin to unfold in the weeks ahead.

Dr. Fauci, during an appearance on the Sunday news program “This Week,” said the best course for Thanksgiving travelers might be “to quarantine yourself for a period of time.”

Dr. Deborah L. Birx, the White House coronavirus response coordinator, said that travelers “have to assume that you were exposed and you became infected and you really need to get tested in the next week.” She urged that travelers avoid anyone in their family over 65 or with underlying illnesses.

That guidance comes as the C.D.C. is considering shortening the recommended isolation period for infected people. And while it is too early to know if holiday travel will affect the virus’s spread, new research suggests that people are most infectious about two days before symptoms begin and for five days afterward, meaning this week will likely be crucial in containment.

On Monday, Mayor Bill de Blasio of New York City urged residents who had ignored official guidance and attended Thanksgiving gatherings to get tested.

In anticipation of a renewed demand, the city has opened 25 new testing locations in the last week. It will also now post online the wait times at its testing sites, which had seen growing lines as New Yorkers scrambled to get tests before their holiday plans.

The city’s seven-day average positive test rate was at 4.03 percent, Mr. de Blasio said, but he warned that the data may be skewed because fewer tests were conducted during Thanksgiving weekend.

“Some of our numbers may be skewed by that,” he said.

The U.S. map shows a country where almost every region is a hot spot. States that were once spared, like Montana and Wyoming, have reported record deaths and infections, while states that were pummeled in the first wave are straining anew.

On Sunday, California became the first state to report more than 100,000 cases in a week, according to a New York Times database.

And in New Jersey, hospitalizations have increased 60 percent in the last two weeks and deaths have increased by 78 percent. Over three days in November, the positivity rate in Newark, the largest city in the state, was 19 percent.

“We begged people to have a somber, respectful, small Thanksgiving,” Gov. Philip D. Murphy said on Fox News Sunday. “And I want to give a shout out to New Jerseyans because I think overwhelmingly that’s what happened, but there’s a lot of fatigue out there.”

Mr. Murphy called the next few months “the fight of our lives,” while also citing the progress of vaccines and noting that there was “light at the end of the tunnel.”

And there was something to celebrate on Sunday in New York City, at least for some parents, when Mr. de Blasio announced that he would reopen the city’s public elementary schools, abruptly shifting policy after an outcry from critics who questioned why gyms and bars remained open while schools were shut.

Credit…Associated Press

Turkey is imposing its strictest lockdown since the outbreak of the pandemic, as the country’s total number of cases surpassed half a million, according to government figures released on Monday.

Starting Tuesday night, everyone will be required to stay home from 9 p.m. to 5 a.m. on weekdays and around the clock on weekends, from Friday evening to Monday morning, President Recep Tayyip Erdogan announced.

The hybrid approach is intended to keep the labor force working in an already staggering economy while limiting the spread of the virus as much as possible.

People older than 65 or younger than 20 will be barred from using public transportation. They are already under restrictions that allow them out of their homes for just three hours a day.

Mr. Erdogan also asked people not to allow guests in their homes, and banned large gatherings in private residences for New Year’s celebrations, religious ceremonies or condolence calls.

Funerals and wedding ceremonies will be limited to 30 people. Traditional Turkish baths, saunas, massage parlors and swimming pools will be closed.

Turkey, which only recently began reporting complete data on confirmed cases, has been averaging nearly 23,000 new cases a day over the last two weeks, according to a New York Times database.

GLOBAL ROUNDUP

Credit…David W Cerny/Reuters

The traditional Christmas markets that dot European cities, drawing thousands of festive revelers into plazas to enjoy mulled wine, colorful lights and public art, have largely been canceled this year.

But on Advent Sunday, the official start of the holiday season, celebrations continued in different forms. In partially locked-down Bratislava, the capital of Slovakia, the mayor, Matus Vallo, led viewers of a Facebook livestream on a walk through the city’s historic center.

Wearing a cheerful Christmas sweater, Mr. Vallo met musicians and artists along the way, received soothing words from a local priest, eyed winter-themed paintings from art galleries and lit up a Christmas tree in the main square.

“We know what the situation is, but we decided that we won’t let Advent be ruined anyway,” he said to the camera.

Locals and visitors in Bratislava will still be able to gawk at the Christmas lights on a stroll, but officials wanted to avoid the large holiday crowds. Moving traditional events online was part of that effort; a series of holiday concerts and events will be streamed throughout December.

It’s just one of several creative solutions as markets were canceled across the continent. In Landshut, Germany, visitors must experience the Christmas markets as a drive-through, according to Agence France-Presse. They can observe the spectacle from inside their cars as mask-wearing employees hand them menus offering typical treats like roasted chestnuts and gingerbread hearts.

And in the United States, New York City will limit visitors to the Christmas tree at Rockefeller Center, in a bid to fight the holiday crowds that usually pack the surrounding plazas and sidewalks. The city will keep the viewing time to 5 minutes, Mayor Bill de Blasio said. Groups will be limited to four people.

The mayor also said that a “reservation system” would be in place. Later, Tishman Speyer, the real estate firm that controls Rockefeller Center, said it would use a “virtual queueing” system to manage long lines, rather than advanced timed ticketing.

Still, the mayor, who has expressed concern that cases of the virus could surge during the holiday, encouraged people to watch the annual tree-lighting ceremony — scheduled for Wednesday — at home instead of flocking to Midtown Manhattan. “Please, if you can make a decision to watch it on TV, that’s so much better,” he said.

  • Hong Kong will limit gatherings in public to two people, including two per table at restaurants, as it battles a surge in cases. Playgrounds, swimming pools and karaoke rooms will close, while gyms will remain open but be limited to two mask-wearing participants, the city’s chief executive, Carrie Lam, said at a news conference on Monday. Hong Kong has reported an average of 85 new daily cases in the past week, far above the near-zero tallies it had reported after a summer surge.

  • Italy approved a stimulus package worth $9.6 billion, or 8 billion euros, on Sunday to support struggling businesses. The deal will postpone or suspend tax deadlines for some businesses, subsidize amateur sports associations and send checks of 1,000 euros to seasonal workers in the tourism, spa and entertainment industries. Italy is currently under a nationwide 10 p.m. curfew with bars and restaurants closing at 6 p.m., and some regions have further restrictions.

  • In Russia, a hospital near Moscow reported on Monday that it had administered the first known batch of the Russian-made Sputnik V vaccine to civilians. The Domodedovo Central City Hospital confirmed in a phone interview that the vaccine had been delivered and that the first shipment available for general use had already run out. Russia’s government backed efforts to develop a vaccine before other countries has been widely criticized for cutting corners. The rush to deliver a vaccine to the general public has also been spurred by the growing number of new cases and deaths in the country, with the total number of cases in Russia nearing 2.3 million.

Credit…Associated Press

Andrej Plenkovic, the prime minister of Croatia, has tested positive for Covid-19 days after his government abandoned some of the most lax pandemic measures on the continent and introduced strict rules meant to curb the virus’s spread, as patients inundated hospitals.

Plenkovic is home and feels well, according to a statement on the government’s website, attributed to a spokesman. The prime minister entered self-isolation on Saturday after his wife tested positive for Covid. He led Monday’s government session from his attic, according to a spokesman.

Croatia has experienced a surge in new infections since late October, with 21,457 active cases and 1,786 deaths in the country of four million. Croatia contained the pandemic this spring by introducing some of the strictest measures in Europe, including a broad lockdown and travel limits. Those same restrictions were abandoned in time for Croatia’s economically vital summer tourism season, and did not return this fall to combat a second wave.

Until last week, Croatia’s measures were some of the most lax on the continent, amounting to limits on gatherings, mask-wearing and social distancing suggestions, as well some curtailed business hours. The prime minister even took part in a memorial walk in Vukovar on Nov. 18 with over 1,000 others. The town is now experiencing a spike in new infections.

The government pushed back against requests that the country adopt tougher measures in the face of an increase in new infections, shying away from the lockdowns and curfews used by other European Union members. Plenkovic frequently said such moves were “not an option.” His ministers repeatedly chastised the public for the increase in new infections, claiming that only responsible behavior could stop the virus’s spread.

Croatia’s government relented last week, after reports from hospitals of dwindling capacity and overworked staffs. On Friday, it introduced greater limits on gatherings and public transport, and shut gyms, bars and restaurants. On Monday, it presented a package of laws that includes fines for anyone violating the new restrictions, and financial aid for struggling businesses.

Five ministers in the Croatian government have contracted Covid since the second wave of the pandemic hit Croatia in late October, including Vili Beros, the health minister.

Credit…Hiroko Masuike/The New York Times

One of the coronavirus’s most unexpected tricks is its ability to cause neurological symptoms, including dizziness, headaches and the blunting of taste and smell. Traces of the virus have shown up in brain tissue, examined post-mortem, but scientists don’t know exactly how the virus got there, much less how it might alter neurons’ function.

A new study, based on autopsies of people who died of Covid-19, provides some of the first clues. The virus may spread to the brain through the nose, where it can invade nerve endings deep in the nasal passages. If further tissue analysis is supportive, the findings should help explain how the virus reaches circuits in the brain that support perception, balance and mental acuity.

In the paper, posted Monday by the journal Nature Neuroscience, a research team based in Berlin produced the first images of intact coronaviruses in the so-called nasopharynx, where the throat meets the nasal cavity, and where odor receptors and perceptual cells converge.

The virus can enter the nervous system “by exploiting the close vicinity of olfactory mucosal, endothelial and nervous tissue, including delicate olfactory and sensory nerve endings” in the mucous layer of the nasopharynx, the authors conclude.

Up to a third of people who fall ill from Covid-19 report at least one neurological deficit, whether in taste, smell, balance or alertness. These symptoms are often transitory, but they are common enough to suggest that people with severe forms of the disease should show some evidence of infection in their central nervous systems.

In the new report, a research team led by Dr. Helena Radbruch and Dr. Frank Heppner, neuropathologists at the Charité-Universitätsmedizin, in Berlin, studied tissue samples from 33 people who had died after contracting Covid-19. The samples came from four areas of the brain, and from the olfactory mucosa, the mucous membrane of the nasopharynx.

The analysis found evidence of the virus in various parts of the brain, and in the olfactory mucosa, where its concentration was highest. Deep in this layer, near nerve endings that project to the brain, the researchers found the coronavirus’s signature spike protein, which it uses to attach to and infect cells.

Taken together, the findings suggest that the virus is “able to use the olfactory mucosa as a port of entry into the brain,” said Dr. Heppner, in a prepared statement.

The authors cautioned that their findings apply only to people with severe disease, and not necessarily to the majority of people infected, who experience modest symptoms, if any.

Credit…Korean Central News Agency/Korea News Service, via Associated Press

North Korea’s leader Kim Jong-un “harshly criticized” his government agencies for mishandling the economy, the country’s state media reported on Monday, as new data revealed just how much the pandemic had slashed the country’s already dwindling trade with China.

Signs had already emerged earlier this month that North Korea’s economic trouble was deepening, driven by long-standing international sanctions and the impact of the pandemic. According to customs data released by Beijing last week, North Korea’s imports from China from January to October plummeted by 76 percent to $487 million, while its exports shrank 74 percent to $45 million in the same period.

​China is North Korea’s only major trading partner, accounting for more than 90 percent of its external trade. In October, the North’s import from China amounted to a mere $253,000, nearly a 99-percent drop from the previous month. South Korean officials and analysts have warned that a sharp decline in imports from China in recent months could drive up domestic prices in the North.

The Chinese government only ​records official trade and does not cover smuggling that takes place across the borders​ between the two neighbors​. Still, the figures provide​d​ fresh evidence that the coronavirus was squeezing the North Korean economy more effectively than international sanctions ever have.

During a meeting of the Workers’ Party that Mr. Kim presided over on Sunday, the government agencies responsible for the economy w​ere harshly criticized for “failing to provide scientific guidance” and “failing to overcome subjectivism and formalism in their work,” the North’s official Korean Central News Agency reported.

But this was not the first time Mr. Kim has admitted to his country’s deepening economic woes, acknowledging in August that his five-year plan for economic growth had failed. Mr. Kim all but sealed North Korea’s borders with China​ earlier this year over fears of the potentially catastrophic consequences the pandemic could inflict on the country’s poor health system.

North Korea insists that it has registered no coronavirus cases, but outside experts remain skeptical.

Those We’ve Lost

Credit…Selene Meda-Schlamel

Iris Meda, 70, didn’t feel right sitting on the sidelines when the pandemic hit. She’d been retired only a few months, and still had a lifetime of nursing experience in hospitals, prisons, schools and long-term care facilities to share.

So she went back to work in August, teaching nursing skills to high school students through Collin College, north of Dallas. But within weeks, she had come down with Covid-19 herself. After nearly a month in the hospital, most of it on a ventilator, she died on Nov. 14.

Her daughter, Selene Meda-Schlamel, said her mother was exposed to the virus on Oct. 2 while teaching a laboratory class, despite the precautions she was taking.

“I wasn’t worried, because I knew she was wearing an N95, and that she was some distance from the students,” Ms. Meda-Schlamel recalled, in an interview.

“I said to myself, ‘If something happens to her, it happens to her doing something she loves, fulfilling her calling and benefiting the world,’” she said. “But that’s a very different outlook from, ‘My best friend is gone, my kids don’t have a grandmother. Everything that we planned on doing will never occur.’”

Ms. Meda grew up in New York, the oldest of nine siblings, and was a natural caretaker from childhood, her daughter said. She married at 20, expecting to be a stay-at-home mother, but at her husband’s urging, she went back to school and earned a nursing degree from City College.

“She had a very personal touch,” Ms. Meda-Schlamel said. “You never felt like she was rushing you.”

Ms. Meda worked as a nurse at the jail on Rikers Island before moving to Texas in 1993, where she spent the rest of her career before retiring in January. When she took up teaching, she wanted to pass along to her students the kind of encouragement she had gotten to pursue an education. After class, she often returned home “lit up” from the thrill she got from teaching, her daughter said.

When her Covid-19 symptoms worsened in mid-October and she began struggling to breathe, Ms. Meda called her daughter for a ride to the hospital. Ms. Meda-Schlamel recalled that in the car, her mother handed her an envelope containing her medical documents and a handwritten card that she forgot about in the hectic days that followed.

When she finally opened it, she said, she found a note her mother had written after their phone call, telling her how proud she was of her and what a wonderful life she had before her. And two signed checks fell out, meant to help her daughter cover the hospital bills. On one, the amount was left blank.

“That was kind of symbolic of how she was as a person,” Ms. Meda-Schlamel said. “She was always giving people blank checks, blank emotional checks: ‘Whatever you need from me, if I have it, I’ll provide it.’”

Credit…James Estrin/The New York Times

Did Thanksgiving gatherings and travel accelerate the spread of the coronavirus in the United States, as many experts had feared? When will we be able to tell?

Those questions do not yet have clear-cut answers, but one thing is certain: The daily figures over the next few days won’t prove anything. It takes time for infections to take hold, time for tests to detect them, and time for results to be reported.

In interviews, four experts agreed that there probably will be an upward bump in cases linked to the holiday, similar to the rises that were seen after Memorial Day and July 4. But they had different estimates for when it would emerge.

Part of the uncertainty stems from the virus itself. Its incubation period — the time after a person catches it but before symptoms appear — can range from two days to two weeks or longer, though five days seems to be typical.

People who suspect infection may then wait to be tested, and test results may take days to come back from a lab.

Dr. Thomas Russo, a professor of medicine at the University at Buffalo, said that taking those factors into account, he expects a holiday bump to become noticeable at the end of this week, and continue through much or all of next week.

“Most people were being good and had celebrations just within their own households,” he said. “But that significant minority that did not is driving this surge, and will be our undoing.”

He noted that around 97 percent of infected people who develop symptoms do so within 12 days after exposure — and will already have been contagious for a day or two.

Others will feel no symptoms at all, an added complication that has dogged public health officials since the pandemic began. Those people may not quarantine or be tested — but they can infect others, lengthening the chain of transmission.

That’s what happened after July 4, said Megan L. Ranney, an emergency physician and public health researcher at Brown University. She said a jump in positive tests began between two and four weeks after the holiday, suggesting that many were pass-along infections.

The American Automobile Association forecast that about 50 million people would travel for Thanksgiving. Even if only 1 percent caught the virus, Dr. Ranney said, “that’s an extra 500,000 infections in one day,” and they could infect untold thousands more before showing up in the statistics. “We are looking at an exponential effect,” she said, one that would only truly be seen around Christmas and New Year’s Eve. “It will be a double whammy.”

Lewis S. Nelson, chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School, said he was not certain that Thanksgiving travel and gatherings would create a widespread surge in new cases. The virus has been tricky, he said, and predicting the numbers can be extremely difficult.

“We keep saying we’ll see a bump, but most of these events don’t seem to really materialize into something really concerning,” Dr. Nelson said. “Sometimes what you expect to happen doesn’t happen.”

Even so, he said, “my gut tells me we should remain concerned and attentive.”

Dr. Nelson said his hospital in Newark, N.J., was overwhelmed in April, but is manageable now, even though the state is reporting many more new cases. He said there were currently about 30 coronavirus patients, compared to more than 200 in April, a drop he and his colleagues were still puzzling over.

“Just the whole fact that we are not experiencing April right now is inexplicable at this point,” he said. “People haven’t changed. A lot of us believe maybe the virus has.”

Officials were trying to make sure that any Thanksgiving exposure would be reflected in the data. On Monday, Mayor Bill de Blasio of New York City urged residents who had ignored official guidance and attended Thanksgiving gatherings to get tested.

In anticipation of a renewed demand, the city has opened 25 new testing locations in the last week. It will also now post online the wait times at its testing sites, which had seen growing lines as New Yorkers scrambled to get tested before their holiday plans.

The city’s seven-day average positive test rate was at 4.03 percent, Mr. de Blasio said, but he warned that the data may be skewed because fewer tests were conducted during Thanksgiving weekend.

Similar issues are clouding daily statistics across the country, as some states held off reporting for some or all of the holiday weekend and then caught up with big batches of new reports. Experts warned against drawing too many conclusions from the daily figures until states get back to a normal reporting rhythm.





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