Americans have agonized over Thanksgiving this year, weighing skyrocketing numbers — more than 2,200 U.S. deaths from Covid-19 were reported on Tuesday for the first time since May 6 — and blunt warnings from the Centers for Disease Control and Prevention against the need, after a grim and worrying year, to gather with family for a traditional, carbohydrate-laden ritual.
Around 27 percent of Americans plan to dine with people outside their household, according to interviews conducted by the global data-and-survey firm Dynata at the request of The New York Times.
Views on whether to risk Thanksgiving gatherings appear to track closely with political views, with respondents identifying as Democrats far less likely to be planning a multihousehold holiday.
Megan Baldwin, 42, had planned to drive from New York to Montana to be with her parents, but last week, she canceled her plans.
“I thought I would get tested and take all the precautions to be safe, but how could I risk giving it to my parents, who are in their 70s?” she said, adding that they were not happy with the decision.
“All they want is to see their grandkids,” she said, “but I couldn’t forgive myself if we got them sick. It’s not worth it.”
Others decided to take the plunge, concluding that the emotional boost of being together outweighed the risk of becoming infected.
“We all agreed that we need this — we need to be together during this crazy, lonely time, and we are just going to be careful and hope that we will all be OK,” said Martha Dillon, who will converge with relatives from four different states on her childhood home in Kentucky.
Thanksgiving travel is clearly down compared with 2019.
The AAA has forecast a 10 percent overall decline in Thanksgiving travel compared with last year, the largest year-on-year drop since the recession of 2008. But the change is far smaller, around 4.3 percent, for those traveling by car, who make up a huge majority of those who plan to travel — roughly 47.8 million people.
About 917,000 people were screened by the Transportation Security Administration on Monday, less than half of the number seen on the same day in 2019, according to federal data published on Tuesday.
Airlines are struggling from a dramatic decline in demand that has forced them to drop flights and make big capacity cuts, said Katherine Estep, a spokeswoman for Airlines for America, an industry trade group. “Currently, cancelations are spiking, and carriers are burning $180 million in cash every day just to stay operating,” she said. “The economic impact on U.S. airlines, their employees, travelers and the shipping public is staggering.”
Demand for travel by train is down more sharply, at about 20 percent of what it was last year, said Jason Abrams, a spokesman for Amtrak.
Susan Katz, 73, said she canceled plans to spend Thanksgiving with her daughter last Friday, after watching a monologue by Rachel Maddow, the MSNBC host, describing her partner’s bout of coronavirus and her fear that it would prove fatal.
“Her emotion, Rachel Maddow’s emotion, made it so real, it just moved us,” Ms. Katz said. “I probably called her within a few hours of seeing that.”
Ms. Katz, who lives in Raleigh, N.C., said she will spend the holiday alone with her husband. She is trying to decide whether to bother thawing a turkey breast.
Warnings from experts swayed Laura Bult, 33, to cancel her Sunday flight to St. Louis two days before she was scheduled to leave.
“I’m on Twitter — there’s a lot of travel-shaming going on,” she said. “Doing the small part of being one less person circulating through an airport felt important enough to me.”
Her decision, she said, means her mother will be alone for the holiday.
“I really wanted to be with my mom,” she said. “I was trying to be careful because of her. She is not looking out for her best interests, because she just wants to see me.”
Interest in travel generally has increased after recent announcements by pharmaceutical companies that their coronavirus vaccine candidates have been effective at preventing infections, according to preliminary data.
Travel bookings increased by about 25 percent after Pfizer said in early November that a vaccine it was developing with BioNTech was more than 90 percent effective, according to Skyscanner, a travel search engine.
Dr. Anthony Fauci, the country’s top infectious-disease expert, has strongly discouraged holiday travel as the number of new infections surges across the country
“Do you really want to have that gathering?” he said, in an interview with PBS. “Or should you say, I know it hurts not to do it, because this is such a beautiful, traditional season, but hang in there with us, because there will be future times when you can do it?”
Tariro Mzezewa contributed reporting.
As Gov. Gavin Newsom of California was briefing reporters on a video conference call on Monday, he stopped to cough. He started to say something more, and coughed again. Then he paused and smiled.
“That’s tea that got in my throat,” he said. “Nothing more.”
It was only natural to wonder. The realities of the coronavirus surge that has reached every corner of California had just penetrated the governor’s mansion as well: Mr. Newsom and his family had gone into quarantine early that morning because three of his children had been in contact with someone who later tested positive.
California reported 17,694 new cases on Monday — well more than it or any other state had ever done before, according to a New York Times database — and another 16,659 on Tuesday.
Over the past week, the state has averaged 13,558 new cases a day — more than Maine’s total for the whole pandemic. And the trajectory in California has lately been almost straight up.
With infections and hospitalizations each rising at an alarming rate in the state, officials announced a curfew late last week for counties in the state’s purple reopening tier — in other words, the counties where almost all of the state’s nearly 40 million residents live.
Officials have implored Californians to take precautions and to reconsider traveling, even within the state. And some local officials have gone further, including closing down outdoor dining in Los Angeles “to reduce the possibility for crowding and the potential for exposure” — an order that takes effect on Wednesday and has drawn pushback.
California is far from the only state where new case reports are shattering records. Oregon hit a new daily high on Sunday, Wyoming did so on Monday, and three states — Rhode Island, Connecticut and Kansas — that do not report separate daily figures over weekends set records for three-day periods ending Monday.
As of Monday night, 11 states — Kansas, Wyoming, Nebraska, Kentucky, Minnesota, Idaho, Tennessee, Illinois, Oklahoma, Indiana and South Dakota — had added more deaths in the last week than in any other week since the pandemic began.
And Texas reported more than 20,300 cases on Tuesday, the most of any state on any day of the pandemic.
Bars and restaurants in Pennsylvania have been ordered by the state to stop selling alcohol at 5 p.m. on Wednesday, in an effort to head off uninhibited pre-Thanksgiving gatherings where the coronavirus could spread rapidly.
“It turns out, the biggest day for drinking is the day before Thanksgiving,” Gov. Tom Wolf said at a news conference on Monday. “I don’t like addressing that more than anyone else does, but it’s a fact. And when people get together in that situation, it leads to the exchange of the fluids that leads to the increased infection.”
“We’re going to defeat this virus,” the governor added. “That should be what we’re focused on, not whether we want to get a transitory benefit from going out with friends the day after tomorrow and having some drinks. Let’s forgo that, this one time.”
The regulation, which allows alcohol sales to resume at 8 a.m. on Thanksgiving Day, was immediately slammed by restaurant and bar owners, who said it put further strain on businesses that are already struggling to survive.
Marc Vetri, a Philadelphia restaurateur, described Mr. Wolf on Twitter as the “dumbest governor in history,” and used an obscene expression that caused a brief social media storm because it appeared to refer to the state’s secretary of health, Dr. Rachel Levine, a transgender woman, using the pronoun “he.” Mr. Vetri quickly deleted the remark and apologized.
Mr. Wolf said he was fully aware of the ill will the decision had engendered. “The virus is what’s doing this — it’s not me, and it’s not the administration, it’s not the government,” he said. “The more we learn about it, the more we know that this is the kind of place that speeds the transmission of the disease.”
Facing the same concerns in neighboring Maryland, Gov. Larry Hogan announced that the state police and local authorities would step up enforcement of pandemic restrictions on bars, restaurants, nightclubs and catering halls starting on Wednesday, including cutting off alcohol sales at 10 p.m. and other measures the governor imposed last week.
In Utah, on the other hand, Gov. Gary Herbert partly relaxed the state’s restrictions on casual private gatherings this week for the holiday. The governor said on Monday that he was not extending an expiring earlier order that banned indoor gatherings of people from more than one household; the state’s mask mandate and other restrictions remain in force.
Federal health officials may shorten the recommended quarantine period for individuals who have been exposed to the coronavirus in an effort to make the guidance more palatable and to improve compliance, a federal official confirmed on Tuesday (not Thursday, as an earlier version of this post reported).
The official was not authorized to speak about the discussions and asked to remain anonymous. The possible change was first reported by The Wall Street Journal.
The Centers for Disease Control and Prevention currently advises people who may have been exposed to the virus to seclude themselves for 14 days in order to avoid spreading the disease, even before they know whether they are infected or develop symptoms.
The proposed change would scale back the required quarantine period to between one week and 10 days, followed by a test for the virus.
If adopted, the more relaxed guidance could lead to some infections being missed. Studies have found that the median incubation period for the virus is five days. A significant majority of people — 97.5 percent of those exposed to the virus — develop symptoms by the 12th day after infection.
One month after announcing a second lockdown, President Emmanuel Macron said on Tuesday that France had succeeded in thwarting a spike in new cases and laid out a plan to ease restrictions.
Mr. Macron said that new cases last week were a third of what they had been in early November. Although France’s Covid-19 death toll officially topped 50,000 on Tuesday, the number of people in hospitals and intensive care has been trending downward for the last few days.
Mr. Macron detailed a three-part softening of the lockdown in a televised address on Tuesday evening. He said that a first phase of lifting would take place on Nov. 28, with the reopening of all nonessential businesses, such as toy stores or bookshops, under strict health rules and with a 9 p.m. time limit.
But bars and restaurants will remain closed for the time being, and are unlikely to reopen until mid-January, Mr. Macron said.
People will still have to carry a permission slip to leave their homes, but the one-kilometer travel restriction will be expanded to 20 kilometers, and for a maximum of three hours away from home, instead of the current one-hour allotment. Outdoor after-school activities will also be allowed.
Mr. Macron said that places of worship will reopen on Saturday with a 30-person capacity limit. Catholic groups had lobbied the government intensely to allow religious ceremonies to take place again.
Health experts had warned the government not to relax restrictions too quickly and repeat the mistakes France made as it emerged from a lockdown in the spring, with no clear policy on masks and limited testing capacity.
Starting on Dec. 15, and provided that daily new cases are limited to 5,000 and that the number of intensive-care patients does not exceed 3,000, restrictions on people’s movement will largely be lifted and theaters and museums will be allowed to reopen with strict health rules.
A nightlife curfew from 9 p.m. to 7 a.m. will replace the current restrictions, and people will be free to move, but not to assemble, on Christmas Eve and New Year’s Eve.
“It won’t be Christmas holidays like any other,” Mr. Macron said, as he urged people to respect social distancing during family gatherings. He added that amusement parks and ski resorts would remain closed for the rest of the year.
“The logic of all these decisions is the same,” Mr. Macron said. “To limit as much as possible all the activities that multiply gatherings, that lead people to gather in enclosed places and to gradually allow the reopening of activities where we can protect ourselves.”
The third phase will start on Jan. 20 with the reopening of all bars, restaurants and gyms as well as the return to class of university students, provided that case numbers remain low. Financial support for companies forced to remain closed until Jan. 20 will be reinforced.
Mr. Macron added that authorities were moving forward to prepare for a wide-ranging vaccination campaign in France. As soon as late December or early January, elderly people will be vaccinated. Hospitals, retirement homes and doctors will be given priority, but vaccination will not be mandatory.
“The return to normal will therefore not be for tomorrow, but I am convinced that we can control the epidemic in the long term,” Mr. Macron said, adding that this year of health, economic and security crises had also shown France’s strengths, as well as the weaknesses that needed to be addressed.
“Today we stand together, tomorrow we will win together,” Mr. Macron said.
Around mid-December, 6.4 million doses of Pfizer’s Covid-19 vaccine will be shipped out across the United States in an initial push after it receives an expected emergency authorization, officials leading Operation Warp Speed, the administration’s push to fast-track a vaccine, said on a call with reporters on Tuesday.
The first doses — which are expected to go to health care workers and potentially a few other vulnerable groups — will be allocated to all 50 states and eight territories, as well as six major metropolitan areas. The quantities will be based on how many adults live in each jurisdiction.
“We wanted to keep this simple,” said Alex M. Azar II, the secretary of health and human services.
Officials decided on that allocation formula, as opposed to one that would prioritize the hardest-hit parts of the country, in part because the virus is spreading rapidly nationwide, Mr. Azar said.
Operation Warp Speed notified states late Friday night of how many doses they’d be receiving in the first push to assist them in their planning, officials said Tuesday. Governors and other local leaders will be responsible for deciding where the shipments should go.
Pfizer will ship doses of the vaccine via UPS and FedEx in special coolers packed with dry ice that will hold a minimum of 975 doses, which must be used up within a few weeks or stored in an ultracold freezer for up to six months.
Pfizer’s vaccine, which was developed with the German company BioNTech, was found to be 95 percent effective in a late-stage study earlier this month. An advisory committee to the Food and Drug Administration is scheduled to meet on Dec. 10 to discuss Pfizer’s clinical-trial data and vote on whether to recommend that the agency authorize it.
From there, it’s not clear how long it will take to make a decision. The agency could take “days” to deliberate on whether to authorize the vaccine, F.D.A. Commissioner Dr. Stephen Hahn said in an interview with USA TODAY published Tuesday.
But Moncef Slaoui, the head of Operation Warp Speed, said during a television appearance Sunday on CNN’s “State of the Union” that the first doses could be administered as soon as Dec. 11. Federal health officials have said the first Americans will start getting vaccinated within 24 hours of an authorization being issued.
Another leading vaccine developer, Moderna, is expected to soon follow Pfizer’s lead in filing for emergency authorization for its vaccine candidate, which an early analysis found to be 94.5 percent effective.
The path forward in the United States is less clear for AstraZeneca and the University of Oxford, which on Monday announced that they had zeroed in on a promising dosing plan for their vaccine candidate.
All three of those vaccines require people to get two doses, spread several weeks apart.
After the initial distribution push, vaccine shipments will go out to states and other jurisdictions on a weekly basis. Federal officials have said they expect to have 40 million doses of Covid-19 vaccines available by the end of the year.
A Chinese state-owned vaccine maker has filed an application with the country’s Food and Drug Administration to market coronavirus vaccines in China before the completion of late-stage trials that will determine their safety and efficacy.
Vaccines made by CNBG, a subsidiary of the state-owned pharmaceutical company Sinopharm, are in late-stage trials with more than 50,000 volunteers in 10 countries, including Argentina, Bahrain, Egypt, Jordan, Morocco, Peru and the United Arab Emirates.
The announcement was made by Sinopharm’s deputy general manager, Shi Shengyi, the state-run Xinhua news agency reported on Wednesday. The article, by the agency’s finance arm, gave no further details and did not specify whether the application was for one or both of the coronavirus vaccines that CNBG manufactures. The company did not respond to requests for comment.
The Chinese government has approved three coronavirus vaccines for emergency use, including two made by CNBG.
Even before the completion of the late-stage trials, Chinese officials had considered those vaccines and one by a rival firm so effective that they allowed tens of thousands of people to be injected. That prompted criticism from scientists that the government was ignoring the risks posed to public health.
Last week, Sinopharm’s chairman, Liu Jingzhen, said the company had injected nearly a million people and that none had reported adverse reactions, with “only a few having some mild symptoms.”
Mr. Liu said those people included construction workers, diplomats and students who took the vaccines before traveling to more than 150 countries. None were infected during their trips, he added.
Many scientists have said that such data is anecdotal and should not be used as evidence that the Sinopharm vaccines are effective.
Britons from up to three households will be able to come together and celebrate Christmas under plans announced on Tuesday for a brief relaxation of the rules designed to curb the spread of the coronavirus.
The decision, agreed upon by political leaders in England, Scotland, Wales and Northern Ireland, means that people will be able to move freely around the United Kingdom between Dec. 23 and 27, regardless of whatever local restrictions are in force before those dates.
Those moving to or from Northern Ireland will be given an additional day to travel at both ends of that period to reflect the additional complexity of some of their journeys.
Under the rules, members of up to three households will be able to gather in private homes and outdoor spaces and travel together to places of worship. But the exemption will not allow these larger groups to meet in pubs or restaurants, where normal restrictions will still apply.
Those rules on indoor dining and drinking will vary from region to region. On Monday, the government in England said that when it ends a national lockdown on Dec. 2 the country will be divided into three tiers of restrictions, depending on the severity of the health situation in each area.
However, the government is not expected to announce which regions will be placed in which tier until Thursday.
Michael Gove, a senior British cabinet minister, said that, while “the Christmas period this year will not be normal,” successful talks with Scottish, Welsh and Northern Irish leaders meant that “families and friends will now have the option to meet up in a limited and cautious way across the U.K. should they wish.”
That message was echoed by Mark Drakeford, the First Minister of Wales. “Everyone has done so much to help control the spread of the virus and to save lives,” he said in a statement. “But that has meant many sacrifices, including not seeing family and close friends. We are all looking forward to Christmas and a chance to spend some time with all those we hold dear.”
Until now, President-elect Joseph R. Biden Jr.’s Covid-19 task force has had to prepare its battle plan without the keys to the government agencies leading the pandemic response.
That changes this week, when Mr. Biden can finally dispatch what are known as landing teams to the Department of Health and Human Services, the Centers for Disease Control and Prevention and the Food and Drug Administration.
They will have prepared the traditional welcome gift: enormous briefing books that detail nearly everything the agencies have been working on for the past four years; lists of friendly lawmakers, budgets, accomplishments, roadblocks; and suggested targets for the new administration.
The president-elect will also inherit something nobody would want: a national crisis that is accelerating by the day. More than 176,400 new cases and more than 2,200 new deaths were announced across the United States on Tuesday, with the seven-day average for new cases reaching more than 175,000 for the first time. At least 40 states are recording sustained caseload increases.
In the weeks since Election Day, the dire outlook has been tempered by encouraging early results from three major vaccine developers. But Mr. Biden and his top aides have said their ability to effectively plan a pandemic response had been stymied by President Trump’s refusal to acknowledge his victory and the refusal of the head of the General Services Administration to formally authorize the transition process that would grant Mr. Biden’s transition team access to funds, equipment and government data. That argument has been seconded by a growing chorus of senior Republican lawmakers, business executives and other public figures.
On Monday, President Trump’s government finally authorized Mr. Biden to begin a formal transition process. It is supposed to be led by career staff, not political appointees — and the Biden team can expect to find a warm welcome from them, particularly scientists on the team who Mr. Trump has criticized for years.
But in a pandemic, there is no time to waste. The F.D.A. landing team will need to get up to speed on a planned vaccine roll out, as well as the most promising new vaccine candidates and therapeutics. It may also designate a career staff member to be the agency’s acting commissioner if the current one, Stephen M. Hahn, leaves before a replacement can be nominated and confirmed.
At the C.D.C., one of the most pressing issues will be taking over a public education campaign, now in development, to persuade the public to trust — and take — the vaccine.
In the absence of a formal transition, Mr. Biden had been left trying to signal to Americans that he is prepared to take charge of a disjointed federal virus response.
“It doesn’t matter who you voted for, where you stood before Election Day,” Mr. Biden said in Delaware in early November after announcing a coronavirus task force. “It doesn’t matter your party, your point of view. We can save tens of thousands of lives if everyone would just wear a mask for the next few months. Not Democratic or Republican lives — American lives.”
New York roundup
Thousands of ultra-Orthodox Jews gathered to celebrate a wedding inside a cavernous hall in Brooklyn’s Williamsburg neighborhood earlier this month, dancing and singing with hardly a mask in sight. The wedding was meticulously planned, and so were efforts to conceal it from the authorities, who said that the organizers would be fined $15,000 for violating public health restrictions.
The four-hour wedding, held on Nov. 8 by the leaders of the Satmar sect of Hasidic Judaism, is the latest incident in a long battle between city and state officials and members of the ultra-Orthodox community, who prize autonomy, chafe at government restrictions and have frequently flouted guidelines like mask-wearing and social distancing.
In October, state officials announced a series of restrictions in several neighborhoods in Brooklyn and Queens with large Orthodox Jewish populations after the positive test rate in those areas rose above 4 percent. Many residents protested the restrictions, which included the closing of nonessential businesses and limiting capacity at houses of worship.
While the rates in several of these areas have decreased since the implementation of the restrictions, tensions between city officials and area leaders have continued.
Mayor Bill de Blasio announced the fine on Monday night after video of the wedding — and a florid account of the event and the extensive efforts to conceal it appeared in a Hasidic newspaper — drew backlash online. He said additional penalties could be imposed on the organizers.
“We know there was a wedding,” the mayor told the local news network NY1. “We know it was too big. I don’t have an exact figure, but whatever it was, it was too big. There appeared to be a real effort to conceal it. Which is absolutely unacceptable.”
Representatives for the Satmar community did not respond to a request for comment on Tuesday.
Elsewhere in New York:
Mayor Bill de Blasio announced an agreement with Verizon to offer internet service to half a million households, prioritizing public housing units and community districts known to lack broadband. Mr. de Blasio said he hoped the new access would offer families an alternative way to connect during the holiday season and support students who were scrambling now that schools are closed indefinitely. The effort to bridge the digital divide was first initiated by the former mayor, Michael Bloomberg, who struck an agreement with Verizon in 2008 to make high-speed Fios internet service available to every household in the city. Nine years later, under the de Blasio administration, the city sued the company for failing to fulfill its obligations.
Gov. Andrew M. Cuomo, facing a barrage of condemnation after discussing his Thanksgiving dinner arrangements in a radio interview, changed his plans. The governor was accused of hypocrisy after he said on Monday that his 89-year-old mother and two of his daughters would be traveling to Albany to join him; he has been pleading with New Yorkers for days to reconsider family gatherings as cases of the virus spike across the nation.
On Staten Island, an emergency hospital will reopen to address a new surge in coronavirus cases that is straining the capacity of the borough’s hospitals. The facility will be located at the South Beach Psychiatric Center and will take in virus patients after officials at Staten Island University Hospital and Richmond University Medical Center said they were running short on beds. The number of Covid-19 hospitalizations in the borough has essentially tripled in the past three weeks — to 91 on Sunday from 33 on Nov. 2 — with no indication that the pace is slowing, Governor Cuomo said Monday.
Thirteen African countries will take part in a clinical trial aimed at identifying treatments that could prevent moderate coronavirus cases from becoming more severe. The randomized trial will be carried out by ANTICOV, a consortium of 26 African and European clinical institutions, and the study’s authors hope the results will lead to fewer hospitalizations, which could overwhelm fragile health systems in the continent.
While many Western countries are preparing plans to distribute a successful vaccine in the coming months, vaccine nationalism and a $4 billion gap in procurement financing in Africa could mean that many countries there experience delays or are left out of the rollout. Governments in these countries are instead exploring other ways to manage any potential case surges.
The clinical trial will explore therapeutic medicines currently used to treat malaria, H.I.V. and certain cancers, among other diseases. Testing is already underway in the Democratic Republic of Congo, with Kenya expected to follow soon. Once individual countries give regulatory approval, the Equatorial Guinea, Ethiopia, Ghana, Guinea, Kenya, Mali, Mozambique, Sudan, and Uganda will also come on board.
Africa has largely avoided the devastating spikes that have swept across Western nations. Experts believe this could be because of younger populations, existing cross-immunity and fewer travel links, among other reasons. Some have suggested numbers may be underreported, although lower hospitalization rates would seem to rule out huge numbers of undetected cases.
But the continent is experiencing a new uptick in cases, and experts warn the holiday season may lead to new outbreaks as families travel or relax social distancing measures.
Africa this week passed the two million cases mark, with the bulk of recorded infections — almost 800,000 — coming from South Africa, the most developed economy in the sub-Saharan region.
Australia’s largest airline, Qantas, is planning to make coronavirus vaccines — when they become available — compulsory for passengers who want to fly internationally, and its chief executive predicted that other airlines would follow.
Alan Joyce, the head of Qantas, said on Monday that the airline was looking at changing its terms and conditions to make vaccines compulsory for those traveling into or out of Australia.
He also said he believed vaccinations as a condition for international air travel would be mandated by more airlines: “I’ve talked to my colleagues at other airlines across the globe, and I think it’s going to be a common theme across the board.”
He said airlines and governments around the world have considered developing an electronic vaccination passport that would certify if passengers were vaccinated and with what vaccine. Mr. Joyce’s comments coincided with an announcement by the International Air Transport Association that it was in the final stages of developing a digital health pass that would provide travelers’ testing and vaccine information to governments and airlines.
The Australian government has said that coronavirus vaccines will be “as mandatory as you can possibly make it.”
Qantas has not finalized any changes since no vaccines are predicted to be available in Australia until early next year, but one British travel company said it would stop selling Qantas flights.
In other news from around the world:
In an upcoming book, Pope Francis criticizes those who do not wear masks, saying, “It is all too easy for some to take an idea — in this case, for example, personal freedom — and turn it into an ideology.” The pope has himself been criticized for not wearing masks at his public appearances.
King Felipe VI of Spain has started a 10-day quarantine after coming into close contact with someone who later tested positive for Covid-19. The royal household did not disclose whom the king had met but said in a statement that all of his official activities had been canceled during the quarantine period. The king’s wife, Queen Letizia, and their two daughters have not been quarantined.
Prime Minister Johnny Briceño of Belize will isolate for two weeks after testing positive for Covid-19, Reuters reported. The country has recorded a total of 5,200 coronavirus cases, according to a New York Times database.
The parliament of Lithuania installed a new prime minister, Ingrida Simonyte, on Tuesday and then swiftly adjourned for a week because of a surge of coronavirus cases in the country, The Associated Press reported. The former government was heavily criticized over soaring unemployment stemming from the pandemic.
The makers of a leading Russian vaccine candidate, Sputnik V, said on Tuesday that it showed an efficacy rate of 95 percent in preliminary results from a clinical trial, which would put it at the same level as or better than three other vaccines that have yielded results in recent weeks.
However, that figure was based on an unspecified small group of volunteers within the ongoing Phase 3 trial of the vaccine, and the vaccine makers did not specify how many people with the vaccine or the placebo got sick. When the trial is done, the company said, they will release more complete data.
While it was hard to immediately assess the efficacy of the vaccine based on the announcement and the fact that the Phase 3 trials are not complete, the news promised to add to the flurry of excitement over the promise that vaccines could bring the coronavirus pandemic to an end.
The American and German team of Pfizer and BioNTech and the American company Moderna have announced efficacy rates of 95 and 94.5 percent, respectively. And AstraZeneca and the University of Oxford said on Monday their vaccine is either 62 percent or 90 percent effective, depending on the manner in which the doses were given.
Russia registered the vaccine for emergency use in August before beginning a clinical trial to measure its efficacy, shortcutting the usual process and drawing international criticism. President Vladimir V. Putin claimed it was the first vaccine in the world to receive government approval.
Russia has marketed its vaccine mostly in former Soviet states and countries with developing economies, saying the cost of one dose will be less than $10 for international markers. Officials said that vaccine makers have received orders for 1.2 billion doses from around 50 countries. The Russian Direct Investment Fund has said that about 10,000 people have been inoculated under the emergency-use approval.
On Nov. 11, the government-backed Russian Direct Investment Fund announced that an analysis of the first 20 volunteers indicated an efficacy rate of 92 percent. On Tuesday, the fund provided a similar estimate with more details. They analyzed 18,794 volunteers who have received both injections of the two-dose regimen; 14,095 got the vaccine and 4,699 got the placebo.
A week after the second dose, they found 39 cases of Covid-19, with only eight of the volunteers who got sick having received the vaccine. Based on the ratio of volunteers who got the vaccine to the placebo, the researchers estimated the efficacy at 91.4 percent.
But in their announcement, the fund said that researchers also looked at an unspecified number of volunteers three weeks after the second dose. In those volunteers, they calculated an efficacy rate of 95 percent.
The researchers will take another look at the results when they reach 78 cases of Covid-19 in the volunteers.
Some experts expressed skepticism about the announcement, which was based on an incomplete dataset and apparently not compiled during a regularly scheduled review of the trial results.
“That’s not how it should be done,” said Dr. John Moore, a virologist at Weill Cornell Medicine. “It seems to me what they’re doing is slicing and dicing and data-dredging to come up with the 95 percent figure.”
In August, the Russian Direct Investment Fund named the vaccine Sputnik V for the first satellite launched by the Soviet Union, though at the time, other vaccines were further along in development.
Russian scientists have begun Phase 3 clinical trials on two other vaccines.
Toronto, the fourth largest city in North America, went into lockdown on Monday. But in contrast to New York and other big American cities, officials are finding it more beneficial to keep schools open.
“We cannot put in-class learning at risk,” Ontario’s premier, Doug Ford, said last week. Along with trying to avoid overwhelming hospitals and protecting older adults in long-term care homes, Mr. Ford said, educating students was “what matters most.”
Mr. Ford’s announcement illustrated how Canada has followed the lead of much of Europe, prioritizing the opening or reopening of schools, while just across the border, many U.S. states have focused on keeping businesses open.
In most places, there are no official thresholds for shutting schools down and there is little appetite to do so, according to Ahmed Al-Jaishi, an epidemiologist who is part of an academic team compiling school outbreaks across Canada. And, despite fears among parents that students would bring the disease home and among teachers that they would get infected, such outcomes have been rare.
Even so, some parents in Toronto have been reluctant to allow their children to return to in-class learning, particularly now, with the city seeing its biggest surge in coronavirus cases since the start of the pandemic. Last week, the city reported a 6.2 percent positive test rate. That is more than double the 3 percent positive test rate in New York that triggered school shutdowns last week.
Most schools across Canada shut in March, when Prime Minister Justin Trudeau asked Canadians to stay home and closed the border. In many cases, the schools didn’t reopen until September, after months of parental complaints, children falling behind in schoolwork and rising concerns about the effects of social isolation.
Facing a spike in coronavirus infections, the government in Hong Kong ordered all bars and nightclubs to shut starting on Thursday.
The city’s fourth wave of cases has emerged under cooler temperatures and what officials warned of as fatigue after months of social distancing. A cluster that began at a dance studio has since spread to similar venues across the city, bringing infections to another high since the summer.
Sophia Chan, Hong Kong’s health secretary, said that all bars, nightclubs, bathhouses and rented rooms for private parties must close, and that live performances and dancing would be banned. Banquets could have 10 tables at most, with each seating up to four people, she said.
The city’s authorities have toughened and relaxed its social-distancing rules with rises and falls in coronavirus cases. On Tuesday, Hong Kong reported 80 new cases, including 54 linked to the dancers, bringing the cluster that originated at Starlight Dance Club — a ballroom and Latin dance studio — to 187 cases, a health department spokeswoman said.
Also on Tuesday, Hong Kong’s leader, Carrie Lam, defended a plan to pay about $645 to those who test positive and who are in financial difficulty. Critics said the government was giving people an incentive to intentionally infect themselves, but officials have since clarified the eligibility requirements for the payments. Mrs. Lam said it was intended to help those who would lose income as a result of getting infected.
Early in the pandemic, public health workers all over the United States launched efforts to trace outbreaks back to their origins, whether at busy restaurants or crowded meatpacking plants. But with the virus now spreading rapidly in much of the country, overwhelmed state and local health officials are scaling back those contact tracing efforts, or even abandoning them altogether.
Revealing the trail of transmission from one person to another is a key tool for containing the spread of an infectious disease. Within 48 hours of testing positive, patients receive a phone call from a trained contact tracer, who conducts a detailed interview, and then hunts down each new person who may have been exposed, warning them to quarantine and get tested.
That, at least, is how it’s supposed to work.
Now, with the United States recording a staggering two million new cases in less two weeks and 42 states recording sustained caseload increases, public health agencies are making hard choices about how much they can still realistically learn, and acknowledging that contact tracing efforts can no longer be expected to contain the virus’s spread.
On Monday, the Centers for Disease Control and Prevention released new guidance that called on health departments to focus contact tracing efforts on people who had tested positive within the past six days and especially those who were at the greatest risk of infecting others. Patients infected more than 14 days ago should not be traced, the new guidance says.
States like Pennsylvania, which had already been revising its tracing protocols, have announced that they will follow the C.D.C.’s new guidance.
Dr. Nirav Shah, who heads Maine’s coronavirus response, explained how his state would scale back its ambitions: Contact tracers would touch base with each new patient only once, and not throughout the course of their illness, to make sure they were well and quarantining.
“Unfortunately, going forward, we have had to make a difficult decision, and I wanted you to hear about that difficult decision from me,” he said when announcing the change.
“Sadly, in Maine and throughout the country, the virus is moving faster and spreading faster than the ability of states to train and deploy new public health investigators.”
Similar decisions were being made all over the country.
New Hampshire last week said that it would only trace cases of people connected to outbreaks or in specific at-risk age or racial groups.
Minnesota’s Itasca County this month said that it was abandoning contact tracing, advising the public that, “if you are in a group setting, just assume that someone has Covid.”
In North Dakota, state officials said last month that they could no longer have one-on-one conversations with everyone who may have been exposed. Aside from situations involving schools and health care facilities, people who test positive were advised to notify their own contacts, leaving residents largely on their own to follow the trail of the outbreak.
Public health experts remain hopeful that contact tracing remains useful in identifying clusters and determining the broad contours of how and where infections are spreading.
“There are diminishing returns when the outbreak is out of control, like it is currently, but the returns aren’t zero,” said Dr. Thomas Tsai, a health policy researcher at Harvard T.H. Chan School of Public Health. “The discourse around our treatments tends to be all or nothing.”
Crystal Watson, an assistant professor at Johns Hopkins Bloomberg School of Public Health, said contract tracers should give first priority to the patients most at risk of spreading the virus.
“It still saves lives, it still breaks chains of transmission,” she said. “Every person we can get to quarantine at home, who is not out in the community — that contributes to reduction in incidence.”
Rich DiPentima, New Hampshire’s former chief of communicable disease and epidemiology, said contact tracing capacity much of in the United States has been weak since the pandemic began, so it is no surprise that it can’t keep up now.
“We have a situation where we missed the boat in the beginning,” he said of the situation in his state. “Then you throw up your hands, saying you can’t do this any more.”
In normal times, civic groups like the Benevolent and Protective Order of Elks would come together every couple of weeks for meetings, spaghetti dinners or events like dart-throwing contests to raise money for charity. Last year, for instance, Elks Lodges raised and distributed $340 million across the country, according to a national spokesman, Roger True.
But since Covid-19 struck, these clubs, whose meetings often take place in bars and restaurants owned by members, are barely holding on.
“The restrictions have been a disaster,” Mr. True said. “It has been a major financial drain on us.” Although none of the country’s nearly 2,000 Elks Lodges have shut down permanently, several are struggling, he said. “If this goes on much longer, we’ll probably lose them.”
Most club members are older, Mr. True said, which can make meeting in person risky during a pandemic. Many groups have switched to Zoom meetings, but some have continued to gather in person, leading to a number of recent outbreaks that have forced lodges to shut their doors.
In mid-October, several members of an Elks Club in Vermont tested positive for the virus after having spent time at the lodge. A couple of weeks later, on Nov. 16, the club announced that it would close until the new year, following a dramatic decrease in meeting attendance.
“We will take this time to study our finances and make necessary changes that position us to better withstand an unknown future,” the local board wrote in a Facebook post.
Last week, at least 31 Covid-19 cases were linked to Fraternal Order of Eagles events between Oct. 31 and Nov. 10, in Ypsilanti, Mich., where health officials said mask and social distancing guidelines had not been followed. And the Fredonia Beaver Club, in Fredonia, N.Y., had about a dozen Covid-19 cases linked to indoor gatherings at its club, forcing it to close temporarily on Nov. 7.
The club, in Chautauqua County, reopened on Monday. “To say it’s been slow is an understatement — it’s been awful,” said Rich Ryan, the club’s financial secretary. “Times aren’t great in social clubs.”