With the coronavirus raging in many parts of the country and hospitals dangerously overstretched, public health officials warned on Sunday that more calamitous days may be ahead, as infections tied to holiday gatherings fuel a fresh spate of illness and death.
“It’s terrible, it’s unfortunate, but it was predictable,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on “Meet the Press.”
This is also the first holiday period in which the new, more transmissible variant of the virus, first found in Britain, was known to be circulating in the United States.
Although air travel is down markedly from years past, American airports had their busiest day of the pandemic on Saturday, with 1,192,881 passengers passing through security checkpoints, according to the Transportation Security Administration. Since Dec. 18, the agency has counted more than 16.3 million trips through its airport checkpoints, down from more than 35.4 million in the same period a year ago. And tens of millions more people were expected to travel by car.
Travelers have some vulnerability to infection while they are in transit, but, as the pattern of transmission from Thanksgiving travel demonstrated, the greater possibility of exposure comes from gatherings at the travelers’ destinations.
Because of the time lag between when people catch the virus and when they become ill and are hospitalized — and also because of holiday reporting anomalies — public health officials say a post-Christmas spike may not emerge clearly until the second week of January.
“Things are bad enough as they are right now,” Dr. Fauci said, “but they could get worse in the next couple of weeks.”
The surgeon general, Dr. Jerome Adams, expressed similar fears, calling the projections of increased infections “pretty scary” and urging Americans to continue wearing masks and embracing social distancing.
“What we do now matters,” he said Sunday in an interview with Jake Tapper of CNN. “If you gathered over the holidays outside of your household without a mask, there are still measures you can take right now. You still can self-quarantine. You still can get tested, knowing that greater than 50 percent of the spread now is among people who are asymptomatic.”
“If we do that,” he added, “we will be able to temper this surge.”
The United States reported at least 291,300 new coronavirus cases on Saturday, a single-day record, but one inflated by holiday reporting backlogs. Regular data reporting is expected to resume later this week.
Regardless of day-to-day reporting anomalies, the United States has had the world’s worst outbreak for most of the pandemic and is experiencing a tsunami of infections as vaccine distribution begins. On Saturday, the country passed yet another once-unthinkable milestone, surpassing 350,000 total deaths. More than 123,000 Covid-19 patients were in hospitals on Saturday, only a slight drop from the record level on Thursday.
Los Angeles County, the most populous in the United States, may already be experiencing a post-Christmas surge. Over the past week it has averaged 16,193 cases a day, about 12 times the average rate of 1,347 a day at the start of November.
Even as the deluge of coronavirus cases has overwhelmed hospitals around the state, and in Los Angeles County in particular, some Angelenos celebrated the new year at clandestine parties. Police dispersed more than a thousand people who had attended a warehouse party, The Los Angeles Times reported.
The latest surge of the coronavirus in Los Angeles County is infecting a new person every six seconds, Mayor Eric Garcetti of Los Angeles said Sunday. And it is accelerating exactly where people are least likely to be on their guard: in private.
Mr. Garcetti said on the CBS program “Face the Nation” that despite what California has done to limit virus transmission in public, including high compliance with mask-wearing and tight restrictions reimposed on businesses, large numbers of new cases were still being detected, including a recent average of 14,000 a day in the county.
“This is something now that really is spreading in the home,” Mr. Garcetti said, adding: “It’s a message for all of America: We might not all have the same density as L.A., but what’s happening in L.A. can and will be coming in many communities in America.”
There are more than twice as many Covid-19 patients in California hospitals now as there were a month ago, and many intensive care units in the state have been overflowing. At least four people in the state have been found to be infected with the new, more transmissible variant of the virus first identified in Britain.
And at the rate that immunization is going so far, the new vaccines offer little hope for quickly reining in the surge, the mayor said. “We are at a pace right now to deliver vaccines in L.A. over five years, instead of over half a year,” he said.
Mr. Garcetti criticized the Trump administration for failing to plan ahead by training more medical personnel to administer the vaccine, and for leaving it up to state and local governments to run a huge inoculation campaign without providing the resources needed to carry it out.
“The federal government can’t tell the local governments and state governments to do something and not give us aid,” he said.
A top official of Operation Warp Speed floated a new idea on Sunday for stretching the limited number of coronavirus vaccine doses in the United States: Halving the dose of each shot of Moderna’s vaccine to potentially double the number of people who could receive it.
Data from Moderna’s clinical trials demonstrated that people between the ages of 18 and 55 who received two 50-microgram doses showed an “identical immune response” to the standard of two 100-microgram doses, said the official, Dr. Moncef Slaoui.
Dr. Slaoui said that Operation Warp Speed was in discussions with the Food and Drug Administration and the pharmaceutical company Moderna over implementing the half-dose regimen. Moderna did not respond immediately to a request for comment.
Each vaccine would still be delivered in two, on-schedule doses four weeks apart, Dr. Slaoui, said in an interview with “CBS’s Face the Nation.” He said it would be up to the F.D.A. to decide whether to move forward with the plan.
Dr. Slaoui was asked whether the United States would follow Britain’s lead on another tactic for getting shots to more people: Delaying second doses of newly authorized vaccines to immunize a larger swath of the population. There is little or no data on dose delays, Dr. Slaoui said, but “injecting half the volume” might constitute “a more responsible approach that will be based on facts and data to immunize more people.”
Natalie Dean, a biostatisitician at the University of Florida, agreed that there might be more data to support a vaccine strategy that relied on half-doses rather than delayed doses.
“There is a path forward if you can show that two lower doses yield a similar immune response,” Dr. Dean said.
As caseloads continue to surge upward around the globe, and concerns mount over a new and potentially more transmissible variant of the coronavirus, “everyone is looking for solutions right now, because there is an urgent need for more doses,” Dr. Dean added. “But the dust has not settled on the best way to achieve this.”
John Moore, a vaccine expert at Cornell University, pointed out that the approach wouldn’t necessarily work for all vaccines. Injections are already doled out in very small volumes, and some might be harder to halve than others, he noted.
While Dr. Moore agreed that halving doses has more scientific backing than dose delays, he noted that “this is not something I would want to see done unless it were absolutely necessary.”
A crashed phone network in Houston. People waiting overnight in long lines in Florida. Older Tennesseans leaning on their walkers outside in the cold alongside a highway.
As distribution of Covid-19 vaccines begins to open up to wider segments of the United States population, there have been scenes of chaos across the country.
The initial vaccine deliveries were mostly for frontline medical workers and nursing home staff members and residents. But there was less of a clear consensus on how to distribute the second round of doses, and public health and elected officials had warned the process would become messier.
Those warnings appear to have been borne out, leaving the U.S. inoculation campaign behind schedule and raising fears about how quickly the country will be able to tame the epidemic.
In Puerto Rico, a shipment of vaccines did not arrive until the workers who would have administered them had left for the Christmas holiday. In California, where coronavirus cases are surging and hospitals are overstretched, doctors are worried about whether there will be enough staff members to both administer vaccines and tend to Covid-19 patients.
Many vaccination sites have operated smoothly since the first U.S. inoculation on Dec. 14, but as availability of vaccines broadened, logistical complications arose at some sites and yielded unnerving images.
In Tullahoma, Tenn., older people lined a sidewalk on Saturday as they waited to enter the Coffee County Health Department’s Tullahoma clinic, about 70 miles northwest of Chattanooga. Most of the people in line were wearing heavy coats or huddled under blankets.
A video of the scene posted to Facebook showed seniors leaning on walkers and canes and sitting on footstools and lawn chairs as they waited for the building to open. Vickie Rayfield Ham, who posted the video, wrote that she thought the distribution center would be a drive-through.
“Some of the elderly were having to walk down the road with their walkers to get to the end of the line, and people were flying by,” she told WTVC, a local television news station.
In a Facebook post that went up shortly before 10 a.m. local time, a couple of hours after Ms. Ham’s video, the city of Tullahoma said that all available doses had been administered for the day and that information about next week’s vaccination schedule would be released on Monday.
The opening day for Houston’s first free public Covid-19 vaccination clinic unleashed so much demand that the city health department’s phone system crashed, causing officials to scramble to move to on-site registration.
Vaccinations began in Houston soon after the first doses of the Pfizer vaccine started arriving at its hospitals on Dec. 14. On Saturday, the city opened a clinic at the Bayou City Event Center providing the Moderna vaccine to high-risk members of the public, saying it could accommodate 750 appointments a day.
Mayor Sylvester Turner said that the health department had received more than 250,000 calls.
“The system was literally overwhelmed,” he said during a news briefing on Saturday.
The clinic’s phone system was back up by the afternoon and as of 2 p.m. local time about 450 people had received a Covid-19 vaccine, Mr. Turner said.
Vaccine rollout sites in Florida continued to be overwhelmed in some places, with people waiting for hours overnight in hopes of getting the shot. The state had expanded its offering of vaccines to older members of the general public — in some cases, on a first-come, first-served basis.
Florida became one of the first states to open up vaccination to anyone older than 65, after Gov. Ron DeSantis issued an executive order on Dec. 23.
Mina Bobel, 74, and her husband, Dave Bobel, lined up at 2 a.m. outside the Lakes Regional Library in Fort Myers, Fla., on Wednesday in hopes of getting vaccinated. They came prepared with snacks and water, and even took turns sleeping in the back of their S.U.V. There were about 300 people ahead of them in line, Ms. Bobel said, and most of them had come well equipped, too — with coats and blankets to keep warm.
“For us, it was an adventure,” Ms. Bobel said, adding that she was “giddy” when finally, around 10 a.m., she stepped up to get her first dose. “We feel really lucky.”
When she left, Ms. Bobel said, the line was even longer than when she arrived.
Pope Francis on Sunday criticized people who traveled abroad during the pandemic “to escape the lockdown,” saying they were ignoring those who were suffering.
In his weekly noontime Sunday address, Francis said, “I read in the papers something that quite saddened me: In a country — I don’t remember which — to escape the lockdown and have a good vacation more than 40 planes took off that afternoon.”
“Those people are good people, but didn’t they think of those who stayed at home, to the economic problems of many people who have been knocked down by the pandemic, to those who are ill?” Francis added. They thought “only to go on vacation, to have fun.”
“This really saddens me,” Francis said in a message streamed from the Vatican’s apostolic library. The pope normally blesses the faithful on Sundays from a window in a palace above St. Peter’s Square, but Italy has been on lockdown for the past 10 days, and the square is closed.
It is not clear what report the pope was referring to, or where the travelers were leaving from and heading to. On Saturday, The New York Times reported that more than half a million Americans went to Mexico in the month of November alone, but that article did not include anything about the number of planes on any given afternoon.
While Mexico has relatively few travel restrictions, stricter measures are in place in many countries — and many have been tightened since a more transmissible variant of the virus was first identified in Britain. And international travelers are often ordered or urged to quarantine for a week or more on arrival.
The United Nations World Tourism Organization reported that international arrivals had dropped by 72 percent for the first 10 months of 2020, and anticipates that, when tabulated, the drop for the full year will be between 70 and 75 percent.
On Sunday, the pope reiterated his plea that all peoples and nations should work together to fight the pandemic.
“We know that things will improve in the measure in which, with the help of God, we will work together for the common good, putting the focus on the weakest and the most disadvantaged,” Francis said.
“We don’t know what 2021 holds for us, but what each of us and all of us together can do, is to commit to taking care of each other and of creation, our common home,” rather than thinking of our own interests, Francis said.
NEW DELHI — India said on Sunday that it had approved two coronavirus vaccines, one made by AstraZeneca and Oxford University and the other developed in India, for emergency use, a major step toward halting the spread of the coronavirus in one of the world’s hardest-hit countries.
Dr. V.G. Somani, the drugs controller general of India, said at a news conference in New Delhi that the decision to approve the Oxford-AstraZeneca vaccine and a local vaccine developed by Bharat Biotech came after “careful examination” of both by the Central Drugs Standard Control Organization, India’s pharmaceutical regulator.
Indian regulators are still considering approvals for other vaccines. One, made by Pfizer and BioNTech, has already been approved in the United States, Canada and Europe. Another, Russia’s Sputnik V, appears to be less far along.
On Wednesday, Britain became the first country to grant emergency approval for the Oxford-AstraZeneca vaccine. Argentina soon followed suit.
Officials in India moved quickly for a number of reasons. The country is No. 2 in confirmed infections behind the United States, and the outbreak is widely believed to be worse than the official figures suggest. The pandemic has devastated the economy, and the unemployment rate is at a 45-year high.
India’s government will face steep challenges as it works to inoculate more than 1.3 billion people across the vast country. The government says it is ready. To get the vaccine across a country famous for its size and its sometimes unreliable roads, officials will tap into knowledge from nationwide polio vaccination and newborn immunization campaigns, and the skill and flexibility employed in India’s mammoth general elections, where ballot boxes are delivered to the furthest reaches of the country.
But the effort has already faced setbacks. The Serum Institute, an Indian drug maker that struck a deal to produce the Oxford vaccine even before its effectiveness had been proven, has managed to make only about one-tenth of the 400 million doses it had committed to manufacturing before the end of last year.
The Bharat Biotech vaccine, called Covaxin, is still in Phase 3 clinical trials in India and has not published efficacy data. Dr. Somani, the regulator, said the vaccine had so far been administered to 22,500 trial participants, “and the vaccine has been found to be safe.”
Both the AstraZeneca vaccine and the Bharat Biotech vaccine require two doses, Dr. Somani said. He did not specify whether the participants in Bharat Biotech’s continuing clinical trials had received both doses.
LONDON — Parts of England may face harsher restrictions in the coming weeks, Prime Minister Boris Johnson said on Sunday, as Britain confronts a surge in coronavirus cases and hospitalizations linked to a new, more transmissible variant of the coronavirus.
But with classes set to resume and his government’s plans for in-person teaching under increasing pressure, he also urged parents to send their children to school.
Mr. Johnson said in an interview with the BBC’s “Andrew Marr Show” that he was “fully reconciled” to implementing more restrictions and that the government had taken “every reasonable step” to prepare for the winter. He said that ministers could not have predicted the emergence of the new variant, which has led dozens of governments to restrict travelers from Britain, and that he hoped more vaccinations would lead the country out of lockdowns.
Britain was the first country to give emergency authorization to the vaccine developed by Pfizer and BioNTech and then, last week, one from AstraZeneca and the University of Oxford.
With classes set to return in many primary schools in England on Monday, Mr. Johnson added that parents should “absolutely” send their children to schools if possible. “We’ve really fought very hard in this pandemic across the country to keep schools open,” he said. “Schools are safe.”
The government had planned for primary schools across England to reopen on Monday, with secondary school students returning later in phases, but it moved last week to delay opening primary schools in parts of London and southeastern England, where the new variant first took off. The delay was extended to cover all of London late last week.
Teaching unions have opposed a return to in-person schooling, and on Saturday the largest, the National Education Union, advised primary-school teachers to stay home and offer to conduct lessons remotely. “The science now tells us that, although children largely do not become ill with Covid-19, they spread it to others,” the union said in a statement.
Britain reported 57,724 new cases on Saturday and 445 new deaths.
Those We’ve Lost
Anyone who had worked with Zelene Blancas in El Paso knew her as a teacher whose goal was to spread compassion above all else.
Ms. Blancas, who was born in Texas and lived in Mexico for much of her childhood, was a bilingual Spanish teacher at Dr. Sue A. Shook Elementary School, and she was hoping to become a bilingual special education teacher.
She gained popularity online after posting a video in 2018 of her students that gained more than 23 million views. It showed classmates hugging one another before a weekend break, smiles spread across their faces as they said goodbye — a reminder of the human capacity for love and connection.
Ms. Blancas tested positive for the virus on Oct. 20 and was hospitalized a few days later, her brother, Mario Blancas, said. After she had spent nearly two months in the I.C.U. and had exhausted all of her available sick days and paid time off, Mr. Blancas set up a GoFundMe page on Dec. 14 to help pay for his sister’s health care since she would soon be “without an income and will have to pay the full cost of her health insurance out of pocket,” according to the page.
But this week, at just 35 years old, Ms. Blancas died of complications from Covid-19. Her death has devastated the city.
During her teaching career, Ms. Blancas would often stay up late to speak on the phone with her students’ parents. She ran a literacy program for parents in the evenings, and when classes shifted to remote learning during the pandemic, she delivered care packages, complete with handwritten notes, to her students. Even from her hospital bed, Ms. Blancas was asking about her work at school, said her principal, Cristina Sanchez-Chavira.
“Her calling was just to spread kindness,” Ms. Sanchez-Chavira said. “I think education was the vehicle that she found, but that was her. She embodied kindness, and making others feel special. And she did that in and outside of the classroom.”
Ms. Blancas had been shocked to see the 2018 video clip of her students being shared so widely, Ms. Sanchez-Chavira said, adding that for Ms. Blancas, encouraging empathy among her students had always been a priority.
“She was so humble about it,” Ms. Sanchez-Chavira said of the video. “She was just doing everything for the kids, and I think that’s what made her such a phenomenal teacher — because she just did everything from her heart.”
Ms. Blancas spent her 35th birthday in her hospital room, without family by her side, Mr. Blancas said. The nurses all signed a birthday card for her, and her father sent her a picture of a cake and balloons.
The day before her death, Mr. Blancas said, he was able to visit his sister. It was painful, he said, to see his only sister in a hospital bed, breathing through a tube, her face swollen from the treatments. He brought a gift he knew would make her happy: a blanket emblazoned with pictures of her two beloved dogs, Chico and Rocky.
The homes of Mitch McConnell and Nancy Pelosi, political opponents and the two most powerful members of Congress, were reported to have been vandalized, as their standoff continues over a stimulus bill that has been criticized as inadequate by from both the left and right — including President Trump.
In a statement on Saturday, Mr. McConnell, a Kentucky Republican and the Senate majority leader, lamented what he called a “radical tantrum” drawn from a “toxic playbook.” The Louisville station WDRB-TV reported that the senator’s home was tagged overnight with red and white spray paint. Photos show writing on the front of Mr. McConnell’s home, including a message that says “Weres my money” on the front door. The Louisville Metro Police Department did not immediately respond to a request for comment on Saturday.
“I’ve spent my career fighting for the First Amendment and defending peaceful protest,” Mr. McConnell said in the statement. “I appreciate every Kentuckian who has engaged in the democratic process whether they agree with me or not. This is different. Vandalism and the politics of fear have no place in our society.”
Around 2 a.m. Friday, San Francisco police officers responded to a report of vandalism at a home in the city’s Pacific Heights neighborhood. Graffiti had been spray-painted on the garage door and “a pig’s head” was left on the sidewalk in front of the house, a spokesman for the Police Department said. The San Francisco Chronicle reported that the home belonged to Ms. Pelosi, a Democrat who serves as House speaker.
The Police Department did not respond to additional questions, including whether the pig’s head discovered on the property was real or fake. The speaker’s office did not respond to a request for comment on Saturday.
President Trump signed a bill providing $900 billion in stimulus last Sunday, but called for payments to individuals be increased to $2,000 from $600. Ms. Pelosi rallied support for the shift, and the House voted to raise the payments on Monday. Mr. McConnell blocked the effort the following day .
Mr. McConnell said on Tuesday that the Senate would “begin a process” to consider bigger payments along with Mr. Trump’s other demands, which include investigations of his baseless claims of voter fraud in the 2020 election and the repeal of certain legal protections for tech giants such as Facebook, Google and Twitter.
Plenty of numbers can quantify the way the pandemic and the resulting recession have battered the United States: At least 7.8 million people have fallen into poverty, the biggest plunge in six decades; 85 million Americans say they have had trouble paying basic household expenses, including food and rent.
But those numbers do not capture the feeling of growing desperation in some communities that had already been struggling before the pandemic. In certain neighborhoods on Cleveland’s east side, for example, longtime residents and workers talk of a steady unraveling.
Gunfire echoes almost nightly, they say. The Cleveland police reported six homicides in one 24-hour period in November. As in Cincinnati, Wichita, Kan., and several other U.S. cities, 2020 was the worst year for murders in Cleveland in decades.
Everyone talks about the crazy driving — over the past few months in the neighborhood of Slavic Village, cars have crashed into a corner grocery store, a home and a beloved local diner. In Cuyahoga County, 19 people died of drug overdoses in one recent week. All as the virus continues its lethal spread.
“Sometimes,” said the Rev. Richard Gibson, whose 101-year-old church stands in Slavic Village, “it feels like we’re losing our grip on civilization.”
The places where many would ordinarily have gone to learn about new benefits and new rules — where they might have access to a decent internet connection, for example — are now closed.
“Our library is not open anymore, our Boys Club is not open anymore,” said Tony Brancatelli, a member of the City Council whose ward includes Slavic Village.
A decade ago, during the foreclosure crisis, parts of Mr. Brancatelli’s ward were among the hardest-hit places in the country, but more people kept their jobs. They had friends and relatives they could move in with or turn to for financial support. Today, with parts of Slavic Village above 30 percent unemployment and a virus that spreads in small gatherings, those supports are not there.
And the virus continues to rage. Cleveland has been spared the catastrophic case totals of cities like Detroit or New Orleans but has nonetheless just endured its worst two-month stretch. As December came to a close, four out of five critical care beds in Cuyahoga County hospitals were being used.
At University Settlement, a 94-year-old social service institution in Slavic Village, there used to be a weekly sit-down dinner for anyone in the community. This has changed to takeout. Some of the people whom the organization routinely checked up on seem to have just disappeared, no longer answering phones or knocks at the door.
“The community felt frayed and forgotten anyway,” said Earl Pike, the executive director of University Settlement. “It’s beginning to feel a little ‘Mad Max’-y.”