UPS and FedEx usually compete fiercely for business. Now, the rivals are working side by side to ship the coronavirus vaccine developed by Pfizer and BioNTech, the first of the vaccines to win U.S. government approval.
The two shipping companies said they had put plans they had been working on for months into action after the Food and Drug Administration gave the vaccine emergency authorization late Friday.
At a news conference on Saturday, Gen. Gustave F. Perna, the chief operating officer of Operation Warp Speed, the federal effort to bring a vaccine to market, said that boxes were being packed at Pfizer’s plant in Kalamazoo, Mich., and would be shipped to UPS and FedEx distribution hubs, where they would be dispersed to 636 locations across the country. Pfizer said shipping would start early Sunday morning.
Mr. Perna specified that 145 sites would receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.
“Make no mistake, distribution has begun,” he said. UPS said it expected to start transporting the vaccine on Sunday morning, when employees stationed at Pfizer’s facility in Michigan will affix special Bluetooth- and radio-enabled tracking tags to each shipment. An aircraft waiting nearby will take the vaccine to the company’s Worldport air cargo hub in Louisville, Ky., a sprawling 5.2 million-square-foot sorting facility. Future shipments of the vaccine will also be transported by truck to the Louisville hub, which is up to a six-hour drive from Michigan.
“This is the moment we’ve been waiting for,” Wes Wheeler, president of the company’s health care division, said in an interview on Saturday. “We’ve been planning for months with daily calls, drilling down to really quite minute details.”
Mr. Wheeler said he planned to oversee the first vaccine shipments from a newly established 24/7 command center in Louisville, which will be staffed at any given time by teams of five to 10 people who will monitor each vaccine package as it moves through UPS’s network.
Once the vaccine shipments arrive at the Louisville hub, they will be sorted alongside other packages and distributed to hospitals and other medical facilities. Every truck driver or airplane pilot will know if they are carrying a vaccine package, Mr. Wheeler said. Both UPS and FedEx have said that doses will arrive at their destinations a day after leaving the Pfizer facilities.
Even before the vaccine was approved, UPS had already started shipping out kits with the medical supplies needed to administer it, such as alcohol wipes and syringes, Mr. Wheeler told a Senate subcommittee this week. UPS and FedEx will split distribution of the vaccine throughout the country. After those shipments arrive, all Pfizer dosing sites will receive another shipment from UPS of 40 pounds of extra dry ice to keep the vaccines at a frigid temperature, he said.
“You have two fierce rivals here, and competitors, in FedEx and UPS, who literally are teaming up to get this delivered,” Richard Smith, a FedEx executive, told the Senate’s Subcommittee on Transportation and Safety on Thursday.
Both companies said the shipments would be closely tracked and monitored, and would be given priority over other packages. To ship its vaccine, Pfizer designed specialized containers packed with enough dry ice to keep a minimum of 975 doses cool for up to 10 days. Each comes with a tracking device.
Like UPS, FedEx said it would also affix its own tracking tags to vaccine shipments. Each UPS truck carrying the doses will have a device that tracks its location, temperature, light exposure and motion, Mr. Wheeler told the senators. The company’s trucks will have escorts, too, he said on Thursday. It is not clear whether he meant the local police or other government officials, or possibly private guards, and he declined to elaborate on that and other details in the interview, citing security concerns. But the trucks leaving Pfizer’s facility will be tracked “by the minute,” he said.
The vaccine administration kits were assembled by McKesson, a medical supplier that was asked by federal authorities to act as a centralized distributor of the vaccines and supplies, such as syringes and alcohol wipes. Unlike Pfizer, Moderna, whose vaccine could be approved soon, plans to have McKesson package its vaccines alongside the supplies, Mr. Smith said.
In the case of Pfizer, UPS plans to deliver the kits — from a McKesson site in Kentucky — in advance of the vaccine, allowing it to identify any errors with addresses in its system, Mr. Wheeler said Thursday. The kits contain a syringe, a substance used to dilute the vaccines, personal protective equipment, instructions and mixing vials, he said.
Shippers have spent months upgrading cold storage infrastructure for the Pfizer vaccine, which must be stored at minus 94 degrees Fahrenheit. UPS, for example, has been installing ultralow-temperature freezer farms that are able to keep goods as cold as minus 112 degrees Fahrenheit near its air cargo hubs in the United States and Europe. It also plans to produce more than 24,000 pounds of dry ice per day at its hub in Louisville. FedEx has added ultracold freezers throughout its U.S. network, too.
Airlines have also been preparing to transport the vaccines, working with plane manufacturers and the Federal Aviation Administration to safely carry more dry ice than is typically allowed. United Airlines said on Saturday that it transported batches of the vaccine from Brussels to Chicago aboard five cargo-only flights this month. (Pfizer is also making the vaccine at a plant in Puurs, Belgium.)
UPS is also sending the F.A.A. a daily file of its flights so it can help prioritize them over others, Mr. Wheeler said. The company is also in daily contact with officials involved in Operation Warp Speed.
An independent committee of experts advising the Centers for Disease Control and Prevention on Saturday afternoon recommended the Pfizer coronavirus vaccine for people 16 years of age and older. That endorsement, which now only awaits final approval by Dr. Robert Redfield, the director of the C.D.C., is a key signal to hospitals and individual health care providers that they should proceed to inoculate patients.
The endorsement follows Friday night’s emergency use authorization of the vaccine by the Food and Drug Administration, which oversees licensing of medical products.
The advisory committee, which typically meets three times a year to review amendments to routine schedules for child, adolescent and adult vaccines, has been engaged in numerous marathon-length sessions this fall to discuss a plethora of issues surrounding the introduction of limited supplies during a pandemic of the novel vaccine.
In meetings on Friday and Saturday, the panel’s heated discussion centered mainly on three areas: whether to recommend the vaccine for patients 16 and 17 years old, for pregnant and lactating women, and for patients who have had an anaphylactic reaction to other vaccines.
C.D.C. officials and scientists will review the debate and post more precise guidance about those specific groups and others on Sunday and throughout next week, as more information about the vaccine becomes known.
This weekend, 2.9 million doses of the Pfizer and BioNTech vaccine are to begin traveling by plane and guarded truck from facilities in Michigan and Wisconsin to designated locations, mostly hospitals, in all 50 states.
The first injections are expected to be given by Monday to high-risk health care workers, the initial step toward the goal of inoculating enough Americans by spring to finally halt the spread of a virus that has killed nearly 300,000, sickened millions and upended the country’s economy, education system and daily life. There are now more than 16 million virus cases reported in the United States, according to a New York Times database.
The rapid development of the vaccine, and the F.D.A.’s emergency authorization of it on Friday night based on data showing it to be 95 percent effective, has been a triumph of medical science, but much in this complicated next stage could go wrong.
States say they have only a fraction of the funding they need from the federal government for staffing to administer the shot, for tracking who has received both doses of the vaccine — a booster is needed three weeks after the initial injection — and for other crucial pieces of the effort.
But for all the planning that has been done and contingencies that have been put in place in recent months, there is still a good deal of confusion. States are receiving initial allocations according to a federal formula based strictly on their adult population, but many hospitals say they still don’t know exactly how much they will get or when shipments will arrive. Some hospital systems are reeling from the news that their initial allocations will be much smaller than they had hoped.
One reason for the shortfall in initial supply is that federal officials decided to send out fewer than half of the 6.4 million doses they had planned for the first wave.
Although there is some variation among their plans, states are largely planning to follow recommendations from the Centers for Disease Control and Prevention about who gets vaccinated first: health care workers at high risk of exposure to the virus and residents of nursing homes and other long-term-care facilities, a population that has died from the virus at disproportionately high rates.
On Thursday, as an F.D.A. advisory committee debated whether to recommend authorization of the Pfizer vaccine, the first packages of supplies to administer it — vaccination record cards, masks, visors, information sheets and syringes — arrived at UPMC Presbyterian, a hospital in Pittsburgh.
The emergency authorization of the Pfizer-BioNTech vaccine on Friday night has set off a frenzy of preparations at hospitals and doctors’ offices across the United States. Among them is Northwell Health, the largest health care provider in the New York region, once the coronavirus epicenter in the United States.
Organizing the receipt and further distribution of the vaccine is a mammoth task. Northwell has set up nine vaccination centers equipped with ultracold freezers at or near its hospitals in Manhattan, Staten Island, Westchester County and Long Island, and plans to start vaccinating tens of thousands of employees as soon as the vaccine shipments arrive, probably on Monday, said Dr. Mark Jarrett, Northwell’s chief quality officer.
The health system, which has 56,000 employees who interact with patients, has already received shipments of kits with supplies for administering the vaccine, including syringes, alcohol swabs and gloves.
Northwell expects to have all of its workers — not just care providers like doctors and nurses, but also others such as cleaning personnel who work in intensive care units and patient rooms — vaccinated within five weeks with the Pfizer-BioNTech or the Moderna vaccines, Dr. Jarrett said.
Employees will be given appointments to come in for shots so they won’t have to stand in line and can maintain social distancing. A backup list of additional recipients will be drawn up in case anyone has to cancel an appointment at the last minute.
“The one thing we don’t want to do is ever waste vaccine,” Dr. Jarrett said. The Pfizer-BioNTech vaccine, which is transported on dry ice, has to be stored at minus 94 degrees Fahrenheit, and then prepared for use.
“Once you’ve defrosted and diluted it, you only have six hours to use it,” Dr. Jarrett said. “You want to certainly use every dose that’s in a vial.”
The health system is carefully scheduling employees for vaccination in various units and hospitals to prevent staffing problems from overburdening any single unit. The idea is to evenly spread staff out in case they have adverse reactions to the shot — such as fever, fatigue or muscle pain — that require them to stay home from work.
That will be even more important when the second dose of the vaccine is administered, three weeks after the first shot; the rate of side effects among clinical trial participants was reported to be higher after the second dose of the vaccine.
Priority will be given to older employees and those who make a request because of medical conditions that leave them especially vulnerable to the coronavirus, Dr. Jarrett said.
No employee will be forced to take the vaccine, Dr. Jarrett said — a decision influenced in part by the fact that the vaccine received an emergency use authorization and has not gone through the F.D.A.’s standard approval process. But he expects demand to be high.
“There will be a certain percentage who are afraid to take the vaccine,” he said. “After they see team members get it and be fine, I suspect most of those will then decide to take it.”
As coronavirus deaths soar across the country, deaths in communities that are home to colleges have risen faster than the rest of the nation, a New York Times analysis of 203 counties where students compose at least 10 percent of the population has found.
In late August and early September, as college students returned to campus and some institutions put into place rigorous testing programs, the number of reported infections surged. Yet because serious illness and death are rare among young coronavirus patients, it was unclear at the time whether the growth of infections on campus would translate into a major health crisis.
But since the end of August, deaths from the virus have doubled in counties with a large college population, compared with a 58 percent increase in the rest of the nation.
Few of the victims were college students but, rather, older people and others living and working in the community.
Since the pandemic began, a Times survey has identified more than 397,000 infections at more than 1,800 colleges and universities. Those cases include more than 90 deaths involving college employees and students.
The link between an outbreak at a college and a coronavirus death in the wider community is often indirect and difficult to document, according to public health experts, especially without extensive contact tracing, which many local health departments in the United States lack resources to pursue.
But researchers have begun finding evidence of ties to college students. Using genetic sequencing to track cases around the University of Wisconsin-La Crosse, Paraic Kenny, a cancer geneticist at the Kabara Cancer Research Institute of the Gundersen Medical Foundation, has found links between infections at the university and cases and deaths in the surrounding region.
That trend highlighted a central fear of health officials — that young adults with limited symptoms might unwittingly transmit the virus, increasing the possibility it would ultimately spread to someone more vulnerable.
Experts suggest an array of ways such spread might happen, including one simple possibility: More than 1.1 million undergraduates work in health-related occupations, census data shows, including more than 700,000 that serve as nurses, medical assistants and health care aides in their communities.
But spread of the virus may also be more invisible, through layers of separation.
“All it really takes is one cavalier interaction,” said Tali Elfassy, an epidemiologist at the University of Miami.
But the three countries have different health care systems and face different challenges in the race to get the vaccine to millions of people. Here are some similarities and differences:
Is it the same vaccine?
For now, yes.
The first vaccine authorized by American regulators, and their British and Canadian counterparts, is the one developed by Pfizer and BioNTech.
But several other vaccines are close behind, particularly one developed by Moderna and the National Institutes of Health, and another from AstraZeneca and the University of Oxford. It could well be that half a dozen or more vaccines are approved in the coming months.
How centralized is the rollout?
In Britain, very. In the United States, not. In Canada, somewhere in between.
With a strong central government and a National Health Service that covers all of its people, Britain is directing the process from London. The national government chose 50 hospitals that would initially get the vaccine and made sure they were prepared; decided how much each one would receive; and drafted rules determining what order people would be eligible to get it.
In the U.S., the federal government is having the vaccine distributed to each state based on population. It will be up to states to decide how to divide the doses among hospitals, clinics and, ultimately, drugstores and doctors’ offices.
Canada has a universal health care system, but it is decentralized, administered by provinces and territories. For vaccine distribution, the central government plans to work through those regional governments. Ottawa will play a large role in directing the process.
How many people will get it at first?
That remains a bit murky.
Canada ordered enough of the Pfizer-BioNTech vaccine for all of its people, Britain enough for 30 percent and the United States enough for 15 percent. But those numbers reflect deliveries that are expected to take months to complete, and Pfizer, like other companies, has hit snags in ramping up production.
All three countries made advance purchases from other companies, as well, so the pace of vaccine approval could significantly affect the speed of rollout. That speed will also be affected by the need for vaccination sites to be equipped with the right freezers, staff, and enough syringes and protective gear.
Initial shipments are a fraction of the pre-purchases — 800,000 doses to Britain and an expected 249,000 this month to Canada. U.S. officials said they hoped to have 40 million doses of the vaccine by the end of the month, which may be optimistic.
In Canada, the government is sending shipments to all 10 provinces. The three northern territories will have to wait. In America, FedEx and UPS will ship vaccines from distribution centers to every part of the country.
How fast will most people get vaccines?
That is even murkier.
Britain, Canada and the United States have followed similar strategies, pre-ordering huge numbers of doses — more than enough to inoculate everyone — from multiple makers, hedging their bets in case some of the vaccines are not approved or some manufacturers have production breakdowns.
Relative to their populations, the United States has ordered far fewer doses than Canada or Britain, and last summer it passed up an offer to increase its advance order from Pfizer. Administration officials say the numbers are misleading, because the government has signed options to buy far more of the vaccine if it sees the need.
But in the face of intense global demand, it is not clear how fast pharmaceutical companies will be able to fulfill the orders they have, much less any additional orders.
In other global developments:
Rizieq Shihab, a radical Indonesian cleric who held large gatherings and called for a “moral revolution” after his return from Saudi Arabia last month, surrendered to the police on Saturday on charges of violating coronavirus protocols. Upon his return, Mr. Rizieq, 55, invited 10,000 people to his daughter’s wedding. Authorities six of his bodyguards were killed by the police in self-defense. In surrendering, he said he would cooperate with the investigation.
Brittanya Karma, a Vietnamese-German rapper and reality television star, died on Nov. 29 in Hamburg, Germany, where she was born and lived. She was 29. The cause was complications of Covid-19, her agent said.
As many as 300,000 coronavirus cases across the United States can be traced to a two-day conference in Boston attended by 175 biotech executives in February, according to a study published Thursday in the journal Science.
The conference, convened by the drug company Biogen, was one of the earliest examples in the pandemic of what epidemiologists call “superspreading events,” where a gathering of people leads to a huge number of infections. But new genetic data made publicly available in recent months by many states has allowed researchers for the first time to estimate the national scope of its astonishing ripple effect.
“It’s a cautionary tale,” said Bronwyn MacInnis, a genomic epidemiologist at the Broad Institute of Harvard and M.I.T. “When we hear these stories of clusters where 20 or 50 or 100 were affected, that does not account for what happens after.”
To track the spread, the researchers took advantage of a kind of genetic fingerprint that they identified in samples of the virus taken from 28 people who had attended the meeting. An earlier version of the paper published online in June suggested that the conference had seeded tens of thousands of cases in the Boston area alone.
By March, the researchers had found, viruses bearing the same signature began to appear in the viral genomes taken from coronavirus patients in several other states. But by November, viruses containing the marker could be found in 29 states, linked to some 70,000 in Florida alone. And because the viral genome data linked to U.S. cases has grown by tenfold since June, the researchers are able to make a reliable national estimate. The conference, the study estimates, is responsible for 1.9 percent of all cases in the United States since the start of the pandemic.
A vast majority of introductions of the virus into a workplace or home or community fizzle, the researchers noted. But the study highlights how a local event with a mobile population can seed a national outbreak. Because the genetic fingerprint identified in the Biogen attendees existed previously in Europe, it was not possible to reliably estimate how many of the transmissions globally came from the Boston event, the researchers said.
Although the Biogen conference occurred at a time when the coronavirus was barely on the radar for most Americans, it might have important implications for the current pandemic moment. The first, eagerly awaited vaccines have been demonstrated to protect from severe Covid-19 symptoms, but it is not known whether they protect people from transmitting the virus.
“We risk having folks going around thinking ‘all is good,’” Dr. MacInnis said. “Our data reminds us what can happen when transmission is unchecked.’’
Los Angeles County could see “catastrophic suffering and death” in the coming weeks, public health officials warn, as the nation’s most populous county reported another record day of new coronavirus cases.
The 13,737 cases reported on Friday bring the county’s total to more than 500,000, as the county and California struggle to contain an explosion. California officials reported 37,124 cases on Friday, the highest one-day total of the pandemic.
“We’re on a very dangerous track to seeing unprecedented and catastrophic suffering and death here in L.A. County if we can’t stop the surge,” Barbara Ferrer, the county’s public health director, said at a news conference on Friday. “These numbers are overwhelming, and the grief that our community continues to experience can’t be comprehended.”
The number of people hospitalized for Covid-19 has sharply risen over the past month. In early November, fewer than 1,000 people were in hospitals for treatment. Today, there are more than 3,600, according to the latest figures from the county.
The steep rise in cases in California mirrors a national spike. Officials reported more than 236,000 new cases on Friday, yet another single-day case record.
During a news conference on Wednesday, Dr. Ferrer fought through tears as she talked about the state’s rising death toll.
“Over 8,000 people who were beloved members of their families are not coming back,” she said. “And their deaths are an incalculable loss to their friends and their families.”
Over the past month, the average number of daily deaths has increased more than 250 percent in Los Angeles County. In the past week, 357 people there have died and at least 71,079 people have contracted the virus.
“We’re in uncharted territory at this point,” Dr. Ferrer said. “We’re seeing daily numbers of cases and hospitalizations that we’ve not experienced and, frankly, did not anticipate.”
British drug regulators recommended on Wednesday that people with severe allergic reactions to food and medicine not receive Pfizer’s coronavirus vaccine after two health care workers, both with such a history, had a serious reaction.
The initial report on the British cases set off alarm and confusion, and left many people with allergies wondering whether the new vaccine would be safe for them.
Here’s what we know so far:
The workers both experienced anaphylaxis, a life-threatening reaction that impairs breathing and can drop blood pressure within minutes or even seconds after exposure to an allergen. Both workers were treated with epinephrine and have recovered, the regulators said.
People with a history of an anaphylactic reaction to any vaccine were excluded from Pfizer’s studies, company officials said on Thursday.
Among those who participated in the Pfizer trials, a very small number of people had allergic reactions. A document published by the F.D.A. on Tuesday said that 0.63 percent of participants who received the vaccine reported potential allergic reactions, compared with 0.51 percent of people who received a placebo.
In Pfizer’s late-stage clinical trial, one of the 18,801 participants who received the vaccine had an anaphylactic reaction, according to safety data published by the F.D.A. None in the placebo group did.
I have allergies, should I be concerned?
Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, said on Wednesday that the allergic reactions were concerning but most likely rare, the kind of effects that show up when a vaccine moves out of testing and into broader distribution.
“If I were a person that had an underlying allergic tendency, I might want to be prepared that I might get a reaction, and therefore be ready to treat it,” Dr. Fauci said, in a webcast moderated by Dr. Sanjay Gupta of CNN, sponsored by Harvard and The New England Journal of Medicine.
Dr. Fauci acknowledged that the problem could turn out to affect a lot of people, but he said that other vaccines would eventually become available for those affected.
Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia, said the initial, broad recommendation in Britain mentioning severe allergic reactions seemed to be an overreaction that could needlessly scare many people away from a desperately needed vaccine in the middle of a raging pandemic.
Fewer than one in a million recipients of other vaccines a year in the United States have an anaphylactic reaction, Dr. Offit said. Those reactions are treatable and much easier to control than a severe case of Covid-19, he said.
Two men were charged with stealing 192 ventilators owned by the U.S. government in Miami, authorities said on Friday.
The ventilators, worth $3 million, were being transported to a Covid-19 intensive care center in El Salvador to treat critically ill patients as part of a federal aid program.
Yoelvis Denis Hernandez, who is known as Guajiro, and Luis Urra Montero, who goes by the name Flaco, were indicted on charges of federal conspiracy, possessing stolen goods that were being shipped across state lines and the theft of government property.
According to the indictment, Mr. Hernandez, 42, and Mr. Montero, 24, stole a tractor-trailer in August that was being used to transport the ventilators to Miami International Airport. The tractor-trailer had been left in a lot overnight. After an investigation, most of the ventilators were found, the authorities said.
At the onset of the pandemic, medical professionals and government authorities were concerned about the shortage of ventilators in the United States and in other countries. Since then, however, the country’s medical device manufacturers have ramped up production of the machines. The U.S. now has more than 200,000 critical care ventilators — 155,000 of them in the Strategic National Stockpile — but there aren’t enough specialists to operate them.
In June, a man was charged with stealing ventilators from a Veterans Affairs medical center in Seattle and selling them on eBay.
About 100 teachers in Arizona’s third-largest school district staged a sickout on Friday, demanding that schools close after winter break and stay remote until the region’s positivity rate declines.
The protest in the school district, Chandler Unified, a sprawling string of suburbs east of Phoenix with 46,000 students, was planned in opposition of the district’s recently announced plan to continue with in-person instruction in January despite a steep rise in infections in the region, according to a letter that teachers sent to the district on Thursday.
“When we returned to in-person learning, teachers and parents did so with the understanding that if any one metric went into the red, we would return to virtual learning,” the letter states. “We were also assured that we would not be expected to teach virtually and in-person at the same time. Both of those promises have now been broken.”
The sickout represents a small fraction of the district’s 2,000 teachers, and the district said it had found enough replacement teachers to keep all of its schools open. But it underscores the anxiety of many teachers in a county that has reached new peaks in cases and deaths from the virus in recent weeks.
Both the state and Maricopa County, home to the Chandler school district, set single-day case records within the past week, and Maricopa County added more cases on Thursday than almost any other county in the United States. This month, both parents of a Chandler High School student died hours apart of complications related to Covid-19.
Over 8,000 new cases and at least 77 deaths were reported in Arizona on Friday. It is currently one of the states in the country where the cases are higher and staying high, according to a New York Times database.
More than three-quarters of the district’s students are attending all of their classes in person, with the rest receiving all-remote instruction.
“Our educators are exhausted and stretched to their breaking point,” said the Chandler Education Association, a teacher advocacy group.
With coronavirus cases surging, Gov. Andrew M. Cuomo of New York has shifted his strategy sharply away from tackling local clusters and toward protecting the state’s health system in a bid to avoid a return to the worst days of spring, when hospitals were stretched to the limit.
The virus statistic that had transfixed New Yorkers — the rate of tests that come back positive — is no longer the primary driver of state action, as it was when Mr. Cuomo sought to quash viral outbreaks in designated areas. That effort did not stem a rising tide of infections statewide, and the focus now is on hospital capacity.
Far from hastening a broad new round of business closings, the governor’s shift is likely to delay by weeks a potential return of the most stringent restrictions from earlier in the year. A rise in the number of hospitalizations follows an increase in positive cases, and the state has anticipated several steps hospitals can take to expand capacity before a shutdown is needed.
Still, there was one area where Mr. Cuomo was taking no chances. On Friday, he ordered a halt to indoor dining in New York City starting on Monday, saying that the ban was necessary to curb the surging outbreak. But the move prompted a backlash from the struggling restaurant industry, one of the city’s economic engines, with owners saying the governor had not proved that restaurants were a significant factor in spreading the virus.
After months of low positive test rates, New York is now in the same position as other states amid a worsening national outbreak: watching with increased concern as hospital beds fill.
More than 5,300 people were hospitalized across New York as of Thursday, a level not seen since May. The per capita rate of new cases in New York is better than it is in most states, but worse than in others, including Texas and Florida, although testing levels vary.
“If you extrapolate out at this rate of growth, you could be looking at the shutdown of New York City within a month,” Mr. Cuomo said in an interview on Friday.