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Covid-19 Live Updates: U.S. and Britain Race to Approve Vaccines

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Coronavirus Vaccine Could Be Ready in a Few Weeks, Says Johnson

Prime Minister Boris Johnson of Britain, during a visit to the pharmaceutical company Wockhardt, said “if we’re lucky” a coronavirus vaccine could be available for distribution within weeks, but stressed that some restrictions will still be necessary to keep the pandemic under control.

I’m here at Wockhardt, who are going to be making, we hope, the Oxford-AstraZeneca vaccine. And they have incredible capacity here to make up to 350 million doses a year. And, you know, this could — if we’re lucky, if everything goes right — this could be available just in a few weeks. What we need now is the approvals. No vaccine has yet got — this must be stressed — no vaccine has yet got M.H.R.A. approval. But we’re obviously hoping that both the Pfizer-BioNTech vaccine and the Oxford-AstraZeneca vaccine will get approved in the course of the next few days and weeks. We can’t afford to take our foot off the throat of the beast, to take our foot off the gas. We can’t afford to let it out of control again. So the tiering system is tough, but it’s designed to be tough and to keep it under control. I particularly understand the frustration of the hospitality sector that has borne so much, and been through so much in the last few months. And we will do everything we can, as we have been doing, to protect and to encourage that sector throughout the weeks and months ahead.

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Prime Minister Boris Johnson of Britain, during a visit to the pharmaceutical company Wockhardt, said “if we’re lucky” a coronavirus vaccine could be available for distribution within weeks, but stressed that some restrictions will still be necessary to keep the pandemic under control.CreditCredit…Pool photo by Paul Ellis

The race to be the first nation to authorize a rigorously tested Covid-19 vaccine is intensifying.

British regulators are considering two vaccines for emergency approval: one developed by AstraZeneca and the University of Oxford, and another by Pfizer and BioNTech. Prime Minister Boris Johnson visited a vaccine manufacturing facility in Wales on Monday, boasting that “if we’re lucky, if everything goes, right, this could be available just in a few weeks.”

“This could, and I stress could, really be the salvation for humanity, these vaccines,” Mr. Johnson said.

Across the Atlantic, Mark Meadows, President Trump’s chief of staff, summoned the F.D.A. commissioner, Stephen Hahn, to the White House on Tuesday morning to explain why regulators have not yet approved the emergency use of the vaccine developed by Pfizer, according to people familiar with the situation.

One official said Mr. Meadows was concerned that the British government may approve emergency use of a coronavirus vaccine before American regulators act, potentially embarrassing the Trump administration. Mr. Trump and Mr. Meadows have pressured the F.D.A. for months to speed up the development and approval of a vaccine, and allies of Dr. Hahn are worried that he could be fired if he fails to satisfy the White House demands.

On Tuesday, the White House said that Mr. Trump will host a “Covid-19 Vaccine Summit” next week, two days before a panel of outside advisers to the F.D.A. meets to decide whether the agency should grant emergency approval to the Pfizer vaccine. Vice President Mike Pence, the head of the White House coronavirus task force, will also attend the meeting with private sector executives and governors.

The global race to develop a vaccine is poised to shatter records for time to market. Around the world, researchers are testing 57 vaccines in clinical trials, and nearly 100 others are being tested in animals or cells. China and Russia have approved vaccines without waiting for the results of late-stage trials, known as Phase 3, which experts say raises serious risks.

Britain and the United States vet vaccine candidates differently: American regulators pore over raw data from vaccine makers to validate their results, while regulators in Britain and elsewhere in Europe lean more heavily on companies’ own analyses.

The European Union is also set to conduct its own review of the Pfizer and BioNTech vaccine. The companies announced on Tuesday that they had submitted their final application to the bloc’s health authorities. Moderna announced on Monday that it had also applied for approval for the European market and in the United States.

But creating a vaccine is only the first step in what will be a gargantuan feat of logistics: injecting enough people around the world to stop a pandemic in which more than 63 million people have been infected and 1.4 million have died. The United States, Britain and other rich countries have bought massive quantities of doses, but will still have to figure out how to ship, store and distribute them.

The Pfizer vaccine brings particular challenges: It must be stored in an ultracold freezer. That quandary already appeared to be affecting distribution plans in Britain. Nursing-home residents were supposed to be Britain’s top priority under an advisory committee’s plans, but a limit on how many times officials believe the Pfizer vaccine can be moved before it loses effectiveness likely means that National Health Service staff members will receive the shots first.

In the United States, states largely devise plans for vaccine distribution, but are likely to follow recommendations from the Centers for Disease Control and Prevention. An advisory committee was meeting on Tuesday to discuss those.

Governments and health care organizations must also figure out how to overcome mistrust and concern about the vaccine’s safety. On Monday, the head of the International Federation of Red Cross and Red Crescent Societies, Francesco Rocca, warned that misinformation and distrust could torpedo vaccination campaigns.

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

Dr. Hahn, the commissioner of the Food and Drug Administration, at a hearing at the Capitol in September.
Dr. Hahn, the commissioner of the Food and Drug Administration, at a hearing at the Capitol in September.Credit…Pool photo by Alex Edelman

Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, headed into the White House on Tuesday morning to meet with Mark Meadows, the chief of staff, who summoned Dr. Hahn to explain why regulators have not yet approved the emergency use of the Covid-19 vaccine developed by Pfizer, according to people familiar with the situation.

Dr. Hahn prepared for the meeting by pulling data from the past few weeks showing how productive the F.D.A. has been, an administration official said.

One official said Mr. Meadows is concerned that the British government may approve emergency use of a Covid-19 vaccine before American regulators act, potentially embarrassing the Trump administration. The meeting was reported earlier by Axios

On Friday, the British government asked its drug regulator to consider AstraZeneca’s vaccine for emergency approval. The regulator, the Medicines and Healthcare products Regulatory Agency, had previously been conducting a rolling review of the vaccine. It is also reviewing Pfizer’s vaccine.

President Trump and Mr. Meadows have pressured the F.D.A. for months to speed up the development and approval of a vaccine, and allies of Dr. Hahn are worried that he could be fired if he fails to satisfy the White House demands.

Pfizer and its German partner, BioNTech, announced on Nov. 18 that clinical trial results showed its vaccine was 95 percent effective and had no serious side effects. It submitted an application for emergency use authorization to the F.D.A. two days later. 

An F.D.A. spokesman said that government experts must now review “thousands of pages of technical information.” Among other matters, he said, they must analyze the effects of the vaccine on various groups of patients and Pfizer’s controls on the manufacturing process.  

The agency’s outside advisory panel of experts is scheduled to meet on the Pfizer vaccine on Dec. 10. Unless the reviews uncover unexpected problems, the F.D.A. is expected to approve the Pfizer vaccine within days.

On Tuesday, the White House said Mr. Trump will host a “Covid-19 Vaccine Summit” on Dec. 8. Vice President Mike Pence, the head of the White House coronavirus task force, will also attend the meeting with private sector executives and governors. The meeting was first reported by the website StatNews.

The event will mark a rare appearance by the president since he lost the election. He has had few public events and did not attend the sole coronavirus task force briefing last month held by Mr. Pence and health officials like Dr. Anthony S. Fauci, the nation’s top infectious disease expert.

Even as he has receded from public view, Mr. Trump is still eager to take credit for the quick development of a vaccine under Operation Warp Speed, the federal effort to accelerate vaccine development and the summit was seen as part of that effort.

“The president looks forward to convening leaders from the federal government, state governments, private sector, military and scientific community for a comprehensive discussion with the American people as the administration prepares to deliver this historic, lifesaving vaccine to every ZIP code in the United States within 24 hours of an FDA approval,” a White House spokesman, Brian Morgenstern, said in a statement.

On Monday, Dr. Scott W. Atlas, the former Stanford University radiologist who espoused disputed theories and rankled government scientists while advising Mr. Trump on the pandemic, resigned his White House position, according to a senior government official. Dr. Atlas’s term was set to expire this week.

A patient arriving by ambulance at Maimonides Medical Center in Brooklyn on Monday.
A patient arriving by ambulance at Maimonides Medical Center in Brooklyn on Monday.Credit…Dave Sanders for The New York Times

As New York City confronts a sharp rise in coronavirus cases, its health commissioner on Tuesday issued an advisory urging people over 65 years old or those who face an increased risk of severe illness from the virus to halt all nonessential activities and stay home as much as possible.

“We need you, if you’re older, if you have pre-existing conditions, to take additional precautions,” Mayor Bill de Blasio said at a news conference. The advisory does not carry penalties if not followed.

Still, the notice comes after the city has seen a sustained increase in positive test results and hospitalizations and a day after the governor warned that every region in the state was facing potential issues with hospitals being overrun. On Tuesday, the city reported a seven-day average rate of positive test results of 4.14 percent, its highest since early June. (Mr. de Blasio has said that the increase could reflect anomalies in testing over the Thanksgiving holiday, when fewer tests were conducted.)

The city health commissioner, Dave A. Chokshi, said that more than 1,100 patients with the coronavirus were hospitalized in the city, more than double the total from three weeks ago.

The numbers are far below those from the spring, when the city was a center of the pandemic and hundreds of virus-related deaths were reported each day. But Dr. Chokshi warned that the recent uptick in cases and hospitalizations followed a “tragically familiar pattern” that would likely bring more deaths as well.

Dr. Mitchell Katz, head of the city’s public hospital system, said that intensive-care units in the 11 public hospitals were about two-thirds full. But he also noted that the city had ventilators and personal-protective equipment ready if cases continued to rise.

“We are well prepared,” he said.

The state’s data show that 28 percent of the city’s intensive-care unit beds, across both public and private facilities, have been available on average in the last week.

The health commissioner’s advisory does not carry enforcement penalties, and does not require the closures of nonessential businesses, a move that would be under the authority of the state government.

The advisory, which mirrors guidance from the Centers for Disease Control and Prevention, recommends that older adults and those with underlying health issues leave home only to travel to work or school, or for essential visits to the doctor, grocery stores or pharmacies. It also covers those sharing households with those people, like caregivers.

In a statement, the city said the advisory was intended to “moderate case growth and preserve hospital capacity.” State health officials have expressed a similar concern: that hospitals may be overwhelmed given an expected jump in cases during the holiday season.

On Tuesday, Gov. Andrew M. Cuomo said that 3,774 people were hospitalized with the virus in New York State, its highest total since late May. The seven-day average rate of positive test results statewide was 3.97 percent, according to state figures.

“My projection is that the numbers will continue to go up through the holiday season,” he said.

Still, as in the city, the spike in the state’s hospitalizations is far less steep than it was in late March and early April.

Gareth Rhodes, an aide to Mr. Cuomo, said on Twitter that the number of virus patients hospitalized in the state had risen by an average of 131 per day in the last week, compared to a weekly average of 1,225 per day in the spring.

New York City accounts for 31.8 percent of those hospitalized statewide, Mr. Rhodes said. In the spring, when hospitalizations climbed above 18,000 statewide, the city accounted for 64.7 percent of the state’s hospitalizations.

Despite rising positivity rates statewide, Mr. Cuomo has resisted imposing the kind of widespread shutdowns seen in March.

In response to a question about the city’s advisory, Mr. Cuomo emphasized that it was “guidance” and not a restriction.

“New York City offers guidance, advice, which is the same advice and guidance that we have been issuing and they have been issuing and every expert has been issuing since this started,” he said.

Global Roundup

Preparing a shop ahead of reopening in London on Monday.
Preparing a shop ahead of reopening in London on Monday.Credit…Andrew Testa for The New York Times

Much of England will swap lockdown for less stringent coronavirus restrictions, after Parliament approved new rules on Tuesday despite a substantial revolt among lawmakers in Prime Minister Boris Johnson’s Conservative Party.

The rebellion, by lawmakers who want to go farther in easing the limits on public life, underscored the rising tide of discontent among Mr. Johnson’s own members of Parliament over his handling of the pandemic, exacerbated by fears that the curbs could lay waste to large swathes of the hospitality industry.

Caught between the competing demands of this vocal faction of his lawmakers, and those of his more cautious scientific advisers, Mr. Johnson opted to keep stringent measures in place, including restrictions on many pubs and restaurants.

From Wednesday there will be some relaxation from the lockdown in all areas, as all stores, gyms, and hairdressers will be allowed to reopen. Religious services and weddings can restart, and limited numbers of spectators will be allowed at some outdoor sporting events.

But England will return to a system under which coronavirus restrictions differ from place to place, with areas of the country divided into three “tiers” based on an assessment of the coronavirus risks in each one. That is similar to the framework in place earlier in the year, which failed to prevent a second wave of the pandemic or avert last month’s lockdown.

In other global developments:

  • In France, President Emmanuel Macron said on Tuesday that he was considering implementing a widespread vaccination campaign next spring after a more targeted one for health workers and vulnerable populations. Mr. Macron, speaking at a news conference in Paris alongside Alexander De Croo, the Belgian prime minister, said there would probably be a first wave of priority vaccinations in early 2021 with first-generation vaccines, which might prove logistically complex to deploy. But Mr. Macron repeated that getting a vaccine would not be mandatory, and he insisted instead on a “strategy of conviction and transparency.”

  • The border between the United States and Canada will remain closed “until the virus is significantly more under control everywhere around the world,” Canada’s prime minister, Justin Trudeau, told the Canadian Broadcasting Corporation. The restrictions on nonessential travel, which were put in place March 21 and have been renewed monthly, do not affect trade.

  • Hamas, the militant group that rules the Gaza Strip, said on Tuesday that Yehya Sinwar, its chief in the territory, had tested positive for the coronavirus. Hamas said that Mr. Sinwar was doing “well” and was working while in quarantine.

  • Vietnam suspended commercial flights on Tuesday, two days after its first case was confirmed in 89 days. Two additional cases were reported in Ho Chi Minh City on Tuesday, both linked to a flight attendant who officials said violated quarantine regulations. Officials were working to trace the contacts of the three infected people, and Prime Minister Nguyen Xuan Phuc urged vigilance in prevention measures.

  • Ireland exited a six-week lockdown on Tuesday, reopening nonessential businesses, gyms and religious services. Health officials still discourage socializing, but groups of six people will be permitted inside bars and restaurants serving substantial meals starting on Friday.

  • The Netherlands began requiring masks in public buildings on Tuesday, making it one of Europe’s last countries to introduce the mandate. The government had long discouraged the use of masks, saying they promoted a false sense of security, before an abrupt shift in October when they advised people to use them. Violations under the new law will carry a fine of 95 euros, or $114.

  • In Spain, the regional leader of Madrid, Isabel Díaz Ayuso, inaugurated her flagship infrastructure project: a new hospital on Tuesday focused on patients affected by epidemics like Covid-19. The hospital has no patients yet, as only a quarter of its infrastructure has been installed and its medical staff is incomplete. Ms. Díaz Ayuso told reporters on Tuesday that “a new hospital can never be bad news,” but the project, which she announced in May, has come under intense criticism, with medical professionals and opposition politicians calling on her government to instead strengthen staffing and resources at existing hospitals.

  • After a Franciscan convent in northwestern Germany without a single known Covid-19 case tested its 161 nuns, 76 of the tests came back positive on Monday, signaling a potentially dangerous cluster in a religious community with many elderly members. “We have an outbreak,” Sister Maria Cordis Riker, who heads the convent, said in a telephone interview. “But we are grateful that so far, the course of the disease has been mild and no one is in hospital.” Local health authorities are trying to find out how the virus got into the convent, which has limited visits during the pandemic. For more than a century, the convent has maintained continuous prayer around the clock, but social distance and health regulations have obliged it to cut back to 50 percent of capacity — one nun praying at a time, instead of the usual two.

  • The United Nations said that the coronavirus pandemic has created a record need for global humanitarian aid, forecasting that 235 million people will require aid in 2021, an increase of 40 percent over the same period last year. The proportion of people needing aid rose to one in 33 people worldwide from one in 45 last year. Fighting off famine, poverty and disease while keeping children vaccinated and in school will require $35.1 billion in funding, or more than double the record $17 billion raised in 2020, the United Nations said.

Passengers leave Los Angeles International Airport after arriving from Shanghai, China, after a positive case of the coronavirus was announced in the Orange County suburb of Los Angeles in January.
Passengers leave Los Angeles International Airport after arriving from Shanghai, China, after a positive case of the coronavirus was announced in the Orange County suburb of Los Angeles in January.Credit…Ringo Chiu/Reuters

The coronavirus may have infected people in the United States as early as Dec. 13, more than a month earlier than researchers had thought, according to scientists who analyzed blood samples taken from American Red Cross donations. Outside scientists cautioned, however, that the virus was probably not spreading that early.

The researchers noted that they cannot say whether the apparent infections were in travelers who had been infected in other countries, or whether the infections themselves were dead ends, and did not lead to community transmission.

Before this new report, the earliest documented infection in the country was on Jan. 19 in someone who had traveled to China. Although other genetic studies have suggested the possible presence of the virus earlier than Jan. 19, the new study found that blood donations from nine states sent to the Centers for Disease Control and Prevention carried coronavirus antibodies — protein markers of past exposure to the virus.

But at least one prominent virus researcher cautioned that these results could be interpreted differently. Trevor Bedford, an epidemiologist at the University of Washington who has been deeply involved in genetic studies of how, when and where the virus has spread, said in a series of tweets that he thought the study could be identifying people who had antibodies to other human coronaviruses, which cause common colds, although he did not rule out that it may have picked up some cases of travelers who had been infected in other countries.

In the new report, which was released online Monday and has been accepted for publication in the journal Clinical Infectious Diseases, Dr. Sridhar V. Basavaraju of the C.D.C. and others reported that they had looked for antibodies that reacted to the specific virus that has caused the pandemic, SARS-CoV-2.

In more than 7,000 samples, 106 showed antibodies, they found. The researchers did not find these tests definitive, however, because they can sometimes reveal antibodies to other coronaviruses.

After further tests, they found one blood sample to be most convincing because it showed antibodies to a specific part of the SARS-CoV-2 protein. It was collected on Jan. 10 in Connecticut and was “likely from an individual with a past or active SARS-CoV-2 infection.” That person could have been infected while traveling.

Face coverings are already mandated on the House floor and encouraged for senators, but lawmakers and aides are now “required” to wear masks if they have had contact with people outside their family unit.
Face coverings are already mandated on the House floor and encouraged for senators, but lawmakers and aides are now “required” to wear masks if they have had contact with people outside their family unit. Credit…Stefani Reynolds for The New York Times

Facing a dangerous spike in coronavirus cases among lawmakers, Congress’s attending physician appealed to members on Monday to steer clear of public dinners and receptions, stay in Washington rather than return home to their states between legislative sessions and keep masks on even when speaking on the House and Senate floors.

Dr. Brian P. Monahan’s recommendations were the most aggressive attempt yet to tamp down the spread of the virus around the Capitol, where about a dozen lawmakers have been infected in the last two weeks and a patchwork of rules have led to inconsistent safety protocols.

In a memo, the doctor detailed a relatively new rapid-testing program for lawmakers traveling to and from their home states, but also strongly discouraged them from traveling at all.

“During this time of dramatic and sustained increase in coronavirus transmission nationally, if you can remain in the Washington, D.C., region and avoid travel, that would be preferable,” Dr. Monahan wrote.

After months of unevenly imposed virus guidelines on Capitol Hill, where virus precautions have been the subject of partisan disputes, the physician urged lawmakers to improve their social-distancing and mask-wearing practices.

“Due to experience in the Congress of increased disease frequency occurring in certain circumstances, I recommend that you DO NOT ATTEND dinners, receptions or restaurant gatherings outside of your family unit,” Dr. Monahan wrote.

While face coverings are already mandated on the House floor and strongly encouraged for senators, Dr. Monahan said they would also be “required” anytime lawmakers or aides had contact with people outside their family unit. He also asked lawmakers to keep their faces covered when speaking on the floor of either chamber, a change for many members who routinely remove their masks when speaking.

He added that while those working in the Capitol were allowed to eat with a mask off for brief periods of time, “you MAY NOT sit at a table with a beverage or a partially consumed food item without a face cover for a prolonged period.”

Dr. Monahan also encouraged lawmakers to switch from cloth facial coverings to surgical masks and to consider using face shields, especially when they fly or travel on public transportation.

“Wherever possible, wear a face shield in addition to a face cover if you anticipate close crowding at these occasions,” he wrote.

A health care worker at testing location in Cheyenne, Wyoming. There is wide agreement that frontline health care workers should be prioritized for vaccines.
A health care worker at testing location in Cheyenne, Wyoming. There is wide agreement that frontline health care workers should be prioritized for vaccines.Credit…Stephen Speranza for The New York Times

A Centers for Disease Control and Prevention advisory committee is meeting on Tuesday afternoon to decide what its advice will be about who should get access to Covid-19 vaccines first. But much like its recommendations about masks and travel restrictions, the C.D.C.’s guidance about vaccine distribution will only inform states, which will ultimately need to devise their own plans.

Alex M. Azar II, the health and human services secretary, said on Monday that vaccine doses will be distributed through normal processes for vaccines, with governors acting as “air traffic controllers” to determine which hospitals or pharmacies receive shipments.

There is wide agreement that frontline health care workers should be prioritized, and the C.D.C. has said in documents sent to public health agencies that essential workers like police offers or workers in food production, as well as employees and residents of long-term care facilities, should be close behind. But it is unclear where other vulnerable populations, like transit workers, inmates and teachers, stand.

States don’t have to follow the C.D.C.’s recommendations, but most probably will, said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which represents state health agencies.

Moncef Slaoui, the head of the Trump administration’s Operation Warp Speed virus program, told Politico that he expects some states “may prefer long-term care facilities or the elderly, while others may prioritize their health care workers.”

The C.D.C. panel hinted last week that it would recommend the country’s 87 million essential workers be next in line. These workers are disproportionately Black and Hispanic, populations that have been hit especially hard by the virus, and at increased risk because they are more likely to work at jobs that preclude working from home.

After essential workers, next are likely adults with medical conditions that put them at high risk of coronavirus infection, and people over 65.

As of Monday, two major vaccine makers, Moderna and Pfizer, have applied to the Food and Drug Administration to authorize its vaccine for emergency use.

With the limited quantities of the Moderna and Pfizer vaccines set to be distributed as early as later this month, states are scrambling to plan their distribution.

Federal officials have said they plan to ship the first 6.4 million doses within 24 hours after the F.D.A. authorizes a vaccine, and the number each state receives will be based on a formula that considers its adult population.

In Kentucky, Gov. Andy Beshear said on Monday that 26,000 residents and employees of nursing homes and other long-term-care facilities would be the first in the state to get vaccinated, along with 12,000 of the state’s more than 200,000 health care workers. The federal government has allocated an initial 38,025 doses of Pfizer’s vaccine for Kentucky, based on its population, he said.

That is a much smaller amount than what the state had planned for, he said, adding that Kentucky is also projected to receive an initial 76,700 doses of a vaccine made by Moderna by the end of December if the regulatory process goes quickly.

The initial allocation would reach about half of the 50,000 patients and staff members in “the highest, most intensive tier of long-term care” in Kentucky, Mr. Beshear said. A staggering 66 percent of deaths from Covid-19 in Kentucky have been among their residents, and protecting them could help prevent hospitals from becoming overwhelmed, he said.

Teachers and emergency medical workers will likely be next in line, he said.

Younger students, like those lined up for the first day of kindergarten at P.S. 161 in Brooklyn last September, would return to in-person learning under Mayor de Blasio’s plan.
Younger students, like those lined up for the first day of kindergarten at P.S. 161 in Brooklyn last September, would return to in-person learning under Mayor de Blasio’s plan.Credit…Juan Arredondo for The New York Times

After a summer of uncertainty and fear about how schools across the globe would operate in a pandemic, a consensus has emerged in recent months that is becoming policy in more and more districts: In-person teaching with young children is safer than with older ones, and particularly crucial for their development.

On Sunday, New York City, home to the country’s largest school system, became the most high-profile example of that trend, when Mayor Bill de Blasio announced that only elementary schools and some schools for children with complex disabilities would reopen after all city classrooms were briefly shuttered in November. There is no plan yet to bring middle and high school students back into city school buildings.

It was an abrupt about-face for the mayor, who had for months promised to welcome all of the city’s 1.1 million children — from 3-year-olds to high school seniors — back into classrooms this fall.

But the decision put New York in line with other cities around America and across the world, which have reopened classrooms first, and often exclusively, for young children, and in some cases kept them open even as they have confronted second waves of the virus.

In-person learning is particularly crucial for young children, who often need intensive parental supervision to even log on for the day, education experts say. And mounting evidence has shown that elementary school students in particular can be safe as long as districts adopt strict safety measures, though it’s an unsettled question for older students.

“With younger kids, we see this pleasant confluence of two facts: science tells us that younger children are less likely to contract, and seemingly less likely to transmit, the virus,” said Elliot Haspel, the author of Crawling Behind: America’s Child Care Crisis and How to Fix It. “And younger children are the ones that most need in-person schooling, and in-person interactions.”

Districts including Chicago, Washington D.C. and Philadelphia have either begun to bring back only young children or have plans to do so whenever they eventually reopen classrooms.

In Rhode Island, Gov. Gina Raimondo, a strong proponent of keeping schools open, recently asked colleges to shift to all-remote learning after Thanksgiving, and gave districts the option of reducing the number of high school students attending in person. But she asserted that middle and elementary schools were not sources of community spread.

That model of giving priority to younger students has been pioneered in Europe, where many countries have kept primary schools open even as most other parts of public life have shuttered during the continent’s second wave.

Italy has kept its primary schools open but kept teaching remote for middle and high schools. All schools in Germany are open, and discussions about possible closures have focused mainly on high schools.

And in America, more and more districts have begun to prioritize elementary school students for in-person learning.

In urban districts that have been slow to reopen, that has meant making plans to bring back the youngest students. In parts of the Midwest where school districts were more aggressive about reopening, and where there has been a huge rise in cases in recent weeks, public health officials have prioritized keeping elementary schools open even as they have closed high schools and in some cases middle schools.

“The data is becoming more compelling that there is very limited transmission in day care and grade schools,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of President-elect Joseph R. Biden Jr.’s coronavirus task force, in a recent interview.

“I keep telling people, ‘Stop talking about kids — talk about those younger than 10,’” he added. “We’re seeing a very different epidemiology in that group than we’re seeing, for example, in high school students.”

In June, the New Hampshire House of Representatives met in the Whittemore Center at the University of New Hampshire, its first meeting away from the State House since the Civil War. 
In June, the New Hampshire House of Representatives met in the Whittemore Center at the University of New Hampshire, its first meeting away from the State House since the Civil War. Credit…Charles Krupa/Associated Press

When the New Hampshire legislature — the largest in the country — assembles on Wednesday to launch its new session, it will do so outdoors, for the sake of coronavirus safety.

The 400 members of the lower chamber, the House of Representatives, will congregate with plenty of social distance on a field hockey pitch at the University of New Hampshire in Durham, according to Paul Smith, the House clerk. Members who choose not to wear masks can attend, but will be put in a separate section from those who wear them.

The much smaller Senate, with 24 members, will meet separately at another spot on the campus, and then join with the House later in the day, Mr. Smith said.

The decision to move outdoors, rather than use the university’s sports arena as it had in the spring, was made on Sunday “out of abundance of caution,” he said: “The fact is, we’ve seen an uptick in numbers across the state.”

New Hampshire has been averaging 422 new coronavirus cases a day lately, 27 percent more than the average two weeks ago, according to a New York Times database.

The State Constitution calls for the legislature to convene on the first Wednesday in December of even-numbered years for what is known as Organization Day, when members are sworn in and a speaker is elected, among other organizational business.

The leaders of the new Republican majorities in each chamber — Dick Hinch in the House and Chuck Morse in the Senate — announced on Sunday that they had proposed moving Organization Day outdoors, because “an outdoor venue will lower the risk for all members and staff.”

The worry isn’t hypothetical. After the House Republican caucus met at a ski resort in Manchester Nov. 20, a number of attendees tested positive. The state health department said on Tuesday that it was “aware of cases stemming from the event,” and was conducting contact tracing. Mr. Hinch said in a statement that the number of people affected was “very small” and that he had no reason to think they would attend the legislative session on Wednesday.

The outgoing Democratic speaker, Steve Shurtleff, said on Tuesday that about 50 Republican members were refusing to wear masks during House sessions. Gov. Chris Sununu is now allowing members to be sworn in remotely, and once the news about the Manchester event broke, Mr. Shurtleff said, more members have been calling in to say they would choose that option and not appear in person.

Shifting gears to get 400 chairs set up outside on short notice “presented many logistical challenges,” Mr. Smith said. But so far, the weather forecast seems to be cooperating: partly cloudy and breezy, with temperatures in the low 40s. “Thank God that that’s happening,” he said.

The dosing of BNT162b2, the mRNA-based vaccine candidate against COVID-19, during the clinical test.
The dosing of BNT162b2, the mRNA-based vaccine candidate against COVID-19, during the clinical test.Credit…BioNTech/EPA, via Shutterstock

Pfizer and BioNTech have submitted their final application to the European health authorities for approval of their Covid-19 vaccine, the companies announced Tuesday.

Initial approval could come as early as Dec. 29 when the European Union’s medicine agency plans to meet in an extraordinary session to decide if the data submitted is “sufficiently robust” to show the safety and efficacy of the vaccine.

“Today’s announcement marks another key milestone in our efforts to fulfill our promise to do everything we can to address this dire crisis given the critical public health need,” Dr. Albert Bourla, chief executive of Pfizer, said in a statement.

Last month, Pfizer announced that the vaccine was more than 90 percent effective based on a Phase 3 study involving 43,538 participants, and that it had already submitted an application to the Food and Drug Administration in the United States to authorize it for emergency use.

“We will continue to work with regulatory agencies around the world to enable the rapid distribution, should the vaccine receive the approval, contributing to the joint efforts to let the world heal and regain its normal pace of life,” said Ugur Sahin, co-Founder of BioNTech, the German start-up that created the vaccine.

The news comes a day after Moderna, the makers of another promising vaccine, announced that it had applied for approval from the European market.

If the applications are approved by the European Medicines Agency, the first doses could be available before the end of the month. The agency is “assessing all the applications for COVID-19 medicines under the minimum time frame necessary to allow for a thorough evaluation of the medicine’s benefits and risks,” it said.

If the agency concludes that the benefits of the vaccine outweigh its risks, it will recommend a conditional marketing authorization, which the European Commission will then fast-track to approve in all European member states within days.

On Tuesday, BioNTech officials, speaking at a news conference, said vaccine doses were waiting for approval to be shipped.

“We have produced a stockpile; everything that we have can really be distributed within a few hours,” said Sierk Poetting, the company’s chief financial officer and chief operating officer.

A Father and daughter wait to get a coronavirus test at the St. John’s Well Child and Family Center mobile clinic in Los Angeles.
A Father and daughter wait to get a coronavirus test at the St. John’s Well Child and Family Center mobile clinic in Los Angeles.Credit…Etienne Laurent/EPA, via Shutterstock

A small but growing body of evidence, some of which has not yet been published in a peer-reviewed scientific journal, suggests that some rapid tests for the coronavirus may falter in children, letting low-level infections slip by unnoticed.

In a recent study of more than 1,600 people in Massachusetts, Binax NOW, a rapid test manufactured by Abbott Laboratories, caught 96.5 percent of the coronavirus infections found by a more accurate laboratory test in adults with symptoms. But the rapid test detected just 77.8 percent of the symptomatic cases in people 18 or under. Among people without symptoms, the test faltered further, identifying 70.2 percent of adults and 63.6 percent of children.

Another recent paper, published in November in Clinical Microbiology and Infection, found that a different rapid test by Abbott, called the PanBio, identified just 62.5 percent of coronavirus cases in people 16 or younger, compared with 82.6 percent of infections in adults, although the number of pediatric samples tested was small.

Children rarely seem to be stricken with serious cases of Covid, and the youngest among them may also be less likely to pass the coronavirus on to others. But the new findings should encourage more in-depth studies of diagnostic tools for the virus in pediatric populations, health experts said.

In medicine, children are often “assumed to be just miniature versions of grown-ups,” said Jennifer Dien Bard, a clinical microbiologist at Children’s Hospital Los Angeles. “But they are not just small adults. It’s really important that any testing that is available, that there are specific strategies offered for children and their specific needs.”

It may be that children are naturally predisposed to carry less of the virus. They might even be less likely to transmit it to others. For now, however, “if your goal is to detect infection, molecular tests are the way to go,” said Dr. Nira Pollock, the associate medical director of the infectious-diseases diagnostic laboratory at Boston Children’s Hospital, referring to laboratory diagnostics that use a different, less rapid method called polymerase chain reaction.

The White House Christmas decorations are themed “America the beautiful.” The holiday season is one area where the norm-breaking president appears intent on savoring tradition.
The White House Christmas decorations are themed “America the beautiful.” The holiday season is one area where the norm-breaking president appears intent on savoring tradition.Credit…Doug Mills/The New York Times

The red and gold party invitations make no mention of the coronavirus, nor do they acknowledge the holiday message that public health officials have been trying to emphasize to Americans: stay home.

Instead, the invitations are the latest example of how President Trump is spending his final weeks in office operating in an alternative universe, denying the realities of life during the pandemic.

“The president and Mrs. Trump request the pleasure of your company at a holiday reception to be held at the White House,” reads the cursive text, displayed under a presidential seal.

Invitations to at least 20 White House parties, beginning Monday at 7 p.m., have been sent out so far. The guest lists include current and former officials and allies, some from out of state; Republican National Committee officials; campaign staff members; and some Republicans on Capitol Hill.

But in more than half a dozen interviews on Tuesday, many invitees said they did not plan to attend because of the personal risk that attendance would require. Others joked that since so many people in the president’s orbit had already tested positive for the virus, the White House had achieved herd immunity and was now a safe space for a quick stop to view the Christmas decorations.

The holiday party season, canceled across most of Washington, will be a rare time when the White House will feel busy. Inside the West Wing in recent weeks, there has been noticeably less foot traffic in and out of the Oval Office, as staff members pondering their career moves give a president who refuses to concede some space. Mr. Trump has made few public appearances since the election was called for Joseph R. Biden Jr.

But the holiday season at the White House — complete with a gingerbread house made with 25 pounds of chocolate and 25 pounds of royal icing by the in-house pastry team — is one area where the norm-breaking president appears intent on savoring tradition.

On the afternoon of Dec. 11, Mr. Trump is hosting a party for the West Wing staff and their families. There are also receptions planned for the evenings of Dec. 14 and Dec. 16, according to guests and copies of invitations. Officials said there were at least 20 holiday events on the calendar through December.

Stephanie Grisham, the chief of staff to Melania Trump, the first lady, said guests would be strongly encouraged to wear masks when they were not eating and the guest lists were smaller than usual. She did not say how many people were invited to each event.

Other restrictions were being put in place that were not instituted when the president hosted a large crowd for an indoor party on election night.

“Guests will enjoy food individually plated by chefs at plexiglass-protected food stations,” Ms. Grisham said in a statement. “All passed beverages will be covered. All service staff will wear masks and gloves to comply with food safety guidelines. Attending the parties will be a very personal choice. It is a longstanding tradition for people to visit and enjoy the cheer and iconic décor of the annual White House Christmas celebrations.”

The latest guidance from Mayor Muriel E. Bowser of Washington, a Democrat, limits indoor gatherings in the city to no more than 10 people. Beginning Dec. 14, restaurants in Washington are allowed to operate indoors only at 25 percent capacity.

The White House is exempt from the city’s restrictions because it is on federal property.

Stanford coach David Shaw during a game. Stanford will practice and play on the road the next two weeks because of coronavirus restrictions in Santa Clara County, Calif.
Stanford coach David Shaw during a game. Stanford will practice and play on the road the next two weeks because of coronavirus restrictions in Santa Clara County, Calif.Credit…Jed Jacobsohn/Associated Press

Stanford University is taking its football team on the road to maneuver around public health restrictions in California.

In a statement on Tuesday, Stanford said its team would leave for Seattle later in the day to practice for Saturday’s game against the University of Washington. Next week, Stanford will prepare for its game against Oregon State University from Corvallis, Ore., after Pac-12 Conference officials moved the matchup there from the Stanford campus.

The university’s decision came a few days after the authorities in Santa Clara County, where Stanford is located, temporarily banned “all recreational activities that involve physical contact or close proximity to persons outside one’s household.”

“I am gravely concerned by the continuing surge in Covid-19 cases and hospitalizations,” Dr. Sara Cody, the Santa Clara County health officer, said when officials announced the new restrictions. “The number of patients hospitalized with Covid-19 in our county has doubled in just the past couple of weeks, and we are at risk of exceeding our hospital capacity very soon if current trends continue.”

The county’s order also affected the San Francisco 49ers, who will play their next two “home” games near Phoenix. San Jose State University, which is also in Santa Clara County, has not yet announced its plans to comply with the new restrictions, which will be in effect until at least Dec. 21.

Some states are using emergency cellphone alerts regarding the coronavirus pandemic.
Some states are using emergency cellphone alerts regarding the coronavirus pandemic.Credit…Susan Montoya Bryan/Associated Press

It was the day before Thanksgiving when Brian Stone, of Tilghman, Md., heard the alarm ring from his phone: the jarring buzz that tells people to look out for missing children or evacuate their homes to escape an advancing wildfire.

But this alert was different: It told him to wear a face mask and to expect stricter enforcement of coronavirus health orders.

Mr. Stone then turned off the notification system.

“You get this beep, this electronic sound, and you think it’s something important, and it’s just ‘Wear a mask and be safe,’” said Mr. Stone, whose wife, Ellen, wrote a letter to The Baltimore Sun about the emergency alert. “It wasn’t an emergency.”

Ed McDonough, a spokesman for the Maryland Emergency Management Agency, said: “We’ve been trying to be very judicious in how we use it.” Mr. McDonough said officials felt that with families gathering for Thanksgiving, it was important to remind them to be as safe as possible.

State and local officials are turning to the Wireless Emergency Alert system to warn residents of rising case counts and of other public health issues related to the virus. The model allows police departments and other public agencies to warn residents with geographically targeted messages, usually when there is severe weather or a child has been abducted.

In Los Angeles, officials used the system to tell residents that virus testing sites were expanding their hours ahead of the holidays.

On Monday, Rhode Island issued an alert to warn residents that hospitals were at capacity. And in Pennsylvania, Gov. Tom Wolf said in a news release last week that the state would use the alerts to target specific regions of the state with high case counts.

While emergency alerts provide an easy way to get important information to residents, the system also potentially oversaturates people with messages, creating a “boy who cried wolf” effect that could lead people, like Mr. Stone, to become disillusioned with the system.

Mr. Wolf said the alerts are “one more way to reach as many Pennsylvanians as we can to provide timely information on Covid-19.”

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