Covid-19 Live Updates: New N.Y.C. Data Shows Wide Gulfs in Vaccination Rates


Credit…James Estrin/The New York Times

Officials in New York City released new data by ZIP codes on Tuesday that they said underscored troubling disparities in the city’s vaccination effort, with the share of residents who are fully vaccinated in some wealthier Upper West and East Side ZIP codes, which have high proportions of white residents, reaching up to eight times the rate in parts of predominantly Black neighborhoods like East New York.

The figures for individual ZIP codes provided one of the most granular pictures of the city’s vaccination effort to date. And it added more evidence suggesting that across the country, the vaccine appears to be flowing disproportionately toward areas with wealthy and white residents, even though low-income communities of color remain the hardest hit by the coronavirus.

Still, questions remained. The new city data does not break down vaccine recipients by race in each ZIP code, nor does it account for how many people in each ZIP code are eligible to be vaccinated.

Asked whether the city knew whether some ZIP codes with high vaccination rates also had high concentrations of residents in the earliest eligible categories, like doctors and nurses, police officers and nursing-home residents, Mayor Bill de Blasio said the city did not “have the level of data that would be ideal.”

Gathering the right data has also been a problem nationally, as federal officials have struggled to keep track of the race and ethnicity of people being vaccinated, despite the emphasis President Biden has given to racial equity in his coronavirus response.

In New York City, Mr. de Blasio said he wanted to see vaccination rates “even out” across the city.

In one ZIP code in Lenox Hill on the city’s Upper East Side, for example, te city found that 16 percent of adults had received both doses of vaccine. The median household income in the Upper East Side and some surrounding neighborhoods is about $120,868, according to recent census data — roughly double the citywide figure.

By contrast, in two ZIP codes around East New York, only two percent of adults have received both vaccine doses. The median household income in and around East New York is about $38,000, according to census data.

In Breezy Point, Queens, some 13 percent of adults had received both doses, and 27 percent had received at least one, the figures show, while on City Island in the Bronx, 25 percent had gotten both doses.

Broadly, ZIP codes in Manhattan and Staten Island showed higher vaccination rates than those in the South Bronx, central Queens or central Brooklyn, according to Dr. Torian Easterling, deputy commissioner and chief equity officer for the city’s health department.

“The ZIP code data not only provides a map of where New Yorkers are being vaccinated, but also a road map to our Covid response,” Dr. Easterling said.

Citywide figures released earlier this year, while incomplete, indicated that a smaller share of Black and Latino residents than of white residents were receiving doses.

Experts say people across the country who live in underserved neighborhoods face a variety of obstacles to vaccination, including registration systems and websites that can take hours to navigate; a lack of transportation; and difficulty getting time off from work to get a shot. Many people in communities of color are more likely to be hesitant about getting vaccinated, in light of the history of unethical medical research in the United States.

Mr. de Blasio said on Tuesday that a new vaccine site was opening on Wednesday at the Teachers Preparatory High School in Brooklyn that would be open six days a week, and would give priority to home health aides and to people living in Brownsville and East New York.

“This is about addressing inequality, doing something very tangible about it,” he said.

Another new vaccine site would open on Thursday at the Empire Outlets in Staten Island, he said.

The city vaccinated 317,227 people last week, including 55,339 people on one day, Mr. de Blasio said, adding that more than 10 percent of New Yorkers had now received at least one dose. He said the city could vaccinate far more people each day if it could get more doses from the federal government.

The South African government said it would share its doses of the AstraZeneca-Oxford vaccine with the African Union.
Credit…Andrew Testa for The New York Times

CAPE TOWN — South Africa will share its unused doses of the AstraZeneca-Oxford vaccine with the African Union, the country’s health minister said on Tuesday.

South Africa, which had bought 1.5 million doses of the vaccine, decided to pause plans to distribute it this month after a small trial failed to show that it could prevent mild or moderate cases of Covid-19 caused by the worrisome variant that has overrun the country.

“The AstraZeneca doses which we purchased have been offered to the African Union platform, which we are part of, and they will be distributed to the countries that have already indicated interest that do not have this particular challenge of this variant,” the country’s health minister, Dr. Zweli Mkhize, told the Parliament. “There will therefore be no wasteful and fruitless expenditure.”

South Africa’s decision not to use the AstraZeneca vaccine, at least for now, highlights the difficult choices countries will face as more variants circulate even as vaccine shortages abound in many places. The vaccine was the only one approved in the country, and the news about the disappointing trial results came just days before its much-anticipated rollout had been set to begin.

The scientists involved in the South African study said that they believed the AstraZeneca vaccine might still protect against more severe cases caused by the virus variant, based on the immune responses detected in blood samples from people who were given it. The health minister has asked for further study.

A World Health Organization panel of experts recently recommended that the AstraZeneca vaccine be used in countries where concerning new variants of the coronavirus are circulating, cautioning that it was difficult to draw firm conclusions from such preliminary data. But the panel also said that each country should take into account the state of the virus and the type of variants spreading there in deciding which vaccines to use.

The AstraZeneca vaccine is cheap and easy to store, and is considered especially important for lower- and middle-income countries around the world, which have generally lost out to wealthier countries in a global rush for vaccines.

Instead of the AstraZeneca-Oxford vaccine, South Africa was planning to inoculate tens of thousands of health workers with the Johnson & Johnson vaccine, which prevented hospitalizations and deaths in clinical trials in the country. Those shots are expected to be given on a trial basis while the nation works through the formal approval process for that vaccine.

The ministry did not say whether the African Union would be buying the doses, accepting them as a donation, or exchanging them for an alternative. The regional body declined to comment.

Dr. Mkhize also rejected a report from an Indian newspaper, The Economic Times, that South Africa had asked the manufacturer of its doses, the Serum Institute of India, to take them back.

“We also want to refute categorically the speculation in the media that we have returned the stock to India. We have not,” said the health minister.

A mass coronavirus vaccination site in Poplar Bluff, Mo., last month. Missouri is halting vaccination distribution for the week because of safety risks from the storm.
Credit…Paul Davis/The Daily American Republic, via Associated Press

The winter storm stretching across much of the United States disrupted distribution of the coronavirus vaccine this week, as clinics giving shots closed and shipments of the vaccine stalled with snow and ice grounding flights and turning highways dangerously slick.

The Centers for Disease Control and Prevention on Tuesday warned of “widespread delays” in vaccine shipments over the next few days, particularly for those doses coming through major shipment hubs like the FedEx facility in Memphis and the UPS facility in Louisville.

Many of the closures and cancellations were in the South, where the storm was particularly fierce — and where the pace of vaccinations in several states has lagged behind the national average. Vaccine appointments have been rescheduled or canceled from Texas to Kentucky.

“It’s just not safe for people to be out. So we need this to thaw,” Mayor Steve Adler of Austin said Tuesday on CBS. “And then we’re just going to have to redouble our efforts and make sure that the vaccine that we have gets into people’s arms. But for right now, we’re on pause.”

The delays appeared likely to grow in the coming days, as the storm continued its path across the country.

In Missouri, Gov. Mike Parson said on Monday that vaccination distribution efforts run by the state would be brought to a halt through the rest of the week, while in Alabama, hospitals and health departments closed vaccination clinics. In New Hampshire, state officials said vaccinations would be canceled on Tuesday.

In Detroit, Mayor Mike Duggan said the 3,000 vaccination appointments scheduled to be carried out on Tuesday at a downtown convention center downtown would be moved to Saturday.

“We’re going to keep the vaccines going to the maximum extent possible,” Mr. Duggan said, “but we’re also not going to ask people to be put at risk coming down in difficult driving conditions.”

In Houston, officials scrambled to deliver more than 8,400 vaccine doses on Monday after the Harris County Public Health Department building — where these vaccines were being stored— lost power and the backup generator failed, Harris County Judge Lina Hidalgo said at a news conference.

Officials ended up distributing more than 5,400 of the vaccines to hospitals in the region, to Rice University and to the county jail. After receiving guidance directly from Moderna, the remaining 3,020 vaccines were re-refrigerated and put back in storage for later administration, Ms. Hidalgo said.

Jen Psaki, the White House press secretary, said at a news conference on Tuesday that the administration’s Covid-19 response team was in “close touch with state and local governments across the country” regarding the storm affecting vaccine distribution, and that the situation in Texas was being monitored closely.

“Mother Nature and the weather,” she said, “requires contingency planning.”

The USS Theodore Roosevelt moored at Naval Base Guam last summer.
Credit…Conner D. Blake/US Navy, via Getty Images

Three sailors aboard the U.S.S. Theodore Roosevelt, an aircraft carrier that was the center of a contentious outbreak last spring, have tested positive for the coronavirus, according to Navy officials.

The sailors, who tested positive on Sunday, were not experiencing any symptoms and were placed in isolation on the ship, which remained “fully operational,” the Navy said in a statement on Monday.

“The ship is following an aggressive mitigation strategy in accordance with Navy and C.D.C. guidelines to include mandatory mask wearing, social distancing, and proper hygiene and sanitation practices,” the statement said.

Last March, the Theodore Roosevelt docked at the naval base in Guam, an American territory in the Pacific, as it contended with a fast-spreading outbreak among its crew of 4,800. For weeks the warship battled the virus that infected at least 585 crew members, including one who died of complications stemming from the coronavirus.

As the ship struggled with the infections in its close, shared quarters, Capt. Brett E. Crozier, the ship’s commander at the time, sent a four-page letter to 20 Navy officials pleading for help, criticizing the Navy’s failures to provide the proper resources to contain the outbreak by moving sailors off the vessel.

In the letter, Captain Crozier pushed for moving nearly the entire crew off the vessel, and then quarantining and testing them while the ship was professionally cleaned.

“We are not at war,” Captain Crozier wrote. “Sailors do not need to die. If we do not act now, we are failing to properly take care of our most trusted asset — our sailors.”

After the letter was leaked, Thomas B. Modly, the acting Navy secretary, fired the captain before an investigation was conducted, prompting widespread criticism, including from Navy officials. Videos of the crew cheering and shouting “Captain Crozier” as he walked off the ship immediately went viral.

Under fire, Mr. Modly later resigned.

The New Hampshire State Legislature met in a drive-in session at the University of New Hampshire in Durham in January.
Credit…Tristan Spinski for The New York Times

A group of medically vulnerable Democratic state legislators in New Hampshire filed a federal lawsuit late on Monday, seeking the right to attend legislative sessions remotely, arguing that requiring them to gather indoors is a violation of the Americans with Disabilities Act.

Republicans gained control of the 400-seat state House of Representatives in November, and have resisted Democrats’ pleas to hold meetings virtually or to allow individual lawmakers to participate remotely, despite the death in December of the newly elected Republican speaker, 71-year-old Richard Hinch, from coronavirus.

The pandemic has given rise to some improvisation: In January, the Legislature convened with lawmakers sitting in their vehicles in a parking lot, listening to speeches over a shared radio frequency, while staff members zipped around in golf carts, sticking microphones in the windows of members who wished to speak.

But a faction of Republicans pushed to resume meeting indoors and in person, and the House speaker, Sherman A. Packard, announced this month that the body’s February gathering would be held in the NH Sportsplex, a 55,000-square-foot arena, over the Democrats’ objections.

“With only nine days until the next House session, and no indication that the speaker will provide remote access, we had no choice but to resort to litigation,” said Representative Renny Cushing, the House Democratic leader.

The seven Democratic lawmakers involved in the suit have limited physical mobility and a variety of health problems, including cancer, cerebral palsy, diabetes and kidney disease.

In correspondence refusing Democratic requests for accommodations, Mr. Packard said enabling remote participation in the meeting would be “impractical.”

“Deployment of equipment, testing, training of members, technical support protocols, and back-end software development would all be tremendously time-consuming and costly,” Mr. Packard wrote.

On Tuesday, Mr. Packard said the arena was large enough to let legislators to “spread out and social-distance.” He said that previous well-attended House sessions had been held indoors without any known coronavirus infections.

Twenty-eight states, as well as Guam, the District of Columbia and the United States Virgin Islands, have altered legislative rules since the spring to allow meeting remotely, according to the National Conference of State Legislatures. New Hampshire’s State Senate is also meeting over Zoom.

Gov. Andrew M. Cuomo of New York conceded on Monday that his administration’s lack of transparency about coronavirus-related deaths in nursing homes in the state had been a mistake.
Credit…Hans Pennink/Associated Press

Gov. Andrew M. Cuomo of New York wrote the book on pandemic leadership, literally. He won an International Emmy for his TV briefings during the outbreak’s early months. Now, his self-created image as America’s Covid-19 governor may be threatened by his efforts to protect it.

Mr. Cuomo conceded on Monday that his administration’s lack of transparency about how it counted coronavirus-related deaths in the state’s nursing homes had been a mistake.

The pandemic has ravaged nursing homes across the country. But as recently as late January, New York was reporting only about 8,500 nursing-home fatalities, excluding virus-related deaths that occurred outside those facilities, such as in hospitals. Now, with those included, more than 15,000 residents of New York’s nursing homes and long-term care facilities are known to have died from Covid-19.

The spike came after the state’s attorney general, Letitia James, accused the Cuomo administration of severely undercounting deaths connected to nursing homes. The state quickly updated those numbers, adding thousands. A court order has since led to more updates and an even higher number.

Speaking Monday in the State Capitol, Mr. Cuomo made his first remarks since a top aide to the governor, Melissa DeRosa, privately told some state lawmakers last week that the state had withheld data from the Legislature. She said it had feared that the Trump administration would use the information to begin a federal investigation into the state’s handling of nursing homes.

The governor echoed Ms. DeRosa’s comments and acknowledged that by failing to answer questions from state lawmakers, the public and the news media, the state created a void that was “filled with skepticism, cynicism and conspiracy theories which furthered confusion.”

The revelation that data was withheld from lawmakers has prompted accusations of a cover-up and calls from lawmakers in both parties for the Democratic governor to be investigated and stripped of the emergency powers that he has exercised during the pandemic.

President Trump’s Justice Department never formally opened an investigation. But the episode has cast a shadow on the governor’s record on nursing homes, darkening his carefully cultivated image as a competent executive beholden to facts. In October, Mr. Cuomo published a memoir, “American Crisis,” offering “leadership lessons” from his approach to the pandemic, which has killed more than 45,000 people in New York.

The nursing-home revelations are “really potentially politically problematic” for Mr. Cuomo, who plans to run for a fourth term in 2022, said Patrick Egan, a political-science professor at New York University. But he added that if the governor successfully pushes for the vaccinations of large numbers of New Yorkers, his transgression “may be long forgotten.”

New York ranks 38th among states in vaccinating its population with at least one shot, according to a New York Times database.

The governor has been eager to expand vaccine access, most recently to millions of New Yorkers with chronic health conditions. He has done so even as demand outstrips supply by far.

New Yorkers lined up to receive the vaccine at sites around the city on Monday, a day after people inundated a state website and call center and found a shortage of appointments.

Last month, state officials scrambled to loosen vaccine eligibility restrictions after medical providers said they had to throw out vaccine doses because they were struggling to find patients who fit the guidelines.

Vaccination bottlenecks “could very quickly resolve themselves,” Dr. Egan said, but Mr. Cuomo’s reputation as a pandemic leader could lose its luster if investigations brought damaging revelations.

“We just don’t know if it’s going to metastasize into a bigger problem,” he said. “Are there more things that the government withheld?”

GLOBAL ROUNDUP

North Korea, which has a decrepit public health system, claims officially to be free of Covid-19. It sealed its borders early last year.
Credit…James Estrin/The New York Times

North Korea has tried to steal Covid-19 vaccine and treatment technology by attempting to hack the computer systems of international pharmaceutical companies, including Pfizer, a South Korean lawmaker said on Tuesday after a briefing by government intelligence officials.

The North, which has a decrepit public health system, claims officially to be free of Covid-19. It sealed its borders early last year.

The South Korean lawmaker, Ha Tae-keung, who is affiliated with the opposition People Power Party, spoke to reporters after he and other lawmakers were briefed by senior officials from the National Intelligence Service in a closed-door session on Tuesday​.

Mr. Ha provided no further details, and the service declined to corroborate his remarks, citing a policy of not confirming information from such briefings. Pfizer did not immediately respond to a request for comment.

​Western officials have ​long accused North Korea ​of steal​ing​ technology and cash from the outside world​ through hacking​. Last week, the Reuters news agency reported that a preliminary United Nations inquiry into the theft of $281 million worth of assets from a cryptocurrency exchange last September “strongly suggests” links to North Korea.

In other developments around the world:

  • Johnson & Johnson has submitted its single-shot Covid-19 vaccine to the European Union’s drug regulator for authorization, the agency said Tuesday. The vaccine could be approved by mid-March if it meets criteria for safety, efficacy and quality, the regulator, the European Medicines Agency, said in a statement. It would then be the fourth vaccine cleared for use in the union, raising hopes that member nations would be able to speed up immunization programs that have gotten off to sluggish starts.

  • Colombia, which will start vaccinations on Wednesday, is kicking off its campaign in a rural part of the country to signal that the vaccines will be available for everyone, not just those in major cities, President Iván Duque said. Colombia has had the second worst coronavirus outbreak in Latin America, and is beginning vaccinations weeks after neighboring countries like Chile and Argentina.

  • A court in the Netherlands ruled that the country’s 9 p.m. curfew to curb the spread of the coronavirus must end immediately, saying there was no “special urgency” to justify it. The court called the curfew, which the government instituted without input from the Parliament, a “far-reaching violation of the right to freedom of movement and privacy.” Last month, after the curfew went into effect, violent demonstrations erupted across the country for multiple nights on end, in which people looted stores and threw rocks at the police.

  • Germany plans to provide free, rapid-turnaround tests for coronavirus antigens starting on March 1, Jens Spahn, the country’s health minister, said on Twitter. They will be administered in pharmacies or test centers, he said. Currently, German health insurers pay for tests for those with symptoms or who have had contact with infected people, although rules vary across the country.

Dr. Anthony Fauci briefing reporters at the White House last month. Dr. Fauci is being honored with an award from Tel Aviv University for his work during the coronavirus pandemic.
Credit…Doug Mills/The New York Times

Dr. Anthony S. Fauci, the veteran director of the National Institute of Allergy and Infectious Diseases and the public face of the battle against the pandemic in the United States, has been awarded a $1 million prize from the Dan David Foundation and Tel Aviv University that is dedicated this year to outstanding contributions in public health.

The prize awards a total of $3 million a year to individuals and organizations for their achievements in three categories: expanding on knowledge of the past, enriching society in the present and promising to improve the future of the world. The theme of the prize varies from year to year. Previous laureates include the cellist Yo-Yo Ma, former Vice President Al Gore, the novelist Margaret Atwood and Dr. Demis Hassabis, an artificial intelligence researcher, neuroscientist and entrepreneur.

Dr. Fauci, 80, won in the “Present” category for his scientific contributions, including his research and his efforts to inform the public about the pandemic. He “leveraged his considerable communication skills to address people gripped by fear and anxiety and worked relentlessly to inform individuals in the United States and elsewhere about the public health measures essential for containing the pandemic’s spread,” the organizers of the Dan David Prize said in a statement.

It added, “He has been widely praised for his courage in speaking truth to power in a highly charged environment,” a reference to Dr. Fauci’s testy relations with former President Donald J. Trump and his supporters, who came to treat him as a villain.

The other Dan David Prizes were shared this year by the health and medicine historians Dr. Alison Bashford, Dr. Katharine Park and Dr. Keith A. Wailoo in the Past category; and Dr. Zelig Eshhar, Dr. Carl June and Dr. Steven Rosenberg, pioneers of an anti-cancer immunotherapy, in the Future category.

Gorillas at the San Diego Zoo Safari Park in January. Several members of the troop tested positive for the virus, with symptoms including congestion and coughing.
Credit…Ken Bohn/San Diego Zoo, via Reuters

Several gorillas at the San Diego Zoo Safari Park that tested positive for the coronavirus last month have fully recovered, the zoo said.

“We’re so grateful for the outpouring concern and support we’ve received while the troop safely recovered,” Lisa Peterson, executive director of the San Diego Zoo Safari Park, said in a statement.

Zoo officials had said they believed the animals, part of an eight-member troop of western lowland gorillas, were infected by an asymptomatic staff member who had been following safety recommendations, including wearing personal protective equipment when near animals. The gorillas, whose symptoms included coughing and congestion, were the first apes in the United States known to be infected with the virus, federal officials said.

The primate habitat where the gorillas are housed is now fully open to visitors, the zoo said. Both the San Diego Zoo and the San Diego Zoo Safari Park reopened on Jan. 30 after closing since early December under a statewide stay-at-home order. Limits on attendance and other safety measures are in place.

There have been multiple instances in the pandemic of animals becoming infected, including domestic cats and dogs, a tiger at the Bronx Zoo in New York, snow leopards at the Louisville Zoo in Kentucky and mink in Utah and Denmark. Two white tiger cubs at a zoo in Pakistan are thought to have died from Covid-19 last month. And in Seoul, South Korea, where pets can be tested free, officials said on Monday that one cat had tested positive.

Though cats and dogs can become infected, they may not get sick or show symptoms. There is no evidence that animals play a major role in spreading the virus, but people can spread it to them.

A Zoom singing lesson put on by the English National Opera. 
Credit…ENO Breathe, via English National Opera and Imperial College Healthcare NHS Trust

LONDON — The Zoom session that the singing coach Suzi Zumpe ran on a recent afternoon resembled those she usually leads at the Royal Academy of Music in London, or at Garsington Opera near Oxford, where she trains young singers.

This time, however, the student she was helping through warm-up exercises wasn’t a singer. He was Wayne Cameron, 56, who manages warehouse logistics for an office-supply company. Doctors prescribed the session as part of his recovery plan after a pummeling experience with Covid-19 last March.

Called E.N.O. Breathe and developed by the English National Opera in collaboration with a London hospital, the six-week program offers patients customized vocal lessons: clinically proven recovery exercises, reworked by professional singing tutors and delivered online.

In a video interview, Jenny Mollica, who runs the English National Opera’s outreach work, explained that the idea was developed last summer, when “long Covid” cases started emerging. These were people who had recovered from the acute phase of the disease but were still suffering effects like chest pain, fatigue, brain fog and breathlessness.

“Opera is rooted in breath,” Ms. Mollica said. “That’s our expertise. I thought, ‘Maybe E.N.O. has something to offer.’”

The program is now being expanded to post-Covid clinics elsewhere in England, supported by charitable donations and free to anyone who is referred by a doctor. The aim is to assist as many as 1,000 people in the next phase, the opera company said in a statement.

Mr. Cameron said that even a few simple breathing exercises had quickly made a huge difference for him. “The program really does help,” he said. “Physically, mentally, in terms of anxiety.”

A gym class in Boston last month. Doctors across the country have been seeing a striking increase in the number of young people with Multisystem Inflammatory Syndrome in Children, or MIS-C.
Credit…Allison Dinner/Reuters

Doctors across the United States have been seeing a striking increase in the number of young people with Multisystem Inflammatory Syndrome in Children, or MIS-C. Even more worrisome, they say, is that more patients are now very sick than during the first wave of cases, which alarmed doctors and parents around the world last spring.

The reasons are unclear. The surge follows the overall spike in Covid-19 in the United States after the winter holidays, and more cases may simply mean more chances for severe disease to emerge. So far, there’s no evidence that recent coronavirus variants are responsible, and experts say it is too early to speculate about any impact of variants on the syndrome.

The condition remains rare. The latest numbers from the Centers for Disease Control and Prevention show 2,060 cases in 48 states, Puerto Rico and the District of Columbia, including 30 deaths. The median age was 9, but infants to 20-year-olds have been afflicted. The data, which is complete only through mid-December, shows the rate of cases has been increasing since mid-October.

While most young people, even those who became seriously ill, have survived and gone home relatively healthy, doctors are uncertain whether any will experience lingering heart issues or other problems.

“We really don’t know what will happen in the long term,” said Dr. Jean Ballweg, the medical director of pediatric heart transplant and advanced heart failure at Children’s Hospital & Medical Center in Omaha, which treated about two hospital cases a month from April through October, about 30 percent of them in the I.C.U. That rose to 10 cases in December and 12 in January, with 60 percent needing I.C.U. care — most requiring ventilators.

Symptoms of the syndrome can include fever, rash, red eyes or gastrointestinal problems. Those can progress to heart dysfunction, including cardiogenic shock, in which the heart cannot squeeze enough to pump blood sufficiently. Some patients develop cardiomyopathy, which stiffens the heart muscle, or abnormal rhythm.

Hospitals say most patients test positive for Covid-19 antibodies that indicate previous infection, but some patients also test positive for active coronavirus infection. Many children were previously healthy and had few or no symptoms from their initial infection. Doctors are uncertain which factors predispose children to the syndrome.

Sixty-nine percent of reported cases have affected Latino or Black young people, which experts believe stems from socioeconomic and other factors that have disproportionately exposed those communities to the virus.

But Omaha’s hospital, where early cases were largely among children of Latino parents working in the meatpacking industry, is now “seeing a much more broad spectrum and every ethnicity,” Dr. Ballweg said.

Dr. Jessica Manning last week in her laboratory inside the National Center for Parasitology, Entomology and Malaria Control in Phnom Penh, Cambodia.
Credit…Thomas Cristofoletti for The New York Times

Covid-19 arrived in Cambodia a year ago, on Jan. 23, when a Chinese national flew in from Wuhan, the city where the illness was first detected, and soon fell sick with a fever. A P.C.R. test came back positive.

For Cambodia, a developing country with a rudimentary health care system and multiple direct flights from Wuhan, the new disease presented an especially high risk.

Dr. Jessica Manning, a public health researcher with the National Institute of Allergy and Infectious Diseases who had been working in Cambodia for years, also saw an opportunity: helping the country join the global effort to watch for new diseases.

In those early days of Covid-19, researchers did not know how accurate the P.C.R. tests were or whether the virus was spawning new strains with potentially different properties. The Cambodian report helped confirm the accuracy of the P.C.R. test, and it revealed that only minor changes in the sequences were appearing. The virus did not seem to be mutating substantially — an indication that the disease would be easier to test for, treat and vaccinate against.

For Dr. Manning, the exercise was proof that even a small research outpost in the developing world could successfully detect new or unexpected pathogens and glean important information about them. As such, her lab and others like it could serve as an early-warning system for the next potential pandemic.

Watching for novel pathogens in Southeast Asia has recently become an important part of the global effort to understand the pandemic. In late January, a group of researchers, most at the Pasteur Institute in Cambodia, announced that it had used metagenomic sequencing to discover a coronavirus closely related to the one that causes Covid-19 in a bat captured in Cambodia in 2010.

“This is what we were looking for, and we found it,” Dr. Veasna Duong, the leader of the study, told Nature in November. “It was exciting and surprising at the same time.”

That finding has drawn attention from researchers who want to better understand how and when viruses cross between species.

Dr. Duong is looking in particular at places where people come near fruit bats. “This kind of exposure might allow the virus to mutate, which might cause a pandemic,” he told the BBC last month.

President Biden and the first lady, Jill Biden, arriving at Joint Base Andrews in Maryland on Monday.
Credit…Al Drago for The New York Times

President Biden, liberated from the distraction of his predecessor’s impeachment trial, is escaping Washington this week — embarking on trips to Wisconsin and Michigan to rally support for his $1.9 trillion pandemic relief plan.

Without the spectacle of a constitutional clash, the new president “takes center stage now in a way that the first few weeks didn’t allow,” said Jennifer Palmieri, who served as communications director for former President Barack Obama. She said the end of the trial means that “2021 can finally start.”

The president plans to fly to Milwaukee on Tuesday, his first work trip as president, and will participate in a CNN town hall where he is expected to tout his proposal to send $1,400 checks to individuals struggling during the pandemic. On Thursday, Mr. Biden will travel to Kalamazoo, Mich., to tour a Pfizer manufacturing site and meet workers producing the company’s coronavirus vaccine.

The travel is intended to represent a clean break from the Trump era. With the reality-TV drama done for now, he is pivoting back to the approach that got him elected: focusing on the coronavirus and the economy — in a way that balances safety precautions with his need to sell his agenda to the public.

He is off to a fairly fast start. House committees have begun debating parts of the coronavirus relief legislation, and several of his cabinet members have been confirmed.

But the president’s bipartisan prospects are complicated by the fact that much of his agenda is aimed at dismantling Mr. Trump’s policies or addressing what Democrats have cast as his failures, most significantly the fumbled response to the pandemic.

That is why Mr. Biden’s first official trips are to the two big Midwestern states he flipped in 2020 from the 2016 Trump column — and he hopes to build support in both places for his presidency by pushing his plan, which already enjoys broad backing among Americans of all political stripes. (So far, Mr. Biden has left Washington only to spend a weekend in Wilmington, Del., and for a visit to Camp David last weekend.)

Nonetheless, the 43 “not guilty” votes from Senate Republicans are a stark reminder that Mr. Trump continues to hold sway over most of his party, and that his influence with Republicans will be an obstacle. Even with control of both houses of Congress, Democrats will still need some Republican support on many of Mr. Biden’s agenda items to overcome a filibuster in the Senate.

To that end, Mr. Biden has been meeting with the handful of Republican lawmakers he views as potential partners. He hosted a group of 10 Republicans — some of whom he served with as a senator from Delaware — in a recent meeting in the Oval Office that stretched on for two hours.

Mr. Biden is banking on those personal connections he made during his 36 years in the Senate to help advance his legislative priorities in a chamber that has been troubled by dysfunction that has only grown worse in the decade since he’s been gone. His identity as a deft navigator of its clubby idiosyncrasies has become a defining feature of his governing approach.

“He loves the Senate,” said Senator Susan Collins of Maine, one of the Republicans who met recently with the president. Ms. Collins and another moderate Republican, Senator Lisa Murkowski of Alaska, recalled that Mr. Biden did not seem to want their meeting to end.

He is also using the power and prestige of his office to woo Democrats who represent more conservative states and are likely to need more persuasion than some of their colleagues. And some of his work appears to be leaving an impression. Senator Jon Tester of Montana, for example, said that in his 14 years in the Senate, no president had invited him to the Oval Office until now.

“I’m going to be honest with you: It was pretty emotional for me,” Mr. Tester said.

Jallesse Flores giving a shot to Alexandra King, 14, as part of a Moderna vaccine trial in children ages 12 through 17 in Houston earlier this month.
Credit…Brandon Thibodeaux for The New York Times

To get out of ninth-grade science period one recent Friday, the King twins had an excuse that is so very 2021.

Alexandra and Isabelle, 14, had to miss class — including a test — because they were going to a Houston clinic to participate in an actual science experiment: a clinical trial of Moderna’s Covid-19 vaccine to evaluate whether the shot is effective and safe in children ages 12 through 17.

Teenagers contract the novel coronavirus almost twice as often as younger children but vaccines authorized in the United States are mostly for adults — Moderna’s for 18 and older, Pfizer’s for 16 and up. While teenagers don’t become severely ill from the virus as often as adults, research suggests that because they are often asymptomatic and casual about social distancing, they can be efficient spreaders — to one another as well as to adults like parents, grandparents and teachers. Although vaccinating educators will be an important factor in keeping schools open, vaccinating students will also be a key element.

Bottom line: If widespread immunity to the coronavirus is to be achieved, adolescents are critical links. They need a Covid vaccine that works for them.

Although the novel coronavirus has had far less impact on children than older adults, some 2.2 million pediatric cases in the United States have been reported and about 280 children have died, according to the Centers for Disease Control and Prevention.

And like an enemy occupation, the pandemic has taken over most children’s lives — shutting down in-person school, sports, socializing. That has prompted some teenagers, who otherwise feel so powerless, to fight back by volunteering for vaccine trials.

Sam, 12, who entered the Pfizer trial at Cincinnati Children’s hospital, said he wanted to participate “because it would be helping science and beat the pandemic. And it was my way of saying thank you to the frontline workers who are keeping us healthy.”

His sister, Audrey, 14, who is also in the study, said, “I thought this would be a really good story I could tell my children and grandchildren — that I tried to help create the vaccine.”

“And I also thought it is important to have people of different ages and races represented,” added Audrey, who, like her brother, is Asian. (Their mother, Rachel, a nurse researcher who volunteered for a vaccine trial, asked that their last names be withheld for privacy reasons.)

Like most trial volunteers, children worry about side effects. Sure enough, after Sam got the second dose from Cincinnati Children’s hospital, he had a rough go of it.

In the middle of the night he woke with a throbbing headache. Then chills, a low-grade fever, muscle aches.

“He looked miserable,” said his mother, Rachel. “It’s one thing to talk theoretically about side effects but it was hard as a mom to see him feeling really bad.”

She felt guilty for having encouraged him to participate. “I’m so sorry,” she said.

Sam was mystified by her reaction. “I’m so happy,” he replied. “This means I got the real thing!”

Audrey, his sister, felt fine after her dose. “I’m jealous,” she said.





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