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State media in China played down the news from Brazil. Global Times, a state-owned nationalist tabloid, ran a headline that said the Sinovac vaccine was “100 percent effective in preventing severe cases, could reduce hospitalizations by 80 percent.”

The new data could heighten skepticism among people around the world who are already wary of Chinese-made vaccines, given that the country has a history of vaccine quality scandals. A study from the Chinese University of Hong Kong found that just 37.2 percent of respondents in Hong Kong were willing to be vaccinated.

Scientists had already raised questions about the piecemeal way in which efficacy data about the Chinese vaccines had been released. Indonesia said on Monday that its interim analysis found CoronaVac to have an efficacy rate of 65.3 percent. Last month, Turkey said it had an efficacy rate of 91.25 percent, but that was based on preliminary results from a small clinical trial.

In Brazil, officials say the higher efficacy rate previously announced for CoronaVac pertained to the protection it offered against developing Covid-19 symptoms significant enough to require treatment. While officials had asserted last week that the vaccine provided absolute protection against moderate to severe symptoms, they had not disclosed another group who had “very mild” infections despite having been vaccinated.

“The lack of transparency really damages people’s trust,” she said. “They’ve just reinforced the narrative that this vaccine is not good.”

In Austria, a nationwide survey by universities and medical institutes found that children under 10 showed a similar rate of infection to those between 11 and 14, and that the children in general were getting infected as often as teachers, said Michael Wagner, a microbiologist at the University of Vienna who oversees the study.

Scientists also point to data from the U.K.’s Office for National Statistics, which conducts a weekly random survey of the population. Just before the Christmas break, when schools were still open, the positivity rate among children was higher than in most adult groups, especially in those older than 11.

German virologist Christian Drosten said in his weekly podcast that the study “pretty much answers the question of how children contribute to the pandemic.”

Still, many policy makers across Europe say schools are safe. The European Center for Disease Prevention and Control states on its website that while clusters have been reported in all types of schools, such outbreaks have been relatively rare. Statistics also show that children rarely fall seriously ill after contracting the virus.

Mr. Wagner, who oversees the Austrian survey, said opening schools while the U.K. variant spreads in Europe bears a big risk. “We should be careful now,” he said.

And variants of the virus that appear to be more transmissible are turning up more frequently, according to the US Centers for Disease Control and Prevention, which warns they could worsen the already raging spread of the virus.

experts including Fauci are optimistic that current vaccines will largely protect against known variants, though they warn the more the virus spreads, the greater chance mutations could defeat current vaccines.

Health experts had warned that the November-December holidays, with boosts in travel and indoor gatherings, would send Covid-19 cases soaring.

And the country has reported fewer than 200,000 new cases a day for 10 straight days -- the longest such stretch since before Thanksgiving.

Experts have said movements in the volume of deaths can lag weeks behind case and hospitalization numbers, because those who succumb to the disease can first be sick for weeks.

That includes one first identified in the UK (B.1.1.7), one first seen in Brazil (P.1) and one seen in South Africa (B.1.351).

Researchers also are eying a variant found in California, Fauci said Monday, though it is unclear if it is more transmissible.

Moderna said it would develop a potential booster shot against this variant, just to be safe.

Biden said Monday he hoped to eventually increase the pace to 1.5 million shots a day. The time frame also would shrink if some people get one-dose vaccines, such as the candidate from Johnson & Johnson, which is expected to reports result of its Phase 3 trials soon.

The World Health Organization, meanwhile, has stressed that rich nations need to do more to ensure vaccines are available worldwide.

Biden last week signed an executive order requiring masks in federal buildings and on federal lands, and asked Americans to wear masks for his first 100 days in office.

Dr. Brannon Traxler, the department's interim public health director, said that the variant's arrival is an important reminder that the fight against COVID-19 is far from over.

Noting the limited supply of vaccines, she added, "Every one of us must recommit to the fight by recognizing that we are all on the front lines now. We are all in this together."

But the one first seen in South Africa has more mutations in its spike protein than the one from the United Kingdom. Several of its mutations are also present in a variant that was first identified in Brazil.

The coronavirus variants have alarmed public health experts in recent months, posing a new challenge even as vaccines from Moderna and Pfizer-BioNTech have raised hopes in the fight against the COVID-19 pandemic.

The company said that when its vaccine was used against the variant from South Africa, the vaccine produced levels of virus-fighting antibody titers that were around six times less than when it's used against other variants.

As a result, Moderna said it will test booster doses of its vaccine, including one that would be tailored to fight strains that have recently emerged.

Earlier this week, Moderna said its COVID-19 vaccine offers protection against new variants of the coronavirus — but that the vaccine is more effective against the strain first identified in the U.K. than the one found in South Africa.

Researchers have found growing evidence that both of the variants circulating in South Africa and Brazil may be capable of evading the body's immune system, heightening the risk of reinfection, as NPR's Michaeleen Doucleff recently reported.

The first U.S. case of the strain from Brazil was identified earlier this week in the Minneapolis metro are

Two important factors seem to be playing a role in Brazil’s resurgence. The first is that, after a COVID-19 infection, the natural immunity that our bodies develop seems to vary in strength and permanence. Protection wanes after infection with most respiratory viruses, including coronaviruses

the variant in Brazil, known as the P.1 (or B.1.1.248) lineage, has a potent combination of mutations. Not only does this variant seem to be more transmissible; its lineage carries mutations that help it escape the antibodies that we develop in response to older lineages of the coronavirus.

it at least has a capacity to infect people who have already recovered from COVID-19, even if their defenses protect them against other versions of the virus.

The mutations that help the virus spread and evade immune responses have arisen independently in multiple places. Combined with waning immunity, these factors underscore the challenge before the world: Populations may still be vulnerable to disaster scenarios just when things seem to be getting better.

the virus’s capacity to cause such a deadly second surge in Brazil suggests a dangerous evolutionary potential.

New, dangerous variants are all but inevitable when there are extremely high levels of transmission of the virus. As more people gain immunity, the selective pressure on the virus will favor the variants that can most effectively evade immune responses

the basic nature of evolutionary biology means that the virus should be expected to evolve in ways that circumvent defense mechanisms. Evidence that it is already doing so has been clear in the latest vaccine trial data.

The solution, then, depends on vaccination. The immune response that the vaccines create is generally more robust than the immune response we get after being infected by a virus, and should buy a population more protected time than would a surge in exposure to the virus

Wealthy countries have time to avoid a fate like Brazil’s through immediate, efficient vaccination.

In most places, however, this is not close to happening. And as of last week, only one of the world’s 29 poorest countries had vaccinated anyone at all. A study in the journal BMJ estimated that vaccines will not be available to more than a fifth of the world’s population until 2022.

The coronavirus’s constantly evolving nature is a stark reminder that the entire world is in this crisis together.

Vaccine distribution is more than just an issue of justice or morality

Ensuring that every human is vaccinated is in everyone’s interest, as global distribution of vaccines is the most effective way to drive down the virus’s capacity to replicate and evolve.

The key will be bringing down the global rates of transmission as quickly as possible—not getting any single country to 100 percent vaccination while dozens of countries roil.

“It is truly confounding that wealthier nations think that hoarding vaccines is the way to protect their citizens from a global pandemic that doesn’t respect borders,”

As the virus currently surges across Africa, some 2.5 million health-care workers are unvaccinated. “Clearly, the failure to address vaccine allocation based on health and epidemiological needs, rather than national interest, is now promising to have a dire impact on the world’s ability to achieve rapid, global control of COVID,”

Certain countries will approach herd immunity by vaccinating almost every citizen. Other countries could see mass casualties and catastrophic waves of reinfection—potentially with variants that evolved in response to the immunity conferred by the very vaccines to which these populations do not have access. In the process, these hot spots themselves will facilitate rapid evolution, giving rise to even more variants that could make the vaccinated populations susceptible to disease once again

The countries that hoard the vaccine without a plan to help others do so at their own peril.

the available vaccines slash the odds that infected people will spread the virus onward by at least half and likely more. In the rare cases that the virus breaks through, infections are generally milder, shorter, and lower in viral load.

Worryingly, a recent study documented several cases during India’s spring surge in which health-care workers who were fully vaccinated with AstraZeneca’s vaccine were infected by Delta and passed it on.

If other vaccines have similar vulnerabilities, vaccinated people might have to keep wearing masks indoors to avoid slingshotting the virus into unvaccinated communities

2. The variants are pummeling unvaccinated people.

Vaccinated people are safer than ever despite the variants. But unvaccinated people are in more danger than ever because of the variants.

While America worries about the fate of states where around 40 percent of people are fully vaccinated, barely 10 percent of the world’s population has achieved that status, including just 1 percent of Africa’s.

Many nations that excelled at protecting their citizens are now facing a triple threat: They controlled COVID-19 so well that they have little natural immunity; they don’t have access to vaccines; and they’re besieged by Delta.

richer nations would be wrong to think that the variants will spare them, because ...3. The longer Principle No. 2 continues, the less likely No. 1 will hold.

it’s how we might eventually face variants that can truly infect even vaccinated people.

“We have to assume that’s going to happen,” Gupta told me. “The more infections are permitted, the more probable immune escape becomes.”

We’re unlikely to be as vulnerable as we were at the beginning of the pandemic. The vaccines induce a variety of protective antibodies and immune cells, so it’s hard for a variant virus to evade them all. These defenses also vary from person to person, so even if a virus eludes one person’s set, it might be stymied when it jumps into a new host.

“I don’t think there’ll suddenly be a variant that pops up and evades everything, and suddenly our vaccines are useless,” Gupta told me. “It’ll be incremental: With every stepwise change in the virus, a chunk of protection is lost in individuals. And people on the edges—the vulnerable who haven’t mounted a full response—will end up bearing the cost.”

The discussion about vaccine-beating variants echoes the early debates about whether SARS-CoV-2 would go pandemic. “We don’t think too well as a society about low-probability events that have far-reaching consequences,”

even highly vaccinated nations should continue investing in other measures that can control COVID-19 but have been inadequately used—improved ventilation, widespread rapid tests, smarter contact tracing, better masks, places in which sick people can isolate, and policies like paid sick leave.

missing just one night of sleep impairs memory.

an impaired mind focuses “on negative information when making decisions.”

losing out on as little as 16 minutes a night could have serious negative impacts on job performance.

When we delay or speed up our internal body clock, it can have the same consequences as not getting enough sleep, a phenomenon known as advanced sleep-wake phase disorder.

“The reason is that our circadian rhythm tells our brain when to produce melatonin, our sleep hormone, so if you try to wake while your brain is still producing melatonin, you could feel excessive daytime sleepiness, low energy, decline in mood and cognitive impact,”

“There are a handful of people who can function adequately on a shorter sleep duration than the average person, but it’s very, very rare,

Missing even two hours here, an hour there, then having a wildly different sleep pattern over the weekend, is the gateway drug to chronic sleep deprivation.

you may be able to adjust your schedule

If you get less than seven hours a night, you can put on weight, since sleep loss can adversely impact energy intake and expenditure. That’s because, in part, the chemical that makes you feel full, leptin, is reduced, while ghrelin, the hunger hormone, increases

chronic sleep loss can increase the amount of free fatty acids in the blood.

People with sleep issues may also be at higher risk for depression and anxiety, while those disorders can also interfere with sleep.

The National Sleep Foundation recommends sticking to a sleep schedule. It won’t happen right away, and you’ll have to build and buy back your debt

Set a goal and regular bedtime, and turn your bedroom into a comfortable, dark, sleep-friendly area. That could mean blackout curtains, maybe a sleeping mask or earplugs.

et your body wake you up, a key to regaining natural circadian rhythm

Reading before bed, something Bill Gates and Arianna Huffington swear by, relaxes the mind

The European Commission, the EU's executive arm, will now fast-track its decision about whether to authorize use of the vaccine.

Like the Pfizer vaccine, the Moderna vaccine requires two doses to be effective. Both medicines work by using messenger RNA to induce the body to produce antibodies to help fight off an infection by the coronavirus. They essentially trick the body into making the same spike protein that the virus uses to invade cells — but without the dangerous coronavirus being present.

The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19."

Fauci also spoke about a new, more contagious variant of the coronavirus that has been detected in dozens of countries, including the U.S. "It does not appear to be more virulent, namely making people sicker or greater incidence of dying," Fauci told NBC's Chuck Todd. "Nor does it seem to elude the protection that's offered by the antibodies that are induced by the vaccine."

Many people are holding out hope that the COVID-19 vaccines will help quell the pandemic.

More than 4.2 million people have received the initial vaccination dose as of Saturday, according to the CDC. That number is far below the government's goal of having 20 million people in the U.S. vaccinated by the end of December.

"I want people to understand that the projections we were putting out were based on what we could control at the federal level. And we did deliver on 20 million doses delivered, but you're always going to have more doses allocated versus delivered. Delivered versus shots in arms," Adams said.

That approach has led to jammed phone lines, websites crashing and in some cases, people camping out in counties that took a first-come, first-served approach. In terms of what happens next with the booster shot, Zaragovia says Florida residents will have to wait for more information

While vaccinations continue, public health officials say it's still important to continue social distancing practices, including wearing masks, washing hands and watching how close people get to others.

President-elect Joe Biden opposes the death penalty and has said he will work to end its use, but as President Trump's administration accelerates the pace of federal executions in the closing days of his presidency, activists and progressive lawmakers are feeling more urgency to push Biden to act immediately upon taking office.

"Ending the barbaric and inhumane practice of government-sanctioned murder is a commonsense step that you can and must take to save lives," the lawmakers write. "We respectfully urge you to sign an executive order on Day 1 to place an immediate moratorium on the country's cruel use of the death penalty and signal your commitment to dismantle its use altogether."

The lawmakers are calling on Biden to "end the federal death penalty" on his first day in office. That's something that he wouldn't be able to do alone. "A U.S. president does not have the power to abolish the federal death penalty," Dunham said. "The only way that the federal death penalty can be abolished is an act of Congress signed by a president, or from a court decision by the U.S. Supreme Court. It's clear from the current composition of the Supreme Court that that's not going to happen, so the only way that the Biden administration would be able to end the federal death penalty would be to have some sort of bipartisan support in Congress."

Secretary of State Mike Pompeo was forced into quarantine after being exposed to someone who had tested positive for the coronavirus after hosting a string of large, indoor holiday parties at the State Department and attending a private party Saturday to watch the annual Army-Navy football game

The president, who recovered from his own bout with the virus after being treated with experimental drugs at Walter Reed National Military Medical Center, is described by aides and allies as preoccupied with the election results he still refuses to accept, and has shown no interest in participating in any kind of public health message.

Instead, Mr. Trump has been focused on his efforts to overturn the election results and consumed by his anger at Senator Mitch McConnell, the majority leader, who this week finally congratulated Mr. Biden on his victory and said that “the Electoral College has spoken.”

After months of positioning himself in opposition to public health experts, people familiar with his thinking said, Mr. Trump feels on some level as if he does not want to be seen as caving in the end to the advice of the same people he has disparaged.

As Mr. Trump hesitates, lawmakers and Supreme Court justices are expected to begin receiving vaccines in the coming days, though the doses will be limited.

Public health officials said they were pleased that the vice president was going to be vaccinated in public, along with Surgeon General Jerome Adams, despite the president’s own lack of interest in sending a similar public health message.

“The question is why don’t they do it together, six feet apart? It would be really powerful for the president, who has gotten exceptional treatment, to say that even in spite of getting the best care, it’s important that I get this vaccine.”

Mr. Trump’s decision, so far, to not get vaccinated, Dr. Gupta said, risked undermining any confidence that Mr. Pence might instill among skeptics who take their cues from the president alone.

“giving false reassurances to the American people that the vaccine is here and vigilance is no longer required.”

White House officials have said Mr. Trump does not need to get vaccinated because he still has the protective effects of the monoclonal antibody cocktail that was used to treat him for the virus in October. But Dr. Gupta said that was a misinterpretation of the results and that there was “no scientific reason not to get vaccinated.”

Mr. Trump said on Sunday that he would delay a plan for senior White House staff members to receive the coronavirus vaccine in the coming days

Doctors from Walter Reed this week set up vaccine stations inside the Indian Treaty Room in the Eisenhower Executive Office Building. There, they began vaccinating staff considered critical to the functioning of government: That included Secret Service members, some medical staff and some other support staff who work near Mr. Trump.

“His priority is frontline workers, those in long-term care facilities, and he wants to make sure that the vulnerable get access first,” Ms. McEnany said this week. When it came to staff working in the West Wing, she added, “it will be a very limited group of people who have access to it, initially.”

Mr. Pence, people familiar with his thinking said, was concerned about the optics of jumping the line, when he wanted the administration to receive credit for the distribution of an effective vaccine to frontline medical workers without any distractions.

Now, based on the U.S. response since February, Lipsitch believes that we’re still likely to see the virus spread to the point of becoming endemic.

That would mean it is with us indefinitely, and the current pandemic would end when we reach levels of “herd immunity,” traditionally defined as the threshold at which enough people in a group have immune protection so the virus can no longer cause huge spikes in disease.

Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said that, because of a “general anti-science, anti-authority, anti-vaccine feeling,” the U.S. is “unlikely” to achieve herd immunity even after a vaccine is available.

The case-fatality rate for COVID-19 is now very roughly 1 percent overall. In the absolute simplest, linear model, if 70 percent of the world were to get infected, that would mean more than 54 million deaths.

Without a better plan, this threshold—the percentage of people who have been infected that would constitute herd immunity—seems to have become central to our fates.

Some mathematicians believe that it’s much lower than initially imagined. At least, it could be, if we choose the right future.

Gomes explains, “There doesn’t need to be a lot of variation in a population for epidemics to slow down quite drastically.”

in dynamic systems, the outcomes are more like those in chess: The next play is influenced by the previous one. Differences in outcome can grow exponentially, reinforcing one another until the situation becomes, through a series of individually predictable moves, radically different from other possible scenarios. You have some chance of being able to predict the first move in a game of chess, but good luck predicting the last.

“selective depletion” of people who are more susceptible—can quickly decelerate a virus’s spread. When Gomes uses this sort of pattern to model the coronavirus’s spread, the compounding effects of heterogeneity seem to show that the onslaught of cases and deaths seen in initial spikes around the world are unlikely to happen a second time.

Based on data from several countries in Europe, she said, her results show a herd-immunity threshold much lower than that of other models.“We just keep running the models, and it keeps coming back at less than 20 percent,” Gomes said. “It’s very striking.”

If that proves correct, it would be life-altering news. It wouldn’t mean that the virus is gone. But by Gomes’s estimates, if roughly one out of every five people in a given population is immune to the virus, that seems to be enough to slow its spread to a level where each infectious person is infecting an average of less than one other person

That’s the classic definition of herd immunity. It would mean, for instance, that at 25 percent antibody prevalence, New York City could continue its careful reopening without fear of another major surge in cases.

he believes that the best we can do is continually update models based on what is happening in the real world. She can’t say why the threshold in her models is consistently at or below 20 percent, but it is. “If heterogeneity isn’t the cause,” she said, “then I’d like for someone to explain what is.”

Lipsitch also believes that heterogeneity is important to factor into any model. It was one reason he updated his prediction, not long after we spoke in February, of what the herd-immunity threshold would be. Instead of 40 to 70 percent, he lowered it to 20 to 60 percent. When we spoke last week, he said he still stands by that, but he is skeptical that the number lands close to the 20 percent end of the range. “I think it’s unlikely,” he said, but added, “This virus is proving there can be orders-of-magnitude differences in attack rates, depending on political and societal decisions, which I don’t know how to forecast.”

Biological variations in susceptibility could come down to factors as simple as who has more nose hair, or who talks the loudest and most explosively, and Langwig shares the belief that these factors can create heterogeneity in susceptibility and transmission. Those effects can compound to dramatically change the math behind predictions for the future.

What’s important to her, rather, is that people are not misled by the idea of herd immunity. In the context of vaccination, herd-immunity thresholds are relatively fixed and predictable. In the context of an ongoing pandemic, thinking of this threshold as some static concept can be dangerously misleading.

She worries that many people conflate academic projections about reaching herd immunity with a “let it run wild” fatalism. “My view is that trying to take that route would lead to mass death and devastation,” she says.

Left totally unchecked, Bansal says, the percentage of infected people could go even higher than 70 percent.

“Within certain populations that lack heterogeneity, like within a nursing home or school, you may even see the herd-immunity threshold be above 70 percent,” Bansal says. If a population average led people in those settings to get complacent, there could be needless death.

Bansal believes that heterogeneity of behavior is the key determinant of our futures. “That magic number that we’re describing as a herd-immunity threshold very much depends on how individuals behave,” Bansal says, since R0 clearly changes with behaviors. On average, the R0 of the coronavirus currently seems to be between 2 and 3, according to Lipsitch.

Social distancing and other reactive measures changed the R0 value, and they will continue to do so. The virus has certain immutable properties, but there is nothing immutable about how many infections it causes in the real world.

The threshold can change based on how a virus spreads. The spread keeps on changing based on how we react to it at every stage, and the effects compound. Small preventive measures have big downstream effects

In other words, the herd in question determines its immunity. There is no mystery in how to drop the R0 to below 1 and reach an effective herd immunity: masks, social distancing, hand-washing, and everything everyone is tired of hearing about. It is already being done.

“I think it no longer seems impossible that Switzerland or Germany could remain near where they are in terms of cases, meaning not very much larger outbreaks, until there’s a vaccine,” he said. They seem to have the will and systems in place to keep their economies closed enough to maintain their current equilibrium.

Other wealthy countries could hypothetically create societies that are effectively immune to further surges, where the effective herd-immunity threshold is low.

We have the wealth in this country to care for people, and to set the herd-immunity threshold where we choose. Parts of the world are illuminating a third way forward, something in between total lockdown and simply resuming the old ways of life. It happens through individual choices and collective actions, reimagining new ways of living, and having the state support and leadership to make those ways possible

as much attention as we give to the virus, and to drugs and our immune systems, the variable in the system is us. There will only be as much chaos as we allow.

On the return trip, Mr. Trump slept as some of his advisers spoke about the condition of Ms. Hicks, who was isolated in the back of the plane.

News that Ms. Hicks tested positive for the virus came as Mr. Trump left the White House by helicopter around 1 p.m. for a fund-raiser at his golf club in Bedminster, N.J.

On a call with Iowa voters and in an interview with Sean Hannity on Fox News, Mr. Trump sounded raspy.Later that night, Mr. Trump and the first lady, Melania Trump, tested positive for the coronavirus, officials said.The president had a mild cough, nasal congestion and fatigue.

Close to 1 a.m., Mr. Trump said on Twitter that he and the first lady had tested positive for the coronavirus.

Later in the morning, Mr. Trump had a high fever and his oxygen saturation levels dipped below 94 percent, Dr. Sean Conley, the White House physician, said.

After about a minute on two liters of supplemental oxygen, Mr. Trump’s saturation levels were back over 95 percent, Dr. Conley said. The president stayed on the supplemental oxygen for about an hour at the White House.

Mr. Trump received an 8-gram dose of an experimental polyclonal antibody cocktail. He also took zinc, vitamin D, famotidine, melatonin and aspirin.

The president also was given his first dose of remdesivir, an antiviral drug that has an emergency approval from the Food and Drug Administration as a Covid-19 therapy.

Mr. Trump has mild heart disease, similar to many men in their 70s. He also takes a statin drug to treat high cholesterol and aspirin to prevent heart attacks. His health summary, released in June, showed that he crossed the line into obesity at 244 pounds.

Mr. Trump was given a second dose of remdesivir and did not exhibit any known side effects, doctors said.

Doctors wanted him to eat, drink and be out of bed as much as possible.

Doctors were tracking any damage to his lungs for signs of pneumonia.“There’s some expected findings, but nothing of any major clinical concern,” Dr. Conley said.

Of all the measures South Africa put in place, Dawood said the most important against the flu was school closures. Studies have shown that children exhibit the highest rates of infection and illness due to influenza. “I think that was the one that interrupted flu’s whole chain,”

experts have offered numerous explanations for why it is more infectious than the seasonal flu. Foremost is the extent to which it spreads when those who carry it are asymptomatic. Flu is almost always transmitted through symptoms such as sneezing and coughing.

People also began taking extra health precaution

Many people also carry “background immunities” for influenza, Dawood said. Repeated infections, as well as worldwide annual vaccination campaigns, have given large portions of the global population at least some influenza antibodies, although new strains appear nearly every year.

With coronavirus cases climbing steeply at the beginning of the country’s flu season, many people rushed to clinics to get flu shots, hoping to avoid at least one co-morbidity.

The continued implementation of personal protective measures may be so effective against flu transmission that entire strains of the virus that relied on incubation in the Southern Hemisphere’s winter before being passed back north might be eliminated for good

“If it works out like this, it would be a very beautiful positive side effect of covid, one of the few good things to come of it.”

The main threat to that possibility is reintroduction from the Northern Hemisphere, where many countries, and parts of the United States in particular, have not required mask-wearing and school closures.

Like many developing countries, South Africa was relying on the relatively cheap and easy-to-store AstraZeneca shot — “the people’s vaccine,” as Ms. Taylor put it — to tamp down new outbreaks. When airport workers rolled vaccine crates out of the belly of an airplane last week, President Cyril Ramaphosa watched from the rain-soaked tarmac.

Because the trial participants in South Africa were relatively young and unlikely to become severely ill, it was impossible for the scientists to determine if the vaccine protected people from hospitalization or death. Immune responses detected in blood samples from vaccinated people suggest it could.

he B.1.351 variant has already spread beyond South Africa to neighboring countries, the United States and Britain. Scientists believe one of its mutations may make it harder for antibodies to grab onto the virus and keep it from entering cells.Among scientists’ worries is that the variant first detected in Britain has acquired the same mutation, known as E484K, in some cases.

Given the proven safety of the AstraZeneca vaccine and the hope that it might yet prevent hospitalizations and deaths from the new variant, Professor Venter said that health officials should consider offering it to anyone who wanted it.

Dr. Nettles said on Tuesday that a total of 20 million doses would be ready by the end of March. The company has a contract to deliver 100 million doses by the end of June.

Johnson & Johnson looked for asymptomatic infections by checking for coronavirus antibodies 71 days after volunteers got a vaccine or a placebo. The new analyses estimate that the vaccine has an efficacy rate of 74 percent against asymptomatic infections. But that calculation was based on a relatively small number of volunteers, and the F.D.A. noted that “There is uncertainty about the interpretation of these data and definitive conclusions cannot be drawn at this time.”“I think it’s going to add to the growing evidence that the vaccines really do prevent infection as well as prevent disease,” Dr. Barouch said.

In a sign that European governments remain concerned about a jump in new infections, masks in the continent are increasingly becoming obligatory. In France and the U.K., masks will be mandatory in public enclosed spaces from next week. In Germany, Italy and much of Spain, they already are. Austria is considering reinstating its indoor-mask order following a recent rise in infections.

“When I look at Europe, there is no single, best way: There are lots of ways,” he adds. “There is no magic formula, but they all begin with taking the virus seriously and not having debates about inane things.”

The shortfall in testing isn’t just a problem for individual patients and their doctors. It is also holding back large-scale surveys of seemingly healthy populations, in workplaces and elsewhere, and scientific research into fundamental properties of the virus and the disease it causes.

there is an escalating need to test much larger groups repeatedly—to track the spread of the virus as restrictions ease—and to carry out population-based studies that will reveal more about how this virus behaves.

in determining whether an individual is safe to enter a workplace or school on a given morning. Ideally, for the later purposes, tests would be conducted swiftly and at high volume at the places where samples are taken

One such approach, still in development, would exploit the ability of the well-known bacterial gene-editing system known as CRISPR to recognize coronavirus RNA.

While the need for greatly expanded testing in the next phase of this pandemic is widely acknowledged, the United States has no coordinated plan for how to achieve it. The technical building blocks are in hand, but how to put them together is not yet clear. Moreover, major regulatory hurdles limit the use of the results from novel tests in patient care, especially in certain states such as New York. And the logistics of deploying enough personnel to track samples and deliver results are daunting. Because of the complexity and importance of such testing, a centralized program, run by a strong scientific leader and paid for with federal dollars, may be the only solution.

rmed with efficient and accurate tests to detect the virus (indicating active infection) and reliable tests to measure antibodies against it (implying prior exposure and possible immunity), public-health programs could paint an accurate picture of the current pandemic. Small and large businesses, schools, health-care facilities, and other organizations could track the outcomes of their attempts to restore normal activities, and scientists could answer key questions about viral transmission and host immunity.

decisive answers will come only from studying human beings who are exposed to the virus under real-life conditions. Such studies may be feasible only under circumstances in which natural transmission is occurring at significant rates, as it currently is. Therefore, if we are to get answers to the following questions, we must act now.

tudies to answer these questions require identifying enough people who have recovered, then testing them repeatedly for the appearance of a new infection. Such people are relatively easy to find. They include doctors and nurses in hospitals in hard-hit metropolitan areas such as New York City; staff and residents at nursing homes with high rates of infection; and crews of U.S. Navy ships that have experienced outbreaks of COVID-19.

identify asymptomatic infections. Following up on those cases will shed light on how many asymptomatic people ultimately develop symptoms; how long it takes for them to do so; whether asymptomatic people who ultimately develop symptoms have higher viral loads than those who don’t get sick; whether symptomatic and asymptomatic people have different immune responses; whether other, simpler procedures (such as tests for some chemical abnormality in the blood) might be used to screen for infection; and how large a contribution asymptomatic people make to the ongoing transmission of the virus.

Despite repeated warnings after prior epidemics about the likelihood of new ones caused by novel microbes, the United States and many other countries failed to respond efficiently to this one. Scientists might have detected the new coronavirus much earlier with the better tools for microbial surveillance that already exist; prevented the pathogen’s worldwide spread by more aggressive testing and contact tracing; and supported better and safer health care with larger stockpiles and pipelines for procurement of medical equipment. Humanity should never be this unprepared again.

Community leaders throughout the city organized a coordinated response, which the police, military and disconnected elected officials never could. Widespread confusion created by decentralized sources of destruction all around the city required a carefully networked response that was grounded in trusted community relationships.

Leaders put out calls on social media and through their own networks, and more than 1,000 residents showed up for a public meeting in Powderhorn Park. They created a plan for community defense that got shared on Facebook almost 8,000 times and crashed the website of the organization that hosted it.

Alondra Cano, a member of the City Council who leads its public safety committee, captured it best when she said to a reporter, “Protesting is good and needed,” but “that third space is needed where we are committed to each other.”

“No single person or organization made this happen. It took years of people, especially black women, doing the groundwork of building trust and accountability. It takes years of conversations about what it means to be community. That is what gave us the opportunity to align when we needed to.”

Those connections are like antibodies that can be activated to rapidly develop a community immune response, anchoring the community even in the midst of tremendous public confusion. The fast-moving information environment meant people were constantly trying to differentiate fact from fiction. Trusted sources of information became ever more important.

The solution is not to meet destruction with destruction, or to douse the flames of people’s pain with empty words. Instead, what we learn from Minneapolis is that when people create solidarity from the ground up, they can hold one another and public institutions accountable to a higher standard that reflects all of their shared interests

a network of community defenders quickly emerged to protect residents. Their goals? Protect people’s ability to safely protest and tamp down on the chaos. These community defenders sought to enable democracy, not squelch it, so that organizers could advance the struggle for reforms.

how to create a system of public safety that does not depend on a domineering police force

Roughly 40,000 got “abortive” polio, with fever, sore throat, headache, vomiting and muscle pain. Fifty-one were paralyzed, and five died,

It was “one of the worst biological disasters in American history: a man-made polio epidemic,” Offit wrote.

“People weren’t sure how you got it,” he said in an interview last week. “Therefore, they were scared of everything. They didn’t want to buy a piece of fruit at the grocery store. It’s the same now. … Everybody’s walking around with gloves on, with masks on, scared to shake anybody’s hand.”

The worst polio outbreak in U.S. history struck in 1952, the year after Offit was born. It infected 57,000 people, paralyzed 21,000 and killed 3,145. The next year there were 35,000 infections, and 38,000 the year after that.

Many survivors had to wear painful metal braces on their paralyzed legs or had to be placed in so-called iron lungs, which helped them breathe

In 1951, Jonas Salk of the University of Pittsburgh’s medical school received a grant from the National Foundation for Infantile Paralysis to find a vaccine. During intense months of research, he took live polio virus and killed it with formaldehyde until it was not infectious but still provided virus-fighting antibodies.

On April 26, 1954, Randy Kerr, a 6-year-old second-grader from Falls Church, Va., stood in the cafeteria of the Franklin Sherman Elementary School in McLean and became the first to be vaccinated in a massive field study.Salk’s vaccine was given to 420,000 children. A placebo was given to 200,000. And 1.2 million were given nothing.

She had started at NIH in 1937, had headed testing of vaccines for influenza, and in 1954 was asked to help test the Salk polio vaccine. The pressure was intense. “For weeks she and her staff worked around-the-clock, seven days a week,” O’Hern wrote.“This was a product that had never been made before, and they were going to use it right away,” Eddy had said.She began testing Cutter’s samples in August 1954 and continued through November, according to a later report in the Congressional Record. She found that three of the six samples paralyzed test monkeys.“What do you think is wrong with these monkeys?” she asked a colleague, Offit recounted.“They were given polio,” the colleague replied.“No,” Eddy said. “They were given the … vaccine.”

The study was posted on the pre-print server MedRXiv.org, which means it wasn't peer reviewed or published in a medical journal.

During a call with reporters, the director of the CDC talked about the need to strengthen systems that monitor fo respiratory illnesses.

But later in the call, he added that the surveillance systems that were in place "really did give us eyes on this disease as it began to emerge" and that his agency was "never blind when it came to surveillance for coronavirus 19."

"The disease spread under the radar," study author Alessandro Vespignani, director of the Network Science Institute at Northeastern University in Boston, said at the time.

"When we've heard about the number of diagnosed cases, we have to be mindful that the number of people who contracted SARS-CoV-2 is actually going to be much larger than that," Holtgrave said.

Some infected people may have had no symptoms, or only mild symptoms, and so never went to the doctor. Others might have wanted to get tested but couldn't find a doctor to test them, given the shortage of tests in February and March. It was winter virus season, and so some people who actually had Covid might have been diagnosed with the flu or another illness. Still others might have been suffering Covid symptoms but didn't go to the doctor because they feared catching the virus there.