President Trump said on Sunday night that he would delay a plan for senior White House staff members to receive the coronavirus vaccine in the coming days.
The shift came just hours after The New York Times reported that the administration was rapidly planning to distribute the vaccine to its staff at a time when the first doses are generally being reserved for high-risk health care workers.
Mr. Trump, who tested positive for the coronavirus in October and recovered after being hospitalized, also implied that he would get the vaccine himself at some point in the future, but said he had no immediate plans to do so.
“People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary,” Mr. Trump tweeted, hours after a National Security Council spokesman had defended the plan. “I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!”
It was not immediately clear why Mr. Trump decided to change the policy, or whether he had even been aware of it ahead of time. But White House staff members who work in close quarters with him had been told that they were scheduled to receive injections of the coronavirus vaccine soon, two sources familiar with the distribution plans said.
The goal of distributing the vaccine in the West Wing was to prevent additional government officials from falling ill in the final weeks of the Trump administration. The hope was to eventually distribute the vaccine to everyone who works in the White House, one of the people said.
It was not clear how many doses were being allocated to the White House or how many were needed, since many staff members had already tested positive for the virus and recovered. While many Trump officials said they were eager to receive the vaccine and would take it if it were offered, others said they were concerned it would send the wrong message by making it appear as if Trump staff members were hopping the line to protect a president who has already recovered from the virus and bragged that he is now “immune.”
Trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine fanned out across the country on Sunday as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour. The inoculation effort, set in motion after the Food and Drug Administration’s emergency authorization of the vaccine on Friday night, comes as the U.S. coronavirus death toll approaches 300,000. Rollout of the Pfizer-BioNTech vaccine is less centralized in the United States than in other countries that are racing to distribute it.
Across the country, according to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites are set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.
New York’s first coronavirus vaccines have arrived, according to one hospital system on Monday morning, signaling a turning point in the battle against a pandemic that has profoundly scarred the state, killing more than 35,000 people and severely weakening the economy.
A majority of the first injections are expected to be given on Monday to high-risk health care workers. In many cases, this first, limited delivery would not supply nearly enough doses to inoculate all of the doctors, nurses, security guards, receptionists and other workers who risk being exposed to the virus every day. Because the vaccines can cause side effects including fevers and aches, hospitals say they will stagger vaccination schedules among workers.
Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin getting vaccinations next week. A vast majority of Americans will not be eligible for vaccinations until the spring or later.
Five of the first vaccinations will take place at what the Department of Health and Human Services is calling a national ceremonial “kickoff event,” scheduled for Monday afternoon at George Washington University Hospital.
The five people were selected with an algorithm the hospital is using to assign the first doses, the result of a survey hospital employees filled out that asked about age, underlying medical conditions and the risk they carry in their jobs, according to a federal health official familiar with the planning who was not authorized to speak publicly. The event is intended to demonstrate the way many health workers will be vaccinated this week, the official said.
The kickoff is part of what the official said will be a series of vaccination events featuring top health officials.
In Canada, the first shipments of the Pfizer-BioNTech vaccine arrived on Sunday, Prime Minister Justin Trudeau announced on Twitter. He called it an “important step in our fight against the virus.”
On the snowy plains of Fargo, N.D., Jesse Breidenbach, the senior executive director of pharmacy for Sanford Health, which operates hospitals and clinics across the Upper Midwest, refreshed his email again and again on Sunday, waiting to receive a FedEx tracking number that would confirm that some 3,400 doses were en route.
The Sanford hospital in Fargo was converting its Veterans Club into a vaccination site, and officials said they would start inoculating a first group of emergency and critical-care doctors and nurses within hours after the vaccine arrived. But when would that be?
The answer came on Sunday afternoon: Expected vaccine delivery, 10:30 a.m. Monday, with vaccinations starting early in the afternoon.
The U.S. Food and Drug Administration commissioner disagreed on Sunday with President Trump’s claims that the Pfizer-BioNTech vaccine could have been released a week ago.
The commissioner, Dr. Stephen Hahn, said the F.D.A.’s decision on Friday to authorize the vaccine for emergency use was made as quickly as possible while still ensuring that the vaccine was safe and effective.
“We do not feel that this could have been out a week earlier,” Dr. Hahn said on the ABC News program “This Week.” “We went through our process. We promised the American people that we would do a thorough review of the application and that’s what we did.”
Pfizer and BioNTech’s vaccine has been developed and has cleared those regulatory hurdles faster than any other vaccine the F.D.A. has evaluated. Work on it began shortly after the coronavirus was identified in Wuhan, China, less than a year ago.
The first of roughly three million doses of Pfizer’s vaccine began their journeys on Sunday morning to sites across the country, where they will be administered to health workers and nursing home residents and employees starting this week.
Dr. Hahn has faced mounting public rebukes and pressure from Mr. Trump, including insulting tweets, and from White House officials to speedily approve treatments and vaccines that are under development, including Pfizer’s and Moderna’s. Pressed in the television interview about whether Mark Meadows, the White House chief of staff, had threatened his job, Dr. Hahn said he didn’t want to get into individual discussions.
In a separate interview on Fox News Sunday, Moncef Slaoui, the scientific head of the administration’s vaccine effort, known as Operation Warp Speed, was asked if political interference had caused problems with vaccine development.
Dr. Slaoui described reports of political pressure as “not helpful” and “not needed,” adding that they could cloud discussions on the vaccine’s safety and efficacy. He noted that the past week had been filled with experts being “remarkably transparent” about the scientific data supporting the vaccine’s performance.
“If that phone call happened,” he said, referring to reports that Mr. Meadows contacted Dr. Hahn, “I think it was useless and unfortunate, and so are some of the tweets.”
Dr. Slaoui predicted that 100 million people in the U.S. would be vaccinated by the end of the first quarter of 2021. He noted that Pfizer’s product was highly unlikely to be the only vaccine to be ready for use soon, and pointed to the similar vaccine developed by Moderna. An independent panel of F.D.A. experts is scheduled to review that vaccine on Thursday, and Dr. Slaoui predicted that it would receive authorization for use as early as Friday.
Some 75 or 80 percent of Americans will need to be immunized before enough people are resistant to the virus to substantially slow its spread, a phenomenon called herd immunity, Dr. Slaoui said.
That benchmark could perhaps be met by the start of next summer. But Dr. Slaoui expressed concern about the degree of vaccine hesitancy that still pervades the country — a sense of skepticism that has not been helped, he noted, by rampant politicization of vaccination efforts or by rumors that powerful political figures had pressed government agencies to rush the timeline of vaccine clearance.
Last week, the F.D.A. released a review of Pfizer’s data from its clinical trials, which indicated that its vaccine can effectively prevent symptomatic cases of Covid-19. Few serious side effects were reported. Researchers will continue to monitor people who receive the vaccine to ensure its safety, but its promising performance in clinical trials has many experts hopeful.
“We hope that, now that all the data is out and available to be discussed in detail, that people will keep their mind open,” Dr. Slaoui said. “This a very effective and safe vaccine.”
Dr. Megan Ranney, an emergency physician in Rhode Island, echoed Dr. Slaoui’s concerns. “The vaccine is great, but only if it gets in people’s arms,” she said.
Dr. Ranney was eagerly anticipating getting her own shot. “Vaccines are one of the greatest miracles of modern medicine,” she said. “I cannot wait to get vaccinated myself and see my community vaccinated.”
Four more states that hesitated to take the Trump administration’s word on a new vaccine have completed their review of the Pfizer-BioNTech vaccine and recommended it as safe for use, according to a statement on Sunday from Gov. Gavin Newsom of California, one of the four states. The others are Washington, Oregon and Nevada.
“With shipments of the vaccine soon on their way to California, we are working hand-in-hand with local public health officials to get the vaccine out to the first phase of recipients,” the statement said. “Their work will continue as data becomes available on other potential vaccines.”
In October, the four states formed the Western States Scientific Safety Review Workgroup, made up of medical experts and officials, to analyze data supplied by the federal government and to review the processes of the federal advisory committees and agencies that were assessing the safety and efficacy of Covid vaccines.
New York State, which also set up an independent review panel, approved the state’s use of the Pfizer-BioNTech vaccine on Friday, hours before the Food and Drug Administration issued its emergency use authorization for the vaccine.
Special committees in about a half-dozen states, mostly Democratic-led, and the District of Columbia were created to add an extra layer of scrutiny and to vet any vaccine authorized by the F.D.A., in part because of concerns that the Trump administration might try to rush vaccine approvals for political reasons.
“The people of this country don’t trust this federal government with this vaccine process,” Gov. Andrew M. Cuomo of New York said in September when announcing his state’s vaccine committee, led by a Nobel-winning virologist.
Prime Minister Ambrose M. Dlamini of Eswatini died of Covid-19 on Sunday, according to a statement from the government. He was 52.
The deputy prime minister, Themba Masuku, notified the country, formerly known as Swaziland, of the leader’s “sad and untimely passing” in a statement on Twitter late Sunday. “His excellency passed on this afternoon while under medical care in a hospital in South Africa,” the statement read. Mr. Masuku added, “May his soul rest in peace.”
Twitter users responded with shock and sadness, sending broken-heart emoji and writing variations of “What a year.” Mr. Dlamini had been moved to a hospital in South Africa two weeks ago for treatment, Reuters reported, after contracting the virus in November. He had served as prime minister for two years in Africa’s last absolute monarchy.
The government did not immediately respond to requests for comment late Sunday. The nation of 1.2 million reported more than 6,714 cases as of Saturday, according to a New York Times database. The country’s health minister, Lizzie Nkosi, released a statement on Friday urging caution ahead of the festive season: “All signs show that we have now begun the second wave,” she wrote, saying the kingdom had recorded more than 120 deaths so far.
Mr. Dlamini is one of several world leaders who contracted the coronavirus — including President Trump, President Jair Bolsonaro of Brazil, Prime Minister Andrej Plenkovic of Croatia and Prime Minister Boris Johnson of Britain — but among very few who have died of Covid-19.
When Mr. Johnson tested positive for the virus, Mr. Dlamini shared his wishes for a speedy recovery on Twitter, writing: “Our thoughts are with the people of Britain and his loved ones. We believe that God will save the world from this scourge that has gripped our planet.”
Peru has suspended clinical trials for an experimental coronavirus vaccine manufactured by the Chinese company Sinopharm, citing concerns about safety, after a report of a “serious adverse event” in a study volunteer.
Pilar Mazzetti, Peru’s minister of health, stressed in a statement on Saturday that the pause in the trials was intended to ensure the vaccine’s safety, and noted the importance of continuing to wear masks and maintain physical distance even in the wake of widespread vaccination.
Sinopharm, a state-owned company, has been testing two vaccines in Peru, and was on the verge of completing its trials in the country. It’s unclear which of the two vaccines the volunteer who became ill was helping to test.
The volunteer’s illness involved feeling weakness in the legs, a medical researcher told a radio station in Lima. A temporary halt to the trial will allow experts to investigate the issue and determine whether it was linked to the vaccine.
Sinopharm’s vaccines contain modified, inactivated versions of the coronavirus, which do not pose an infectious threat. When injected into people, they can teach the immune system to recognize the virus’s “corpse,” preparing it to fight an active version of the virus should the recipient be exposed.
The United Arab Emirates gave full approval last week to one of Sinopharm’s vaccines, developed by the Beijing Institute of Biological Products, and said that the vaccine had an efficacy rate of 86 percent. On Sunday, the neighboring country of Bahrain followed suit.
Sinopharm did not respond immediately to a request for comment on the suspension in Peru, which has reported more than 36,500 deaths from the coronavirus.
While the pandemic has made Dr. Anthony Fauci, the U.S. government’s top expert on infectious diseases, a highly visible figure in American life, “Saturday Night Live” has been circumspect about satirizing him in comedy sketches.
But this weekend, the “S.N.L.” cast member Kate McKinnon played Fauci in the show’s opening sketch. She was joined by Heidi Gardner, playing Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, as they explained how Pfizer’s Covid-19 vaccine, newly approved for emergency use, would be distributed to the American public.
Following some applause from the audience, McKinnon said, “Let’s try to keep the woos to a minimum, please. As you all know, woos spread droplets.”
McKinnon proudly announced that “the vaccine is approved and I am officially joining the Biden administration to continue the fight against Covid.”
With some hesitation, Gardner added, “And I think I’ll be joining as well, right? Remember when Trump said to inject bleach and I did a stanky little face? And I almost whispered, ‘No’? Remember?”
McKinnon said that “we’re doing this vaccine World War II-style,” and further explained: “We made England go in first, see what’s what. And then we swoop in at the end and steal the spotlight. Tom Hanks will make 10 movies about it and when it’s all over you can kiss any nurse you want.”
On Trump’s performance during the pandemic, McKinnon said, “This president has done about as good a job with this rollout as I did throwing out that first pitch at the Nationals game.” “S.N.L.” played video of Fauci’s pitch from July, which markedly missed home plate.
The virus was a focus in other skits, as Timothée Chalamet, the week’s host, played a rebellious teenage son in a family of coronavirus cells. “I’m sorry,” he said. “Are my proteins not perfect like my little sis, back from her first semester at the University of Phoenix in person?”
The New Zealand government intends to establish a travel bubble with Australia in the first quarter of next year, Prime Minister Jacinda Ardern announced on Monday.
The arrangement would allow people to travel freely between Australia and New Zealand without needing to quarantine for two weeks on arrival. Passengers arriving from New Zealand to Australia are already exempt from quarantine requirements.
The travel bubble was “pending confirmation” from Australian officials, Ms. Ardern said during a live-streamed news conference, and would be contingent on “no significant changes in the circumstances of either country.”
New Zealand has been among the countries least affected by the pandemic, with 2,096 cases and 25 lives lost, according to a New York Times database. In Australia, 28,031 people have tested positive for the coronavirus, while 908 have died.
In May, the governments of New Zealand and Australia first announced that they had reached a formal agreement to form a travel bubble as soon as it was safe to do so. But surges in the number of cases, most notably in Victoria, Australia, led to the plans being temporarily scrapped.
Ms. Ardern said she would not give a more detailed timeline for when the bubble might be established. Further details still needed to be fine tuned, she said, including how airlines would handle the travel corridor and the two countries’ contingency plans in the event of another outbreak.
New Zealand is expected to establish quarantine-free travel with the Cook Islands before it opens its borders to Australia.
BERLIN — Germans will be forced into a strict lockdown over Christmas after weeks of milder restrictions failed to prevent the coronavirus from spreading through the country, leading to record numbers of new infections and deaths.
Starting on Wednesday, most stores, schools and hairdressers will be required to close, and gatherings over the holidays will be restricted, Chancellor Angela Merkel said on Sunday. The measures, which Ms. Merkel announced after consultation with the governors of Germany’s 16 states, will apply through at least Jan. 10. Restaurants will still be allowed to sell takeaway food, but consumption of both food and alcohol in public will be banned.
“The ‘lockdown light’ had an effect, but it was not enough,” Markus Söder, governor of Bavaria, said, referring to the partial restrictions on social contacts that have been in place since early November. “If we are not careful, Germany will become the problem child of Europe,” he added.
Under the new restrictions, private meetings between people from two separate households will be limited to no more than five people over the age of 14, in addition to children. The restrictions will be expanded for Christmas, when people from up to four different households, plus children, will be allowed to meet, but only from Dec. 24 to 26.
No exception will be made over New Year’s, when gatherings will be banned, as will the fireworks that normally accompany the holiday in Germany.
Germany recorded 20,200 new infections on Sunday, over 2,000 more than what was recorded on the same day last week. The country has lost 21,787 people to the virus and the number of people being treated in intensive care is increasing.
The Food and Drug Administration’s emergency authorization on Friday night of the vaccine developed by Pfizer and BioNTech cleared the way for a complex effort led by the giant pharmacy chains CVS and Walgreens to give the vaccine to nursing home residents and workers, who have died from the virus at disproportionate rates.
Both companies have contracts with the federal government to send teams of pharmacists and support staff into thousands of long-term care facilities in the coming weeks to vaccinate all willing residents and staff members. CVS and Walgreens are both planning to administer their first vaccinations on Dec. 21.
More than 40,000 facilities have chosen to work with CVS. Nearly 35,000 picked Walgreens. Each U.S. state has already picked, or will soon pick, either the Pfizer or the Moderna vaccine for all of its long-term care facilities that will be working with CVS and Walgreens.
CVS has designated about 1,000 of its store pharmacies to serve as hubs for receiving the Pfizer vaccine. The shipments will come via FedEx and UPS.
“Those folks know that they are to bring that product right back to our pharmacy,” said Chris Cox, a CVS executive leading the company’s planning of the effort. “So no dropping it off at the back door, no dropping it off with our front store colleagues — it is to go straight to the pharmacy counter, so that the pharmacists themselves can receive it.”
On the morning the Pfizer doses are ready to go out to a nursing home, pharmacists will load them into small, hand-held coolers intended to keep the doses refrigerated for up to 24 hours. The pharmacists will drive with the doses in their own cars — traveling separately from several support staff members in an effort to maintain social distancing restrictions. The farthest long-term care facility will be about 75 miles by car, though most drives will be much shorter.
Once the CVS teams arrive at a nursing home, they’ll go room by room to administer shots to residents, while facility workers will generally be vaccinated in a common area. The visit will last two to four hours on average, Mr. Cox said. The CVS teams will generally make three visits to each home. For the Pfizer vaccine, each visit will be separated by about three weeks, the amount of time between the first shot and the booster.
“There’s a healthy level of anxiety here because the stakes are so high and the purpose is so great,” Mr. Cox said. “But I’d also say that we’ve been planning this for months — and we’ve been planning for the hardest and most potentially complex scenarios that could face us — so I feel confident that we’re ready to go.”
Although states are largely planning to follow C.D.C. recommendations about who to vaccinate first, there is some variation among their plans.
Gov. Ron DeSantis of Florida said that “tip-of-the-spear, high-contact workers” in hospitals would receive the very first shots and that he hoped to reach “as many elderly people as we can” by the end of December. Ohio has prioritized getting initial doses of the vaccine to people in nursing homes and assisted living centers. And in Mississippi, Dr. Thomas Dobbs, the state health officer, said frontline hospital workers would get the shots ahead of nursing home residents, in part to ease any anxiety those residents might have about the vaccine.
“They’re still a little bit hesitant,” he told reporters on Tuesday. “If we don’t put ourselves out there first, take the first doses of vaccine and show that we believe in it and trust it, I don’t think the long-term care folks are going to have the uptake they need.”
In most states, the concerted effort to vaccinate nursing home residents will begin a week later.
CVS, Walgreens and other pharmacies are also set to play a key role in vaccinating the general public once vaccines are more widely available, but that process will involve people going into their local pharmacies and could be weeks or months away.
Abby Goodnough contributed reporting.
Italy on Sunday unveiled a floral logo and a slogan for its coronavirus vaccination campaign: “With a flower, Italy comes back to life.”
A Milanese architect, Stefano Boeri, and a team of consultants came up with the flower design, which will be used on the temporary pavilions where the vaccine will be dispensed.
“This idea of a spring flower helping us emerge from a dark and cold winter is the message we want to give,” Mr. Boeri said in a streamed news conference on Sunday morning.
About 1.8 million Italians — health workers and nursing home residents — are expected to start receiving the Pfizer vaccine in mid-January, said Domenico Arcuri, the official in charge of the coronavirus response, at the news conference. Vaccines in Europe are awaiting approval from the European Medicines Agency.
About 1,500 pavilions will be set up in the main squares of Italian cities, Mr. Arcuri said, along with information booths also bearing the flower design.
Mr. Arcuri said that logistical questions, such as acquiring needles and syringes, were under control and that Italy had issued “a call to arms for 3,000 doctors and 12,000 nurses” to operate the pavilions.
Italy was the first European country to impose a nationwide lockdown in March, when the coronavirus swelled its hospitals, and a resurgence of the virus in the fall led to restrictions being reimposed. The country has registered a total of more than 64,500 virus deaths, the most in Europe.
Mr. Arcuri said he hoped the “campaign of information and communication” would persuade Italians skeptical of the vaccine that the shots were safe.
Dr. Jerrold M. Post, a C.I.A. analyst and the founder of the agency’s Center for the Analysis of Personality and Political Behavior, has died at 83. He is credited for his sharp psychological analysis of world leaders, both foreign and domestic, over the years.
Carolyn Post, his wife, said the cause of death was Covid-19. Dr. Post tested positive on Nov. 15 and died in hospice care a week later.
Cynthia Post, his daughter, said she believed he was infected while riding in a medical taxi. In recent years, Dr. Post lived with renal failure and had to make weekly trips to a dialysis center. After a stroke in July, he was unable to drive himself to his dialysis appointments.
During his more than 20 years with the C.I.A., Dr. Post profiled leaders such as Saddam Hussein and Ayatollah Khomeini. Later in his academic career, he analyzed figures such as former President Bill Clinton and President Trump.
In 1978, President Jimmy Carter credited Dr. Post for a successful summit with Prime Minister Menachem Begin of Israel and President Anwar el-Sadat of Egypt. Dr. Post provided Mr. Carter with in-depth “psychobiographies” along with insight on the leaders’ personalities.
Dr. Post approached studying world leaders with an understanding that they needed to be analyzed within their cultural and historical contexts, an idea that was relatively unheard-of in the 1960s and ’70s.
He sometimes faced opposition within the C.I.A., as some thought psychology offered limited insight, especially because Dr. Post was unable to directly interview most of his subjects in person.
Dr. Post, however, said he saw it as an obligation to offer insight on political leaders.
“We have satellite photography that can zero in on the dimples on a golf ball,” he told The New Yorker, “but we can’t peer into the minds of our adversaries.”
Born on Feb. 8, 1934, in New Haven, Conn., to Jacob and Lillian (Chaikind) Post, Dr. Post graduated from Yale University in 1956 and later attended the Yale School of Medicine.
Dr. Post is survived by two daughters from his first marriage, Cynthia Post, a psychologist, and Meredith Gramlich, a disability specialist; his sister, Judith Tischler; and a stepdaughter, Kirsten Davidson.
The pandemic is pummeling New York City’s commercial real estate industry, one of its main economic engines, threatening the future of the nation’s largest business districts as well as the city’s finances.
The damage caused by the emptying of office towers and the permanent closure of many stores is far more significant than many experts had predicted early in the crisis.
The powerful real estate industry is so concerned that the shifts in workplace culture caused by the outbreak will become long-lasting that it is promoting a striking proposal: to turn more than one million square feet of Manhattan office space into housing.
Nearly 14 percent of office space in Midtown Manhattan is vacant, the highest rate since 2009. On Madison Avenue in Midtown, one of the most affluent retail stretches in the country, more than a third of all storefronts are empty, double the rate from five years ago.
The collapse of commercial real estate is another major burden for New York, since the industry provides a significant portion of the city’s tax revenues.
Filings to erect new buildings in the city, a key indicator of industry confidence, have dropped 22 percent this year to 1,187, the lowest number since 2010.
As of late October, only 10 percent of Manhattan’s one million office workers were reporting to the office, according to a survey by the Partnership for New York City, an influential business group.
And this already bleak picture could even get worse, real estate experts and industry executives said.
Talk to the staff members of charitable organizations these days and they will tell you they have never seen a year like 2020. Millions of Americans are out of work or newly living in poverty and many others are socially isolated, creating a greater-than-ever demand for services. Kenneth Hodder, the national commander of the Salvation Army, described the present moment as “a tsunami of human need.”
And yet many charities have had their normal operations disrupted, creating a mismatch between that need and the ability to fill it. People who gave money in years past may not have the financial means to do so this year. Organizations that provide direct, in-person services, like food banks and homeless shelters, are just as reliant on volunteers despite public concerns about the virus.
This is the time of year when people traditionally donate to toy drives, food banks and other favored charities or give their time as volunteers. And for many charities, the money raised in November and December is the major part of their budgets for the next year.
In many cases, organizations are continuing to try to fill people’s needs. Others have taken their work online.
The Salvation Army has placed Google Pay, Apple Pay and QR codes on red kettles nationwide to facilitate contactless payments. And some coat drives are now drive-through or virtual.
Despite the horrifying surge of Covid-19 cases and deaths in the United States right now, one bit of good epidemiology news is emerging this winter: It now looks unlikely that the country will endure a “twindemic” of flu and the coronavirus hitting at the same time.
That comes as a profound relief to public health officials who predicted as far back as April that thousands of flu victims with pneumonia could pour into hospitals this winter, competing with equally desperate Covid-19 pneumonia victims for scarce ventilators.
“Overall flu activity is low, and lower than we usually see at this time of year,” said Dr. Daniel B. Jernigan, director of the influenza division of the Centers for Disease Control and Prevention. “I don’t think we can definitively say there will be no twindemic; I’ve been working with flu for a long time, and I’ve been burned. But flu is atypically low.”
Since September, the C.D.C. “FluView” — its weekly report on influenza surveillance — has shown all 50 states in shades of green and chartreuse, indicating “minimal” or “low” flu activity. Normally by December, at least a few states are painted in oranges and reds for “moderate” and “high.”
A combination of factors has made the flu season remarkably quiet, experts said.
In the Southern Hemisphere, where winter stretches from June through August, widespread mask-wearing, rigorous lockdowns and other precautions against Covid-19 transmission also drove the incidence of flu down to record lows. In the United States, the cancellation of large indoor gatherings, closings of schools and use of masks have been mitigating all respiratory diseases, including influenza.
That has buoyed the spirits of flu experts.
Dr. William Schaffner, medical director at the National Foundation for Infectious Diseases, which promotes flu shots, said he was recently on a telephone discussion with other preventive medicine specialists. “Everybody was in quiet awe about how low flu is,” he said. “Somebody said: ‘Shh, don’t talk about it. The virus will hear us.’”
As the virus surges, outbreaks are starting to re-emerge in ports across the United States.
In interviews with over a dozen longshoremen, their families and maritime officials at multiple ports in the country, all urged government officials to recognize the essential nature of longshore work and protect individuals from conditions that make it ripe for the virus to spread.
They say longshore workers should be provided rapid testing and early access to the vaccine so they can remain on the job and prevent outbreaks from shutting the nation’s ports.
“We’re hidden,” said Kenneth Riley, the president of the local longshoremen’s union in Charleston, S.C. “But if you think some of the store shelves were empty as we got into this pandemic, let these ports shut down and see how empty they’ll be.”
Longshore work is exhausting, and often requires close contact with others. The trade is essential to the economy, with longshore workers serving as a crucial link between moving goods from a shipping vessel onto trucks and trains that send them to their final destination, experts said.
Over 95 percent of overseas trade for the United States flows through one of around 150 deepwater ports in the country, according to the Army Corps of Engineers.
The workers at highest risk of being exposed to the virus are deep sea longshoremen, who are primarily Black and do most of the work that requires the lifting and moving of goods, union officials noted.
Many officials note that since the nature of longshore work is day labor, workers may look for any reason to escape getting tested unless they show symptoms to prevent going weeks without pay as they isolate.
“There are people who know they’re sick, and go into work,” said Alan A. Robb, the president of the longshore union’s Gulf Coast district office, in Texas. “They can’t afford to miss a day.”
The International Longshoremen’s Association, a union that represents about 65,000 longshore workers, has lobbied the federal government and state officials for support.
In the coming weeks, major airlines including United, JetBlue and Lufthansa plan to introduce a health passport app, called CommonPass, that aims to verify passengers’ coronavirus test results — and perhaps soon, vaccinations.
CommonPass notifies users of local travel rules — like having to provide proof of a negative virus test — and then aims to check that they have met them. The app will then issue confirmation codes, enabling passengers to board certain international flights.
“This is likely to be a new normal need that we’re going to have to deal with to control and contain this pandemic,” said Dr. Brad Perkins, the chief medical officer at the Commons Project Foundation, a nonprofit organization in Geneva that developed CommonPass.
Electronic vaccination credentials could have a profound effect on efforts to control the virus and restore the economy. They could prompt more employers and college campuses to reopen. And developers say they may also give some consumers peace of mind by creating an easy way for movie theaters, cruise ships and sports arenas to admit only those with documented virus vaccinations.
But the digital passes also raise the specter of a society split into health pass haves and have-nots, particularly if venues begin requiring the apps as entry tickets. The apps could make it difficult for people with limited access to vaccines or online verification tools to enter workplaces or visit popular destinations. Civil liberties experts also warn that the technology could create an invasive system of social control, akin to the heightened surveillance that China adopted during the pandemic — only instead of federal or state governments, private actors like employers and restaurants would determine who can and cannot access services.
In October, United tested CommonPass on a flight to Newark Liberty International Airport in New Jersey from Heathrow Airport in London. United and four other airlines plan to start using it soon on some international flights.