As U.S. Vaccinations Ramp Up, Some Recipients Struggle to Secure a Second Dose

The next hurdle in the U.S. vaccination campaign may be securing a second dose.

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Patients are observed for adverse reactions after receiving their first Covid-19 vaccine doses in downtown Seattle last month. Scheduling the next dose has not always been a streamlined process.Credit...Grant Hindsley/Agence France-Presse — Getty Images

In some American states, people who have received their first dose of a Covid-19 vaccine have been experiencing maddening difficulties as they try to schedule their second.

In New Hampshire, officials said this week that they were switching scheduling systems for second-dose appointments after some people were given slots on dates that were past the time frame recommended by the Centers for Disease Control and Prevention. In Connecticut, some frustrated older adults were waiting to have their second doses scheduled after getting their first shot, The Connecticut Mirror reported.

The problems are pronounced in Washington State, where some residents are anxiously scrambling for second-dose appointments because of scheduling systems that do not always simultaneously schedule appointments for both doses.

Kathy Beachy was initially one of them. She received her first shot on Jan. 21 at Overlake Medical Center in Bellevue, and had been desperately trying to book an appointment for her second ever since. Finally, more than two weeks after her first shot, she got a call lining her up for a shot on Feb. 19. Both Ms. Beachy and her husband, Brad Beachy, are 65 and older and have received their first shots of the Pfizer-BioNTech vaccine.

“We’re kind of scrambling,” Ms. Beachy said before she got the call on Saturday evening. “It’s extremely nerve-racking and stressful.”

When she tried to schedule an appointment for her second dose after her first one, all of the slots were booked until April, Ms. Beachy said. Since then, she has been continuously calling Overlake. Now, the confirmation for her second dose finally has her feeling relieved after two weeks stuck in limbo.

The Pfizer-BioNTech vaccine requires two injections, given 21 days apart, while Moderna’s two injections should be given 28 days apart. But the C.D.C. said last month that the interval can be expanded to six weeks if giving the second dose sooner was “not feasible.”

Overlake said in a statement that it was aware of some patients who did not schedule or were unable to schedule appointments for a second dose “for a variety of reasons,” and apologized for any challenges that the self-scheduling system may have caused. Overlake has identified the patients who still need to schedule their second dose, a spokeswoman said, and “began the process of contacting them in order to complete their vaccination process” within the required time frame.

In Snohomish County, north of Seattle, two sites run by the county at Arlington Municipal Airport and Evergreen State Fairgrounds also do not schedule second-dose appointments until later, said Jason Biermann, the county’s emergency management director, but he assured the public that everyone would still get their second shot.

“We’re not anticipating being short of second doses,” Mr. Biermann said. “We wanted to focus on getting folks vaccinated, and so the system that we were able to get quickly in place would only allow us to schedule one dose at a time.”

Still, this system brings with it some serious angst for people like Ed O’Malley, who received his first shot on Jan. 20 at the state fairgrounds, but still has not heard back about the date of his second one.

“It makes you anxious,” Mr. O’Malley, 76, said in an interview. “It does make you worry a little bit.” Mr. Biermann acknowledged that everyone might not get their second dose exactly 21 or 28 days after their first shot, but said that they surely would within the six-week window.

Cassie Sauer, president and chief executive of the Washington State Hospital Association, said she recommended that all vaccination sites schedule appointments for both doses at the same time, and at the same place, to make the process as seamless as possible. She also provided some reassurance. “We do actually believe that it’s going to get sorted out,” she said. “I have confidence that people are going to get their second doses.”

They died within hours of each other early in the pandemic. Their countries then went down two very different roads.

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Floral tributes outside Wuhan Central Hospital in memory of Li Wenliang before the anniversary of his death. Dr. Li, one of the first to warn publicly about the coronavirus, died in the early hours of Feb. 7, 2020.Credit...Ng Han Guan/Associated Press

One day. Two deaths. A year later, despite the hundreds of thousands of deaths that followed, the loss of two people — one in China and one in the United States — still reverberates in two countries where the pandemic took drastically different paths.

Saturday is the anniversary of the death of Dr. Li Wenliang in Wuhan, China, from the illness that he had sounded the alarm about, before being silenced by the authorities there.

At the end of December 2019, Dr. Li warned his medical school classmates, in an online chat room, of a lab report about a spreading virus that resembled Severe Acute Respiratory Syndrome, or SARS, a coronavirus that had spread from China 17 years earlier. Shortly after that, he was summoned in the middle of the night by health officials, and later by the police, and forced to sign a statement disavowing his “illegal behavior.” Without naming Dr. Li, Chinese state television news reported that eight people in Wuhan had been punished for spreading “rumors” about the virus.

Dr. Li was 34, and expecting a second child with his wife. His silencing and his death set off rare waves of fury and revolt online in China, flooding Sina Weibo, a Chinese microblogging platform similar to Twitter, with an illustration of him muzzled by a barbed wire mask.

Though his initial warning wasn’t heeded, China reversed course, locking down Wuhan and offering the world a forewarning about the dangers of the virus. A year later, far from the long months of harsh lockdown, the city shows what awaits when the virus is contained: unmasked faces, joyous get-togethers and daily commutes.

The anniversary of Dr. Li’s death early on Feb. 7 in China (and Feb. 6 in the United States) inspired an outpouring of online messages in China, including many from people who warned that the lessons from his persecution should not be forgotten. Many left comments, some with emoticons of lit candles, on Dr. Li’s personal page on Weibo.

“So many people have visited here to thank you,” one message said. “We must not forget,” said another, a sentiment echoed by many other comments.

On Sunday in China, comments with a hashtag created in remembrance of Dr. Li had attracted over 410 million views on Weibo, and — even with censorship — many longer posts took aim at the official censorship and secrecy that led to his punishment.

Some mourning Dr. Li cited his own words in an interview days before he died: “I think a healthy society should not have just one voice.”

Saturday is also exactly one year since the first known coronavirus-related death in the United States, where a unified pandemic strategy never existed under the Trump administration and the virus was never controlled.

On Feb. 6, 2020, weeks before there was evidence that the coronavirus was spreading in U.S. communities, Patricia Dowd, an otherwise healthy 57-year-old auditor at a Silicon Valley semiconductor manufacturer, developed flulike symptoms and abruptly died in her kitchen in San Jose, Calif. The startling discovery months later that her death was from Covid-19 rewrote the timeline of the virus’s early spread in the United States, and suggested that the optimistic assumptions that drove federal policies over the early weeks of the outbreak were misplaced.

“R.I.P. Patricia,” Pam Foley, a San Jose City Council member who represents Ms. Dowd’s district, wrote on Twitter on Saturday. “You are loved & deeply missed.”

A year and over 460,00 deaths later, about 1.3 million people in the United States are receiving a vaccine dose every day and the spread of the virus is finally slowing, but the threat of more contagious variants looms. A return to normalcy remains an aspiration, but only that, a notion that is far from reality.

Tracking the Coronavirus ›

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Coronavirus testing in the U.S. is declining. Experts aren’t sure why.

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The seven-day average of daily new coronavirus tests has declined to 1.7 million from a high of 2.1 million last month.Credit...Pete Kiehart for The New York Times

The number of coronavirus tests administered daily in the United States has been trending downward for more than two weeks. And though experts say the trend is too fresh to set off major alarm bells, the decline raises the possibility that testing has reached a ceiling at a time when scientists say the nation should be conducting millions more tests per day to help stop the spread of the virus.

On Jan. 18, the seven-day average of daily new tests reached an all-time high of more than 2.1 million, according to the Covid Tracking Project. On Thursday, it was about 1.7 million. Maintaining a level of at least two million tests per day is considered an important threshold by public health experts, who say that it is a level of testing that will allow them to identify most people with symptoms, as well as two people with whom each sick person has been in close contact.

This dip coincides with a downturn in another important coronavirus metric: the seven-day average of new reported coronavirus cases, which was down 57 percent Thursday compared with its peak on Jan. 8.

When the number of tests performed and cases reported go down at the same time, public health experts want to know if the dip in new cases is tied to the fact that fewer tests are being performed — the theory being that “If you don’t test, you don’t find cases,” as Dr. Jodie Guest, an epidemiologist at Emory University, put it recently.

For now it seems the number of new cases is indeed falling, said Dr. Ashish Jha, dean of the Brown University School of Public Health, who noted that the percentage of positive tests is also on the decline. “That’s why I’m convinced the decline is real,” Dr. Jha said in an interview Friday night.

The decline, unfortunately, is also relative. Friday’s seven-day average of about 130,953 daily reported cases in the U.S. is still significantly higher than peaks in the spring and summer.

The Covid crisis is still with us. So why are the testing numbers going down?

Dr. Emily Martin, an associate professor of epidemiology at the University of Michigan, said that the recent dip in testing should come with “lots of caveats on what exactly it is we can take away” from the trend. It may be, she said, that testing spiked in January, possibly caused by people returning to jobs and schools after holiday breaks and being subjected to mandatory testing.

But Dr. Martin and other experts say that the numbers could also reflect a complacency about testing, as vaccine distribution is ramping up.

It is also possible that the dip reflects the burden on public health offices that are being asked to administer both vaccines and tests at the same time — and that vaccinations, in some cases, are taking precedence. The seven-day average of vaccinations has been on the rise, topping 1.3 million in recent days and approaching the Biden administration’s goal of 1.5 million doses per day.

“I do know that there are testing facilities that have been shifting their focus to vaccinations right now,” Dr. Guest said. “And I do wonder if the numbers we’re seeing go down are based on some shifting of priorities.”

And that is not particularly good news: Experts say that widespread testing must continue to be part of the fight against the virus, because scientists don’t know exactly how effective most of the vaccines are at slowing its spread. Vaccine trials, in the interest of speed, were intended primarily to study how effective the inoculations are against stopping the onset of severe Covid-19 disease and not whether they would prevent the transmission of the virus.

There was some progress on that front this week, with a study that showed that the vaccine developed by the University of Oxford and AstraZeneca has the potential to slow transmission, according to researchers at the university.

A San Diego area school district quarantines more than 100 students and staff members just days after reopening.

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An elementary school in Escondido, Calif. The city school district is continuing with its reopening plan, despite an outbreak.Credit...Google Maps

As classes start up again and schools try to bring students and teachers back to campus safely — if at all — one school district north of San Diego was forced to quarantine more than 100 students and staff members, just days after welcoming them back for hybrid instruction.

On Friday, the district, Escondido Union School District, reported 17 positive coronavirus cases, and said eight of those individuals came to campus while potentially infectious. In the previous days, 81 students and 15 staff members from three elementary schools and one middle school in the district were informed of their potential exposure and began a 10-day quarantine. As of Friday night, the number of positive cases had increased to 26, with 99 students and 17 staff members quarantining, 10 of whom had attended school while potentially infected.

It is unclear whether those who attended while potentially infected were awaiting test results after possible exposure to the virus, but a spokeswoman for the district said it was “possible” that some came to school before receiving a result.

“Our city struggles with a high case rate, and our community includes many multigenerational families,” Luis Rankins-Ibarra, the district superintendent, said in the statement, adding that it was “unfortunate” that individuals come to school while awaiting test results, after having close contact with someone who contracted the virus, or while they feel ill.

“We are doing everything possible to ensure a safe environment for our students and employees while they are on campus,” he said. “However, we cannot control the environments off campus.” About 8,700 students are enrolled in the district’s hybrid model from transitional kindergarten to eighth grade, the district said.

News of the quarantine comes amid a new semester and a reignited national debate about reopening schools.

Officials in Chicago and Philadelphia issued ultimatums to some educators, while teachers’ unions in both cities pushed back against reopening plans.

In Escondido, Dr. Rankins-Ibarra said data showed a decline in cases and hospitalizations when he recommended returning to campus with a hybrid model.

Coronavirus cases in San Diego County, which includes the school district, remain high — January was its worst month for cases — but virus numbers have declined over the past two weeks, according to a New York Times database.

Though he called the quarantines “frustrating and concerning,” Dr. Rankins-Ibarra said the district would continue with its reopening plan, which includes temperature checks, questionnaires about symptoms, enhanced air filtration systems and social distancing, among other measures.

“Safety continues to be our top priority as we work to provide education and support for our families during this pandemic,” Dr. Rankins-Ibarra said.

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The pandemic is pushing American mothers over the edge.

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Liz Halfhill, 30, works full time as a paralegal while in school and is her son’s primary caregiver. Some mornings, the two let out guttural screams — catharsis amid the stress of the past 11 months.Credit...Brenda Ann Kenneally for The New York Times

In early September, as the school year inched closer, a group of mothers in New Jersey decided they would gather in a park, at a safe social distance, and scream their lungs out. For months, as the pandemic disrupted work and home life, these moms, like so many parents, had been stretched thin — acting as caregivers, teachers and earners at once. They were breaking.

As are mothers all over the United States.

By now, you have read the headlines, repeating like a depressing drum beat:

Working moms are not OK.” “Pandemic Triples Anxiety and Depression Symptoms in New Mothers.” “Working Moms Are Reaching the Breaking Point.”

You can also see the problem in numbers: Almost one million mothers have left the work force — with Black mothers, Hispanic mothers and single mothers among the hardest hit. Almost one in four children experienced food insecurity in 2020, which is intimately related to the loss of maternal income. And more than three-quarters of parents with children ages 8 to 12 say the uncertainty around the school year is causing them stress.

Despite these alarm bells clanging, signaling a financial and emotional disaster among America’s mothers, who are doing most of the increased amount of child care and domestic work during this pandemic, the cultural and policy response enacted at this point has been nearly nonexistent.

The impact is not just about mothers’ fate as workers, though the economic fallout of these pandemic years might have lifelong consequences. The pandemic is also a mental health crisis for mothers that fervently needs to be addressed, or at the very least acknowledged.

Almost 70 percent of mothers say that worry and stress from the pandemic have damaged their health. The statistics are shocking, but they are sterile; they don’t begin to expose the frayed lives of American mothers and their children during this pandemic.

Jessica Bennett, a New York Times editor at large, spent months communicating with three women, who kept detailed diaries of their days, for a look at just how much American mothers are doing every waking second.

“With everything going on, I just don’t have time to take care of my mental health right now. I have to keep it together for everyone else,” said Dekeda Brown, 41, one of the three mothers featured in Ms. Bennett’s piece. “I feel like a ticking time bomb that is constantly being pushed to the breaking point, but then I am able to defuse myself. Goodness, this is taxing.”

“I don’t know how to feel sane again,” said Elise Kelner, 30, a mother of two children under 4, when she called in from Gilbert, Ariz. “I’m just stuck in this position for God knows how much longer.”

The Times collected the voices of women on a special phone line set up to give mothers across the country the opportunity to scream it out like the moms in New Jersey. Hundreds responded with shouts, cries, guttural yells and lots and lots of expletives.

Check out the series below, which shows all the messy, heartbreaking moments of everyday fear and chaos, and the rays of joy that can sometimes shine through.

How Tampa, Florida, is preparing for a pandemic Super Bowl.

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Football fans in Tampa, Fla., on Wednesday.Credit...Zack Wittman for The New York Times

TAMPA, Fla. — Super Bowl Sunday is usually a big party where family and friends gather to share tailgating food and watch a national football game, but it could also represent a potential for new coronavirus infections across the United States.

The central Florida city of Tampa is in an unenviable position as the host of this weekend’s showdown between the reigning champions, the Kansas City Chiefs, and the hometown Tampa Bay Buccaneers. The city faces two seemingly opposite challenges at once: celebrating the home team’s slot in the Super Bowl, a first in National Football League history, while keeping the game from becoming an embarrassing superspreader event.

Mayor Jane Castor will have none of the downer talk. “We’ll make the best of it,” she said.

The people of Tampa — Tampanians or Tampeños, not Tampans, thank you — seem intent on having a good time.

Bars are open in Florida — and they will be during Sunday’s game. Some of them are advertising watch parties, though thanks to the mild subtropical winter — the low in Tampa is forecast to be 57 degrees on Sunday — at least some of the festivities can be held outdoors. And 22,000 fans, about a third of the usual capacity of Raymond James Stadium, will be gathered in the stands.

Tampa had already pulled off a victory parade during the pandemic, after the Lightning won the Stanley Cup in September. The Tampa Bay Rays then made the World Series in October, making Tampa the country’s undisputed sports pinnacle these days.

The virus did lead Tampa to postpone until April its annual Gasparilla festival, a pirate-themed celebration akin to Mardi Gras that would normally have taken place the last weekend in January.

“Of course, you have to have a concern: We’re in the midst of a pandemic, there’s no denying that, and it’s a virus that is easily transferable,” Ms. Castor said of the Super Bowl. “But on the other hand, it can be easily managed if people take the simple steps of wearing masks and separating when possible.”

Ahead of the game, she extended the city’s mask order to apply to outdoor areas of town where people are likely to gather.

In other Super Bowl news by The New York Times:

  • Although the coronavirus pandemic continues to loom and Super Bowl tickets are almost $7,000 each, ticket-holders and fans can’t be stopped as most fans will have only a few opportunities, if any, to watch their team play in the national football game, let alone go to a game in person.

  • Experts offered tips on how to enjoy the game safely. “I know that no one wants to be the guy that got hospitalized or died because of the Super Bowl,” said Dr. Joshua Barocas, an infectious diseases physician at Boston Medical Center. “With the highly transmissible variants around and a largely unvaccinated public, we are all at high risk.”

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Global Roundup

China approves a second Covid-19 vaccine, and other news from around the world.

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A technician working in a Sinovac Biotech lab in Beijing, where the company is producing the vaccine CoronaVac.Credit...Kevin Frayer/Getty Images

Beijing has approved a second Chinese Covid-19 vaccine — a drug made by the private company Sinovac Biotech that will be distributed to developing countries — in a move that furthers the country’s efforts to be a global player in ending the pandemic.

Sinovac said in a statement on Saturday that it had received conditional approval from China’s National Medical Products Administration a day earlier. In December, China approved a vaccine made by Sinopharm Group, a state-owned company.

Sinovac and Sinopharm have released little data from late-stage trials that would allow scientists to draw independent conclusions on their vaccines’ efficacy. Sinovac’s vaccine, CoronaVac, has had four different efficacy rates announced in recent months by the countries that conducted Phase 3 trials. In the most recent, Brazilian officials said that CoronaVac had an efficacy rate of just over 50 percent, though those who received it and still became infected showed only “very mild symptoms.”

Sinovac said the approval was based on two months of clinical trial data. It said it had not obtained the final analysis data, adding that “the effectiveness and safety results have yet to be further confirmed.”

The company has struck deals with at least 11 countries and regions, including Brazil, Chile, Indonesia and Turkey, in keeping with President Xi Jinping’s promise last year that a Chinese Covid-19 vaccine would be a global public good.

Sinovac said it had completed a second production line that would increase its manufacturing capacity to more than one billion doses after it is put into use this month.

Even before the completion of late-stage trials, Chinese officials approved the vaccines from Sinopharm and Sinovac for emergency use and rolled them out to millions of people, prompting criticism from scientists who argued that the move could pose a risk to public health.

In other news from around the world:

  • A nightly 9 p.m. curfew that started on Friday in Havana is Cuba’s latest attempt to bring the spread of the virus under control. The country has four vaccines in development, and the Cuban health authorities have said that tourists will be able to receive vaccinations during their stay, creating the prospect of health tourism once workers at package holiday destinations have been vaccinated.

  • About 500 protesters marched against coronavirus restrictions in Zug, Switzerland, a lakeside tax haven, Reuters reported. Some among the masked marchers wore placards that read, “Wearing a mask is modern slavery,” as a voice over a loudspeaker said, “Closeness is dangerous” and “Denounce those you love.” Switzerland’s restrictions have been less severe than those in Germany and Austria, countries that have also seen significant opposition to safety restrictions.

In a late-night ruling, the Supreme Court partly lifts virus restrictions on religious services in California.

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A film director, John Soares, receiving communion at the Cathedral of Our Lady of the Angels in downtown Los Angeles in June of last year.Credit...Damian Dovarganes/Associated Press

A splintered Supreme Court on late Friday night partly lifted restrictions on religious services in California that had been prompted by the pandemic.

The court ruled in cases brought by South Bay United Pentecostal Church in Chula Vista and Harvest Rock Church in Pasadena. The churches said restrictions imposed by Gov. Gavin Newsom, a Democrat, violated the Constitution’s protection of the free exercise of religion.

The restrictions set varying limits on attendance at religious services by county, depending on infection rates. With the pandemic raging, in-person worship services were entirely barred in Tier 1, which covers almost all of the state.

In a brief, unsigned opinion, the court blocked that total ban but left in place a 25 percent capacity restriction and a prohibition on singing and chanting. Justices Clarence Thomas and Neil M. Gorsuch said they would have blocked all of the restrictions. Justices Stephen G. Breyer, Sonia Sotomayor and Elena Kagan dissented, saying they would have left all of the restrictions in place.

Chief Justice John G. Roberts Jr., in a concurring opinion, explained why a middle ground was appropriate. He said that the court should generally defer to public health experts but that there were limits to that deference.

“The state has concluded, for example, that singing indoors poses a heightened risk of transmitting Covid-19,” he wrote. “I see no basis in this record for overriding that aspect of the state public health framework.”

“At the same time,” the chief justice continued, “the state’s present determination — that the maximum number of adherents who can safely worship in the most cavernous cathedral is zero — appears to reflect not expertise or discretion, but instead insufficient appreciation or consideration of the interests at stake.”

Justice Amy Coney Barrett, in her first opinion, wrote that she would not have blocked the restrictions on singing and chanting based on the available evidence. Justice Brett M. Kavanaugh joined her opinion.

Justice Gorsuch, joined by Justices Thomas and Samuel A. Alito Jr., said the state had favored its entertainment industry over worship services.

“If Hollywood may host a studio audience or film a singing competition while not a single soul may enter California’s churches, synagogues and mosques,” Justice Gorsuch wrote, “something has gone seriously awry.”

In dissent, Justice Kagan, joined by Justices Breyer and Sotomayor, said the majority had intruded into matters best left to public health officials.

“Justices of this court are not scientists,” Justice Kagan wrote. “Nor do we know much about public health policy. Yet today the court displaces the judgments of experts about how to respond to a raging pandemic.”

The ruling followed a similar one in November in a case from New York.

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How the pandemic silenced New York’s $25 billion Hudson Yards development.

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Hudson Yards has suffered during the pandemic, raising questions about its future.Credit...Todd Heisler/The New York Times

When Hudson Yards opened in 2019 as the largest private development in American history, it aspired to transform Manhattan’s Far West Side with a sleek spread of ultraluxury condominiums, office towers for powerhouse companies like Facebook, and a mall with coveted international brands and restaurants by celebrity chefs like José Andrés.

All of it surrounded a copper-colored sculpture that was supposed to be to New York what the Eiffel Tower is to Paris.

But the pandemic has ravaged New York City’s real estate market and its premier, $25 billion development, raising significant questions about the future of Hudson Yards and signaling the broader challenges facing the city as it tries to recover.

Hundreds of condominiums remain unsold, and the mall is barren of customers. Its anchor tenant, Neiman Marcus, filed for bankruptcy and closed permanently, and at least four other stores, as well as several restaurants, have also gone out of business.

The development’s centerpiece, the 150-foot-tall scalable structure known as the Vessel, closed to visitors in January after a third suicide in less than a year. The office buildings, whose workers sustained many of the shops and restaurants, have been largely empty since last spring.

Even more perilous, the promised second phase of Hudson Yards — eight additional buildings, including a school, more luxury condos and office space — appears on indefinite hold as the developer, the Related Companies, seeks federal financing for a nearly 10-acre platform on which it will be built.

Related, which had said the entire project would be finished in 2024, no longer offers an estimated completion date.

A flood of emotions, along with a first shot.

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Hannah Wise received the first dose of the Pfizer-BioNTech Covid-19 vaccine on Wednesday.Credit...Hannah Wise

One morning this week, as I was driving 90 minutes down a highway, past frost-covered fields and bright white church steeples, I finally cried. I was on my way to get the vaccine, and after nearly a year of bottling up emotions, they were suddenly pouring out.

I qualified for the vaccine in Missouri’s Phase 1B-Tier 2 because I have Crohn’s disease, an autoimmune illness that affects the intestinal tract, as well as psoriasis and psoriatic arthritis — conditions managed through a rigid medication schedule that suppresses the immune system, leaving people like me particularly vulnerable to severe illness from the coronavirus.

The virus has felt inescapable, as it has for so many people. At work, as an editor at The New York Times, I read story after story about the loss of life and try to find words to help readers understand and process the pandemic’s toll. At home, the virus has laid bare my own health concerns. I moved to Kansas City, Mo., from New York in June, after 100 days alone in my apartment, to be closer to family in case I were to be infected.

Every step outside my apartment has felt like a calculated risk.

Driving east on I-50 toward the Missouri State Fairgrounds in Sedalia, I felt all the emotions of the year bursting forth. Could this be what hope feels like?

Getting a vaccine is far from guaranteed, even for the two million Missourians who qualify. As of Feb. 4, only 6.3 percent of the state’s six million residents have received one vaccine dose.

I set up alerts to see every tweet from Gov. Mike Parson, the Kansas City and Jackson County health departments and nearly every hospital system in the area. A tweet is how I learned about openings at a state-run mass vaccination event.

On Monday, I signed up for my fourth vaccine list. Tuesday afternoon, I got the call: My appointment would be the next day.

Inside the agricultural building turned vaccine clinic, I was one of the youngest patients. Concerned that I’d be turned away at the door because my disability is invisible, I rattled off my conditions as I checked in. But my paperwork was there waiting for me.

Samantha Unkel, 24, who comes from a family of nurses, said she was excited to give me the vaccine. I felt tears welling up again behind my mask. She congratulated me as I took my vaccine selfie.

I’ve felt a physical lightness since the shot. It is a glimmer of joy during a dark and cold winter. Friends who will most likely not be vaccinated for many months said that my vaccination cheered them too: evidence of tangible progress.

At the end of February, I hope to drive back for my second dose. My life after the vaccine will look much like my life before. I’ll still be wearing my mask and social distancing, but I’ll do so with less fear.

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The week in Covid-19 news: Reassuring data on the AstraZeneca vaccine, 24 states are inoculating teachers and more.

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Pharmacists prepared to administer the AstraZeneca-Oxford Covid-19 vaccine on Thursday in Birmingham, England.Credit...Oli Scarff/Agence France-Presse — Getty Images

A series of new findings about a vaccine developed by AstraZeneca and the University of Oxford this week show some promising results on several fronts: slowing the spread of the virus, protecting against a more contagious variant and possibly being effective in just one dose.

Researchers reported that a single dose of the AstraZeneca vaccine provided strong protection against Covid-19 even when its second shots were delayed by at least three months. The results help sustain the strategy used by Britain and other countries to prioritize providing as many first doses of vaccines as possible without worrying that people will get their second doses later than initially planned.

The paper also showed that the vaccine has the potential to slow the transmission of the virus itself, though scientists have emphasized that the data are preliminary and that the degree of protection is unknown. Studies so far have been focused on determining whether vaccines could prevent the onset of severe Covid-19.

Another report released later in the week on the vaccine showed it was about as effective against the more contagious virus variant found in Britain as it was against other lineages of the virus. The paper, which has not yet been peer-reviewed, said that the vaccine had 74.6 percent efficacy against the variant, which U.S. officials have warned could become dominant by the spring.

However, as the variant has circulated in Britain, it has gained a new and worrisome mutation — the same mutation that scientists believe explains the vaccine resistance of the variant found in South Africa.

In other news from the past week:

  • Almost half of U.S. states have begun allowing teachers to be vaccinated. How quickly states give shots to teachers from a growing-but-still-limited vaccine supply has become a central point in the debate about how best to reopen school systems. By this week, 24 states and Washington, D.C., were providing shots to teachers of kindergarten through high school students.

  • Moderna is asking U.S. regulators to allow it to increase the amount of vaccine put into each vial by as much as 50 percent. The upstart drugmaker says it can raise the doses per vial to as much as 15 doses from 10. The F.D.A. could decide within a few weeks if the company can up the dosages.

  • The federal government is expected to send one million vaccine doses to about 6,500 retail pharmacies across the United States on Thursday, the beginning of a federal program that will deliver vaccines directly to as many as 40,000 drugstores and grocery stores, Jeffrey D. Zients, the White House’s Covid-19 response coordinator, announced on Tuesday. The federal program will not cut into the doses allocated to states — and over time, it will greatly expand the number of sites where eligible people can get vaccines.

  • On Saturday, Gov. Andrew M. Cuomo of New York said the state had administered 91 percent of its first vaccine doses. A day earlier, the governor said New York would move to expand vaccine eligibility beyond health care workers and residents of long-term care facilities to include people with some chronic health conditions that put them at greater risk of severe Covid. The conditions include cancer, heart conditions, lung diseases, liver disease, diabetes and obesity, among others.

For single people, pandemic isolation has presented a unique type of loneliness.

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The coronavirus pandemic has been especially hard on single people.Credit...Andrea Mantovani for The New York Times

The coronavirus pandemic has been rough on virtually everyone.

But those who have been single through the isolation, fear and upheaval say they’ve been confronted with a distinct set of challenges — not necessarily more or less severe than those who are coupled up, but different.

“The first few months I thought: ‘This is OK, I can work on myself,’” said Gagan Bhatnagar, 35, a clinical oncology consultant in London. “But then it just dragged on. One day I realized it had been three months since I had touched a human being.”

With a widely shared Twitter thread in December, Mr. Bhatnagar tapped into a wide range of single angst. The thousands of responses he received indicated single people often felt their needs were being overlooked or dismissed, and they frequently felt guilty about expressing them. What’s a bit of mopey loneliness when others are dying?

Being unable to date as usual has robbed people of the hope and excitement that can sustain them through typical rough patches, he said. (Many reported that socially distanced walks in the cold, one of the few Covid-safe ways to meet people after matching online, wasn’t conducive to forming connections.)

“The most physical contact I’ve had was with a cashier giving me change,” said Marc Fein, 35, an educator and mental health advocate in Jerusalem. “I don’t think I realized how much I needed it.”

Science supports the necessity of human touch: Tiffany Field, the director of the Touch Research Institute at the University of Miami, said research had shown touch to be crucial as a mood stabilizer.

“To have well-being, you need to have touch,” she said. “And if you don’t have that, you go into these states of anxiety and depression.”

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Housing aid may not reach people who are renting informally.

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Angelica Gabriel, 47, and her husband, Felix Cesario, 50, at their apartment complex in Mountain View, Calif. The couple share their apartment with others to manage the rent.Credit...Sarahbeth Maney for The New York Times

As the pandemic enters its second year, millions of renters are struggling with a loss of income and with the insecurity of not knowing how long they will have a home. Savings depleted, they are running up credit card debt to make the rent, or accruing months of overdue payments. Families are offsetting housing costs by moving in together.

Even before the pandemic, about 11 million households — one in four U.S. renters — were spending more than half their pretax income on housing, and overcrowding was on the rise.

Now, the pressure has grown worse. One study by the Federal Reserve Bank of Philadelphia showed that tenants who lost jobs in the pandemic had amassed $11 billion in rental arrears.

On Friday, as monthly jobs data provided new evidence of a stalling recovery, President Biden underscored the housing insecurity faced by millions. The rental assistance in his $1.9 trillion relief plan, he said, is essential “to keep people in their homes rather than being thrown out in the street.” And $25 billion in federal rental aid approved in December is set to be distributed. That, and Mr. Biden’s extension of an eviction moratorium, should help many people.

But for every million or so households who are evicted in the United States each year, there are many more millions who move out before they miss a payment, who cut back on food and medicine to make rent, or who take up informal housing arrangements that exist outside the traditional landlord-tenant relationship. The federal rental aid may not reach these people, who are the most vulnerable to slipping into homelessness.

While rents have fallen in many big cities, vacancy rates for the cheapest buildings are essentially flat from last year, according to CoStar Group, a commercial property group. Before the pandemic there was already a longstanding shortage of affordable housing, so anyone who loses an affordable home will still have a hard time finding a new one.

Those We’ve Lost

Albert Hale, a trailblazing lawyer and former president of the Navajo Nation, dies at 70.

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Albert Hale was elected the second president of the Navajo Nation in 1994, and later served in the Arizona State Senate and House of Representatives.Credit...Ross D. Franklin/Associated Press

This obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.

Albert Hale was serving as president of the Navajo Nation when one of the most powerful political figures in the United States flared tempers by telling leaders in Indian Country that he had trouble understanding the concept of tribal sovereignty.

So in 1998, Mr. Hale, a trailblazing lawyer all too familiar with Washington’s methods of dealing with tribal nations, issued a retort to the official, Newt Gingrich, a Republican who was then speaker of the House of Representatives.

“When I come to Washington, you don’t send me to the Bureau of Indian Affairs,” said Mr. Hale, representing the largest Indian reservation in the United States, according to an article in The New York Times. “You have a state dinner for me.”

After a long political career, Mr. Hale died on Feb. 2 at a hospital in Mesa, Ariz. He was 70. The cause was Covid-19, his daughter April Hale said.

Mr. Hale was elected the second president of the Navajo Nation in 1994, not long after it created a three-branch system of government similar to many other democracies. He later served in the Arizona State Senate and House of Representatives.

Mr. Hale’s death was a reminder of how the virus is devastating the Navajo Nation, which has been one of the hardest-hit places in the United States during the pandemic. At least 1,038 people have died from the virus in the nation, which spreads over parts of Arizona, New Mexico and Utah, tribal officials said Wednesday.

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South Africa says AstraZeneca’s vaccine doesn’t work well against a variant.

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Paramedics caring for a Covid-19 patient at his home in Lenasia, South Africa, last month.Credit...Bram Janssen/Associated Press

South Africa has halted use of the AstraZeneca-Oxford coronavirus vaccine after evidence emerged that the vaccine did not protect clinical-trial participants from mild or moderate illness caused by the more contagious virus variant that was first seen in the country.

The findings were a devastating blow to the country’s efforts to combat the pandemic.

Scientists in South Africa said on Sunday that a similar problem held among people who had been infected by earlier versions of the coronavirus: The immunity they acquired naturally did not appear to protect them from mild or moderate cases when reinfected by the variant, known as B.1.351.

The developments, coming nearly a week after a million doses of the AstraZeneca-Oxford vaccine arrived in South Africa, were an enormous setback for the country, where more than 46,000 people are known to have died from the virus. And they were another sign of the dangers posed by new mutations. The B.1.351 variant has already spread to at least 32 countries, including the United States.

The low number of cases evaluated as part of the studies outlined by South African scientists on Sunday made it difficult to pinpoint the precise effect of the variant. And it was not clear whether the AstraZeneca-Oxford vaccine protected against severe disease from the B.1.351 variant.

The clinical trial participants who were evaluated were relatively young and unlikely to become severely ill, making it impossible for the scientists to determine whether the variant interfered with the AstraZeneca-Oxford vaccine’s ability to protect against severe Covid-19, hospitalizations or deaths.

However, based on the immune responses detected in blood samples from people who were given the vaccine, the scientists said they believed that the vaccine could yet protect against more severe cases.

If further studies show that it does, South African health officials said on Sunday that they would consider resuming use of the AstraZeneca-Oxford vaccine.

Even so, the fact that it showed minimal efficacy in preventing mild and moderate cases of the new variant added to the mounting evidence that B.1.351 makes current vaccines less effective. These research findings have not been published in a scientific journal.

Pfizer and Moderna have both said that preliminary laboratory studies indicate that their vaccines, while still protective, are less effective against B.1.351. Novavax and Johnson & Johnson have also sequenced test samples from their clinical trial participants in South Africa, where the variant caused the vast majority of cases — and both reported lower efficacy there than in the United States.

“These results are very much a reality check,” Shabir Madhi, a virologist at University of the Witwatersrand who ran the AstraZeneca-Oxford vaccine trial in South Africa, said of the findings released on Sunday.

The pause in the country’s rollout of the AstraZeneca-Oxford vaccine means that the first shipments will now be put in warehouses. Instead, South African health officials said they would inoculate health workers in the coming weeks with the Johnson & Johnson vaccine, which has strong efficacy in preventing severe cases and hospitalizations caused by the new variant.

Johnson & Johnson has applied for an emergency use authorization in South Africa. But health officials there indicated that even before it is authorized, some health workers could be given the vaccine as part of an ongoing trial.

In the AstraZeneca-Oxford trial in South Africa, roughly 2,000 participants were given either two doses of the vaccine or placebo shots.

There was virtually no difference in the numbers of people in the vaccine and placebo groups who were infected with B.1.351, suggesting that the vaccine did little to protect against the new variant. Nineteen of the 748 people in the group that was given the vaccine were infected with the new variant, compared with 20 of 714 people in the group that was given a placebo.

That equates to a vaccine efficacy of 10 percent, though the scientists did not have enough statistical confidence to know for sure whether that figure would hold among more people.

60 Black health experts urge Black Americans to get vaccinated.

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Diann Ferril-Reader vaccinating Ramona Perez, 75, and her husband, Robert Occasio, 93, on Thursday at the Castle Hill Community Center in New York.Credit...James Estrin/The New York Times

Black Americans are being killed by Covid-19 at 1.5 times the rate of white Americans, yet many Black people are hesitant to line up for a vaccine.

According to a survey in January by the Kaiser Family Foundation, 43 percent of Black adults say they will most likely take a “wait and see” approach before deciding whether to get the vaccine. Eight percent say they will get it only if it is required.

But Kaiser also said that the numbers reflected “a rise in enthusiasm across racial and ethnic groups since December,” with more of the public now wanting to get the vaccine “as soon as possible.”

Still, the finding was troubling to Thomas A. LaVeist and Dr. Georges C. Benjamin, who wrote an opinion essay published on Sunday in The New York Times, urging Black Americans “to claim your place in line to get vaccinated.” The article is signed by 60 Black health experts.

“Our country is facing a public health crisis on a level not experienced for more than 100 years,” wrote Dr. LaVeist, dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans, and Dr. Benjamin, a physician and the executive director of the American Public Health Association. “It should be reasonable to expect that all citizens can rely on their government and health institutions to protect them. But for many Black Americans, trust in the government does not come easily.”

They point to disinformation that has “pervaded social media” and to distrust in health institutions in Black communities as reasons that Black Americans are getting vaccinated at lower rates than white people.

In New York City, recent data show that of the nearly 300,000 city residents who have received their first doses of the vaccine, 11 percent were Black. (The city’s population is made up of roughly 24 percent Black people.)

“Vaccines are now available,” Dr. LaVeist and Dr. Benjamin wrote, adding: “We have reviewed the research and feel confident the research was done correctly. Most importantly, we know that the trials were conducted across a diverse group of Americans from all backgrounds — Black, Native American, White, Hispanic, Asian, and men and women. While we understand why there might be hesitancy about getting vaccinated, we need to weigh the risks of taking the vaccine versus being infected by the virus and the potential of health problems, hospitalization, even death.”

Black Americans are among the most affected in the country by the pandemic, mostly because of socioeconomic factors. Compared with white Americans, Black Americans tend to live in more crowded households and are more likely to have jobs that require them to work in close contact with others.

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