Ohio announced a nightly curfew. Illinois is suspending indoor dining and drinking. Mississippi extended a mask mandate to seven more counties, while Iowa will issue its first statewide mask order.
Those actions, announced in the past 24 hours by governors who warn that hospitals are reaching capacity, are just the latest to be added to the ever-expanding patchwork of pandemic-related restrictions as the coronavirus erupts to crisis levels across the United States. And they came as Dr. Anthony S. Fauci, the government’s top infectious disease expert, said on Tuesday that the nation needed “a uniform approach,” instead of a “disjointed” state-by-state, city-by-city response.
Some states are a patchwork within America’s crazy-quilt virus response. In Mississippi, where Gov. Tate Reeves lifted a statewide mandate in September, Monday’s extensions of a mandatory mask mandate meant that it was now in effect in 22 counties out of 82.
Across the United States, more than 1 million new cases have been identified over the last week as officials in all 50 states reported increasing caseloads. Though the situation is especially dire in the Midwest and Mountain West, the outbreak is spreading rapidly throughout the country. New Hampshire, Texas, Oregon and Tennessee are among 39 states that have set weekly case records in the last few days. Deaths are also rising, with a national average of more than 1,100 a day, the most since early August, when a summer surge was peaking.
Coronavirus-related curfews are in force across New Mexico and Puerto Rico, and Gov. Gavin Newsom of California has said he is considering imposing one as the virus surge gathers speed.
Several Republican governors are finally, if reluctantly, wielding the power of their authority as President Trump largely cedes the pandemic response on his way out of office. Gov. Kim Reynolds of Iowa, with hospitals filled to the brink and under pressure from doctors, hospitals, mayors and farmers alike, abruptly reversed herself this week and began requiring masks indoors.
In North Dakota, Gov. Doug Burgum had been preaching personal responsibility for months, but last week issued a mask order “until further notice” as the state leads the nation in rates of new cases and deaths per person, according to a New York Times database. In Utah, Gov. Gary Herbert also mandated masks, and Gov. Mark Gordon of Wyoming, visibly angry at a news conference last week, warned that he, too, may have to resort to requiring masks because people in his state were being “knuckleheads” about the virus.
Gov. Mike DeWine of Ohio, a rare Republican leader of a red state who has consistently bucked Mr. Trump’s opposition to tough restrictions, announced that his state will be under a curfew from 10 p.m. until 5 a.m. for three weeks starting on Thursday.
Ohio has seen a sharp rise in coronavirus cases and hospitalizations in recent weeks. It has been reporting an average of more than 7,000 new cases a day lately, seven times as many as in early October and more than at any time since the pandemic began. “These are astronomical numbers,” the governor said at a news conference on Tuesday, urging residents to wear masks and maintain strict social distancing until a vaccine is widely available.
Governor DeWine said all retail businesses would have to close during the curfew and that residents should stay home unless they are commuting to work or traveling for emergency purposes. He called the rules “common sense.”
In Illinois, Gov. J.B. Pritzker said that starting Friday the whole state would move to Tier 3 under the state’s mitigation plan, which bans indoor service at bars and restaurants, imposes lower capacity ceilings on many businesses, and restricts private indoor gatherings to people in the same household, among other measures. Casinos and indoor venues like theaters and museums must close, and outdoor group activities will be limited to 10 people.
On the East Coast, Gov. Larry Hogan of Maryland announced that, beginning Friday, all bars, restaurants and night clubs would have to close by 10 p.m. and businesses, religious institutions and organizations would be limited to 50 percent of capacity.
“This is not the flu,” Mr. Hogan said as he pleaded with residents to take the virus seriously. “It’s not fake news. It’s not going to magically disappear just because we’re all tired of it and we want our normal lives back.” He warned that the state’s hospitals were coming under severe strain, and that some in the western part of the state were completely full.
In Pennsylvania, state health department officials strengthened the state’s mask order, requiring them to be worn in all indoor facilities, including homes, whenever people are with anyone from outside their households, even if they maintain social distance. The state also issued an order requiring anyone who enters, whether visitors or Pennsylvanians returning from travel, to be tested in the 72 hours before arrival.
The pandemic is already reaching into next year and affecting at least one iconic American celebration: Mardi Gras, suspected for igniting an early outbreak in New Orleans, will not be celebrated with parades in February. “Mardi Gras 2021 is not canceled,” at least as a religious holiday, a spokesman for Mayor LaToya Cantrell said at a news conference on Tuesday. “It is going to look different.”
Senator Charles E. Grassley of Iowa, at 87 the oldest Republican serving in the chamber, on Tuesday announced that he had tested positive for the coronavirus, becoming the second octogenarian member of Congress to be diagnosed in the past week.
Mr. Grassley, who had said earlier that he was quarantining after exposure to the virus, said on Twitter that he was “feeling good” and would “keep up on my work” for Iowans from home, following his doctor’s orders and public health guidelines.
He did not disclose any details about the circumstances of his exposure, but Mr. Grassley was on hand Monday as usual to open the Senate in his role as president pro tempore — the post typically reserved for the most senior member of the majority party — and for the first vote of the week. Mr. Grassley took his mask off briefly to deliver remarks on the Senate floor, as many senators do. His remarks focused on the need for continued social distancing and mask-wearing in order to stem the spread of the pandemic, urging “everyone to do their part.”
His positive test result marked the latest alarming development in what is threatening to become a mini-outbreak on Capitol Hill, where lawmakers continue to meet in close quarters with inconsistently applied health precautions.
Senator Rick Scott, Republican of Florida, was also in quarantine after being exposed to someone in Florida who tested positive for the virus, and several House lawmakers remained in quarantine after similar exposures in their home states.
Representative Don Young of Alaska, the longest-serving member of the House and its oldest member, who is also 87, disclosed on Monday that he had been hospitalized over the weekend as he battled a case of the virus. Two other lawmakers — Cheri Bustos of Illinois and Tim Walberg of Michigan — also announced positive tests the same day.
As multiple votes took place on Tuesday, Mr. Grassley’s absence ended the longest consecutive streak of voting in the Senate held by a single member. The Iowan often boasted of his record of having never missed a vote since 1993, when floods ravaged his state.
Among the votes he missed was one to move to confirm Judy Shelton, President Trump’s pick for the Federal Reserve board, whose nomination stalled in the Senate after it failed to draw enough support to advance.
Dr. Anthony S. Fauci, the government’s top infectious disease expert, said on Tuesday that the nation needed “a uniform approach” to the coronavirus pandemic, rather than “a disjointed” state-by-state response — a remark that echoed the views of President-elect Joseph R. Biden Jr. and contrasted sharply with President Trump’s coronavirus strategy.
Dr. Fauci, who has directed the National Institute of Allergy and Infectious Diseases since 1984, has been in Mr. Trump’s cross hairs on and off during the pandemic. Speaking to Andrew Ross Sorkin of The New York Times at a DealBook virtual conference, Dr. Fauci steered clear of mentioning Mr. Trump or Mr. Biden by name, and insisted he wants to “stay out of the political stuff.”
But his remarks suggested that his own thinking is far more in line with that of Mr. Biden, who has promised a far more muscular federal approach to the pandemic.
“We need some fundamental public health measures that everyone should be adhering to, not a disjointed, ‘One state says one thing, the other state says another thing,’” Dr. Fauci said.
He also made clear — without overtly saying so — that he believes Mr. Trump should allow the Biden transition team access to federal health officials.
“I’ve been through five transitions; I can say that transitions are extremely important to the smooth continuity of whatever you’re doing,” he said, adding, “We need to transition to the team that will be doing it, similar to how we’re doing it.”
Mr. Biden had initially played down Mr. Trump’s refusal to allow the Biden transition “landing teams” access to federal agencies. But on Monday, in a speech in his home city of Wilmington, Del., Mr. Biden sharpened his criticism of the president, warning that “more people may die if we don’t coordinate.”
When Mr. Biden takes office on Jan. 20, he will inherit the immense task of distributing the coronavirus vaccine, assuming that one has been approved by then.
Dr. Fauci said that there were two elements to a successful vaccine: its level of efficacy and how many people take it. On Monday, Moderna announced that its vaccine appeared to be 94.5 percent effective; the drug maker Pfizer announced last week that its vaccine was more than 90 percent effective.
But those figures will not matter unless most people are inoculated, Dr. Fauci said. Unless the “overwhelming majority” of Americans, about 75 to 80 percent, receive a vaccine, the country will continue to face serious public health challenges, he said.
The incoming president will be taking command of a nation torn by divisions that have created opposition to masks and skepticism of vaccines. Dr. Fauci made a plea for an end to that divide, which he said was hindering the federal response.
“We’ve got to get public health issues out of the realm of political divisiveness — this is not a political issue,” he said. “We’ve got to do everything we possibly can to pull together as a nation.”
He said that public health measures, like mask wearing and social distancing, would still be required, albeit to a lesser degree, while the public is vaccinated. If a sizable majority of Americans do get a vaccine, “we could be quite close to some degree of normality” by the fall of 2021, he predicted.
How long might immunity to the coronavirus last? Years, maybe even decades, according to a new study — the most hopeful answer yet to a question that has shadowed plans for widespread vaccination.
Eight months after infection, most people who have recovered still have enough immune cells to fend off the virus and prevent illness, the new data show. A slow rate of decline in the short term suggests, happily, that these cells may persist in the body for a very, very long time to come.
The research, published online, has not been peer-reviewed or published in a scientific journal. But it is the most comprehensive and long-ranging study of immune memory to the coronavirus to date.
“That amount of memory would likely prevent the vast majority of people from getting hospitalized disease, severe disease, for many years,” said Shane Crotty, a virologist at the La Jolla Institute of Immunology who co-led the new study.
The findings are likely to come as a relief to experts worried that immunity to the virus might be short-lived, and that vaccines might have to be administered repeatedly to keep the pandemic under control.
And the research squares with a recent finding that survivors of SARS, caused by another coronavirus, still carry certain important immune cells 17 years after recovering, as well as with other encouraging evidence emerging from other labs.
Akiko Iwasaki, an immunologist at Yale University, said she was not surprised that the body mounts a long-lasting response because “that’s what is supposed to happen.” Still, she was heartened by the research: “This is exciting news.”
Top health advisers to President-elect Joseph R. Biden Jr. warned on Tuesday that planning for the distribution of a Covid-19 vaccine and other attempts to fight the coronavirus were being frustrated by President Trump’s refusal to allow an organized transition to begin.
The leaders of Mr. Biden’s Covid Advisory Board said they were being prevented from working with government officials who are in charge of distributing the vaccines. And they said that they did not have access to any government data on case counts, deaths or hospitalization, relying instead on media and private reports.
“There’s no time to waste. We don’t have a day to waste,” said Dr. David Kessler, a former commissioner of the Food and Drug Administration. “Vaccine distribution is difficult and daunting under any circumstance.”
The grim warnings from the health officials come as a political appointee of Mr. Trump’s at the General Services Administration has refused to formally recognize that Mr. Biden is the winner, a move that would allow current government health officials to work with the Biden transition team.
Mr. Biden on Monday said that “more people may die” from the virus as a result.
His health advisers offered more specifics on Tuesday, saying that the incoming team needs access to information about medical supply chains, data on testing, specifics about therapeutic efforts, and other data that will be critical once the Biden administration is in charge of responding to the pandemic.
“There is valuable information inside the information that is held by career officials,” said Vivek Murthy, a co-chair of Mr. Biden’s advisory board and a former surgeon general. “We need to talk to those individuals. We need to work together with them.”
From move-in day to commencement, colleges across the country have been disrupted by the pandemic in myriad ways. The latest is the demise of spring break, with the risks it poses of super-spreading beach parties and cross-country debauchery.
Academic calendars for the next semester increasingly are omitting the traditional week off near the end of winter. Instead, they are starting later or are including scattered shorter breaks instead, to deter the spread of the virus by discouraging travel during the term.
Cornell University, for instance, announced this week that the usual week’s respite from the gloomy Ithaca, N.Y., winter will be replaced by two short respites for “wellness” — a two-day midweek break in early March and a long weekend at the end of April.
Syracuse University and the 64-campus State University of New York system have replaced their spring breaks with a later start for in-person instruction. The University of Michigan and Michigan State University will each divide the break into single days off throughout the semester. The University of Kentucky and the University of Louisville plan a blend of those strategies.
Students who traveled for spring break early in the pandemic contributed significantly to the virus’ spread, according to a study by Daniel Mangrum, a research economist at the Federal Reserve Bank of New York and Paul Niekamp, an assistant professor of economics at Ball State University. Although many colleges canceled fall breaks this term, Halloween parties were linked to Covid-19 outbreaks at a number of colleges.
In Florida, a popular spring break destination, dozens of cases and at least two deaths were traced to the delay of a statewide stay-at-home order until after the traditional early March spring break season. Gov. Ron DeSantis, who did not issue the order until April 1, said at the time that the state was supportive of local governments that ordered event cancellations and beach closures, but that it was not his role to step in first.
Officials trying to curb the spread of the coronavirus continue to wrestle with getting people to accept a cap on the size of major social occasions, with the latest transgression coming in Washington State, where the number of guests at a wedding reached 10 times the official quota.
More than 17 people among the 300 guests at the wedding, near Ritzville, Wash., about 60 miles southwest of Spokane, have since tested positive for Covid-19, the Grant County Health District said in a statement, and the number of cases continues to tick up.
The Nov. 7 wedding also ignited a chain reaction, the county said, with two subsequent outbreaks linked to the event.
In September, Gov. Jay Inslee had limited social gatherings to a maximum 30 people. He then instituted stronger measures that started on Tuesday, including a ban on all indoor gatherings — including wedding receptions — with certain exceptions, as well as a halt to dining in restaurants and drinking in bars.
Theresa Adkinson, the district administrator for Grant County, made a plea for anyone who attended the wedding to both get tested for the virus and to quarantine for two weeks. The public announcement was designed to reach people whom contact tracers could not.
“With more than 300 people attending the wedding from many communities, local health jurisdictions are unlikely to reach them all,” she said.
The county’s statement encouraged wedding planners to keep a log of the guests attending any ceremony for at least two weeks.
“If an outbreak occurs, this information may be critical to help save lives,” it said, also recommending that anyone who attends a social event get tested five to seven days afterward.
Other weddings around the country have also been notorious superspreader events.
An August wedding reception in rural Maine with 55 guests led to 177 coronavirus cases, including seven deaths, and caused outbreaks in a home for the elderly 100 miles away, in addition to one within a prison some 200 miles away, according to the Centers for Disease Control and Prevention.
Mayor Lori Lightfoot of Chicago and other city officials announced a plan on Tuesday to begin reopening the city’s public schools in January, if the rapid increase in cases stabilizes. The plan calls for bringing pre-kindergarten and some special education students back first, on Jan. 11., followed by all kindergarten through eighth grade students starting on Feb. 1.
Mayor Lightfoot said in a statement that many students had not been well-served by remote instruction and that the decision to reopen early next year was “the result of balancing our commitment to equity with our current public health situation.”
Chicago made the announcement even as it is facing a second wave of cases. It noted that many states in the United States and countries in Europe were keeping schools open even as cases rose, because mitigation strategies in schools have been largely successful.
City officials said that before the city moves forward with its plan, it would need to achieve a 50 percent improvement in “doubling time” — the amount of time it takes for the number of newly diagnosed cases to double. Since early October, the doubling time in Chicago has been 12 days.
The city said it planned to do surveillance testing of school staff, though it was still working out the plan.
A number of big school systems, including Los Angeles and San Francisco, remain closed for in-person instruction and have no concrete plans for reopening. But some, including Houston and Miami-Dade, have brought many of their students back into classrooms.
New York City, the nation’s largest district, opened its schools for hybrid learning in October, but the system now teeters on the edge of closing down classrooms again because Mayor Bill de Blasio had committed to closing schools if the city’s seven-day average positivity exceeded 3 percent, a number it has been approaching. More than 70 percent of students in New York City have opted to receive remote-only instruction.
When Chicago Public Schools asked parents of pre-kindergarten and special education students in October if they wanted in-person instruction, roughly a third of students opted in, the district said.
In an op-ed in the Los Angeles Times on Tuesday, the superintendent of the Los Angeles Unified School District, Austin Beutner, wrote that, without significant changes in policy to reduce the spread of the virus, “it is unlikely that schools in Los Angeles will reopen for in-person instruction any time soon.”
In a sign that Americans are becoming less hesitant to take a coronavirus vaccine, a Gallup poll released on Tuesday showed that 58 percent of the adults who were surveyed were willing to be vaccinated, up from 50 percent in September.
The survey was conducted between Oct. 19 and Nov. 1, as coronavirus cases were surging across the country but before Pfizer and Moderna announced that their vaccines were 90 percent effective or better against the virus in late-stage trials.
Still, the results were promising for an eventual vaccine rollout, as widespread inoculation against the virus is seen as essential before restrictions can be lifted and life can return to normal, or something close to it.
Phoebe Danziger, a pediatrician at the University of Michigan who writes about medicine, ethics and culture, said in an interview that the Gallup data was consistent with what she had observed anecdotally.
“Clearly there’s a lot of hesitation out there, but it seems like there’s a slight shift into a positive view,” she said. As cases continue to rise across the Midwest, she senses that people across the political spectrum are starting to see that they are “really going to need this to get out of this mess.”
A rushed approval process for a vaccine was a concern for 37 percent of the adults Gallup polled, while 26 percent said they would wait for confirmation that a vaccine was safe. A smaller group — 12 percent — said that they did not trust vaccines in general, reflectinga mistrust of vaccines that has been on the rise across the country in recent years, stemming from the legacy of government experimentation on African-Americans and the disadvantaged as well as distrust of the pharmaceutical industry.
Scrambling to avert the first famines of the coronavirus era, the top relief official at the United Nations announced Tuesday that he was taking $100 million from a disaster emergency fund so the organization could fight acute hunger in seven countries.
Afghanistan, Burkina Faso, the Democratic Republic of Congo, Nigeria, South Sudan and Yemen will each receive a share of $80 million, with an extra $20 million set aside for Ethiopia, said the relief official, Mark Lowcock, the under secretary general for humanitarian affairs and emergency relief coordinator.
Mr. Lowcock has been warning for months about the possibility that the coronavirus pandemic could hasten the onset of famine in countries that have chronically struggled with armed conflict, drought, pestilence and pervasive shortages of food.
“No one should view a slide into famine as an inevitable side effect of this pandemic,” Mr. Lowcock said. “If it happens it is because the world has allowed it to happen.”
While famine is preventable in these countries, he said, “we have to act in time to make a difference.”
He withdrew the money from the Central Emergency Response Fund, a United Nations pool of money supplied by donor nations to help battle humanitarian disasters that often happen abruptly, like severe storms, earthquakes or floods. It is unusual for money from the fund to be used for a foreseeable hunger crisis.
It is unclear, however, whether the $100 million allocation can help stave off famine in these countries. Mr. Lowcock and the leaders of many nonprofit humanitarian groups have said it will take many billions of dollars in aid to counter the effects of the pandemic in the underdeveloped world.
On Tuesday, CARE, the global anti-poverty group, released a report that recommended the United States government alone allocate an extra $20 billion “to respond to the COVID-19 pandemic and its effects around the world.”
Switzerland has reached capacity in its intensive care wards, a national medical association said Tuesday. The group urged people who are especially vulnerable to the coronavirus to consider writing a living will, specifying whether they would want to be put on life support.
All of the country’s 876 adult intensive care beds, which are certified by the Swiss Society of Intensive Care Medicine, “are currently completely full,” the society said in a statement on Tuesday.
The country, with a population of 8.5 million, has seen new infections explode recently, with more than 83,500 reported since Nov. 3, according to government figures. In that same period, 986 people have died.
Switzerland has been reluctant to introduce far-reaching measures to prevent the spread of the virus, and images from the country’s ski resorts have shown people packed together, most without face masks, as they wait for lifts up the mountain, despite a requirement to wear nose and mouth coverings in crowded public spaces.
The country’s health care system has been widely lauded in the past as a model for other countries. But with its intensive care wards now at capacity, doctors are having to face difficult choices about who receives care.
In asking for Swiss residents to consider writing a living will, the medical society explained: “That will make it easier for your own relatives, as well as the intensive care ward teams, to make decisions, so that we can provide the best possible and individualized care.”
On Monday, the Massachusetts-based company Moderna reported promising preliminary results from its coronavirus vaccine trial. Coming just a week after similar news from Pfizer and BioNTech, the announcement immediately gave the stock market a fresh jolt. It offered more hope that there’s going to be a way out of the pandemic.
Like Pfizer, however, Moderna released only early data from their trial. There’s more work to be done before they’ll know if the vaccine really is safe and effective. And even if Moderna’s vaccine gets the green light from the Food and Drug Administration, it will take months to reach widespread distribution. In the meantime, the United States is suffering a devastating explosion of new cases of Covid-19.
Here’s where things stand with the development of coronavirus vaccines.
Do the new vaccine trial results mean the end to the pandemic?
In the short term, no. The soonest that coronavirus vaccines could possibly become widely available would be in the spring. But if effective vaccines do indeed become available — and if most people get them — the pandemic could drastically shrink. As coronavirus infections became rarer, life could gradually return to normal.
Who participated in the vaccine trial?
Moderna recruited 30,000 volunteers across the United States to participate in its trial. A quarter of the participants are 65 years or older. White people make up 63 percent of the volunteers; 20 percent are Hispanic; 10 percent are Black; and 4 percent are Asian-Americans.
The 95 people who got sick with Covid-19 reflect the diversity of Moderna’s volunteers: Fifteen were 65 or older. The group also included 12 Hispanic volunteers, four Black participants, three Asian-Americans and one multiracial person. The efficacy and safety appeared the same in all of the subgroups, Moderna said in its announcement. But researchers will have to wait for the trial to advance further to confirm this finding.
What happens next?
Both the Moderna and Pfizer trials are continuing to gather more data from large studies. The two companies expect to apply to the Food and Drug Administration in the next few weeks for an emergency use authorization to begin vaccinating the public.
The F.D.A. will review the applications and consult with its own external committee of experts before making a decision. If it authorize the vaccines — as experts think it will — a committee at the Centers for Disease Control and Prevention will then make recommendations for who should be first to receive a vaccine.
It’s possible that the distribution of one or both vaccines will begin by the end of the year.
Is it safe to go to a holiday get-together?
“This is not going to dig us out of what’s ahead this next month,” Natalie Dean, a biostatistician at the University of Florida, warned about Thanksgiving and the coming holiday season.
If the preparations for vaccines don’t hit any major snags, we can realistically hope for large-scale distribution to begin in the spring.
But with exploding cases across the country right now, we have to take immediate measures. The only way to drive down infection rates for now will be to avoid large indoor gatherings, wear masks, practice physical distancing and use other public health measures.
The American Medical Association on Tuesday called on correctional facilities and immigrant detention centers to adopt increased infection-control measures, provide additional protective equipment, and give inmates and workers priority access to vaccines to prevent the spread of the coronavirus.
The association also said in a statement that it supports the compassionate release of incarcerated people who have serious medical conditions or have reached an advanced age.
“Throughout the COVID-19 pandemic, we’ve seen the virus spread quickly in high-density populations, particularly in correctional facilities,” said Dr. Ilse R. Levin, an A.M.A. board member. “Being incarcerated or detained should not be synonymous with being left totally vulnerable to COVID-19. These steps are vital to protect people and stop the spread of the virus.”
The 1984 Sentencing Reform Act gave federal courts the power to reduce the sentences of federal prisoners for “extraordinary and compelling reasons,” such as a terminal illness. As the threat of the coronavirus loomed, several states moved to ease overcrowded prisons with ordered releases.
But critics said the response among prison officials and lawmakers has been largely uneven. As part of its new recommendations, the A.M.A. called for the development of clear criteria for prisoner release.
The coronavirus has spread quickly in confined and crowded national correctional facilities, where social distancing is impractical, bathrooms and day rooms are shared by hundreds of inmates, and access to cleaning supplies is tightly controlled. Many inmates are 60 or older, and many suffer from respiratory illnesses or heart conditions, putting them at increased risk.
In American jails and prisons, more than 252,000 people have been infected and at least 1,450 inmates and correctional officers have died, according to a New York Times database. Correctional facilities have seen a disproportionate rate of infection and death as compared with the general population.
Over the summer, the five largest known clusters of the virus in the United States were at correctional institutions, according to New York Times data. In one of those facilities, Cook County Jail in Chicago, cases exploded in just a little over two weeks, with more than 350 people infected. Last month, cases skyrocketed at a jail in central Montana’s Cascade County, where some prisoners had been sleeping on mats on an overcrowded floor. Nearly 50 people were infected.
The middle of a pandemic might not seem like the most opportune time to slash a state health department’s budget. But with the outbreak in his state worse now than it has ever been, Gov. Mark Gordon of Wyoming has proposed chopping another $46 million from the department, after cutting it by $89 million in August.
The downturn in the energy industry caused by pandemic shutdowns in the spring cost Wyoming more than $1 billion in lost state revenue, according to an analysis by NPR. The governor has resisted raising taxes to make up the budget shortfall and is looking to cut spending instead.
The latest proposed cuts, which require legislative approval, will affect services for the elderly, health care coverage for children, Medicaid payments to health care providers, and community mental health and substance abuse services. Together, the two reductions amount to about 14 percent of the department’s annual budget.
“These are really tough decisions,” Mr. Gordon, a Republican, wrote in his proposal, noting that the people affected will be “those suffering with increased depression, hopelessness and isolation during the pandemic.”
Wyoming was almost untouched by the coronavirus in the spring and summer, but over the past two months the virus has spread rapidly. It is now reporting about 900 new cases a day on average, up from about 130 a day in early October. Hospitalizations have risen by 64 percent over the past two weeks.
Mr. Gordon has said that the state’s hospitals are already overwhelmed, and he announced last week that he would use $10 million in federal relief money to bring additional medical workers into the state to help.
Kim Deti, a spokeswoman for the health department, said the governor’s budget cuts did not come as a surprise. “The reductions that were made are not going to directly affect our ability to respond to the pandemic,” she said.
Ms. Deti said the state’s contact tracers are now focusing mainly on notifying people who test positive for the virus, and do not always have time to start calling their close contacts as well. Other states have also cut back contact tracing when the virus began spreading out of control.
The drug maker Pfizer says it will work with four states — Rhode Island, Texas, New Mexico, and Tennessee — to refine their plans for delivering and administering its Covid-19 vaccine before the vaccine receives its expected authorization. The step reflects the complexity of distributing on a large scale a vaccine that requires ultracold storage.
The pilot program, which the company announced on Monday, is aimed at helping the states with their planning, but it will not mean that they receive doses of the vaccine any earlier than other states do. The four participants were chosen to represent states of different sizes, populations, and existing capacities for delivering vaccines against other viruses, the statement said.
“We are hopeful that results from this vaccine delivery pilot will serve as the model for other U.S. states and international governments,” Angela Hwang, a Pfizer executive, said in a statement.
Pfizer, which announced last week that an early analysis had found its vaccine to be more than 90 percent effective, expects to collect the final safety data this week that it needs to submit its results to the Food and Drug Administration. Another developer, Moderna, announced on Monday that its vaccine candidate appeared to be 94.5 percent effective in an early analysis.
Both vaccines use what is known as messenger RNA technology, but their cold storage requirements are different. Pfizer’s vaccine must be kept much colder, at around minus 70 degrees Celsius, for long-term storage, though it can be kept for short periods in a conventional freezer or a cooler. That ultracold storage requirement could hinder its distribution, particularly in rural areas.
Moderna’s vaccine, on the other hand, can be kept for up to a month at 2 to 8 degrees Celsius (about 36 to 46 degrees Fahrenheit), the temperature of an ordinary refrigerator, the company said on Monday.
A rash of provocative headlines have flooded social media platforms, touting a tantalizing notion: Mouthwash, they claim, can “kill” the coronavirus “within 30 seconds,” according to a new study that has not yet been published in any peer-reviewed scientific journal.
The idea echoed several other findings published earlier this year that also promoted the virus-trouncing powers of familiar oral hygiene products. But experts have repeatedly cautioned against over-interpreting these results and others, because the studies examined how mouthwash works against viruses infecting cells in the lab, not people.
Nothing should be considered conclusive “unless human studies are performed,” said Dr. Maricar Malinis, an infectious disease expert at Yale University.
“I don’t have a problem with using Listerine,” said Angela Rasmussen, a virologist at Georgetown University. “But it’s not an antiviral.”
Even if people did a very thorough job of coating the inside of their mouths or noses with a coronavirus-killing chemical, a substantial amount of the virus could still remain in the body. The new coronavirus infiltrates not only the mouth and nose, but also deep in the throat and lungs, where mouthwash and nasal washes hopefully never enter.
Viruses that have already hidden away inside cells will be shielded from the fast-acting chemicals found in oral hygiene products, and “infected cells are constantly making more virus,” Dr. Rasmussen said. “It’s a timing issue.”
Relying on mouthwash or a nasal rinse to rid the body of infectious virus would be about as futile as trimming the tops of a cluster of weeds while paying little heed to the roots, and then expecting the garden pests to disappear.
In the context of the pandemic, a false sense of security could be dangerous, Dr. Rasmussen noted, adding that people should not rely on ordinary products in their medicine cabinets to cleanse their bodies of the coronavirus.
“You can use mouthwash to reduce your own chance of getting gingivitis,” she said. “I don’t think it’s going to have a meaningful impact on your ability to transmit this virus.”
With several Covid-19 vaccine trials showing initial promising results, hopes are high that we might soon put the virus behind us. But the reality is likely a lot more complicated, experts told DealBook’s Andrew Ross Sorkin.
Bill Gates, the co-chairman of the Bill and Melinda Gates Foundation, explored the rush to develop an effective vaccine, and the political, social and behavioral obstacles that may hinder acceptance of treatments, even those deemed safe. He was joined on a video conference by Heidi Larson, the director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, and Albert Bourla, chief executive of Pfizer.
Mr. Gates expressed surprise at the widespread resistance to public health measures in the United States. “I wouldn’t have expected mask wearing to become controversial,” he said. “I wouldn’t have expected the administration to find sort of the wildest fringe opinion possible.”
His organization was working on vaccine development before the pandemic, but people were disconnected from those “reasonably obscure” efforts. The attention the coronavirus has brought to his foundation’s work hasn’t always been positive, however. He expressed dismay over conspiracy theories circulating about his financial interest in vaccine development, saying, “They’re not true.”
“Where does that come from? Is it because these are uncertain times? People prefer a simpler story?” he said. “I hope it fades away, because we’re just trying to play a constructive role.”
Mistrust is problematic from a health perspective, the panel members said. Without trust in a vaccine and people willing to take it, infection rates won’t fall.
But it’s important to understand skepticism the public has been feeling, Ms. Larson said: “We have to appreciate that it’s been a hyper-uncertain time.” Her research has shown only about half of people surveyed would take a vaccine, but “there’s always a chance” that things can change, she added.
Distrust can be countered by building community momentum and listening to concerns, Ms. Larson said, and that may help persuade people to participate, as she has seen in work on polio eradication.
The one thing that seemed clear to everyone on the panel is that the pandemic has changed habits, perhaps forever.
“My prediction would be that over 50 percent of business travel and over 30 percent of days in the office will go away,” Mr. Gates said of a post-coronavirus world.
Senator Rob Portman, Republican of Ohio, announced on Tuesday that he would participate in a coronavirus vaccine trial, in what he said was an effort to encourage broader participation in the vaccine trials and emphasize the safety of the vaccines once they have gone through the trial process and certification by the Food and Drug Administration.
He will participate in the Phase 3 trial for the vaccine being developed by the parent company, Johnson & Johnson, at a Cincinnati-based research site, CTI Clinical Trial and Consulting Services.
“I look at it as a way I can play a small role in supporting our country’s health care response to this pandemic,” Mr. Portman said in a statement. “The more people Johnson & Johnson has in the trial, the sooner they can have the complete data they need to finalize this phase of the trial, and move on to the FDA approval process.”
Mr. Portman’s announcement comes after weeks of concern about the politicization of vaccine development and fears that the rapid development and maligning of the federal government’s scientists during the pandemic will stop some people from seeking out a vaccine once it is released.
Vice President-elect Kamala Harris faced criticism earlier this year for saying she would not trust President Trump’s word on the safety of a vaccine, and would instead wait for medical experts to confirm the validity of the treatment.
“I hope that my announcement today will encourage others to feel confident in participating in vaccine clinical trials being conducted across this country,” Mr. Portman said. “I also hope it will reassure people about the safety and effectiveness of vaccines once they have gone through the trials and FDA approval process.”
Two companies, Moderna and Pfizer, this month have announced promising early data results in the development of their respective vaccines.
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