The drugmaker Moderna said it would apply on Monday to the Food and Drug Administration to authorize its coronavirus vaccine for emergency use.
The first injections may be given as early as Dec. 21 if the process goes smoothly and approval is granted, Stéphane Bancel, the company’s chief executive, said in an interview.
Moderna’s application is based on data that it also announced on Monday, showing that its vaccine is 94.1 percent effective, and that its study of 30,000 people has met the scientific criteria needed to determine whether the vaccine works. The finding from the complete set of data is in line with an analysis of earlier data released on Nov. 16 that found the vaccine to be 94.5 percent effective.
The new data also showed that the vaccine was 100 percent effective at preventing severe disease from the coronavirus. The product was developed in collaboration with government researchers from the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.
Mr. Bancel said the company was “on track” to produce 20 million doses by the end of December, and 500 million to a billion in 2021. Each person requires two doses, administered a month apart, so 20 million doses will be enough for 10 million people.
Shares of Moderna surged nearly 18 percent, to $149.50, by early afternoon, after the company’s announcement Monday.
Moderna is the second vaccine maker to apply for emergency use authorization; Pfizer submitted its application on Nov. 20. Pfizer has said it can produce up to 50 million doses this year, with about half going to the United States. Its vaccine also requires two doses per person.
Speaking on “CBS This Morning” on Monday, Alex M. Azar II, the secretary of the Department of Health and Human Services, reiterated that distribution would begin quickly after the expected approvals of the Pfizer and Moderna vaccines.
“We could be seeing both of these vaccines out and getting into people’s arms before Christmas,” he said.
Asked about the role of states in the distribution process, Mr. Azar said that doses would be shipped out through normal vaccine distribution systems, and governors would be “like air traffic controllers” determining which hospitals or pharmacies receive shipments. While governors will determine which groups are prioritized, he said he hoped that they would follow the federal recommendations. He added that he would speak to governors on Monday afternoon with Vice President Mike Pence.
The first shots of the two vaccines are likely to go to certain groups, including health care workers; essential workers like police officers; people in other critical industries; and employees and residents in nursing homes. On Tuesday, a panel of advisers to the Centers for Disease Control and Prevention will meet to determine how to allocate initial supplies of vaccine.
Mr. Azar said that C.D.C. experts will base their recommendations on the latest data on virus cases around the country.
But generally, “Be thinking people in nursing homes, the most vulnerable, be thinking health care workers who are on the front lines,” he said.
The White House moved quickly on Monday to take credit for the Moderna vaccine’s development.
“President Trump’s Operation Warp Speed is rapidly advancing on a trajectory of success to save millions of American lives — five times faster than any other vaccine in history,” Michael Bars, a spokesman for President Trump, said in an emailed statement.
The hopeful news arrives at a particularly grim moment in the U.S. health crisis. Virus cases have surged and overwhelmed hospitals in some regions, and health officials have warned that the numbers may grow even worse in the coming weeks because of Thanksgiving travel and gatherings. In November alone, there have been more than four million new cases and 25,500 deaths.
More than 70 vaccines are being developed around the world, including 11 that, like Pfizer’s and Moderna’s vaccines, are in large-scale trials to gauge effectiveness.
Moderna’s application for emergency use authorization will include data from its Phase 3 study of 30,000 people. F.D.A. scientists will examine the information, and the application is likely to undergo a final review on Dec. 17 by a panel of expert advisers to the agency, Mr. Bancel said, adding that he expected the advisers to make a decision within 24 to 72 hours. The F.D.A. usually follows the recommendations of its advisory panels.
Officials at Operation Warp Speed, the government’s program to accelerate vaccine development, have said vaccinations could begin within 24 hours after the F.D.A. grants authorization.
Mr. Bancel said that Moderna had not yet begun shipping vaccines across the country, and would not do so until the emergency authorization is granted.
The government has arranged to buy vaccines from both Moderna and Pfizer and to provide it to the public free of charge. Moderna has received a commitment of $955 million from the U.S. government’s Biomedical Advanced Research and Development Authority for research and development of its vaccine, and the United States has committed up to $1.525 billion to buy 100 million doses.
The federal government will also begin a publicity campaign to encourage vaccinations, with ads on radio this week and on TV soon, he said.
In response to a question about how officials can guard against people using money or connections to jump the proverbial line, Mr. Azar vowed to “call out any inequities or injustices that we see.”
As he warned that New York State had entered a new phase in fighting the spread of coronavirus, Gov. Andrew M. Cuomo announced on Monday a new series of emergency measures to combat rising hospitalizations and case numbers statewide.
Among other steps, Mr. Cuomo urged hospitals to form plans in case of staff shortages, develop emergency field protocols and prepare to add 50 percent of bed capacity. In Erie County in western New York, all elective surgeries will be stopped on Friday and similar protocols could be enacted in other areas of the state.
“It’s a new phase in the war against Covid,” Mr. Cuomo said at a news conference in Manhattan. “It’s a war in terms of preparation and mobilization.”
The number of New Yorkers hospitalized with the virus has more than tripled over November, to 3,532 on Sunday from 1,125 on Nov. 1, he said. The governor also raised the possibility that a “critical hospitalization situation” could trigger the return of the most stringent measures enacted in the spring, which led to the closure of all nonessential businesses statewide.
“We are not going to live through the nightmare of overwhelmed hospitals again,” he said. “If a hospital does get overwhelmed, there will be a state investigation.”
Mr. Cuomo has warned that the holidays and indoor social gatherings during the winter season could trigger a further resurgence of the virus, a concern shared in neighboring New Jersey. Gov. Philip D. Murphy said Monday that the state will limit all outdoor gatherings to 25 people in an attempt to stem an ongoing surge of cases — and an expected spike after the Thanksgiving holiday.
The new limit on outdoor gatherings, which takes effect on Dec. 7, will sharply reduce the permitted number of people from 150. Religious and political gatherings will be exempt, as will funerals, memorial services and wedding ceremonies, Mr. Murphy said at a news conference.
New Jersey will also suspend all indoor youth and adult sports, including practices and competitions, starting Saturday and extending through Jan. 2. College and professional sports will be exempt from the ban, which Mr. Murphy said he hoped would only be temporary.
Instead of regional or statewide shutdowns in New York this fall as cases increased, Mr. Cuomo had opted for a “micro-cluster” approach to targeting communities where rates of positive test results are particularly high. On Monday, he said new statistics — including hospitalization rates, death rates and available hospital beds — would be used to determine lockdown levels under the state’s color-coded restriction system. The state will evaluate how virus metrics change following Thanksgiving — the effects of which could be delayed because the incubation period for the virus is up to 14 days — before deciding how those restrictions would be determined, he added.
Hospital networks across the state should also better prepare for a surge in patients than they did in the spring, and plan to spread out patients between individual sites, Mr. Cuomo said. The hope is to avoid an overwhelming number of patients at any one site, as happened in the spring at hospitals at the center of the pandemic in New York City. “That has always been my nightmare,” he said, referring to Elmhurst Hospital Center in Queens, where beds were filled in March and refrigerated trucks sat outside to hold the dead.
As virus cases continue to rise across the county, hospitals have also begun to face crisis-level shortages of staff in addition to beds. Mr. Cuomo said on Monday that he was “very worried” about those potential issues in New York, urging hospitals to identify retired nurses and doctors in case of a need. “We can build beds, we can’t create more staff,” he said.
He added that further increasing and better distributing testing across the state, as well as establishing ongoing testing in schools with a focus on elementary school, middle school and special education students at all levels were also top priorities.
Still, the governor was hopeful that the situation in New York was “manageable” and said the state was better prepared than in the spring to curb the spread of the virus.
“I think we’re going to be fine here on all of this,” Mr. Cuomo said. “But we have our work cut out for us. You can’t just sit by and let this happen.”
The head of the International Federation of Red Cross and Red Crescent Societies, Francesco Rocca, warned on Monday that misinformation and mistrust could hinder efforts to distribute a coronavirus vaccine around the world, even as countries scramble to secure doses for their populations.
Speaking at a virtual news conference ahead of a United Nations meeting on the virus this week, Mr. Rocca argued that since the start of the pandemic, high levels of mistrust of health authorities “clearly facilitated transmission of the virus at all levels.”
For example, many people refused to wear face masks or practice social distancing.
The same dynamics could create a disaster if vaccine distribution is not handled properly, he said. The challenge is compounded by growing hesitancy about vaccines in general.
For that reason, Mr. Rocca said, his organization shared the widespread sense of relief and optimism that has come with the progress in vaccine development , but with “a dose of caution.”
“To beat this pandemic, we also have to defeat the parallel pandemic of distrust,” he said.
Mr. Rocca also called for greater efforts to ensure the equitable distribution of vaccines around the world — and criticized the “vaccine nationalism” of wealthy countries that bought up massive quantities of vaccines in exclusive deals with pharmaceutical companies. He called on all governments — including the incoming administration of President-elect Joseph R. Biden Jr. — to join a global immunization effort known as Covax.
“I would like to repeat here our urgent warning to all governments: None of us are safe until all of us are safe,” he said.
While many in the United States celebrated a muted Thanksgiving over Zoom, millions of people traveled instead, rejecting the advice of public officials.
According to Transportation Safety Administration data, about 800,000 to one million people passed through T.S.A. checkpoints each day in the days before and after the holiday — far lower than the same period last year, but likely far higher than epidemiologists had hoped to see.
A United Airlines spokeswoman, Annabelle Cottee, said the week of Thanksgiving was “the busiest since March” for the carrier.
Americans also took to the roads. AAA predicted significant declines in bus, train and cruise travel, but predicted only a modest drop in car travel.
For several days leading up to Thanksgiving, as case numbers and hospitalizations across the country grew exponentially, political leaders and medical experts warned of the dangers of compounding the virus spread by being with others. In November alone, there have been more than 4.1 million cases and more than 25,500 deaths.
There were 91,635 current hospitalizations as of Nov. 28, according to the Covid Tracking Project, almost twice as many as there were on Nov. 1, and triple the number on Oct. 1.
Aware of the emotional resonance of the holiday, experts tried to thread a narrative from these numbers that would convince people of the danger. Their warnings were direct — sometimes stern, sometimes impassioned pleas.
“Keep the gatherings, the indoor gatherings as small as you possibly can,” Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said on “Good Morning America” last week. By making that sacrifice, he said, “you’re going to prevent people from getting infected.”
The Centers for Disease Control and Prevention was also urging people not to travel. “All Americans want to do what they can to protect their loved ones,” Dr. Henry Walke, a Covid-19 incident manager at the C.D.C., said at a news briefing.
And though it would have been unrealistic to expect a public that is restive from months of restrictions to universally abide by such recommendations, the aftermath of those decisions will begin to unfold in the weeks ahead.
Dr. Fauci, during an appearance on the Sunday news program “This Week,” said the best course for Thanksgiving travelers might be “to quarantine yourself for a period of time.”
Dr. Deborah L. Birx, the White House coronavirus response coordinator, said that travelers “have to assume that you were exposed and you became infected and you really need to get tested in the next week.” She urged that travelers avoid anyone in their family over 65 or with underlying illnesses.
That guidance comes as the C.D.C. is considering shortening the recommended isolation period for infected people. And while it is too early to know if holiday travel will affect the virus’s spread, new research suggests that people are most infectious about two days before symptoms begin and for five days afterward, meaning this week will likely be crucial in containment.
On Monday, Mayor Bill de Blasio of New York City urged residents who had ignored official guidance and attended Thanksgiving gatherings to get tested.
In anticipation of a renewed demand, the city has opened 25 new testing locations in the last week. It will also now post online the wait times at its testing sites, which had seen growing lines as New Yorkers scrambled to get tests before their holiday plans.
The city’s seven-day average positive test rate was at 4.03 percent, Mr. de Blasio said, but he warned that the data may be skewed because fewer tests were conducted during Thanksgiving weekend.
“Some of our numbers may be skewed by that,” he said.
The U.S. map shows a country where almost every region is a hot spot. States that were once spared, like Montana and Wyoming, have reported record deaths and infections, while states that were pummeled in the first wave are straining anew.
On Sunday, California became the first state to report more than 100,000 cases in a week, according to a New York Times database.
And in New Jersey, hospitalizations have increased 60 percent in the last two weeks and deaths have increased by 78 percent. Over three days in November, the positivity rate in Newark, the largest city in the state, was 19 percent.
“We begged people to have a somber, respectful, small Thanksgiving,” Gov. Philip D. Murphy said on Fox News Sunday. “And I want to give a shout out to New Jerseyans because I think overwhelmingly that’s what happened, but there’s a lot of fatigue out there.”
Mr. Murphy called the next few months “the fight of our lives,” while also citing the progress of vaccines and noting that there was “light at the end of the tunnel.”
And there was something to celebrate on Sunday in New York City, at least for some parents, when Mr. de Blasio announced that he would reopen the city’s public elementary schools, abruptly shifting policy after an outcry from critics who questioned why gyms and bars remained open while schools were shut.
Turkey is imposing its strictest lockdown since the outbreak of the pandemic, as the country’s total number of cases surpassed half a million, according to government figures released on Monday.
Starting Tuesday night, everyone will be required to stay home from 9 p.m. to 5 a.m. on weekdays and around the clock on weekends, from Friday evening to Monday morning, President Recep Tayyip Erdogan announced.
The hybrid approach is intended to keep the labor force working in an already staggering economy while limiting the spread of the virus as much as possible.
People older than 65 or younger than 20 will be barred from using public transportation. They are already under restrictions that allow them out of their homes for just three hours a day.
Mr. Erdogan also asked people not to allow guests in their homes, and banned large gatherings in private residences for New Year’s celebrations, religious ceremonies or condolence calls.
Funerals and wedding ceremonies will be limited to 30 people. Traditional Turkish baths, saunas, massage parlors and swimming pools will be closed.
Turkey, which only recently began reporting complete data on confirmed cases, has been averaging nearly 23,000 new cases a day over the last two weeks, according to a New York Times database.
GLOBAL ROUNDUP
The traditional Christmas markets that dot European cities, drawing thousands of festive revelers into plazas to enjoy mulled wine, colorful lights and public art, have largely been canceled this year.
But on Advent Sunday, the official start of the holiday season, celebrations continued in different forms. In partially locked-down Bratislava, the capital of Slovakia, the mayor, Matus Vallo, led viewers of a Facebook livestream on a walk through the city’s historic center.
Wearing a cheerful Christmas sweater, Mr. Vallo met musicians and artists along the way, received soothing words from a local priest, eyed winter-themed paintings from art galleries and lit up a Christmas tree in the main square.
“We know what the situation is, but we decided that we won’t let Advent be ruined anyway,” he said to the camera.
Locals and visitors in Bratislava will still be able to gawk at the Christmas lights on a stroll, but officials wanted to avoid the large holiday crowds. Moving traditional events online was part of that effort; a series of holiday concerts and events will be streamed throughout December.
It’s just one of several creative solutions as markets were canceled across the continent. In Landshut, Germany, visitors must experience the Christmas markets as a drive-through, according to Agence France-Presse. They can observe the spectacle from inside their cars as mask-wearing employees hand them menus offering typical treats like roasted chestnuts and gingerbread hearts.
And in the United States, New York City will require reservations to see the Christmas tree at Rockefeller Center, in a bid to fight the holiday crowds that usually pack the surrounding plazas and sidewalks. The city will keep the viewing time to 5 minutes, Mayor Bill de Blasio said. Groups will be limited to four people.
Still, the mayor, who has expressed concern that cases of the virus could surge during the holiday, encouraged people to watch the annual tree-lighting ceremony — scheduled for Wednesday — at home instead of flocking to Midtown Manhattan. “Please, if you can make a decision to watch it on TV, that’s so much better,” he said.
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Hong Kong will limit gatherings in public to two people, including two per table at restaurants, as it battles a surge in cases. Playgrounds, swimming pools and karaoke rooms will close, while gyms will remain open but be limited to two mask-wearing participants, the city’s chief executive, Carrie Lam, said at a news conference on Monday. Hong Kong has reported an average of 85 new daily cases in the past week, far above the near-zero tallies it had reported after a summer surge.
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Italy approved a stimulus package worth $9.6 billion, or 8 billion euros, on Sunday to support struggling businesses. The deal will postpone or suspend tax deadlines for some businesses, subsidize amateur sports associations and send checks of 1,000 euros to seasonal workers in the tourism, spa and entertainment industries. Italy is currently under a nationwide 10 p.m. curfew with bars and restaurants closing at 6 p.m., and some regions have further restrictions.
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In Russia, a hospital near Moscow reported on Monday that it had administered the first known batch of the Russian-made Sputnik V vaccine to civilians. The Domodedovo Central City Hospital confirmed in a phone interview that the vaccine had been delivered and that the first shipment available for general use had already run out. Russia’s government backed efforts to develop a vaccine before other countries has been widely criticized for cutting corners. The rush to deliver a vaccine to the general public has also been spurred by the growing number of new cases and deaths in the country, with the total number of cases in Russia nearing 2.3 million.
With coronavirus vaccine distribution expected to start as early as this month, public health officials are scrambling to develop guidelines for the equitable allocation of limited supplies. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention will meet on Tuesday to make initial determinations about who gets the first shots.
There is broad consensus that health care workers who treat Covid-19 patients should be first in line. Other high-priority groups include residents and employees of long-term care facilities, essential workers whose jobs keep people fed and society running, and medically vulnerable and older adults — roughly in that order.
Prison inmates are not ranked in the top tiers, however, even though some of the largest outbreaks have occurred in the nation’s prisons. Instead, the C.D.C. advisory committee has prioritized correctional officers and others who work in jails and prisons for the first phase of immunizations — but not inmates. The federal prison system will set aside its initial allotment for such employees, according to documents obtained by The Associated Press.
Now several groups, including the American Medical Association, are calling for coronavirus vaccines to be given to inmates and employees at prisons, jails and detention centers, citing the unique risks to people in confinement — and the potential for outbreaks to spread from correctional centers, straining community hospitals.
“We aren’t saying that prisoners should be treated any better than anybody else, but they shouldn’t be treated any worse than anybody else who is forced to live in a congregate setting,” said Dr. Eric Toner, co-author of a report on vaccine allocation published by the Johns Hopkins Center for Health Security.
There is also a powerful public health argument to be made for prison vaccination: Outbreaks that start in prisons and jails may spread to the surrounding community. “Prisons are incubators of infectious disease,” Dr. Toner said.
“It’s a fundamental tenet of public health to try and stop epidemics at their source,” he added.
North Korea’s leader Kim Jong-un “harshly criticized” his government agencies for mishandling the economy, the country’s state media reported on Monday, as new data revealed just how much the pandemic had slashed the country’s already dwindling trade with China.
Signs had already emerged earlier this month that North Korea’s economic trouble was deepening, driven by long-standing international sanctions and the impact of the pandemic. According to customs data released by Beijing last week, North Korea’s imports from China from January to October plummeted by 76 percent to $487 million, while its exports shrank 74 percent to $45 million in the same period.
China is North Korea’s only major trading partner, accounting for more than 90 percent of its external trade. In October, the North’s import from China amounted to a mere $253,000, nearly a 99-percent drop from the previous month. South Korean officials and analysts have warned that a sharp decline in imports from China in recent months could drive up domestic prices in the North.
The Chinese government only records official trade and does not cover smuggling that takes place across the borders between the two neighbors. Still, the figures provided fresh evidence that the coronavirus was squeezing the North Korean economy more effectively than international sanctions ever have.
During a meeting of the Workers’ Party that Mr. Kim presided over on Sunday, the government agencies responsible for the economy were harshly criticized for “failing to provide scientific guidance” and “failing to overcome subjectivism and formalism in their work,” the North’s official Korean Central News Agency reported.
But this was not the first time Mr. Kim has admitted to his country’s deepening economic woes, acknowledging in August that his five-year plan for economic growth had failed. Mr. Kim all but sealed North Korea’s borders with China earlier this year over fears of the potentially catastrophic consequences the pandemic could inflict on the country’s poor health system.
North Korea insists that it has registered no coronavirus cases, but outside experts remain skeptical.
By the end of the third week of England’s second national lockdown, which began early this month in a bid to stem a second wave of coronavirus infections, the number of new cases has fallen 30 percent, according to new data.
Some parts of northern England, which had been hit particularly hard by the new outbreak, experienced an even greater drop, the latest interim findings from Imperial College London’s React study showed.
But Matt Hancock, the British health secretary, warned that the data, while promising, showed the country could not “take our foot off the pedal just yet,” according to the BBC. In a post on Twitter late Sunday, Mr. Hancock cautioned that “we mustn’t waste our progress now we can see light at the end of the tunnel” with mass testing and promising coronavirus vaccine candidates on the horizon.
England’s current lockdown is set to end just after midnight Wednesday. But the lifting of restrictions will be different across the country, as regions move into one of three tiers based on their current rate of infection. Britain is still grappling with the highest number of Covid-19 deaths in Europe and its deepest recession on record, with experts warning that the knock-on effects of the pandemic could last for years.
Those We’ve Lost
Iris Meda, 70, didn’t feel right sitting on the sidelines when the pandemic hit. She’d been retired only a few months, and still had a lifetime of nursing experience in hospitals, prisons, schools and long-term care facilities to share.
So she went back to work in August, teaching nursing skills to high school students through Collin College, north of Dallas. But within weeks, she had come down with Covid-19 herself. After nearly a month in the hospital, most of it on a ventilator, she died on Nov. 14.
Her daughter, Selene Meda-Schlamel, said her mother was exposed to the virus on Oct. 2 while teaching a laboratory class, despite the precautions she was taking.
“I wasn’t worried, because I knew she was wearing an N95, and that she was some distance from the students,” Ms. Meda-Schlamel recalled, in an interview.
“I said to myself, ‘If something happens to her, it happens to her doing something she loves, fulfilling her calling and benefiting the world,’” she said. “But that’s a very different outlook from, ‘My best friend is gone, my kids don’t have a grandmother. Everything that we planned on doing will never occur.’”
Ms. Meda grew up in New York, the oldest of nine siblings, and was a natural caretaker from childhood, her daughter said. She married at 20, expecting to be a stay-at-home mother, but at her husband’s urging, she went back to school and earned a nursing degree from City College.
“She had a very personal touch,” Ms. Meda-Schlamel said. “You never felt like she was rushing you.”
Ms. Meda worked as a nurse at the jail on Rikers Island before moving to Texas in 1993, where she spent the rest of her career before retiring in January. When she took up teaching, she wanted to pass along to her students the kind of encouragement she had gotten to pursue an education. After class, she often returned home “lit up” from the thrill she got from teaching, her daughter said.
When her Covid-19 symptoms worsened in mid-October and she began struggling to breathe, Ms. Meda called her daughter for a ride to the hospital. Ms. Meda-Schlamel recalled that in the car, her mother handed her an envelope containing her medical documents and a handwritten card that she forgot about in the hectic days that followed.
When she finally opened it, she said, she found a note her mother had written after their phone call, telling her how proud she was of her and what a wonderful life she had before her. And two signed checks fell out, meant to help her daughter cover the hospital bills. On one, the amount was left blank.
“That was kind of symbolic of how she was as a person,” Ms. Meda-Schlamel said. “She was always giving people blank checks, blank emotional checks: ‘Whatever you need from me, if I have it, I’ll provide it.’”
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