As America slogs through this grimmest of winters, there is no relief in the daily tabulations of coronavirus-related deaths: More than 4,400 were reported across the United States on Tuesday, according to a New York Times database, a number once unimaginable.
Yet even as Covid-19 touches thousands of families, the nation is distracted by the political crisis gripping Washington in the last days of the Trump administration.
Tuesday’s death count, which set another daily record, represented at least 1,597 more people than those killed in the terrorist attacks of Sept. 11, 2001.
The U.S. death toll, already the world’s highest by a wide margin, is now about 20,000 shy of 400,000 — only a month after the country crossed the 300,000 threshold, a figure greater than the number of Americans who died fighting in World War II.
But much of the nation’s attention is focused on the fallout from the Capitol siege, prompted in part by President Trump’s efforts to prevent Congress from certifying Joseph R. Biden Jr.’s victory in the November election.
On Wednesday, the House will vote to formally charge Mr. Trump with inciting violence against the country. House lawmakers have formally notified Vice President Mike Pence that they will impeach the president if Mr. Pence and the cabinet do not remove Mr. Trump from power by invoking the 25th Amendment.
As people in the country wait to see how Mr. Trump’s tenure will end, they have also focused on the stories of the five people who were left dead after last week’s rampage — in particular, the death of Brian D. Sicknick, a Capitol Police officer who was overpowered by the mob and struck on the head with a fire extinguisher.
“Brian is a hero,” his brother Ken Sicknick said. “That is what we would like people to remember.”
Each coronavirus death is no less painful to the families and friends who have lost loved ones. Among the latest victims are a revered basketball coach, a travel writer who loved country winters and an architect who had survived the Holocaust.
The health Secretary Alex M. Azar II tried to highlight the urgency of the crisis on Tuesday as the Trump administration said that it would release all available vaccine doses and instructed states to immediately begin inoculating every American 65 and older.
“This next phase reflects the urgency of the situation we face,” he said. “Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost or one more hospital bed occupied.”
Johnson & Johnson expects to release critical results from its coronavirus vaccine trial in as little as two weeks but probably won’t be able to provide as many doses this spring as it promised the federal government because of manufacturing delays.
If the vaccine can strongly protect people, as some outside scientists expect, it will offer big advantages over the two vaccines authorized in the United States. Unlike those, which require two doses, Johnson & Johnson’s could need just one, greatly simplifying logistics for local health departments and clinics struggling to get shots in arms. Its vaccine can also stay stable in a refrigerator for months, whereas the others have to be frozen.
But the encouraging prospect of a third effective vaccine is tempered by apparent lags in the company’s production. In the company’s $1 billion contract signed with the federal government in August, Johnson & Johnson pledged to have 12 million doses ready by the end of February, ramping up to a total of 100 million doses by the end of June.
Federal officials have been told that the company has fallen as much as two months behind the original production schedule and won’t catch up until the end of April, when it was supposed to have delivered more than 60 million doses, according to two people familiar with the situation who were not authorized to discuss it publicly.
Dr. Paul Stoffels, Johnson & Johnson’s chief scientific officer, said he expected to see clinical trial data showing whether the company’s vaccine is safe and effective in late January or early February. He declined to provide details about the company’s production capacity.
When a handful of new coronavirus cases materialized this month in a province surrounding Beijing — apparently spread at a village wedding party — the Chinese authorities bolted into action.
They locked down two cities with more than 17 million people, Shijiazhuang and Xingtai. They ordered a testing regime of nearly every resident there, which was completed in a matter of days.
They shut down transportation and canceled weddings, funerals and, most significantly, a provincial Communist Party conference.
By this week, the lockdowns had expanded to include another city on the edge of Beijing, Langfang, as well as a county in Heilongjiang, a northeastern province. Districts in Beijing itself, the Chinese capital, also shut down.
More than 22 million people in all have been ordered to remain inside their homes — double the number affected last January when China’s central government locked down Wuhan, the central city where the virus was first reported, in a move that was then seen as extraordinary.
The flare-ups remain small compared with the devastation facing other countries, but still threaten to undercut the success that the country’s Communist Party has had in subduing the virus, allowing its economy to surge back after last year’s slump and its people to return to something close to normal lives.
The urgency of the government’s current response stands in contrast to that of officials in Wuhan last year who feared a backlash if they disclosed the mysterious new illnesses then emerging. Local officials there had gone ahead with a Communist Party conference like the one now canceled in Hebei, despite knowing the risk of the disease spreading among people.
Since Wuhan, the authorities have created a playbook that mobilizes party cadres to quickly respond to new outbreaks by sealing off neighborhoods, conducting widespread testing and quarantining large groups.
China, a country of 1.4 billion people, has reported an average of 109 new cases a day over the past week, according to a New York Times database. Those would be welcome numbers in countries experiencing far worse — including the United States, which is averaging more than 250,000 new cases a day — but they are the worst in China since last summer.
Indonesia’s president, Joko Widodo, received an injection of a Chinese-made vaccine on live television on Wednesday as health officials prepared for a nationwide rollout.
Human trials in Indonesia have found that the vaccine, CoronaVac, was safe and 65.3 percent effective. But scientists in Brazil said on Tuesday that it had an efficacy rate there of just over 50 percent — far lower than the 78 percent efficacy rate announced last week.
Mr. Joko was the first in Indonesia to receive the inoculation, health officials said, because he wanted to assure the public that it was safe, effective and halal, meaning that it is approved under Islamic law.
Behind him as he received his injection was a red sign with white lettering proclaiming the vaccine to be “safe and halal.”
“Covid vaccination is important for us to break the chain of transmission of this coronavirus and provide health protection for all of us, the people of Indonesia, and help accelerate the process of economic recovery,” Mr. Joko said after getting his shot.
Indonesia, which authorized emergency use of the Sinovac vaccine on Monday, had previously ordered 125.5 million doses from the company and smaller amounts from several others. Indonesia, the world’s fourth-largest country with 270 million people, hopes to achieve herd immunity by vaccinating two-thirds of the population within 15 months.
But there are still questions around the Sinovac vaccine, which China began administering last year before human trials were completed.
The company has yet to release data publicly on the results of its trials. And the vaccine’s efficacy rate, as measured in Brazil and Indonesia, is still far below the 90-plus-percent rates achieved by the Pfizer and Moderna vaccines that have been approved in the United States and other countries.
Dicky Budiman, an Indonesian epidemiologist at Griffith University in Australia, said the relatively low efficacy rate for CoronaVac should prompt Indonesia to look for alternatives. He also questioned the transparency of the various trials and the data being released.
“At least Indonesia has one vaccine as a tool to protect its health care workers and prevent staff shortages,” he said. “Of course, the government should do its best in getting other vaccines.”
Indonesia plans to give the vaccine first to medical staff, police officers and soldiers. It also has begun a national promotion campaign to persuade members of the public to get the vaccine, which will be free.
Following Mr. Joko to be vaccinated in front of the cameras were the head of the army, the national police chief and the newly appointed health minister, along with other dignitaries and so-called influencers.
Indonesia has reported nearly 850,000 coronavirus cases and nearly 25,000 deaths, Southeast Asia’s highest tallies in both categories.
Japan expanded its state of emergency to seven more prefectures on Wednesday, citing rising new coronavirus infections and strains on the medical system.
The seven prefectures, which include Osaka and Kyoto, were added to an emergency declaration made for Tokyo and three surrounding prefectures last week.
The expanded state of emergency goes into effect Thursday and lasts until Feb. 7. Carrying little legal heft and relying mostly on voluntary compliance, the measure urges restaurants and bars to close by 8 p.m. and encourages employers to allow 70 percent of their employees to work from home. The measure also limits large sporting and cultural events to 5,000 spectators or half a venue’s capacity.
Toshio Nakagawa, the chairman of the Japan Medical Association, said on Wednesday that the state of emergency might need to be extended to all of Japan’s 47 prefectures. “I don’t think it’s necessary at this moment,” Dr. Nakagawa said. “However, there is no rule that it can be declared only after everybody thinks it’s absolutely too late.”
Japan has recorded nearly 296,000 cases of the coronavirus and at least 4,100 deaths, according to a New York Times database.
In other global developments:
To alleviate the burden on hospitals in Britain, which are facing a surge in coronavirus patients, the country’s health secretary said on Wednesday that the government was considering measures to relieve the pressure, including a contingency plan in which thousands of patients who require only minimal treatment could be discharged to hotels.
Germany’s cabinet agreed to tighten the rules for entering the country in an attempt to limit the spread of new coronavirus variants. Travelers coming from countries, such as Britain, where new variants are especially widespread, will require a negative test result before being allowed into Germany.
Germany’s health minister, Jens Spahn, said the planned end of the country’s lockdown on Feb. 1 was “not possible.” In an interview, Mr. Spahn said, “This virus is still too present for that, and the health care system is still too burdened for that.” Mr. Spahn on Wednesday is expected to defend the country’s vaccination rollout, which critics say has been too slow.
The Vatican said it had started its virus vaccination campaign, although it was unclear when Pope Francis, who had said he would get the vaccine, would be inoculated. The Vatican said this month that vaccines would be given to those who lived in or worked for the “Holy See and Vatican City State,” giving priority to health workers, security forces, older people and those who have frequent contact with the public.
The prime minister of Estonia resigned after his coalition government became engulfed by a corruption scandal over the misuse of state loans intended for pandemic relief.
The government of the Philippines said a virus variant that was first detected in Britain had been found in a traveler who arrived from the United Arab Emirates last week. The variant, known as B.1.1.7, has been found in about 50 countries. The Philippines has also added China, Jamaica, Luxembourg, Oman and Pakistan to its list of countries and territories whose citizens are barred from entering.
The head of the Tokyo Olympic organizing committee, Yoshiro Mori, said on Tuesday that it would be “absolutely impossible” to postpone the Summer Games again. The Olympics are scheduled to begin on July 23, after the pandemic delayed the original start from July of last year. Mr. Mori said another delay would not be possible because officials involved in the preparations were on loan from other organizations.
The first 100 members of the prison staff at Guantánamo Bay, Cuba, have received initial vaccines against the coronavirus, the U.S. military said on Tuesday evening, though it declined to say whether any of the 40 wartime prisoners at the detention center were offered or received vaccines.
Capt. Garrett Kasper, a Navy spokesman at the prison, said in a statement that a shipment of Moderna vaccines arrived at the base on Friday, and 100 people assigned to the detention operation that has 1,800 staff members were vaccinated the next day.
More vaccinations were scheduled to take place on Wednesday morning, according to an announcement posted by the base’s small community hospital. Recipients were to include emergency room and urgent care workers as well as some other emergency workers described as “first responders.”
About 6,000 people live at the base, but the detention center apparently received a separate supply of the vaccines for its personnel.
The military did not say whether the first 100 people to receive vaccine doses included civilian workers in the prison zone, such as translators, or whether they were given exclusively to U.S. forces, such as National Guard troops on temporary assignment as prison guards and Navy medics who care for the detainees in the cellblocks.
Captain Kasper said the prison headquarters was expected to receive a second shipment of Moderna vaccines this week.
In the first months of the pandemic, Guantánamo disclosed that two service members had tested positive for the virus and were isolated. It provided no further updates on cases, because the Pentagon banned base-by-base disclosures.
Most legal visits and military commission proceedings involving the prisoners — including Khalid Shaikh Mohammed and four other men accused of conspiring in the Sept. 11, 2001 attacks — have come to a standstill during the pandemic. Troop rotations have continued, and some base families have traveled to and from Guantánamo on military leaves and vacations.
People arriving on the base are required to individually quarantine for two weeks. The commissary, gym, church compound, 245-pupil school system and pub are all open, the last with a 50-patron limit and a requirement that the wait staff wears masks.
The leader of a secretive religious sect that was at the center of a coronavirus outbreak in South Korea last year received a three-year prison term on Wednesday on charges of embezzling church money.
But Lee Man-hee, 89, the founder of Shincheonji Church of Jesus, was acquitted on a charge of conspiring to impede the health authorities’ efforts to fight the coronavirus. Mr. Lee’s prison term was suspended for four years, which means that he will remain free unless he commits a crime within that time.
The rapid spread of the virus among the church’s worshipers in Daegu, a city in the country’s southeast, in February and early March last year briefly made South Korea home to the world’s largest coronavirus outbreak outside China. A total of 5,213 cases have been found among church members and their contacts, according to government data.
Prosecutors arrested Mr. Lee in August on charges that he and other church officials had obstructed the government’s efforts to fight the epidemic by not fully disclosing the number of worshipers and their gathering places. Mr. Lee was also accused of embezzling 5.6 billion won, or $5.1 million, from church funds to build a luxurious “peace palace” north of Seoul, the capital.
He was also accused of using public facilities for religious activities without permission from the local authorities.
Mr. Lee was released on bail in November. On Wednesday, a judge in the district court of Suwon, south of Seoul, ruled that a failure to provide a full list of worshipers and church facilities did not amount to impeding the government’s disease-control efforts.
Mr. Lee’s church welcomed the acquittal and said he would appeal to a higher court to try to reverse his conviction on embezzlement and other charges.
In today’s edition of the Morning newsletter, David Leonhardt writes:
Last week’s attack on the Capitol has understandably dominated the news. But I want to take a few minutes to focus on the other vital story right now — the pandemic.
Below is a three-point summary of where we are, with help from my colleagues covering the story and from a couple of charts. I’ll warn you up front: The situation is not good.
1. The new variants are scary. Scientists are still learning about new versions of the coronavirus, including variants that emerged in Britain, South Africa and Brazil. The evidence so far indicates that they “are much more infectious than the Italian strain, which has been circulating here since February,” my colleague Donald G. McNeil Jr. told me. “That’s a game changer.”
Behavior that may once have been only moderately risky — say, airplane travel — may now be more so. The variants seem to be one reason cases worldwide are spiking:
2. The mass vaccination campaign in the U.S. is off to a terrible start. The Trump administration promised that 20 million Americans would be vaccinated by Jan. 1. Instead, fewer than three million were — and only about nine million have now had their shots.
The Deep South has the country’s lowest vaccination rates. But this isn’t just a Republican failure: California, Virginia and some other Democratic-run states have also been slow. (Here’s data for every state.)
Vaccinations will probably accelerate in coming weeks, especially because President-elect Joe Biden and his team seem much more focused on the problem than President Trump has been. Goldman Sachs forecasts that about one-quarter of Americans will have received their first shot by April 1, half by June 1 and three-quarters by mid-autumn. The coming vaccination speedup is the one good piece of good news right now.
3. Things are likely to get worse before they get better. The virus is spreading so rapidly that hospitals are struggling to keep up. About 130,000 Americans are hospitalized with Covid symptoms, more than double the number two months ago. The strain on hospitals raises the possibility that many people will not receive the best available treatments.
Los Angeles has recently had to ration oxygen. And Esteban Trejo, an executive at a company in El Paso, Texas, that provides oxygen to temporary hospitals, told Kaiser Health News, “It’s been nuts, absolutely nuts.”
The recent data on cases and deaths is noisy, because diagnoses artificially slowed during the holidays, says Mitch Smith, a Times reporter who follows the numbers. Still, deaths have already hit a record this week — more than 3,000 a day, on average — and the recent explosion of cases suggests they may be heading to above 3,500 and perhaps to 4,000.
The bottom line: Biden will be taking office next week during the nadir of the coronavirus crisis. His administration will need to both accelerate vaccine distribution and persuade more people to change their behavior — and the second goal is even more urgent than the first.
Unless Americans start wearing masks more often and spending less time together in cramped spaces, many more people are going to die.
Native Americans, who are dying of Covid-19 at nearly twice the rate of white people, are also facing a cultural crisis: The coronavirus is tearing through the ranks of tribal elders, inflicting an incalculable toll on bonds of language and tradition that flow from older generations to the young.
“It’s like we’re having a cultural book-burning,” said Jason Salsman, a spokesman for the Muscogee (Creek) Nation in eastern Oklahoma whose grandparents contracted the virus but survived. “We’re losing a historical record, encyclopedias. One day soon, there won’t be anybody to pass this knowledge down.”
Native Americans and volunteer groups are trying to protect the elders as a mission of cultural survival, and putting elders and fluent Indigenous language speakers at the head of the line for vaccinations. But the efforts face huge obstacles. Elders who live in remote locations often have no means to get to the clinics and hospitals where vaccinations are administered. And there is deep mistrust of the government in a generation that was used as medical guinea pigs, shipped off to boarding schools and punished for speaking their own languages.
Activists say there is still is no reliable death toll of Native elders. They say the deaths are often overlooked or miscounted, especially off reservations and in urban areas, where about 70 percent of Indigenous people live.
Adding to the problem, tribal health officials say their sickest members can essentially vanish once they are transferred out of small reservation health systems to larger hospitals with intensive-care units.
“We don’t know what happens to them until we see a funeral announcement,” said Abigail Echo-Hawk, the director of the Urban Indian Health Institute.
The virus has claimed fluent Choctaw speakers and dressmakers from the Mississippi band of Choctaws. It took a Tulalip family matriarch in Washington State, then her sister and brother-in-law. It killed a former chairman of the Yocha Dehe Wintun Nation in California who had spent decades fighting to preserve Native arts and culture. Remote meetings of the Diné Hataałii Association, a group of Navajo medicine men and women, now regularly include updates on members who have died.
“When they pass on, all that knowledge is gone forever, never to be retained,” said Avery Denny a member of the association and professor at Diné College. “It’s just lost.”
Health authorities are investigating the case of a Florida doctor who died from an unusually severe blood disorder 16 days after receiving the Pfizer coronavirus vaccine.
Dr. Gregory Michael, a 56-year-old obstetrician and gynecologist in Miami Beach, received the vaccine at Mount Sinai Medical Center on Dec. 18 and died 16 days later from a brain hemorrhage, his wife, Heidi Neckelmann, wrote in a Facebook post.
Shortly after receiving the vaccine, Dr. Michael developed an extremely serious form of a condition known as acute immune thrombocytopenia, which prevented his blood from clotting properly.
Pfizer said in a statement that it was “actively investigating” the case, “but we don’t believe at this time that there is any direct connection to the vaccine.”
“There have been no related safety signals identified in our clinical trials, the post-marketing experience thus far,” or with the technology used to make the vaccine, the company said. “Our immediate thoughts are with the bereaved family.”
About nine million people in the United States have received at least one shot of either the Pfizer or Moderna coronavirus vaccine, the two authorized in the United States. Serious reported problems have included 29 cases of anaphylaxis, a severe allergic reaction, though none were reported as fatal. Many people have had side effects like sore arms, fatigue, headache and fever, which are usually transient.
Local and federal agencies are investigating Dr. Michael’s death. Several experts said the case was highly unusual but could have been a severe reaction to the vaccine.
The Florida Department of Health referred Dr. Michael’s death to the Centers for Disease Control and Prevention for investigation. Kristen Nordlund, a C.D.C. spokeswoman, said in a statement that the agency would “evaluate the situation as more information becomes available and provide timely updates on what is known and any necessary actions.”