Coronavirus outbreak: California reports 2nd highest daily deaths

4:07 PM CT on 1/20/21

California reported its second-highest number of COVID-19 deaths Wednesday but also a dip in hospitalizations below 20,000 for the first time since Dec. 27.

The California Department of Public Health has reported the total of 694 new deaths is second to the record 708 reported on Jan. 8. Hospitalizations stood at 19,979.

California officials are pinning their hopes on President Joe Biden as they struggle to obtain coronavirus vaccines to curb a coronavirus surge that has packed hospitals and morgues.

Doses of COVID-19 vaccines have been arriving haphazardly as they make their way from the source to counties, cities and hospitals.

Former Gov. Arnold Schwarzenegger put in a pitch for vaccination, posting a Twitter video of himself getting a shot in his right bicep at the drive-through site at Dodger Stadium.

“Today was a good day,” he wrote. “I have never been happier to wait in a line. If you’re eligible, join me and sign up to get your vaccine. Come with me if you want to live!”

2:17 PM CT on 1/20/21

(AP) Nebraska's campaign to vaccinate people for the coronavirus is further along in some rural parts of the state.

At least half a dozen health districts across the state have already started giving vaccines to seniors living outside long-term care facilities, the Lincoln Journal Star reported. Officials in Lincoln and Omaha are still working to vaccinate healthcare workers and residents of long-term care facilities.

Health districts based in Scottsbluff, Grand Island, Kearney, Dakota City and Burwell have all started to vaccinate older residents of the areas they serve.

State health officials have said they expected the campaign to progress at different rates throughout parts of Nebraska.

Overall, the state has administered 109,526 of the 192,078 doses of the vaccines it has received so far. Officials said Tuesday that more than 75,000 of the state's roughly 90,000 healthcare workers have received at least one dose of the vaccine, and shots have been administered at 428 long-term care facilities.

2:17 PM CT on 1/20/21

Hospital executives are considering outsourcing more information technology services as a way to recoup losses and focus on core business functions in the wake of COVID-19, experts say.

By the end of 2020, the proportion of hospitals indicating interest in outsourcing had grown for 44 of 50 common clinical, financial and technology services when compared to before COVID-19, according to data from Black Book Research. The firm polled roughly 1,000 hospitals before the onset of the pandemic in February, and then again near the end of the year.

The six IT areas included in the survey all experienced an uptick in interest between February and November; none remained the same or experienced decreasing interest.

“Intention to (outsource) things that are primarily technology-associated really jumped,” said Doug Brown, Black Book’s founder and president.

That’s at least in part due to possible cost savings organizations could get from outsourcing. Hospitals in 2021 will have to work to replenish some of the revenue lost from low patient volumes in 2020, while also recognizing the need to invest in IT budgets to support virtual care, remote work and other innovations that spread during the pandemic.

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11:48 AM CT on 1/20/21

(AP) While the state struggles to bolster its vaccination distribution efforts, the Washington Department of Health on Tuesday began reporting its most updated vaccination numbers on its online COVID-19 data dashboard.

The dashboard, launched months ago, updates Washingtonians every day on the state's latest number of COVID-19 cases, deaths, hospitalizations, tests and other information. On Tuesday evening, vaccination data was added to the list.

As of Monday night, 294,386 doses had been given, with a seven-day average of 14,064 per day. The state's goal is to reach 45,000 vaccine doses per day, Gov. Jay Inslee said Monday, promising to add new vaccination sites, mobilize thousands of workers and make everyone 65 and over immediately eligible.

But The Seattle Times reports there is pushback from the health community to Inslee's plan for meeting the new goal. Instead of waiting for vaccines to arrive before making appointments, providers should operate on the assumption that more supplies are coming and cancel appointments if necessary, Inslee said.

"We have really serious concerns about this idea," said Washington State Hospital Association CEO Cassie Sauer at a briefing with several other hospital leaders. Nurses would be pulled away from other work for vaccinations that might not happen. And, Sauer said, "I believe the public outrage at having a vaccine appointment scheduled and then canceled will be extreme and will really undermine the confidence in our vaccine delivery system."

9:37 AM CT on 1/20/21

(AP)  In his first hours as president, Joe Biden will aim to strike at the heart of President Donald Trump's policy legacy, signing a series of executive actions that reverse his predecessor's orders on immigration, climate change and handling of the coronavirus pandemic.

Biden on Wednesday will end construction on Trump's U.S.-Mexico border wall, end the ban on travel from some Muslim-majority countries, rejoin the Paris Climate Accord and the World Health Organization and revoke the approval of the Keystone XL oil pipeline, aides said Tuesday. The new president will sign the orders almost immediately after taking the oath of office at the Capitol, pivoting quickly from his pared-down inauguration ceremony to enacting his agenda.

The 15 executive actions are an attempt to essentially rewind the last four years of federal policies with striking speed. Only two recent presidents signed executive actions on their first day in office — and each signed just one. But Biden, facing the debilitating coronavirus pandemic, is intent on demonstrating a sense of urgency and competence that he argues has been missing under his predecessor.

"I think the most important thing to say is that tomorrow starts a new day," said Jeff Zients, Biden's choice to lead a new White House office that will coordinate the federal government's revamped response to the pandemic.

Biden's first actions reach well beyond the current health crisis. He intends to order a review of all Trump regulations and executive actions that are deemed damaging to the environment or public health. He will order federal agencies to prioritize racial equity and review policies that reinforce systemic racism. He will revoke a Trump order that sought to exclude noncitizens from the census and will order federal employees to take an ethics pledge that commits them to upholding the independence of the Justice Department.

COVID-19 restrictions, along with tight security surrounding the Inauguration, were severely curtailing the number of aides in Biden's West Wing. Aides, one official said, were told to pack snacks to eat in their offices because of pandemic protocols.

9:08 PM CT on 1/19/21

(AP) Hawaii’s leaders say limited supply is the main thing constraining distribution of the coronavirus vaccine in the state.

Hawaii received 59,000 doses of the vaccine last week, but expects to get only about 32,000 this week.

Still, Lt. Gov. Josh Green says the state expects to be able to vaccinate everyone in the top priority category by the end of February. That category includes health care workers, long-term care facility residents, people over 75, and teachers and other front-line essential workers.

The federal government is distributing vaccine to each state in accordance with their share of the U.S. population.

6:57 PM CT on 1/19/21

(AP) West Virginia’s speedy coronavirus vaccination drive is facing a roadblock, with state leaders saying they didn’t receive an expected increase in doses this week.

With 99.6% of first doses delivered already administered, officials are clamoring for the federal government to send more vaccine.

Noting that other states have doses unused, Gov. Jim Justice said Tuesday: “We’ve got them all in people’s arms and we’ve done exactly what we should have done. … I think performance ought to be rewarded.”

He says the state hasn’t received a promised 25,000 additional doses this week on top of its usual weekly allocation of about 23,000.

West Virginia officials say 7.4% of the state’s 1.78 million people have received at least one of two doses — the highest rate among the 50 states.

4:11 PM CT on 1/19/21

(AP) The race against the virus that causes COVID-19 has taken a new turn: Mutations are rapidly popping up, and the longer it takes to vaccinate people, the more likely it is that a variant that can elude current tests, treatments and vaccines could emerge.

The coronavirus is becoming more genetically diverse, and health officials say the high rate of new cases is the main reason. Each new infection gives the virus a chance to mutate as it makes copies of itself, threatening to undo the progress made so far to control the pandemic.

On Friday, the World Health Organization urged more effort to detect new variants. The U.S. Centers for Disease Control and Prevention said a new version first identified in the United Kingdom may become dominant in the U.S. by March. Although it doesn't cause more severe illness, it will lead to more hospitalizations and deaths just because it spreads much more easily, said the CDC, warning of "a new phase of exponential growth."

"We're taking it really very seriously," Dr. Anthony Fauci, the U.S. government's top infectious disease expert, said Sunday on NBC's "Meet the Press."

"We need to do everything we can now ... to get transmission as low as we possibly can," said Harvard University's Dr. Michael Mina. "The best way to prevent mutant strains from emerging is to slow transmission."

So far, vaccines seem to remain effective, but there are signs that some of the new mutations may undermine tests for the virus and reduce the effectiveness of antibody drugs as treatments.

"We're in a race against time" because the virus "may stumble upon a mutation" that makes it more dangerous, said Dr. Pardis Sabeti, an evolutionary biologist at the Broad Institute of MIT and Harvard.

2:10 PM CT on 1/19/21

(AP) The U.S. death toll from the coronavirus eclipsed 400,000 on Tuesday in the waning hours in office for President Donald Trump, whose handling of the crisis has been judged by public health experts a singular failure.

The running total of lives lost, as compiled by Johns Hopkins University, is nearly equal to the number of Americans killed in World II. It is about the population of Tulsa, Oklahoma; Tampa, Florida; or New Orleans. It is equivalent to the sea of humanity that was at Woodstock in 1969.

It is just short of the estimated 409,000 Americans who died in 2019 of strokes, Alzheimer's, diabetes, flu and pneumonia combined.

And the virus isn't finished with the U.S. by any means, even with the arrival of the vaccines that could finally vanquish the outbreak: A widely cited model by the University of Washington projects the death toll will reach nearly 567,000 by May 1.

2:10 PM CT on 1/19/21

As Joe Biden takes over as president, inheriting a failing vaccination effort, public health experts are cautiously optimistic that the new administration will provide some much-needed direction to the process. But some are already questioning whether his strategy will be aggressive enough to stem the pandemic’s spread.

Under President Donald Trump, of the more than 30 million vaccine doses that have been distributed, just 11 million people had received an initial dose as of Jan. 14, according to the Centers for Disease Control and Prevention. That amounts to roughly 3% of the U.S. population and comes well under initial projections by federal health officials. In early December, HHS Secretary Alex Azar estimated as many as 20 million Americans would receive an initial dose by the end of 2020, with a goal of administering 100 million by the end of March.

Last week, Biden unveiled details of his $1.9 trillion COVID relief plan that calls for allocating $20 billion toward a national vaccination program.

Biden and his pandemic task force set a target of administering 100 million doses of vaccine in the first 100 days of his administration in an effort to get the country on pace to achieve herd immunity by later this year.

Some argue that more vaccinations are needed. “One million should not be the ultimate target, that’s not nearly ambitious enough,” said Dr. Leana Wen, an emergency physician and public health professor at George Washington University who previously was Baltimore’s health commissioner.

Wen said a goal of 1 million vaccinations a day serves as a good baseline but is still too slow to achieve herd immunity by fall. Experts have estimated around 75% of Americans would need to get vaccinated to reach a threshold to effectively stop widespread transmission of the virus. “We need to be doing 3 million vaccinations a day,” Wen said.

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12:00 PM CT on 1/19/21

(AP)  India's homegrown coronavirus vaccine developer Bharat Biotech on Tuesday warned people with weak immunity and other medical conditions including allergies, fever or a bleeding disorder to consult a doctor before getting the shot — and if possible avoid the vaccine.

The company said those receiving vaccinations should disclose their medical condition, medicines they are taking and any history of allergies. It said severe allergic reactions among vaccine recipients may include difficulty breathing, swelling of the face and throat, rapid heartbeat, body rashes, dizziness and weakness.

The vaccine developed by Bharat Biotech ran into controversy after the Indian government allowed its use without concrete data showing its effectiveness in preventing COVID-19. Tens of thousands of people have been given the shot in the past three days after India started inoculating healthcare workers last weekend in what is likely the world's largest coronavirus vaccination campaign.

India on Jan. 4 approved the emergency use of two vaccines, one developed by Oxford University and U.K.-based drugmaker AstraZeneca, and the other by Bharat Biotech. The regulator took the step without publishing information about the Indian vaccine's efficacy.

Bharat Biotech has still not published data on its vaccine's effectiveness but said it is complying with clinical trial guidelines.

The regulator maintains the vaccine is safe and gave its approval in the belief that it could be more effective in tackling a new variant of the coronavirus found in the U.K. The regulator and the company have said efficacy data will be published after ongoing late clinical trials conclude.

9:42 AM CT on 1/19/21

(AP)  A panel of experts commissioned by the World Health Organization has criticized China and other countries for not moving to stem the initial outbreak of the coronavirus earlier and questioned whether the U.N. health agency should have labeled it a pandemic sooner.

In a report issued to the media Monday, the panel led by former Liberian President Ellen Johnson Sirleaf and former New Zealand Prime Minister Helen Clark said there were "lost opportunities" to set up basic public health measures as early as possible.

"What is clear to the panel is that public health measures could have been applied more forcefully by local and national health authorities in China in January," it said.

China's Foreign Ministry spokesperson Hua Chunying disputed whether China had reacted too slowly.

"As the first country to sound the global alarm against the epidemic, China made immediate and decisive decisions," she said, pointing out that Wuhan — where the first human cases were identified — was locked down within three weeks of the outbreak starting.

"All countries, not only China, but also the U.S., the U.K., Japan or any other countries, should all try to do better," Hua said.

At a press briefing on Tuesday, Johnson Sirleaf said it was up to countries whether they wanted to overhaul WHO to accord it more authority to stamp out outbreaks, saying the organization was also constrained by its lack of funding.

"The bottom line is WHO has no powers to enforce anything," she said. "All it can do is ask to be invited in."

8:15 PM CT on 1/18/21

(AP) Frustrated by the flow of coronavirus vaccine from the federal government, Gov. Andrew Cuomo on Monday floated the idea of buying shots for New Yorkers directly from one of the vaccine makers, Pfizer.

The idea seemed far from a sure bet, with the pharmaceutical giant saying it would need federal approval to sell to state governments. If that were to happen, the cost and amount have yet to be be discussed.

Regardless, Cuomo said he felt compelled to broach the idea as his state, like many others, faces tough vaccine math. At the current pace of federal vaccine shipments to New York, it could take six months or more to get shots to the 7 million residents already eligible under federal guidelines, let alone the roughly 12 million other New Yorkers. Residents have been scrambling to try to get the shots, with many getting shut out and upset.

“My job as governor of New York is to pursue every avenue, and that's what I'm doing,” the Democratic governor said at a virtual news conference as he released a letter he'd written to New York-based Pfizer about his idea. He told the company it “could help us save lives right here in New York.”

Pfizer Inc., which developed one of the current vaccines with German partner BioNTech, said in a statement that it appreciated Cuomo's praise and was open to working with the federal Health and Human Services Department on getting the shots as quickly as possible to as many Americans as it could.

“However, before we can sell directly to state governments, HHS would need to approve that proposal,” the company said.

An inquiry was sent to HHS representatives about Cuomo's proposal on Monday, the federal Martin Luther King Jr. holiday.

Under the current system, HHS allocates vaccine doses to states and ships them. The federal Food and Drug Administration's emergency-based authorization for the Pfizer vaccine specifies that it will be supplied “as directed by the U.S. government.”

The federal government has been paying $19.50 per dose for the Pfizer vaccine and has ordered 200 million doses so far, enough to give the two-shot regimen to 100 million people. Other nations around the world have also placed orders.

Earlier in the pandemic, Cuomo complained last spring about U.S. states competing against one another, or being outbid by the federal government, for then-scarce protective gear and ventilators. At the time, he called on the federal government to nationalize medical supply acquisition of those items.

5:33 PM CT on 1/18/21

(AP) California has become the first state to record more than 3 million known coronavirus infections.

That’s according to a tally Monday by Johns Hopkins University. The grim milestone wasn’t entirely unexpected in a state with 40 million residents but its speed was stunning.

California only reached 2 million reported cases on Dec. 24. The count is also far ahead of other large states, such as Texas. California also has seen more than 33,600 deaths due to COVID-19.

A caseload surge that began last fall has strained hospitals. Although there’s been a slight downward trend, officials warn that could reverse when the full impact from holiday gathering transmissions is felt.

3:06 PM CT on 1/18/21

(AP) The European Union sought Monday to ease concerns that citizens might be obliged to get shots against the coronavirus before they’re allowed to travel, as debate swirls over the use of vaccination certificates to help reopen tourism across the 27-nation bloc.

The European Commission has been weighing a Greek proposal to issue vaccination certificates to help get travelers to their vacation destinations more quickly and avoid another disastrous summer for Europe’s tourism sector.

Greece plans to issue digital vaccination certificates to each person inoculated against COVID-19. EU heads of state and government are due to discuss the proposal at a video-summit on Thursday.

European Commission Vice-President Maros Sefcovic insisted that “vaccination is voluntary.” He noted that some people cannot be inoculated for health reasons while others might simply object.

“We are taking all the precautions that we would not create any ground for different treatment of these people, or any kind of limitations of their rights,” he told reporters after taking part in videoconference talks between European affairs ministers.

Sefcovic said the priority now must be to gather data about the disease and its treatment on digital platforms on a Europe-wide scale so that health experts can compare the way the virus mutates, how the vaccines are working and whether testing standards are harmonized across the 27 member countries.

“We need to make sure that the data would be collected electronically in respect of all data privacy rules and it should be done on interoperable platforms so we can share the data,” he said, adding that it’s need to assess the “efficiency of the vaccines, for the evaluation of the whole vaccination process.”

Vaccinations have started across the 27-nation EU, but it is unclear what proportion of the population will be vaccinated in time for the summer holiday season.

12:46 PM CT on 1/18/21

(AP) Some hospitals in Poland have suspended vaccination against COVID-19 after they did not get the expected deliveries of their Pfizer vaccine doses.

A government official monitoring the vaccination process, Michal Dworczyk, said Monday that the latest delivery over the weekend was at least 50% smaller than expected, and the government needs to make changes to the national inoculation schedule that began in late December.

Of some 1.5 million doses Poland has received, the government has secured half for the second jab for those who have received the first portion. The second round of inoculation should be starting this week.

Hospitals in Szczecin region, in the northwest, and in Krakow, in the south, on Monday temporarily halted first vaccinations, saying they have not received the requested doses.

10:50 AM CT on 1/18/21

(AP) The World Health Organization chief on Monday lambasted drugmakers' profits and vaccine inequalities, saying it’s “not right” that younger, healthier adults in wealthy countries get vaccinated against COVID-19 before older people or healthcare workers in poorer countries and charging that most vaccine makers have targeted locations where “profits are highest.”

Director-General Tedros Adhanom Ghebreyesus kicked off WHO’s week-long executive board meeting — virtually from its headquarters in Geneva — by lamenting that one poor country received a mere 25 vaccine doses while over 39 million doses have been administered in nearly 50 richer nations.

“Just 25 doses have been given in one lowest income country -- not 25 million, not 25,000 -- just 25. I need to be blunt: The world is on the brink of a catastrophic moral failure,” Tedros said. He did not specify the country, but a WHO spokeswoman identified it as Guinea.

“It’s right that all governments want to prioritize vaccinating their own health workers and older people first," he said. “But it’s not right that younger, healthier adults in rich countries are vaccinated before health workers and older people in poorer countries. There will be enough vaccine for everyone.”

Tedros, an Ethiopian who goes by his first name, nonetheless hailed the scientific achievement behind rolling out coronavirus vaccines less than a year after the pandemic erupted in China, where a WHO-backed team has now been deployed to look into origins of the coronavirus.

“Vaccines are the shot in the arm we all need, literally and figuratively,” Tedros said. “But we now face the real danger that even as vaccines bring hope to some, they become another brick in the wall of inequality between the worlds of the world’s haves and have-nots.”

He noted the WHO-backed COVAX program, which aims to get vaccines out to all countries, rich or poor, based on need, has so far secured 2 billion vaccine doses from five producers and options on a billion doses more.

“We aim to start deliveries in February,” he said. "COVAX is ready to deliver what it was created for.”

That target date could be a tall order, because a key producer of vaccines for the developing world — the Serum Institute of India — has not confirmed a date and predicted that its rollout might not happen before March or April.

In his opening remarks, Tedros aired some of his toughest public words yet toward vaccine makers, criticizing “bilateral deals” between them and countries that WHO says can deplete the effectiveness of the COVAX facility — and went further to raise the issue of profits.

“The situation is compounded by the fact that most manufacturers have prioritized regulatory approval in rich countries, where the profits are highest, rather than submitting full dossiers to WHO,” he said.

That appeared to allude to a shortage of data the U.N. health agency says it has received from vaccine makers so that WHO can approve their shots for wider emergency use.

8:21 AM CT on 1/18/21

(AP) Delaware residents who are not currently eligible for the COVID-19 vaccine nevertheless received it at a mass vaccination event attended by Gov. John Carney, according to state officials.

The Division of Public Health said after Saturday’s vaccination event that screening would be “tightened” for vaccination events on Sunday and Monday, and those not in the state’s top-priority phase 1A, which is limited to health care workers and long-term care residents and staff, might be turned away.

It’s unclear how ineligible people were allowed to get the vaccine at Saturday’s drive-thru event at the Division of Motor Vehicles in Dover. Carney’s office had billed the event as a “Phase 1A Vaccination Clinic” as “Delaware ‘sprints’ to vaccinate individuals in Phase 1A.”

Officials have previously said that phase 1B, targeting front-line essential workers and people 65 and older, was expected to begin by the end of the month.

“We are still in Group 1a and the vaccines today were supposed to be given to health workers and first responders,” House Speaker Pete Schwartzkopf said in a Facebook post Saturday.

“A few people went through and should have been challenged but weren’t primarily because the staff doing the vaccination is made up of volunteers and they didn’t have access to a database to verify that they were first responders,” Schwartzkopf added. “Others arrived and got vaccinated because friends ... called them or posted online and told them to come get vaccinated because they had gotten theirs.”

Near the end of the event, the number of first responders arriving had slowed down, so a decision was made to try to get some people 65 years or older to come through,” Schwartzkopf said in the post.

“The organizers wanted to use all of the vaccine they had so they dipped down into group 1b and had Modern Maturity bring about 100 seniors over,” he wrote, referring to a senior community center in Dover.

Andrea Wojcik, a spokeswoman for the Division of Public Health, said in an email Sunday that to test the logistics and process for vaccinating the 65 and older population once the state moves to Phase 1B, and to use available vaccine doses, DPH asked a small number of organizations with senior citizen members to come to drive-thru vaccination events being held in Dover through Monday.

Wojcik said in a subsequent email that the technology being tested was for registering and managing vaccinations at drive through clinics.

“Misinformation was spread by social media and word of mouth that caused some people to come out and go through the line,” she wrote.

Wojcik did not explain why officials did not announce the testing ahead of time or when they invited senior groups to attend.

“The select group of 65 and over was included to help with a test of a technology project that will be used to register and process vaccinations in the next phase,” Wojcik wrote. “Also, due to increased risk of allergic reactions and more involved medical history, it may take longer to process a person aged 65 or older through the vaccination process, including potentially longer observation times after the vaccine is administered, and DPH wanted to review that effect on the drive-through clinic process, again in preparation for the next phase.

7:03 PM CT on 1/17/2021

The director of the Alabama Board of Funeral Service says businesses across the state have been reaching out for advice on how to handle the large volume of recent deaths due to COVID-19 and other causes.

“Funeral homes don’t always operate on regular business hours,” Charles Perine told AL.com. “However, to the point that you are having to run the crematorium around the clock, that is unique.”

Some funeral businesses report adding extra cremation shifts to handle the extra load.

There is no precise count yet on how many people in Alabama died from the virus. But hospitalizations have set new highs throughout the month. And Alabama in January watched the total deaths from the pandemic cross 5,000 and then keep climbing to pass 6,000.

Homicides and drug overdoses also surged last year, adding to an unprecedented death toll.

Glennis Points is a manager at the Patterson-Forest Grove Funeral Home, which cremates remains for other funeral homes around Pleasant Grove. He said the crematory usually ran from about 8 a.m. to 6 p.m. prior to the pandemic.

“Now we are working until 3 a.m. most nights and starting back up again around 8 in the morning,” Points said.

Patterson said the funeral home also has struggled to obtain the concrete vaults that hold and protect buried caskets.

Arlillian Kate Bushelon, manager of Bushelon Funeral Home in Birmingham, said casket companies have also reported shortages and asked her to call ahead before ordering.

“Last week, we waited on 20 families, where it had typically been five to ten a week prior to the pandemic,” Bushelon said.

3:45 PM CT on 1/17/2021

(AP) New Orleans is among cities that will play a part in events surrounding the upcoming inauguration of President-elect Joe Biden.

Those events include remembrances of people lost to the coronavirus pandemic.

A city news release says that, in advance of Wednesday’s inauguration, white flags will be placed at the city’s Lafayette Square to commemorate New Orleans residents lost to COVID-19. At a historic downtown building, Gallier Hall, there will be a temporary memorial where people will be encouraged to leave flowers, cards, photographs, or tokens in remembrance of their loved ones.

A Tuesday afternoon ceremony at Gallier Hall will coincide with a national event with Biden and Vice President-elect Kamala Harris at the Lincoln Memorial Reflecting Pool. Towns and cities around the country have been invited to light up buildings and ring church bells as part of a national moment of unity and remembrance.

1:16 PM CT on 1/17/2021

(AP) Data from Johns Hopkins University shows that the seven-day rolling average of new U.S. cases has risen from about 206,000 on Jan. 2 to more than 223,000. The seven-day rolling average of new deaths, meanwhile, climbed from about 2,600 on Jan. 2 to more than 3,300 on Saturday. That has pushed the country’s COVID-19 death toll to 395,855, virtually assuring that it will reach 400,000 by the time President-elect Joe Biden is inaugurated on Wednesday.

11:08 AM CT on 1/17/2021

(AP) Incoming White House chief of staff Ron Klain says the coronavirus pandemic will get worse before it gets better, projecting another 100,000 deaths from COVID-19 in the first five weeks of President-elect Joe Biden’s administration.

Speaking to CNN’s “State of the Union,” Klain said Biden was inheriting a dire situation, saying even with vaccines, “It’s going to take a while to turn this around.”

Biden has set a goal of injecting 100 million doses of coronavirus vaccine in his first 100 days in office, a goal Klain said they were on pace to meet.

Klain added he believed there was enough supply of the pair of vaccines currently granted emergency approval to ensure that those who have received their first shot will get the required second.

UK aims to give 1st COVID-19 shot to all adults by September

The U.K. government plans to offer a first dose of COVID-19 vaccine to every adult by September as the nation’s health care system battles the worst crisis in its 72-year-history.

Foreign Secretary Dominic Raab said Sunday that the government will soon begin a trial of round the clock injections at some locations as it continues to add more vaccination sites to increase the pace of delivery. The National Health Service opened a mass vaccination center on Saturday at the historic Salisbury Cathedral, where injections were accompanied by organ music.

“Our target is by September to have offered all the adult population a first dose,” he told Sky News. “If we can do it faster than that, great, but that’s the road map.”

9:21 AM CT on 1/17/2021

(AP) The U.K. government plans to offer a first dose of COVID-19 vaccine to every adult by September as the nation’s health care system battles the worst crisis in its 72-year-history.

Foreign Secretary Dominic Raab said Sunday that the government will soon begin a trial of round the clock injections at some locations as it continues to add more vaccination sites to increase the pace of delivery. The National Health Service opened a mass vaccination center on Saturday at the historic Salisbury Cathedral, where injections were accompanied by organ music.

“Our target is by September to have offered all the adult population a first dose,” he told Sky News. “If we can do it faster than that, great, but that’s the road map.”

Britain has more than 51 million adults in its population of 67.5 million people.

The ambitious vaccination program comes amid crushing pressures on the National Health Service. Already beleaguered hospitals are admitting another COVID-19 patient every 30 seconds, putting the service in its most precarious situation ever, said Simon Stevens, chief executive of NHS England.

“The facts are very clear and I’m not going to sugarcoat them, hospitals are under extreme pressure and staff are under extreme pressure,” he told the BBC. “Since Christmas Day we’ve seen another 15,000 increase in the in-patients in hospitals across England. That’s the equivalent of filling 30 hospitals full of coronavirus patients.”

Britain’s health care system is staggering as doctors and nurses battle a more contagious variant of the coronavirus coupled with cold, wet winter weather that drives people inside, where infections spread more easily.

The surge in infections has pushed the number of people hospitalized with COVID-19 to a record 37,475, more than 73% higher than during the first peak of the pandemic in April. Britain has reported 88,747 coronavirus-related deaths, more than any other country in Europe and the fifth-highest number worldwide.

8:14 PM CT on 1/16/2021

(AP) Mexico posted its second straight day of more than 20,000 coronavirus cases Saturday, suggesting a surge in a country already struggling in many areas with overflowing hospitals.

There were 20,523 newly confirmed cases Saturday after 21,366 infections were reported Friday. That was about double the daily rate of increase just a week ago. Reporting normally declines on weekends, suggesting next week may bring even higher numbers.

The country also recorded 1,219 more deaths, a near-record. The country has now seen almost 1.63 million total infections and has registered over 140,000 deaths so far in the pandemic.

In Mexico City, the current center of the pandemic in Mexico, 88% percent of hospital beds are full.

7:03 PM CT on 1/16/2021

(AP) Louisiana has identified the state’s first case of a coronavirus variant believed to be more transmissible than the original.

The governor's office said Saturday the case was detected in a person in the New Orleans area.

The variant, first detected in Britain, has alarmed officials in many nations because studies indicate it may spread more easily than other viral strains, though it it is not believed to be more deadly and appears to be vulnerable to vaccines.

Gov. John Bel Edwards issued a statement saying it is urgent “that everyone double down on the mitigation measures that we know are effective in reducing the spread of the virus.”

Edwards noted that the variant has been detected in at least 15 other states.

In neighboring Texas, health officials in Dallas County on Saturday reported the state's third case of the variant, this one in a Dallas man in his 20s with no history of travel outside the United States.

Texas reported a Houston-area man as its first case of a person infected with the new variant on Jan. 7.

3:03 PM CT on 1/16/2021

(AP) President-elect Joe Biden introduced his team of scientific advisers on Saturday, saying they will lead with “science and truth. We believe in both.”

Biden is elevating the position of science adviser to Cabinet level, a White House first. He called Eric Lander, a pioneer in mapping the human genome is in line to be director of the Office of Science and Technology Policy, “one of the most brilliant guys I know.”

Lander is the founding director of the Broad Institute of MIT and Harvard and was the lead author of the first paper announcing the details of the human genome.

Lander says Biden has tasked his advisers and “the whole scientific community and the American public” to “rise to this moment.”

Vice President-elect Kamala Harris recalled her late mother Shyamala Gopalan Harris, a cancer researcher, who she credited with teaching her to think critically.

“The science behind climate change is not a hoax. The science behind the virus is not partisan,” Harris said. “The same laws apply, the same evidence holds true regardless of whether or not you accept them.”

As the rollout of coronavirus vaccines begins, the U.S. leads the world with 23.6 million cases and more than 393,000 confirmed deaths.

12:03 PM CT on 1/16/2021

(AP) South Dakota is looking to build on one of the nation's fastest COVID-19 vaccinations rollouts so far by making vaccines available to a much larger group of people, though some health care providers are cautioning that vulnerable people in rural areas could be left behind in the rush.

South Dakota has vaccinated 6.5% of the population, one of the highest rates in the country, and distributed over 60% of the vaccine doses it has received from the federal government.

Secretary of Health Kim Malsam-Rysdon announced that the state will begin vaccinating people age 80 and over, as well as people with high-risk medical conditions, on Monday. It is almost done vaccinating medical workers and residents of long-term care facilities, which have been hard-hit by the virus.

While other states have seen clunky roll-outs and jammed lines for vaccine appointments, the distribution program in South Dakota has been relatively smooth. That's thanks to a partnership between the Department of Health and the major hospital systems, which have handled the distribution and administration of shots.

The Department of Health and hospital systems have been preparing for months for the arrival of vaccines. They pored over a map of the state and divided it between the hospital systems, marking each county for which hospital system would handle vaccine distribution, said Dr. Jeremy Caulwels, the chief physician at Sanford Health.

Caulwels described the move to vaccinate patients who live in the community as one of the most exciting developments in the battle against the coronavirus.

“Hopefully this represents the beginning of the end,” he said.

Sanford has purchased ultra-cold freezers and set them up at strategic locations across the region so that vaccines can be stored and rapidly deployed where they are needed. At one site in Sioux Falls, freezers keep vaccines ready for use at a distribution site across the street that can administer up to 2,000 shots in a day, Caulwels said.

He acknowledged that the next phase of administering vaccines could be a challenge, as roughly 300,000 become eligible for shots. He said they are tackling that by breaking the group into “bite-size” pieces and utilizing an electronics records system and hospital network that is designed to follow patients as they receive medical care across the mostly rural state.

But as vaccines become available to communities across the state, some health care providers in rural areas are worried their patients will be left behind by the reliance on large hospital systems, according to Lori Dumke, the director of clinical and quality services at Community HealthCare Association of the Dakotas, which represents medical clinics in rural areas.

"What if you have 75 miles to drive to your closest Sanford or Avera clinic?” Dumke said.

She said that the physicians who tend to the people in rural communities are used to overcoming barriers like a lack of access to the internet or concerns over the safety of vaccines, but so far, they have been mostly kept out of the vaccination plans.

Dumke compared the plan in South Dakota to North Dakota, where shots have also been given at one of the highest rates in the nation. In that state, local health care providers and county health departments are providing vaccines that are distributed based on population.

“We need to focus on getting as many high-risk patients as possible distributed to stop COVID," she said. “To have equal distribution across the state is imperative for that to happen.”

9:50 AM CT on 1/16/2021

(AP) Germany has carried out more than a million vaccinations as new infections and deaths remain high and officials mull whether to increase lockdown measures.

Figures released by the national disease control center, the Robert Koch Institute, on Saturday showed nearly 1.05 million vaccinations have been recorded — 79,759 more than a day earlier — in the nation of 83 million people.

Chancellor Angela Merkel and the country’s 16 state governors will consult Tuesday on how to proceed with lockdown measures, which are currently due to expire on Jan. 31.

On Saturday, Germany recorded 18,678 confirmed cases in the previous 24 hours and another 980 deaths. It says there have been 139 cases per 100,000 residents in the past seven days -- far above the maximum of 50 authorities want to reach.

6:12 PM CT on 1/15/2021

(AP) President-elect Joe Biden pledged Friday to boost supplies of coronavirus vaccine and set up new vaccination sites to meet his goal of 100 million shots in 100 days. It's part of a broader COVID strategy that also seeks to straighten out snags in testing and ensure minority communities are not left out.

“Some wonder if we are reaching too far,” Biden said. “Let me be clear, I'm convinced we can get it done.”

The real payoff, Biden said, will come from uniting the nation in a new effort grounded in science.

Biden spoke a day after unveiling a $1.9 trillion “American Rescue Plan” to confront the virus and provide temporary support for a shaky economy. About $400 billion of the plan is focused on measures aimed at controlling the virus. Those range from mass vaccination centers to more sophisticated scientific analysis of new strains and squads of local health workers to trace the contacts of infected people.

“You have my word: We will manage the hell out of this operation,” Biden declared. He underscored a need for Congress to approve more money and for people to keep following basic precautions, such as wearing masks, avoiding gatherings and frequently washing their hands.

Throughout the plan, there’s a focus on ensuring that minority communities that have borne the brunt of the pandemic are not shortchanged on vaccines and treatments.

A key challenge for Biden and the nation: Vaccines are in too-short supply.

Biden said he would use the Defense Production Act, a Cold War-era law, to boost vaccine supplies and work with the Federal Emergency Management Agency to set up 100 vaccination centers around the country by the end of his first month in office.

“Almost a year later, we’re still far from back to normal. The honest truth is this: Things will get worse before they get better," he said Friday, as U.S. deaths climbed closer to 400,000. The global toll has now reached 2 million.

Biden seconded the Trump administration's call earlier this week for states to start vaccinating more seniors, reaching those 65 and older as well as younger people with certain health problems. Until now states have been focused on inoculating health care workers, and some are starting to vaccinate people 75 and older. Relatively few are providing shots to people between 65 and 75.

Another carryover from the Trump administration plan: Biden said he intends to mobilize local pharmacies to administer vaccines.

“Is it achievable?" he asked. "It’s a legitimate question to ask. Let me be clear. I’m convinced we can get it done.”

In fact, Dr. Leana Wen, a public health expert and emergency physician, said the president-elect should aim higher.

“At this point, mass vaccination is our last and best chance to restoring normalcy,” she said. “There should be no expenses spared in the vaccine rollout. A hundred million in 100 days needs to be seen as only a start."

Two medical groups, the Infectious Diseases Society of America and the HIV Medicine Group, said Friday evening they “strongly support” the Biden plan. The strategy “will be vital to ending the impacts of COVID-19” in the U.S., the groups said.

As Biden spoke, some governors blasted the Trump administration for what at least one said was “deception” in suggesting earlier this week that a reserve of vaccine doses was ready to ship, augmenting supplies. An administration official said states have still not ordered all of the doses allocated to them, and called it a problem with states' expectations.

Biden committed to better communication with the states, to avoid such surprises. His plan calls for the federal government to fully reimburse states that mobilize their National Guards to help distribute vaccines.

Biden's proposal comes as a divided nation is in the grip of the pandemic’s most dangerous wave yet. “We remain in a very dark winter,” he said.

The political outlook for the legislation remains unclear, although a powerful business lobbying group, the U.S. Chamber of Commerce, welcomed its focus on controlling the pandemic.

“This is not a political issue,” Biden said. “This is about saving lives. I know it’s become a partisan issue, but what a stupid, stupid thing to happen.”

Biden has long held that economic recovery is inextricably tied to control of the coronavirus.

Under Biden's multipronged strategy, about $20 billion would be allocated for a more disciplined focus on vaccination, on top of some $8 billion already approved by Congress. Biden has called for setting up mass vaccination centers and sending mobile units to hard-to-reach areas.

On Friday, he announced former FDA chief David Kessler as his chief science officer for the vaccine drive. Kessler has been advising Biden as a co-chair of his advisory board on the coronavirus pandemic. A pediatrician and attorney, he has emphasized a need to ease public concerns about the safety of the vaccines.

With the backing of Congress and the expertise of private and government scientists, the Trump administration delivered two highly effective vaccines and more are on the way. Yet a month after the first shots were given, the nation’s vaccination campaign is off to a slow start with about 12.3 million doses administered out of more than 31 million delivered, or 39%.

About 10.6 million individuals have received first or second doses, according to the Centers for Disease Control and Prevention. But the American Hospital Association estimates that 246 million must be vaccinated to reach widespread or “herd” immunity by the summer. Vaccines currently available require two shots to be fully effective.

Biden has called the vaccine rollout “a dismal failure so far."

“We need to be getting to more than 3 million vaccinations a day, rapidly,” said Wen.

Biden's plan also would provide $50 billion to expand testing, which is seen as key to reopening most schools by the end of the new administration's first 100 days. About $130 billion would be allocated to help schools reopen without risking further contagion.

The plan would fund the hiring of 100,000 public health workers, to focus on encouraging people to get vaccinated and on tracing the contacts of those infected with the coronavirus. The Biden administration also plans to launch a public education campaign to overcome doubts about vaccination.

4:29 PM CT on 1/15/21

(AP) The global death toll from COVID-19 topped 2 million Friday as vaccines developed at breakneck speed are being rolled out around the world in an all-out campaign to vanquish the threat.

The milestone was reached just over a year after the coronavirus was first detected in the Chinese city of Wuhan.

The number of dead, compiled by Johns Hopkins University, is about equal to the population of Brussels, Mecca, Minsk or Vienna. It is roughly equivalent to the population of the Cleveland metropolitan area or the entire state of Nebraska.

While the count is based on figures supplied by government agencies around the world, the real toll is believed to be significantly higher, in part because of inadequate testing and the many fatalities that were inaccurately attributed to other causes, especially early in the outbreak.

It took eight months to hit 1 million dead. It took less than four months after that to reach the next million.

“Behind this terrible number are names and faces — the smile that will now only be a memory, the seat forever empty at the dinner table, the room that echoes with the silence of a loved one,” said U.N. Secretary General Antonio Guterres. He said the toll “has been made worse by the absence of a global coordinated effort.”

“Science has succeeded, but solidarity has failed,” he said.

In wealthy countries including the United States, Britain, Israel, Canada and Germany, millions of citizens have already been given some measure of protection with at least one dose of vaccine developed with revolutionary speed and quickly authorized for use.

But elsewhere, immunization drives have barely gotten off the ground. Many experts are predicting another year of loss and hardship in places like Iran, India, Mexico and Brazil, which together account for about a quarter of the world’s deaths.

2:15 PM CT on 1/15/21

Health officials say by March, a new and more infectious strain of coronavirus — first found in the United Kingdom — will likely become the dominant strain in the United States.

The UK variant currently is in 12 states but has been diagnosed in only 76 of the 23 million U.S. cases reported to date. However, it’s likely that version of the virus is more widespread in this country than is currently reported, according to scientists at the U.S. Centers for Disease Control and Prevention.

While it’s considered more infectious than the virus that’s been causing the bulk of U.S. cases so far, there’s no evidence that it causes more severe illness or is transmitted differently. Therefore, mask wearing, social distancing and hand washing and other prevention strategies can still work, the CDC says.

2:15 PM CT on 1/15/21

At nursing homes across the country, residents are stepping up for a shot of what Mary Lynn Spalding, CEO of Christian Care Communities, calls "liquid gold." But staff have been more hesitant to receive a COVID-19 vaccine.

The Kentucky-based senior-living provider's staff vaccination rate was at about 60% after the first round of on-site clinics in late December. Since then, more workers have signed up to receive the vaccine, Spalding said.

"I think we're going to continue to see our numbers increase as consumers get more comfortable," Spalding said.

But it's unclear if that optimism will translate to other nursing homes across the country. As of Jan. 3, about 50% of nursing home workers were declining to be vaccinated against COVID-19, said Ruth Katz, senior vice president of policy at LeadingAge, an association representing aging services providers.

"It does look like there's clearly some room for all of us to make some progress," Katz said during a LeadingAge webinar.

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11:41 AM CT on 1/15/21

(AP) Howard Jones, who's 83, was on the phone for three to four hours every day trying to sign up for a coronavirus vaccine.

Jones, who lives alone in Colorado Springs, doesn't have the internet, and that's made it much more difficult for him to make an appointment. It took him about a week. He said the confusion has added to his anxiety about catching what could be a life-threatening disease at his age.

"It has been hell," Jones said. "I'm 83 and to not have the use of a computer is just terrible."

As states across the U.S. roll out the COVID-19 vaccine to people 65 and older, senior citizens are scrambling to figure out how to sign up to get their shots. Many states and counties ask people to make appointments online, but glitchy websites, overwhelmed phone lines and a patchwork of fast-changing rules are bedeviling older people who are often less tech-savvy, may live far from vaccination sites and are more likely to not have internet access at all, especially people of color and those who are poor.

Nearly 9.5 million seniors, or 16.5% of U.S. adults 65 and older, lack internet access, according to U.S. Census Bureau data. Access is worse for seniors of color: more than 25% of Black people, about 21% of Hispanic people and over 28% of Native Americans 65 and older have no way to get online. That's compared with 15.5% of white seniors.

Some health officials have been trying to find other solutions to ease the confusion and help senior citizens sign up, just as the Trump administration urged states this week to make the nation's 54 million seniors eligible for the COVID-19 vaccine.

Some places have found simple ideas work. In Morgantown, West Virginia, county health officials used a large road construction sign to list the phone number for seniors to call for an appointment. Others are considering partnering with community groups or setting up mobile clinics for harder-to-reach populations.

Some seniors may be waiting to hear from their doctor. But there are limits to using healthcare systems, pharmacies or primary-care providers to reach underserved people who don't have the internet, said Claire Hannan, executive director of the Association of Immunization Managers.

She said the two coronavirus vaccines available in the U.S. and their cold temperature requirements "don't lend themselves to being sent out to rural areas."

9:36 AM CT on 1/15/21

(AP) The coronavirus vaccines have been rolled out unevenly across the U.S., but four states in the Deep South have had particularly dismal inoculation rates that have alarmed health experts and frustrated residents.

In Alabama, Georgia, Mississippi and South Carolina, less than 2% of the population had received its first dose of a vaccine at the start of the week, according to data from the states and the U.S. Centers for Disease Control and Prevention.

As in other parts of the country, states in the South face a number of challenges: limited vaccine supplies, healthcare workers who refuse to get inoculated and bureaucratic systems that are not equipped to schedule the huge number of appointments being sought.

But other states have still managed — at their best — to get the vaccines into the arms of more than 5% of their populations.

Though it's not clear why the Deep South is falling behind, public health researchers note that it has typically lagged in funding public health and addressing disparities in care for its big rural population.

"When you combine a large percentage of rural residents who tend to be the hard-to-reach populations and have lower numbers of providers with trying to build a vaccine infrastructure on the fly, that's just a recipe for a not-so-great response," said Sarah McCool, a professor in public health at Georgia State University.

In Georgia, the state's rural health system has been decimated in recent years, with nine hospital closures since 2008, including two last year. Local health departments have become the primary vaccine providers in some locations, as officials work to add sites where doses can be administered.

Alabama and Mississippi have also been hit hard by rural hospital closures. Seven hospitals have shut down in Alabama since 2009 and six in Mississippi since 2005, according to researchers at the University of North Carolina's Sheps Center. Alabama, Georgia and Mississippi ranked in the bottom five of U.S. states in their access to health care, according to a 2020 report from a not-for-profit foundation connected to insurance giant UnitedHealth.

But overall, experts say it's too early in the vaccine rollout to draw conclusions about the region's shortcomings, and they can't easily be attributed to a particular factor or trend.

"We're sort of building this plane as we're flying, and there are going to be missteps along the way," said Amber Schmidtke, a microbiologist who has been following vaccine dissemination in the South.

8:39 PM CT on 1/14/21

(AP) Dozens of COVID-19 patients in the Amazon rainforest's biggest city will be flown out of state as the local health system collapses, authorities announced Thursday as dwindling stocks of oxygen tanks meant some people were starting to die breathless at home.

Doctors in Manaus, a city of 2 million people, were choosing which patients to treat, and at least one of the city’s cemeteries asked mourners to line up to enter and bury their dead. Patients in overloaded hospitals waited in despair throughout the day as oxygen cylinders arrived to save some, but came too late for others.

The strains prompted Amazonas state's government to say it would transport 235 patients who depend on oxygen but aren't in intensive-care units to five other states and the federal capital, Brasilia.

“I want to thank those governors who are giving us their hand in a human gesture,” Amazonas Gov. Wilson Lima said at a news conference on Thursday.

"All of the world looks at us when there is a problem as the Earth’s lungs," he said, alluding to a common description of the Amazon. "Now we are asking for help. Our people need this oxygen.”

Many other governors and mayors elsewhere in the country offered help later amid a flood of social media videos in which distraught relatives of COVID-19 patients in Manaus asked followers to buy oxygen for them.

Brazilian Vice President Hamilton Mourão said on Twitter that the country's air force had taken more than eight tons of hospital items including oxygen cylinders, beds and tents to Manaus.

Federal prosecutors in the city, however, asked a local judge to put pressure on President Jair Bolsonaro's administration to step up its support. The prosecutors said later in the day that the main air force plane in the region for oxygen supply transportation “needs repair, which brought a halt to the emergency influx.”

Neither air force nor the federal health ministry answered a request for comment from The Associated Press.

The U.S Embassy in Brasilia confirmed it had received a request from local authorities to give support to the initiative, without providing details.

Manaus authorities recently called on the federal government to reinforce their dwindling stock of oxygen needed to keep COVID-19 patients breathing. The city’s 14-day death toll is approaching the peak of last year’s first wave of the coronavirus pandemic, according to official data.

6:54 PM CT on 1/14/21

(AP) New Yorkers lined the sidewalks and cars jammed the streets near a Brooklyn coronavirus vaccine site Thursday after false rumors spread of extra doses available to the general public.

Messages spread online claimed several hundred doses had to be given out by Thursday evening and that any adult was welcome, whether they had an appointment or not.

The resulting chaos near the Brooklyn Army Terminal brought out police and city workers to tell people that no, it wasn't true and vaccinations are appointment-only, and for certain populations according to priority.

Online, mayoral spokesman Bill Neidhardt said on Twitter, “There is NOT available vaccine for people without appointments. This was misinformation and the notification did not come from the NYC gov."

There is high demand for the vaccine, which in New York state is currently available for people 65 and over, healthcare workers and those in certain key professions like police officers and teachers.

4:27 PM CT on 1/14/21

(AP) Health mandates issued in Anchorage helped reduce the spread of the coronavirus last year, a new Alaska Division of Public Health report said.

The report released this week said a June mask mandate was responsible for reducing case counts in Alaska's largest city by almost 20%.

The study found there was a 60% decline in coronavirus transmission in the month after the mask mandate went into effect.

Additional transmission drops happened after two emergency orders by former Anchorage Mayor Ethan Berkowitz were implemented in July and August. They limited capacity in bars, restaurants, gyms and indoor public venues.

The business capacity restrictions and month-long shutdown dropped transmissions more than 30%, the report said.

The report evaluated a wide range of data gathered before, after and during Anchorage's early "hunker down" emergency orders to track their effectiveness.

Through August "exponential growth not only slowed, but was reversed," the report said.

"They definitely were followed by sharp reduction in the spread of COVID-19, which was the goal. And they proved to be effective in reducing transmission in the city," said Dr. Thomas Hennessy, a University of Alaska infectious disease epidemiologist and one of the report's authors.

2:05 PM CT on 1/14/21

(AP) Florida's director of emergency management said Thursday that a statewide appointment system for COVID-19 vaccinations should be ready within weeks, bringing order to the chaos marking Florida's rollout of vaccines to its most vulnerable residents.

Director Jared Moskowitz described plans for the online portal in an appearance before a legislative House committee holding hearings on the pandemic in Tallahassee.

Gov. Ron DeSantis has made it a priority to provide coronavirus vaccines to seniors 65 and older, prompting a crush in demand. State health officials mostly left it to hospitals and county health departments to administer the vaccines, and some seniors camped out in long lines outside vaccination sites, only to be turned away when supplies ran out.

"I know it feels chaotic — 67 different counties, systems and interpretations — but healthcare is delivered at the local level," Muskowitz told lawmakers. He said a registration system could help alleviate the strain counties are now under as they deliver vaccinations.

"We're working on a registration system that we plan to launch in the coming weeks to help integrate site registration and fix some of the problems that we've all read about," he said.

The design of a statewide online portal is still under discussion and will be made available to counties — who are not required to use the system — to help them coordinate vaccinations.

Since then, the governor has sought to widen the number of vaccination sites. The state is receiving $194 million from the federal government to help distribute the vaccines.

As of Wednesday, about 774,000 Floridians had at least one shot of two vaccines approved by the federal government. More than 1.5 million people have tested positive for the virus in the state since the pandemic began; nearly 24,000 have died.

State Rep. Carlos Guillermo Smith, a Democrat from the Orlando area, wants state officials to further expand vaccination sites and to give seniors who might not have access to computers and online portals an opportunity to register for vaccinations through their phones or in-person.

"It should not be an online-only system," he said. He also urged state officials to do a better job in reaching out to communities, particularly those of color, that might be reluctant to trust in the vaccine.

2:05 PM CT on 1/14/21

As COVID-19 immunization speeds up across the U.S., vaccine makers hope the country will reach mass immunization by the summer and be the first country of its size to meet that goal.

In a panel at the virtual J.P. Morgan Healthcare Conference on Wednesday, Moderna CEO Stephane Bancel said that if the Moderna and Pfizer vaccines' distribution continues to go smoothly, 400 million vaccines will have reached 70% of the U.S. population by the end of the second quarter of 2021. While smaller countries like Israel may reach herd immunity earlier, the timeline would still put the U.S. ahead of some of its peers.

"I think Europe will be much later," Bancel said. "I would not be surprised if it takes Europe through the end of the year to get good immunization across the country."

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11:42 AM CT on 1/14/21

(AP) A coronavirus action plan from President-elect Joe Biden centers on a mass vaccination campaign and closer coordination among all levels of government.

The plan comes as more than 380,000 Americans have died.

Biden hopes his multidimensional strategy will put the country on the path to recovery, aiming for 100 million vaccinations in his administration’s first 100 days.

The nation’s vaccination campaign is off to a slow start. About 10.3 million people received the first of two shots, although more than 29 million doses have been delivered.

As part of the plan to be unveiled in a speech Thursday evening, Biden will ask Americans to recommit to wearing masks, practicing social distancing and avoiding indoor gatherings.

A record of more than 4,400 deaths were reported on Tuesday.

9:54 AM CT on 1/14/21

(AP)  A global team of researchers arrived Thursday in the Chinese city where the coronavirus pandemic was first detected to conduct a politically sensitive investigation into its origins amid uncertainty about whether Beijing might try to prevent embarrassing discoveries.

The group sent to Wuhan by the World Health Organization was approved by President Xi Jinping's government after months of diplomatic wrangling that prompted an unusual public complaint by the head of WHO.

Scientists suspect the virus that has killed more than 1.9 million people since late 2019 jumped to humans from bats or other animals, most likely in China's southwest. The ruling Communist Party, stung by complaints it allowed the disease to spread, has suggested the virus came from abroad, possibly on imported seafood, but international scientists reject that.

The team includes virus and other experts from the United States, Australia, Germany, Japan, Britain, Russia, the Netherlands, Qatar and Vietnam.

A government spokesman said this week they will "exchange views" with Chinese scientists but gave no indication whether they would be allowed to gather evidence.

8:23 PM CT on 1/13/21

(AP) A Las Vegas hospital said Wednesday that it declared a capacity crisis over the weekend, citing a surge of COVID-19 patients that overfilled its intensive care unit.

With nearly half its 147 beds occupied by coronavirus patients, St. Rose Dominican Hospital's San Martin campus in southwest Las Vegas canceled elective surgeries beginning Saturday and pressed units like post-anesthesia recovery, maternal-child and same-day surgery into service for non-COVID-19 patients, according to a hospital memo to medical staff.

"San Martin has moved into a Level 2 disaster declaration due to COVID-19," the memo said, which means the number of patients had surpassed resources. At the time, the hospital had exceeded its overall capacity.

Patients were not turned away, hospital spokesman Gordon Absher said Wednesday, and the surge capacity plan was slated to stay in effect until Jan. 22.

"The actions we've taken have made things more manageable," Absher said.

The disaster declaration was first reported  by the Las Vegas Review-Journal. Two other St. Rose hospitals in the area have not issued disaster declarations but also are strained, Absher told the newspaper.

5:51 PM CT on 1/13/21

(AP) California is immediately allowing residents 65 and older to get scarce coronavirus vaccines, Gov. Gavin Newsom announced Wednesday.

The move puts seniors in line before emergency workers, teachers, childcare providers and food and agriculture workers even as counties complain they already don't have enough doses to go around.

"There is no higher priority than efficiently and equitably distributing these vaccines as quickly as possible to those who face the gravest consequences," Gov. Gavin Newsom said in a statement. "To those not yet eligible for vaccines, your turn is coming. We are doing everything we can to bring more vaccine into the state."

While health care workers and those in nursing homes and other congregate living facilities can still be vaccinated, state officials are expanding the program to those 65 and up because they are at the greatest risk of being hospitalized and dying.

A growing list of states that includes Florida, New York and Oregon either already are offering vaccines to that age group or have announced plans to do so.

In California, virus cases and hospitalizations have exploded since Thanksgiving, though in recent days the numbers have flattened.

"With our hospitals crowded and ICUs full, we need to focus on vaccinating Californians who are at highest risk of becoming hospitalized to alleviate stress on our health care facilities," said Dr. Tomás Aragón, director of the California Department of Public Health and the state's Public Health Officer. "Prioritizing individuals age 65 and older will reduce hospitalizations and save lives."

4:13 PM CT on 1/13/21

(AP) Hours after South Carolina opened up access to the coronavirus vaccine for seniors Wednesday morning, people trying to schedule their shots inundated hospitals and the health department with thousands of phone calls.

By Wednesday afternoon, more than one hospital said it had already run out of appointment slots.

It was the first day people ages 70 and older could register to get the COVID-19 vaccine in the state. Until Wednesday, the Department of Health and Environmental Control had limited vaccine access to mostly healthcare workers and those living and working in long-term care facilities. Some people in those groups are still being vaccinated.

The DHEC hotline helping people find vaccine sites was "experiencing higher than usual call volumes and wait times" by Wednesday morning, according to the department's website. More than 5,000 calls came in that morning, leading the agency to double the number of call center operators through a contractor, interim Public Health Director Brannon Traxler said.

Health officials have said they are using an appointment-only system to avoid the long lines and wait times seen in some other states.

On Wednesday, Conway Medical Center said it had reached appointment capacity "due to an overwhelming response with thousands of requests."

Kershaw Health in Camden implored people not to call its hospitals or physicians offices to schedule vaccine appointments after receiving more than 1,000 vaccination requests in two days. The health system said it was receiving only 150 to 200 doses of the vaccine a week.

Hospitals and health officials urged patience as the state onboards more vaccine providers. On Wednesday, DHEC said it was also looking to hire 150 or more people to staff the agency's own vaccination clinics.

2:11 PM CT on 1/13/21

(AP) Wolf administration officials said Wednesday the state does not have the money to maintain a key feature of its response to coronavirus outbreaks in Pennsylvania's nursing homes, and are working to retain a short-term, scaled-down model now that federal funding ran out.

Human Services Secretary Teresa Miller told reporters that the Wolf administration is running a scaled-down version of a program that distributed $175 million in federal coronavirus aid to 11 regional health systems or health organizations to help contain outbreaks in nursing homes.

Miller said the partnership had helped save lives in the state's roughly 2,000 long-term care facilities, and that Gov. Tom Wolf's administration will keep asking the federal government for more money to continue the program.

In the meantime, the state is using up to $6 million through the Federal Emergency Management Agency to maintain rapid response services through Feb. 28 and another $28 million over the coming months to support testing, officials said.

One key difference will be the duration and size of a response involving staffing support, said Keara Klinepeter, a Department of Health official.

Fewer support staff would be deployed and they would stay for three to five days, rather than periods of more like two weeks under the federally funded program, Klinepeter said.

More than 740,000 people have tested positive in Pennsylvania and more than 18,400 have died, including almost 10,000 in long-term care facilities, according to state data.

2:11 PM CT on 1/13/21

Moderna's top doctor on Monday cautioned against giving patients only half doses of its COVID-19 vaccine in an attempt to inoculate more people, saying there isn't data to prove its efficacy.

Chief Medical Officer Dr. Tal Zaks said at the J.P. Morgan Healthcare Conference, which kicked off virtually on Monday, that the company is studying the question but has only preliminary findings to date. Once it has more information, he said the company will discuss the issue with regulators. Moderna's data showing the vaccine is 94% effective is based on two doses administered four weeks apart.

"On cutting the dose in half, we're advocating for following the data and the science," Zaks said. "We do not have data on efficacy for half the dose."

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11:48 AM CT on 1/13/21

(AP) A trade group representing chain pharmacies says its members can “easily” meet President-elect Joe Biden’s goal of administering 100 million coronavirus vaccines in the first 100 days of his administration.

The National Association of Chain Drug Stores says “the existing retail pharmacy network—where 90% of Americans live within 5 miles of a store—can swiftly and efficiently accelerate the vaccination of priority populations.”

The group spoke a day after the Trump administration expanded the number of Americans who can receive vaccines to include all seniors and younger people with certain health conditions.

The drug store group called for activating an arrangement known as the Federal Pharmacy Partnership Program, under which the Trump administration had planned to enlist pharmacies later in the vaccination campaign. It means the government would have to start delivering vaccines to pharmacies.

The association estimated that each of 40,000 chain pharmacies would have to give seven shots per hour over a 12-hour day to meet the Biden goal. But the group says drug stores using several employees to provide shots would actually exceed that estimate.

9:53 AM CT on 1/13/21

(AP) Coronavirus deaths in the U.S. hit another one-day high at over 4,300 with the country's attention focused largely on the fallout from the deadly uprising at the Capitol.

The nation's overall death toll from COVID-19 has eclipsed 380,000, according to Johns Hopkins University, and is closing in fast on the number of Americans killed in World War II, or about 407,000. Confirmed infections have topped 22.8 million.

With the country simultaneously facing a political crisis and on edge over threats of more violence from far-right extremists, the U.S. recorded 4,327 deaths on Tuesday by Johns Hopkins' count. Arizona and California have been among the hardest-hit states.

The daily figure is subject to revision, but deaths have been rising sharply over the past 2 1/2 months, and the country is now in the most lethal phase of the outbreak yet, even as the vaccine is being rolled out. New cases are running at nearly a quarter-million per day on average.

More than 9.3 million Americans have received their first shot of the vaccine, or less than 3% of the population, according to the Centers for Disease Control and Prevention. That is well short of the hundreds of millions who experts say will need to be inoculated to vanquish the outbreak.

The effort is ramping up around the country. Large-scale, drive-thru vaccination sites have opened at stadiums and other places, enabling people to get their shots through their car windows.

Also, an increasing number of states have begun offering vaccinations to the next group in line — senior citizens — with the minimum age varying from place to place at 65, 70 or 75. Up to now, healthcare workers and nursing home residents have been given priority in most places.

And the Trump administration announced plans Tuesday to speed up the vaccination drive by releasing the whole supply of doses, instead of holding large quantities in reserve to make sure people get their second shot on time.

9:17 PM CT on 1/12/21

(AP) Anyone flying to the U.S. will soon need to show proof of a negative test for COVID-19, health officials announced Tuesday.

The Centers for Disease Control and Prevention requirement expands on a similar one announced late last month for passengers coming from the United Kingdom. The new order takes effect in two weeks.

COVID is already widespread in the U.S., with more than 22 million cases reported to date, including more than 375,000 deaths. The new measures are designed to try to prevent travelers from bringing in newer forms of the virus that scientists say can spread more easily.

The CDC order applies to U.S. citizens as well as foreign travelers. The agency said it delayed the effective date until Jan. 26 to give airlines and travelers time to comply.

International travel to the U.S. has already been decimated by pandemic restrictions put in place last March that banned most foreigners from Europe and other areas. Travel by foreigners to the U.S. and by Americans to international destinations in December was down 76% compared to a year earlier, according to trade group Airlines for America.

The new restrictions require air passengers to get a COVID-19 test within three days of their flight to the U.S., and to provide written proof of the test result to the airline. Travelers can also provide documentation that they had the infection in the past and recovered.

Airlines are ordered to stop passengers from boarding if they don’t have proof of a negative test.

“Testing does not eliminate all risk,” CDC Director Robert R. Redfield said in a statement. "But when combined with a period of staying at home and everyday precautions like wearing masks and social distancing, it can make travel safer, healthier, and more responsible by reducing spread on planes, in airports, and at destinations.”

The CDC order is “a reasonable approach” to reducing the risk of new variants from abroad entering the U.S., said Dr. Ashish Jha, dean of Brown University’s school of public health.

It’s likely that the recently identified version of the virus from the United Kingdom is “probably in every state or most states. This is going to do nothing for that,” Jha said. So far, 10 states have reported 72 cases of the variant.

But the new order may stop or diminish spread of other new versions of the virus, like one recently identified in South Africa.

“I can imagine other countries are going to impose (preflight testing) on us,” he added.

Airlines have been lobbying for preflight testing to replace broad travel restrictions between the U.S. and the rest of the world. In some cases, they have arranged for passengers to avoid quarantines after arrival by getting tested before their flight.

Testing “is key to unlocking international borders and safely reopening global travel,” said Nicole Carriere, a spokeswoman for United Airlines, one of three major U.S. carriers that flies to Europe and Asia.

Others say the CDC order is unlikely to cause an immediate spike in international travel.

“People are being encouraged by their public health authorities to not travel, even domestically,” said Henry Hartevedlt, a travel analyst for Atmosphere Research Group.

He doesn’t expect air travel to pick up until the summer when more people have been vaccinated.

6:57 PM CT on 1/12/21

HHS and the Department of Defense purchased 1.25 million additional treatment courses of Regeneron’s investigational monoclonal antibody therapeutic, which are slated to be delivered during the first half of the year. The treatment is used for non-hospitalized, high-risk COVID-19 patients. With this buy, the government will have over 1.5 million treatment courses.

“With COVID-19 cases continuing to rise, treating people with mild or moderate infections can help prevent hospitalizations, which will reduce the burden on healthcare systems,” said HHS Assistant Secretary for Preparedness and Response Dr. Robert Kadlec. “To ensure equitable and efficient distribution, we will continue coordinating with state and territorial health departments to get these additional therapeutics into the hands of healthcare providers quickly, with a focus on areas of the country currently hardest hit by the pandemic.”

Allocations to state and territorial health departments are based proportionally on confirmed COVID-19 cases in each state and territory over the previous seven days, based on data that hospitals and state health departments enter into the HHS Protect data collection platform.

4:39 PM CT on 1/12/21

(AP) A group of Tennessee doctors that has been pushing Gov. Bill Lee for a statewide mask mandate turned its attention to the legislature Tuesday, the first day of the 2021 legislative session.

Speaking to reporters via videoconference, Dr. Diana Sepehri-Harvey, a Franklin primary-care physician, addressed Lee's stance that individual personal responsibility, not a mandate, is the best way for Tennessee to fight the virus.

"This is a global pandemic, so cannot be fought by individuals," she said. "We need to come together with a cohesive response. We are asking our state representatives to do the job Gov. Lee has not."

Despite the severity of the coronavirus outbreak in Tennessee, where more than 7,800 people have died, it seemed unlikely that lawmakers would act on the call for a mask mandate. In the GOP-dominant General Assembly on Tuesday, neither the Senate nor the House speaker was requiring masks for lawmakers and few were wearing them.

Sepehri-Harvey is part of a group of more than 2,000 physicians that previously urged Lee to issue a stay-at-home order, which he did at the beginning of April. The group continues to urge Lee to issue a statewide mask mandate and to let science guide policy with regard to the virus.

2:09 PM CT on 1/12/21

(AP) The Austin area opened a field hospital in a convention center Tuesday as cases of the disease caused by the coronavirus continue to soar.

For now the facility has 25 beds and can expand if needed.

“This Alternate Care Site in central Texas will reduce the burden on local hospitals and help ensure that Texans diagnosed with COVID-19 receive the care they need,” Gov. Greg Abbott said in a statement.

Dr. Mark Escott, the interim Austin-Travis County health director, said last week that the convention center could be pressed into service as a field hospital as cases surge from gatherings for the Christmas and New Year’s holidays.

Other parts of Texas, including the Rio Grande Valley, opened make-shift hospitals last year as COVID-19 bore down.

Now Texas is working to rapidly ramp up vaccinations. Cities throughout the state are using new mass hubs for people to get shots, but the effort is still limited by the supply of medicine coming from the federal government.

Texas has seen a surge in newly confirmed coronavirus cases, hospitalizations and deaths. More than 13,000 COVID-19 patients were hospitalized statewide on Monday, state health officials reported, and nearly 30,000 people in the state have died since the pandemic started.

2:09 PM CT on 1/12/21

Johnson & Johnson expects to share clinical trial results for its much-anticipated one-dose COVID-19 vaccine candidate "very soon," company CEO Alex Gorsky said Monday.

Johnson & Johnson last year enrolled 45,000 patients into a phase three clinical trial for its vaccine candidate. Those patients are still being monitored.

"We're in the final stages of that analysis as we speak," Gorsky said at J.P. Morgan's annual healthcare conference. "We hope to have that information very soon."

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12:02 PM CT on 1/12/21

(AP) California is transforming baseball stadiums, fairgrounds and even a Disneyland Resort parking lot into mass vaccination sites as the coronavirus surge overwhelms hospitals and sets a deadly new record in the state.

California's COVID-19 death toll reached 30,000 on Monday, according to data collected by Johns Hopkins University.

It took six months for the nation's most populous state to reach 10,000 deaths but barely a month to jump from 20,000 to 30,000 deaths. California ranks third nationally for COVID-19-related deaths, behind Texas and New York, which is No. 1 with nearly 40,000.

Gov. Gavin Newsom and public health officials are counting on widespread vaccinations to help stem the tide of new infections, starting with medical workers and the most vulnerable elderly, such as those in care homes.

Newsom, a Democrat, acknowledged the rollout of vaccines has been too slow and he pledged 1 million shots will be administered this week, more than twice what's been done so far.

That effort will require what Newsom called an "all-hands-on-deck approach," including having vaccinations dispensed by pharmacists and pharmacy technicians, dentists, paramedics and emergency medical technicians, and members of the California National Guard.

Orange County, south of Los Angeles County, announced Monday that its first mass vaccination site will be at a Disneyland Resort parking lot in Anaheim. It's one of five sites to be set up to vaccinate thousands of people daily.

The sites are "absolutely critical in stopping this deadly virus," county Supervisor Doug Chaffee said in a statement.

The state will vastly expand its effort with new mass vaccination sites at parking lots for Dodger Stadium in Los Angeles, Petco Park in San Diego and the CalExpo fairgrounds in Sacramento.

9:43 AM CT on 1/12/21

(AP) The European Medicines Agency said Tuesday that AstraZeneca and Oxford University have submitted an application for their COVID-19 vaccine to be licensed across the European Union.

The EU regulator said it received a request for the vaccine to be green-lighted under an expedited process and that it could be approved by Jan. 29 "provided that the data submitted on the quality, safety and efficacy of the vaccine are sufficiently robust and complete."

The EMA, the drugs agency for the 27-nation EU, has already approved two other coronavirus vaccines, one made by American drugmaker Pfizer and Germany's BioNTech and another made by U.S. biotechnology company Moderna. Switzerland approved the Moderna vaccine on Tuesday and plans to immunize about 4% of its population using that and the Pfizer-BioNTech shot.

Britain gave its approval to the Oxford-AstraZeneca vaccine last month and has been using it. India approved it this month.

The Oxford-AstraZeneca vaccine is expected to be a key vaccine for many countries because of its low cost, availability and ease of use. It can be kept in refrigerators rather than the ultra-cold storage that the Pfizer vaccine requires. The company has said it will sell it for $2.50 a dose and plans to make up to 3 billion doses by the end of 2021.

Researchers claim the Oxford-AstraZeneca vaccine protected against disease in 62% of those given two full doses and in 90% of those initially given a half dose because of a manufacturing error. However, the second group included only 2,741 people -- too few to be conclusive.

Questions also remain about how well the vaccine protects older people. Only 12% of study participants were over 55 and they were enrolled later, so there hasn't been enough time to see whether they develop infections at a lower rate than those not given the vaccine.

The U.S. Food and Drug Administration says it will not consider approving the Oxford-AstraZeneca vaccine until data are available from late state research testing the shot in about 30,000 people.

8:25 PM CT on 1/11/2021

U.S. health officials have created a website to help people find where they can get antibody drugs for COVID-19, medicines that may help prevent serious illness and hospitalization if used early enough after infection occurs.

Two of these drugs — from Eli Lilly and Regeneron Pharmaceuticals — have been authorized for emergency use in the U.S. but red tape, health care staff shortages and other problems have prevented many patients and doctors from getting them.

Department of Health and Human Services officials said Monday that only 25% of the more than 641,000 treatment courses distributed to states and local health sites have been used as of last week.

A big problem has been finding a place that has the drugs. The web site includes a tool where people can find locations administering the treatment within 50 miles. Doctors will determine if patients meet the criteria. Treatment must start within 10 days of first symptoms.

The drugs are free, although people may be charged a fee for the IV infusion, a one-time treatment that takes about an hour.

5:53 PM CT on 1/11/2021

A new study finds during the first few months of the pandemic, patients were more likely to use telehealth services for behavioral health treatment than physical conditions. Click here to read more. 

4:22 PM CT on 1/11/21

(AP) President-elect Joe Biden received his second dose of the coronavirus vaccine on Monday, three weeks after getting his first one with television cameras rolling in an attempt to reassure the American public that the inoculations are safe.

Biden took off his sport jacket and said, "Ready, set, go." Chief Nurse Executive Ric Cumin administered the Pfizer vaccine at Christiana Hospital in Newark, Delaware, close to the president-elect's home.

Biden got his first shot on Dec. 21. The virus has now killed more than 375,000 people in the United States — about 60,000 more than when the president-elect got his first round of vaccination — and continues to upend life around the globe.

In comments to reporters after his shot, Biden said he has confidence in his COVID-19 medical team to hit ambitious vaccination rate targets after he takes office on Jan. 20. He also called the current rate of thousands of people dying daily because of the pandemic "beyond the pale."

"The No. 1 priority is getting vaccines in people's arms as rapidly as we can," Biden said.

Biden said he has a virtual meeting later Monday with his virus team and planned to outline more of his pandemic response plan on Thursday. His transition team has vowed to release as many vaccine doses as possible, rather than continuing the Trump administration policy of holding back millions of doses to ensure there would be enough supply to allow those getting the first shot to get a second one.

Biden's goal is to protect more people, more quickly, his team announced last week. The plan would not involve cutting two-dose vaccines in half, a strategy that top government scientists recommend against. Instead, it would accelerate shipment of the first doses and use the levers of government power to provide required second doses in a timely manner.

3:29 PM CT on 1/11/21

(AP) California's coronavirus catastrophe reached a staggering new level Monday as Johns Hopkins University data showed the nation’s most populous state has recorded more than 30,000 deaths since the pandemic started nearly a year ago.

Deaths have exploded since a COVID-19 surge began in October. It took California six months to record its first 10,000 deaths. But in barely a month, the total rose from 20,000 to 30,000.

Over the weekend, state officials reported a two-day record of 1,163 deaths. Hospitalizations also have exploded and many hospitals are stretched to the limit.

California ranks third nationally in coronavirus deaths, behind Texas and New York, which is in the No. 1 position with nearly 40,000.

Health officials have warned the worst is yet to come later this month, when there’s full picture on infections from the holidays.

In Los Angeles County, deaths have topped 12,000 and confirmed coronavirus cases have surpassed 900,000.

During the weekend, county Public Health Director Barbara Ferrer characterized the spread of the virus as “immense” and said it reflected unsafe things people did during the holidays, making any activity outside a household much more risky.

“This is just not the time to go to the shopping mall or to a friend’s house to watch a basketball or football game,” Ferrer said.

2:06 PM CT on 1/11/21

(AP) The World Health Organization's chief scientist warned that even as numerous countries start rolling out vaccination programs to stop COVID-19, herd immunity is highly unlikely this year.

At a media briefing on Monday, Dr. Soumya Swaminathan said it was critical that countries and their populations maintain strict social distancing and other outbreak control measures for the foreseeable future. In recent weeks, Britain, the U.S., France, Canada, Germany, Israel, the Netherlands and others have begun vaccinating millions of their citizens against the coronavirus.

"Even as vaccines start protecting the most vulnerable, we're not going to achieve any levels of population immunity or herd immunity in 2021," Swaminathan said. "Even if it happens in a couple of pockets, in a few countries, it's not going to protect people across the world."

Scientists typically estimate that a vaccination rate of about 70% is needed for herd immunity, where entire populations are protected against a disease. But some fear that the extremely infectious nature of COVID-19 could require a significantly higher threshold.

Dr. Bruce Aylward, an adviser to WHO's director-general, said the U.N. health agency was hoping coronavirus vaccinations might begin later this month or in February in some of the world's poorer countries, calling on the global community to do more to ensure all countries have access to vaccines.

"We cannot do that on our own," Aylward said, saying WHO needed the cooperation of vaccine manufacturers in particular to start immunizing vulnerable populations. Aylward said WHO was aiming to have "a rollout plan" detailing which developing countries might start receiving vaccines next month.

2:06 PM CT on 1/11/21

In the months leading up to the rollout of COVID-19 vaccines, key members of the C-suite at Trinity Health told employees they plan to take it at their first opportunity.

The Livonia, Mich.-based health system has been hosting series of town halls about the safety and efficacy of the vaccines after a survey of employees conducted before vaccine distribution began showed only about 60% were willing to take it.

In communications with staff, Dr. Daniel Roth, chief clinical officer, said he’s made clear his eagerness to take the vaccine after workers in patient-facing jobs get their chance. Trinity Health’s CEO, Mike Slubowski, has told employees he’ll be taking the vaccine as well at his first opportunity, according to Roth.

“We wanted to focus first on our front-line caregivers,” Roth said. “For our leadership team and for people like me, we have said, ‘We’ll get the vaccine when it’s our turn and we are eager for that.’ ”

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11:44 AM CT on 1/11/21

(AP)  Los Angeles County will stop using Curative COVID-19 tests at pop-up testing sites after a U.S. Food and Drug Administration alert to patients and healthcare providers that the test could produce false negatives.

The county Department of Health Services said in a statement Sunday that the change to Fulgent Genetics tests will take place this week.

The department said Curative PCR tests used at the pop-up sites between Dec. 13 and Jan. 2 made up about 10% of all COVID-19 tests administered at county-supported test sites during that same time frame.

The county said all COVID-19 tests have a risk of false negative results but all PCR tests including the Curative test are better at detecting disease than other tests.

The city of Los Angeles, meanwhile, announced that its massive COVID-19 testing site at Dodger Stadium will transition into a vaccination center by the end of this week.

9:47 AM CT on 1/11/21

(AP) Experts from the World Health Organization are due to arrive in China this week for a long-anticipated investigation into the origins of the coronavirus pandemic, the government said Monday.

The experts will arrive on Thursday and meet with Chinese counterparts, the National Health Commission said in a one-sentence statement that gave no other details.

It wasn't immediately clear whether the experts will travel to the central Chinese city of Wuhan, where the coronavirus was first detected in late 2019.

Negotiations for the visit have long been underway. WHO Director-General Tedros Adhanom Ghebreyesus expressed disappointment last week over delays, saying that members of the international scientific team departing from their home countries had already started on their trip as part of an arrangement between WHO and the Chinese government.

Foreign Ministry spokesperson Zhao Lijian said China had approved the visit following consultations between the sides and called it an opportunity to "exchange views with Chinese scientists and medical experts on scientific cooperation on the tracing of the origin of the new coronavirus."

China's government has strictly controlled all research at home into the origins of the virus, an Associated Press investigation found, while state-owned media have played up fringe theories that suggest the virus could have originated elsewhere.

The AP investigation found that China's government is handing out hundreds of thousands of dollars in grants to scientists researching the virus' origins in southern China. But it is monitoring their findings and mandating that the publication of any data or research be approved by a new task force managed by China's Cabinet, under direct orders from President Xi Jinping, according to internal documents obtained by the AP.

The culture of secrecy is believed to have delayed warnings about the pandemic, blocked the sharing of information with WHO and hampered early testing. There was considerable frustration among WHO officials over not getting the information they needed to fight the spread of the deadly virus, AP has found.

8:14 PM CT on 1/10/21

(AP) Texas health providers getting doses of the COVID-19 vaccine this week will include 28 providers that will focus on large community vaccination efforts, state health officials said Sunday.

Texas is currently vaccinating health care workers, people 65 and older and those with medical conditions that put them at greater risk of hospitalization and death from COVID-19.

The Texas Department of State Health Services said Sunday that the hub providers will get more than 158,000 doses of the vaccine this week.

Researchers from Johns Hopkins University say more than 30,000 people in Texas have died due to COVID-19, the second highest in the country.

Johns Hopkins says that over the past two weeks, the rolling average number of daily new cases in Texas has increased by 9,363.7, an increase of 76.9%.

After steadily rising over the last week, hospitalizations in Texas fell by 824 on Sunday to 13,111.

6:14 PM CT on 1/10/21

HHS on Thursday extended its COVID-19 public health emergency declaration, which is attached to increased funding for healthcare providers and regulatory flexibilities.

The declaration was set to expire on Jan. 20, the day when President-elect Biden is scheduled to be inaugurated. The renewal takes effect on Jan. 21 and extends for 90 days. The renewal eliminates the risk of a lapse as the new administration takes over.

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3:41 PM CT on 1/10/21

(AP) Coronavirus infections have now surpassed 90 million confirmed cases around the world, as more countries braced for wider spread of more virulent strains of a disease that has now killed nearly 2 million worldwide.

The number of infections worldwide has doubled in just 10 weeks, according to a tally by John Hopkins University on Sunday. COVID-19 infections had hit 45 million as recently as late October.

As of Sunday afternoon, John Hopkins counted 90,005,787 infections around the world.

The United States, now with more than 22.2 million infections, led the world with the highest number of infections recorded since the global pandemic began. The number of U.S. cases was more than double that of India, which has recorded nearly 10.5 million infections.

1:20 PM CT on 1/10/21

(AP) A state prison inmate has sued the Utah Department of Corrections to stop the movement of inmates among buildings, an alleged lack of mask and glove use by prison officials and other measures he claims spread the coronavirus.

Damon Christ, who is serving time for theft, alleges the practices contributed to COVID-19 outbreaks at the Draper facility, The Deseret News reports. Since October, more than 1,200 inmates have been infected and 12 have died.

Christ says he tested positive for the coronavirus in November.

“I’m not asking for money damages. I’m not asking to be released,” Crist said of his 3rd District Court lawsuit. “I’m just saying, ‘Look, the department is moving people recklessly. It’s causing mass outbreaks and it’s infecting and killing people."

A department spokeswoman declined comment, citing pending litigation. The department previously has said it consults health officials in moving inmates among buildings and quarantining those who test positive from the general prison population.

Judge Keith Kelly has ordered the department to respond to the allegations within 30 days.

11:15 AM CT on 1/10/21

(AP) Africa passed the milestone of 3 million confirmed cases COVID-19 Sunday, including more than 72,000 deaths, according to the Africa Centers for Disease Control and Prevention.

South Africa accounts for more than 30% of the continent’s total with more than 1.2 million reported cases, including 32,824 deaths. The high proportion of cases in South Africa could be because the country carries out more tests than many other African countries.

South Africa is battling a resurgence of the disease, driven by a variant of the virus that is more contagious and spreading quickly. Many hospitals are reaching capacity, yet the numbers of those infected are expected to continue rising, according to health experts.

South Africa’s 7-day rolling average of daily new cases has risen over the past two weeks from 19.86 new cases per 100,000 people on Dec. 26 to 30.18 new cases per 100,000 people on Jan. 9, according to Johns Hopkins University.

South African President Cyril Ramaphosa will meet with his Cabinet this week to consider if further restrictions should be taken to slow the spread of the disease, while balancing the need to encourage economic growth.

8:23 AM CT on 1/10/21

(AP) In a growing consensus, religious leaders at the forefront of the anti-abortion movement in the United States are telling their followers that the leading vaccines available to combat COVID-19 are acceptable to take, given their remote and indirect connection to lines of cells derived from aborted fetuses.

One outspoken foe of abortion based in Dallas, Southern Baptist megachurch pastor Robert Jeffress, has called the vaccines a “present from God.”

“To ask God for help but then refuse the vaccine makes no more sense than calling 911 when your house is on fire, but refusing to allow the firemen in,” Jeffress said via email. “There is no legitimate faith-based reason for refusing to take the vaccine.”

The Rev. Al Mohler, president of the Southern Baptist Theological Seminary, also has celebrated their development.

“I will take it not only for what I hope will be the good of my own health, but for others as well,” he said on his website.

The U.S. Conference of Catholic Bishops, which says fighting abortion is its “preeminent” priority, said last month that getting vaccinated against the coronavirus “ought to be understood as an act of charity toward the other members of our community,” according to a statement by the chairmen of its Committee on Doctrine and Committee on Pro-Life Activities.

The bishops said it is morally acceptable for Catholics to use either of the two vaccines approved for use in the U.S. — made by Pfizer and Moderna — despite a “remote connection to morally compromised cell lines.” This entailed the use of fetal cell lines for lab tests seeking to confirm the vaccines' effectiveness.

Another leading vaccine, made by AstraZeneca and approved for use in Britain and some other countries, is “more morally compromised,” and should be avoided if there are alternatives available, the bishops said.

Coinciding with the USCCB, four bishops in Colorado issued their own statement taking a somewhat more negative stance on AstraZeneca, describing it as “not a morally valid option.”

AstraZeneca used a cell line known as HEK293 to develop its vaccine. According to the Oxford University team that developed it, the original HEK293 cells were taken from the kidney of an aborted fetus in 1973, but the cells used now are clones of the original cells and are not the original fetal tissue.

As the first vaccines neared approval last year, some Catholic bishops warned they might be morally unacceptable. Among them was Bishop Joseph Brennan of Fresno, California, who urged Catholics not to jump on the “vaccine bandwagon.”

He later modified his stance, saying that due to health risks for individuals and communities, “Catholics may ethically decide for serious reasons to utilize such vaccines.”

8:11 PM CT on 1/9/21

CMS is giving providers an extra two months to file their annual cost reports, an extension that's likely to bring relief to hospitals struggling with influxes of coronavirus patients.

Providers typically get five months from when their reporting period ends to file the reports, which are required for any provider that accepts Medicare, including hospitals, nursing homes, home health agencies and others. Now, they'll get that plus a 60-day extension, the agency announced in a frequently asked questions update.

Cost reports contain a wealth of information on providers' facilities, volumes and finances, including their costs and charges, uncompensated care and wage information. Unlike health systems' quarterly and annual financial reports, which allow them to report at the system-wide level, cost reports are done at the individual facility level.

Read the rest of the story.

7:12 PM CT on 1/9/21

(Crain's Chicago Business) University of Chicago researchers have created what they say is the first usable computer model of the entire virus that causes COVID-19, which could help better understand the disease and improve treatment.

“If you can understand how a virus works, that’s the first step toward stopping it,” chemistry professor Gregory Voth said in a statement. “Each thing you know about the virus’s life cycle and composition is a vulnerability point where you can hit it.”

So far, many researchers have focused on modeling individual proteins in the virus. “Viruses are more than just the sum of their parts,” said Voth, whose team created the model published in Biophysical Journal this week.

Although computers have gotten far more powerful over time, they still can’t routinely handle the massive amount of data involved in a virus and its interaction with the human body. To solve this problem, researchers at U of C focus on the most important characteristics of the virus.

“You could try running an atom-level model of the actual entire virus, but computationally, it would bog you down immediately,” said Voth, a computational scientist “You might be able to manage it long enough to model, say, a few hundred nanoseconds worth of movement, but that’s not really long enough to find out the most useful information.”

4:33 PM CT on 1/9/21

(AP) Health officials in Austin and Travis County announced Saturday plans to to open space in the Austin Convention Center for COVID-19 patients as hospitalizations in Texas set a record high for the 13th consecutive day.

State health officials reported 13,935 patients hospitalized statewide, 14 more than Friday.

The Alternate Care Site in Austin was initially established during a summer surge of the coronavirus, but has not yet taken patients, according to a statement from the Austin-Travis County Health Authority.

"Activating the Alternate Care Site means that we believe that it is inevitable that the healthcare system in Central Texas will exceed capacity and will soon be overwhelmed," said Dr. Jason Pickett, deputy medical director of the health authority.

The site is for patients who do not need high-level or intensive care, according to the statement. Patients needing high-level or intensive care will remain at hospitals.

As of Saturday, there have been more than 1.9 million virus cases in Texas and 29,691 deaths since the pandemic began.

The seven-day rolling average of new cases in Texas has risen from 14,553.7 per day on Dec. 25 to 20,396.8, according to data from Johns Hopkins University, and the average positivity increased from 14.18% to 20.88%.

1:45 PM CT on 1/9/21

(AP) British Health Secretary Matt Hancock turned up at a doctor's office in London this week to highlight the start of coronavirus vaccinations by local general practitioners.There was only one problem: There was no vaccine. It didn't arrive in time for Hancock's press event.

It was an embarrassing moment for the U.K.'s top health official and a reminder of the challenges Britain faces as it races to vaccinate some 15 million people by mid-February.

GPs like Dr. Ammara Hughes are crucial to the National Health Service's plan to expand vaccinations from hospitals and clinics to doctors' offices around the country.

"It's just more frustrating than a concern," Dr. Hughes told Sky News. "If we had a regular supply, we do have the capacity to vaccinate 3,000-4,000 patients a week … which would ease the pressure on the health service and we could get more and more people vaccinated quickly, and hopefully get out of the pandemic."

To ensure vaccines get to the right place at the right time, along with the syringes, alcohol swabs and protective equipment needed to administer them, the government has called in the army.

Brigadier Phil Prosser is leading the army's response. He is commander of 101 Logistics Brigade, which normally delivers supplies to British forces in war zones.

"My team are used to complexity and building supply chains at speed in the most arduous and challenging conditions," Prosser said during a briefing Thursday. "In this case, the mission is to support the NHS in delivering the maximum amount of vaccine to minimize the number of infections and deaths as quickly and as safely as possible."

11:36 AM CT on 1/9/21

(AP) California desperately needs more medical workers at facilities swamped by coronavirus patients, but almost no help is coming from a volunteer program that Gov. Gavin Newsom created at the start of the pandemic. An army of 95,000 initially raised their hands, and just 14 are now working in the field.

Very few volunteers actually met qualifications for the California Health Corps, and only a tiny sliver have the high-level experience needed to help with the most serious virus cases that are stretching intensive care units to the limit.

"Unfortunately, it hasn't worked out, and the goal is laudable," said Stephanie Roberson, government relations director for the California Nurses Association.

Newsom formed the Health Corps in anticipation of the cascading crises that California and other states are now experiencing. COVID-19 infections, hospitalizations and intensive care needs are spiraling out of control in the most populous state just as the rest of the nation sees a surge, overwhelming the usual pool of traveling nurses.

Similarly, New York had more than 80,000 medical volunteers respond to a call for help early in the pandemic when it was a hot spot, and some were deployed. But hospitals more often turned to temporary workers to fill the gap, said Jean Moore, director of the Health Workforce Research Center at University at Albany.

Other states, including Illinois, Indiana and Pennsylvania, tried variations of recruiting volunteers with limited results.

California officials say they need 3,000 temporary medical workers but had about one-third of those as of Thursday. As one result, hospitals are waiving the state's nurse-to-patient ratios, which can mean less care for critically ill patients.

Some of the volunteers "don't have the training at the highest levels to be helpful right now," California Hospital Association spokesman David Simon said.

"It could just be that nurses know that this just might not be the safest place to work," Roberson said.

9:33 AM CT on 1/9/21

(AP) A South Florida nurse fraudulently obtained about $420,000 in coronavirus relief funds, federal prosecutors said.

Giraldo Caraballo, 55, of Miami, made his initial appearance Friday in Miami federal court. He's charged with engaging in transactions in unlawful proceeds and making false statements to a financial institution.

Caraballo applied for and received a Paycheck Protection Program loan on behalf of his company, Professional Skills Inc., according to a criminal complaint. He claimed the company had 28 employees and an average monthly payroll of $168,000, which investigators said was untrue. The complaint also alleges that Caraballo applied for and received approximately $55,000 in Economic Injury Disaster Loan. Instead of using the money for payroll, prosecutors said Caraballo transferred the money to other accounts and used it for personal expenses.

Online court records didn't list a defense attorney who could comment on the case against Caraballo.

8:23 PM CT on 1/8/21

(AP) San Diego County is opening what it calls a “vaccination super station” that aims to inoculate up to 5,000 healthcare workers daily with a coronavirus vaccine.

The effort that begins Monday is one of the most ambitious yet in California to accelerate the pace of vaccinations that Gov. Gavin Newsom said this week was “not good enough.” Only about 1% of California’s 40 million residents have been vaccinated against the virus.

Medical crews from the University of California, San Diego, will operate the station in a parking lot near the downtown baseball stadium.

Health care workers will remain in their vehicles while they are given the shot and then will be asked to remain on-site for 15 minutes to be monitored in case of any allergic reaction.

6:21 PM CT on 1/8/21

(AP) Pennsylvania on Friday released an updated coronavirus vaccine plan that makes more people eligible for shots in the initial phases of the rollout.

Healthcare workers and nursing home residents remain at the front of the line, followed by people 75 years and older and “essential workers” like police officers, grocery store clerks and teachers.

With COVID-19 continuing to rage throughout Pennsylvania, health officials cautioned the state is still months away from having enough doses of the two approved vaccines to inoculate the general public.

“I know it is difficult to ask, but we must have patience,” Dr. Rachel Levine, the state health secretary, said Friday. “It will take several months before this vaccine is available for everyone.”

To date, the federal government has allocated to Pennsylvania more than 827,000 doses of the Pfizer and Moderna vaccines. More than 235,000 shots have been given, though Levine said the actual number is certain to be higher because reporting by hospitals and pharmacies lags by one to three days.

Doctors, nurses and other health workers, and residents and staff at nursing homes and long-term care facilities — a group that numbers about 1 million — are rolling up their sleeves first. State officials have not offered a timeline for when that initial phase of the vaccination campaign, which began last month, will be completed.

Next up under the state’s revised vaccine plan are people 75 and older and frontline essential workers, a huge and diverse group that includes clergy; first responders; prison guards; school staff; and food, manufacturing, postal, public transportation and grocery store workers.

After that, eligibility will extend to people from ages 65 to 74, those with serious health conditions, and another huge batch of workers in industries ranging from banking to energy.

The state reported more than 10,000 new, confirmed cases of the virus on Friday — the most in several weeks — likely indicating the beginning of a post-holiday surge, according to Levine. The state has been averaging about 7,500 new cases per day.

4:19 PM CT on 1/8/21

(AP) World Health Organization experts have issued recommendations saying that the interval between administration of two doses of the Pfizer-BioNTech vaccine can be extended to up to six weeks.

WHO’s Strategic Advisory Group of Experts on immunization, known as SAGE, formally published guidance Friday saying that an interval of 21 to 28 days between the first and second doses is recommended.

But the U.N. health agency also noted that “a number of countries face exceptional circumstances of vaccine supply constraints combined with a high disease burden,” and some have considered postponing the administration of second doses as a way to expand the number of people initially immunized.

WHO said this “pragmatic approach” could be considered as a response to “exceptional epidemiological circumstances.” It said that countries seeking to extend the interval should make sure that vaccinated patients still have access to a second dose.

“WHO’s recommendation at present is that the interval between doses may be extended up to 42 days (6 weeks), on the basis of currently available clinical trial data,” it said, adding: “Should additional data become available on longer intervals between doses, revision of this recommendation will be considered.”

WHO also said no data is available yet on the interchangeability of the Pfizer-BioNTech vaccine with other COVID-19 vaccines. It also cited a lack of evidence about whether vaccination reduces the risk of transmission of the virus to other people.

2:07 PM CT on 1/8/21

(AP) The U.S. topped 4,000 coronavirus deaths in a single day for the first time, breaking a record set just one day earlier, with several Sun Belt states driving the surge.

The tally from Johns Hopkins University showed the nation had 4,085 deaths Thursday, along with nearly 275,000 new cases of the virus — evidence that the crisis is growing worse after family gatherings and travel over the holidays and the onset of winter, which is forcing people indoors.

Deaths have reached epic proportions. Since just Monday, the United States has recorded 13,500 deaths — more than Pearl Harbor, D-Day, 9/11 and the 1906 San Francisco earthquake combined.

Britain, with one-fifth the population of the U.S., likewise reported on Friday its highest one-day count of deaths yet: 1,325. That brings the country's toll to nearly 80,000, the highest in Europe.

Overall, the scourge has left more than 365,000 dead in the U.S. and caused nearly 22 million confirmed infections. At least 5.9 million Americans have gotten their first shot of the COVID-19 vaccine, according to the Centers for Disease Control and Prevention. The goal is to vaccinate hundreds of millions.

2:07 PM CT on 1/8/21

The number of healthcare jobs held by women has not yet recovered from the massive losses the industry took in the beginning of the pandemic, a recent study finds.

As many as 530,000, or 3.8%, fewer healthcare jobs were held by women in October compared to February, according to a study by Altarum, a not-for-profit health research and consulting organization. There were about 36,000, or 1.2%, fewer healthcare jobs for men, who typically make up a significantly smaller segment of the healthcare workforce.

Women's jobs have recovered the most in physician offices and outpatient facilities but continue to decline in nursing homes, where the most women's jobs have been lost, the study said. In nursing homes and residential care facilities, 200,000 women's jobs have been lost.

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12:03 PM CT on 1/8/21

(AP) New research suggests Pfizer's COVID-19 vaccine can protect against a mutation found in the two more-contagious variants of the coronavirus that have erupted in Britain and South Africa.

The results are reassuring, albeit preliminary, and not surprising to scientists who didn't expect a single mutation to defeat the shots on which the world has pinned its hopes. But the study marks just the beginning of continual monitoring to make sure that all the vaccines being rolled out around the world continue to work as the coronavirus, like all viruses, evolves.

"There's no reason to think the vaccines won't work just as well on these strains," said Dr. Frederic Bushman of the University of Pennsylvania, who tracks how the virus mutates.

The mutated version circulating in Britain has also been detected in the U.S. and numerous other countries. That and the variant seen in South Africa are causing global concern because they appear to spread more easily — although how much more isn't yet known.

Bushman, who wasn't involved with the Pfizer study, cautioned that it tested just one vaccine against one worrisome mutation. But the other vaccines now being used in the West — Moderna's and AstraZeneca's — are undergoing similar testing, and he said he expects similar findings.

That's because all the vaccines so far are prompting recipients' bodies to make antibodies against multiple spots on the spike protein that coats the virus.

"A mutation will change one little place, but it's not going to disrupt binding to all of them," Bushman explained.

10:05 AM CT on 1/8/21

(AP) The European Union's drug agency on Friday approved doctors drawing one more dose from each vial of the coronavirus vaccine made by Pfizer-BioNTech, in a move that — combined with the purchase of 300 million extra shots of the serum — could speed up the pace of vaccinations in the 27-nation bloc.

The European Medicines Agency said its human medicines committee recommended updating the product information for the vaccine to clarify that each vial contains six doses instead of the five that were advised when it originally greenlighted the Pfizer-BioNTech vaccine on Dec. 21.

German Health Ministry spokesman Hanno Kautz told reporters in Berlin that the change would come into effect immediately, boosting available doses of the vaccine by 20%.

Many doctors across the EU have already been drawing six doses of the vaccine from each vial, a practice that is already permitted in the United States, Britain and elsewhere.

Pharmaceutical companies regularly put more vaccine than necessary into vials so that minimum dosage can be ensured even if there is some spillage.

8:16 PM CT on 1/7/21

(AP) Gov. Tim Walz proposed to legislative leaders Thursday that they write into law some of the key emergency measures that he has imposed to deal with the coronavirus pandemic, a move that would give lawmakers more of a say in shaping the state's response.

The Democratic governor didn't propose specific legislation, but he offered some bullet-point principles that he said would facilitate the eventual wind-down of the state's peacetime state of emergency.

“With a light now at the end of the tunnel, I encourage you to begin the work of enacting into law the core provisions of the emergency response that have been keeping Minnesotans safe,” he wrote.

Walz proposed codifying the mandate for face masks in public indoor spaces and indoor businesses, which he imposed via executive order. Similarly, he proposed flexibility for school districts to decide on the right mix for themselves of distance learning and in-person instruction. He proposed continuing the state's evictions moratorium with a specific end date to avoid surprises and a surge in evictions.

The governor also proposed measures to ensure that businesses provide safe environments, increased protections for workers from unsafe working conditions and from retaliation for raising workplace safety concerns and improvements to the unemployment insurance program.

Republican lawmakers, in particular, have chafed over the governor's heavy reliance on executive orders to manage the pandemic, complaining that they've been shut out of the process. But the House Democratic majority has blocked all GOP attempts to rescind the peacetime emergency, from which he derives his special powers. Writing some of those executive orders into law would allow lawmakers to modify them to address their constituents' concerns.

In another sign of the partisan split on the coronavirus response, the GOP-controlled Minnesota Senate voted along party lines Thursday against mandating that senators wear masks on the floor. The state House has a mask mandate, though some conservative lawmakers have resisted compliance.

“For the members who have underlying health conditions that are scared to come here right now and their doctors are advising against it, I would not tell them ‘You should come in here,’” Democratic Sen John Marty, of Roseville, said on the floor.

But Republican Sen. Michelle Benson, of Ham Lake, said the Senate should adopt a mask mandate only if all members are required to show up in-person rather than participate remotely, as many currently do.

6:33 PM CT on 1/7/21

(AP) An Oklahoma State Department of Health proposal that would make it easier for parents to opt out of vaccinating their children is being criticized by several state medical experts.

The leaders of the Oklahoma State Medical Association and the Oklahoma Alliance for Health Families, a pro-vaccination group of medical professionals, both urged the public to voice their concerns about the proposed change.

The proposed rule change comes as state health officials are urging Oklahomans to receive the coronavirus vaccine.

The proposed rule would permanently eliminate a requirement that parents seeking to exempt their children from vaccines watch an educational video about the benefits of vaccinations. Oklahoma law authorizes parents to opt out of immunizing their children by simply providing a written statement, and a summary of the proposed rule change suggests that requiring parents to watch an informational video is in conflict with that law. The rule had been temporarily suspended earlier this year, and the new proposal would permanently eliminate it.

The health department did not immediately respond Thursday to telephone and email messages seeking comment about the proposed change.

OSMA President Dr. George Monks said eliminating a requirement that parents watch an informative video before opting out, particularly during the coronavirus pandemic, “is unconscionable."

“COVID-19 has shown just how dangerous the spread of a contagious disease can be,” Monks said in a statement. “Myths about vaccines spread on social media almost as fast as the diseases themselves. The Health Department’s process protects kids by providing science-based information about vaccines through local health departments."

Monks said rampant disinformation about vaccines on social media and elsewhere is responsible for a sharp increase in the number of parents in Oklahoma who are deciding not to vaccinate their children.

Previous attempts by the Oklahoma Legislature to require vaccinations for children in public schools have faced fierce resistance from some conservative lawmakers and groups of parents who believe vaccines are harmful.

4:04 PM CT on 1/7/21

The American Hospital Association is urging HHS to provide more support to accelerate the distribution of COVID-19 vaccines.

In a letter to Secretary Alex Azar, AHA CEO Rick Pollack urged HHS to take steps like sharing vaccination goals, tracking numbers of vaccinations against those expectations, developing a process to answer questions from hospitals and local governments, and sharing best practices.

“We urge you to establish a process within HHS with the ability to be able to coordinate the national efforts among all of the states and jurisdictions and the many stakeholders; answer all of the questions expeditiously; establish and maintain effective communication among all involved; and identify and resolve barriers to the rapid deployment of millions of doses of vaccines,” wrote Pollack.

2:04 PM CT on 1/7/21

(AP) The U.S. registered its highest deaths yet from the coronavirus on the day a mob attacked the Capitol.

On Wednesday, the nation recorded nearly 3,900 deaths. The virus is surging in nearly every state. California is particularly hard hit, with skyrocketing deaths and infections threatening to force hospitals to ration care.

On Thursday, there were 583 deaths in California for a record two-day total of 1,042. The confirmed death toll now stands at 28,045. The state has registered over a quarter million weekly cases.

More than 360,000 people in the U.S. have died of the coronavirus. December was the nation’s deadliest month. Health experts are warning January could be worse because of holiday travel and family gatherings.

About 1.9 million people around the world have died of the coronavirus.

2:04 PM CT on 1/7/21

HHS will dole out more than $22 billion to states and local jurisdictions by Jan. 19 to support COVID-19 containment and lagging vaccination rollouts, the federal government announced Wednesday.

More than $19 billion will aid testing, contact tracing and other mitigation efforts as well as $3 billion to boost vaccination campaigns.

"We're making these billions in new funds available to states as quickly as possible to support our combined efforts to end the pandemic," HHS Secretary Alex Azar said in prepared remarks.

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11:57 AM CT on 1/7/21

Arizona reported nearly 300 coronavirus deaths, a pandemic high, and nearly 10,000 new infections on Thursday.

The surge has stressed Arizona’s healthcare system, with a record 4,920 COVID-19 patients occupying inpatient hospital beds and a record 1,101 patients in intensive care.

The state’s seven-day rolling average of daily cases rose in the past two weeks from 6,293 cases on Dec. 23 to 8,994 on Wednesday. The rolling average of daily deaths rose from 92 to 103.

Health officials have urged Gov. Doug Ducey to install new measures as cases skyrocket. Arizona has the highest coronavirus diagnosis rate in the country, with one out of every 119 people testing positive in the past week.

Ducey has rejected calls to tighten restrictions, including a mask mandate. He also dismissed a proposal to have all public schools go to remote learning for two weeks after the holidays.

The Department of Health Services says the 297 deaths reported Thursday were newly attributed to recent reviews of past death certificates. The numbers increased the state’s confirmed totals to 9,741 deaths and 584,593 cases.

9:26 AM CT on 1/7/21

(AP) New Mexico is among the top states in the U.S. when it comes to vaccine distribution. But state Health Secretary Dr. Tracie Collins said Wednesday that more work is being done to ensure that providers can quickly and accurately report the number of doses that are being administered.

Collins during an online briefing pointed to the state's registration website, saying it has helped to streamline the process of getting people scheduled for their shots. The first phase has included frontline health care workers, first responders and staff and residents at long-term care facilities.

The state this week will release its plans for how other groups of people will be prioritized when more doses become available, and the registration website will be used to notify people when it's their turn, Collins said.

"We really want to get this right the first time," she said. "We don't want to put something out and then recognize we didn't make the most thoughtful decision and so I'm working closely with the governor's office to make sure that we have everything aligned as we think about what's best for the community and keeping us safe and how we can do this efficiently and effectively given the limited supply."

More than 106,500 doses have been delivered to New Mexico so far. While not all providers are reporting yet, the state estimates that roughly 60% of those doses have been administered.

Collins said the state is working with providers to address barriers to reporting so the data is more accurate. Eventually, she said, the state plans to post a public dashboard online that would show how many vaccines have been delivered and how many have been administered.

Nearly 300,000 people in New Mexico have registered to be vaccinated.

7:35 PM CT on 1/6/21

(AP) As a slow distribution of the coronavirus vaccine rolls out across Louisiana, hospital leaders warned Wednesday that they are running dangerously short of beds because of the influx of COVID-19 patients, a situation only expected to worsen after the holidays.

Gov. John Bel Edwards described state efforts to improve the pace of vaccinations, but he and public health officials noted nothing would happen quickly enough to combat the state's coronavirus outbreak except the precautionary measures they've been preaching for months.

The Democratic governor, whose current virus restrictions expire next week, said he didn't know whether he'd try to toughen the rules in place or renew them as is. New Orleans announced new restrictions Wednesday.

Nearly 7,300 deaths in the state have been confirmed from the COVID-19 disease caused by the virus, according to the health department. The state has been averaging more than 2,000 new confirmed cases of COVID-19 daily for weeks.

Dr. Catherine O'Neal, chief medical officer of Our Lady of the Lake Regional Medical Center, said the Baton Rouge hospital is admitting record numbers of COVID-19 patients, forcing people to wait for beds in the emergency department.

"It seems to be our most sustained peak yet and doesn't look like it's stopping," O'Neal said. "We are running out of beds for these patients, and we need this COVID surge to go down and to go down soon."

Ochsner Health CEO Warner Thompson and Chief Medical Officer Robert Hart said the Ochsner system and its affiliates had about 640 COVID-19 patients as of midday Wednesday, an increase they attributed to the virus being spread during parties and get-togethers early in the holiday season.

"This is not even the Christmas spike yet," Hart said.

6:15 PM CT on 1/6/21

(AP) Florida launched an investigation Wednesday into an upscale nursing home amid reports that it administered coronavirus vaccines to wealthy donors and members of a country club along with its residents and employees.

The Washington Post and New York Post  both reported that MorseLife Health System, a nonprofit that operates a nursing home and assisted living facility in West Palm Beach, has given vaccinations to donors and members of the Palm Beach Country Club, whose foundation has donated at least $75,000 to MorseLife since 2015, tax records show.

The newspapers reported that the vaccinations were organized by MorseLife CEO Keith Myers and New Jersey-based developer David Mack, who is a member of various MorseLife boards and chairman of the country club foundation's board. The vaccines were distributed at the Joseph L. Morse Health Center, which is on David S. Mack Drive.

Meredith Beatrice, a spokeswoman for Gov. Ron DeSantis, said in an email to The Associated Press that the governor "has been extremely clear that vaccine should only be administered to Florida's seniors 65 and older, frontline health care workers, and long-term care facility residents and staff."

"We are investigating this situation and will hold any bad actors accountable," she wrote.

George Shea, a spokesman for David Mack and his brother, Bill Mack, said in a statement Wednesday that the Macks were helping MorseLife in its efforts to distribute the vaccine and did nothing wrong. He said the vaccinations followed state protocols by limiting those given to non-employees to people who are 65 and older.

He denied that the distribution was targeted at Palm Beach Country Club members. Shea did not respond to reports that the Macks were among those getting vaccinated.

4:27 PM CT on 1/6/21

(AP) U.S. health officials say they have reports of at least 29 people developing severe allergic reactions to the coronavirus vaccines, but they stress that the risk for most people is low.

The CDC on Wednesday released its latest count of side effects suffered by more than 5.3 million people who have been vaccinated. The 29 had suffered anaphylaxis, a life-threatening allergic reaction that can be controlled through an epinephrine injection.

That’s a rate of about 5.5 cases per million people, which is roughly four times higher than the rate seen in a study of people who got flu shots.

The CDC also published a more detailed study of the first 1.9 million Americans vaccinated as of Dec. 23. Among that group, 21 of suffered the severe allergic reaction. CDC had full data on 20 of the cases, and none of them died, agency officials said. Nineteen got epinephrine and four were hospitalized.

Anyone who has a severe reaction to a first dose should not get a second dose of the vaccine, the CDC says.

2:06 PM CT on 1/6/21

Walgreens said Wednesday it should administer the first dose of the COVID-19 vaccines in all of its partner skilled nursing facilities by Jan. 25.  

“Since receiving our first allotments of vaccines in late December, Walgreens has remained on track in vaccinating our most vulnerable populations and we are steadfast in our commitment to continuing to accelerate access to COVID-19 vaccines as we receive additional guidance from state governments and jurisdictions,” Walgreens President John Standley said in a prepared statement.  

Through the CDC’s Pharmacy Partnership for Long-term Care Program, Walgreens are CVS are administering the vaccine across the country to staff and residents in long-term care.  

Walgreens first started inoculating staff and residents in late December and now is holding vaccination clinics at facilities in 49 states, Washington, D.C. and Puerto Rico. The pharmacy chain is working with 35,000 long-term care facilities and held clinics first in skilled nursing facilities before moving to assisted living facilities, per CDC and state guidance, according to a news release.  

2:05 PM CT on 1/6/21

COVID-19 brought tensions between healthcare workers and their employers to a boiling point this year.

Strikes, picketing and organizing efforts cropped up as the pandemic wore on, as frontline workers used their collective power to put pressure on their administrations. And, as cases COVID-19 continue to surge, tensions don't seem to be lightening.

Workers, on the front lines of the pandemic, say employers aren't taking their safety seriously and are endangering both them and patients through lack of personal protective equipment and low staffing levels. Meanwhile, employers say they're doing their best to handle supply shortages, COVID-19 surges and skyrocketing costs.

"It's opened the eyes of a lot of nurses," said Jean Ross, co-president of the National Nurses United union and a nurse for 46 years. "I think people are more willing to stage actions whether they're unionized or not. It's almost like right now like what do you have to lose?"

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11:44 AM CT on 1/6/21

(AP) The crush of patients with coronavirus is so severe in Los Angeles that on Tuesday they exceeded the normal capacity at Martin Luther King Jr. Community Hospital, which serves many Blacks and Latinos in America's largest county.

The hospital in the south part of the city, which has a capacity of 131 patients, was treating 215 patients, 135 of them with COVID-19, said Jeff Stout, the interim chief nursing and operating officer.

MLK is emblematic of what is happening at hospitals in Los Angeles, where a surge of coronavirus cases has overwhelmed medical staff, created a shortage of oxygen and led to a directive to ambulance crews to stop transporting patients they can't revive in the field.

Stout said the hospital was finalizing its crisis standards of care, which are guidelines for rationing treatment when staff, medicine and equipment are in short supply.

"We're not there yet," Stout said. "Every day, every hour we're trying to avoid going into crisis care. The ultimate goal with crisis care is never to get there."

For much of the year, the nation's most populous state did the right things to avoid a catastrophe. But now the virus is raging and California remains at or near the top of the list of states with the most new cases per capita. Even with vaccines now being administered, albeit slowly, it is expected to take many more weeks to quell the contagion.

LA is the epicenter of California's surge that is expected to get worse in coming weeks when another spike is expected after people traveled or gathered for Christmas and New Year's. Much of the state is under a stay-home order and open businesses are operating with limited capacity.

Los Angeles continues to see hospitalizations rise day after day, setting a new record Tuesday with almost 8,000 hospitalized and more than a fifth of those in intensive care units. The county, which accounts for a quarter of California's 40 million residents, has more than 40% of the state's 27,000 coronavirus deaths.

9:28 AM CT on 1/6/21

(AP) The European Union's medicines agency gave the green light Wednesday to Moderna Inc.'s COVID-19 vaccine, a decision that gives the 27-nation bloc a second vaccine to use in the desperate battle to tame the virus rampaging across the continent.

The approval recommendation by the European Medicines Agency's human medicines committee — which must be rubber-stamped by the EU's executive commission — comes amid high rates of infections in many EU countries and strong criticism of the slow pace of vaccinations across the region of some 450 million people.

"This vaccine provides us with another tool to overcome the current emergency," said Emer Cooke, Executive Director of EMA. "It is a testament to the efforts and commitment of all involved that we have this second positive vaccine recommendation just short of a year since the pandemic was declared by WHO."

European Commission President Ursula von der Leyen welcomed the move and added in a tweet: "Now we are working at full speed to approve it & make it available in the EU."

The EMA has already approved a coronavirus vaccine made by American drugmaker Pfizer and Germany's BioNTech. Both vaccines require giving people two shots.

The EU has ordered 80 million doses of the Moderna vaccine with an option for a further 80 million. The bloc also has committed to buying 300 million doses of the Pfizer-BioNTech vaccine.

Ahead of the meeting on the Moderna vaccine, the agency said in a tweet that its experts were "working hard to clarify all outstanding issues with the company." It did not elaborate on what those issues were. Moderna also declined to comment.

8:31 PM CT on 1/5/21

(AP) Hawaii officials said Tuesday they plan to have people make online reservations to receive the coronavirus vaccine in order to avoid crowding and long lines at distribution centers.

Health care officials are currently vaccinating health care workers, first responders and those living in long-term care facilities — all people in the highest priority groups for getting doses.

Next up will be those over the age of 75, a group estimated to number 109,000 people in Hawaii. Vaccinations for the general public are expected to begin in early summer, depending on the availability of doses.

Dr. Libby Char, the director of the state Department of Health, said online reservations will allow officials to match capacity with those receiving doses.

She said she wants to avoid scenes witnessed in Florida, where older adults waited in long lines to receive the vaccine on a first-come first-serve basis.

“To think of our kupuna being outdoors camping out overnight trying get vaccine is a pretty scary thought,” Char said, using the Hawaiian word for elder.

Char said the state has used already used the reservation system to vaccinate people and her expectations are high it will work for the elderly.

Lt. Gov. Josh Green said vaccination “pods” have been giving shots to 400 to 500 people a day with no lines. He envisions vaccine distribution centers eventually having multiple such pods as more and more people are vaccinated.

Green said the state's coronavirus information website hawaiicovid19.com would have information on making reservations. He urged those interested to keep checking that site in coming days. A phone line will also be available that people may call.

Elderly who living in long-term care facilities will be able to receive the vaccine at their place of residence.

Green expressed hope that older adults living independently would get help from family and friends to make reservations and get their vaccinations.

Based on surveys the state has conducted, Green said he expects about 80% of the state's 1.4 million people will eventually get the vaccine. He said some 55% said they would absolutely get the vaccine and 25% said they were open to getting shots after seeing others get it and determine the vaccine is safe.

6:38 PM CT on 1/5/21

(AP) Washington Gov. Jay Inslee says some pandemic restrictions will be eased next week and the state will change its reopening plan to move from a county-based oversight system to one focused on regions.

Inslee said Tuesday that the new guidelines will include “a small resumption of some activities statewide.” He says some live entertainment with very tight capacity restrictions and some fitness programs will be allowed.

Also, instead of having each of Washington’s 39 counties treated separately, the state will be divided into eight geographic regions based on health system resources when considering virus oversight.

Since the beginning of the pandemic there have been more than 256,000 confirmed coronavirus infections in Washington and more than 3,480 deaths related to COVID-19.

4:17 PM CT on 1/5/21

(AP) Frustrated with what he said is a slow rollout in South Carolina of COVID-19 vaccines, Gov. Henry McMaster said Tuesday that hospital and health workers have until Jan. 15 to get a shot or they will have to "move to the back of the line."

McMaster said he has asked health officials to speak to hospitals and then revise the rules.

Current state rules say 70% of eligible healthcare workers and nursing home residents need to be vaccinated. When that has been accomplished, the state will start vaccinating people over age 75 and frontline workers such as police officers, prison guards, grocery store workers, teachers and postal employees.

McMaster wants to establish the deadline instead.

"If we need to move the next group up early, we're going to do it," McMaster said at a news conference.

The South Carolina Department of Health and Environmental control did not immediately comment on the governor's idea, but McMaster said health officials were meeting and planned to send out the new rules later Tuesday.

As of Monday, the state had given out less than half its initial allotment of the Pfizer vaccine to about 43,000 people. Statistics on the Moderna vaccine have not been released.

McMaster said he puts much of the blame on hospitals for the slow rollout because they have been too strict — only giving shots to workers who deal directly with COVID-19 patients instead of to any healthcare provider. The governor said hospital leaders have promised to do better.

1:58 PM CT on 1/5/21

(AP) Distribution hiccups and logistical challenges have slowed the initial coronavirus vaccine rollout in California, setting a pace that's "not good enough," Gov. Gavin Newsom said.

The state is trying to execute the massive immunization campaign "with a sense of urgency that is required of this moment and the urgency that people demand," but so far only about 1% of California's 40 million residents have been vaccinated, the Democratic governor said.

The 454,000 doses of vaccine that have been administered in California represent just a third of the more than nearly 1.3 million received in the state so far, according to the California Department of Public Health.

Newsom's comments came Monday as the state's death toll topped 26,500 and confirmed cases neared 2.4 million since the pandemic began. The state's swamped hospitals held more than 22,000 coronavirus patients, including nearly 4,700 in intensive care units, the Department of Public Health said.

Even as he acknowledged the state must do better, Newsom sought to shift some responsibility for the slow rollout, noting "the vaccines don't arrive magically in some state facility."

Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said the state assigns the number of doses that local health jurisdictions will receive after getting an allocation from the federal government. The vaccine is then shipped directly to entities like hospitals or local public health offices. Pfizer distributes its vaccine directly, while Moderna uses the pharmaceutical company McKesson as an intermediary, which initially led to slow communication, Newsom said.

California is working to expand the list of sites where the vaccine can be distributed to include pharmacies, clinics and dental offices. Officials are also completing a survey of health care workers to find out how many of them do not want to take the vaccine, in response to anecdotal evidence that some are refusing it.

While the state wants to make sure no one is jumping ahead in the line, Newsom said he wants to give providers the flexibility to distribute doses to people not on the priority list if doses are at risk of going to waste.

"We are working hard to make sure that 100% of what we get, we get out as quickly as possible," Ghaly said.

1:58 PM CT on 1/5/21

At Jamaica Hospital Medical Center in Queens, N.Y., Dr. Alan Roth oversees care delivery operations for one of the most diverse patient populations in the country, serving people from 130 countries speaking more than 160 languages.

During the 30 years Roth has worked at Jamaica Hospital, Queens County has doubled in size from a population of 1.2 million to 2.4 million with the increase almost entirely made up of immigrants, including an estimated 400,000 individuals with undocumented resident status.

Roth acknowledged there is a challenge to serving people from so many different backgrounds and understanding their cultural religious beliefs. But the dynamic has also provided opportunities for the hospital to learn effective ways of building relationships with various cultures that goes beyond providing language translation services or hiring a more diver clinical staff.

"Translation is the easiest," Roth said. "You need to have an understanding of their customs and beliefs, and in general, their distrust of the American healthcare system and what we do (to) people rather than what we do for people."

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11:42 AM CT on 1/5/21

(AP) Alabama on Monday hit a new high for the number of COVID-19 patients in state hospitals with more than 3,000 hospitalized.

The new peak comes as health officials feared a new surge of cases in the wake of the winter holidays. There were a record 3,064 people in state hospitals Monday with COVID-19, according to numbers from the Alabama Department of Public Health.

Dr. Don Williamson, the president of the Alabama Hospital Association, said the surge is likely attributable to the continued fallout from Thanksgiving, the earliest Christmas parties as well as increased community transmission.

He is concerned the caseloads will grow from people who got infected during Christmas gatherings but haven't started exhibiting serious symptoms.

"If anything, this is the very first part of the Christmas surge, and we still have a lot of the surge to deal with," Williamson said.

"It's rapidly deteriorating, and probably will over this week continue to deteriorate pretty rapidly as we do get the Christmas surge," Williamson said.

Williamson said half of all intensive care beds in the state are occupied by COVID-19 patients. Across the state there were about 500 COVID-19 patients on ventilators, a new high, Williamson said.

9:35 AM CT on 1/5/21

(AP) Gov. Ned Lamont said staff and residents at all of Connecticut's nursing homes are on track to have their first dose of the COVID-19 vaccine by Friday, but he acknowledged some workers have been reluctant to get the shot.

The state plans to begin airing a public service announcement on Tuesday, hoping to encourage more workers to get vaccinated.

"I am told that the overwhelming (number) of the (nursing home) residents are eager to get the vaccine and are getting vaccinated," Lamont said. "I understand there's a little more hesitancy when it comes to some of the nurses. Most are getting it, but not all. So we're doing a pretty aggressive public outreach campaign to address them."

Lamont said as of Monday, more than 75,000 of the 167,00 doses Connecticut has received so far have been administered. He said some "first tier responders" were getting their second doses on Monday, while residents and staff at some assisting living facilities were getting their first ones. He said Connecticut is among the first eight states that have administered the vaccine to more than 2% of the population.

Eighty-five sites across the state are now administering vaccine doses, including hospitals and nursing homes, with plans to roll out to pharmacies over the next couple weeks.

"So as we broaden our population, it'll be easier for people to get their vaccine on a retail basis right at their local pharmacy, Walgreens, CVS, you name it ... federally qualified health centers," he said.

To prevent vaccine from "just sitting on a shelf and not being used," an issue that has cropped up in other states, Lamont said the state has developed a "just-in-time inventory" system where unused doses of vaccine are transferred to other facilities at the end of the day.

Lamont said as Connecticut receives more vaccine from the federal government, state officials will "open up the lens a little bit more, either in terms of age groups, demographics or other front line responders to make sure that every drop of that vaccine is administered on a timely basis."

"I don't want to leave anything to chance, and I don't want to leave anybody behind," said Lamont, who hopes all "first tier folks in the healthcare and nursing homes" will have had their second vaccine by late January.

8:05 PM CT on 1/4/21

(AP) As seniors lined up at coronavirus vaccination sites and frustrations mounted over their inability to make appointments for life-saving injections, Gov. Ron DeSantis warned hospitals against stockpiling vaccinations and urged them to work more quickly to administer vaccines to Floridians who are 65 and older.

“The light’s at the end of the tunnel,” DeSantis said during a news conference in Orlando on Monday, adding that hospitals that don’t meet vaccination goals will see their allotment of vaccines reduced and redistributed to other providers.

“I do not want to see a vaccine sitting around not being used when you could be putting a shot in an arm,” he said.

Meanwhile, the first five Florida hospitals to start inoculating their frontline workers three weeks ago began administering booster shots this week to those same employees.

As of Monday, more than 260,000 Floridians had been vaccinated, most of them health care workers and first responders — although an increasing number are seniors 65 years and older, whom the governor has made a key demographic for vaccinations.

The state has received more than 960,000 doses of the Pfizer and Moderna vaccines — which means that 700,000 doses are sitting in freezers waiting to be injected into the arms of Floridians.

Both vaccines require two doses — an initial inoculation and a booster shot weeks later. Some hospitals, out of caution, may be reluctant to immediately use their entire stockpile because of uncertainty over the future supply of the vaccines.

About 83% of those who have died from the disease in Florida have been older than 65.

Florida has one of the nation’s oldest populations with 4.4 million of the state’s 21 million people 65 years or older.

The governor spoke at Orlando Health South Seminole Hospital, where 4,000 people were expected to be vaccinated by day’s end.

DeSantis has ordered hospitals to inform state officials how they plan to offer vaccinations to the public.

Mary Mayhew, chief executive officer of the Florida Hospital Association, said the state’s hospitals were “working tirelessly” to serve the community and roll out the vaccinations.

“Hospitals are absolutely committed to efficiently administering the vaccines,” Mayhew said, noting that “the vast majority of the vaccine just arrived within the last week and a half prior to two holidays.”

During both news conferences, DeSantis asserted that 80% of the doses delivered to the state thus far have been sent to hospitals, but the hospital association says only about half of them have. The governor’s office said it was working to verify the governor’s statement, which he asserted at two news conferences Monday.

During DeSantis’ news conference in Miami, Carlos Migoya, the president and CEO of Jackson Health System, said some hospital workers — the first of about 5,000 associated with the Miami-based health care system — began receiving their booster shots on Monday.

“The focus right now has been health care workers and people over 65. Once we get to a big percentage of those ... we’ll open it to the next at-risk population,” Migoya said.

“We are giving the vaccine as fast as we get it. We’re not holding back any vaccine because the supply is coming,” he said.

The governor’s response to the outbreak is certain to loom large in his bid for reelection, and Democrats will surely seize on the governor’s missteps.

“With this flawed vaccine rollout, Governor DeSantis has once again failed to rise to the occasion,” said Florida Democratic Party Chair Terrie Rizzo.

“Instead of taking responsibility for the disastrous rollout, Governor DeSantis is blaming hospitals and doctors for rollout problems — saying that he will take away vaccine allotments, when he is the one without a plan,” Rizzo asserted.

During his news conferences, DeSantis said he intends to convert some COVID-19 testing sites to vaccination sites, recruit places of worship in underserved communities to help vaccinate seniors of color and hire 1,000 more nurses to help with injections.

“We believe the sooner the better. There’s no time to waste,” he said.

Still, the rollout to the senior citizens has been fraught with complications, especially in larger counties.

Various county health departments had challenges and problems in their online reservations system on Monday. Pinellas County opened its reservation system at noon, but the portal experienced trouble at that time. In Hillsborough County, the registration website for seniors wanting the COVID-19 vaccine had crashed apparently due to the high volume of traffic.

In Broward County, the signup website crashed repeatedly. On Monday, the county’s health department said all of its slots — 26,465 of them — for people 65 and older are full for now.

“This is a very difficult logistical operation,” DeSantis said. “I’m not going to say that there’s not been any problems, but I think all in all, you know, the distribution has gone probably better than what we could have reasonably expected.”

On Monday, the state Department of Health added more than 11,200 new confirmed coronavirus cases to its tally, bringing the state’s total to nearly 1.4 million. With more 100 new deaths, the state’s death toll surpassed 22,000.

6:02 PM CT on 1/4/21

(AP) As lawmakers around the U.S. convene this winter to deal with the crisis created by the pandemic, statehouses themselves could prove to be hothouses for infection.

Many legislatures will start the year meeting remotely, but some Republican-controlled statehouses, from Montana to Pennsylvania, plan to hold at least part of their sessions in person, without requiring masks. Public health officials say that move endangers the safety of other lawmakers, staffers, lobbyists, the public and the journalists responsible for holding politicians accountable.

The risk is more than mere speculation: An ongoing tally by The Associated Press finds that more than 250 state lawmakers across the country have contracted COVID-19, and at least seven have died.

The Montana Legislature convened Monday without masking rules. The Republican majority shot down recent Democratic requests to hold the session remotely or delay it until vaccines are more widely available. Failing that, Democrats asked for requirements on masks and virus testing, which were also rejected.

Democratic lawmakers wore masks as they were sworn in. Few Republicans did the same.

“If the session is held without public health precautions, it is highly likely that the virus will spread in that environment, and it’s highly likely that we’ll see serious illness and, God forbid, deaths come from that,” said Drenda Niemann, the health officer in Lewis and Clark County, which includes the state capital of Helena.

Rather than address COVID-19 guidelines ahead of the session, Republicans decided to address them after lawmakers convene by creating a panel that will meet regularly to consider updating policies. The Senate president pro tem, Republican Jason Ellsworth, said the panel “allows us to be more fluid with the situation" and "allows for our personal freedoms and our responsibilities.”

The divergent approaches to the virus — with Republican lawmakers mostly rejecting mask mandates and lockdown measures, and Democrats urging a more cautious approach — mirrors that of Americans generally. That contrast was reflected over the holidays, when millions of people hit the roads and airports despite pleas from health officials to avoid travel and family gatherings to help contain the virus, which has claimed more than 350,000 American lives.

Some legislatures are trying to strike a balance between conducting business in person and protecting against the disease.

The 400-member New Hampshire House plans to hold its first session day Wednesday with a drive-in event at the University of New Hampshire in what acting Speaker Sherm Packard called the body's “most risk-mitigated session” yet during the pandemic.

The House clerk and speaker will conduct business from a heated platform, and members can watch and listen via a screen or through their car radios. Microphones will be brought to their windows for questions and debate, and voting will be conducted via electronic devices.

New Hampshire House Speaker Dick Hinch, a Republican, died from COVID-19 on Dec. 9, a week after being sworn in during an outdoor gathering at UNH. Democrats have pushed for remote gatherings.

Legislatures in Alaska, North Dakota, Pennsylvania and Washington are requiring masks, but the requirement is not being enforced in Pennsylvania. Lack of enforcement is a concern for news outlets that have to balance their ability to cover events with the safety of their reporters.

“If we start getting into a high-profile issue and there's a scrum of reporters shouting questions to a legislator who's unmasked, it couldn't be a worse situation,” said Paula Knudsen Burke, with the Reporters Committee for Freedom of the Press in Pennsylvania.

In Idaho, where lawmakers are not required to wear masks, Melissa Davlin of Idaho Public Television said media outlets are trying to keep reporters safe while also ensuring adequate access to lawmakers, many of whom are not adhering to the same public safety guidelines as newsrooms.

Casual hallway conversations “are so valuable for coverage and insight and even just background,” Davlin said. “Missing out on that is a real loss for our ability to cover the session. But at the same time, we are not going to do our viewers and readers any good if we get sick.”

Republicans in the Ohio House have blocked efforts to enforce a mask mandate, despite the fact that more than a dozen lawmakers there have tested positive for COVID-19.

Incoming Ohio Senate President Matt Huffman was to be sworn into office from his home Monday after testing positive for COVID-19. Huffman experienced mild symptoms and will return to the statehouse after a quarantine period, spokesperson John Fortney said.

In conservative Wyoming, where Republican Gov. Mark Gordon did not issue a mask mandate until early December, lawmakers plan to convene virtually Jan. 12 to hear the governor's State of the State address. Legislative leaders will decide later whether to begin a virtual session in February or hold an in-person session starting in March, the Wyoming Tribune Eagle reported.

Wyoming Republican Rep. Roy Edwards died a day before Election Day of what his family later confirmed was COVID-19. Edwards spoke in opposition to public health restrictions to prevent the spread of the coronavirus during his campaign.

In Montana, all floor sessions and committee meetings will be available to view or hear online, and lawmakers will be allowed to attend many hearings virtually, but voting on final bills by proxy is discouraged. Members of the public and lobbyists will be able to testify on bills using video conferencing, if they have access to the technology.

“I feel like that’s going to preferentially kind of censor the people who are either vulnerable or who actually value the advice that experts are putting out,” said M. Kumi Smith, assistant professor of epidemiology and community health at the University of Minnesota.

Ellsworth, the Republican Senate leader, acknowledged that the Legislature's COVID-19 panel will not solve everything.

“At the end of the day, this is an animal that we can’t control,” he said of the pandemic during a rules hearing on Dec. 16. “I would imagine we are going to have members that are going to get sick. It’s possible that we have members that die. But that possibility is there irregardless, even if we’re here or not.”

4:12 PM CT on 1/4/21

The U.S. Surgeon General Jerome Adams said Monday he hopes that all healthcare workers and nursing home staff and residents will be vaccinated by the end of January.

During a LeadingAge call with long-term care providers, Adams said that under “an aggressive timeline” essential workers and other vulnerable adults would be vaccinated in February and March, and otherwise healthy adults could be vaccinated starting in April and May.

So far, 4.5 million people in the U.S. have received the first dose of a COVID-19 vaccine, either from Moderna or Pfizer BioNTech, including Adams. Of those, 365,000 are staff and residents in nursing homes, according to the CDC Monday.

Adams said he thinks there is a big gap between the number of people who have been administered the first dose of the vaccine and what’s been reported. In the U.S., 15 million doses of the vaccines had been distributed as of Monday, 2.5 million of which were part of the Federal Pharmacy Partnership for Long-Term Care Program in charge of vaccinating staff and residents in nursing homes.

The federal government anticipates there will be 50 million doses of Moderna and Pfizer COVID-19 vaccines manufactured by the end of January and 100 million doses manufactured by the end of February, Adams said.

With new vaccines like the Oxford/AstraZeneca vaccine, likely to be approved by the end of the month, and the newly developed Johnson & Johnson vaccine, Adams said there could be enough doses of COVID-19 vaccines manufactured to inoculate every adult in the country who wants to be vaccinated by spring.

“I don’t want to be Pollyannaish here but I’m talking about sheer manufacturing numbers,” Adams said.

2:43 PM CT on 1/4/21

(AP) Louisiana pharmacy phone lines and websites were inundated Monday with people seeking the coronavirus vaccine, after the state unveiled the list of 107 pharmacies that will begin offering immunizations this week for people 70 and older.

With demand certain to outstrip limited supplies and interest running so high, the state website crashed within minutes of the information's release. The Louisiana Department of Health quickly reworked the website to get the list back online.

Hoping to avoid long lines seen in other states with people awaiting vaccination, the health department stressed that appointments for the immunizations are required. Still, people started showing up at their local pharmacies and calling them days ahead of the expanded eligibility, seeking vaccines for themselves or elderly family. Monday's release of the specific pharmacies offering the vaccine only heightened interest.

Gov. John Bel Edwards' administration called for patience.

"Patients who arrive without an appointment will not be vaccinated. Do not arrive at a location without an appointment," the health department said as it announced the list.

An estimated 640,000 people in Louisiana are newly eligible for the shot this week, but only about 10,000 doses of the Moderna vaccine were initially shipped to the state's pharmacies for this cohort, leaving each pharmacy with no more than about 100 doses available to their customers.

"My phone has been ringing off the wall this morning," said state Sen. Fred Mills, the Republican chairman of the Senate healthcare committee and a pharmacy owner in St. Martin Parish. "I think there is going to be a huge demand of the 70 and older population. This population is concerned for their health, and they want the vaccination. I think for right now, the supply is not at all adequate to meet the demand."

2:43 PM CT on 1/4/21

The 2021 financial outlook for healthcare providers is more difficult to predict than ever, as so much of it depends on the trajectory of an out-of-control pandemic.

While many had expected the crisis that began in earnest in March 2020 to be contained by year’s end, it’s clearly far from over.

“It’ll be more of a two-year event,” said Megan Neuburger, a managing director with Fitch Ratings. Neuburger studies investor-owned hospitals, and she’s not forecasting a complete earnings recovery for them until 2022.

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11:32 AM CT on 1/4/21

Minnesota and 3M are working together to stop 500,000 counterfeit N95 masks from reaching healthcare facilities in the state. The masks are worth an estimated $2.1 million.

The state contracted with Supply Link Inc. to obtain the PPE as a backstop for hospitals and clinics that couldn’t procure their own masks. 3M inspected the procured N95s and found they were counterfeit. Supply Link turned over the masks and 3M will destroy the counterfeit masks. The state will not have to pay for the products.

3M says its inspections have uncovered 7 million counterfeit masks across the country.

9:43 AM CT on 1/4/21

(AP) The campaign to vanquish the coronavirus is picking up speed, with Britain beginning to dispense the second vaccine in its arsenal Monday, and India, the world's second-most populous country, authorizing its first shots.

In the U.S., meanwhile, government officials reported that vaccinations have accelerated markedly after a disappointingly slow start. Dr. Anthony Fauci, the nation's top infectious-disease expert, said over the weekend that 1.5 million shots were administered in 72 hours, bringing the total to about 4 million.

Britain on Monday became the first nation to start using the COVID-19 vaccine developed by AstraZeneca and Oxford University, ramping up its nationwide inoculation campaign amid soaring infection rates blamed on a new and seemingly more contagious variant of the virus.

Britain's mass vaccination program began Dec. 8 with the shot developed by Pfizer and its German partner BioNTech.

The country has recorded more than 50,000 new coronavirus infections a day over the past six days, and deaths have climbed past 75,000, one of the worst tolls in Europe.

On Sunday, India authorized two COVID-19 vaccines — the Oxford-AstraZeneca one and another developed by an Indian company — paving the way for a huge inoculation program to stem the outbreak in the desperately poor country of about 1.4 billion people.

Prime Minister Narendra Modi called it a "decisive turning point to strengthen a spirited fight."

In the U.S., the rollout has been marked by a multitude of logistical hurdles, a patchwork of approaches by state and local governments, and confusion. Some people are uncertain where or when to get a shot.

Fauci said over the weekend that he saw "some little glimmer of hope" in the stepped-up rate of vaccinations. He acknowledged the U.S. fell short of its goal of having 20 million doses shipped and distributed by the end of December, saying, "We are not where we want to be."

But he expressed optimism that the momentum will pick up by mid-January and that ultimately the U.S. will be vaccinating 1 million people a day. He said President-elect Joe Biden's goal of vaccinating 100 million people in his first 100 days in office is "realistic."

8:23 PM CT on 1/3/2021

(AP) Congress convened Sunday for the start of a new session, swearing in lawmakers during a tumultuous period as a growing number of Republicans work to overturn Joe Biden's victory over President Donald Trump and the coronavirus surges.

Democrat Nancy Pelosi was reelected as House speaker by her party, which retains the majority in the House but with the slimmest margin in 20 years after a November election wipeout.

Opening the Senate could be among Mitch McConnell’s final acts as majority leader. Republican control is in question until Tuesday’s runoff elections for two Senate seats in Georgia. The outcome will determine which party holds the chamber.

The House and Senate were required to convene Sunday, by law, and imposed strict COVID protocols for what's typically a celebratory day. Elbow bumps replaced handshakes as senators took the oath of office. Fewer family members than usual joined lawmakers at the Capitol. A special enclosed seating section was designed for lawmakers in COVID quarantine.

“To say the new Congress convenes at a challenging time would be an understatement,” McConnell said as the chamber opened.

Still, McConnell said with the start of a new year there are reasons for optimism, “let’s make the American people proud.”

Pelosi said the top priority is defeating the coronvirus. And “defeat it we will,” she said to applause.

It’s often said that divided government can be a time for legislative compromises, but lawmakers are charging into the 117th Congress with the nation more torn than ever, disputing even basic facts including that Biden won the presidential election.

Fraud did not spoil the 2020 presidential election, a fact confirmed by election officials across the country. Before stepping down last month, Attorney General William Barr, a Republican appointed by Trump, said there was no evidence of fraud that affected the election’s outcome. Arizona’s and Georgia’s Republican governors, whose states were crucial to Biden’s victory, have also stated that their election results were accurate.

Nevertheless, a dozen Republicans bound for the new Senate, led by Sens. Josh Hawley and Ted Cruz, and even more in the House have pledged to become a resistance force to Biden’s White House, starting with efforts to subvert the will of American voters. These GOP lawmakers plan to object to the election results when Congress meets on Wednesday to tally his 306-232 Electoral College victory over Trump.

Vice President Mike Pence, who as president of the Senate, presides over the session and declares the winner, is facing growing pressure from Trump’s allies over that ceremonial role.

Pence's chief of staff, Marc Short, said in a statement Saturday that Pence “welcomes the efforts of members of the House and Senate to use the authority they have under the law to raise objections.”

Democrats, meanwhile, are pushing ahead, eager to partner with Biden on shared priorities, starting with efforts to stem the pandemic and economic crisis. They plan to revisit the failed effort to boost pandemic aid to $2,000 for most people.

“This has been a moment of great challenge in the United States of America filled with trials and tribulations, but help is on the way,” Rep. Hakeem Jeffries, D-N.Y., the chairman of the House Democratic caucus, said in an interview.

“America is a resilient nation, filled with resilient people,” he said. “We will continue to rise to the occasion, emerge from this pandemic and continue to march toward our more perfect union.”

Among the House Republican newcomers are Trump-aligned Marjorie Taylor Greene of Georgia, who has given nod to conspiracy Q-Anon theories, and gun rights advocate Lauren Boebert of Colorado, who circulated a letter of support to retain the right of lawmakers to carry firearms in the Capitol.

Greene was among a group of House Republicans led by Rep. Mo Brooks of Alabama who visited with Trump at the White House during the holiday season about their effort to undo the election.

The “Jan. 6 challenge is on,” Taylor Greene said in a tweet pinned to the top of her social media account. Boebert also tweeted support for those challenging Biden's victory.

House Republicans boosted their ranks in the November election, electing a handful of women and minorities, more than ever. Some of the new GOP lawmakers are being called the “Freedom Force,” and a counter to the “squad” — Rep. Alexandria Ocasio-Cortez of New York and other liberal Democratic women who swept to office in the last session.

In a statement Rep. Kevin McCarthy, R-Calif., the minority leader, said the new Republican members “are a strong representation of who America is and where we come from.”

Progressive Democrats bolstered their ranks with newcomers aligned with more liberal priorities.

The Capitol itself is a changed place under coronavirus restrictions. Lawmakers are arriving in Washington from all parts of the country potentially exposed to the virus during their travel.

Several lawmakers have been sickened by the virus and some will be absent Sunday. Also, a memorial was held Saturday for newly elected Republican lawmaker Luke Letlow, 41, of Louisiana, who died of complications from COVID-19 days before the swearing in.

The Office of the Attending Physician has issued several lengthy memos warning lawmakers off meeting in groups or holding traditional receptions to prevent the spread of the virus. Masks have been ordered worn at all times and Pelosi has required them to be used in the House chamber. Members are required to have coronavirus tests and have access to vaccines.

“Do not engage any in-person social events, receptions, celebrations, or appointments, outside your family unit, and always wear a face covering outside your home,” the physician’s office warned in one memo. “You should strictly avoid any type of office-based reception or celebration during the days ahead.”

Even the traditional swearing in ceremonies will be limited in the House. No more big family portraits with new lawmakers taking the oath of office. Instead, each representative-elect can bring one guest in line with social distancing protocols.

The vice president typically swears in the senators and Pence elbow-bumped senators as he did.

Pelosi, who is returning as speaker, the first woman to hold the job, faced a tight race, with the House split 222-211, with one race still undecided and one vacancy after Letlow's death.

The California Democrat could endure some defections from her ranks, but only a few, barring absences. She won a majority of those present and voting to retain the speaker’s gavel.

8:15 PM CT on 1/3/2021

(AP) Hospitals struggling to provide enough oxygen for the sickest coronavirus patients in the Los Angeles area began to receive help on Saturday when U.S. Army Corps of Engineers crews arrived to update their oxygen delivery systems.

The collaboration comes as the six aging hospitals struggle to maintain oxygen pressure while treating an unprecedented number of patients with respiratory issues. Besides the shortage of oxygen, the hospitals were having difficulty keeping up with demand for oxygen tanks for discharged patients to take home.

Some COVID-19 patients can require 10 times as much oxygen as a normal patient.

California started the new year on Friday by reporting a record 585 coronavirus deaths in a single day. The state Department of Public Health on Saturday reported another 386 deaths and more than than 53,341 new confirmed COVID-19 cases, bringing the total to 2.3 million.

A total of 26,357 people have died from the virus in California, making it the third state to exceed 25,000 COVID-19 deaths since the start of the pandemic, behind New York with nearly 38,000 deaths and Texas with more than 27,000, according to a tally by Johns Hopkins University.

More than 20,000 people were hospitalized as of Saturday with COVID-19; 4,500 of them were in intensive care, according to state records.

The southern half of the state has seen the worst effects, from the agricultural San Joaquin Valley to the Mexico border. Hospitals are swamped with patients and intensive care units don’t have any more beds for COVID-19 patients. Makeshift wards are being set up in tents, arenas, classrooms and conference rooms.

Ambulances were being forced to wait in bays as long as eight hours before they could transfer patients inside hospitals — and in some cases, doctors were treating patients inside ambulances, said Cathy Chidester, director of the county’s Emergency Medical Services Agency.

Meanwhile, refrigerated trucks were on standby, ready to store the dead and mortuaries are turning away bereaved families because they’re running out of space.

More than 7,600 people were hospitalized for COVID-19 in Los Angeles County, which has a fourth of the state’s population of nearly 40 million but has seen 40% of its virus deaths. LA County on Friday reported 20,414 new confirmed virus cases, indicating a spike in cases after the Christmas holiday.

6:11 PM CT on 1/3/2021

(AP) Bars and restaurants across Wyoming will be allowed to return to normal operating hours beginning Jan. 9 as COVID-19 hospitalizations decline in the state.

The Wyoming Tribune Eagle reports Gov. Mark Gordon made the announcement Saturday. He praised businesses for adapting to health orders and thanked residents for recognizing the strain on hospitals.

The updated health orders allow bars and restaurants to resume onsite consumption from 10 p.m. to 5 a.m., and they allow gyms to increase the number of participants in group fitness classes from 10 to 25.

Counties can still opt out of the requirements if local conditions move to safer levels in accordance with White House metrics.

3:58 PM CT on 1/3/2021

(AP) Nancy Pelosi was narrowly reelected Sunday as speaker, giving her the reins of Democrats’ slender House majority as President-elect Joe Biden sets a challenging course of producing legislation to tackle the pandemic, revive the economy and address other party priorities.

The California Democrat, who has led her party in the House since 2003 and is the only woman to be speaker, had been widely expected to retain her post. Rep. Kevin McCarthy R-Calif., again will be the chamber’s minority leader.

To gain her victory, Pelosi had to overcome some Democratic grumbling about her longevity, a slim 222-211 edge over Republicans after the November election, and a handful of absences because of the coronavirus.

There are two vacancies in the 435-member House, and whatever happens Democrats will have the smallest House majority in two decades.

2:22 PM CT on 1/3/2021

(AP) Speaker Nancy Pelosi seemed on track Sunday to renew her hold on the House's top job, but ahead of her is the challenge of producing legislation to tackle the pandemic and revive the economy while leading the chamber's narrowest majority in two decades.

The new Congress convened Sunday, just two days after lawmakers wrapped up their contentious previous session and with COVID-19 guidelines requiring testing and masks for House members. There was widespread mask-wearing and far fewer lawmakers and guests in the chamber than usual. It was a scene unimaginable two years ago when the last Congress commenced, before the pandemic struck.

As usual, the House was using its first vote to elect its speaker. Pelosi, who has led House Democrats since 2003 and is the only woman to be speaker, was widely expected to retain her post despite grumbling among some Democrats, a slim 222-211 edge over Republicans and a handful of absences because of the coronavirus. There were two vacancies in the 435-member House.

“No one counts better in the House of Representatives than Nancy Pelosi,” said Rep. Hakeem Jeffries, D-N.Y., in an interview, describing her vote-counting skills. “And she has earned the right to continue to lead the House forward because of an incredible track record of success in the midst of turbulent times in getting things done for everyday Americans,” said Jeffries, a member of his party's leadership and a leading contender to replace her whenever Pelosi steps down.

To be reelected, Pelosi needed a majority of votes cast for specific candidates and could afford to lose only a handful of Democratic votes. House rules give her a bit of wiggle room because lawmakers who are absent or who vote “present” are not counted in the total number of those voting.

Rep. Kevin McCarthy, R-Calif., may receive unanimous backing from Republicans, but he seemed likely to once again be minority leader.

Pelosi won plaudits from many Democrats for two years of leading their opposition to President Donald Trump, largely keeping her party's moderates and progressives united on their joint goal of defeating him and raising mountains of campaign funds. No Democrat has stepped forward to challenge her, underscoring the perception that she would be all but impossible to topple.

But Pelosi is 80 years old, and ambitious younger members continue chafing at the longtime hold she and other older top leaders have had on their jobs. Democrats were also angry and divided after an Election Day that many expected would to mean added House seats for the party but instead saw a dozen incumbents lose, without defeating a single GOP representative.

Pelosi recently suggested anew that these would be her final two years as speaker, referencing a statement she made two years ago in which she said she would step aside after this period.

The speaker's election was coming 17 days before Democrat Joe Biden is inaugurated as president. Yet rather than a fresh start for him and Pelosi, there were issues and undercurrents that will be carrying over from Trump's tempestuous administration.

Though Congress enacted — and Trump finally signed — a $900 billion COVID-19 relief package late last month, Biden and many Democrats say they consider that measure a down payment. They say more aid is needed to bolster efforts to vaccinate the public, curb the virus and restore jobs and businesses lost to the pandemic.

Many Democrats, with the unlikely support of Trump, wanted to boost that bill's $600 per person direct payments to $2,000 but were blocked by Republicans. Democrats want additional money to help state and local governments struggling to maintain services and avoid layoffs.

Biden's priorities also include efforts on health care and the environment.

Guiding such legislation through the House will be a challenge for Pelosi because her party's narrow majority means just a handful of defectors could be fatal.

In addition, cooperation with Republicans could be made more difficult as many in the GOP are continuing to demonstrate fealty to the divisive Trump, backing his unfounded claims that his reelection loss was tainted by fraud. Congress will meet Wednesday to officially affirm Biden's clear Electoral College victory over Trump. Many House and Senate Republicans say they will contest the validity of some of those votes, but their efforts that are certain to fail.

There was no widespread fraud in the election, which a range of election officials across the country, as well as Trump’s former attorney general, William Barr, have confirmed. Republican governors in Arizona and Georgia, key battleground states crucial to Biden’s victory, have also vouched for the integrity of the elections in their states. Nearly all the legal challenges from Trump and his allies have been dismissed by judges, including two tossed by the Supreme Court, which includes three Trump-nominated justices.

Meanwhile, it's not clear which party will control the Senate, which Republicans will hold unless Democrats win both Senate runoff elections in Georgia on Tuesday.

In the House, one race in New York is still being decided and there is a vacancy in Louisiana after GOP Rep.-elect Luke Letlow, 41, died after contracting COVID-19.

The Constitution requires the new Congress to begin on Jan. 3, a date that can only be changed by passing a law.

Lawmakers almost always move the Congress' opening day to a weekday. That didn't happen this year because Democrats were concerned that Trump might use the gap in the calendar to appoint administration officials without getting Senate confirmation.

11:13 AM CT on 1/3/2021

(AP) Congress prepared to convene for the start of a new session Sunday, swearing in lawmakers during a tumultuous period as a growing number of Republicans work to overturn Joe Biden's victory over President Donald Trump and the coronavirus surges.

Democrat Nancy Pelosi was set to be reelected as House speaker by her party, which retains the majority in the House but with the slimmest margin in 20 years after a November election wipeout.

Opening the Senate could be among Mitch McConnell’s final acts as majority leader. Republican control is in question until Tuesday’s runoff elections for two Senate seats in Georgia. The outcome will determine which party holds the chamber.

It’s often said that divided government can be a time for legislative compromises, but lawmakers are charging into the 117th Congress with the nation more torn than ever, disputing even basic facts including that Biden won the presidential election.

Fraud did not spoil the 2020 presidential election, a fact confirmed by election officials across the country. Before stepping down last month, Attorney General William Barr, a Republican appointed by Trump, said there was no evidence of fraud that affected the election’s outcome. Arizona’s and Georgia’s Republican governors, whose states were crucial to Biden’s victory, have also stated that their election results were accurate.

Nevertheless, a dozen Republicans bound for the new Senate, led by Sens. Josh Hawley and Ted Cruz, and even more in the House have pledged to become a resistance force to Biden’s White House, starting with efforts to subvert the will of American voters. These GOP lawmakers plan to object to the election results when Congress meets on Wednesday to tally his 306-232 Electoral College victory over Trump.

Vice President Mike Pence, who as president of the Senate, presides over the session and declares the winner, is facing growing pressure from Trump’s allies over that ceremonial role.

Pence's chief of staff, Marc Short, said in a statement Saturday that Pence “welcomes the efforts of members of the House and Senate to use the authority they have under the law to raise objections.”

Democrats, meanwhile, are pushing ahead, eager to partner with Biden on shared priorities, starting with efforts to stem the pandemic and economic crisis. They plan to revisit the failed effort to boost pandemic aid to $2,000 for most people.

“This has been a moment of great challenge in the United States of America filled with trials and tribulations, but help is on the way,” Rep. Hakeem Jeffries, D-N.Y., the chairman of the House Democratic caucus, said in an interview.

“America is a resilient nation, filled with resilient people,” he said. “We will continue to rise to the occasion, emerge from this pandemic and continue to march toward our more perfect union.”

Among the House Republican newcomers are Trump-aligned Marjorie Taylor Greene of Georgia, who has given nod to conspiracy Q-Anon theories, and gun rights advocate Lauren Boebert of Colorado, who circulated a letter of support to retain the right of lawmakers to carry firearms in the Capitol.

Greene was among a group of House Republicans led by Rep. Mo Brooks of Alabama who visited with Trump at the White House during the holiday season about their effort to undo the election.

The “Jan. 6 challenge is on,” Taylor Greene said in a tweet pinned to the top of her social media account. Boebert also tweeted support for those challenging Biden's victory.

House Republicans boosted their ranks in the November election, electing a handful of women and minorities, more than ever. Some of the new GOP lawmakers are being called the “Freedom Force,” and a counter to the “squad” — Rep. Alexandria Ocasio-Cortez of New York and other liberal Democratic women who swept to office in the last session.

In a statement Rep. Kevin McCarthy, R-Calif., the minority leader, said the new Republican members “are a strong representation of who America is and where we come from.”

Progressive Democrats bolstered their ranks with newcomers aligned with more liberal priorities.

The Capitol itself is a changed place under coronavirus restrictions. Lawmakers are arriving in Washington from all parts of the country potentially exposed to the virus during their travel.

Several lawmakers have been sickened by the virus and some will be absent Sunday. Also, a memorial was held Saturday for newly elected Republican lawmaker Luke Letlow, 41, of Louisiana, who died of complications from COVID-19 days before the swearing in.

The Office of the Attending Physician has issued several lengthy memos warning lawmakers off meeting in groups or holding traditional receptions to prevent the spread of the virus. Masks have been ordered worn at all times and Pelosi has required them to be used in the House chamber. Members are required to have coronavirus tests and have access to vaccines.

“Do not engage any in-person social events, receptions, celebrations, or appointments, outside your family unit, and always wear a face covering outside your home,” the physician’s office warned in one memo. “You should strictly avoid any type of office-based reception or celebration during the days ahead.”

Even the traditional swearing in ceremonies will be limited in the House. No more big family portraits with new lawmakers taking the oath of office. Instead, each representative-elect can bring one guest in line with social distancing protocols.

The vice president typically swears in the senators and Pence was expected to do so Sunday.

Pelosi, who is returning as speaker, faces a tight race, with the House split 222-211, with one race still undecided and one vacancy after Letlow's death.

The California Democrat can endure some defections from her ranks, but only a few, barring absences. In a letter to colleagues Sunday, she said she was “confident that the Speaker’s election today will show a united Democratic Caucus ready to meet the challenges ahead.” She needs to win a majority of those present and voting to retain the speaker’s gavel.

9:35 AM CT on 1/3/2021

(AP) The COVID-19 death toll in the United States has surpassed 350,000 as experts anticipate another surge in coronavirus cases and deaths stemming from holiday gatherings over Christmas and New Year's.

Data compiled by Johns Hopkins University shows the U.S. passed the threshold early Sunday morning. More than 20 million people in the country have been infected. The U.S. has begun using two coronavirus vaccines to protect health care workers and nursing home residents and staff but the rollout of the inoculation program has been criticized as being slow and chaotic.

Multiple states have reported a record number of cases over the past few days, including North Carolina and Arizona. Mortuary owners in hard-hit Southern California say they’re being inundated with bodies.

The U.S. by far has reported the most deaths from COVID-19 in the world, followed by Brazil, which has reported more than 195,000 deaths.

8:18 PM CT on 1/2/2021

Hospital executives are planning for how they can sustain telehealth momentum from the COVID-19 pandemic and build the practice into their future care delivery strategies.

Patient visits conducted via video or phone could account for between 10% to 30% of total visits after the COVID-19 pandemic subsides, according to healthcare executives and analysts. But to achieve that, hospitals will need to fine-tune the patient experience, improve training and trouble-shooting resources for clinicians, and figure out payment challenges.

"The technology part of this is sophisticated, but the really hard part is the human factors," said Dr. Arthur Southam, executive vice president of health plan operations and chief growth officer at Oakland, Calif.-based Kaiser Permanente. "How do you make the telehealth experience—the waiting room, and the start, and the finish—a really good consumer and clinician experience?"

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6:38 PM CT on 1/2/2021

(AP) New Hampshire has set a goal of administering 100 shots per hour at each of the 13 state-run COVID-19 vaccination sites when it moves to Phase 2.

Perry Plummer, the former assistant commissioner of safety, is overseeing vaccine distribution. He told WMUR-TV the goal is realistic but it will take time to get the effort up to speed.

“We expect this to be a little bit of a windy road, and to make sure we’re ready to take turns wherever we need to, to make sure we can get people vaccinated in the State of New Hampshire as quickly as possible,” said Plummer.

The first phase of distribution has focused on health care workers, nursing home residents and staff and first responders. The second phase includes teachers, critical workers in high-risk settings, homeless shelter residents and others.

As of Friday, more than 21,000 vaccines had been administered.

4:05 PM CT on 1/2/2021

(AP) As communities across the country feel the pain of a surge in coronavirus cases, funeral homes in the hot spot of Southern California say they must turn away grieving families as they run out of space for the bodies piling up.

The head of the state funeral directors association says mortuaries are being inundated as the United States nears a grim tally of 350,000 COVID-19 deaths. More than 20 million people in the country have been infected, according to data compiled by Johns Hopkins University.

“I’ve been in the funeral industry for 40 years and never in my life did I think that this could happen, that I’d have to tell a family, ‘No, we can’t take your family member,’” said Magda Maldonado, owner of Continental Funeral Home in Los Angeles.

Continental is averaging about 30 body removals a day — six times its normal rate. Mortuary owners are calling one another to see whether anyone can handle overflow, and the answer is always the same: They’re full, too.

In order to keep up with the flood of bodies, Maldonado has rented extra 50-foot (15-meter) refrigerators for two of the four facilities she runs in LA and surrounding counties. Continental has also been delaying pickups at hospitals for a day or two while they deal with residential clients.

Bob Achermann, executive director of the California Funeral Directors Association, said that the whole process of burying and cremating bodies has slowed down, including embalming bodies and obtaining death certificates. During normal times, cremation might happen within a day or two; now it takes at least a week or longer.

Achermann said that in the southern part of the state, “every funeral home I talk to says, ‘We’re paddling as fast as we can.’"

“The volume is just incredible and they fear that they won’t be able to keep up,” he said. “And the worst of the surge could still be ahead of us.”

Los Angeles County, the epicenter of the crisis in California, has surpassed 10,000 COVID-19 deaths alone. Hospitals in the area are overwhelmed, and are struggling to keep up with basics such as oxygen as they treat an unprecedented number of patients with respiratory issues. On Saturday, U.S. Army Corps of Engineers crews arrived to update some hospital's oxygen delivery systems.

Nationally, an average of just over 2,500 people have died of COVID-19 over the past seven days, according to Johns Hopkins data. The number of daily newly reported cases in that period has averaged close to 195,000, a decline from two weeks earlier.

1:45 PM CT on 1/2/2021

(AP) The U.K. has registered a record 57,725 daily coronavirus cases.

Government figures show the U.K. has recorded five straight daily highs — all above 50,000 and nearly double the levels of two weeks ago.

Also, hospitals in Britain have started receiving batches of the coronavirus vaccine developed by Oxford University and AstraZeneca, approved by British regulators this week.

Some 530,000 doses of the vaccine will be available for rollout across the country from Monday. Nursing home residents and their caretakers, those over 80 and hospital staff are set to receive the first doses.

The Princess Royal Hospital in Haywards Heath, part of Brighton and Sussex University Hospitals NHS Trust in southern England, was among the first to get the vaccine. Dr. George Findlay, the trust’s chief medical officer, says the Oxford-AstraZeneca vaccine is “much easier” to administer than the Pfizer-BioNTech, which needs storage at extremely cold temperatures.

Second doses of both vaccines will occur within 12 weeks rather than the 21 days initially planned, following a change in guidance that aims to increase the number of people who get the first vaccine. More than a million people in the U.K. have received their first shot of the Pfizer vaccine.

The government says 445 people have died in the 28 days after testing positive for the coronavirus. That takes the confirmed total to 74,570, the sixth-highest death toll in the world.

11:00 AM CT on 1/2/2021

(AP) India tested its COVID-19 vaccine delivery system with a nationwide trial on Saturday, as it prepares to roll out an inoculation program to stem the coronavirus pandemic.

The trial included data entry into an online platform for monitoring vaccine delivery, along with testing of cold storage and transportation arrangements for the vaccine, the health ministry said in a statement.

The massive exercise was followed by India’s drug regulator recommending the emergency-use approval of two vaccines for COVID-19 — one developed by Oxford University and U.K.-based drugmaker AstraZeneca, and another by the Indian manufacturer Bharat Biotech.

Both the vaccines will now have to wait for final approval from the Indian regulator.

Serum Institute of India, the world’s largest vaccine manufacturing company, has been contracted by AstraZeneca to make 1 billion doses for developing nations, including India. On Wednesday, Britain became the first to approve the shot.

The vaccine developed by Bharat Biotech is based on an inactivated form of the coronavirus. It is being made in collaboration with agencies of the Indian government. Early clinical studies showed that the vaccine doesn’t have any serious side effects and produces antibodies for COVID-19. The company said in November that it was starting late clinical trials.

The government plans to inoculate 300 million people in the first phase of the vaccination program, which will include healthcare and front-line workers, police and military troops, and those with comorbidities who are over the age of 50.

The government is expected to initially lean on the vaccine produced by Serum Institute of India, which doesn’t require the ultra-cold storage facilities that some others do. Instead, it can be stored in refrigerators. This makes it a feasible candidate, not just for India but also for other developing nations.

Indian Health Minister Harsh Vardhan reviewed the preparedness for the vaccination drive at a government hospital in New Delhi on Saturday and urged the public not to pay heed to anti-vaccine rumors. “We will not compromise on any protocol before approving a vaccine,” he told reporters.

Pooja Moriya, a health worker in the capital who will be one of the first to be inoculated, said hospital staff has had several meetings about the vaccine and how it works. “Our seniors have told us to not be scared at all,” Moriya said.

India has confirmed over 10.3 million coronavirus cases, second in the world behind the U.S. More than 149,000 people have died from the virus in India.

9:15 PM CT on 1/1/2021

(KBTX) Even after Texas state health officials expressed concern that vaccines are going unused, many eligible people are finding it difficult to track down where they can get vaccinated. It's also unclear whether whether anyone in the state knew how many doses of the vaccine had been administered. State health departments are rarely administering the vaccines themselves but they are setting the guidelines that providers must follow for orderly and fair distribution. 

In Texas, state officials would allocate an appropriate number of vaccine doses to providers and pharmacies. The vaccines would then come directly from the federal government.

Shipments of the vaccine first began arriving at Texas hospitals on Dec. 14, according to KBTX. The limited supply, under Phase 1A of the state’s rollout, was reserved for front-line healthcare workers and residents and staff members of nursing homes and other long-term care facilities, which have been decimated by the virus. State officials estimated there were 1.9 million Texans eligible in that first tier.

6:35 PM CT on 1/1/2021

(AP) The Senate wrapped up a rare New Year’s Day session with Republicans rejecting President Donald Trump’s demand for $2,000 COVID-19 aid checks and overriding his veto of a sweeping defense bill, an unusual one-two rebuke at the end of a chaotic Congress.

Democrats tried a final time to push forward a House-passed bill that would boost the $600 direct aid payments just approved by Congress to $2,000 as Trump demanded for millions of Americans. Republicans blocked a vote, arguing in favor of a more targeted approach.

The rejection of Trump’s top priorities, along with the first veto override of his presidency, offered an unusual willingness by the president’s party to confront Trump, now in his final days in the White House after losing the November election to President-elect Joe Biden.

Trump lashed out at GOP leadership on Twitter. “Pathetic!!!” he wrote.

But Trump appeared more focused on his next battle to overturn the results of the election during next week’s session tallying the Electoral College votes.

Congress is ending a dizzying session, a two-year political firestorm that started with the longest federal government shutdown in U.S. history, was riven by impeachment and a pandemic, and now closes with the GOP’s rare rebuke of the president.

Democrats vowed to swiftly revive the $2,000 checks after the new Congress is sworn in Sunday.

“President-elect Joe Biden has made clear that the pandemic relief bill that Congress passed is simply a down payment on the work that needs to continue,” said Rep. Hakeem Jeffries, D-N.Y., the chair of the House Democratic caucus. “We’re going to continue to fight for a $2,000 direct payment check.”

Tensions ran high as senators sniped over slogging through the holiday season at the Capitol.

Trump’s demands for additional aid upended the year-end COVID-19 relief and federal funding package, forcing his Republican allies to stand alone as Democrats embraced his push for more direct payments to struggling American households.

Senate Democratic leader Chuck Schumer tried, as he has all week, to push the proposal for a vote.

“This is it — the last chance,” Schumer said.

The New York senator said “the only thing standing in the way” is Senate Majority Leader Mitch McConnell and other Republican senators.

The second-ranking Republican, Sen. John Thune of South Dakota, rose to object, saying the proposal was “not an effective way” to meet the needs of Americans.

That drew an angry tweet from Trump.

Trump said the state’s Republican Gov. Kristi Noem, an ally, should pose a primary challenge to Thune, who faces reelection. Noem has previously said she intends to run again for governor.

But presidential tweets that once sparked fear in Republicans may be losing their punch.

Sen. Lisa Murkowski, R-Alaska, told reporters at the Capitol that she found it “very dispiriting at this time, New Year’s Day, that the president would be working to pit Republicans against Republicans.”

Trump’s last-minute demands threw Congress into a tumultuous year-end session that deepened the divide within the party between the GOP’s new wing of Trump-styled populists wary of defying the president and what had been mainstay conservative views.

Sen. Josh Hawley, R-Mo., who has pledged to lead Trump’s challenge to overturn the election during next week’s session, was among those senators who also supported Trump’s push for COVID-19 aid.

Hawley found himself in common cause with Sen. Bernie Sanders, the independent from Vermont, who argued Friday for a vote.

“Bring the bill to the floor,” Sanders said.

Hawley agreed. He said with the president and the House supporting more aid, only the GOP-led Senate stood alone.

“This seems to be the Senate versus the United States of America,” Hawley said.

McConnell has shown little interest in Trump’s push to bolster the $600 relief checks just approved in a sweeping year-end package, declaring Congress has provided enough pandemic aid, for now.

He dismissed the proposal, as passed by the House, as “socialism for rich people” who don’t need the federal help.

McConnell proposed his own bill, loaded up with Trump’s other priorities to rein in big tech companies and investigate the 2020 presidential election. But it was not a serious effort, and he did not push it forward for a vote.

The refusal to act on the checks, along with the veto of the defense bill, could very well be among McConnell’s final acts as majority leader as two GOP senators in Georgia are in the fights of their political lives in runoff elections next week that will determine which party controls the Senate.

At one point Friday, the Senate’s presiding officer mistakenly called Schumer the majority leader.

“Someday soon,” Schumer quipped.

Trump and Biden are poised to campaign in Georgia ahead of Tuesday’s election as GOP Sens. David Perdue and Kelly Loeffler face Democrats Jon Ossoff and Raphael Warnock.

It’s a chaotic end to a session of Congress that resembles few others for the sheer number of crises and political standoffs as Trump’s presidency defined and changed the legislative branch.

Congress opened in 2019 with the federal government shutdown over Trump’s demands for money to build the border wall with Mexico. Nancy Pelosi regained the speaker’s gavel after Democrats swept to the House majority in the midterm election.

The Democratic-led House went on to impeach the president over his request to the Ukrainian president to “do us a favor” against Biden ahead of the presidential election. The Republican-led Senate acquitted Trump in 2020 of the charges of abuse of power and obstruction of Congress.

When the pandemic struck, Congress rallied with unusual speed and agreement to pass a $2 trillion relief package, the largest federal intervention of its kind in U.S. history.

The usually bustling halls of Congress became eerily silent most days. Many members tested positive for the virus.

The Congress had few other notable legislative accomplishes and could not agree on how to respond to the racial injustice reckoning that erupted after the deaths of George Floyd, Breonna Taylor and other Black Americans at the hands of law enforcement.

Instead, the Senate was primarily focused on filling the courts with Trump’s conservative judicial nominees, including confirming his third Supreme Court justice, Amy Coney Barrett.

For now, the smaller $600 checks are being sent to households. Americans earning up to $75,000 qualify for the full payments, which are phased out at higher income levels, and there’s an additional $600 payment per dependent child.

4:45 PM CT on 1/1/2021

A pharmacist at Aurora Medical Center-Grafton in Wisconsin admitted to removing 57 vials, which each contained approximately 10 doses of the Moderna vaccine, from freezers at least twice between Dec. 24 and Dec. 26.

The employee, who has not yet been identified, returned the vials into storage each time and has been fired. Local and federal authorities are investigating the incident. Meanwhile, Advocate Aurora and other systems are defending their security protocol, calling the instance an anomaly. Click here to read more.  

1:34 CT PM on 1/1/2021

(AP) The number of confirmed U.S. coronavirus cases has surpassed 20 million, according to data from Johns Hopkins University.

That’s nearly twice as many as the No. 2 country, India, and nearly one-quarter of the more than 83 million cases globally.

The U.S. continued to surpass other countries in COVID-19 cases as it reached 20 million at the start of the new year, according to data kept by Johns Hopkins University.

COVID-19 deaths have also increased in the country, now totaling more than 346,000.

India and Brazil trail behind the U.S. in coronavirus cases at over 10 million and 7 million, respectively.

The increase comes as officials race to vaccinate millions of Americans but have come off to a slower and messier start.

President-elect Joe Biden criticized the Trump administration Tuesday for the pace of distributing COVID-19 vaccines and vowed to ramp up the current speed of vaccinations. However, Biden acknowledged that it “will still take months to have the majority of Americans vaccinated.”

Globally, more than 83 million cases have been confirmed.

11:36 AM CT on 1/1/2021

(AP) The Maryland Department of Health is working with regional and federal partners to test patient samples for infection with the new variant of the coronavirus.

The Baltimore Sun reports the U.S. Centers for Disease Control and Prevention are collaborating with the state’s public health lab, as well as state laboratories in California and Delaware to test for the apparently more contagious variant.

There have been at least two cases of the COVID-19 variant identified in the U.S., one in California and another in Colorado.

A Maryland health department spokesman says the variant has not been detected in Maryland.

The CDC says medical professionals do not now believe that the new variant is more deadly than existing ones or that it will not respond to vaccines. But it could much more contagious and make the pandemic even harder to contain.

9:21 AM CT on 1/1/2021

(AP) California surpassed 25,000 coronavirus deaths since the start of the pandemic and officials disclosed Thursday that three more cases involving a mutant variant of the virus have been confirmed in San Diego County.

The grim developments came as an ongoing surge swamps hospitals and pushes nurses and doctors to the breaking point as they brace for another likely increase after the holidays.

“We’re exhausted and it’s the calm before the storm,” said Jahmaal Willis, a nurse and emergency room leader at Providence St. Mary Medical Center in Apple Valley. “It’s like we’re fighting a war, a never-ending war, and we’re running out of ammo. We have to get it together before the next fight.”

Public health officials continued to plead with residents just hours before the start of 2021 not to gather for New Year's Eve celebrations.

In Los Angeles County, where an average of six people die every hour from COVID-19, the Department of Public Health tweeted out snippets every 10 minutes on lives that have been lost.

“The hair stylist who worked for 20 years to finally open her own shop.”

“A grandmother who loved to sing to her grandchildren.”

“The bus driver who put her daughter through college and was beaming with pride.”

The tweets, which included messages to wear a mask, physically distance, stay home and “Slow the spread. Save a life,” came on a day when the county reported a record 290 deaths. That would be a rate of one death every five minutes, though it included a backlog.

Los Angeles County, which has a quarter of the state's 40 million residents, has had 40% of the deaths in California, the third state to reach the 25,000 death count. New York has had nearly 38,000 deaths, and Texas has had more than 27,000, according to a tally by Johns Hopkins University.

Infections are spreading rapidly. San Diego County confirmed Thursday that it had found a total of four cases of the virus variant that appears to be more contagious. A 30-year-old man tested positive for the variant on Wednesday and three more men — two in their 40s and one in his 50s — also have been confirmed to have the strain. Other cases involving the variant have been confirmed in Florida and Colorado.

At least two of the men in San Diego County hadn't traveled outside of the country and none had “any known interaction with each other," the county said. Officials believed many more cases will surface.

San Diego County also reported a record high number of new deaths in a single day at 62, well over the previous record of 39 reported only a week earlier.

Hospitals, particularly in Southern California and the agricultural San Joaquin Valley in the middle of the state, have been overrun with virus patients and don't have any more intensive care unit beds for COVID-19 patients.

In Los Angeles County, hospitals have been pushed "to the brink of catastrophe,” said Dr. Christina Ghaly, health services director. “This is simply not sustainable. Not just for our hospitals, for our entire health system.”

Cathy Chidester, director of the county's Emergency Medical Services Agency, said hospitals are facing problems with oxygen with so many COVID-19 patients needing it because they are struggling to breathe. Older hospitals are having difficulty maintaining oxygen pressure in aging infrastructure and some are scrambling to locate additional oxygen tanks for discharged patients to take home.

Ambulances are being forced to wait in bays as long as eight hours before they can transfer patients inside hospitals — and in some cases, doctors are treating patients inside ambulances, she said.

8:38 PM CT on 12/31/20

(AP) California surpassed 25,000 coronavirus deaths since the start of the pandemic, reporting the grim milestone Thursday as an ongoing surge swamps hospitals and pushes nurses and doctors to the breaking point as they brace for another likely increase after the holidays.

“We’re exhausted and it’s the calm before the storm,” said Jahmaal Willis, a nurse and emergency room leader at Providence St. Mary Medical Center in Apple Valley. “It’s like we’re fighting a war, a never-ending war, and we’re running out of ammo. We have to get it together before the next fight.”

Public health officials continued to plead with residents just hours before the start of 2021 not to gather for New Year's Eve celebrations.

In Los Angeles County, where an average of six people die every hour from COVID-19, the Department of Public Health tweeted out snippets every 10 minutes on lives that have been lost.

“The hair stylist who worked for 20 years to finally open her own shop.”

“A grandmother who loved to sing to her grandchildren.”

“The bus driver who put her daughter through college and was beaming with pride.”

The tweets, which included messages to wear a mask, physically distance, stay home and “Slow the spread. Save a life,” came on a day when the county reported a record 290 deaths. That would be a rate of one death every five minutes, though it included a backlog.

Los Angeles County, which has a quarter of the state's 40 million residents, has had 40% of the deaths in California, the third state to reach the 25,000 death count. New York has had nearly 38,000 deaths, and Texas has had more than 27,000, according to a tally by Johns Hopkins University.

Infections are spreading rapidly and California confirmed Wednesday that it found a second reported U.S. case of a mutant variant of the coronavirus that appears to be more contagious. It's not clear where the 30-year-old San Diego man was infected with the variant or if it had led to any wider spread of the disease.

Hospitals, particularly in Southern California and the agricultural San Joaquin Valley in the middle of the state, have been overrun with virus patients and don't have any more intensive care unit beds for COVID-19 patients.

In Los Angeles County, hospitals have been pushed "to the brink of catastrophe,” said Dr. Christina Ghaly, health services director. “This is simply not sustainable. Not just for our hospitals, for our entire health system.”

6:14 PM CT on 12/31/20

(AP) An ambitious goal of vaccinating 1 million New York City residents against COVID-19 in January was set Thursday by Mayor Bill de Blasio, who noted that meeting the target would require outside cooperation and the city dramatically increasing access.

“We need to go into overdrive now,” the mayor said at his regular briefing. “We need every day to speed up and reach more and more people.”

The city has vaccinated 88,000 people since vaccines first became available Dec. 14, working at a pace that would leave the city far short of the goal for next month.

Health Commissioner Dr. Dave Chokshi said officials want to double citywide access points to at least 250 sites, including hospitals, community health centers and urgent care clinics. Deputy Mayor Melanie Hartzog said officials also plan to double the city's 150,000-dose-a-week capacity over the course of January.

Meeting the goal also would require help from the federal and state governments, as well as manufacturers, the mayor said. He called it a “team effort” also involving schools, other city agencies and communities.

De Blasio announced the goal amid criticism that the nation's vaccine rollout has been too slow. Trump administration officials said this month they planned to have 20 million doses of the vaccine distributed by the end of the year.

But according to data provided by the Centers for Disease Control and Prevention, just over 11.4 million doses had been distributed this week, and only 2.1 million people have received their first dose.

De Blasio also said that March 14, a year after the first COVID-19-related death in New York, will be a day of remembrance for lives lost in the pandemic.

“We need to recognize 25,000 of our fellow New Yorkers gone,” he said.

3:17 PM CT on 12/31/20

(AP) China authorized its first homegrown COVID-19 vaccine for general use Thursday, adding another shot that could see wide use in poorer countries as the virus surges back around the globe.

The Sinopharm vaccine had already been given to groups such as health care professionals and essential workers under emergency-use guidelines as part of China's program to inoculate 50 million people before the Lunar New Year holiday in February. But the go-ahead should allow it to be supplied more broadly at home and moves Beijing closer to being able to ship it abroad. It comes one day after British regulators authorized AstraZeneca's inexpensive and easy-to-handle vaccine.

Both shots have been closely watched by developing countries, many of which have been unable to secure the Pfizer and Moderna doses being snapped up by rich nations. Pakistan's science minister said Thursday that his government will buy 1.2 million doses of a Sinopharm shot, two days after its death toll topped 10,000.

The greenlight came a day after the state-owned company announced that preliminary data from last-stage trials had shown it to be 79.3% effective. That announcement did not detail the size of the control group, how many people were vaccinated and at what point the efficacy rate was reached after injection, and experts have cautioned that trial data needs to be shared.

Officials have said the vaccine standards were developed in “close cooperation” with the World Health Organization. Securing WHO's so-called pre-qualification could go some way toward assuring the rest of the world about the quality of Chinese vaccines, which already face a reputation problem back home. It would also open the path for the shots to be distributed in the global vaccine consortium, COVAX, and potentially in countries that don’t have their own regulatory agencies.

China is eager to ship its vaccines globally, driven by a desire to repair the damage to its image caused by the pandemic that started a year ago in the central city of Wuhan.

Technically, China granted conditional approval for the vaccine, meaning that research is still ongoing, and the company will be required to submit follow-up data as well as reports of any adverse effects after the vaccine is sold on the market, Chen Shifei, the deputy commissioner of the National Medical Products Administration, told a news conference. Final proof of its effectiveness will depend on publication of more data.

Sinopharm, which has another shot under development, is one of at least five Chinese developers that are in a global race to create vaccines for the disease that has killed more than 1.8 million people. While the Pfizer and Moderna shots have been greeted with much fanfare in the West, those shots must be stored at ultra-cold or freezer temperatures, complicating distribution.

The Sinopharm vaccine, like the AstraZeneca one, could be easier for countries around the world to handle since they can be stored at normal fridge temperatures.

Both shots, as well as Russia’s Sputnik, are expected to be supply much of the developing world. That means the cost will also be important. AstraZeneca is expected to cost about $2.50 a dose, while Russia has said its doses will be priced at $10 for the global market. Pfizer’s vaccine costs about $20, while Moderna’s is $15 to $25, based on agreements with the U.S. government.

1:05 PM CT on 12/31/20

(AP) The Connecticut Supreme Court ruled Thursday that many of Gov. Ned Lamont's shutdown orders related to the coronavirus pandemic are constitutional, thwarting a challenge from a pub owner.

Justices upheld a lower court judge's decision in September that rejected claims the Democratic governor was exceeding his legal authority in ordering the closing of bars and restricting certain other business activities in efforts to curb the spread of the virus. Superior Court Judge Barbara Bellis had also denied a request to block the orders, which also was upheld by the Supreme Court.

Kristine Casey, who runs Casey's Irish Pub in Milford, sued Lamont in June, saying he exceeded his authority under the public health and civil preparedness emergencies he declared in March and that remain in effect until Feb. 9.

The Supreme Court disagreed with Casey on Thursday.

“Although the plaintiffs raise important questions regarding the governor’s authority in a pandemic, our analysis of the pertinent law and relevant facts leads us to conclude that the governor’s challenged actions to date have been constitutional,” the court said.

“We acknowledge the incredibly difficult economic situation that the plaintiffs and thousands of others across the state are in given the COVID-19 pandemic,” it said. “We also acknowledge, however, that the governor is charged with protecting the health, safety and welfare of the citizens of this state, and that COVID-19 presents an unforeseen and unpredictable pandemic that is not a static or isolated crisis.”

Casey had no immediate comment on the ruling Thursday. She said in her lawsuit that her pub has been closed since March to comply with Lamont's order on bars, but she still has to pay $3,200 a month in rent and is racking up $14,000 a month in other expenses.

“Casey is hemorrhaging personal savings and borrowing from her father to try to stay afloat,” the lawsuit said. “She has not been able to secure any loans through the Small Business Administration. She is fast running out of funds and the shutdown forced upon her by the Governor’s executive orders will put her out of business if it continues much longer.”

Casey's attorney, Jonathan Klein, said he was disappointed with the Supreme Court's ruling. He said it was too early to say whether an appeal to federal courts was possible, because the Supreme Court only issued an initial ruling Thursday that does not give many details on its reasoning.

The Supreme Court did not say when it will issue the full, official decision.

10:41 AM CT on 12/31/20

(AP) The European Union medicines watchdog said Thursday that German company BioNTech has applied for clearance in the 27-nation bloc to administer up to six doses of its COVID-19 vaccine from each vial, instead of the five doses currently approved.

In an email to The Associated Press, the European Medicines Agency said that BioNTech, which developed its vaccine together with Pfizer, has “submitted a request for change” which will be reviewed by the agency's human medicines committee “in the shortest possible timeframe.”

It said that if the committee establishes that six doses can be consistently extracted from each vial of vaccine, it will recommend changing the authorization that clears the vaccine for use in EU nations.

Neither BioNTech nor Pfizer commented Thursday.

German weekly Der Spiegel first reported this week that BioNTech has asked European regulators to change the conditions of approval to allow doctors to use excess vaccine in the vials to draw a sixth dose if possible, rather than tip the leftovers away after five as currently required.

This could result in hundreds of thousands of additional doses in Germany alone during the first quarter, Spiegel reported.

Regulators in the United States, Switzerland and the U.K. already allow up to six doses of 0.3 milliliters each to be drawn from vials.

“The vaccine is manufactured with enough volume for five doses,” the U.K. regulator MHRA said in an email. “However, it is normal for some vials to contain a slight excess volume, and in some cases this could allow a full sixth dose to be extracted.”

“However, care needs to be taken to ensure a full 0.3 ml dose can be administered to the individual,” it added. “Where this cannot be achieved when diluted as recommended, the vial and its contents should be discarded after the fifth dose has been extracted.”

Mixing leftovers from multiple vials is forbidden by all regulators, though.

German Health Minister Jens Spahn on Wednesday backed the idea of extracting additional doses if possible.

BioNTech intentionally fills the vials with more vaccine than necessary to ensure that even inexperienced doctors can get at least five doses out of them.

8:48 AM CT on 12/31/20

(AP) As a result of holiday gatherings, African officials warn of a resurgence of COVID-19 on the continent and urge increased testing to combat it.

The level of testing across the continent is considerably less than what health experts say is needed to effectively control the spread of the disease.

Africa makes up about 3.3% of the global total of confirmed virus cases, but this is believed to be just a fraction of the actual cases on the continent of 1.3 billion people.

When the pandemic began only two of Africa’s 54 countries had laboratories to test for the disease. Now virtually every one of the continent’s countries can carry out the tests. Together Africa’s countries have conducted at least 25 million COVID-19 tests, with a recent increase of 3%, according to the Africa Centers for Disease Control and Prevention.

Compared to the small amount of testing at the beginning of the pandemic, Africa CDC Director John Nkengasong has said the increased testing is “good progress and we continue to be hopeful of this.”

The distribution of the tests, however, is very uneven. Just 10 countries — South Africa, Morocco, Ethiopia, Egypt, Kenya, Ghana, Nigeria, Uganda, Rwanda and Cameroon — are carrying out more than 70% of the continent’s testing. To make the testing more widespread, 2.7 million additional tests have been procured by member states, the Africa CDC said some weeks ago.

Increased testing is needed to help Africa locate where cases are rising and where additional medical responses are needed. And, when they become available to Africa, where vaccines should go.

Africa’s rural areas have even less testing than its cities, where most hospitals and clinics are located. More testing is needed in rural areas, said Nkengasong, especially as urban Africans travel to remote areas to unite with their families as the New Year approaches.

Rapid antigen tests would dramatically boost the ability to test in Africa’s remote, rural areas, according to the Africa CDC and WHO.

The rapid tests look for antigens, or proteins found on the surface of the virus. They are generally considered less accurate — though much faster — than PCR tests, which are higher-grade genetic tests. PCR tests require processing with specialty lab equipment and chemicals and it can take several days before patients get the results.

In contrast, the rapid antigen tests can provide results at the testing site in less than 30 minutes.

The World Health Organization and its partners announced in September that 120 million of the rapid tests would be made available to help Africa’s poor and middle-income countries test at levels closer to those of richer countries, which are deemed necessary to effectively fight the spread of COVID-19.

“Once we begin to use the antigen test more broadly, it will become a game-changer aspect of the way we do testing for the across the continent, especially in the remote areas and especially during this holiday period,” said Nkengasong.

7:40 PM CT on 12/30/2020

(AP) Florida Gov. Ron DeSantis begged for patience from anxious seniors waiting their turn to get inoculated against COVID-19, as confusion and frustration arose over the availability of the life-saving vaccine among some of the state's most vulnerable.

At vaccination sites across the state, seniors formed long lines — some camping out overnight with lawn chairs and blankets — hoping to gain immunity to fight the virus. Before the sun had even risen Wednesday morning, one southwest Florida county's vaccine supply for the day was already accounted for, prompting officials to turn down anyone else who was arriving.

Seniors in other parts of the state were frustrated by busy phone lines and websites that would no longer issue new vaccination appointments.

DeSantis has prioritized Floridians older than 65 to be next in line for the state's stock of vaccine, now that most healthcare workers and other first responders are protected against the virus that has infected more than 1.2 million Floridians.

On Wednesday, health officials reported 13,871 new cases and 139 new deaths, raising the death toll to 21,857.

5:02 PM CT on 12/30/2020

California on Wednesday announced the nation's second confirmed case of the new and apparently more contagious variant of the coronavirus, offering a strong indication that the infection is spreading more widely in the United States.

Gov. Gavin Newsom announced the infection found in Southern California during an online conversation with Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases.

"I don't think Californians should think that this is odd. It's to be expected," Fauci said.

Newsom did not provide any details about the person who was infected.

The announcement came 24 hours after word of the first reported U.S. variant infection, which emerged in Colorado.

1:42 PM CT on 12/30/2020

(AP) The rollout of the coronavirus vaccines in Massachusetts has gone largely as planned with just a few minor glitches along the way, Gov. Charlie Baker said Wednesday.

About 78,000 doses of the vaccine have been administered statewide as of Tuesday, and an estimated 20,000 people who live and work at long-term care facilities should be vaccinated at one of 50 vaccination clinics by the end of this week, the Republican governor said at a news conference.

"The progress obviously in this respect shows that while it is lumpy and bumpy, which we said it would be, it's moving forward and it speaks well with what's ahead with respect to 2021," he said.

The state has already received 86,000 initial doses of the Pfizer vaccine and 146,000 initial doses of the Moderna vaccine, with another 68,000 doses of the Pfizer product allocated to the CVS and Walgreen pharmacy chains, he said.

"This is the largest rollout of a vaccination program in U.S. history and it can't happen fast enough," he said. The state is expected to get about 300,000 doses of the vaccines by the end of the year.

The initial rollout includes inoculating residents and staff at two state-run, long-term care facilities for veterans, both of which ere ravaged by the coronavirus in the spring.

10:35 AM CT on 12/30/2020

(AP) What does a medical professional do when his wife and in-laws contract the disease at the center of a months-long pandemic?

Gabriel Tachtatzoglou, a critical care nurse, did not feel good about the treatment options available in Greece's second-largest city when his wife, both her parents and her brother came down with COVID-19 in November. Thessaloniki has been among the areas of Greece with the most confirmed coronavirus cases, and hospital intensive care units were filling up.

Tachtatzoglou, who had to quarantine and could not go to work once his relatives tested positive for the virus, decided to put his ICU experience to use by looking after them himself.

That decision, his family says, probably saved their lives.

"If we had gone to the hospital, I don't know where we would have ended up," Polychoni Stergiou, the nurse's 64-year-old mother-in-law, said. "That didn't happen, thanks to my son-in-law."

Tachtatzoglou set up a makeshift ICU in the downstairs apartment of his family's two-story home in the village of Agios Athanasios, located about 30 kilometers (nearly 20 miles) from the city. He rented, borrowed and modified the monitors, oxygen delivery machines and other equipment his loved ones might need.

He also improvised. Out of a hat stand, he fashioned an IV bag holder. At one point, the repurposed pole supported four bags dispensing antibiotics, fluids to address dehydration and fever-reducing medicine.

"I've been working in the intensive care ward for 20 years, and I didn't want to put my in-laws through the psychological strain of separation. Plus, there was already a lot of pressure on the health service," Tachtatzoglou told the AP in an interview.

In most countries, doctors and nurses are discouraged from treating close relatives and friends on the theory that emotional bonds could cloud their judgment and affect their skills. Tachtatzoglou says he remained in daily contact with doctors at Papageorgiou Hospital, the overwhelmed facility where he works, while caring for his sick family members, and that he would have hospitalized any of the four if they needed to be intubated.

9:16 PM CT on 12/29/2020

President-elect Joe Biden Tuesday bulked up his coronavirus response team, naming three public health experts to oversee supply chain management, vaccinations and testing:

• Dr. Bechara Choucair, senior vice president and chief health officer for Kaiser Permanente, will lead the Biden administration's vaccination efforts. In this role, he'll be charged with "making sure vaccines turn into vaccinations by coordinating the timely, safe, and equitable delivery of COVID-19 vaccinations for the U.S. population, in close partnership with relevant federal departments and agencies, as well as state and local authorities," according a press release from the Biden transition team.
• Tim Manning, who served as a deputy administrator of FEMA under President Barack Obama, was named supply chain coordinator. Manning, currently an adviser to the Pacific Disaster Center, "will coordinate the federal effort focused on securing, strengthening, and ensuring a sustainable pandemic supply chain, working with departments and agencies to ensure there is sufficient PPE, tests, vaccines, and related supplies and equipment."
• Carole Johnson, New Jersey's health commission, will serve as the testing coordinator. There will be an emphasis on "expanding and targeting testing for schools, nursing homes, other at-risk populations, and communities hardest hit by the pandemic."

Biden named several other operational members to the response team. He also charged the Trump administration with moving slowly on vaccination efforts.

“As I long feared and warned the effort to distribute and administer the vaccine is not progressing as it should," he said.

8:18 PM CT on 12/29/2020

(AP) Texas Gov. Greg Abbott and the state's top health official on Tuesday urged vaccine providers not to hold any doses in reserve and to distribute them as quickly as possible as the state deals with record-breaking numbers of virus patients in hospitals and new cases.

In separate statements, Abbott and state health Commissioner Dr. John Hellerstedt suggested that some hospitals are not moving fast enough in distributing the vaccine to the first rounds of eligible patients.

“A significant portion of vaccines distributed across Texas might be sitting on hospital shelves as opposed to being given to vulnerable Texans. The state urges vaccine providers to quickly provide all shots. We get plenty more each week. Always voluntary,” Abbott tweeted.

On Tuesday, Texas reported 11,775 hospitalized COVID patients, setting a record high for the second day in a row. The state also reported a record high 26,990 newly-confirmed cases.

State health officials report Texas has received nearly 612,000 vaccine doses and 163,700 people have received the first of two shots.

"All providers that have received COVID-19 vaccine must immediately vaccinate healthcare workers, Texans over the age of 65, and people with medical conditions that put them at a greater risk of severe disease or death from COVID-19,” said Dr. John Hellerstedt, commissioner of the Department of State Health Services.

"No vaccine should be kept in reserve,” he said, shortly before Texas reported 11,775 hospitalized COVID patients, setting a record high for the second day in a row. The state also reported a record high 26,990 newly-confirmed cases.

State health officials report Texas has received nearly 612,000 vaccine doses and 163,700 people have received the first of two shots.

5:06 PM CT on 12/29/2020

(AP) Some Arizona hospitals have stopped accepting patients brought to them by ambulance runs and transfers as they scramble to address a backlog of sick people amid a COVID-19 surge, the state's largest hospital chain said Tuesday.

Banner Health said 10 hospitals were diverting ambulances and transfers to other medical facilities late Monday and six were still doing so early Tuesday. All hospitals continued to accept walk-in patients needing emergency care.

Arizona is grappling with the second highest coronavirus infection rate in the nation. California has the highest.

Moving to keep hospitals from getting further overwhelmed, state officials announced Tuesday that Arizona will include people aged 75 and older — over 534,000 residents — in the second phase of COVID-19 vaccinations. Older adults are more likely to be hospitalized with severe complications from the disease and fill ICU beds.

Prioritizing people 75 and older “will keep a lot of vulnerable people from getting sick,” noted Will Humble, Arizona Public Health Association director and a former state health services director.

Humble said diverting ambulances and patient transfers is not unusual during Arizona's winter months when they are more full due to the flu, but he had never seen more than a couple hospitals undertake the measure at the same time.

The state’s coronavirus dashboard reported that 4,475 people were hospitalized for COVID-19 as of Monday, the latest in several records reported since early December. COVID-19 hospitalizations during the summer surge peaked at 3,517 on July 30.

COVID-19 patients occupied 53% of all inpatient beds and 59% of intensive care beds.

Prioritizing people 75 and older ensures those most at risk are vaccinated sooner, protecting them and “relieving the strain on our hardworking healthcare professionals," Gov. Doug Ducey said in the statement.

12:55 PM CT on 12/29/2020

(AP) Missouri hospitals are beginning to see a glimmer of hope as new cases of COVID-19 decline but the possibility of a post-holiday surge is keeping them on edge.

State health officials reported that the rolling seven-day average of cases was 1,816, down from a peak of 4,723 on Nov. 20.

Dr. Alex Garza, who leads the St. Louis Metropolitan Pandemic Task Force, described the situation as “encouraging" in a media briefing Monday, although his enthusiasm was tempered.

“We have a lot of patients in the hospitals right now, so any bump-up that we have from a holiday surge could put us right back into those areas where we don’t want to be, where we are stretching our staff way too thin," he said, adding, “The fact is that COVID is not going to go away over the holidays. It won’t leave when 2020 leaves either."

On Tuesday alone, the state added 2,479 more coronavirus cases and 117 more deaths, bringing Missouri’s totals since the pandemic began to 383,616 confirmed cases and 5,316 deaths. State health officials said that 97 of the deaths were added as the result of a review of death certificates, with 32 of them dating back to November.

9:54 AM CT on 12/29/2020

(AP) State lawmakers across the country will convene in 2021 with the continuing COVID-19 pandemic rippling through much of their work — even affecting the way they work.

After 10 months of emergency orders and restrictions from governors and local executive officials, some lawmakers are eager to reassert their power over decisions that shape the way people shop, work, worship and attend school.

They also will face virus-induced budget pressures, with rising demand for spending on public health and social services colliding with uncertain tax revenue in an economy that is still not fully recovered from the pandemic.

“COVID will frame everything,” said Tim Storey, executive director of the National Conference of State Legislatures.

The virus even will affect the mechanics of making laws. Some legislatures will allow their members to vote remotely, instead of gathering in tightly packed chambers. Temperature checks, health screenings, plexiglass dividers and socially distanced seating are planned in some capitols.

Lawmakers will be meeting as COVID-19 vaccines are being distributed, first to medical workers and high-risk groups such as the elderly. That may spark debates in some states about whether the distribution plans should be subject to legislative approval and whether workplaces and institutions can require people to receive the shots.

All 50 states are scheduled to hold regular legislative sessions in 2021. In many, it will mark their first meeting since the November elections in which Republicans again secured statehouse supremacy. The GOP will control both legislative chambers in 30 states compared with 18 for Democrats. Minnesota is the only state where Republicans will control one chamber and Democrats the other. Nebraska's legislature is officially nonpartisan.

A December report by Moody’s Investors Service warned that states face a negative outlook for 2021 because of weak revenue and budget uncertainties caused by the pandemic. In many states, revenues aren’t likely to recover until the end of 2021 or later, Moody’s said. That could create tough financial choices for lawmakers, especially in states that have had to tap their reserves, borrow or rely on one-time revenue sources to balance their current budgets.

8:17 PM CT on 12/28/2020

(AP) The House voted Monday to increase COVID-19 relief checks to $2,000, meeting President Donald Trump’s demand for bigger payments and sending the bill to the GOP-controlled Senate, where the outcome is uncertain.

Democrats led passage, 275-134, their majority favoring additional assistance. They had settled for smaller $600 payments in a compromise with Republicans over the big year-end relief bill Trump reluctantly signed into law.

The vote divides Republicans who mostly resist more spending. But many House Republicans joined in support, despite being wary of bucking the president. Senators are set to return to session Tuesday to consider the measure.

6:12 PM CT on 12/28/2020

"It truly is a historical event. That's the way we all need to look at this," Mary Lynn Spalding, president and CEO of Christian Care Communities, a senior living provider in Kentucky, said of the vaccinations starting. Long-term care leaders who have already held vaccination clinics offered tips Monday during a webinar on how to prepare. Acute setting could adapt some of those learnings for their distribution efforts currently under way. To read more, click here.

4:27 PM CT on 12/28/2020

(AP) The residents and staff members at a Seattle-area nursing home that had the first deadly COVID-19 outbreak in the United States began receiving vaccines on Monday.

The first death associated with the Life Care Center of Kirkland, Washington, was reported in late February, and more than 40 people connected to the facility later died of coronavirus. The Seattle Times reports that Monday was the first day long-term care facilities can receive vaccines under a federal partnership with CVS and Walgreens, which is handling shots for the bulk of the state’s approximately 4,000 long-term care facilities.

Along with health-care workers, Washington state has recommended that nursing home residents receive the vaccine first, followed by residents of assisted-living facilities, adult family homes and other care sites. State officials have set a goal for all residents to receive the first dose of the two-dose vaccine by the end of January.

2:21 PM CT on 12/28/2020

(AP) The $900 billion economic relief package that President Donald Trump signed over the weekend will deliver vital aid to millions of struggling households and businesses. Yet his nearly one-week delay in signing the bill means that it will take that much longer for the financial support to arrive.

The package that Trump signed at his private club in Florida on Sunday will extend two unemployment benefit programs providing aid to 14 million people that expired last week. It will also provide small business loans and up to $600 in cash payments to most individuals. In addition, it extends a moratorium on evictions for one month. The measure does not include aid for states and localities that are being forced to turn to layoffs and service cuts as their tax revenue dries up — a potential long-run drag on the economy.

The legislation extends the two federal jobless aid programs until mid-March and adds a $300 supplemental weekly payment. But because Trump signed the bill on Sunday, a day after the two programs lapsed, that could cost the unemployed a week of benefits, with payments not restarting until next week.

“The date was really unfortunate,” said Michele Evermore, a senior policy analyst at the National Employment Law Project, a workers' advocacy group. “Now there's some question as to when this gets paid out.”

It is possible that the Labor Department will interpret the law to allow payments for the week ending Jan. 2, Evermore said. But if the bill had been signed Saturday, payments clearly could have restarted this week.

And it will likely take two to three weeks for states to update their computer systems to resume the aid programs and pay out the extra $300, Evermore said, a process that could have started earlier, after Congress first approved the bill about a week ago.

The delay will force those out of work to make hard decisions about paying for food, medicine or rent.

“These are people who have been living in poverty for months,” she said. “Any delay is an immense hardship.”

Months from now, economists say, the widespread distribution and use of vaccines could potentially unleash a robust economic rebound as the virus is quashed, businesses reopen, hiring picks up and consumers spend freely again. Yet the aid likely won't last long enough to support struggling small businesses and the unemployed until the vaccine has been broadly distributed and a strong rebound has begun.

“Some aid is better than no aid,” said Gregory Daco, chief U.S. economist at Oxford Economics. "It’s positive. But it’s likely going to be insufficient to bridge the gap from today until late spring or early summer, when the health situation fully improves.”

President-elect Joe Biden has said he will seek another relief package soon after his inauguration next month, setting up another political brawl given that some Senate Republicans have said that with vaccines on the way, further government aid may be unnecessary.

The new aid package should boost the broader economy, according to Goldman Sachs. Economists at the investment bank said late Sunday that they are boosting their growth forecast for the first three months of next year to 5% at an annual rate, up from an earlier estimate of 3%.

Much of that upgrade is based on the inclusion of $600 stimulus checks, Goldman economists said.

Right now, however, the economy is in a renewed slump as a resurgent virus intensifies hardships for businesses. Consumers have cut back on shopping, traveling, dining out and attending sports and entertainment events. Key measures of the economy — retail sales, applications for jobless aid, travel spending — have weakened.

Roughly 14 million Americans faced a cutoff of their federal unemployment benefits if Congress hadn't agreed to the new package after months of stalemate. Perhaps 2 million Americans would have been able to transfer to a state-run extended benefit program, but the rest would have had no income at all. More than 4 million have already used all the unemployment aid available to them, which lasts 26 weeks in most states; they will be able to reapply.

A program that provides unemployment aid for self-employed and contract workers will now pay benefits for 50 weeks, up from 39. A federal program that provides extended benefits, on top of the 26 provided by most states, will also last for another 11 weeks.

12:10 PM CT on 12/28/2020

(AP) The head of the World Health Organization says it’s important to step up genomic sequencing worldwide to ensure that new variants of the coronavirus are detected as the pandemic enters its second year.

New variants detected in Britain and South Africa that appear to be more infectious have caused concern and triggered new travel restrictions this month.

WHO Director-General Tedros Adhanom Ghebreyesus said at an online news conference Monday from Geneva that “there will be setbacks and new challenges in the year ahead — for example new variants of COVID-19 and helping people who are tired of the pandemic continue to combat it.”

He said that the WHO is working closely with scientists across the world to “better understand any and all changes to the virus” and their impact.

Tedros said he wanted to “underscore the importance of increasing genomic sequencing capacity worldwide” and of sharing information with the U.N. health agency and other countries. He said that “only if countries are looking and testing effectively will you be able to pick up variants and adjust strategies to cope.”

10:45 AM CT on 12/28/2020

(AP) Nearly 1.3 million people went through U.S. airports on Sunday, the highest level of air travel in more than nine months, despite fear that travel will lead to more cases of COVID-19.

The Transportation Security Administration said it screened 1,284,599 on Sunday, the highest total since March 15. More than 10 million people have traveled by air since Dec. 18, including six days with at least 1 million people getting screened.

Figures on road trips aren’t available, but AAA predicted that about 85 million Americans would travel during the Christmas holiday season, most of them by car.

Dr. Anthony Fauci, the government’s top expert on infectious disease, said that level of travel could lead to a further increase in COVID-19 cases. Fauci said crowded airports make it difficult to maintain social distance, and holiday gatherings combine people from different households.

“As much as we advise against it, nonetheless, it happens,” he said on CNN. “And that’s one of the reasons why we’re concerned about that being a real risk situation for the spread of infection.”

New cases of COVID-19 have been surging for about two months. There have been more than 330,000 reported deaths from the virus.

9:15 AM CT on 12/28/20

(AP) President Donald Trump has signed a $900 billion pandemic relief package, ending days of drama over his refusal to accept the bipartisan deal that will deliver long-sought cash to businesses and individuals and avert a federal government shutdown.

The deal also provides $1.4 trillion to fund government agencies through September and contains other end-of-session priorities such as an increase in food stamp benefits.

The signing Sunday, at his private club in Florida came as he faced escalating criticism over his eleventh-hour demands for larger, $2,000 relief checks and scaled-back spending even though the bill had already passed the House and Senate by wide margins. The bill was passed with what lawmakers had thought was Trump's blessing, and after months of negotiations with his administration.

His foot-dragging resulted in a lapse in unemployment benefits for millions and threatened a government shutdown in the midst of a pandemic. But signing the bill into law prevents another crisis of Trump’s own creation and ends a standoff with his own party during the final days of his administration.

It was unclear what, if anything, Trump accomplished with his delay, beyond angering all sides and empowering Democrats to continue their push for higher relief checks, which his own party opposes.

In his statement, Trump repeated his frustrations with the COVID-19 relief bill for providing only $600 checks to most Americans instead of the $2,000 that his fellow Republicans already rejected. He also complained about what he considered unnecessary spending by the government at large.

“I will sign the Omnibus and Covid package with a strong message that makes clear to Congress that wasteful items need to be removed,” Trump said in the statement.

While the president insisted he would send Congress “a redlined version” with items to be removed under the rescission process, those are merely suggestions to Congress. The bill, as signed, would not necessarily be changed.

Democrats, who have the majority in the House, immediately vowed to prevent any cuts. Democrats “will reject any rescissions” submitted by the president, said Rep. Nita Lowey of New York, chair of the Appropriations Committee.

Lawmakers now have breathing room to continue debating whether the relief checks should be as large as the president has demanded. The Democratic-led House supports the larger checks and is set to vote on the issue Monday, but it's expected to be ignored by the Republican-held Senate, where spending faces opposition. For now, the administration can only begin work sending out the $600 payments.

Republican Rep. Mo Brooks of Alabama, a conservative who supported Trump's extraordinary and futile challenge of the election results, counted himself Monday among the opponents of a more generous relief package and Trump's call for higher payments.

“It’s money we don’t have, we have to borrow to get and we can’t afford to pay back," he said on “Fox and Friends." ”Someone's got to show me how we’re going to pay for it. How far before we all go into debilitating insolvency and bankruptcy?”

But Republican Rep. Elise Stefanik of New York said she was open to the idea of $2,000 checks. “Many Americans are in dire need of relief," she said on the show.

Altogether, Republicans and Democrats alike swiftly welcomed Trump's decision to sign the bill into law.

“The compromise bill is not perfect, but it will do an enormous amount of good for struggling Kentuckians and Americans across the country who need help now,” said Senate Majority Leader Mitch McConnell, R-Ky. “I thank the President for signing this relief into law."

House Speaker Nancy Pelosi, D-Calif., called the signing “welcome news for the fourteen million Americans who just lost the lifeline of unemployment benefits on Christmas weekend, and for the millions more struggling to stay afloat during this historic pandemic and economic crisis.”

Others slammed Trump's delay in turning the bill into law. In a tweet, Rep. Gerry Connolly, D-Va., accused Trump of having “played Russian roulette with American lives. A familiar and comfortable place for him.”

Senate Democratic leader Chuck Schumer, D-N.Y., said he would offer Trump’s proposal for $2,000 checks for a vote in Senate — putting Republicans on the spot.

“The House will pass a bill to give Americans $2,000 checks," Schumer tweeted. “Then I will move to pass it in the Senate.” He said no Democrats will object. "Will Senate Republicans?”

Democrats are promising more aid to come once President-elect Joe Biden takes office, but Republicans are signaling a wait-and-see approach.

Congress will push ahead Monday, with the House expected to vote to override Trump’s veto of an annual Defense bill, confronting the president on another big issue in the final days of the session. The Senate is expected to follow on Tuesday.

In the face of growing economic hardship, spreading disease and a looming shutdown, lawmakers spent Sunday urging Trump to sign the legislation immediately, then have Congress follow up with additional aid. Aside from unemployment benefits and relief payments to families, money for vaccine distribution, businesses and more was on the line. Protections against evictions also hung in the balance.

“What the president is doing right now is unbelievably cruel,” Sen. Bernie Sanders, I-Vt., said of Trump's delaying tactic before the president signed the law. “So many people are hurting. ... It is really insane and this president has got to finally ... do the right thing for the American people and stop worrying about his ego.”

Republican Sen. Pat Toomey of Pennsylvania said he understood that Trump “wants to be remembered for advocating for big checks, but the danger is he’ll be remembered for chaos and misery and erratic behavior if he allows this to expire.”

Toomey added: “So I think the best thing to do, as I said, sign this and then make the case for subsequent legislation.”

Republican Rep. Adam Kinzinger of Illinois said too much is at stake for Trump to “play this old switcheroo game.”

“I don’t get the point,” he said. “I don’t understand what’s being done, why, unless it’s just to create chaos and show power and be upset because you lost the election.”

Washington had been reeling since Trump turned on the deal. Fingers pointed at administration officials, including Treasury Secretary Steven Mnuchin, as lawmakers tried to understand whether they were misled about Trump’s position.

“Now to be put in a lurch, after the president’s own person negotiated something that the president doesn’t want, it’s just — it’s surprising,” Kinzinger said.

8:57 PM CT on 12/27/20

(Canadian Press) A contagious new strain of the virus that causes COVID-19 has infiltrated two more regions of Canada, health officials said Sunday, a day after announcing the country's first cases of the variant had been detected.

The strain of the novel coronavirus has now been found in Ottawa and the Vancouver Island area of B.C., public health authorities said.

Both patients had recently returned from the U.K., where the variant was first detected.

"This further reinforces the need for Ontarians to stay home as much as possible and continue to follow all public health advice, including the provincewide shutdown measures," said Dr. Barbara Yaffe, Ontario's associate chief medical officer of health.

Ontario reported Canada's first two known cases of the virus on Saturday in a couple from Durham Region, just east of Toronto.

Public Health Ontario announced Sunday that after further investigation, they found the couple had been in contact with someone who recently returned from the U.K.

The agency had initially said the couple had no known history of travel or contact with people who had recently travelled.

Public Health Ontario said it is screening large volumes of positive COVID-19 samples to investigate how prevalent the U.K. variant is in the province. But health officials are not planning to report the different strains out separately in provincial summary reports.

The Public Health Agency of Canada said while early data suggests the new variant may be more transmissible, there is no evidence the variant causes more severe symptoms or impacts vaccine effectiveness.

7:06 PM CT on 12/27/20

Pfizer and BioNTech will supply the U.S. with an additional 100 million doses of their COVID-19 vaccine under a second agreement.

The drugmakers said Wednesday that they expect to deliver all the doses by July 31.

Pfizer already has a contract to supply the government with 100 million doses of its vaccine, which requires two doses per patient.

READ MORE

4:29 PM CT on 12/27/20

(AP) The head of drugmaker AstraZeneca, which is developing a coronavirus vaccine widely expected to be approved by U.K. authorities this week, said Sunday that researchers believe the shot will be effective against a new variant of the virus driving a rapid surge in infections in Britain.

AstraZeneca chief executive Pascal Soriot also told the Sunday Times that researchers developing its vaccine have figured out a “winning formula” making the jab as effective as rival candidates.

Some have raised concern that the AstraZeneca vaccine, which is being developed with Oxford University, may not be as good as the one made by Pfizer already being distributed in the U.K. and other countries. Partial results suggest that the AstraZeneca shot is about 70% effective for preventing illness from coronavirus infection, compared to the 95% efficacy reported by Pfizer and its German partner BioNTech.

“We think we have figured out the winning formula and how to get efficacy that, after two doses, is up there with everybody else,” Soriot said. “I can’t tell you more because we will publish at some point.”

Britain’s government says its medicines regulator is reviewing the final data from AstraZeneca’s phase three clinical trials. The Times and others have reported that the green light could come by Thursday, and the vaccines can start to be rolled out for the U.K. public in the first week of January.

Asked about the vaccine’s efficacy against the new variant of coronavirus spreading in the U.K., Soriot said: “So far, we think the vaccine should remain effective. But we can’t be sure, so we’re going to test that.”

British authorities have blamed the new virus variant for soaring infection rates across the country. They said the variant is much more transmittable, but stress there is no evidence it makes people more ill.

Prime Minister Boris Johnson sounded an urgent alarm about the variant days before Christmas, saying the new version of the virus was spreading rapidly and that plans to travel and gather must be canceled for millions. Authorities have since put increasing areas of the country — affecting about 24 million people, or 43% of the population — in the strictest level of restrictions.

Many countries swiftly barred travel from the U.K., but cases of the new variant have since also been reported in a dozen locations around the world.

Public health officials said on Dec. 24 that more than 600,000 people had received the first of two doses of the Pfizer vaccine.

The head of drugmaker AstraZeneca, which is developing a coronavirus vaccine widely expected to be approved by U.K. authorities this week, said Sunday that researchers believe the shot will be effective against a new variant of the virus driving a rapid surge in infections in Britain.

AstraZeneca chief executive Pascal Soriot also told the Sunday Times that researchers developing its vaccine have figured out a “winning formula” making the jab as effective as rival candidates.

Some have raised concern that the AstraZeneca vaccine, which is being developed with Oxford University, may not be as good as the one made by Pfizer already being distributed in the U.K. and other countries. Partial results suggest that the AstraZeneca shot is about 70% effective for preventing illness from coronavirus infection, compared to the 95% efficacy reported by Pfizer and its German partner BioNTech.

“We think we have figured out the winning formula and how to get efficacy that, after two doses, is up there with everybody else,” Soriot said. “I can’t tell you more because we will publish at some point.”

Britain’s government says its medicines regulator is reviewing the final data from AstraZeneca’s phase three clinical trials. The Times and others have reported that the green light could come by Thursday, and the vaccines can start to be rolled out for the U.K. public in the first week of January.

Asked about the vaccine’s efficacy against the new variant of coronavirus spreading in the U.K., Soriot said: “So far, we think the vaccine should remain effective. But we can’t be sure, so we’re going to test that.”

British authorities have blamed the new virus variant for soaring infection rates across the country. They said the variant is much more transmittable, but stress there is no evidence it makes people more ill.

1:39 PM on 12/27/20

(AP) While governments across Europe kicked off their virus vaccination plans this weekend with fanfare, France took a more low-key approach because of widespread skepticism among it citizens around the vaccines.

After the first shots were injected Sunday into the arm of 78-year-old Mauricette, a woman in a long-term care facility near Paris, President Emmanuel Macron appealed to his compatriots: “Let’s have trust in our researchers and doctors. We are the nation of the Enlightenment and of (vaccine pioneer Louis) Pasteur. Reason and science should guide us.”

Yet many of his compatriots worry. They remember French health scandals in recent decades, including those involving mismanaged vaccines. They fear that the coronavirus vaccines were developed too quickly, are aimed at bringing profit to big pharmaceutical companies, or risk long-term side effects that the world will only discover years from now.

France has lost more lives to the virus than most countries, and its economy — one of the world's biggest — has been deeply crippled by two virus lockdowns. Doctors hope that French vaccine hesitancy will fade as more people get vaccinated.

Dr. Jean-Jacques Monsuez, a 65-year-old cardiologist at a nursing home northeast of Paris, was France’s second vaccine recipient Sunday. After he and several elderly patients were injected, he said, “they are vaccinated, we are vaccinated, we are all in the same boat. And the boat cannot sink.

“And around the boat there is a country that cannot sink.”

Politicians on France's far right and far left have fueled vaccine concerns, but polls commissioned by the national health agency suggest that the skepticism comes from some moderate voters too.

Justine Lardon walks with a crutch after suffering severe side effects from a hepatitis B vaccine in 2010, and is hesitating over whether to get vaccinated against the virus. She told regional newspaper Le Progres that she supports vaccination, but is concerned that doctors don’t pay enough attention to individual health issues.

“If (the vaccine) can wipe out the epidemic, that’s really great, but I don’t want a vaccine that is a time bomb,” she is quoted as saying.

The French government has been cautious in its messaging, keen to ensure that it's not seen as forcing vaccination on the public. Instead, authorities are counting on doctors to convince patients that the vaccine is in their, and the country’s, best interests.

Macron reiterated Sunday that the vaccine will be free of charge — and not obligatory.

France’s first vaccination wasn't broadcast on live television as it was elsewhere, and no government ministers attended. No top officials have said they’re getting the vaccine yet, instead insisting it should go to the most vulnerable first.

In a country with a large elderly population, including many with cognitive impairments, the government came under pressure from concerned families to devise extensive guidance for collecting consent from nursing home patients before vaccinating them.

10:43 AM CT on 12/27/20

(AP) Police and health officials were probing Saturday whether an Orange County health care provider violated state guidelines in the distribution of COVID-19 vaccines.

State Health Commissioner Dr. Howard Zucker said in a statement that his office and state police were investigating Parcare Community Health Network in Orange County.

Zucker said he had received reports that Parcare may have fraudulently obtained the vaccine and diverted it to other facilities to be given to members of the public. The state has prioritized front-line health care workers, long-term care residents and staffers to receive the vaccine first. The first vaccine in the state was given to a critical care nurse in Queens on Dec. 14.

“We take this very seriously and DOH will be assisting State Police in a criminal investigation into this matter,” Zucker said. "Anyone found to have knowingly participated in this scheme will be held accountable to the fullest extent of the law.”

Parcare lists four locations in Brooklyn, one in Manhattan and one in Monroe, Orange County on its website.

In an emailed statement, the company said it would cooperate with the investigation and that it “has a long history of partnering with the city of New York to provide vital healthcare services to New Yorkers who need them most — including providing COVID-19 testing — especially for New Yorkers in medically underserved communities who’ve been hardest hit by COVID-19.”

8:12 AM CT on 12/27/20

(AP) West Virginia Gov. Jim Justice reported that nearly half of his state's stock of COVID-19 vaccines has been administered. But the promising news was tempered by the governor's announcement on Christmas Day that 55 more West Virginians had died from the disease.

During a press briefing Friday, the governor described, one by one, the latest people who had succumbed to the pandemic.

“Not good, not good,” he said afterward.

By Saturday, that number had further climbed — with deaths now surpassing 1,250, according to state health officials.

Earlier in the week, Justice said he expects West Virginia to complete within three weeks all vaccinations at hospitals, health departments and long-term care facilities.

During his Christmas Day announcement, the governor reported that the state’s vaccination rate, about 47%, was the highest of any state. He said 28,623 of the 60,875 total doses delivered to West Virginia to date have been administered.

“You’ve got people out there that are battling the elements, that are trying to get vaccines in people’s arms,” Justice said.

The West Virginia Department of Health on Saturday said that the state has had nearly 80,200 confirmed cases of the disease thus far.

5:40 PM CT on 12/26/2020

While hospital beds are filling up across the country, rural hospitals have felt the brunt of the latest COVID-19 surge, new research shows.

About 40% of adult hospitalizations at rural hospitals were COVID-19 related as of Nov. 27, up from a median of 28% in late July, Chartis Center for Rural Health's analysis of HHS data shows. The share of COVID-related hospitalizations at urban hospitals increased from 14% to 23% over that span.

Rural hospitals typically lack the capacity, equipment and staffing to best manage acute cases. There is one ICU bed for every 9,500 Americans who live in rural communities, where intensive care beds are hard to come by. Nearly two-thirds of rural hospitals don't have any ICU beds, Chartis data show.

Read the whole story.

2:44 PM CT on 12/26/2020

The number of COVID-19 cases worldwide has topped 80 million.

Data compiled by Johns Hopkins University reported the mark Saturday morning after 472,000 cases were recorded Christmas Day. The number of deaths related to the coronavirus pandemic across the globe stands at 1.75 million.

The U.S. is by far the leader among nations in cases of coronavirus illness, reporting nearly 18.8 million Saturday. India follows with 10.2 million; Brazil has counted 7.45 million. There have been more than 330,000 deaths in the U.S., 190,000 in Brazil and 147,000 in India.

9:34 AM CT on 12/26/2020

(AP) Fallen pine cones covered 16-year-old Leslie Keiser's fresh grave at the edge of Wolf Point, a small community on the Fort Peck Indian Reservation on the eastern Montana plains.

Leslie, whose father is a member of the Fort Peck Assiniboine and Sioux Tribes, is one of at least two teenagers on the reservation who died by suicide this summer. A third teen's death is under investigation, authorities said.

In a typical year, Native American youth die by suicide at nearly twice the rate of their white peers in the U.S. Mental health experts worry that the isolation and shutdowns caused by the COVID-19 pandemic could make things worse.

"It has put a really heavy spirit on them, being isolated and depressed and at home with nothing to do," said Carrie Manning, a project coordinator at the Fort Peck Tribes' Spotted Bull Recovery Resource Center.

It's not clear what connection the pandemic has to the youth suicides on the Fort Peck reservation.

Tribal members typically lean on one another in times of crisis, but this time is different. The reservation is a COVID hot spot. In remote Roosevelt County, which encompasses most of the reservation, more than 10% of the population has been infected with the coronavirus. The resulting social distancing has led tribal officials to worry the community will fail to see warning signs among at-risk youth.

So tribal officials are focusing their suicide prevention efforts on finding ways to help those kids remotely.
Poverty, high rates of substance abuse, limited health care and crowded households elevate both physical and mental health risks for residents of reservations.

"It's those conditions where things like suicide and pandemics like COVID are able to just decimate tribal people," said Teresa Brockie, a public health researcher at Johns Hopkins University and a member of the White Clay Nation from Fort Belknap, Mont.

10:14 PM CT on 12/25/2020

(AP) — South Korea had seemed to be winning the fight against the coronavirus: Quickly ramping up its testing, contact-tracing and quarantine efforts paid off when it weathered an early outbreak without the economic pain of a lockdown. But a deadly resurgence has reached new heights during Christmas week, prompting soul-searching on how the nation sleepwalked into a crisis.

The 1,241 infections on Christmas Day were the largest daily increase. Another 1,132 cases were reported Saturday, bringing South Korea’s caseload to 55,902.

Over 15,000 were added in the last 15 days alone. An additional 221 fatalities over the same period, the deadliest stretch, took the death toll to 793.

As the numbers keep rising, the shock to people’s livelihoods is deepening and public confidence in the government eroding. Officials could decide to increase social distancing measures to maximum levels on Sunday, after resisting for weeks.

Tighter restrictions could be inevitable because transmissions have been outpacing efforts to expand hospital capacities.

In the greater Seoul area, more facilities have been designated for COVID-19 treatment and dozens of general hospitals have been ordered to allocate more ICUs for virus patients. Hundreds of troops have been deployed to help with contract tracing.

At least four patients have died at their homes or long-term care facilities while waiting for admission this month, said Kwak Jin, an official at the Korea Disease Control and Prevention Agency. The agency said 299 among 16,577 active patients were in serious or critical condition.

“Our hospital system isn’t going to collapse, but the crush in COVID-19 patients has significantly hampered our response,” said Choi Won Suk, an infectious disease professor at the Korea University Ansan Hospital, west of Seoul.

Choi said the government should have done more to prepare hospitals for a winter surge.

“We have patients with all kinds of serious illnesses at our ICUs and they can’t share any space with COVID-19 patients, so it’s hard,” Choi said. “It’s the same medical staff that has been fighting the virus for all these months. There’s an accumulation of fatigue.”

Critics say the government of President Moon Jae-in became complacent after swiftly containing the outbreak this spring that was centered in the southeastern city of Daegu.

The past weeks have underscored risks of putting economic concerns before public health when vaccines are at least months away. Officials had eased social distancing rules to their lowest in October, allowing high-risk venues like clubs and karaoke rooms to reopen, although experts were warning of a viral surge during winter when people spend longer hours indoors.

Jaehun Jung, a professor of preventive medicine at the Gachon University College of Medicine in Incheon, said he anticipates infections to gradually slow over the next two weeks.

The quiet streets and long lines snaking around testing stations in Seoul, which are temporarily providing free tests to anyone regardless of whether they have symptoms or clear reasons to suspect infections, demonstrate a return of public alertness following months of pandemic fatigue.

Officials are also clamping down on private social gatherings through Jan. 3, shutting down ski resorts, prohibiting hotels from selling more than half of their rooms and setting fines for restaurants if they accept groups of five or more people.

Still, lowering transmissions to the levels seen in early November — 100 to 200 a day — would be unrealistic, Jung said, anticipating the daily figure to settle around 300 to 500 cases.

The higher baseline might necessitate tightened social distancing until vaccines roll out — a dreadful outlook for low-income workers and the self-employed who drive the country’s service sector, the part of the economy the virus has damaged the most.

“The government should do whatever to secure enough supplies and move up the administration of vaccines to the earliest possible point,” Jung said.

South Korea plans to secure around 86 million doses of vaccines next year, which would be enough to cover 46 million people in a population of 51 million. The first supplies, which will be AstraZeneca vaccines produced by a local manufacturing partner, are expected to be delivered in February and March. Officials plan to complete vaccinating 60% to 70% of the population by around November.

There’s disappointment the shots aren’t coming sooner, though officials have insisted South Korea could afford a wait-and-see approach as its outbreak isn’t as dire as in America or Europe.

South Korea’s earlier success could be attributed to its experience in fighting a 2015 outbreak of MERS, the Middle East respiratory syndrome, caused by a different coronavirus.

After South Korea reported its first COVID-19 patient on Jan. 20, the KDCA was quick to recognize the importance of mass testing and sped up an approval process that had private companies producing millions of tests in just weeks.

When infections soared in the Daegu region in February and March, health authorities managed to contain the situation by April after aggressively mobilizing technological tools to trace contacts and enforce quarantines.

But that success was also a product of luck — most infections in Daegu were linked to a single church congregation. Health workers now are having a much harder time tracking transmissions in the populous capital area, where clusters are popping up just about everywhere.

South Korea has so far weathered its outbreak without lockdowns, but a decision on Sunday to raise distancing restrictions to the highest “Tier-3” could possibly shutter hundreds of thousands of non-essential businesses across the nation.

That could be for the best, said Yoo Eun-sun, who is struggling to pay rent for three small music tutoring academies she runs in Incheon and Siheung, also near Seoul, amid a dearth of students and on-and-off shutdowns.

“What parents would send their kids to piano lessons” unless transmissions decrease quickly and decisively, she said.

Yoo also feels that the government’s middling approach to social distancing, which has targeted specific business activities while keeping the broader part of the economy open, has put an unfair financial burden on businesses like hers.

“Whether it’s tutoring academies, gyms, yoga studies or karaokes, the same set of businesses are getting hit again and again,” she said. “How long could we go on?”

3:52 PM CT on 12/25/2020

(AP) As much of the country experiences spiking virus rates, a reprieve from a devastating surge of the coronavirus in the Upper Midwest has given cautious relief to health officials, though they worry that infections remain rampant and holiday gatherings could reignite the worst outbreaks of the pandemic.

States in the northern stretches of the Midwest and Great Plains saw the nation's worst rates of coronavirus infections in the weeks before Thanksgiving, stretching hospitals beyond capacity and leading to states such as North Dakota, South Dakota, Minnesota, Iowa and Wisconsin reporting some of the nation’s highest deaths per capita during November.

But over the last two weeks, those states have seen their average daily cases drop, with decreases ranging from 20% in Iowa to as much as 66% in North Dakota, according to Johns Hopkins researchers. Since the middle of November, the entire region has returned to levels similar to those seen in October.

“We’re in a place where we’ve controlled the fire, but it would be very easy for it to flare up again if conditions were right,” said Ryan Demmer, an epidemiologist at the University of Minnesota School of Public Health.

For a region that was a harbinger of the virus waves that now plague much of the country, the positive direction in the Midwest offers hope that people can rally to take virus precautions seriously as they await vaccines during what experts think will be the final months of the pandemic.

Governors have used the declining numbers to justify their divergent approaches to fighting the pandemic, even jousting at times. In Minnesota, Gov. Tim Walz, a Democrat, has defended keeping some restrictions in place through early January, saying limits on bars and restaurants are working. In neighboring South Dakota, Republican Gov. Kristi Noem has argued the opposite, using the recent decline in numbers in her state to argue that mask mandates don't make a difference.

But some epidemiologists believe the most compelling factor for many who redoubled their efforts to prevent infections may be that they experienced the virus on a personal level. As the pandemic crept into communities across the Midwest, more people had loved ones, friends or acquaintances fall ill or die.

“It's fox hole religion — the whole thing gets a lot more real when the guy next to you gets shot,” said Dr. Christine Petersen, the director of the Center for Emerging Infectious Diseases at the University of Iowa. “All of a sudden, your local hospital is full, and your sister, aunt, or grandmother is in the hospital.”

Roughly one of out every 278 people across northern states spanning from Wisconsin to Montana required hospital care for COVID-19, according to data from the COVID Tracking Project. In tight-knit communities, those experiences hit home.

The virus outbreak was so widespread by early November that nearly everyone has known someone severely affected by COVID-19, said Dr. James Lawler with the University of Nebraska Medical Center’s Global Center for Health Security.

“That seems to bring things home in a way that just talking about it earlier did not,” he said, noting that he's observed more people wearing face masks, as well as avoiding gatherings, parties and indoor dining.

Until the fall, the Upper Midwest had not seen the widespread outbreaks and high death rates that other parts of the country experienced in the early months of the pandemic. Many took lax approaches to virus mitigation measures. Republican governors in the region eschewed government mandates for mask-wearing or other efforts to prevent infections.

Many health experts warned that the region was ripe for widespread infections, especially as the weather cooled and people gathered inside, making it easier for the coronavirus to spread.

“Once the snowball started, it took everybody down,” Petersen said. “We knew that this was coming. It was those who took the precautions and doubled down that did slightly better, but we knew it was going to be hard, no matter what.”

Petersen credited the renewed efforts to slow infections to a combination of factors: warnings from health officials and medical workers that hospitals were filling; some Republican governors issuing orders to wear masks; and the lived experience of the pandemic. Other experts say some pockets of people, such as those who work in meatpacking plants where infections were widespread, had experienced such high rates of infections that the virus has slowed.

But across the region, many worried that the success in avoiding a Thanksgiving spike could be undone by Christmas and New Year's celebrations. Petersen worried that people had decided to forgo Thanksgiving gatherings, only to have family celebrations on Christmas. As a Midwesterner, she acknowledged that the draw to gather with family on holidays was difficult to resist.

“I hope a lot of us aren’t feeling guilty in a few weeks," she said.

1:43 PM CT on 12/25/2020

(AP) California’s deadly Christmas was marked by pleas to avoid holiday gatherings outside the home and indoor church services in what could be a make-or-break effort to curb a coronavirus surge that already has filled some hospitals well beyond normal capacity.

Gov. Gavin Newsom said hospitals are under “unprecedented pressure” and if current trends continue the number of those hospitalized because of the virus could double in 30 days.

“We could have a surge on top of surge on top of a surge in January and February,” Newsom said in a social media video posting Thursday. “I fear that but we’re not victims to that if we change our behaviors.”

Coronavirus cases, hospitalizations and deaths have mounted exponentially in recent weeks and are breaking new records. On Christmas Eve, California became the first state in the nation to exceed 2 million confirmed COVID-19 cases.

The first coronavirus case in California was confirmed Jan. 25. It took 292 days to get to 1 million infections on Nov. 11. Just 44 days later, the number topped 2 million.

The crisis is straining the state’s medical system well beyond its normal capacity, prompting hospitals to treat patients in tents, offices and auditoriums.

As of Thursday, California had record numbers of COVID-19 patients in the hospital and in ICUs, at nearly 19,000 and nearly 4,000, respectively.

“In most hospitals about half of all of the beds are filled with COVID patients and half of all the ICU beds are filled with COVID patients, and two-thirds of these patients are suffocating due to the inflammation that’s in their lungs that’s caused by the virus,” said Dr. Christina Ghaly, director of the Los Angeles County Department of Health Services.

“They’re suffocating to the point that they can no longer breathe on their own, and they have to have someone put a tube down their throat, in order to oxygenate their organs. Many of these people will not live to be in 2021,” she said.

Hospitals have also hired extra staff and canceled elective surgeries — all to boost capacity before the cases contracted over Christmas and New Year’s show up in the next few weeks.

“We understand that people are tired, but public health measures are not the enemy — they are the roadmap for a faster and more sustainable recovery,” said a statement from the Public Health Alliance of Southern California, which includes 10 neighboring local health departments covering nearly 60% of the state’s population.

11:23 AM CT on 12/25/2020

(AP) — U.S. factories have been cranking out goods during much of the pandemic at rates that are remarkably close to normal. However, manufacturers are concerned they may not be able to keep pace until most of the country is vaccinated because the coronavirus continues to surge in areas where many plants are based.

Safeguards that were put in place after the initial wave of the virus appear to have prevented the large outbreaks that sickened hundreds of workers and forced automakers, meat processors and other businesses to halt production last spring. But with the nation's COVID-19 death toll eclipsing 300,000 and the virus spiking in communities that surround the plants, industry and union officials say it may be impossible to keep the virus out of factories.

“We are seeing an increase in the number of positive (test) rates like you're seeing in the surrounding communities,” said Gary Johnson, chief manufacturing officer at Ford Motor Co., which has about 56,000 hourly factory workers nationwide.

Federal Reserve statistics show that U.S. industrial output is about 5% below levels in February, before the pandemic hit. It fell by 16.5% between February and April but has rebounded since, led by auto manufacturing.

Beef and pork production have both been running just below last year’s levels, Iowa State University agricultural economist Lee Schulz said.

But as it will be months before many people will be able to get vaccinated, factories will remain vulnerable.

9:12 AM CT on 12/25/2020

The United States will require airline passengers from Britain to get a negative COVID-19 test before their flight, the Centers for Disease Control and Prevention announced late Thursday.

The U.S. is the latest country to announce new travel restrictions because of a new variant of the coronavirus that is spreading in Britain and elsewhere.

Airline passengers from the United Kingdom will need to get negative COVID-19 tests within three days of their trip and provide the results to the airline, the CDC said in a statement. The agency said the order will be signed Friday and go into effect on Monday.

“If a passenger chooses not to take a test, the airline must deny boarding to the passenger,” the CDC said in its statement.

The agency said because of travel restrictions in place since March, air travel to the U.S. from the U.K. is already down by 90%.

Last weekend, Britain’s Prime Minister Boris Johnson said the new variant of the coronavirus seemed to spread more easily than earlier ones and was moving rapidly through England. But Johnson stressed “there’s no evidence to suggest it is more lethal or causes more severe illness,” or that vaccines will be less effective against it.

This week, New York Gov. Andrew Cuomo said three airlines with flights from London to New York — British Airways, Delta and Virgin Atlantic — had agreed to require passengers to take a COVID-19 test before getting on the plane. United Airlines on Thursday agreed to do the same for its flights to Newark, New Jersey.

Britain has been under considerable pressure since the word of the new variant of the virus was made public. Some 40 countries imposed travel bans on Britain, leaving the island nation increasingly isolated.

France relaxed its coronavirus-related ban on trucks from Britain on Tuesday after a two-day standoff that had stranded thousands of drivers and raised fears of Christmastime food shortages in the U.K.

French authorities said delivery drivers could enter by ferry or tunnel provided they showed proof of a negative test for the virus.

But the French restrictions were particularly worrisome, given that Britain relies heavily on its cross-Channel commercial links to the continent for food this time of year.

7:52 PM on 12/24/20

(AP) Christmas Day has brought South Korea its biggest daily increase in coronavirus infections of the pandemic as officials urged for citizen vigilance to help curb a viral surge that has worsened hospitalization and deaths.

The 1,241 new confirmed cases reported Friday raised the country’s total to 54,770. Officials said 17 more people had died from COVID-19 in the previous 24 hours, bringing the death toll to 773.

The country has been expanding its mass testing program to slow the rate of transmissions and more than 118,000 tests were conducted Thursday alone. Officials are also clamping down on private social gatherings through Jan. 3, shutting down national parks and ski resorts and setting fines for restaurants if they serve groups of five people or more.

6:02 PM on 12/24/20

(AP) Kansas is working through the details of exactly who will be eligible for coronavirus vaccines in exactly what order as it concentrates on giving shots mostly to health care workers this month.

Democratic Gov. Laura Kelly told leaders of the Republican-controlled Legislature this week that the vaccines have gone mostly to health care workers, though that group also includes employees in state prisons. She said vaccines could go “almost exclusively” to health care workers into mid-January but also suggested some doses already have reached nursing homes.

Kelly told The Topeka Capital-Journal in an interview that prison inmates are to get vaccinated before the general public because they’re in “congregate” housing, but the state doesn’t expect vaccines to be available for some adults for at least several months.

The state’s vaccine plan made health care workers and nursing home workers and residents the first in line, followed by other “essential” workers and people 75 or older, particularly those at high risk of coronavirus complications.

2:20 PM on 12/24/20

(AP) California became the first state to record 2 million confirmed coronavirus cases, reaching the milestone on Christmas Eve as nearly the entire state was under a strict stay-at-home order and hospitals were flooded with the largest crush of cases since the pandemic began.

A tally by Johns Hopkins University showed the nation’s most populous state has recorded 2,010,157 infections since January.

At least 23,635 people have died from the virus.

The first COVID-19 case in California was confirmed Jan. 25. It took 292 days to get to 1 million infections on Nov. 11.

Just 44 days later, the number topped 2 million.

The California Department of Public Health separately tallied 2,003,146 cases, a one-day bump of 39,070 infections but down from the one-day peak of nearly 54,000 cases at mid-month. The state's death toll climbed by 351, also down from the record high set last week. Another 427 people were hospitalized, raising the total to 18,875. The 3,962 in intensive care units was a record high, as is the number of those hospitalized

California’s infection rate — in terms of the number of cases per 100,000 people — is lower than the U.S. average. But its nearly 40 million residents mean the outbreak outpaces other states in sheer numbers.

The grim milestone comes as the COVID-19 crisis strains the state's medical system well beyond its normal capacity, prompting hospitals to put emergency room patients in tents and treat others in offices and auditoriums, while filling many of its intensive care units to overflowing.

“In most hospitals about half of all of the beds are filled with COVID patients and half of all the ICU beds are filled with COVID patients, and two thirds of these patients are suffocating due to the inflammation that’s in their lungs that’s caused by the virus," said Dr. Christina Ghaly, director of the Los Angeles County Department of Health Services.

12:09 PM on 12/24/20

Some healthcare providers—along with states, universities and other organizations—are getting an extra three months to audit their COVID-19 relief aid.

The White House's Office of Management and Budget on Tuesday released guidance with instructions on how to audit money received under its COVID-19 relief distributions, including the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. The rules extend the audit deadline, as many had anticipated. Health systems that received Provider Relief Fund grants had held off on auditing that money while they waited for specific rules.

Some healthcare providers will need to have their auditors perform a type of audit they've never been subject to before. So-called single audits are required when not-for-profit and governmental entities receive more than $750,000 in federal grant awards, which does not include Medicare and Medicaid.

READ MORE

9:36 AM on 12/24/20

(AP) House Republicans shot down a Democratic bid on Thursday to pass President Donald Trump's longshot, end-of-session demand for $2,000 direct payments to most Americans as he ponders whether to sign a long-overdue COVID-19 relief bill.

The made-for-TV clash came as the Democratic-controlled chamber convened for a pro forma session scheduled in anticipation of a smooth Washington landing for the massive, year-end legislative package, which folds together a $1.4 trillion governmentwide spending with the hard-fought COVID-19 package and dozens of unrelated but bipartisan bills.

Instead, Thursday's unusual 12-minute House session instead morphed into unconvincing theater in response to Trump's veto musings about the package, which was negotiated by Treasury Secretary Steven Mnuchin on Trump's behalf. House Majority Leader Steny Hoyer, the No. 2 House Democrat, sought the unanimous approval of all House members to pass the bill, but GOP leader Kevin McCarthy, who was not present in the nearly-empty chamber, denied his approval and the effort fizzled.

If Trump were to follow through on his implied veto threat, delivered via video clip on Tuesday, the government would likely experience a brief, partial shutdown of the government starting on Dec. 29. It would also delay delivery of the $600 direct payments that the bill does contain.

8:05 PM on 12/23/20

(AP) Two new studies give encouraging evidence that having COVID-19 may offer some protection against future infections. Researchers found that people who made antibodies to the coronavirus were much less likely to test positive again for up to six months and maybe longer.

The results bode well for vaccines, which provoke the immune system to make antibodies — substances that attach to a virus and help it be eliminated.

Researchers found that people with antibodies from natural infections were "at much lower risk ... on the order of the same kind of protection you'd get from an effective vaccine," of getting the virus again, said Dr. Ned Sharpless, director of the U.S. National Cancer Institute."It's very, very rare" to get reinfected, he said.

The institute's study had nothing to do with cancer — many federal researchers have shifted to coronavirus work because of the pandemic.

Both studies used two types of tests. One is a blood test for antibodies, which can linger for many months after infection. The other type of test uses nasal or other samples to detect the virus itself or bits of it, suggesting current or recent infection.

One study, published Wednesday by the New England Journal of Medicine, involved more than 12,500 health workers at Oxford University Hospitals in the United Kingdom. Among the 1,265 who had coronavirus antibodies at the outset, only two had positive results on tests to detect active infection in the following six months and neither developed symptoms.

That contrasts with the 11,364 workers who initially did not have antibodies; 223 of them tested positive for infection in the roughly six months that followed.

The National Cancer Institute study involved more than 3 million people who had antibody tests from two private labs in the United States. Only 0.3% of those who initially had antibodies later tested positive for the coronavirus, compared with 3% of those who lacked such antibodies. "It's very gratifying" to see that the Oxford researchers saw the same risk reduction — 10 times less likely to have a second infection if antibodies were present, Sharpless said.

His institute's report was posted on a website scientists use to share research and is under review at a major medical journal.

The findings are "not a surprise ... but it's really reassuring because it tells people that immunity to the virus is common," said Joshua Wolf, an infectious disease specialist at St. Jude Children's Research Hospital in Memphis who had no role in either study.

Antibodies themselves may not be giving the protection, they might just be a sign that other parts of the immune system, such as T cells, are able to fight off any new exposures to the virus, he said.

"We don't know how long-lasting this immunity is," Wolf added. Cases of people getting COVID-19 more than once have been confirmed, so "people still need to protect themselves and others by preventing reinfection."

6:02 PM on 12/23/20

(AP) Pfizer said Wednesday it will supply the U.S. government with an additional 100 million doses of its COVID-19 vaccine under a new agreement between the pharmaceutical giant and the Trump administration.

Pfizer and its German partner BioNTech said that will bring their total current commitment to 200 million doses for the U.S. That should be enough to vaccinate 100 million people with the two-shot regimen. The government also has an option to purchase an additional 400 million doses.

"This new federal purchase can give Americans even more confidence that we will have enough supply to vaccinate every American who wants it by June 2021," said HHS Secretary Alex Azar in a statement.

The cost to taxpayers: $1.95 billion for the additional 100 million doses.

3:31 PM on 12/23/20

(AP) Russia’s Health Ministry agreed Wednesday to cut the size of a study of a domestically developed coronavirus vaccine and to stop the enrollment of volunteers.

The decision comes a week after developers said enrollment of study volunteers has slowed since Russia began giving out the Sputnik V vaccine while the late-stage study was still continuing. They also cited ethical concerns about giving a dummy shot to some of the volunteers. The study size was cut to about 31,000 from 40,000 participants.

Alexander Gintsburg, head of the Gamaleya Center, the state-run medical research institute that developed Sputnik V, said that many of those who received dummy shots had figured it out and gotten vaccinated.

If large numbers of volunteers in the placebo group drop out, it could affect the results, Svetlana Zavidova, executive director of Russia’s Association of Clinical Trials Organizations, said.

“They simply won't be able to gather (the necessary) statistics," she said.

Russia has been widely criticized for giving Sputnik V regulatory approval in August after the vaccine only had been tested on a few dozen people. Two weeks later, the 40,000-volunteeer study was announced.

Despite warnings to wait for the study's results, Russian authorities started offering it to people in risk groups — such as medical workers and teachers — within weeks of approval.

President Vladimir Putin, who has publicly hailed Sputnik V, ordered the Russian government this month to start a large-scale immunization campaign. By mid-December, over 150,000 people had been vaccinated, according to Gintsburg.

In a statement, the Health Ministry said that interim study data on the vaccine's safety and effectiveness was considered as part of the decision to reduce the study size. The ministry said the study would continue and participants will be monitored for at least six more months.

2:21 PM on 12/23/20

Some healthcare providers—along with states, universities and other organizations—are getting an extra three months to audit their COVID-19 relief aid.

The White House's Office of Management and Budget on Tuesday released guidance with instructions on how to audit money received under its COVID-19 relief distributions, including the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. The rules extend the audit deadline, as many had anticipated. Health systems that received Provider Relief Fund grants had held off on auditing that money while they waited for specific rules.

READ MORE

11:02 AM on 12/23/20

(AP) Joseph Johnson was going about his life, getting ready for the holidays at the Jersey Shore, when he started to feel ill and wound up in a hospital. It turned out he had diabetes, and it was threatening his life.

The shock of a sudden illness and hospitalization was compounded by the coronavirus pandemic. To slow its spread, most hospitals are forbidding visitors, meaning patients like Johnson find themselves alone during what is supposed to be a joyous season.

“Because of the plague, my wife can't come visit; all she can do is call and text,” he said. “It's pretty depressing.”

Then one day a small bit of cheer came his way. Tucked next to the covered dish on his meal tray at Shore Medical Center in Somers Point were two Christmas cards, handmade by local children, wishing him a speedy recovery and a happy holiday season.

It was part of a wave of greeting cards being collected independently by hospitals this December for patients cut off from the support of visitors. It does not appear to have any central coordination; many hospitals just decided on their own that it would be a kind thing to do.

Realizing this year's unique dynamic, hospitals asked adults, organizations and schoolchildren to either make or buy holiday cards and send them to the institutions for distribution to patients. The goal is for everyone in the hospital to get a card and at least a tiny bit of holiday cheer.

“It was definitely a surprise,” Johnson said of his two cards, one of which had plastic jewels glued to it. “It was really cute, and quite enjoyable, and it made me feel a little better.”

He has since been released from the hospital.

It put out a request for cards in late November and had received nearly 1,000 by early December. They range from elaborate store-bought cards to hand-drawn construction-paper creations from grade-school children, several wishing the recipient “Happy Hoildays!" or a “Meery Christmas!”

A more somber note came tucked inside a box of Christmas cards that was short and to the point.

“If you could give these to people on the top floor where my husband died, I would appreciate it,” a woman named Lori wrote.

The holidays arrive as the nation undergoes a grim December, with the virus surging to record levels in many parts of the country. Hospital beds are filling up and some facilities are opening overflow centers in parking lot tents or buildings used for other purposes.

9:25 AM on 12/23/20

(AP) Gov. Mike DeWine's veto of a bill limiting the Health Department's ability to fight the pandemic will stand after Republican lawmakers wrapped up their two-year session without making good on a veto override threat.

The bill that DeWine vetoed Dec. 3 would have allowed the Ohio Legislature to adopt resolutions to rescind Health Department orders to prevent the spread of contagious diseases. It would also prevent the agency from implementing regional or statewide quarantines for people who haven’t been directly exposed or diagnosed with the disease.

DeWine, a Republican, said the bill would hamstring the state from responding quickly to situations that might require a quarantine, such as a bioterrorism attack. The measure was one of several that Republican lawmakers passed this year trying to limit the governor's coronavirus protection efforts.

Senate President Larry Obhof, a Medina Republican, signaled in recent days he was open to a compromise that would eliminate criminal penalties for health order violations. He also questioned whether the House had votes for an override.

House Speaker Bob Cupp, a Lima Republican, disputed that late Tuesday, saying the House had the votes. But six Republican House members were absent Tuesday, with several having previously confirmed they or family members had positive coronavirus tests, Gongwer News Service reported.

The seven-day rolling average of daily new cases in Ohio did not increase over the past two weeks, going from 11,418 on Dec. 8 to 8,239 on Dec. 22, according to an Associated Press analysis of data provided by The COVID Tracking Project.

8:58 PM CT on 12/22/2020

(AP) Peru has passed 1 million confirmed cases of coronavirus infection. It is the fifth nation in Latin America to report that number as the region struggles with the pandemic’s economic and health effects.

Peru’s government was quick to declare lockdown measures for its 32 million people last March as the pandemic spread in Europe. But in spite of closing its airports for almost six months and ordering most of its residents to stay at home it has struggled to contain the virus.

Officials say they had recorded 1,000,153 cases as of Tuesday evening.

More than 37,000 people have died from COVID-19 in Peru. That gives the Andean nation the world’s second highest per capita death toll from the pandemic, according to data compiled by John Hopkins University.

7:05 PM CT on 12/22/2020

(AP) The U.S. government is close to a deal to acquire tens of millions of additional doses of Pfizer's vaccine in exchange for helping the pharmaceutical giant gain better access to manufacturing supplies.

A person with knowledge of the negotiations told The Associated Press on Tuesday that the deal is under discussion and could be finalized shortly. The person spoke on condition of anonymity to describe ongoing deliberations.

Pfizer's vaccine was the first to gain approval from the Food and Drug Administration and initial shipments went to states last week. It has now been joined by a vaccine from Moderna, which was developed in closer cooperation with scientists from the National Institutes of Health.

Moderna’s vaccine comes under the umbrella of the government’s own effort, which is called Operation Warp Speed. That public-private endeavor was designed to have millions of vaccine doses ready and available to ship once a shot received FDA approval.

But another deal with Pfizer would move the nation closer to the goal of vaccinating all Americans.

A law dating back to the Korean War gives the government authority to direct private companies to produce critical goods in times of national emergency. Called the Defense Production Act, it's expected to be invoked to help Pfizer secure some raw materials needed for its vaccine.

Pfizer already has a contract to supply the government with 100 million doses of its vaccine under Operation Warp Speed, but government officials have said it's more of an arms-length relationship with the company and they don't have as much visibility into its operations.

Pfizer said in a statement that “we continue to work collaboratively with the U.S. government to get doses of our COVID-19 vaccine to as many Americans as possible. The company is not able to comment on any confidential discussions that may be taking place with the U.S. government.”

Operation Warp Speed is on track to have about 40 million doses of vaccine by the end of this month, of which about 20 million would be allocated for first vaccinations. Distribution of those doses would span into the first week of January. Both the Pfizer and Moderna vaccines require two shots to be fully effective.

The New York Times first reported the new details of negotiations between Pfizer and the Trump administration.

3:53 PM CT on 12/22/2020

Lyft on Dec. 22 announced plans to provide 60 million rides to make it easier for low-income and at-risk patients to travel to COVID-19 vaccination sites, once the vaccine is available.

The effort, dubbed the universal vaccine access campaign, is part of LyftUp—an initiative the company launched to subsidize rides for people in need. As part of the COVID-19 vaccine access campaign, Lyft and corporate partners including JPMorgan Chase and Anthem will fund discounted and free rides for those who need help accessing transportation.

Community partners, such as United Way, will distribute ride credits to those in need, including vulnerable populations prioritized for early vaccine distribution.

“Making sure people can get to vaccination sites when they need to is mission critical to beating this virus,” said John Zimmer, Lyft’s co-founder and president, in a statement. “We cannot let lack of transportation be a factor in determining whether people have access to healthcare.”

Lyft and its main competitor, Uber, have been pushing into healthcare for the past several years. Uber also in December pledged to provide 10 million discounted or free rides to vulnerable populations—with an emphasis on minority populations—in partnership with Morehouse School of Medicine in Atlanta, the National Urban League and the National Action Network.

Other partners on Lyft’s vaccine access campaign include Epic Systems Corp., Centene Corp., Modern Health, One Medical, the National Hispanic Council on Aging, the National Asian Pacific Center on Aging, the National Urban League and the National Action Network.

3:12 PM CT on 12/22/2020

Hospitals in New York are being directed by Gov. Andrew Cuomo to start testing for the new COVID-19 strain identified in the U.K. which has been found to be more transferrable than prior iterations. Cuomo told local newspapers that state public health officials have looked at more than 3,700 virus sequences identified in New York, but has yet to find the UK variant present in any of the samples.

The World Health Organization has said the new strain was identified in England as early as September and had been detected as far away as Australia. Six hospitals across the state have agreed to obtain samples from patients. 

The hospitals with agreements already in place include:

Montefiore, Memorial Sloan Kettering, Northwell Long Island, University of Rochester, Albany Medical Center, and Saratoga Hospital.

Statewide, a total of 857,049 New Yorkers have tested positive for COVID-19 out of 23.47 million tests administered in the past 10 months, including 28,709 fatalities.

12:54 PM on 12/22/20

Of the $182 million in grants the Mayo Clinic is keeping, it has already booked $173 million as revenue. The remaining $9 million will be recognized by the year's end, Mayo spokesperson Jay Furst wrote in an email to our reporter Tara Bannow. To read the story, click here.

11:15 AM on 12/22/20

A security expert at Microsoft and a Harvard medical school professor are warning of the challenges IT will face in tracking COVID vaccination and reaching 70% coverage.

"The hard truth that policymakers, health systems, pharmacies, and public health leaders must face is the current U.S. data infrastructure is not up to the task. In this article, we outline four broad actions to improve the data infrastructure that can be taken to ensure that the vaccination effort is effective and equitable, protects privacy, and thwarts wrongdoing," write Joram Borenstein and Rebecca Weintraub in a Harvard Business Review blog post. 

They offer the following suggestions:

1. Standardize how personal health data is exchanged.

2. Align states’ immunization registries and state and federal reporting analytics.

3. Design immunization “passports” that are portable, equitable, and protect privacy.

4. Address privacy, portability, and cybersecurity tradeoffs.

8:58 AM on 12/22/20

(AP) The nation's top infectious disease expert estimates that most Americans will have access to the new COVID-19 vaccines by mid-summer.

Dr. Anthony Fauci told Good Morning America on Tuesday that he expects to start vaccinating the general population “somewhere in the end of March, the beginning of April.”

He said the process could take up to four months to reach all Americans who want to receive the vaccine.

The first doses started rolling out last week, with health care workers, first responders and the elderly on the priority list. Fauci planned to receive his own shot of the vaccine created by Moderna on Tuesday.

Fauci also said it was “certainly possible” that the new COVID-19 strain discovered in the U.K. had reached America as well. He said travel bans were unnecessary and “rather draconian,” but that pre-travel testing requirements for visitors from the U.K. might be preferable.

Fauci reiterated his longstanding plea for Americans to curb their normal Christmas and holiday plans this year as the virus continues to surge all around the country.

9:07 PM on 12/21/20

(AP) Developers of the Russian coronavirus vaccine Sputnik V on Monday announced signing an agreement with AstraZeneca to test a combination of the British drugmaker's COVID-19 shots and a component of the vaccine created in Moscow.

The developers of Sputnik V proposed the approach to AstraZeneca last month, suggesting it could increase the effectiveness of the British vaccine. The company announced on Dec. 11 a study to test the combination, and on Monday signed a memorandum of cooperation with Moscow-based medical research facility the Gamaleya Institute, the Russian Direct Investment Fund and Russian drugmaker R-Pharm.

AstraZeneca developed its vaccine with Oxford University. The Gamaleya Institute developed Sputnik V, and the Russian Direct Investment Fund bankrolled the project.

Speaking at a teleconference marking the signing of the memorandum, Russian President Vladimir Putin hailed cooperation between AstraZeneca and Russian scientists, saying it "will make it possible to achieve a breakthrough while working on vaccines and on a number of other vitally important medicines.”

The trials are expected to start “in the nearest future,” according to Kirill Dmitriev, head of the Russian Direct Investment Fund.

Russia has been widely criticized for giving Sputnik V regulatory approval in August after the vaccine only been tested on a few dozen people. This month, Russian authorities started mass vaccinations with Sputnik V, even though it is still undergoing the advanced studies among tens of thousands of people needed to ensure its safety and effectiveness.

The vaccine's developers have said study data suggested the vaccine was 91% effective, a conclusion based on 78 infections among nearly 23,000 participants. That’s far fewer cases than Western drugmakers have accumulated during final testing before analyzing their candidates’ efficacy, and important demographic and other details from the study have not been released.

The latest study results on the vaccine developed by AstraZeneca and Oxford University suggest it it safe and about 70% effective. Health officials around the world hope to rely on the British vaccine due to comparatively low cost, availability and ease of use. However, questions remain about how well it may help protect those over age 55, a key concern given that older individuals are more vulnerable to COVID-19.

7:22 PM on 12/21/20

Ray Bellia had a good business before the coronavirus pandemic. He topped $4 million in annual sales from his New Hampshire store that specialized in protective gear for police.

Then he got a call from a buyer with the state of Massachusetts asking if he had anything that could protect people from COVID-19. As it happened, he did. He went on to sell the state 300,000 disposable masks for 97 cents each.

"From that point on, it's been just insanity," Bellia said.

READ MORE

5:42 PM on 12/21/20

(AP) As Turkey faces a dramatic rise in COVID-19 infections during the pandemic’s second wave, hospitals that were quickly built in the early days of the outbreak are dealing with some of the country’s most serious cases.

Two prefabricated infirmaries in Istanbul, constructed in less than 45 days and opened in May, are offering state-of-the-art intensive care facilities dedicated to COVID-19 patients.

Named after renowned Turkish physicians who died from the disease, the hospitals are located near airfields to give ease of access to sufferers from across Turkey and are built to similar specifications, each with 1,008 beds, 16 operating theaters, dialysis units and wards for infected pregnant women and babies.

The Associated Press visited the Dr. Feriha Oz Emergency Hospital, located in Cekmekoy district on Istanbul’s Asian side, on Saturday.

In a pristine intensive care room, the air cleaned with filters that capture the airborne virus, 52-year-old construction worker Ismet Yucel was recovering.

“They brought me here in an ambulance. I couldn’t breathe," he said through an oxygen mask. “My lungs were infected. I was in a very bad condition, I couldn’t breathe. Thank God, I’m fine now.”

When the pandemic first struck, Turkey was credited for quickly bringing infection rates under control. It is now seeing an explosion in cases that is putting a serious strain on its health system.

The seven-day average for daily infections is more than 25,000 while the daily death toll has been breaking record highs in recent weeks, with total fatalities reaching above 18,000.

Turkey’s Health Ministry insists the ICU occupancy rate across Turkey stands at 68% but the Turkish Medical Association has painted a different picture, saying doctors are scrambling to find beds for seriously sick patients.

Erdogan’s government has imposed nighttime curfews and weekend lockdowns to try to slow the surge, as well as announcing a four-day lockdown from New Year’s Eve. Restaurants can only serve takeaway meals, while some businesses such as hairdressers are allowed to operate limited hours. Children and the elderly have been barred from using public transport.

Batuhan Yagci, a nurse at Dr. Feriha Oz hospital, stressed that the coronavirus does not just represent a danger to the elderly.

“Even those who are 27, 25, 20 years old are having difficulties breathing and breakdown crying in front of our eyes,” he said. “They say ‘I can’t breathe, please don’t leave me. Hold my hand.’”

During its visit, the AP’s team saw nurses caring for an 11-day-old baby boy who arrived just five days after his birth.

Dr. Cigdem Akalan Kuyumcu, an infectious disease expert working in the ICU, said many patients feared admission to the unit.

“We have patients that ask as they are entering the ICU, ‘Will I be able to come back?’ This affects us profoundly,” she said. “It saddens us. Of course, when our patients recover we are overjoyed.”

3:17 PM CT on 12/21/2020

(AP) President-elect Joe Biden on Monday received his first dose of the coronavirus vaccine on live television as part of a growing effort to convince the American public the inoculations are safe.

The president-elect took a dose of Pfizer vaccine at a hospital not far from his Delaware home, hours after his wife, Jill Biden, did the same. The injections came the same day that a second vaccine, produced by Moderna, will start arriving in states. It joins Pfizer's in the nation's arsenal against the COVID-19 pandemic, which has now killed more than 317,000 people in the United States and upended life around the globe.

“I'm ready,” said Biden, who was administered the dose at a hospital in Newark, Delaware, and declined the option to count to three before the needle was inserted into his left arm. “I’m doing this to demonstrate that people should be prepared when it’s available to take the vaccine. There’s nothing to worry about.”

The president-elect praised the health care workers and said President Donald Trump's administration “deserves some credit getting this off the ground.” And Biden urged Americans to wear masks during the upcoming Christmas holiday and not travel unless necessary.

Vice President-elect Kamala Harris and her husband are expected to receive their first shots next week.

Other top government officials have been in the first wave of Americans to be inoculated against COVID-19 as part of the largest largest vaccination campaign in the nation's history.

1:37 PM CT on 12/21/2020

(AP) When Eileen Carroll's daughter tested positive for the coronavirus, Rhode Island health officials called with the results, then told her to notify anyone her daughter might have been around. Contact tracers, she was told, were simply too overwhelmed to do it.

That's also why tracers didn't call to warn the family that it had been exposed in the first place, said Carroll, of Warwick, Rhode Island. Luckily, she said, the relative with COVID-19 they had been around at Thanksgiving already alerted them.

"They said, 'We have 500 people a day and we cannot keep up with this,'" Carroll said.

READ MORE...

11:30 AM CT on 12/21/2020

(AP) California Gov. Gavin Newsom is back in a precautionary coronavirus quarantine for the second time in two months as surging COVID-19 cases swamp the state’s hospitals and strain medical staffing.

Newsom will quarantine for 10 days after one of his staffers tested positive for COVID-19 on Sunday afternoon, the governor’s office said. Newsom was then tested and his result came back negative, as did the tests of other staffers who were in contact.

Last month, members of the governor’s family were exposed to someone who tested positive for the virus. Newsom, his wife and four children tested negative at that time.

As of Sunday, more than 16,840 people were hospitalized with confirmed COVID-19 infections — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach 75,000 by mid-January.

More than 3,610 COVID-19 patients were in intensive care units. All of Southern California and the 12-county San Joaquin Valley have exhausted their regular ICU capacity, and some hospitals have begun using “surge” space. Overall, the state’s ICU capacity was just 2.1% on Sunday.

The explosion of cases in the last six weeks has California’s death toll climbing. Another 161 fatalities reported Sunday raised the total to 22,593.

9:25 AM CT on 12/21/2020

(AP) Trucks waiting to get out of Britain backed up for miles and people were left stranded at airports Monday as countries around the world imposed stringent travel restrictions on the U.K. because of a new and seemingly more contagious strain of the coronavirus in England.

A growing number of countries halted air travel from Britain, while France banned British trucks for 48 hours while the new variant is assessed.

Meanwhile, the European Union's drug regulatory agency recommended use of Pfizer-BioNTech's vaccine, setting the stage for the first COVID-19 shots across the 27-nation bloc. The vaccine is already being dispensed in Britain and the U.S.

The EU was expected to give final approval to the recommendation within hours. Authorities in Germany and several other European countries said they hope to begin vaccinating people on Dec. 27.

Canada, India, France, Germany, Italy, Spain and Poland were among the countries that halted flights from Britain. In the U.S., New York Gov. Andrew Cuomo said he wanted a ban on flights from Britain to New York City. Eurotunnel, the rail service that links Britain with mainland Europe, also suspended outbound service from Britain.

The European Centre for Disease Prevention and Control said that while preliminary analysis suggests the new variant is “significantly more transmissible,” there is no indication that infections are more severe. Experts, however, have stressed that even if the new strain is not more lethal, it is inevitable that more infections will lead to more hospitalizations and deaths.

The chaos at the border comes at a time of huge uncertainty for Britain, less than two weeks before the final stage of the country's exit from the EU.

“Shoppers should not panic buy,” said Kevin Green, director of marketing and communications. “If freight gets moving again today, then the overall impact on fresh produce arriving to supermarkets should be fairly minimal."

8:43 PM CT on 12/20/2020

(AP) The leader of the Trump administration's vaccination program says people who have been infected with the coronavirus — a group that includes President Donald Trump — should receive the vaccine.

Moncef Slaoui, the chief adviser of Operation Warp Speed, told CNN's “State of the Union” on Sunday that the vaccine is safe for those who have recovered and offers stronger and potentially longer protection than does the virus itself.

“We know that infection doesn’t induce a very strong immune response and it wanes over time. So I think, as a clear precaution, it is appropriate to be vaccinated because it’s safe," he said. “I think people should be vaccinated, indeed.”

Trump is now one of the only senior-most U.S. officials who has not received the first of two vaccination shots, which began being administered last week as part of the largest vaccination campaign in the nation's history. Vice President Mike Pence, House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Mitch McConnell, R-Ky., all were given doses Friday. President-elect Joe Biden was to receive his Monday.

All have chosen to publicize their injections as part of a campaign to convince a skeptical public that the vaccines are safe and effective, in hopes of finally putting an end to a pandemic that has killed more than 317,000 people in the United States and upended life around the globe.

Trump, who in the past has spread misinformation about vaccine risks, tweeted earlier this month that he was “not scheduled” to take the vaccine, but looked “forward to doing so at the appropriate time.” The White House says he is still discussing timing with his doctors.

Trump was hospitalized with COVID-19 in October and given an experimental monoclonal antibody treatment that he credited for his swift recovery.

A Centers for Disease Control and Prevention advisory board has said people who received that treatment should wait at least 90 days to be vaccinated to avoid any potential interference.

“When the time is right, I’m sure he will remain willing to take it,” White House spokesperson Brian Morgenstern echoed Friday. “It’s just something we’re working through.”

Trump has spent the last week largely out of sight as he continues to stew about his election loss and floats increasingly outlandish schemes to remain in power. It's an approach that has bewildered top aides who see his silence as a missed opportunity for the president, who leaves office Jan. 20, to claim credit for helping oversee the speedy development of the vaccine and to burnish his legacy.

Trump has also come under criticism for failing to take the vaccine himself as an example to help allay concerns about its safety, especially among Republicans.

The CDC's Advisory Committee on Immunization Practices said the Pfizer-BioNTech vaccine, which was the first to receive authorization, “is safe and likely efficacious" in people who have been infected with COVID-19 and “should be offered regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection.”

While there is no recommended minimum wait time between infection and vaccination, because reinfection is uncommon in the three months after a person is infected, the committee said people who tested positive in the preceding 90 days "may delay vaccination until near the end of this period, if desired.”

But the advisers also recommended that those who received the kind of treatment Trump did should put off being vaccinated for at least 90 days.

“Currently, there are no data on the safety and efficacy of Pfizer-BioNTech COVID-19 vaccination in persons who received monoclonal antibodies or convalescent plasma as part of COVID-19 treatment," they wrote, recommending that vaccination "be deferred for at least 90 days, as a precautionary measure until additional information becomes available, to avoid interference of the antibody treatment with vaccine-induced immune responses.”

Surgeon General Jerome Adams cited that recommendation on CBS’s “Face the Nation” on Sunday when asked if Trump planned to receive the shot on camera.

“From a scientific point of view, I will remind people that the president has had COVID within the last 90 days. He received the monoclonal antibodies. And that is actually one scenario where we tell people maybe you should hold off on getting the vaccine, talk to your health provider to find out the right time,” Adams said.

White House press secretary Kayleigh McEnany has given other explanations for the delay. She told reporters last week that Trump was holding off, in part, "to show Americans that our priority are the most vulnerable.”

“The President wants to send a parallel message, which is, you know, our long-term care facility residents and our frontline workers are paramount in importance, and he wants to set an example in that regard,” she said.

Dr. Anthony Fauci, the nation’s top infectious diseases expert, is among those who have recommended that Trump be vaccinated without delay.

“Even though the president himself was infected, and he has, likely, antibodies that likely would be protective, we’re not sure how long that protection lasts. So, to be doubly sure, I would recommend that he get vaccinated,” he told ABC News.

7:02 PM CT on 12/20/2020

(AP) A growing list of European Union nations and Canada barred travel from the U.K. on Sunday and others were considering similar action, in a bid to block a new strain of coronavirus sweeping across southern England from spreading to the continent.

France, Germany, Italy, the Netherlands, Belgium, Austria, Ireland and Bulgaria all announced restrictions on U.K. travel, hours after British Prime Minister Boris Johnson announced that Christmas shopping and gatherings in southern England must be canceled because of rapidly spreading infections blamed on the new coronavirus variant.

Johnson immediately placed those regions under a strict new Tier 4 restriction level, upending Christmas plans for millions.

France banned all travel from the U.K. for 48 hours from midnight Sunday, including trucks carrying freight through the tunnel under the English Channel or from the port of Dover on England's south coast. French officials said the pause would buy time to find a “common doctrine” on how to deal with the threat, but it threw the busy cross-channel route used by thousands of trucks a day into chaos.

The Port of Dover tweeted Sunday night that its ferry terminal was “closed to all accompanied traffic leaving the UK until further notice due to border restrictions in France.”

Eurostar passenger trains from London to Paris, Brussels and Amsterdam were also halted.

Germany said all flights coming from Britain, except cargo flights, were no longer allowed to land starting midnight Sunday. It didn’t immediately say how long the flight ban would last. Belgian Prime Minister Alexander De Croo said he was issuing a flight ban for 24 hours starting at midnight “out of precaution.” “There are a great many questions about this new mutation,” he said, adding he hoped to have more clarity by Tuesday.

Canada announced its own ban Sunday night. Prime Minister Justin Trudeau said in a statement that for 72 hours starting at midnight Sunday, “all flights from the UK will be prohibited from entering Canada.” He added that travelers who arrived Sunday would be subject to secondary screening and other health measures.

The British government said Johnson would preside at a meeting of the government's crisis committee, COBRA, on Monday in the wake of the other nations' measures. They come at a time of huge economic uncertainty for the U.K., less than two weeks before it leaves the EU's economic structures Dec. 31, and with talks on a new post-Brexit trade relationship still deadlocked.

3:57 PM CT on 12/20/2020

(AP) A federal advisory panel put people 75 and older and essential workers like firefighters, teachers and grocery store workers next in line for COVID-19 shots as a second vaccine began rolling out Sunday to hospitals, a desperately needed boost as the nation works to get the coronavirus pandemic under control.

The two developments came as the nation seeks to ramp up a vaccination program that only began in the last week and has given initial shots to about 556,000 Americans, according to the Centers for Disease Control and Prevention.

The COVID-19 vaccine developed by Pfizer Inc. and Germany’s BioNTech already is being distributed, and regulators last week gave approval to one from Moderna Inc.

Earlier this month, the Advisory Committee on Immunization Practices said health care workers and nursing home residents — about 24 million people — should be at the very front of the line for the vaccines.

Sunday's vote by the panel was who should be next in line, and by a vote of 13-1, it decided that next in line should be people 75 and older, who number about 20 million, as well as certain front-line workers, who total about 30 million. Those essential workers include firefighters and police; teachers and school staff; those working in food, agricultural and manufacturing sectors; corrections workers; U.S. Postal Service employees; public transit workers; and grocery store workers.

They are considered at very high risk of infection because their jobs are critical and require them to be in regular contact with other people.

It’s not clear how long it will take to vaccinate those groups. Vaccine doses have come out slower than earlier projections. But at the same time, some experts noted that not everyone who is recommended to get vaccinated may choose to get a shot.

1:43 PM CT on 12/20/2020

(AP) Top Washington negotiators, propelled by a late-night agreement on the last major obstacle to a COVID-19 economic relief package, said a Sunday agreement is all but inevitable to deliver long-overdue pandemic aid of almost $1 trillion.

Only a handful of issues remained, said the Senate's top Democrat. “Barring a major mishap, the Senate and House will be able to vote on final legislation as early as tonight,” said Sen. Chuck Schumer of New York.

The breakthrough involved a fight over Federal Reserve emergency powers that was resolved by Schumer and conservative Republican Pat Toomey of Pennsylvania. Aides to lawmakers in both parties said the compromise sparked a final round of negotiations.

Lawmakers and aides said it would likely require all of Sunday to finalize and draft the final agreement, which is already guaranteed to be the largest spending measure yet, combining COVID-19 relief with a $1.4 trillion omnibus spending bill and reams of other unrelated legislation on taxes, health, infrastructure and education.

The measure is finally nearing passage amid a frightening spike in coronavirus cases and deaths and accumulating evidence that the economy is struggling. Lawmakers and aides say it would establish a temporary $300 per week supplemental jobless benefits and $600 direct stimulus payments to most Americans. It would provide a fresh round of subsidies for hard-hit businesses and money for schools, health care providers and renters facing eviction.

Late-breaking decisions would limit $300 per week bonus jobless benefits — one half the supplemental federal unemployment benefit provided under the CARES Act in March — to 10 weeks instead of 16 weeks as before. The direct $600 stimulus payment to most people is also half the March payment, subject to the same income limits in which an individual's payment begins to phase out after $75,000.

President Donald Trump is supportive, particularly of the push for providing more direct payments. “GET IT DONE,” he said in a late-night tweet.

It would be the first significant legislative response to the pandemic since the $1.8 trillion CARES Act passed virtually unanimously in March.

The COVID-19 legislation was held up by months of dysfunction, posturing and bad faith. But talks turned serious last week as lawmakers on both sides finally faced the deadline of acting before leaving Washington for Christmas.

The measure is being added to a $1.4 trillion spending bill and combined with lots of other unfinished work, including previously stalled legislation to extend tax breaks, authorize water projects, and address the problem of surprise sky-high medical bills for out-of-network procedures.

It would be virtually impossible for lawmakers to read and fully understand the sprawling legislation before a House vote expected on Monday. Senate action would follow.

In the meantime, with a government shutdown deadline looming at midnight Sunday, lawmakers faced the reality of needing to enact another temporary spending bill — the second in as many days — to avert a shutdown of non-essential activities by federal agencies on Monday.

12:31 PM CT on 12/20/2020

(AP) President-elect Joe Biden’s nominee for U.S. surgeon general says it’s more realistic to think it may be mid-summer or early fall before coronavirus vaccines are available to the general population in the United States, rather than late spring.

“I think it’s more realistic to assume that it may be closer to mid-summer or early fall when this vaccine makes its way to the general population,” Murthy said. “So, we want to be optimistic, but we want to be cautious as well.”

Murthy, who also served as surgeon general in the Obama administration, said Biden’s promise of 100 million vaccines during his first 100 days in office is realistic and that the Biden team has seen more cooperation from Trump administration officials.

Speaking on Sunday on NBC’s “Meet the Press,” Vivek Murthy said Biden’s team is working toward having coronavirus vaccines available to lower-risk individuals by late spring but doing so requires “everything to go exactly on schedule.”

10:43 AM CT on 12/20/2020

(AP) Initial shipments of the second COVID-19 vaccine authorized in the U.S. left a distribution center Sunday, a desperately needed boost as the nation works to bring the coronavirus pandemic under control.

The trucks left the factory in the Memphis area with the vaccine developed by Moderna Inc. and the National Institutes of Health. The much-needed shots are expected to be given starting Monday, just three days after the Food and Drug Administration authorized their emergency rollout.

Later Sunday, an expert committee will debate who should be next in line for early doses of the Moderna vaccine and a similar one from Pfizer Inc. and Germany’s BioNTech. Pfizer's shots were first shipped out a week ago and started being used the next day, kicking off the nation’s biggest vaccination drive.

Public health experts say the shots — and others in the pipeline — are the only way to stop a virus that has been spreading wildly. Nationwide, more than 219,000 people per day on average test positive for the virus, which has killed at least 314,000 in the U.S. and upwards of 1.7 million worldwide.

The Pfizer and Moderna shots shipped so far and going out over the next few weeks are nearly all going to health care workers and residents of long-term care homes, based on the advice of the Advisory Committee on Immunization Practices.

That panel meets Sunday to debate who should get the doses available after those early shots are given.

There won’t be enough shots for the general population until spring, so doses will be rationed at least for the next several months.

The panel members are leaning toward putting “essential workers” next in line, because people like bus drivers, grocery store clerks and others are the ones getting infected most often. But other experts say people 65 and older should be next, along with people with certain medical conditions, because those are the Americans who are dying at the highest rates.

The expert panel’s advice is almost always endorsed by the U.S. Centers for Disease Control and Prevention. No matter what the CDC says, there will be differences from state to state, because their health departments have different ideas about who should be closer to the front of the line.

The measure is being added to a $1.4 trillion spending bill and lots of other unfinished work, including previously stalled legislation to extend tax breaks, authorize water projects, and address the problem of surprise sky-high medical bills for out-of-network procedures.

It would be virtually impossible for lawmakers to read and fully understand the measure before a House vote expected Sunday night.

Schumer said he hoped both the House and Senate would vote on the measure Sunday. That would take more cooperation than the Senate can usually muster, but a government shutdown deadline loomed at midnight Sunday and all sides were eager to leave for the holiday.

Toomey defended his provision in a Senate speech, saying the emergency powers were designed to stabilize capital markets at the height of the pandemic this spring and were expiring at the end of the month anyway. The language he had sought would block the Biden administration from restarting them.

Toomey has a stubborn streak and Democrats held firm as well, but both sides saw the need for a compromise.

The Fed's emergency programs provided loans to small and mid-size businesses and bought state and local government bonds. Those bond purchases made it easier for those governments to borrow, at a time when their finances were under pressure from job losses and health costs stemming from the pandemic.

Treasury Secretary Steven Mnuchin said last month that those programs, along with two that purchased corporate bonds, would close at the end of the year, prompting an initial objection by the Fed. Under the Dodd-Frank financial overhaul law passed after the Great Recession, the Fed can only set up emergency programs with the support of the treasury secretary.

Democrats also said that Toomey was trying to limit the Fed’s ability to boost the economy, just as Biden prepared to take office.

“This is about existing authorities that the Fed has had for a very long time, to be able to use in an emergency,” said Sen. Elizabeth Warren, D-Mass. “It’s about a lending authority for helping small businesses, state government, local government in the middle of a crisis.”

Toomey disputed that, saying his proposal “is emphatically not a broad overhaul of the Federal Reserve’s emergency lending authority.” His office issued a statement early Sunday calling the compromise with Schumer “an unqualified victory for taxpayers” that met Toomey's aim of shutting down the emergency facility.

A Senate vote would follow, possibly on Monday. One more short-term funding bill would be needed to avoid the looming deadline — or a partial shutdown of nonessential agencies would start on Monday.

The emerging agreement would deliver more than $300 billion in aid to businesses as well as the extra $300-per-week for the jobless and renewal of state benefits that would otherwise expire right after Christmas. It included $600 direct payments to individuals; vaccine distribution funds; and money for renters, schools, the Postal Service and people needing food aid.

It would be the first significant legislative response to the pandemic since the landmark CARES Act passed virtually unanimously in March, delivering $1.8 trillion in aid, more generous $600 per week bonus jobless benefits and $1,200 direct payments to individuals.

The governmentwide appropriations bill would fund agencies through next September. That measure was likely to provide a last $1.4 billion installment for President Donald Trump’s U.S.-Mexico border wall as a condition of winning his signature.

8:32 AM CT on 12/20/2020

(AP) Top congressional lawmakers struck a late-night agreement on the last major obstacle to a COVID-19 economic relief package costing nearly $1 trillion, clearing the way for votes as early as Sunday.

The breakthrough involved a fight over Federal Reserve emergency powers and was resolved by the Senate’s top Democrat and a senior conservative Republican.

Congressional aides confirmed the agreement late Saturday, which clears the way for an expected deal Sunday on the aid bill. The measure is finally nearing passage amid a frightening spike in cases and deaths and accumulating evidence that the economy is struggling through the pandemic.

“We’re getting very close, very close," Minority Leader Chuck Schumer, D-N.Y., as he left the Capitol late Saturday. Schumer spent much of the day going back and forth with GOP Sen. Pat Toomey of Pennsylvania. Toomey had been pressing a provision to close down Fed lending facilities. Democrats and the White House said it was too broadly worded and would have tied the hands of the incoming Biden administration.

The compromise, aides said, preserved Toomey's goal but retained the Fed's existing powers to restart similar facilities in the future.

The COVID-19 legislation has been held up after months of dysfunction, posturing and bad faith. But talks turned serious last week as lawmakers on both sides finally faced the deadline of acting before leaving Washington for Christmas.

The relief bill, lawmakers and aides say, would establish a temporary $300 per week supplemental jobless benefits and $600 direct stimulus payments to most Americans. It would provide a fresh round of subsidies for hard-hit businesses and money for schools, health care providers and renters facing eviction.

8:15 PM CT on 12/19/20

(AP) The number of New Yorkers hospitalized with coronavirus has risen to the highest level since mid-May, according to state figures released Saturday.

Officials said 6,208 people were hospitalized with the virus as of Friday — the largest number in the state since May 15.

The state on Saturday also reported 127 new deaths and 9,919 new cases.

Still, Democratic Gov. Andrew Cuomo said New York “can see the light at the end of the tunnel” with the arrival of the first vaccines.

"If we stay tough and be smart by socially distancing and wearing masks, we can avoid the holiday surge the experts are predicting and finally win this war,” the governor said in a news release.

The numbers were announced as Cuomo sent a letter to President Donald Trump calling on the Republican to ensure Congress passes an “urgently needed” relief package with support for not only families but state and local governments.

“The American people need financial assistance to make it through the end of the year,” Cuomo wrote. ”Republican families need these relief checks as much as Democratic families."

Also Saturday, Cuomo signed an executive order lifting the requirement that low-income senior citizens and people with disabilities must appear in person to renew their property tax exemptions. To claim or renew benefits, eligible seniors and people with disabilities typically line up at city and town halls across New York to file the required documentation, raising concerns about the potential spread of COVID-19.

Cuomo's order allows local governments to automatically renew 2021 benefits for all property owners who received the benefit in 2020 unless local officials believe the person is no longer eligible.

His executive order also extends the sales tax deadline until March for restaurants located in orange alert zones, including New York City, which have been required to suspend indoor dining. Payments were originally due on Dec. 21.

6:10 PM CT on 12/19/20

While hospital beds are filling up across the country, rural hospitals have felt the brunt of the latest COVID-19 surge, new research shows.

About 40% of adult hospitalizations at rural hospitals were COVID-19 related as of Nov. 27, up from a median of 28% in late July, Chartis Center for Rural Health's analysis of HHS data shows. The share of COVID-related hospitalizations at urban hospitals increased from 14% to 23% over that span.

Rural hospitals typically lack the capacity, equipment and staffing to best manage acute cases. There is one ICU bed for every 9,500 Americans who live in rural communities, where intensive care beds are hard to come by. Nearly two-thirds of rural hospitals don't have any ICU beds, Chartis data show.

Of those that have ICU beds, 82% were occupied as of late November, up from 73% in August, according to its updated research. Many patients have had to be transported to metro areas, where capacities are similarly strained, said Michael Topchik, the national leader for Chartis.

READ MORE

3:13 PM CT on 12/19/20

(AP) The United States added a record of nearly a quarter million coronavirus cases in the past day.

Health experts says the record could increase as cases surge in various parts of the country and health care systems struggle to keep up.

Along with 249,709 new cases, there were an additional 2,814 reported deaths nationwide in the past 24 hours. That pushed the confirmed U.S. death toll past 313,000, according to researchers at Johns Hopkins University.

California led the case surge with 48,221 more infections. Almost 17,000 people are hospitalized in California and health officials are scrambling to find enough beds for patients. Texas, Florida, New York and Tennessee all registered more than 10,400 new cases.

The seven-day rolling average for new cases in the U.S. rose in the past two weeks from 183,787 to 219,324 on Friday, an increase of nearly 20%.

Health officials are concerned about future cases brought on by travel and gatherings during the holidays and New Year’s.

12:33 PM CT on 12/19/20

(AP) An Army general in charge of COVID-19 vaccines apologized Saturday for “miscommunication” with states on the number of early doses delivered.

Gen. Gustave Perna’s remarks came a day after a second vaccine was added in the fight against the coronavirus. Governors in more than a dozen states says the federal government has told them next week’s shipment of the Pfizer-BioNTech vaccine will be less than originally projected.

“I want to take personal responsibility for the miscommunication,” he said. “I know that’s not done much these days. But I am responsible. ... This is a herculean effort and we are not perfect.”

Perna says the government now is on track to get approximately 20 million doses to states by the first week of January, a combination of the newly approved Moderna vaccine and the Pfizer-BioNTech vaccine. He says 2.9 million Pfizer-BioNTech doses have been delivered so far.

The coronavirus has killed more than 313,000 people in the U.S., the highest death toll in the world.

9:38 AM CT on 12/19/20

(AP) India’s confirmed coronavirus cases have crossed 10 million with new infections dipping to their lowest levels in three months, as the country prepares for a massive COVID-19 vaccination in the new year.

Additional cases in the past 24 hours dropped to 25,152 from a peak of nearly 100,000 in mid-September. The epidemic has infected nearly 1% of India’s more than 1.3 billion people, second to the worst-hit United States.

The Health Ministry on Saturday also reported 347 deaths in the past 24 hours, taking total fatalities to 145,136.

Dr. Randeep Guleria, a government health expert, said India is keeping its fingers crossed as the cases tend to increase in winter months.

“If we can sustain our declining trend for the next two to three months, we should be able to start the vaccination program and start moving away from the pandemic,” Guleria told The Associated Press.

India is home to some of the world’s biggest vaccine-makers and there are five vaccine candidates under different phases of trial in the country.

The Serum Institute of India, the world’s largest vaccine-maker, is licensed to produce the Oxford University-AstraZeneca shots. India’s Bharat Biotech vaccine also is a front-runner, and the two vaccines are expected to get authorization for emergency use within weeks, said Guleria.

India aims to provide vaccines to 250 million people by July 2021. The government is planning to receive 450 million to 500 million doses, the Health Ministry said.

The first group will include health care and front-line workers. The second group to receive the COVID 19 vaccine will be people over 50 years of age and those under 50 with comorbid conditions, it said.

The pace of new cases has slowed down. It took India 12 days to get from 5 million to 6 million cases, but 22 days to go from 8 million to 9 million, and 29 days to hit 10 million.

India’s economy contracted by 7.5% in the July-September quarter following a record slump of 23.9% in the previous three months, pushing the country into a recession for the first time in its history. With millions becoming jobless, the Indian government is continuing to relax harsh lockdown restrictions that were imposed in late March.

A large number of offices, shops, businesses, liquor stores, bars and restaurants have reopened. Restricted domestic and international evacuation flights are being operated along with train services. Schools remain closed.

7:32 PM CT on 12/18/20

As many as 66% of nursing homes say they could close in 2021 due to COVID-19 costs, according to a new survey of nursing home providers.

The American Health Care Association and National Center for Assisted Living, which represents more than 14,000 nursing homes and assisted living facilities across the U.S., found 90% of the 953 nursing homes that responded said their profit margins are 3% or less, and 65% said they are currently operating at a loss. The biggest increase in cost was staffing.

"Our nursing home providers are facing the worst financial crisis in the history of the industry due to increased costs related to COVID (testing, personal protective equipment, staffing) and chronic Medicaid underfunding," AHCA/NCAL President and CEO Mark Parkinson said in a prepared statement.

Read the rest of the story.

6:42 PM CT on 12/18/20

(AP) Increasingly desperate California hospitals are being "crushed" by soaring coronavirus infections, with one Los Angeles emergency doctor predicting Friday that rationing of care is imminent.

The most populous state recorded more than 41,000 new confirmed cases and 300 deaths, both among the highest single-day totals during the pandemic. In the last week, California has reported more than a quarter-million cases and 1,500 deaths.

"I'm not going to sugarcoat this. We are getting crushed," said Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center, which has more than 600 beds and is one of the largest in the county.

It's a scene playing out across California. According to state data Friday, all of Southern California and the 12-county San Joaquin Valley to the north had exhausted their regular intensive care unit capacity and some hospitals have begun using "surge" space.

Statewide, the available ICU capacity on Friday was a miniscule 2.1%.

Dr. Anthony Fauci, the country's top infectious-disease expert, discussed California's predicament during an event organized by the California State University system.

He warned that unless people curtail their holiday travels and gatherings, "it is very likely we're going to get what I call a surge upon a surge" that is particularly dangerous "in the state of California, which is just right at that cusp of getting overrun in some areas of the state."

Many emergency rooms already have been using outdoor tents to make more space, said Dr. Marc Futernick, an emergency room physician in Los Angeles who is on the board of the California chapter of the American College of Emergency Physicians. One hospital that has maxed out its outdoor overflow tent is expanding into a nearby gym, he said.

Yet coronavirus cases have not reached their peak in this third and most devastating wave, and that means more drastic measures are on the horizon. Statewide, about 16,000 coronavirus victims are hospitalized — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach an unfathomable 75,000 by mid-January.

"Even though it is true that I don't think anyone is doing this kind of rationing of care, or feeling truly overwhelmed in this exact moment, there's no doubt it is right around the corner," Futernick said. "There's no feasible way for this to be avoided. The numbers are too big."

Corona Regional Medical Center southeast of Los Angeles has converted an old emergency room to help handle nearly double the usual number of ICU patients. It's using space in two disaster tents to triage ER patients because the emergency room is filled with patients who need to be hospitalized. Ambulances can sit for two hours unless they are bringing in patients with critical, life-or-death emergencies.

"There's no room at the inn, so to speak," hospital chief executive Mark Uffer said. "Literally every nook and cranny of the hospital is being used."

He and Spellberg said it only feeds health workers' angst when they see people not following state-mandated safety precautions to slow the virus' spread when disaster seems imminent.

"Whatever's coming, I don't think any of us are going to be able to manage it," Uffer said. "You have a dam that's about to break, and you've got to stop putting water into the dam."

Spellberg said that every day for the last week at his hospital has begun with no available intensive care beds and a scramble to find room in spaces that don't usually handle critical patients, like post-surgery recovery areas.

Los Angeles County Health Services Director Dr. Christina Ghaly said hospitals "are adding three beds to a room that maybe was a double room, or turning a single room into a double room," dangerously stretching staff.

Meanwhile, emergency rooms are filling up with patients who should be hospitalized but can't be because there's no space. Ambulance providers are planning for how to handle the rising caseload and may have to start triaging patients in the field rather than bringing them in except in the most critical cases, Futernick said.

"I am fearful it will be worse than what we saw in New York," he said. "When New York's hospitals became overwhelmed, health care providers poured in from around the country."
"None of that is happening right now, and there's no way for it to happen because every place is busy," Futernick said. "There's no cavalry coming."

4:36 PM CT on 12/18/20

(AP) The Trump administration abruptly closed the Washington Monument over exposure concerns from a recent visit by Interior Secretary David Bernhardt, who tested positive this week for the coronavirus.

Interior spokesman Nicholas Goodwin said Friday “a couple” of employees have quarantined since Bernhardt's visit, “resulting in a temporary workforce reduction at the monument and its temporary closure." The park service posted a brief notice of the closure on its website sometime Thursday.

An official with an independent advocacy group for national parks and park workers on Friday criticized Bernhardt, saying the interior secretary had failed to protect health and safety overall during the pandemic .

Bernhardt had been slow to allow closing of national parks to limit infection among park employees, visitors and local residents, said Kristen Brengel, a vice president of the National Parks Conservation Association. National park employees also have expressed concern at his and other Interior officials continuing to visit national parks and other federal sites during the pandemic, Brengel said.

“It really is putting your own interest over the health and safety of park staff, is what it comes down to,” she said.

Goodwin said in an email that "the health and safety of the public and our employees is our top priority."

“Interior has an incredible team of more than 60 public health professionals on staff that have been leading the Department’s pandemic response efforts with the Secretary and other members of leadership over the past year,” he said.

Goodwin said the Washington Monument, normally one of the capital's most visited sites, would reopen Monday, with tickets going on sale Sunday.

The closure comes after the Interior Department disclosed Wednesday, after an inquiry from The Washington Post, that Bernhardt had tested positive for the coronavirus.

1:39 PM CT on 12/18/20

(AP) As COVID-19 vaccinations roll out to more and more people, health authorities are keeping close watch for any unexpected side effects.

On Tuesday, a health worker in Alaska suffered a severe allergic reaction after receiving the Pfizer COVID-19 vaccine. She is in the hospital for another night under observation while another worker, vaccinated Wednesday, has recovered. Doctors already knew to be on the lookout after Britain reported two similar cases last week.

In the U.S., vaccine recipients are supposed to hang around after the injection in case signs of an allergy appear and they need immediate treatment — exactly what happened when the health worker in Juneau became flushed and short of breath 10 minutes after the shot. The second worker experienced eye puffiness, light headedness and scratchy throat.

READ MORE... 

11:35 AM CT on 12/18/20

(AP) The U.S. stood on the verge of adding a second COVID-19 vaccine to its arsenal Friday as the outbreak descended deeper into its most lethal phase yet, with the nation regularly recording over 3,000 deaths per day.

The Food and Drug Administration was evaluating a shot developed by Moderna Inc. and the National Institutes of Health and was expected to give it the green light soon, clearing the way for its use to begin as early as Monday.

That would give the U.S. a critical new weapon against the coronavirus in addition to the Pfizer-BioNTech vaccine now being dispensed to millions of health care workers and nursing home patients as part of the biggest vaccination drive in U.S. history.

The go-ahead from the FDA would mark the world’s first authorization of Moderna’s shots. Large but unfinished studies show that both vaccines appear safe and strongly protective, though Moderna's is easier to handle, since it does not need to be kept at ultra-frozen temperatures like the Pfizer-BioNTech shot. Both require two doses for full protection.

A second vaccine represents a ray of hope amid despair as the virus continues to spread unabated even before holiday gatherings certain to fuel the outbreak.

9:35 AM CT on 12/18/20

(AP) The Green Bay Packers will honor workers who have been on the frontlines caring for coronavirus patients.

The team says it will welcome about 250 health care employees, first responders and their families to Lambeau Field for Saturday night’s game against the Carolina Panthers.

“We are so thankful and appreciative of all they have done for our community during this challenging time,” Packers President/CEO Mark Murphy said in a statement. “While we cannot invite large numbers of these special guests due to the pandemic, we want to express our community’s collective appreciation for all their great work.”

The group will join Packers employees and their families at the game. The spectators will continue to follow safety protocols set by the team.

The Packers say they continue to take a cautious approach by not allowing a large number of ticketed fans, citing ongoing high coronavirus rates.

The Packers say that attendance at one or more home playoff games will be decided at a later date.

8:40 PM CT on 12/17/20

(AP) Gov. Brian Kemp says the state of Georgia will keep paying for extra nurses to assist hospitals, nursing homes and other health care facilities that have struggled to find staff and keep up with demand because of the coronavirus pandemic.

The Republican governor made the announcement Thursday during a news conference at Grady Memorial Hospital in Atlanta where Public Health Commissioner Kathleen Toomey and an intensive care unit nurse received a coronavirus vaccine in an attempt to demonstrate that it's safe and effective.

Kemp said Georgia will commit as much as $70 million to pay staffing agencies that are providing extra nurses through March. Georgia is on track to spend $250 million on the program this year. The state has spent federal coronavirus aid on the program so far. Kemp said he hopes the federal government will free up more money to cover the costs, but spokesman Cody Hall said Georgia would use state money if no federal money is available.

Hospitals and nursing homes have struggled with staffing, as some employees are infected or quarantined, and they haven't been able to easily hire more people to address surging demand.

Kemp reiterated that he won't make any more orders to try to limit the spread of the coronavirus, which again set a daily record with more than 6,000 cases statewide on Thursday. Some people never show symptoms and most recover, but some sicken and die. Georgia has recorded more than 10,000 deaths.

Kemp said he hoped people would recognize that Thanksgiving had resulted in many more cases and downscale Christmas celebration plans to limit further transmission.

“I'm hopeful they'll really help us,” Kemp said. “Don't go out unless you need to. If you do, just wear a mask. Try not to go to things you don't have to to stop the spread. Limit your gatherings for the holidays.”

6:23 PM on 12/17/20

A state website where Indiana healthcare workers sign up to receive the COVID-19 vaccine temporarily crashed Monday after being overwhelmed with traffic.

The vaccination enrollment website crashed before the first shipment of COVID-19 vaccines arrived in the state, according to Indianapolis NBC affiliate WTHR, which first reported the news.

"Due to a large amount of traffic, the site is currently down," reads a message from the state health department Monday morning and obtained by WTHR. "Check back this afternoon."

READ MORE

4:05 PM CT on 12/17/20

(Crain's Detroit Business) Michigan public health officials expect to receive 29 percent fewer doses of Pfizer Inc.'s COVID-19 vaccine next week, an unexplained drop in supplies on just the second full week of the state's mass inoculation of health care workers on the front lines of the pandemic.

Lynn Sutfin, a spokeswoman for the Michigan Department of Health and Human Services, said Wednesday that federal officials have informed state officials that next week's shipment of the Pfizer vaccine will drop from 84,000 doses to 60,000.

1:29 PM CT on 12/17/20

ManorCare Health Services in Palm Harbor, Fla. launched its COVID-19 vaccination Wednesday.

This marks the beginning of the country's efforts to vaccinate long-term care residents, who have represented 40% of the U.S. COVID-19 deaths.

READ MORE...

11:32 AM CT on 12/17/20

(AP) — From speculation that the coronavirus was created in a lab to hoax cures, an overwhelming amount of false information clung to COVID-19 as it circled the globe in 2020.

Public health officials, fact checkers and doctors tried to quash hundreds of rumors in myriad ways. But misinformation around the pandemic has endured as vexingly as the virus itself. And with the U.S., U.K. and Canada rolling out vaccinations this month, many falsehoods are seeing a resurgence online.

A look at five stubborn myths around COVID-19 that were shared this year and continue to travel:

MYTH: MASKS DON’T OFFER PROTECTION FROM THE VIRUS

In fact, they do.

MYTH: THE VIRUS WAS MAN-MADE

It was not.

MYTH: COVID-19 IS SIMILAR TO THE FLU

In fact, COVID-19 has proved to be far deadlier.

MYTH: OFFICIALS ARE EXAGGERATING COVID-19’S TOLL

They are not.

“I don’t think it was one myth that caused the problem,” said Nancy Kass, deputy director for public health at the Johns Hopkins Berman Institute of Bioethics. "It’s the fact that there were many, many, many myths.”

9:44 AM CT on 12/17/20

(AP) —The number of Americans applying for unemployment benefits rose again last week to 885,000, the highest weekly total since September, as a resurgence of coronavirus cases threatens the economy's recovery from its springtime collapse.

The Labor Department said Thursday that the number of applications increased from 862,000 the previous week. It showed that nine months after the virus paralyzed the economy, many employers are still slashing jobs as the pandemic forces more business restrictions and leads many consumers to stay home. The number of claims was much higher than the 800,000 that economists had expected.

Before the coronavirus erupted in March, weekly jobless claims had typically numbered only about 225,000. The far-higher current pace reflects an employment market under stress and diminished job security for many.

8:44 PM CT on 12/16/20

(AP) — Gov. Doug Ducey implored people to get the COVID-19 vaccine when they're eligible as hospital capacity on Wednesday hit a record low since the start of the pandemic.

Ducey continued to resist pressure to impose new business restrictions or a statewide mask mandate, measures requested by hospital leaders and several mayors to constrain the spread of the virus.

"We need Arizonans to step up and get the vaccine if we want to stop the spread of this virus," Ducey told reporters during a stop at the state fairgrounds, where Banner Health plans to begin vaccinating health care workers on Thursday. "It's our best shot at returning to normalcy."

Arizona was allotted 384,000 vaccine doses by the end of the year. Immunizations began Tuesday for health care workers. Nursing home patients and staff will follow. Older people and those with underlying conditions that make them more vulnerable if infected are expected to be eligible sometime in the spring, followed by healthy adults.

Arizona on Wednesday reported 108 new deaths attributed to COVID-19, tying a previous one-day record during the current virus surge. A record 92% of Arizona's inpatient beds were filled Tuesday, mixed almost evenly between coronavirus patients and those hospitalized for other reasons, according to the state's coronavirus dashboard.

There are fewer measures in place to slow the spread and limited backup resources for hospitals than were available in the summer, said Dr. Joshua LaBaer, executive director of Arizona State University's Biodesign Institute.

"We're pushing on almost one of two beds in the hospitals right now is that one disease," LaBaer said. "That's a staggering statistic when you think about the things that can afflict people. And it certainly means that hospitals at this point are having to make decisions about keeping people out of the hospital to keep beds available for the COVID patients."

6:00 PM CT on 12/16/20

(AP) California reported more than 50,000 new coronavirus cases and 293 deaths on Wednesday, setting new daily records as hospitals struggled to keep up with the surge.

Southern California and the state's Central Valley — regions that together include 23 counties and most of the state's nearly 40 million residents — had exhausted their regular supply of intensive care beds and many hospitals were tapping into their "surge" capacity.

Los Angeles County Public Health Director Barbara Ferrer said the transmission of the virus is rampant and noted two people are dying every hour in the county.

"We're experiencing an explosive and very deadly surge," Ferrer said.

LA County Health Services Director Dr. Christina Ghaly said "hospitals are under siege and our models show no end in sight" She characterized the facilities as "strained and under immense stress."
Hospitals are filling up so fast in California that officials are rolling out mobile field facilities and scrambling to hire doctors and nurses. The state is distributing 5,000 body bags mostly to the hard-hit Los Angeles and San Diego areas and has 60 refrigerated trailers standing by as makeshift morgues in anticipation of more deaths.

Jeremy Zoch, chief executive at Providence St. Joseph Hospital of Orange, said nurses, respiratory therapists and housekeepers are taking extra shifts to keep up with rising cases. Registry and traveling nurses have come in to help, and officials are talking to a nearby children's hospital about using additional space to care for patients, he said.

"It has challenged us so every single one of our units that we have available to us we've been redesigning them and utilizing them to care for COVID patients," Zoch said at a news conference marking the hospital's first coronavirus vaccinations. "It is really challenging us on the capacity front. Our ICUs are very close to full."
California is averaging more than 35,000 new cases a day. Health officials estimate 12% of them — 4,200 — end up in hospitals.

Hospitalizations are now are nearly 15,000, and California now is averaging 177 deaths per day and has a total of 21,481.

On Wednesday, state health officials announced the San Francisco Bay Area would join three of the state's five regions already under state-mandated shutdowns as ICU available beds dropped below 15%. Many of the Bay Area counties had already applied the state's order as a precaution and those that hadn't must now do so on Thursday.

Dr. Marty Fenstersheib, testing director for Santa Clara County, the Bay Area's most populous, said infections are topping 1,000 per day, compared with 300 in July.

3:41 PM CT on 12/16/20

(Crain's New York) Phase two of the Covid-19 vaccine distribution plan could be enacted in late January, assuming no supply interruptions, said Gov. Andrew Cuomo in his Wednesday briefing.

Workers in phase two include first responders, school staff, essential frontline workers who regularly interact with the public and individuals at high risk because of other health conditions, according to the state’s website.

1:24 PM CT on 12/16/20

Some insurers worry that the Biden administration could put them on the hook for more COVID-19 testing costs.

The Trump administration issued guidance stating that insurers' responsibility to pay for COVID-19 tests is limited to tests that are medically necessary, despite Democratic lawmakers' insistence that they intended to institute a broader requirement. However, that interpretation could change under a Democratic administration.

The Families First Coronavirus Response Act requires insurers to cover COVID-19 tests without patient cost-sharing, but the guidance, issued June 23, says that the law only applies to tests that are deemed "medically appropriate" by a healthcare provider.

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12:07 PM CT on 12/16/20

HHS on Wednesday distributed $24.5 billion in COVID-19 grants to healthcare providers who applied for them. 

The agency said it initially planned to send $20 billion, but after reviewing applications decided to send more. Unlike some prior distributions, healthcare providers had to apply for additional funds and supply data about their financial situations to qualify. 

Those who had already received grants worth 2% of their annual revenue were eligible for an add-on payment if their revenue data justified it, HHS said. The add-on payments were calculated using a combination of operating revenues, operating expenses and prior Provider Relief Fund grants.

More money to replenish the fund may be on the way in Congress’ next COVID-19 relief package. A bipartisan framework for negotiations recommended another $35 billion for the fund and multiple tweaks to the terms and conditions, but details of a potential deal remain unclear.

10:55 AM CT on 12/16/20

(AP) Germany reported a record level of coronavirus deaths as it entered a harder lockdown Wednesday, closing shops and schools to try to bring down stubbornly high new daily infections.

The country recorded 179.8 virus infections per 100,000 residents over the last seven days, a new high and significantly more than the 149 per 100,000 reported a week ago by the Robert Koch Institute, the country's disease control center.

It also blew past its previous daily death toll, with Germany's 16 states reporting that 952 more people had died of the virus, the institute said. That was far greater than the previous daily record set Friday of 598 deaths, although it included two days of figures from the hard-hit eastern state of Saxony, which did not report Tuesday. It brought the country's overall pandemic death toll to 23,427.

“It's as if the virus wanted to remind us how important what we're now doing is,” Health Minister Jens Spahn said of the surge in deaths being reported on the day new restrictions come into force.

Faced with exponentially increasing cases in October, Germany implemented a “lockdown light” at the start of November, which closed bars and restaurants but left shops open. The measures slowed the weekly increase in new infections but didn't bring them down, prompting officials to take more drastic measures.

In addition to closing shops and moving children to remote learning for the few days before the Christmas holidays, private gatherings are being limited to two households with a maximum of five people, among other things.

On Berlin's upscale Kurfuerstendamm boulevard, Berlin resident Noury Oeddin looked around at the empty streets and shuttered shops in disbelief as the lockdown measures announced Sunday were put into force.

“It's very strange, it's not normal,” said the 46-year-old bakery manager. "I don’t know what these politicians want to do — they left it all open for too long, and now all of a sudden we had to quickly buy everything in two days. We people don’t know what they are doing anymore.”

Retiree Hans-Joachim Pauer said, however, that the measures were understandable.

“This is certainly harmful to the economy, but what alternative do we have?” the 71-year-old asked. “Certainly it is not good.”

8:55 AM CT on 12/16/20

(AP) Amber Johnson is terrified her 63-year-old father will get the coronavirus. He has high blood pressure, asthma and is pre-diabetic, and she worries he's especially vulnerable as an inmate in Colorado, where outbreaks in prisons are raging.

Prisons across the U.S. have been hit hard by COVID-19. Social distancing is virtually impossible behind bars: inmates sleep in close quarters and share bathrooms. Masks, hygiene supplies and safety protocols are often lacking, and many inmates have health problems that make them susceptible to the virus.

Johnson believes a vaccine might be the only hope for her father, Ronald Johnson, who is serving time for theft, forgery and drug possession.

But in Colorado and most other states, prisoners aren't near the front of the line for initial doses of COVID-19 vaccine now being distributed. Health care workers and nursing home residents are getting the first wave of shots, and many argue that those who break the law — despite living in conditions that put them at risk — shouldn't be a priority when many others are vulnerable.

“To think about him dying in prison is an awful thought because from what I’ve heard, if you have a loved one who dies in prison, you just kind of get the remains in a box. They cremate them and send them home," Amber Johnson said. "You don’t have the opportunity to sit by them and hold their hand.”

Initially, Colorado had inmates in the second phase of vaccine distribution, set for the spring, behind health workers and first responders but ahead of other adults over 65 with health conditions. Prisoners were to be treated like others in group housing, including homeless shelters and college dorms.

But an outcry followed. Suburban Denver prosecutor George Brauchler said the plan would have allowed two men convicted of killing the son of 66-year-old state Sen. Rhonda Fields to be vaccinated before her.

“The people who murdered her son would get it before she would,” Brauchler said.

Democratic Gov. Jared Polis bowed to criticism last week, updating the plan to prioritize age and health risks over where people live. Jail staffers will still get the vaccine in the second phase, along with first responders.

“Whether you’re in prison or not, if you’re 67 years old or at risk, wherever you are, you’ll have access to the vaccine when 67-year-old's have access to vaccines," Polis said.

Though Colorado changed course, California, North Carolina, Maryland, Delaware, Utah, New Mexico, Nebraska, Montana and Massachusetts have prisoners among the first to get the vaccine this winter. Some states also have taken steps to reduce COVID-19 risks behind bars by releasing nonviolent offenders early.

But even in states with the biggest prison outbreaks, inmates often weren't on early vaccine distribution plans.

The five states with the highest number of coronavirus cases in their prisons, according to data compiled as part of a joint project by The Associated Press and The Marshall Project — Texas, California, Florida, Michigan and Wisconsin — did not include details about how they would prioritize prisoners in their October draft reports to the Centers for Disease Control and Prevention.

9:03 PM CT on 12/15/20

(AP) California is distributing 5,000 body bags mostly to the hard-hit Los Angeles and San Diego areas and has 60 refrigerated trailers standing by as makeshift morgues in anticipation of a surge of coronavirus deaths from hospitalizations that now are double the summertime peak and threaten to overwhelm the hospital system, Gov. Gavin Newsom said Tuesday.

The number of average daily deaths has quadrupled from 41 a month ago to 163 now, while positive cases have surged to more than 32,500 each day. Of those new cases, an anticipated 12% will wind up in the hospital and 12% of those hospitalized will crowd already stretched intensive care units.

That means one day's worth of cases can be expected to produce a staggering 3,900 hospitalizations and nearly 500 ICU patients.

The surge in cases throughout much of California is forcing an urgent scramble for more staff and space, a crush that Newsom and the state’s top health official said might not abate for two months despite the arrival of the first doses of vaccines this week.

The surge already has prompted an easing of normal nurse-to-patient ICU ratios and quarantine standards for health care workers, and the opening of more alternative care facilities. State officials are reaching out to the Department of Defense and overseas staffing services for desperately needed medical workers.

The California Nurses Association denounced reducing the ratio of ICU nursing care, saying in a statement that it “will inevitably lead to more patient, nurse, and other health care worker infections and deaths."

Newsom said it is part of “a very dynamic effort” to get more staffing, particularly in intensive care units.

Newsom announced a new shutdown order nearly two weeks ago that is based on ICU capacity. Nearly the entire state now is under the most severe restrictions.

California has brought in 507 extra staff and deployed them around the state, though most don't have the skills to help in ICUs. The state is seeking a total of 3,000 contracted medical staff.

6:40 PM CT on 12/15/20

(AP) Prime Minister Justin Trudeau said Tuesday that Canada has contracted to receive up to 168,000 doses of the Moderna COVID-19 vaccine before the end of December, pending approval by the country's health regulator.

Trudeau said deliveries could begin within 48 hours of regulatory approval and health officials said they expect to approve use of the Moderna vaccine soon.

Canadians began receiving vaccine shots developed by Pfizer and BioNTech on Monday and Trudeau said Canada expects to receive about 200,000 doses from Pfizer next week. Canada received an initial batch of 30,000 this week.

Trudeau said they will have 70 sites ready to administer these doses next week, up from 14 sites this week.

The U.S. Food and Drug Administration said its preliminary analysis confirmed the effectiveness and safety of the vaccine developed by Moderna and the National Institutes of Health, bringing it to the cusp of U.S. authorization. A panel of outside U.S. experts is expected to vote to recommend the vaccine on Thursday, with a final FDA decision coming soon thereafter.

Moderna’s vaccine is the same type as Pfizer’s, made with the same technology. In scrutinizing early results of a 30,000-person study, the FDA found it worked just about the same.

The Moderna vaccine was more than 94% effective overall at preventing COVID-19 illness, and 86% effective in people 65 and older. The FDA uncovered no major safety issues.

Trudeau noted the Moderna vaccine does not need some of the extra special handling requirements of the one from Pfizer, including ultra cold freezers.

“That makes it a better option to ship over long distance to remote areas so doses of this vaccine will be directed to the north as well as remote and Indigenous territories,” Trudeau said.

The French-speaking province of Quebec, meanwhile is closing non-essential businesses from Christmas until at least Jan.11. Quebec Premier Francois Legault said that big box stores will be prohibited from selling any goods that are deemed non-essential. The premier is also forcing all office towers to empty starting Thursday and requiring employees to work from home until at least Jan. 11. Legault said elementary and secondary schools will close Dec. 17 and can reopen at the earliest on Jan. 11.

He said hospitals across the province are under too much pressure because of the COVID-19 pandemic to allow non-essential businesses to stay open during the holidays.

Quebec reported 1,741 COVID-19 infections on Tuesday.

Ontario, Canada's most populous province, is reporting a new single-day record of 2,275 new cases including 711 in Toronto.

4:13 PM CT on 12/15/20

The Centers for Disease Control and Prevention will give 64 jurisdictions nearly $220 million for COVID-19 vaccine preparedness and response.

According to HHS, the agency will dedicate $140 million in CARES Act funding to vaccine preparedness. Another $87 million in Paycheck Protection Program and Health Care Enhancement Act funding will go to tracking and testing.

“These are critical investments at a critical time in the COVID-19 pandemic,” said CDC Director Dr. Robert Redfield in a statement. “Vaccine is being distributed now, and this additional funding is an important step along the road to restoring some normalcy to our lives and to our country. These investments will also have lasting effects on our Nation’s public health infrastructure, including strengthened capabilities for public health labs across the country.”

2:09 PM CT on 12/15/20

(AP) With Americans, Britons and Canadians rolling up their sleeves to receive coronavirus vaccines, the route out of the pandemic now seems clear to many in the West, even if the rollout will take many months. But for poorer countries, the road will be far longer and rougher.

The ambitious initiative known as COVAX created to ensure the entire world has access to COVID-19 vaccines has secured only a fraction of the 2 billion doses it hopes to buy over the next year, has yet to confirm any actual deals to ship out vaccines and is short on cash.

The virus that has killed more than 1.6 million people has exposed vast inequities between countries, as fragile health systems and smaller economies were often hit harder. COVAX was set up by the World Health Organization, vaccines alliance GAVI and CEPI, a global coalition to fight epidemics, to avoid the international stampede for vaccines that has accompanied past outbreaks and would reinforce those imbalances.

But now some experts say the chances that coronavirus shots will be shared fairly between rich nations and the rest are fading fast. With vaccine supplies currently limited, developed countries, some of which helped fund the research with taxpayer money, are under tremendous pressure to protect their own populations and are buying up shots. Meanwhile, some poorer countries that signed up to the initiative are looking for alternatives because of fears it won't deliver.

"It's simple math," said Arnaud Bernaert, head of global health at the World Economic Forum. Of the approximately 12 billion doses the pharmaceutical industry is expected to produce next year, about 9 billion shots have already been reserved by rich countries. "COVAX has not secured enough doses, and the way the situation may unfold is they will probably only get these doses fairly late."

2:09 PM CT on 12/15/20

Federal officials expect 100 million Americans to be fully immunized from COVID-19 by the end of March, authorities said Monday, noting that they are on track to have the capacity to immunize every American by mid-2021.

The federal government, in partnership with distributor McKesson, FedEx and UPS, started delivering its first tranche of Pfizer and BioNTech's COVID-19 vaccine Monday. They plan to send 2.9 million doses to 636 sites across the country by Wednesday, with enough vaccine saved so that each person who gets the first dose can get a second shot three weeks later, HHS Secretary Alex Azar said during a news conference Monday.

"Pending the successful authorization of other vaccine options, we have enough vaccines already purchased to ensure we can meet our goal of vaccinating every American who wants it by the end of the second quarter of 2021," Azar said, adding that the federal government plans to purchase another 100 million doses of Moderna's vaccine—set for emergency use authorization this week—to be delivered in the second quarter.

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12:03 PM CT on 12/15/20

The American Hospital Association, American Medical Association and American Nurses Association are urging healthcare workers to get the COVID-19 vaccine and share their experiences with others.

In an open letter to front-line workers, the organizations wrote the U.S. will need high rates of vaccination to overcome the pandemic, and health professionals could help increase trust among the public.

“As front-line caregivers, our essential role in protecting the health and wellbeing of our communities goes beyond the care we provide,” wrote the AHA, AMA and ANA. “As a valued and trusted voice, our example is perhaps the strongest health resource we have.”

9:54 AM CT on 12/15/20

(AP)  Hundreds more U.S. hospitals geared up to vaccinate their workers Tuesday as federal regulators issued a positive review of a second COVID-19 vaccine that's likely to soon boost the nation's largest vaccination campaign.

The Food and Drug Administration said its preliminary analysis confirmed the effectiveness and safety of the vaccine developed by Moderna and the National Institutes of Health, bringing it to the cusp of U.S. authorization.

The positive news came as hospitals ramped up vaccinations with the shot developed by Pfizer and BioNTech, which the FDA cleared last week. The Moderna vaccine uses the same technology and showed similarly strong protection against COVID-19.

Packed in dry ice to stay at ultra-frozen temperatures, shipments of Pfizer's COVID-19 vaccine began arriving at 400 additional hospitals and other distribution sites, one day after the nation's death toll surpassed a staggering 300,000. The first 3 million shots are being strictly rationed to front-line health workers and elder-care patients, with hundreds of millions more shots needed over the coming months to protect most Americans.

Following another initial set of deliveries Wednesday, officials with the Trump administration's Operation Warp Speed said they will begin moving 580 more shipments through the weekend.

"We're starting our drumbeat of continuous execution of vaccine as it is available," Army Gen. Gustave Perna, chief operating officer for Warp Speed, told reporters Monday. "We package and we deliver. It is a constant flow of available vaccine."

Shots for nursing home residents won't begin in most states until next week, when some 1,100 facilities are set to begin vaccinations.

Perna and other U.S. officials reiterated their projection that 20 million Americans will be able to get their first shots by the end of December, and 30 million more in January.

8:02 PM CT on 12/14/20

(AP) — Top Washington negotiators continued to reach for a long-delayed agreement on COVID-19 relief on Monday, but rank-and-file Democrats appeared increasingly resigned to having to drop, for now, a scaled-back demand for fiscal relief for states and local governments whose budgets have been thrown out of balance by the pandemic. Read more.

6:33 PM CT on 12/14/20

(AP) A bipartisan group of lawmakers unveiled a detailed COVID-19 aid proposal on Monday in hopes it would serve as a model for its battling leaders to follow as they try to negotiate a final agreement on a new round of virus relief.

The dozen or so lawmakers unveiled two bills. One is a $748 billion aid package containing money for struggling businesses, the unemployed, schools, and for vaccine distribution. The other bill proposes a $160 billion aid package for state and local governments that's favored by Democrats and GOP-sought provisions shielding businesses from COVID-related lawsuits. But agreement proved impossible and most Democrats opposed a compromise on the liability issue forged by GOP Sen. Rob Portman of Ohio.

The path forward for their proposals — and for COVID-19 aid more generally — remains unclear. Parallel negotiations over virus relief and government funding are proceeding on the leadership level involving House Speaker Nancy Pelosi, D-Calif., and Treasury Secretary Steven Mnuchin. Senate Majority Leader Mitch McConnell, R-Ky., and that's where any agreement is likely to be forged.

Outstanding issues in the leadership talks include a potential second round of direct payments to individuals, a plan for $300 bonus unemployment benefits, state and local aid, and the GOP-sought liability shield against COVID-19-related lawsuits.

4:23 PM CT on 12/14/20

(AP) The U.S. death toll from the coronavirus topped 300,000 Monday just as the country began dispensing COVID-19 shots in a monumental campaign to conquer the outbreak.

The number of dead rivals the population of St. Louis or Pittsburgh. It is equivalent to repeating a tragedy on the scale of Hurricane Katrina every day for 5 1/2 months. It is more than five times the number of Americans killed in the Vietnam War. It is equal to a 9/11 attack every day for more than 100 days.

"The numbers are staggering—the most impactful respiratory pandemic that we have experienced in over 102 years, since the iconic 1918 Spanish flu," Dr. Anthony Fauci, the government's top infectious-disease expert, said days before the milestone.

The U.S. crossed the threshold on the same day healthcare workers rolled up their sleeves for Pfizer's COVID-19 shot, marking the start of the biggest vaccination campaign in American history. If a second vaccine is authorized soon, as expected, 20 million people could be immunized by month's end.

The death toll was reported by Johns Hopkins University from data supplied by health authorities across the U.S. The real number of lives lost is believed to be much higher, in part because of deaths that were not accurately recorded as coronavirus-related during the early stages of the crisis.

Globally the virus is blamed for more than 1.6 million deaths.

2:11 PM CT on 12/14/20

(AP) London and its surrounding areas will be placed under Britain's highest level of coronavirus restrictions beginning Wednesday as infections rise rapidly in the capital, the health secretary said Monday, adding that a new variant of the virus may be to blame for the spread.

Health Secretary Matt Hancock said the government must take swift action after seeing "very sharp, exponential rises" in Greater London and nearby Kent and Essex. He said in some areas cases are doubling every seven days.

He told lawmakers that the surge of COVID-19 cases in southern England may be associated with a new variant of coronavirus. He said officials are assessing the new strand, but stressed there was nothing to suggest it was more likely to cause serious disease, or that it wouldn't respond to a vaccine.

"We've currently identified over 1,000 cases with this variant predominantly in the south of England, although cases have been identified in nearly 60 different local authority areas," he said. Initial analysis suggests that the new variant is growing faster than existing variants, he added.

"The medical advice that we have is that it is highly unlikely that this new variant will impinge the vaccine and the impact of the vaccine," he said.

2:11 PM CT on 12/14/20

To start checking-in for an appointment at Piedmont Healthcare, patients don’t even have to be in the facility anymore.

For the past several months, they’ve had the option to fill out paperwork online—such as verifying demographic and insurance information and signing forms—through the health system’s patient portal before an appointment, as part of an effort Piedmont began rolling out last year to make check-in more convenient.

The long-term vision at Atlanta-based Piedmont is to eliminate the need for registration staff to hand patients a clipboard or tablet at the start of their visit. It fits into a growing trend across industries to revamp processes as consumers say they feel more comfortable decreasing shared touch points and face-to-face interactions, particularly in the wake of COVID-19.

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11:47 AM CT on 12/14/20

(AP) Germany's health minister demanded that the European Union's regulatory agency work faster to approve a coronavirus vaccine and bring an end to the suffering on the continent, but the head of the agency said Monday that his team is already working "around the clock."

Expressing impatience, Health Minister Jens Spahn said in tweets late Sunday that Germany, which has created more than 400 vaccination centers and has activated about 10,000 doctors and medical staff to start mass vaccinations as early as Tuesday, was hamstrung by the lack of regulatory approval.

It was especially galling because the vaccine developed by Germany's BioNTech and American drugmaker Pfizer has been authorized for use in Britain, the United States, Canada and other countries. But it's still waiting for approval by the European Medicines Agency, or EMA, and can therefore not be used in Germany yet or in any of the EU's 27 nations.

The EMA has a Dec. 29 meeting on vaccines but Spahn said the agency's assessment and approval of the Pfizer-BioNTech vaccine should "take place as quickly as possible."

"This is also about the trust of the citizens in the European Union's capacity to act," Spahn wrote. "Every day that we can start sooner with the vaccinations lessens the suffering and protects those who are the most vulnerable."

In response to questions from The Associated Press about Spahn's tweets, the executive director of the EMA said Monday that the agency is "working around the clock towards the licensing of the first COVID-19 vaccine."

Emer Cooke said while EMA's expert committee was expected to give its recommendation by Dec. 29 at the latest, "these timelines are of course constantly under review."

"European citizens have told us they want a fast approval, but more importantly they want a thorough evaluation of the benefits and the risks of the vaccine, so that they can be confident it is safe, effective and of high quality," Cooke added.

9:45 AM CT on 12/14/20

(AP) Deaths from the coronavirus pandemic are spiking across the country, yet a new poll finds little increase in alarm among Americans about COVID-19 infections and no significant change in opinion about how the government should act to slow the spread.

The survey from The Associated Press-NORC Center for Public Affairs Research finds about 4 in 10 Americans say they are extremely or very worried about themselves or a family member being infected with the virus, about the same as in October and slightly lower than in surveys conducted in March and in July. Stable majorities continue to favor requirements that people wear masks and limit the size of gatherings.

The risks of infection are greater than ever across broad swaths of the country — more than 1 million people tested positive for the coronavirus over five days last week. The surge has led to record numbers of daily virus deaths as the U.S. nears 300,000 people dying from the virus over the course of the pandemic.

The nation's top health officials have pleaded with Americans to redouble their efforts to prevent infections, especially during the holidays. Roughly three-quarters of Americans say they're at least somewhat worried about the virus, a figure that's about the same as in October. In March and then again in July, about half of Americans were highly worried.

"We know our risks. We see what's happening. We see people dying," said Sarah Totta, a 36-year-old from Kansas City, Missouri. "But to be honest, I think we knew this was coming in the winter, and I just think you have to manage the risks."

Support for stay-at-home orders peaked in April, with about 8 in 10 in favor, and has steadily dropped since. Fifty percent now support requiring Americans to stay home except for essential errands, up somewhat from 44% in October. Now 45% favor closing bars and restaurants, just slightly higher than 41% two months ago. About a third of Americans oppose both steps.

9:03 PM CT on 12/13/20

(AP) Senior U.S. government officials, including some White House officials who work in close proximity to President Donald Trump and Vice President Mike Pence, will be offered coronavirus vaccines as soon as this week, while its public distribution is limited to front-line health workers and people in nursing homes and long-term care facilities.

Doses of the newly approved vaccine from Pfizer will be made available to those who work in close quarters with the nation's top leaders, two people familiar with the matter confirmed. They said the move was meant to prevent more COVID-19 spread in the White House, which has already suffered from several outbreaks of the virus that infected Trump and other top officials, and other critical facilities.

It was not immediately clear how many officials would be offered the vaccine initially and whether Trump or Pence would get it.

The Trump administration is undertaking the vaccination program under federal continuity of government plans, officials said.

“Senior officials across all three branches of government will receive vaccinations pursuant to continuity of government protocols established in executive policy,” said National Security Council spokesperson John Ulyot. “The American people should have confidence that they are receiving the same safe and effective vaccine as senior officials of the United States government on the advice of public health professionals and national security leadership.”

The two people spoke on condition of anonymity because they were not authorized to discuss the matter publicly. The New York Times first reported the news.

The move to vaccinate top U.S. officials would be consistent with the rollout of rapid testing machines for the coronavirus, which were similarly controlled by the federal government with kits reserved to protect the White House complex and other critical facilities.

According to guidance from the Centers for Disease Control and Prevention, there is not yet enough information to determine whether those who have had COVID-19 should also get the vaccine. Pence has not come down with the virus, and his aides have been discussing when and how he should receive the vaccine as the administration looks to boost public confidence in the shot.

The Pfizer vaccine requires two doses administered three weeks apart, meaning Trump administration officials would receive the final shot just weeks before leaving office.

The Trump administration's vaccination plan could prove to be a boon for his successor, as aides to President-elect Joe Biden have been discussing when and how he should receive the vaccine and working to establish plans to boost virus safeguards in the West Wing to keep the 78-year-old Democrat healthy.

The White House vaccinations come as Trump and his aides have consistently flouted the COVID-19 guidelines issued by his own administration, including hosting large holiday parties with maskless attendees this December.

According to a Capitol Hill official, lawmakers have not been informed how many doses would be made available to them, adding it would be premature to speculate who might receive them. The official was not authorized to discuss it publicly and spoke on condition of anonymity.

6:47 PM CT on 12/13/20

Drugmakers GlaxoSmithKline and Sanofi said Friday that their potential COVID-19 vaccine won’t be ready until late next year because they need to improve the shot’s effectiveness in older people.

The companies said early trials showed the vaccine produced an “insufficient” immune response in people over 60 because it didn’t contain enough of the material that triggers the production of disease-fighting antibodies. They said they plan to reformulate the vaccine and do more testing, which is likely to delay approval to the fourth quarter of 2021 from the middle of the year.

“The results of the study are not as we hoped,” Roger Connor, president of London-based GSK Vaccines, said in a statement.

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3:42 PM CT on 12/13/20

(AP) Italy on Sunday eclipsed Britain to become the nation with the worst official coronavirus death toll in Europe.

Italy, where the continent's pandemic began, registered 484 COVID-19 deaths in one day, one of its lowest one-day death counts in about a month.

Still, those latest deaths pushed Italy's official toll up to 64,520, while Britain's stood at 64,267, according to a tally by Johns Hopkins University.

Both numbers understate the true toll of the pandemic. Counting criteria differ in the two countries, and many coronavirus deaths, especially early in the pandemic, are believed to have gone undetected, including those of elderly people in nursing homes who were not tested for COVID-19.

Among the reasons cited for Italy's high death toll was it that was the first country in Europe to be slammed in the pandemic, leaving health workers to grapple with a largely unknown virus. Italy also has a lower ratio of medical staff to patients compared to other European nations.

Germany, a nation much bigger than Italy, has a death toll one-third of Italy's or Britain's.

A little more than half of Italy's known COVID-19 deaths were registered in the first surge.

On Sunday, Italy reported another 17,938 coronavirus infections to raise its official tally to 1.84 million.

By far, the region registering the highest number of new infections was the northern region of Veneto. Italy's Lombardy region has the highest number of cases and deaths overall.

Largely heeding the advice of medical experts, Italian Premier Giuseppe Conte has tightened travel rules for the period straddling Christmas, New Year's and Epiphany Day holidays. Starting on Dec. 21 and running through Jan. 6, people in Italy won't be able to travel between regions except for work or urgent reasons such as health problems.

On the holidays themselves, under the nationwide restrictions, Italians can't leave their towns, as the government seeks to discourage families and friends from gathering in large numbers indoors.

12:24 PM CT on 12/13/20

(AP) A White House Coronavirus Task Force report for Florida recommended stricter measures for stopping the virus including mask wearing at all times in public, increased physical distancing by reducing capacity or closing indoor spaces at restaurants and bars and limiting gatherings outside of immediate households.

The Dec. 6 report obtained by the Center for Public Integrity also urged leaders to begin warning about the risks of gathering during the December holiday season.

“Florida has seen stability in new cases, an increase in test positivity, and increasing hospitalizations and deaths, indicating unrelenting community spread and inadequate mitigation,” the Dec. 6 report said.

Florida Gov. Ron DeSantis has ruled out further business restrictions or a mask mandate aimed at stopping the virus’ spread.

“No one’s losing their job because of a government dictate. Nobody’s losing their livelihood or their business,” DeSantis said earlier this month at an elementary school in Kissimmee.

The White House Coronavirus Task Force is chaired by Vice President Mike Pence, and Dr. Deborah Birx serves as its response coordinator. The task force’s reports are sent to governors across the U.S.

Two newspapers last week sued DeSantis’ administration for failing to make public the weekly reports about coronavirus conditions in the Sunshine State put together by the White House Coronavirus Task Force.

The lawsuit filed by the Orlando Sentinel and its sister publication, the South Florida Sun Sentinel, said the DeSantis administration is violating the Public Records Act by refusing to release the reports, which provide recommendations and snapshots of virus conditions state by state. The lawsuit filed last week in state court in Tallahassee seeks the immediate release of requested and future reports.

“The state has given us no explanation as to why this crucial health information should be withheld,” said Julie Anderson, the editor in chief of the Orlando Sentinel and the South Florida Sun Sentinel. “We had no choice but to ask a court to intervene to uphold the public records law.”

The White House has indicated these reports should be “widely” shared, including with the media, according to the newspapers’ lawsuit.

The Orlando Sentinel began requesting the reports in October, and the governor's office provided three reports after the newspaper involved its attorneys. However, DeSantis' office hasn't provided any reports from November, despite the newspaper's weekly requests, according to the lawsuit.

Among all states, Florida had the 41st most new cases per 100,000 residents and the 33rd highest rate of positive cases, according to the Dec. 6 report.

10:13 AM CT on 12/13/20

(AP) The governor of New Jersey says healthcare workers in New Jersey will begin receiving vaccinations for the coronavirus this week at a Newark hospital.

Gov. Phil Murphy told ABC's “This Week" program that he will be one hand Tuesday morning at University Hospital in Newark for the first COVID-19 vaccinations. He said the bulk of the 76,000 doses constituting the first batch of the Pfizer vaccine will go to healthcare workers with some going to residents and staff at long-term care homes.

The governor said he believes that by April or May, everyone in the state will have access to one of the vaccines. He's urging people not to relax efforts to stem the spread of the virus, especially limiting holiday celebrations to immediate family, since he said 60 to 80 percent of transmission is now occurring in private settings.

New Jersey, like the rest of the country, has seen a resurgence of the virus, with daily caseloads climbing above their highest points in the spring. The rolling weekly average has also ticked up steadily.

8:05 AM CT on 12/13/20

(AP) The director of the Rhode Island Department of Health has tested positive for the coronavirus, according to a statement Saturday night from the governor's office.

Dr. Nicole Alexander-Scott is asymptomatic and will continue to work from home. She had attended the state's weekly coronavirus briefing on Thursday.

Gov. Gina Raimondo tested negative Saturday and will continue to be tested throughout her seven-day quarantine, according to her spokesman Josh Block. Commerce Secretary Stefan Pryor, Block and consultant medical director Dr. Philip Chan will also quarantine since they also attended Thursday's news conference.

Block said he tested negative and Commerce spokesman Matt Sheaff said Pryor tested negative on Saturday. Chan will be tested Sunday.

Alexander-Scott is the second member of Raimondo’s cabinet to test positive. Director of Administration Brett Smiley tested positive on Thursday.

7:52 PM CT on 12/12/20
(AP) The U.S. has recorded more than 16 million cases of COVID-19, by far the most of any country in the world, according to data kept by Johns Hopkins University.

Cases of the virus have been rising across much of the U.S., causing record death totals in recent days.

India and Brazil are the only two other countries that have reported more than 3 million cases of COVID-19.

Globally, more than 71 million cases have been confirmed. The actual number of cases is believed to be far higher because many people haven't been tested and some who get the disease don't show symptoms.

The U.S. also leads the world in deaths related to the coronavirus at more than 297,600, including a record 3,309 recorded on Friday.

The increases come as millions of doses of the COVID-19 vaccine developed by Pfizer start rolling into U.S. hospitals on Monday. The first vaccines will go to hospital staff and other health care professionals.

The coronavirus has caused more than 1.6 million global deaths.
 

6:25 PM CT on 12/12/20

LabCorp said that it has received Emergency Use Authorization for an over-the-counter version of its COVID-19 home test.

With the EUA, LabCorp is able to sell the test kit directly to consumers without requiring a prescription. The kit is the first over-the-counter at-home collection kit for SARS-CoV-2 to receive EUA.

Users can self-collect nasal swab samples and send them in for processing at LabCorp, which will run the samples on its COVID-19 PCR test.

Read the full story.

3:55 PM CT on 12/12/20

(AP) A new pilot program in Avondale, Ariz., is helping families who have found themselves stuck in a desperate position after testing positive for COVID-19.

Some have no place to isolate and no means to get the help or resources they need to protect themselves and their families. The pilot program just launched in November, and already they've been able to help 11 families. It took a partnership between several entities to make it possible, and for some of those involved, it's personal.

In a time where making ends meet is already difficult for some, getting a positive COVID-19 diagnosis can feel like rock bottom.
"They're scared. A lot of them are scared they don't know what to do," said Edny Gonzalez. "Right now, there's a lot of need but not a lot of help available because of funds that have run out."

Gonzalez knows firsthand. Her husband was diagnosed with COVID-19 in July, azfamily.com reported.

"I think all I needed was that emotional support, somebody calling to see if you're OK or do you need anything?

It was hard. So that's where my heart is in this. I want to be that person that's there asking, 'Do you need something? Are you OK?'" Gonzalez said.

She's part of the nonprofit " Helping Families in Need AZ " and teamed up with Valleywise hospitals and Arizona

State University to launch this pilot program to help families who just tested positive and may have nowhere to turn.

"This really started in some of the discussions we were having about rising case counts," said Dr. Satya Sarma.

Dr. Sarma, with ASU's College of Health Solutions, helped start the project with Valleywise Health after seeing a similar trend in vulnerable areas, like Avondale.

"We really became convinced that while testing is critical, we were seeing some signs that after people test positive, they really don't have the help they need to be able to isolate," she said.

Once somebody tests positive at Valleywise Avondale, the program can help with anything from rent assistance to a place to isolate, to utility assistance, and even grocery help. But everyone involved is seeing the change they're making in these people's lives.

"She just stood at the door and she was just telling me, 'God bless you.' You know they're just so grateful with the help," said Gonzalez.

"We're able to visit them. Able to see them. Able to see if they're sick."

This is a pilot program, so if they want to continue, they'll need more funding.

They're hoping to get help from the state, public universities and private foundations moving forward, so they can eventually expand this program to all 11 Valleywise health centers in the Phoenix area.

1:54 PM CT on 12/12/20

(AP) In San Joaquin County, part of California's vast Central Valley that produces most of the country's fruits and vegetables, the coronavirus is spreading like a weed and the hospitals are running out of beds for the sickest patients.

San Joaquin is part of a 12-county region that on Friday had nearly 97% of its intensive care unit beds filled, the highest rate anywhere in California. And with cases continuing at an unprecedented rate, the death toll inevitably will grow, too.

A new stay-at-home order was imposed this week but it's anybody's guess whether it will have the intended consequence of finally changing enough people's behavior to slow infections as a vaccine is rolled out.

"It's been frustrating," said Chuck Davis, CEO of data science company Bayesiant that tracks virus numbers for the county. "It's like we see the train coming down the track and we're telling people, and some people listen and get off the track and other people get on the track and start dancing."

The virus has found a foothold in Lodi, a city of 68,000 on the county's northern rim. The birthplace of A&W Root Beer, Lodi is surrounded by vineyards that rely on Latino farmworkers.

On School Street, the city's picturesque retail and restaurant hub, sycamore leaves as big as your hand littered the sidewalk. In normal times, volunteers clear the leaves. But that stopped during the pandemic, and the leaves piled up, a subtle reminder of how things have changed.

More stark reminders are at the local hospital, where a second intensive care unit was created to handle patients. A team of 17 nurses arrives Monday so the hospital can begin accepting patients from some of the county's six other hospitals, all of which are at 100% capacity or more in ICU units.

Dr. Patricia Iris, medical officer for Adventist Health Lodi Memorial, said during the first surge of cases this year 75% of patients were Latino. The hospital interviewed 30 Latino families to find out why, discovering they didn't trust the hospital.

Things improved after Adventist partnered with Spanish-language TV and radio stations to educate people about wearing masks and social distancing.

But across the city, many residents still don't follow the rules, Iris said.

"People can't help themselves. They want to be near family," she said. "We don't have the same culture and the rigidity around following the guidance here than, for example, San Francisco. We need to educate, educate, as much as we can so we can get some relief."

11:28 AM CT on 12/12/20

(AP) The nation's first COVID-19 vaccine will begin arriving in states Monday morning, U.S. officials said Saturday, after the government gave the final go-ahead to the shots needed to end an outbreak that has killed nearly 300,000 Americans.

Trucks will roll out Sunday morning as shipping companies UPS and FedEx begin delivering Pfizer's vaccine to nearly 150 locations, said Army Gen. Gustave F. Perna of Operation Warp Speed, the Trump administration's vaccine development program. Another 450 sites will get the vaccine Tuesday and Wednesday.

The locations include hospitals and other sites able to meet the ultra-cold storage requirements for the vaccine. Within three weeks, vaccines should be delivered to local pharmacies and other locations, Perna said at a news conference.

The vaccine was timed to arrive Monday morning so that health workers would be available to receive the shots and begin giving them, Perna said.

It was unclear who would receive the first dose of the vaccine, though health workers and nursing home residents were the priority. Perna said that decision would be determined by health authorities.

The announcement kicks off a massive logistical operation involving the federal and state governments, private companies and health care workers to quickly distribute limited vaccine supplies throughout the U.S.

Initially, about 3 million shots are expected to shipped nationwide, according to officials with Operation Warp Speed. A similar amount is to be held in reserve for those recipients' second dose.

Initial shipments are expected to leave Pfizer's manufacturing plant in Kalamazoo, Michigan, via truck and then be flown to regional hubs around the country.

Adding to the distribution challenge is that the Pfizer-BioNTech vaccine must be stored and shipped at ultra-low temperatures of about 94 degrees below zero Fahrenheit. Pfizer has developed shipping containers that use dry ice, and GPS-enabled sensors will allow the company to track each shipment and ensure it stays cold.

The green light to begin vaccinations came late Friday after the Food and Drug Administration authorized emergency use of the vaccine. The signoff capped an unprecedented global race to speed vaccines through testing and review, chopping years off the normal development process.

The FDA found the vaccine highly protective with no major safety issues. U.S. regulators worked for months to emphasize the rigor and independence of their review, but the Trump administration pressured the agency up until the final announcement. A top White House official even threatened to remove FDA chief Stephen Hahn if a ruling did not come before Saturday.

Concerns that a shot was rushed out could undermine vaccination efforts in a country with deeply ingrained skepticism about vaccines. Hahn again emphasized his agency's independence to reporters Saturday.

"Science and data guided the FDA's decision," Hahn said. "We worked quickly because of the urgency of this pandemic, not because of any other external pressure."

While determined to be safe, regulators in the U.K. are investigating several severe allergic reactions. The FDA's instructions tell providers not give it to those with a known history of severe allergic reactions to any of its ingredients.

The FDA's vaccine director, Dr. Peter Marks, said the agency will carefully track any reports of allergic reactions in the U.S.

"I think we still need to learn more, and that's why we'll be taking precautions," Marks said.

The FDA next week will review a second vaccine from Moderna and the National Institutes of Health that appears about as protective as Pfizer's shot. On Friday, the Trump administration announced it had purchased 100 million more doses of that vaccine on top of 100 million it previously ordered.

The announcement came after revelations last week that the White House opted not to lock in an additional 100 million doses of Pfizer's vaccine for delivery in the second quarter of 2021. The Trump administration contends the current orders plus those in the pipeline will be enough to accommodate any American who wants to be vaccinated by the end of the second quarter of 2021.

9:18 AM CT on 12/12/20

(AP) Doctors and nurses around the U.S. are becoming exhausted and demoralized as they struggle to cope with a record-breaking surge of COVID-19 patients that is overwhelming hospitals and prompting governors to clamp back down to contain the virus.

New York Gov. Andrew Cuomo on Friday banned indoor dining in New York City, saying he had been waiting in vain for hospitalization rates to stabilize. Pennsylvania Gov. Tom Wolf did the same on Thursday and also suspended school sports and closed gyms, theaters and casinos.

A record of more than 107,000 people were in the hospital in the U.S. with COVID-19 as of Thursday, according to the COVID Tracking Project. More than 290,000 Americans have died of the virus.

Hospitals around the country have been overrun. "We're constantly looking for beds," said Cassie Ban, an intensive care nurse at Indiana University Health.

Health care workers will be among the first to start getting the nation's first COVID-19 vaccine in the coming days after the Food and Drug Administration gave it the final go-ahead Friday.

Before the pandemic, an ICU nurse might handle two patients per shift. Ban said she now regularly cares for four or five. The national death toll doesn't begin to capture what COVID-19 does to each critically ill patient or the medical teams who care for them, she said.

"I wish people could see what I do," Ban said. "People are terrified and they're alone. Each one of those numbers is the death of a person who wasn't ready to go yet."

Although concerns remain about getting enough beds, masks and other equipment, many frontline health workers are most worried about staff shortages.

Nurses are the most scarce resource of all, said Kiersten Henry, an ICU nurse practitioner at MedStar Montgomery Medical Center in Olney, Maryland.

"I feel we've already run a marathon, and this is our second one. Even people who are upbeat are feeling run down at this point," Henry said.

Many expressed frustration over some Americans' disregard and even contempt for basic precautions against the virus.

Dr. Lew Kaplan, a critical care surgeon at the University of Pennsylvania's Perelman School of Medicine, said health care workers are treated as "heroes" for helping patients but are seen as "close to evil incarnate" when they ask people to wear masks.

"It is very disheartening, while you are struggling to manage the influx of patients, there are others who won't accept public health measures," said Kaplan, president of the Society of Critical Care Medicine.

Raju Mehta, a critical care physician at Advocate Health and Hospital in the Chicago area, said that early on in the pandemic, many frontline workers were energized by a sense of purpose. Now, that morale is beginning to crumble.

"Seeing what we're seeing, day in, day out, for eight months, takes a toll," Mehta said. "It's tough knowing what we see, and then what happens outside our walls."

8:38 PM CT on 12/11/20

The Food and Drug Administration late Friday gave emergency use authorization to a COVID-19 vaccine made by Pfizer and BioNTech. 

Government officials have said that nearly 3 million doses of the vaccine could start being distributed about a day after authorization. And while many healthcare organizations have been planning for weeks to get doses and start inoculating staff, there is still a fair amount of confusion over who will get what and when. 

Earlier in the day, White House officials reportedly told FDA Commisserion Stephen Hahn to grant emergency authorization or turn in his resignation. 

8:12 PM CT on 12/11/20

(AP) Mexico’s medical safety commission has approved the emergency use of the Pfizer-BioNTech vaccine for the coronavirus.

Assistant Health Secretary Hugo López-Gatell said Friday that Mexico is the fourth country to do so, behind Britain, Canada and Bahrain.

Mexico is set to receive 250,000 doses of the vaccine, enough for 125,000 people.

López-Gatel has said that front-line health workers will get the shots first. Vaccinations are expected to begin as soon as next week.

López-Gatel says the approval “is of course a reason for hope,” though the initial rounds of shots are not nearly enough for Mexico’s health-care workforce.

6:26 PM CT on 12/11/20

(AP) As Mississippi's coronavirus hospitalizations continue to surpass records, the state's top health official said Friday that hospitals full with COVID-19 patients can no longer handle elective surgeries, and he's ordering the facilities to start postponing many of the procedures next week.

Dr. Thomas Dobbs, Mississippi's state health officer, announced the decision on Twitter, saying the state's intensive care unit beds are full and he expects more hospitalizations of coronavirus patients.

“Beginning next Tues elective surgeries that require hospitalization must be delayed - statewide," Dobbs said in his tweet.

An order issued by Dobbs later Friday confirmed the move and spelled out the details: A specific list of elective surgery types that require overnight hospitalization must be delayed starting Tuesday, at least until Dec. 23. The list of procedures include colonoscopies, knee replacements and certain cancer surgeries.

The state Health Department reported Friday that Mississippi had 2,327 new confirmed cases of the highly contagious virus as of Thursday evening. The department also reported 41 new deaths Friday with 32 of them happening between Nov. 8 and Thursday. The state has reported nearly 175,300 cases of the virus and 4,124 deaths from it since the start of the pandemic.

4:41 PM CT on 12/11/20

(AP) Doctors are reporting that a two-drug treatment is especially helpful for COVID-19 patients who need extra oxygen.

Adding the anti-inflammatory drug baricitinib to the antiviral medicine remdesivir helped these patients recover eight days sooner, in 10 days on average versus 18 for those given remdesivir alone, according to a study.

The medicines have been recommended since September, when early results from this U.S. government-sponsored study suggested the combination shortened recovery time for hospitalized patients by one day.

Full results published Friday by the New England Journal of Medicine show the benefit was even greater for those needing oxygen or other respiratory support short of a breathing machine. Serious side effects and new infections also were fewer in the combo treatment group.

The study involved more than 1,000 COVID-19 patients. All were given Gilead Sciences’ remdesivir, sold as Veklury, and half also received baricitinib, a drug Eli Lilly sells as Olumiant to treat rheumatoid arthritis, the less common form of arthritis that occurs when a mistaken or overreacting immune system attacks joints, causing inflammation. An overactive immune system also can lead to serious problems in some coronavirus patients.

2:24 PM CT on 12/11/20

(AP) White House chief of staff Mark Meadows on Friday pressed Food and Drug Administration chief Stephen Hahn to grant an emergency use authorization for Pfizer's coronavirus vaccine by the end of the day or face possible firing, two administration officials said.

The vaccine produced by Pfizer Inc. and its German partner BioNTech won a critical endorsement Thursday from an FDA panel of outside advisers, and signoff from the agency — which is expected within days — is the next step needed to get the shots to the public.

The FDA is not required to follow the guidance of its advisory committees, but often does.

Meadows spoke to Hahn by telephone on Friday, according to a senior administration official who was familiar with the conversation but was not authorized to discuss private conversations.

The chief of staff also told Hahn his job was in jeopardy if the emergency use authorization was not issued before Saturday, said a second administration official familiar with the conversation.

Hahn signaled that he would tell regulators to allow the vaccine to be issued on an emergency basis, the official said.
President Donald Trump has been pressing for quick approval for the vaccine and tweeted directly at Hahn earlier Friday, complaining that FDA "is still a big, old, slow turtle." Trump has publicly bashed the pace of the FDA's vaccine review process.

"Get the dam vaccines out NOW, Dr. Hahn," Trump tweeted Friday. "Stop playing games and start saving lives."
Hahn disputed characterizations of his conversation with Meadows.

"This is an untrue representation of the phone call with the Chief of Staff," Hahn said in a statement. "The FDA was encouraged to continue working expeditiously on Pfizer-BioNTech's EUA request. FDA is committed to issuing this authorization quickly, as we noted in our statement this morning."

2:00 PM CT on 12/11/20

Big questions remain about who should and will receive the first COVID-19 vaccinations as federal approval is expected to come this week for the first of two vaccine candidates.

A federal advisory panel Thursday recommended that the Food and Drug Administration grant emergency use authorization to a vaccine candidate made by Pfizer and BioNTech based on safety and efficacy results included in a briefing document released prior to the meeting. Full FDA approval could come as soon as Friday.

Federal health officials have estimated distributing enough doses to vaccinate as many as 20 million Americans by the end of year.

A Centers for Disease Control and Prevention advisory panel earlier this month recommended that front-line healthcare workers and residents of long-term nursing care facilities be given the highest priority for getting the vaccine. But there won't be enough doses initially for all of the people in the the CDC's highest tier and the federal government didn't recommend either group go first, leaving it to the states to decide.

READ MORE

11:32 AM CT on 12/11/20

(AP) The number of coronavirus patients in Nebraska's hospitals appears to have stabilized for now even though the numbers are still elevated, according to new data.

State officials said 779 people were hospitalized with the virus as of Thursday evening, a number that has remained relatively unchanged over the last several days. The state reached a single-day high of 987 hospitalizations last month, raising the prospect of tougher social-distancing restrictions.

Nebraska confirmed 1,850 new coronavirus cases on Thursday, a number that has been trending downward since the latest peak in the middle of November. The state reported 145,774 known cases and 1,329 deaths since the pandemic began.

The elevated numbers have raised concerns that hospitals could become overwhelmed with patients and lead to even more deaths. Most of the people who have died from the virus in Nebraska are elderly.

Nebraska still has 28% of its hospital beds, 26% of its intensive care unit beds and 70% of its ventilators available for virus patients.

9:31 AM CT on 12/11/20

(AP) The head of the Food and Drug Administration says his agency has told Pfizer that it “will rapidly work” to grant emergency use of its COVID-19 vaccine following a positive recommendation by government advisers.

The FDA decision will kickstart an unprecedented vaccination campaign needed to eventually defeat the virus. The FDA’s greenlight of the vaccine, co-developed with BioNtech, was practically assured after the positive vote by agency advisers a day earlier.

The FDA’s brief statement came less than an hour after President Donald Trump tweeted directly at FDA Commissioner Stephen Hahn, complaining that FDA “is still a big, old, slow turtle.”

FDA staff have repeatedly said they expect to issue a decision within days of Thursday’s meeting. Many FDA observers predict action by Saturday ahead of a Sunday meeting by the Centers for Disease Control and Prevention.

The panel of CDC advisers will vote on who should get priority for the initial shots. Federal officials plan to allocate the first 6.4 million doses of the vaccine to states based on their population.

8:43 PM CT on 12/10/2020

(AP) An emerging $900 billion COVID-19 aid package from a bipartisan group of lawmakers all but collapsed Thursday after Senate Majority Leader Mitch McConnell said Republican senators won't support $160 billion in state and local funds as part of a potential trade-off in the deal.

McConnell's staff conveyed to top negotiators that the GOP leader sees no path to an agreement on a key aspect of the lawmakers' existing proposal — a slimmed-down version of the liability shield he is seeking for companies and organizations facing potential COVID-19 lawsuits — in exchange for the state and local funds that Democrats want.

The GOP leader criticized “controversial state bailouts” during a speech in the Senate, as he insists on a more targeted aid package.

The hardened stance from McConnell, who does not appear to have enough votes from his Republican majority for a far-reaching compromise, creates a new stalemate over the $900-billion-plus package, despite days of toiling by a bipartisan group of lawmakers to strike compromise.

Other legislative pile-ups now threaten Friday's must-pass government funding bill. If it doesn't clear Congress, that would trigger a federal government shutdown on Saturday.

McConnell’s office confirmed it’s “unlikely” the trade-off proposed by the bipartisan group would be acceptable, as COVID aid talks continue. A senior Democrat first shared the Republican leader's views after being granted anonymity to discuss the private conversations.

Deadlines, real and perceived, haven’t been sufficient to drive Washington’s factions to an agreement, despite the U.S. breaking a record-high 3,000 daily COVID fatalities, and hospitals straining at capacity from soaring caseloads nationwide.

The House recessed for a few days, with leaders warning members to be prepared to return to Washington to vote on the year-end deals, while the Senate was planning a rare Friday session.

The breakdown over the COVID aid package, after days of behind-the-scenes talks by a group of lawmakers fed up with inaction, comes as President Donald Trump has taken the talks in another direction — insisting on a fresh round of $600 stimulus checks for Americans.

Sending direct cash payments to households was not included in the bipartisan proposal, but has been embraced by some of the president's fiercest critics — including Rep. Alexandria Ocasio-Cortez, D-N,Y., and Sen. Bernie Sanders, the Vermont Independent who introduced an amendment to include the checks with Trump ally Sen. Josh Hawley, R-Mo.

Sanders said the unprecedented moment facing the nation with the pandemic and its economic fallout requires Congress to “take unprecedented action.”

Trump's top negotiator on COVID-19 financial aid, Treasury Secretary Steven Mnuchin reported headway Thursday, before the package from the bipartisan senators' group fell apart.

“I think we’re making a lot of progress," Mnuchin said.

A one-week stop-gap measure to prevent a federal shutdown appears to have sapped some urgency from the talks. The short-term government-wide funding bill, approved by the House on Wednesday, needs to clear the Senate before Friday at midnight to avert a partial closure.

The next deadline would be Dec. 18, but both House and Senate leaders say they won’t adjourn without passing an aid measure.

4:38 PM CT on 12/10/20

(AP) Senate Majority Leader Mitch McConnell is hitting the brakes on the emerging COVID-19 aid package from a bipartisan group of lawmakers, saying Republican senators won't support $160 billion in state and local funds as part of a potential trade-off in the deal.

McConnell's staff conveyed to top negotiators that the GOP leader sees no path to an agreement on a key aspect of the lawmakers' existing proposal — a slimmed-down version of the liability shield for companies and organizations facing potential COVID-19 lawsuits — in exchange for $160 billion in state and local funds that Democrats want.

A senior Democrat confirmed that McConnell's position was conveyed to negotiators and was granted anonymity to discuss the private talks. McConnell's office did not immediately respond for a request for comment.

The hardened stance from McConnell, who does not appear to have the votes from Republicans for a far-reaching compromise, creates a new stalemate over the $900-billion-plus package, despite days of toiling by a bipartisan group of lawmakers toward a deal.

It comes as President Donald Trump's top negotiator on COVID-19 financial aid took the opposite view. Treasury Secretary Steven Mnuchin reported headway Thursday on the package from the bipartisan senators' group.

"I think we're making a lot of progress," Mnuchin said.

2:06 PM CT on 12/10/20

(AP) Just when the U.S. appears on the verge of rolling out a COVID-19 vaccine, the numbers have become gloomier than ever: Over 3,000 American deaths in a single day, more than on D-Day or 9/11. One million new cases in the span of five days. More than 106,000 people in the hospital.

The crisis across the country is pushing medical centers to the breaking point and leaving staff members and public health officials burned out and plagued by tears and nightmares.

All told, the crisis has left more than 290,000 people dead nationwide, with more than 15 million confirmed infections.

The U.S. recorded 3,124 deaths Wednesday, the highest one-day total yet, according to Johns Hopkins University. Up until last week, the peak was 2,603 deaths on April 15, when New York City was the epicenter of the nation's outbreak. The latest number is subject to revision up or down.

Wednesday's toll eclipsed American deaths on the opening day of the Normandy invasion during World War II: 2,500, out of some 4,400 allied dead. And it topped the toll on Sept. 11, 2001: 2,977.

New cases per day are running at all-time highs of over 209,000 on average. And the number of people in the hospital with COVID-19 is setting records nearly every day.

2:06 PM CT on 12/10/20

The healthcare industry was the hardest hit by supply shortages, new data on the U.S. economy show.

That was one of the findings from the Bureau of Labor Statistics' survey of nearly 600,000 U.S. businesses gathered from mid-July through September. The results illustrate the COVID-19 pandemic's impact on businesses based on size, location and industry.

READ MORE

11:58 AM CT on 12/10/20

(AP) President Donald Trump's top negotiator on COVID-19 financial aid reported headway Thursday on a $900 billion-plus plan, citing similarities between the latest administration offer and an emerging measure from a bipartisan group of senators.

"I have had a bunch of conversations. I spoke to senators on both sides last night, this morning," Treasury Secretary Steven Mnuchin said. "We had a very productive call yesterday with a lot of people. So I think we're making a lot of progress."

But a one-week extension of a potential government shutdown appears to have sapped some urgency from the talks. The only must-pass measure this week is the short-term government-wide funding bill, which was approved by the House on Wednesday and needs to clear the Senate before Friday at midnight to avert a partial closure.

That measure would give lawmakers more time to sort through the mess they created for themselves with months of fighting and posturing on pandemic aid. Deadlines, real and perceived, haven't been sufficient to drive Washington's factions to an agreement. The next deadline would be Dec. 18, but both House and Senate leaders say they won't adjourn without passing an aid measure.

House Speaker Nancy Pelosi, D-Calif., who is sending lawmakers home with no set schedule for their return, said Congress would keep working up to or even after Christmas to get an agreement. The new Congress is being sworn in on Jan. 3.

"Now if we need more time then we take more time, but we have to have a bill and we cannot go home without it," Pelosi said Thursday. She also gave an upbeat assessment on the talks.

9:39 AM CT on 12/10/20

(AP) A U.S. government advisory panel convened on Thursday to decide whether to endorse mass use of Pfizer's COVID-19 vaccine to help conquer the outbreak that has killed close to 300,000 Americans.

The meeting of outside advisers to the Food and Drug Administration represented the next-to-last hurdle before the expected start of the biggest vaccination campaign in U.S. history. Depending on how fast the FDA signs off on the panel's recommendation, shots could begin within days.

The FDA panel functions like a science court. During the scheduled daylong session, it was expected to debate and pick apart the data — in public and live-streamed — on whether the vaccine is safe and effective enough to be cleared for emergency use.

"The American public demands and deserves a rigorous, comprehensive and independent review of the data," said FDA's Dr. Doran Fink, who described agency scientists working nights, weekends and over Thanksgiving to get that done.

With unprecedented interest in the normally obscure panel, the FDA broadcast the meeting via Youtube, and thousands logged on to follow the discussion.

The FDA is not required to follow the committee's advice but is widely expected to do so. Once that happens, the U.S. will begin shipping millions of doses of the shot.

The meeting came as the coronavirus continues surging across much of the world, claiming more than 1.5 million lives, including more than 289,000 in the U.S.

Hanging over the meeting is a warning from British officials that people with a history of serious allergic reactions shouldn't get the vaccine. Government officials there are investigating two reports of reactions that occurred when the country began mass vaccinations on Tuesday.

Still, a positive recommendation and speedy U.S. approval appeared nearly certain after FDA scientists issued an overwhelmingly positive initial review of the vaccine earlier this week.

8:31 PM CT on 12/9/20

DALLAS (AP) — For a second day this week, hospitalizations of people with the coronavirus in Texas topped 9,000, state health officials said Wednesday.

The Texas Department of State Health Services said 9,053 were hospitalized Wednesday. The state reported 9,028 hospitalizations the day before.

Last week marked the first time Texas surpassed a daily count of 9,000 hospitalizations since a deadly summer outbreak.

Texas officials reported 10,930 new coronavirus cases Wednesday after reporting 15,103 a day earlier.  Texas has reported more than 1.2 million cases since the pandemic began.

The true number of infections in Texas is likely higher because many haven't been tested, and studies suggest people can be infected and not feel sick.

Researchers at Johns Hopkins University say the death toll in Texas is at more than 23,000, the second highest in the country.

There were 575.3 new cases per 100,000 people in Texas over the past two weeks, which ranks 40th in the country for new cases per capita, according to Johns Hopkins. One in every 300 people in Texas tested positive in the past week.

For most people, the coronavirus causes mild or moderate symptoms that clear up within weeks. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms and be fatal.

7:04 PM CT on 12/9/20

An advisory panel of experts for the Centers for Disease Control and Prevention recommended that healthcare workers should be first-in-line to receive a coronavirus vaccine.

In a 13-1 vote, the Advisory Committee on Immunization Practices said vaccine allocation should prioritize the country's 21 million frontline healthcare workers and 3 million residents in long-term care facilities, it is unclear whether hospitals will require their workers to inoculate once it becomes available.

Hospital executives contacted by Modern Healthcare offered varied responses when asked if they would do so.

Read the full story.

5:24 PM CT on 12/9/20

(AP) Indiana's hospitals will have to postpone elective surgeries starting next week under an order the state's governor said Wednesday was needed to free up hospital capacity amid steep recent increases in serious COVID-19 illnesses.

Gov. Eric Holcomb said that hospitals were being directed to postpone all non-urgent in-patient surgeries beginning Dec. 16 through Jan. 3.

Holcomb said Indiana is "on fire" with coronavirus spread as the number of Indiana counties with the highest risk level of coronavirus spread more than doubled in the state health department's weekly update. The tracking map labels 36 of the state's 92 counties the most dangerous red category, up from 16 a week ago. All other counties are in the next riskiest orange rating.

The state halted elective medical procedures for most of April, but Holcomb lifted that restriction as concerns eased about availability of equipment and protective gear. Indiana's hospitals are currently treating more than quadruple the number of COVID-19 patients than they were in September, with health officials worried about hospitals being overwhelmed.

"Our nurses and our doctors, understandably, are overwhelmed and beyond exhausted ... to go into one of the toughest environments that anyone in our state's history has had to face on a day in, day out basis," Holcomb said.

2:06 PM CT on 12/9/20

(AP) A new poll find only about half of Americans are ready to roll up their sleeves for COVID-19 vaccines even as states prepare to begin months of vaccinations.

The survey from The Associated Press-NORC Center for Public Affairs Research shows about a quarter of U.S. adults aren’t sure if they want to get vaccinated when their turn comes. Roughly another quarter say they won’t.

The Food and Drug Administration is poised to decide whether to allow emergency use of two candidates.

Many on the fence have safety concerns and want to see how the initial rollout fares. The coronavirus has killed nearly 290,000 Americans. The U.S. also leads the world with 15.2 million confirmed cases.

2:06 PM CT on 12/9/20

Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday indicated a willingness to abandon liability protections for businesses and healthcare providers to get a COVID-19 relief bill passed by the end of the year.

McConnell had called an enhanced liability shield a "red line" for months during failed negotiations. He said he would be willing to push negotiations on liability protections and funding for state and local governments to next year if that's what it took to get relief passed this year.

"What I recommend is that we set aside liability and set aside state and local and pass things that we can agree on knowing full well we will be back at this after the first of the year," McConnell told reporters.

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11:57 AM CT on 12/9/20

(AP) Canada's health regulator on Wednesday approved Pfizer's COVID-19 vaccine, days ahead of possible approval in the United States.

Health Canada posted on its website that the vaccine made by U.S. drugmaker Pfizer and Germany's BioNTech is authorized. The vaccine already has been approved by the United Kingdom and Bahrain and officials have said they expect U.S. approval within days.

"This is a critical milestone," Dr. Supriya Sharma, chief medical advisor at Health Canada.

"Canadians can have confidence in our rigorous review process, and that the vaccine was only authorized only after a thorough assessment of the evidence demonstrated that it met Canada's strict standards for safety, efficacy and quality."

Health Canada said terms of the approval require the manufacturer to continue providing information on the safety, efficacy and quality of the vaccine.

Canada is set to receive up to 249,000 doses this month and Canadian officials expect to administer them within days.

9:26 AM CT on 12/9/20

(AP) Some California hospitals are close to reaching their breaking point, prompting Gov. Gavin Newsom to bring in hundreds of hospital staff from outside the state and to prepare emergency hospitals that were created but barely used when the coronavirus surged last spring.

California officials paint a dire picture of overwhelmed hospitals and exhausted health workers as the state records an average of 22,000 new cases a day. After nine months of the pandemic, they recognize about 12% of people who test positive will end up going to the hospital two to three weeks later. At the current rate, that means 2,640 hospitalizations from each day's new case total.

"We know that we can expect in the upcoming weeks alarming increases in hospitalizations and deaths," said Barbara Ferrer, health director for Los Angeles County, the state's largest with 10 million residents.

For some, "the respiratory infection becomes unbearable — they have difficulty breathing and it's very frightening," said California Hospital Association president and CEO Carmela Coyle. What starts with a spike in emergency room visits can cascade into jammed hospital beds and ultimately intensive care units.

California's hospitalizations already are at record levels, and the state has seen a roughly 70% increase in ICU admissions in just two weeks, leaving just 1,700 of the state's 7,800 ICU beds available.

"That fragile but important system may be overwhelmed," Dr. Mark Ghaly, the state's top public health officer, said Tuesday.

8:16 PM CT on 12/8/20

(AP) The Trump administration dove back into Capitol Hill's confusing COVID-19 negotiations on Tuesday, offering a $916 billion package to House Speaker Nancy Pelosi that would send a $600 direct payment to most Americans — but eliminate a $300 per week employment benefit favored by a bipartisan group of Senate negotiators.

Treasury Secretary Steven Mnuchin made the offer to Pelosi late Tuesday afternoon, he said in a statement. He offered few details, though House GOP Leader Kevin McCarthy said it proposes the $600 direct payment for individuals and $1,200 for couples, which is half the payment delivered by the March pandemic relief bill.

Mnuchin reached out to Pelosi after a call with top congressional GOP leaders, including Senate Majority Leader Mitch McConnell, who remains at odds with Democratic leaders over COVID-19 relief. Pelosi and Senate Minority Leader Chuck Schumer, D-N.Y., responded to Mnuchin's entreaty with a statement that said they would prefer to let a bipartisan group take the lead.

The bipartisan group, led by Democratic Sen. Joe Manchin of West Virginia and GOP Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, among others, is seeking to rally lawmakers in both parties behind a $908 billion framework that includes a $300-per-week pandemic jobless benefit and $160 billion for states and local governments. It is more generous than a GOP plan that’s been filibustered twice already but far smaller than a wish list assembled by House Democrats.

McConnell said Congress will not adjourn without providing the long-overdue COVID-19 relief. He had previously said he would not put any pandemic relief bill on the floor that does not include the liability shield, which is being sought by businesses, universities, nonprofits, and others that are reopening during the pandemic.

6:51 PM CT on 12/8/20

(AP) Large U.S. employers saw their smallest health care cost increase in more than two decades due to COVID-19, and workers may benefit from that next year, according to the consulting firm Mercer.

Patients stayed home and out of doctor’s offices this year to avoid the global pandemic, and that led to an average 1.9% cost hike for companies with 500 or more employees, Mercer found in a national survey.

Those employers were expecting a 3.5% increase, said Beth Umland, Mercer’s director of health and benefits research.

The lowest cost increase since 1997 will help many large employers avoid raising deductibles or doing other things to shift costs to workers in 2021, Umland said.

Many companies also will spend some of what they saved adding programs that help improve the health of those covered by their plans. That could include expanding telemedicine, improving access to behavioral health care like therapy or adding programs that help people with a specific condition such as diabetes.

Large employers pay their own health care claims. They can see fairly quickly if costs fall, unlike small employers that pay a fixed premium for coverage.

Those employers may receive rebates for a similar drop in health care use, but they won’t know the extent of that until next year.

Employer-sponsored health insurance covers about 157 million people, according to the non-profit Kaiser Family Foundation.

4:10 PM CT on 12/8/20

(AP) Top health officials say New Mexico has a solid plan in place to stretch hospital and healthcare resources as far as possible before having to ration care, but they also warned Tuesday that the state could face that prospect if the coronavirus pandemic worsens.

Human Services Secretary Dr. David Scrase said there are hospitals around New Mexico facing extremely high demands and state health officials are expected to formally declare soon that providers are at a stage where rationing care. Such a step is likely despite a slowdown in the rate of spread and a decrease in the number of COVID-19 cases being reported daily in the state.

Under a crisis standards of care declaration, an established framework and guidelines would be used for making ethical decisions about triaging care.

"The trigger for when that happens is actually when the resources don't match the demand," said Dr. Michael Richards, vice chancellor for clinical affairs with the University of New Mexico Health System. "In our case, we've had months of this and months to prepare."

Local triage boards are up and running at hospitals around the state and a centralized call center has been helping to identify which hospitals have room and which ones need help. Unlike other states, the idea early on was for separate providers in New Mexico to work together to pool their resources since the state already ranked near the bottom nationally for the number of hospital beds per 1,000 residents.

Richards and other officials stressed that the tools used by the local triage boards to make decisions are objective and based on equity and fairness. They also said the foundation for developing those tools is rooted in plans that have been crafted over recent years and months by experts both nationally and in New Mexico.

The only criteria that would determine the allocation for resources and care is whether a person would be likely to survive a COVID-19 infection, officials said.

And the situation is fluid as pressure on the healthcare system changes daily, Richards said.

"There's no one bright line that we cross that then says we'll do this for every patient in every circumstance," he said. "What I mean by that is that the healthcare professionals won't make decisions about allocation of resources until it's necessary. We will continue to build as much contingency capacity, use as much alternative ways of delivering the care as possible and only apply this as needed."

As resources become more scarce, officials explained, the duty of healthcare providers shifts from focusing on the individual patient to making sure decisions maximize benefits for all patients.

2:22 PM CT on 12/8/20

(AP) Deaths from COVID-19 in the U.S. have soared to more than 2,200 a day on average, matching the frightening peak reached last April, and cases per day have eclipsed 200,000 on average for the first time on record, with the crisis all but certain to get worse because of the fallout from Thanksgiving, Christmas and New Year's.

Virtually every state is reporting surges just as a vaccine appears days away from getting the go-ahead in the U.S.

"What we do now literally will be a matter of life and death for many of our citizens," Washington Gov. Jay Inslee said Tuesday as he extended restrictions on businesses and social gatherings, including a ban on indoor dining and drinking at restaurants and bars.

While the impending arrival of the vaccine is reason for hope, he said, "at the moment, we have to face reality, and the reality is that we are suffering a very dire situation with the pandemic."

The virus is blamed for more than 280,000 deaths and almost 15 million confirmed infections in the United States.

2:18 PM CT on 12/8/20

Like other physician practices across the country, DuPage Medical Group in west-suburban Chicago has been managing the care of COVID-19 patients who are recovering at home.

The patients—particularly those at high risk for negative outcomes from the coronavirus—would often ask the physicians at DuPage if there are treatments available to encourage a faster recovery and less severe symptoms.

But because the coronavirus’ strain is new, and well-researched treatments were not available, physicians didn’t have much to offer.

Motivated to give patients remedies, a team at DuPage began looking into the recent data on hospitalized coronavirus patients to see if something could be offered to patients that may improve their chances of recovery.

The result was a new treatment protocol involving aspirin and supplements such as vitamin D, zinc and iron.

READ MORE

11:32 AM CT on 12/8/20

(AP) A retired British shop clerk received the first shot in the country's COVID-19 vaccination program Tuesday, the start of an unprecedented global immunization effort intended to offer a route out of a pandemic that has killed 1.5 million.

Margaret Keenan, who turns 91 next week, got the shot at 6:31 a.m. on what public health officials have dubbed "V-Day." She was first in line at University Hospital Coventry, one of several hospitals around the country that are handling the initial phase of the United Kingdom's program. As luck would have it, the second injection went to a man named William Shakespeare, an 81-year-old who hails from Warwickshire, the county where the bard was born.

"I feel so privileged to be the first person vaccinated against COVID-19," said Keenan, who wore a surgical mask and a blue Merry Christmas T-shirt decorated with a cartoon penguin wearing a Santa hat. "It's the best early birthday present I could wish for because it means I can finally look forward to spending time with my family and friends in the New Year after being on my own for most of the year."

The U.K. is the first Western country to start a mass vaccination program after British regulators last week authorized the use of a COVID-19 shot developed by U.S. drugmaker Pfizer and Germany's BioNTech. U.S. and European Union regulators may approve the vaccine in the coming days or weeks, fueling a global immunization effort.

Britain's program is likely to provide lessons for other countries as they prepare for the unprecedented task of vaccinating billions of people. U.K. health officials have been working for months to adapt a system geared toward vaccinating groups of people like school children and pregnant women into one that can rapidly reach much of the nation's population.

Amid the fanfare that greeted Britain's first shot, authorities warned that the vaccination campaign would take many months, meaning painful restrictions that have disrupted daily life and punished the economy are likely to continue until spring.

"We still have a long road ahead of us, but this marks the route out," British Health Secretary Matt Hancock told the BBC.

9:35 AM CT on 12/8/20

(AP) Documents released by U.S. regulators Tuesday confirmed that Pfizer and BioNTech's COVID-19 vaccine was strongly protective against COVID-19—offering the world's first detailed look at the evidence behind the shots.

The Food and Drug Administration posted its analysis online even as across the Atlantic, Britain on Tuesday began vaccinating its oldest citizens with the Pfizer-BioNTech shots.

But the U.S. judges experimental vaccines in a unique way: On Thursday, the FDA will convene what's essentially a science court that will debate—in public and live-streamed—just how strong the data backing the shots really is.

A panel of independent scientists will pick apart the FDA's first-pass review before recommending whether the vaccine appears safe and effective enough for millions of Americans. The FDA, which typically follows the committee's advice, is expected to issue a decision in the days following the review. If given the green light, the first recipients would be health care workers and nursing home residents according to plans laid out by each state.

Pfizer and its German partner BioNTech previously reported the shots appear 95% effective at preventing mild to severe COVID-19 disease in a large, ongoing study. That's based on the first 170 infections detected. Only eight of the infections were among volunteers given the real vaccine while the rest had received a dummy shot.

That was measured soon after study participants got their second dose. Still unknown is how long that protection lasts. "We're looking at the best possible data," Dr. Paul Offit of Children's Hospital of Philadelphia and an FDA adviser recently cautioned. "People worry, reasonably, how about six months later?"

The other critical issue: Safety. Pfizer has reported no serious side effects. Some recipients experience flu-like reactions—including fever, fatigue or muscle aches—especially after the required second dose. It's a sign the immune system is revving up, able to recognize and fight back if the real virus comes along.

8:12 PM CT on 12/7/2020

(AP) — The Trump administration opted last summer not to lock in a chance to buy millions of additional doses of one of the leading coronavirus vaccine contenders, a decision that could delay the delivery of a second batch of doses until manufacturer Pfizer fulfills other international contracts.

The revelation, confirmed Monday by people familiar with the matter, came a day before President Donald Trump aimed to take credit for the speedy development of forthcoming coronavirus vaccines at a White House summit Tuesday.

Pfizer's vaccine is expected to be approved by a panel of Food and Drug Administration scientists as soon as this week, with delivery of 100 million doses — enough for 50 million Americans — expected in coming months.

Under its contract with Pfizer, the Trump administration committed to buy an initial 100 million doses, with an option to purchase as many as five times more.

This summer, the White House opted not to lock in an additional 100 million doses for delivery in the second quarter of 2021, according to people who spoke about the matter on condition of anonymity because they were not authorized to discuss it publicly.

Days ahead of the vaccine's expected approval, the administration is reversing course, but it is not clear that Pfizer, which has since made commitments to other countries, will be able to meet the latest request on the same timeline.

The Pfizer vaccine is one of two on track for emergency FDA authorization this month, the other coming from drugmaker Moderna.

The Trump administration insisted late Monday that between those two vaccines and others in the pipeline, the U.S. will be able to accommodate any American who wants to be vaccinated by the end of the second quarter of 2021.

The administration's decision not to lock in additional Pfizer purchases last summer was first reported by The New York Times. Health and Human Services Secretary Alex Azar told NBC the administration is "continuing to work across manufacturers to expand the availability of releasable, of FDA-approved vaccine as quickly as possible. … We do still have that option for an additional 500 million doses.”

Seeking to tamp down public skepticism over the vaccine and secure a key component of Trump's legacy, Tuesday's summit will highlight the administration's plans to distribute and administer the vaccine. But officials from President-elect Joe Biden’s transition team, which will oversee the bulk of the largest vaccination program in the nation’s history once he takes office Jan. 20, were not invited.

The “Operation Warp Speed” summit will feature Trump, Vice President Mike Pence and a host of government experts, state leaders and business executives, as the White House looks to explain that the vaccine is safe and lay out the administration’s plans to bring it to the American people.

Senior administration officials provided details on the summit on Monday. An official with the Biden transition confirmed no invitation was extended.

Officials from the pharmaceutical companies developing the vaccines also were not expected to attend, despite receiving invitations, according to people familiar with the matter. Some expressed concerns about the event contributing to the politicization of the vaccine development process and potentially further inhibiting public confidence in the drugs.

Trump is set to kick off the event with remarks aiming to “celebrate" vaccine development, according to an official who previewed the event. Trump also will sign an executive order to prioritize Americans for coronavirus vaccines procured by the federal government. A second official said the order would restrict the U.S. government from donating doses to other nations until there is excess supply to meet domestic demand. Both officials spoke on condition of anonymity to discuss plans for the summit.

It was not immediately clear what, if any, impact the order would have on other nations' abilities to access the vaccines. Canadian Prime Minister Justin Trudeau announced Monday he expects his country to receive about 250,000 doses of a vaccine from Pfizer by the end of the year.

The Food and Drug Administration is to meet Thursday to conduct a final review of the Pfizer drug, and it will meet later this month on a vaccine developed by Moderna. Both have been determined to be 95% effective against the virus that causes COVID-19. Plans call for distributing and then administering about 40 million doses of the two companies’ vaccines by the end of the year — with the first doses shipping within hours of FDA clearance.

Biden said Friday that “there’s no detailed plan that we’ve seen” for how to get the vaccines out of containers, into syringes and then into people’s arms.

Trump administration officials insist that such plans have been developed, with the bulk of the work falling to states and municipal governments to ensure their most vulnerable populations are vaccinated first. The administration says it has leveraged partnerships with manufacturers, distributers and health care providers, so that outside of settings like veterans' hospitals, “it is highly unlikely that a single federal employee will touch a dose of vaccine before it goes into your arm.”

In all, about 50,000 vaccination sites are enrolled in the government's distribution system, the officials said.

Each of the forthcoming vaccines has unique logistical challenges related to distribution and administration. The Pfizer vaccine must be transported at super-cooled temperatures, and comes in batches of 975 doses. Each vial contains 5 doses, requiring careful plannning. The administration has prepared detailed videos for providers on how to safely prepare and administer doses, to be posted after the FDA issues its emergency use authorization.

One such plan is to be announced Tuesday: Pharmacy chains CVS and Walgreens have stood up a “mobile vaccination service" ready to vaccinate people in every nursing home and long-term care facility in the country. The roughly 3 million residents of those facilities are among the most vulnerable for COVID-19 and have been placed at the front of the line to access the vaccine, along with more than 20 million healthcare workers. So far 80-85% of the facilities have signed on to the service, the officials said.

6:09 PM CT on 12/7/2020

The payments are the second in a five-phase $2-billion incentive program, the Nursing Home Quality Incentive Program, and will be distributed starting Dec. 9. There were 9,128 nursing homes—68% of those eligible—that met the program's mortality criteria in the second round. To read more, click here for the premium content.

4:39 PM CT on 12/7/20

(AP) The coronavirus is running rampant throughout Pennsylvania and could soon force overwhelmed hospitals to begin turning away patients, Gov. Tom Wolf warned Monday, calling it a "dangerous, disturbing scenario" that will become reality if people don't take steps to slow the spread.

Additional pandemic restrictions might be on the way, said Wolf, who did not elaborate on what his administration is considering but acknowledged the ones already in place have not worked.

"Over the course of the past two weeks, unfortunately, Pennsylvania's situation has become even more dire, and I find myself here saying things I really, really wish I didn't have to say," Wolf said at a virtual news conference. "If we don't slow the spread of this dangerous virus now, the reality is that COVID-19 will overwhelm our hospitals, will overwhelm our healthcare system."

Citing sharp increases in new infections, hospitalizations and deaths, Wolf said the unchecked spread of the virus in all regions of the state means that resource-sharing agreements among hospitals could soon begin to break down and force them to begin rationing care.

"If the worst happens, hospitals will not be able to treat all sick Pennsylvanians," he said. "They'll be forced to turn away people who need treatment, and that means more Pennsylvanians will die."

Even with that stark warning, Wolf, a Democrat, all but ruled out a return to the kinds of statewide restrictions he imposed last spring, when schools were closed, thousands of businesses deemed non-essential were shut down, and all 12.8 million Pennsylvanians were under a stay-at-home order.

"The blunt instruments that we had to use to buy time back in March and April, we don't need anymore. We can be much more targeted," he said.

2:07 PM CT on 12/7/20

(AP) Dr. Anthony Fauci, the nation’s top infectious disease expert, is warning that the upcoming holiday season may be even worse than Thanksgiving in terms of spreading the coronavirus.

Fauci told CNN on Monday that because the traditional Christmas season is an extended period that stretches into New Year’s, the prospects for spreading the virus as people travel “may be even more compounded than what we saw at Thanksgiving.”

Fauci said “it’s a very critical time in this country right now” with the virus surging and more important than ever for people to take precautions like avoiding indoor gatherings, wearing masks and social distancing.

Over Thanksgiving, many people traveled to gather with families, against warnings from health officials. Fauci said the U.S. is “probably just at the beginning” of seeing the resulting uptick in cases.

2:07 PM CT on 12/7/20

Black and Latino COVID-19 patients' worse outcomes stem largely from not being able to access care quickly enough, rather than any underlying health conditions, according to a new study.

A new study of more than 2,600 patients hospitalized for COVID-19 published Friday in JAMA Network Open found Black and Latino patients had a lower risk of mortality or critical illness and were less likely of being discharged to hospice compared to white patients.

While pre-existing health conditions certainly contribute to patients having an increased risk of complications from COVID-19, study lead author Dr. Gbenga Ogedegbe, professor of medicine and population health at NYU Langone Health, said Black patients had a lower risk of death compared to white patients after adjusting for age, sex, insurance status and comorbidity, while Latino and Asian patients had similar death rates to white patients.

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11:41 AM CT on 12/7/20

(AP) California is rolling out a voluntary smartphone tool to alert people if they spent time near someone who tests positive for the coronavirus as cases and hospitalizations soar throughout the state.

Gov. Gavin Newsom, a Democrat, announced the tool on Monday and said people can opt in to use it starting on Thursday.

Officials say the tool doesn’t track people’s identities or locations but uses Bluetooth wireless signals to detect when two phones are within 6 feet (1.8 meters) of each other for at least 15 minutes.

Sixteen other states, plus Guam and Washington, D.C., have already made available the system co-created by Apple and Google, though most residents of those places aren’t using it. The tool has been used on a pilot basis on University of California campuses.

9:40 AM CT on 12/7/20

(AP) Michigan hospital officials said Monday the state's partial shutdown of businesses and schools to curb the coronavirus is working and should be extended through the holiday season to alleviate stress on the healthcare system.

The statement came hours before Democratic Gov. Gretchen Whitmer's administration planned to announce to what extent it will continue restrictions due to end late Tuesday. The three-week "pause" is expected to be lengthened.

The state health department has prohibited in-person instruction at high schools, dine-in eating at restaurants and organized sports. Entertainment venues like movie theaters and bowling alleys are closed.

The chief medical officers of hospitals and health systems issued a joint statement saying the order is slowly stabilizing the spread of COVID-19.

"As a state, we must not let our guard down and reverse this progress," they said, reporting slight declines in virus-related emergency room visits, daily admissions and total hospitalizations.

The restrictions, many of which were in place earlier in the pandemic, took effect Nov. 18.

The seven-day average of daily new cases was 6,918 on Sunday, down from 7,604 two weeks before, according to the COVID Tracking Project. The rate of tests coming back positive, 12.4%, was up from 11.3%. The average daily death count was 122 — an increase from 71.3 on Nov. 22 — and fourth-highest in the country.

More than 4,100 people were hospitalized with symptoms, including about 500 on ventilators.

8:12 PM CT on 12/6/2020

Increased testing and isolation is the most effective tactic at controlling spread of COVID, according to the results of a new study published in Health Affairs. Researchers used linear regression to quantify testing's impact on COVID's transmissibility in 173 countries, accounting for 99% of the world's COVID cases, during March to June 2020.

PCR testing had a ten-fold increase in the ratio of tests to new cases reported, reducing the average reproduction number by 9% across a range of testing levels. Shelter-in-place orders were less effective in developing countries than in developed countries. 

6:30 PM CT on 12/6/2020

A 220-bed field hospital operated by UMass Memorial Health Care in Worcester, Mass. has started accepting COVID patients. It's the first field hospital to re-open in the state since June.

Officials said in a release that the DCU site will not take walk-ins or emergency cases, but will provide beds to help those who are too sick to go home yet no longer require critical care. 

“The field hospital was an enormous asset for Central Massachusetts hospitals during the spring surge. I believe it can serve an even greater purpose today because we have learned so much more about the virus and caring for COVID-19 patients since then,” said UMass President and CEO Eric Dickson said in a statement.

4:33 PM CT on 12/6/2020

(AP) President Donald Trump said Sunday his personal attorney Rudy Giuliani has tested positive for the coronavirus, making him the latest in Trump's inner circle to contract the disease that is now surging across the U.S.

The 76-year-old former New York mayor has traveled extensively to battleground states in recent days and weeks in an effort to help Trump subvert his election loss. On numerous occasions he has met with officials for hours at a time without wearing a mask.

Trump, who confirmed Giuliani's positive test in a Sunday afternoon tweet, wished him a speedy recovery.

“Get better soon Rudy, we will carry on!!!” Trump wrote.

Giuliani did not immediately respond to a request for comment.

Giuliani attended a hearing at the Georgia Capitol on Thursday where he went without a mask for several hours. Several state senators, all Republicans, also did not wear masks at the hearing.

On Wednesday night, Giuliani was in Lansing, Michigan, to testify in a highly unusual 4 1/2-hour legislative hearing in which he pushed Republican lawmakers to ignore the certification of Joe Biden’s Michigan victory and appoint electors for Trump. He did not wear a mask, nor did lawyer Jenna Ellis, who was sitting next to him. At one point, he asked one of his witnesses — a Detroit election worker — if she would be comfortable removing her mask. But legislators said they could hear her.

Research shows that people who contract the virus may become infectious to others several days before they start to feel ill.

Georgia state Sen. Jen Jordan, a Democrat who attended Thursday's hearing, expressed outrage after learning of Giuliani's diagnosis.

“Little did I know that most credible death threat that I encountered last week was Trump’s own lawyer,” Jordan tweeted. “Giuliani — maskless, in packed hearing room for 7 hours. To say I am livid would be too kind.”

Before the hearing, Giuliani and Michigan Republican Party Chairman Laura Cox — both maskless — did a virtual briefing for GOP activists.

Giuliani made an appearance earlier Sunday on Fox News “Sunday Morning Futures” to speak about his legal challenges in several states on behalf of Trump.

The diagnosis comes more than a month after Trump lost reelection and more than two months after Trump himself was stricken with the virus in early October. Since then, a flurry of administration officials and others in Trump's orbit have also been sickened, including White House chief of staff Mark Meadows and Ben Carson, the secretary of housing and urban development. The president's wife, Melania Trump, and teenage son, Barron Trump, have also been stricken.

Last month, Giuliani’s son, Andrew Giuliani, a special assistant to Trump, said he tested positive for coronavirus.

“I am experiencing mild symptoms, and am following all appropriate protocols, including being in quarantine and conducting contact tracing,” the younger Giuliani said in a Nov. 20 tweet disclosing his COVID-19 positive test.

2:31 PM CT on 12/6/2020

(AP) — Many Californians were preparing Sunday for a new stay-at-home order that bars restaurant dining, shutters salons and limits retail in an effort to curb spiraling coronavirus infections and hospitalizations.

The new rules that take effect before midnight in the vast region of Southern California, much of the San Francisco Bay Area and a large swath of the Central Valley also prohibit residents from gathering with people not in their households.

Public health officials contend the measures are critical as space dwindles in intensive care units in Southern California and much of the Central Valley amid a surge in coronavirus infections

Some law enforcement officials in these same areas, however, said they don’t plan to enforce the rules and are counting on residents to wear masks and practice physical distancing to protect themselves during the pandemic.

12:11 PM CT on 12/6/20

(AP) Virginia is reporting a record number of coronavirus cases in the state for the second straight day.

Virginia reported 3,880 cases on Sunday morning. That compares to Saturday’s total of 3,793.

Virginia has reported a total number of 255,053 virus cases. The state’s health department reports there have been 4,200 total deaths from the virus in Virginia.

The state reported a 10.6% positivity rate, up from 10% on Saturday.

The Virginia Hospital and Healthcare Association says there are 1,490 people hospitalized in the state with confirmed cases of the virus. Of them, 395 were in intensive care.

10:43 AM CT on 12/6/20

(AP) The head of the U.S. vaccine development effort said Sunday he believes the COVID-19 vaccine could have long-lasting effect once distributed.

Dr. Moncef Slaoui told CNN’s “State of the Union” that only time will tell for certain, but that in his opinion, the vaccine’s effectiveness could last for “many, many years,” with older people and others who are more vulnerable requiring a booster every three to five years.

He said that one of the hallmarks of immune systems is memory, so the body’s response to the coronavirus will be much faster once vaccinated.

Still, Slaoui said it’s not known whether vaccinated persons could spread the virus to others even if protected themselves. He said there may be an initial indication on that sometime in February or March.

Slaoui stressed that the continuing unknowns make it important for people to remain cautious and take safeguards to protect themselves and others against COVID-19.

He said that once 70 to 80% of the population is vaccinated, “the virus will go down.”

9:21 AM CT on 12/6/20

(AP) The vast region of Southern California, much of the San Francisco Bay area and a large swath of the Central Valley are about to be placed under a sweeping new lockdown in an urgent attempt to slow the rapid rise of coronavirus cases.

The California Department of Public Health said Saturday the intensive care unit capacity in Southern California and Central Valley hospitals had fallen below a 15% threshold that triggers the new measures, which include strict closures for businesses and a ban on gathering with anyone outside of your own household. The new measures will take effect Sunday evening and remain in place for at least three weeks, meaning the lockdown will cover the Christmas holiday.

Much of the state is on the brink of the same restrictions. Some counties have opted to impose them even before the mandate kicks in, including five San Francisco Bay Area counties where the measures also take effect starting Sunday.

With a new lockdown looming, many rushed out to supermarkets Saturday and lined up outside salons to squeeze in a haircut before the orders kicked in.

San Francisco resident Michael Duranceau rushed to a market to load up on supplies.

“I’m just stocking up before Sunday — the basics, bread, eggs,” he told KGO-TV, clutching a heavy grocery bag and a baguette.

Gov. Gavin Newsom announced the new plan Thursday. It is the most restrictive order since he imposed the country’s first statewide stay-at-home rule in March. But the situation is bleaker than in March.

“The risk of contracting COVID in the community now is higher now than it has ever been," Dr. Eric McDonald, the medical director for San Diego County, told reporters Saturday. He and other officials urged the public to bear down, heed the rules and help the state get through the latest and worst wave of cases the state has seen.

California has tallied a staggering total of 1.3 million COVID-19 cases since the pandemic started, setting a new daily record on Friday when 25,068 confirmed cases were recorded.

The new order divides the state into five regions and uses ICU capacity as the trigger for closures.

8:11 PM CT on 12/5/20

(AP) The Oregon Medical Board has suspended the medical license of a doctor who said at a pro-Trump rally that he doesn’t wear a mask at his Dallas, Oregon, clinic.

KGW-TV reported Friday that Dr. Steven LaTulippe also said at the November rally that he also encourages others not to wear masks.

A state order requires health care workers to wear a mask in health care settings.

The medical board voted this week to suspend LaTulippe’s license immediately due to concerns about patient safety.

LaTulippe did not respond to a request for comment from KGW-TV and has previously declined to comment.

5:38 PM CT on 12/5/20

(AP) St. Louis children’s hospitals have started treating adult patients as area hospitals struggle to keep up with rising coronavirus cases.

Dr. Marya Strand, chief medical officer for SSM Health Cardinal Glennon Children’s Hospital, told the St. Louis Post-Dispatch that is treating adults who don’t have COVID-19 to take some of the pressure off other hospitals. St. Louis Children’s Hospital also has opened its doors to adults.

About 1,054 people were hospitalized in the St. Louis area Wednesday for COVID-19, including 221 patients in intensive care units. St. Louis-area hospitals are at about 82% capacity for in-patient beds and 81% capacity for ICU beds.

Staff at SSM Health and BJC Healthcare children’s hospitals have also started volunteering to work at other overwhelmed hospitals.

3:06 PM CT on 12/5/20

(AP) The city of Moscow opening 70 vaccination facilities where thousands of doctors, teachers and others in high-risk groups had signed up to receive COVID-19 vaccines starting Saturday, a precursor to a sweeping Russia-wide immunization effort.

The centers in the capital started giving shots to willing recipients three days after President Vladimir Putin ordered the launch of a “large-scale” COVID-19 immunization campaign even though a Russian-designed vaccine has yet to complete the advanced studies needed to ensure its effectiveness and safety in line with established scientific protocols.

The Russian leader said Wednesday that more than 2 million doses of Sputnik V will be available in the next few days, allowing authorities to offer jabs to medical workers and teachers across the country starting late next week.

Moscow, which currently accounts for about a quarter of the country's new daily infections, moved ahead of the curve with the opening of the vaccination facilities on Saturday. Doctors, teachers and municipal workers were invited to book a time to receive a shot. Moscow Mayor Sergei Sobyanin said that about 5,000 signed up in a few hours after the system began operating on Friday.

“Of course I had doubts, especially given that all the clinical trials haven’t ended," said Tatyana Kirsanova, who received the vaccine Saturday at a Moscow clinic. "But I decided to go ahead and protect myself with all possible options.”

Russia boasted that Sputnik V was the world’s “first registered COVID-19 vaccine” after the government gave it regulatory approval in early August. The move drew criticism from international experts, who pointed out that the vaccine had only been tested on several dozen people at the time.

Putin has shrugged off doubts about it, saying in August that one of his daughters was among the early vaccine recipients.

Sputnik V has been offered to medical workers and teachers for several months even though the vaccine was still in the middle of advanced trials. Several top Russian officials said they had gotten the required two jabs, and the Russian military this week began vaccinating the crews of navy ships scheduled to depart on a mission.

Health Minister Mikhail Murashko said Wednesday that more than 100,000 people in Russia have received the shots.

Russia is offering the vaccine for free to people aged 18 to 60 who don’t suffer from chronic illnesses and aren’t pregnant or breastfeeding.

The two-shot Sputnik V was developed by the Moscow-based Gamaleya Institute. An advanced study among 40,000 volunteers was announced two weeks after the vaccine received government approval and that is still ongoing.

Kirill Dmitriyev, head of the Russian Direct Investment Fund that bankrolled Sputnik V’s development, said last month that more than 1 billion doses of the vaccine were expected to be produced outside of Russia next year.

Last month, developers of the vaccine said interim analysis of trial data showed it was 91.4% effective. The conclusion was based on 39 infections among 18,794 study participants that received both doses of either the vaccine or a placebo, which is a much lower number of infections than Western drugmakers have looked at when assessing the effectiveness of their vaccines. Two other Russia-designed vaccines are also undergoing tests.

On Wednesday, Britain became the first country in the West to authorize the use of a vaccine against the coronavirus developed by U.S. drugmaker Pfizer and Germany’s BioNTech.

Russia has been swept with a resurgence of the outbreak this fall, with numbers of new infections exceeding the levels recorded early in the pandemic, but the authorities so far have refrained from a tight lockdown imposed in the spring.

On Saturday, Russia reported a new record high of daily infections at 28,782, including 7,993 in Moscow. The government task force has recorded a total of 42,684 virus-related deaths since the start of the outbreak.

Russia’s total of over 2.4 million confirmed cases is currently the fourth-largest caseload in the world behind the United States, India and Brazil.

12:16 PM CT on 12/5/20

(AP) National Guard troops are directing people outside a Boise urgent-care clinic revamped into a facility for coronavirus patients.

Health officials say Idaho’s attempt to hold the coronavirus in check is failing as infections and deaths surge. They’ve halted elective surgeries to save bed space.

Inside Primary Health Medical Group’s clinic, physician assistant Nicole Thomas works extra 12-hour shifts. She dons protective gear to examine 36 patients a day with symptoms. Some days, she says, half test positive for coronavirus.

In a state where many citizens are resisting pandemic restrictions, overworked staff are getting sick or quitting to avoid the stress. It takes at least two days to get an appointment for a test. Primary Health officials say they’ll turn three more facilities into COVID-19 clinics by Dec. 30.

More than 1,000 people have died from the coronavirus in Idaho. Confirmed infections have surpassed 100,000.

9:55 AM CT on 12/5/20

Many infection preventionists working at hospitals and other healthcare organizations claim frontline workers are reusing personal protective equipment as surges of COVID-19 occur across the U.S.

A recent survey released by the Association for Professionals in Infection Control and Epidemiology found of the 1,083 infection preventionists who responded, 68.7% reported extended use or reuse was being applied to surgical masks while 73% said the policy was used for respirators. Additionally, 43.8% said isolation gowns and 10% said gloves were being worn more than once or for an extended time period.

The reuse of respirators, surgical masks, gloves and isolation gowns is concerning because they were intended to be used only one time, said Terri Rebmann, a member of APIC's COVID-19 task force and professor of epidemiology at St. Louis University College.

The survey shows 56.8% of respondents are at healthcare organizations where using the surgical or medical mask as many times as possible is the practice.

Additionally, 38.6% of respondents said frontline caregivers are asked to wear a respirator mask as many times as possible while 37.3% said caregivers are told to use it for five days and 13% responded staff are told to use it for three days.

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8:06 PM CT on 12/4/20

(AP) The initial delivery of vaccines to prevent COVID-19 in Illinois will be distributed among the 50 counties with the highest death rates per capita, Gov. J.B. Pritzker said Friday as the coronavirus claimed an additional 148 lives in the state.

Officials are expecting an opening shipment of 109,000 vaccine doses as early as mid-month. While hundreds of thousands more are expected in subsequent weeks, Pritzker said, he would not predict how long it would take to vaccinate those first in line.

Dr. Ngozi Ezike, the state public health director, reported 10,526 newly confirmed cases of the coronavirus. The 148 deaths was the eighth-highest single-day total during the pandemic. Fatalities have topped 100 on eight of the last 11 days.

Illinois is following federal guidelines for distributing the vaccine, with health professionals and nursing home residents part of what's called Phase 1a. Nationally, there are 24 million front-line health care workers and residents of long-term care facilities, Pritzker said. State officials did not respond to a question regarding the number of Illinois residents who qualify for Phase 1a.

“The very first vaccinations will be dedicated to hospitals and health care workers in the 50 counties with the highest death rates per capita,” Pritzker said at his daily COVID-19 briefing in Chicago. “Some quick math will tell you that it’s going to take multiple weeks of distribution to even get our health care workers their first of the two doses that they require, while also getting to the long-term care facility residents.”

Vaccines created by Pfizer and Moderna, which experts predict will get federal regulatory approval next week, each require two shots, with the second shot of the Pfizer vaccine coming three weeks after the first and Moderna's, four weeks.

Complicating matters is the storage requirement for the Pfizer product. The state has purchased 20 specialized freezers to store it at the required minus 94 degrees, Ezike said.

Pritzker was asked how he will ensure that the priority list isn't disrupted by the wealthy or connected cutting in line, an especially sensitive subject in Illinois, where there's a history of favoritism to those with political clout. Pritzker said that each of the 96 county public health departments is required to submit a plan for approval by the Illinois Department of Public Health that conforms with state parameters.

“Then they’re responsible for distributing the vaccine to the providers that will administer it to the communities that are in each phase as it's laid out,” Pritzker said. “That's the most important thing.”

6:04 PM CT on 12/4/20

Hospital operating margins are poised to fall as COVID-19 cases increase, new data show.

Although the federal relief funding buoyed hospitals, the median hospital operating margin still dropped 1.2 percentage points (8.5%) year over year, and 1.7 percentage points for January through October compared with the same prior-year period, according to Kaufman Hall's analysis of around 900 hospitals.

Without the relief funding, the median operating margin dropped 6 percentage points comparing the first 10 months of 2020 with the first 10 months of 2019. But on a month-to-month basis, Kaufman Hall's median hospital operating margin index slightly improved, without factoring in relief funding.

Read the rest of the story.

4:23 PM CT on 12/4/20

(AP) With Alabama's mask mandate set to expire next week even as COVID-19 cases explode statewide, filling hospitals and killing people daily, health leaders urged the state Friday to again extend the requirement, perhaps into 2021.

Dr. Sarah Nafziger, who teaches emergency medicine at the University of Alabama at Birmingham, told an online news briefing it was "critically important" for Gov. Kay Ivey to extend the mask requirement, which is opposed by some who consider it an infringement on personal rights or discount the threat of the coronavirus.

"A lot of people like to argue that masking is not helpful, that it's a bunch of voodoo," Nafziger said. "I'm here to tell you that the science shows that it works."

The president of the Alabama Hospital Association, Dr. Don Williamson, said the organization "absolutely" supports continuing the order as coronavirus trends worsen.

"We would support one probably through January. The situation is slipping rapidly in the wrong direction," Williamson said.

The order, which expires Dec. 11, requires anyone older than 6 to wear a mask in public spaces indoors and outside if they can't socially distance. First imposed in July, health officials credit the mandate with a sharp decline in cases until a recent spike began nationwide.

Dr. Scott Harris, head of the state health department, said the decision of whether to extend the order ultimately rests on the Republican governor, who publicly encouraged mask wearing in recent days while saying she would not shut down the state's economy again.

"I would say unequivocally in public health we believe masks work," Harris said at a news briefing. "I don't have any indication the mask order is going to go away, particularly given the kind of numbers we are seeking right now."

2:08 PM CT on 12/4/20

(Canadian Press) Healthcare workers in Ontario are on the frontlines in the fight against COVID-19, but according to a new study, they are feeling "sacrificed" and "violated" by their employers and the provincial government.

Researchers affiliated with the University of Windsor in collaboration with CUPE's Ontario Council of Hospitals Union co-authored a report titled "Sacrificed: Ontario Healthcare Workers in the Time of COVID-19."

Healthcare workers represent 20% of all COVID-19 cases in the province, according to the study, a number that is much higher than the global rate of 14%.

Due to fear of reprisal, those on the frontlines are extremely hesitant to speak out – but those who participated in the study told a story of "dismal" working conditions and "unrelenting" stress.

Front-line workers, including PSWs, RNs, RPNs, and custodial and clerical staff, all reported feeling unprotected and unsupported in their place of work.

"We have lost about 100 staff who have either taken a leave of absence because of fear or have taken a leave to go work other jobs. We have a few who have taken early retirement," said a participant in the study.

"When I leave this interview, I'm heading into work and I'm going to work 44 out of the next 60 hours. I've prepared enough food for six meals and they're in two shopping bags right now. That's what it's doing to me."
Some interviewees reported going home to cry after their shifts, sleeping in separate bedrooms away from their spouses,

and experiencing increased social isolation because they fear infecting their family and friends.

"The words on the page cannot convey the level of emotion we heard in the voices of healthcare workers we interviewed," said Dr. James Brophy, one of the lead authors of the new study.

"We did not expect to hear the degree of anger and desperation that came out. The stories they told us were tinged with anger, frustration and fear."

2:08 PM CT on 12/4/20

Many infection preventionists working at hospitals and other healthcare organizations claim frontline workers are reusing personal protective equipment as surges of COVID-19 occur across the U.S.

A survey released Thursday by the Association for Professionals in Infection Control and Epidemiology found of the 1,083 infection preventionists who responded, 68.7% reported extended use or reuse was being applied to surgical masks while 73% said the policy was used for respirators. Additionally, 43.8% said isolation gowns and 10% said gloves were being worn more than once or for an extended time period.

The reuse of respirators, surgical masks, gloves and isolation gowns is concerning because they were intended to be used only one time, said Terri Rebmann, a member of APIC's COVID-19 task force and professor of epidemiology at St. Louis University College.

"We don't have a lot of data (about the safety of reusing PPE) and that is where it's a little concerning," she said. "We don't have definitive evidence that reusing that equipment isn't harmful."

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11:35 AM CT on 12/4/20

(AP) U.K. regulators went on the offensive Friday to beat back criticism that they rushed their authorization of a COVID-19 vaccine, saying they rigorously analyzed data on safety and effectiveness in the shortest time possible without compromising the thoroughness of their review.

The comments from the Medicines and Healthcare Products Regulatory Agency came as the Times newspaper reported that the agency's chief executive, Dr. June Raine, planned to give a series of radio interviews so she could speak directly to people who may be concerned about getting vaccinated.

The MHRA reiterated earlier statements that the agency is conducting rolling reviews of COVID-19 vaccine candidates, allowing regulators to speed up the review process by looking at data as it becomes available. The agency gave emergency approval on Wednesday to a vaccine produced by U.S. drugmaker Pfizer and Germany-based BioNTech, making Britain the first Western country to authorize a vaccine against the coronavirus.

The ability to act more quickly "does not mean steps and the expected standards of safety, quality and effectiveness have been bypassed," the MHRA said. "No vaccine would be authorized for supply in the U.K. unless the expected standards of safety, quality and efficacy are met."

The media blitz comes amid concerns that criticism of the approval process could undermine public confidence in the Pfizer/BioNTech vaccine, leading some individuals to shun shots. Britain plans to begin vaccinating people within the next few days, starting with nursing home residents, caregivers and people over age 80.

America's top infectious disease expert late Thursday apologized for suggesting that U.K. authorities had rushed their authorization of the vaccine.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, had told U.S. media outlets that U.K. regulators hadn't acted "as carefully" as the Food and Drug Administration. He later clarified to the BBC that he had meant to say that U.S. authorities do things differently than their British counterparts, not better, but didn't phrase his comments properly.

"I do have great faith in both the scientific community and the regulatory community at the U.K., and anyone who knows me and my relationship with that over literally decades, you know that's the case," Fauci told the BBC.

9:32 AM CT on 12/4/20

(AP) The White House coronavirus response coordinator says Americans must not gather indoors with outsiders or take off their masks at any time when they are outdoors -- even when they are eating and drinking.

Dr. Deborah Birx says people also have to observe social distancing and wash their hands to contain the coronavirus pandemic. She says some states are taking these measures, but in others it’s “not happening at the level that they need to happen.”

Birx says that even once vaccines are approved, it will take weeks to months before “the most vulnerable individuals in America” can be immunized.

She made the comments after meeting with U.N. Secretary-General Antonio Guterres and General Assembly President Volkan Bozkir at U.N. headquarters in New York on Thursday.

8:36 PM on 12/3/20

(AP) The U.N. chief warned Thursday that the social and economic impact of COVID-19 “is enormous and growing” and said it’s foolish to believe a vaccine can undo damage from the global pandemic that will last for years or even decades.

Speaking to world leaders at the General Assembly’s first and mainly virtual special session on COVID-19, Secretary-General Antonio Guterres accused some countries he didn't name of ignoring or rejecting the World Health Organization’s recommendations at the start of the crisis early this year, resulting in nations going in their own directions and the virus spreading “in every direction.”

“Nearly a year into the pandemic, we face a human tragedy, and a public health, humanitarian and development emergency,” Guterres said.

The U.N. chief pointed to rising poverty, the looming threat of famine, and the prospect of “the biggest global recession in eight decades,” saying these impacts aren’t due to the coronavirus alone but are the result of long-term inequalities and injustices exposed by the pandemic that must be addressed.

General Assembly President Volkan Bozkir opened the two-day session, calling it a historic and overdue moment of reckoning to forge a path to end the pandemic that not only ensures people everywhere have access to vaccines but mobilizes financial resources for “an inclusive and resilient recovery.”

Nearly 80 world leaders, over 50 government ministers and 10 deputy leaders and ministers were scheduled to speak during the special session that began with Bozkir asking masked diplomats from the U.N.’s 193 member nations in the assembly hall to stand in silent tribute to the 1.5 million people who have lost their lives to COVID-19.

Bozkir called the session “a test for multilateralism” and said what the world must do is clear -- ensure fair and equitable access to vaccines, work together “to protect the most vulnerable countries,” provide adequate resources for an economic recovery that goes beyond pre-pandemic levels, and adopt policies that don't harm human rights or undermine democratic institutions.

Guterres has been urging the Group of 20 — the world’s richest nations — to back WHO’s cash-strapped ACT-Accelerator program to develop and distribute vaccines that includes Covax, an ambitious global project to buy and deliver virus vaccines for the world’s poorest people.

The secretary-general, clearly frustrated at the lack of a significant response, told world leaders there is a $28 billion financial gap, “including $4.3 billion urgently needed for the next two months.”

6:35 PM on 12/3/20

Although healthcare workers and nursing home residents are at the top of the list for COVID-19 vaccinations, there are still many steps needed to guarantee a smooth rollout.

"I wish it were as simple as saying we're going to vaccinate residents and staff," said David Grabowski, a professor of healthcare policy at Harvard Medical School. Instead, he predicts some challenges on adoption and education.

There's a level of distrust of management among nursing home workers, Grabowski said, and "it's unclear you're going to a get a high share of the staff willing to vaccinate."

"This is a very vulnerable workforce, and I think, in many regards, they've been asked to do a lot, especially during COVID, in terms of working long hours and working short-handed on many shifts. I very much believe that there's a lot of dissatisfaction with management at nursing homes," Grabowski said.

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4:12 PM CT on 12/3/20

(AP) A 220-bed field hospital at a sports and convention center in Worcester is scheduled to open Sunday, and the state is already working on establishing a second to care for an expected torrent of coronavirus patients, Gov. Charlie Baker said Thursday.

“Field hospitals play a critical role in our preparedness strategy that helps us alleviate pressure on the health care system generally, and enable hospitals to focus on non-COVID patients," the Republican governor said after touring the field hospital set up at the DCU Center in Worcester and run by UMass Memorial Health Care.

Baker also said there are plans to establish a field hospital in Lowell.

Marylou Sudders, the state Secretary of Health and Human Services, said the state is also looking into the possibility of another field hospital in the southeastern part of the state.

The visit to Worcester came a day after the state reported 4,613 new cases of the coronavirus, the highest single-day total since the pandemic began, with nearly 1,300 patients in the hospital.

“Obviously the numbers that were reported yesterday indicate that we have community transmission across the Commonwealth,” Baker said.

There is some concern about staffing the field hospitals, and Sudders implored healthcare professionals to come forward.

“If you have the skills, the ability, the can-do attitude, and have time to work in a hospital, we need you," she said. “Now is the time to step up, serve your neighbors, your community, your loved ones in the Commonwealth."

2:25 PM CT on 12/3/20

More than a third of American adults do not plan on getting a flu shot this season, even as public health officials push vaccinations to avoid putting even more strain on the healthcare system.

A NORC Spotlight on Health survey found 49% of Americans had already gotten a flu shot, while 16% said they still plan to get vaccinated. Though 35% said they didn’t plan on getting a shot this year, that number did decrease from last year. In 2019, 37% said they weren’t going to get a flu shot, and only 44% had already been vaccinated.

“It is particularly important that people get their flu shot this year to minimize the number of serious flu cases, as COVID-19 patients are straining hospital capacity in many regions,” said Caroline Pearson, senior vice president at NORC at the University of Chicago. “While we have seen a slight increase in early vaccination rates in 2020 compared to past years, half of all residents have yet to be immunized.”

2:25 PM CT on 12/3/20

Federal officials on Wednesday said they anticipate vaccinating as many as 100 million people by March once a coronavirus vaccine is approved and ready to be distributed.

In a call with reporters, HHS Secretary Alex Azar said federal agencies have made preparations to begin allocating a vaccine, or vaccines, immediately after the U.S. Food and Drug Administration grants emergency use authorization for use.

Among the most likely candidates to gain FDA approval first include vaccines developed by makers Pfizer and BioNTech, which won approval for use in Britain on Wednesday, as well as one developed by Moderna.

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12:50 PM CT on 12/3/20

(AP) California's quarantined governor was expected to announce new "drastic action" Thursday to combat the sudden surge in coronavirus cases, potentially issuing a new stay-at-home order for the state's nearly 40 million people amid fears that hospitals could be overwhelmed within weeks.

Newsom scheduled a news conference three days after warning he would issue new restrictions if the trends continue.

California on Wednesday reported more than 20,000 new coronavirus cases, the most ever in one day. A record 8,500 people are in hospitals, including more than 2,000 in intensive care units, leaving the state with fewer than 2,000 available intensive care beds.

Newsom — who is staying at home after three of his children were exposed to the virus — already has imposed restrictions, including a nighttime curfew in 51 of the state's 58 counties, an area with nearly the entire state population.

Los Angeles County, the nation's most populous with 10 million residents, also has imposed tighter stay-at-home restrictions and a three-week ban on in-person restaurant dining because of what county health director Barbara Ferrer called "terrifying increases in numbers."

On Wednesday night, Los Angeles Mayor Eric Garcetti issued a city order in apocalyptic tones telling people to remain in their homes.

LA "is now close to a devastating tipping point" that could overwhelm the hospital system, "in turn risking needless suffering and death," the order said.

9:41 AM CT on 12/3/20

(AP) The U.S. recorded over 3,100 COVID-19 deaths in a single day, obliterating the record set last spring, while the number of Americans hospitalized with the virus has eclipsed 100,000 for the first time and new cases have begun topping 200,000 a day, according to figures released Thursday.

Across the U.S., the surge has swamped hospitals and left nurses and other healthcare workers shorthanded and burned out.

"The reality is December and January and February are going to be rough times. I actually believe they are going to be the most difficult time in the public health history of this nation," Dr. Robert Redfield, head of the Centers for Disease Control and Prevention, said Wednesday.

Health authorities had warned that the numbers could fluctuate strongly before and after Thanksgiving, as they often do around holidays and weekends, when because of reporting delays, figures often drop, then rise sharply a few days later as state and local agencies catch up with the backlog.

Still, deaths, hospitalizations and cases in the U.S. have been on a fairly steady rise for weeks, sometimes breaking records for days on end.

Nationwide the coronavirus is blamed for over 270,000 deaths and about 14 million confirmed infections.

The U.S. recorded 3,157 deaths on Wednesday, according to the tally kept by Johns Hopkins University. That's more than the number of people killed on 9/11, and it shattered the old mark of 2,603, set on April 15, when the New York metropolitan area was the epicenter of the U.S. outbreak.

The number of people in the hospital likewise set an all-time high Wednesday, according to the COVID Tracking Project. It has more than doubled over the past month.

7:57 PM CT on 12/2/20
(AP) Missouri plans to bring in hundreds of healthcare workers from other states to help provide care as already-stretched hospitals prepare for a possible increase in COVID-19 cases resulting from the Thanksgiving holiday.

Gov. Mike Parson and Herb Kuhn, president and CEO of the Missouri Hospital Association, announced Wednesday the state will partner with Vizient, a private national health care company, to recruit up to 760 more health care workers for Missouri.

Kuhn said the partnership comes as early data raised concerns about a possible surge in new COVID-19 cases because of Thanksgiving travel. "In the days and weeks ahead as these workers arrive, they will provide essential support to our hospitals and health care workers, those who have been on the front lines of care since March," he said. "These extra skilled care givers are essential to address staff shortages that are presenting a critical threat to hospital capacity here in Missouri."

Parson said the state will use federal stimulus money to pay for Vizient, a Texas-based company, to provide the care for at least the next 12 weeks. The cost will be paid by the state and hospital partners.

The workers will include registered nurses, respiratory therapists and certified nurse assistants. When fully deployed, the plan will add nearly 600 hospital beds to Missouri's statewide bed capacity, Parson said.

6:48 PM CT on 12/2/20

The CEO of Reno-based Renown Health is speaking out against a tweet President Donald Trump posted Tuesday claiming the COVID-19 surge the health system is experiencing is exaggerated.

Trump shared a tweet from an events website called Network in Vegas claiming that a parking garage Renown Health has transformed to an alternative care site for COVID-19 patients is "fake" and isn't treating any patients. Trump retweeted the caption with the comment: "Fake election results in Nevada, also." The tweet occurred as Nevada and the city of Reno experience a surge of COVID-19 hospitalizations.

"I sleep better at night knowing we can support the needs of our community," said Dr. Anthony Slonim, CEO of Renown. "Nothing would please me more than never needing to use it (the makeshift site) but unfortunately we are needing to do that."

More on this.

4:26 PM CT on 12/2/20

(AP) Don't travel over the upcoming holidays. But if you must, consider getting coronavirus tests before and after, U.S. health officials urged Wednesday.

The agency also announced new guidelines that shorten recommended quarantines after close contact with someone infected with coronavirus. The agency said the risk in a shorter quarantine is small, but that the change makes following the guidance less of a hardship.

"Cases are rising, hospitalizations are increasing , deaths are increasing. We need to try to bend the curve, stop this exponential increase," the CDC's Dr. Henry Walke said during a briefing.

He said any travel-related surge in cases from travel would likely be apparent about a week to 10 days after Thanksgiving.

"The safest thing to do is to postpone holiday travel and stay home," said Dr. Cindy Friedman, another CDC official. "Travel volume was high over Thanksgiving," and even if small numbers were infected, that could result in hundreds of thousands of new infections."

"Travel is a door-to-door experience that can spread virus during the journey and also into communities that travelers visit or live," she added.

For those who decide to travel, COVID-19 tests should be considered one to three days before the trip and again three to five days afterward, the CDC said. The agency also recommended travelers reduce non-essential activities for a full week after they return or for 10 days if not tested afterward. And it emphasized the importance of continuing to follow precautions including masks, social distancing and frequent hand-washing.

The revised quarantine guidance says people who have been in contact with someone infected with the virus can resume normal activity after 10 days, or seven days if they receive a negative test result. That's down from the 14-day period recommended since the pandemic began.

2:08 PM CT on 12/2/20

Carol Siewert wasn't planning to leave hospital-based nursing for another two to five years. But then the novel coronavirus swept across the globe and into her 39-bed unit in a teaching hospital in Madison, Wis., and she knew it was time to go.

"I left because of staffing. I left because of health reasons, because I had blood clots in both lungs last summer, and I'm concerned that I'm higher risk for COVID complications like blood clots or acute respiratory distress. I also left because I was, quite literally, heartsick at doing my job," she said. "I realized I was experiencing what healthcare people have come to call 'moral injury,' or a kind of PTSD, and that it was best for my health if I left."

Siewert has been a cancer nurse for 17 years and has periodically worked as an in-home hospice nurse. She's seen people dying and comforted them and their families. She loves the work, even though it's emotionally draining. But COVID-19 made the stakes too high.

Siewert isn't alone in making the impossible decision to leave her job to take care of herself. The American Hospital Association doesn't collect data on how many workers are leaving the field — and doesn't plan to add that burden on providers during a pandemic. The association has heard anecdotal reports from health systems across the country that people are retiring early or looking for healthcare jobs that don't involve caring for hospitalized patients, said Nancy Foster, AHA's vice president of quality and patient safety policy. And with each loss, the nationwide healthcare staffing crisis worsens.

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2:08 PM CT on 12/2/20

(AP) A health system serving a swath of the central Appalachian mountains said Wednesday it will halt nonemergency elective procedures due to surging cases of COVID-19 and capacity concerns at its Virginia and Tennessee hospitals.

Ballad Health officials announced the change, which will take effect Monday and last for at least 30 days, at a news conference where they again implored community members to follow basic public health guidelines such as mask wearing and social distancing.

"The way we're seeing people act in the community, the way we're seeing people attend large gatherings, we can expect to see the numbers continuing to rise higher and higher. So I'm pleading with you, please change your behavior if you haven't yet," said Eric Deaton, Ballad's chief operating officer.

Ballad officials said pausing the surgeries — including those previously scheduled — was a difficult decision that will impact patients' quality of life and the system's finances. But they said it was necessary to free up staff to provide bedside care instead. They said there were no plans to furlough any staff.

The health system has also acquired a refrigerated morgue truck at its hospital in Johnson City, Tennessee, and has ordered a second one for a hospital in nearby Kingsport, Ballad President and CEO Alan Levine said.

Ballad's seven-day percent positivity rate in the areas of southwest Virginia and northeast Tennessee it serves reached a record high of 20% on Wednesday, according to data the system released.

Deaton said that rate is among the highest in the nation and is worse than either Virginia's or Tennessee's statewide rate.

"The spread of COVID-19 is not under control in our area. The direction that we're heading with our numbers is not sustainable," he said.

The system had about 13 or 14 available ICU beds as of Wednesday, he said.

11:33 AM CT on 12/2/20

A leader of the Trump administration’s effort to produce and distribute a coronavirus vaccine says he expects the Food and Drug Administration to soon authorize the use of a vaccine.

Operation Warp Speed chief science adviser Moncef Slaoui says he hopes by Dec. 10 or 11, a Pfizer vaccine is approved in the U.S.

Slaoui told ABC’s “Good Morning America” he “would expect the FDA to reach a similar conclusion” as British authorities did by approving emergency use of a vaccine developed by American drugmaker Pfizer and Germany’s BioNTech.

Slaoui is urging people to listen to the experts about taking the vaccine, look at the data and keep their minds open. He says “great science” allowed researchers to do discovery work “in weeks rather than in years.”

Slaoui calls the vaccine “an insurance against this virus” and says it’s “what will get us out of this pandemic.”

9:37 AM CT on 12/2/20

(AP) Healthcare workers and nursing home residents should be at the front of the line when the first coronavirus vaccine shots become available, an influential government advisory panel said Tuesday.

The panel voted 13-1 to recommend those groups get priority in the first days of any coming vaccination program, when doses are expected to be very limited. The two groups encompass about 24 million people out of a U.S. population of about 330 million.

As the virtual meeting got underway, panel member Dr. Beth Bell of the University of Washington noted that on average, one person is dying of COVID-19 per minute in the U.S. right now, "so I guess we are acting none too soon."

About 3 million people are living in nursing homes, long-term chronic care hospitals, and other U.S. long-term care facilities. Those patients and the staff members who care for them have accounted for 6% of the nation's coronavirus cases and a staggering 39% of the deaths, CDC officials say.

Despite the heavy toll, some board members at Tuesday's meeting said they hesitated to include such patients in the first group getting shots.

Dr. Helen Keipp Talbot, an infectious diseases researcher at Vanderbilt University who was the lone committee member to vote against the proposal, cited flu research that found vaccinating the staff of such facilities has a greatest impact on preventing its spread there.

Dr. Richard Zimmerman, a University of Pittsburgh flu vaccine researcher who watched the meeting online, echoed Talbot's concerns.

"I think it was premature" to include nursing home residents as a priority group, said Zimmerman, a former ACIP member. "Their vote seems to assume that these people will respond well to the vaccine. ... I don't think we know that."

Committee members were unanimous in voicing support for vaccinating healthcare workers — about 21 million people, according to CDC officials.

The government estimates people working in healthcare account for 12% of U.S. COVID-19 cases but only about 0.5% of deaths. Experts say it's imperative to keep healthcare workers on their feet so they can administer the shots and tend to the booming number of infected Americans.

8:41 PM CT on 12/1/20

(AP) Maryland Gov. Larry Hogan announced measures on Tuesday to boost the number of available health care workers and plan for more hospital beds.

In a partnership with the Maryland Hospital Association, the governor announced the launch of an initiative called MarylandMedNow to recruit people with clinical backgrounds to work at state hospitals, nursing homes, testing sites and vaccination clinics.

The state has asked colleges and universities to develop emergency policies and procedures to award academic credit to students who are willing to get hands-on work experience during the pandemic.

The governor also announced steps to increase hospital beds. Hospitals across the state will be required to submit a patient surge plan, including strategies to expand bed and staffing capacity adjustments. They will be due at the health department Dec. 8.

Also, if hospitalizations reach a total of 8,000 hospitalizations or more, hospitals will be required to expand their staffed bed capacity by 10% of each hospital’s physical bed capacity within seven calendar days. Of the 6,816 people in hospitals, 1,583 had confirmed cases of the coronavirus as of Tuesday.

8:15 PM CT on 12/1/20

Hospital operating margins are poised to fall as COVID-19 cases increase, new data show.

Although the federal relief funding buoyed hospitals, the median hospital operating margin still dropped 1.2 percentage points (8.5%) year over year, and 1.7 percentage points (18.7%) for January through October compared to the same prior-year period, according to Kaufman Hall's analysis of around 900 hospitals.

Without the relief funding, the median operating margin dropped 6 percentage points (69.4%) comparing the first 10 months of 2020 to the first 10 months of 2019. But on a month-to-month basis, Kaufman Hall's median hospital operating margin index slightly improved, without factoring in relief funding.

Emergency department visits remained the hardest hit, falling 16% over that span. Meanwhile, expenses per adjusted discharge increased 13.5% over that 10-month period as labor, personal protective equipment and drug costs rose.

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6:35 PM CT on 12/1/20

(AP) Gov. Tate Reeves instituted mask mandates in 13 more Mississippi counties Tuesday but chose not to implement the measure statewide, a week after several prominent health care leaders called on him to do so.

During a press briefing, the Republican governor said he believes issuing mask requirements in counties with the highest number of new cases will encourage people to take the regulations more seriously than a blanket approach would. A total of 54 out of the state’s 82 counties now have a mask mandate.

“I almost feel like there are those out there who really, truly believe if I were to write an executive order, a statewide prohibition against hurricanes in 2021, that we won’t have any hurricanes," Reeves said. “It just doesn’t work that way.

Reeves instituted a statewide mask mandate in early August, but revoked the measure at the end of September when new coronavirus cases were declining in Mississippi. As cases have risen again in recent weeks, he has begun implementing mask mandates in individual counties.

Four health care leaders have said it's time for Reeves to go a step further. They wrote a letter to Reeves on Nov. 24 calling for another statewide mask mandate.

“The statewide mask mandate, which was highly effective, needs to be reinstituted,” said a letter signed by Dr. LouAnn Woodward of the University of Mississippi Medical Center; Dr. Anita Henderson, president-elect of the Mississippi Chapter of the American Academy of Pediatrics; Dr. Claude Brunson, executive director of the Mississippi State Medical Association; and Dr. James Griffin Jr., president of the Mississippi Academy of Family Physicians.

4:24 PM CT on 12/1/20

(AP) Alabama hospitals that already are treating a record number of COVID-19 patients are bracing for a "tidal wave" of additional cases linked to holiday gatherings, a health official said Tuesday as schools and more grappled with the worsening coronavirus pandemic.

Despite the fact that less testing is going on now than earlier in the outbreak, the state has still recorded at least 2,000 new cases daily since Nov. 15. Hospitals are treating more patients than ever, and an expected post-Thanksgiving surge of cases has yet to begin, said Dr. Jeanne Marrazzo, director of infectious diseases at the University of Alabama at Birmingham.

Only 11% of the state's intensive care beds were available Monday, according to the Alabama Hospital Association, and the remaining spaces could be filled as more patients are admitted than leave hospitals.

"We could really be in a situation in two to three weeks that compromises our ability to provide health care," Marrazzo said.

While experts have tried to avoid "alarmist terminology" during the crisis, she said: "I think this is a time when we need to start thinking about things like tidal wave imagery or tsunami imagery."

At UAB Hospital, where 60 to 70 COVID-19 patients have been treated at a time ever since summer, the number of patients has jumped to 125 recently, she said, and an expected flood of cases linked to holiday travel could overwhelm the system as even nurses and doctors fall ill.

"This is a really, really scary inflection point, and I don't think that we're going to be able to turn it around without experiencing some more stress and some more pain," she said. While vaccines could arrive as early as this month, officials say it will be spring at the earliest before most people can receive the shots.

2:07 PM CT on 12/1/20

(AP) An influential government advisory panel convened on Tuesday to answer one of the most pressing questions in the U.S. coronavirus outbreak: Who should be at the front of the line when the first vaccine shots become available?

The Advisory Committee on Immunization Practices held a virtual, open-to-the-public meeting where it was scheduled to vote on a proposal that would give priority to healthcare workers and nursing home patients.

The two groups encompass around 23 million Americans out of a U.S. population of about 330 million.

Later this month, the Food and Drug Administration will consider approval of two vaccines made by Pfizer and Moderna. Current estimates project that no more than 20 million doses of each vaccine will be available by the end of 2020. And each product requires two doses.

As a result, the shots will be rationed in the early stages.

The advisory panel will meet again at some point to decide who should be next in line. Among the possibilities: teachers, police, firefighters and workers in other essential fields such as food production and transportation; the elderly; and people with underlying medical conditions.

Experts say the vaccine will probably not become widely available in the U.S. until the spring.

2:07 PM CT on 12/1/20

Like many primary-care physicians across the country, Dr. Trevor Huber is using telehealth to triage patients for COVID-19 symptoms.

In one of these recent visits, a man in his mid-60s was complaining of chest pain, thinking it may be the virus. Huber wasn’t convinced, urging him to come into his practice in Little Elm, Texas, right away to make sure he wasn’t having a heart attack.

After hooking the patient up to an electrocardiogram, it was clear the patient was in cardiac arrest. Huber’s team called 911 right away.

This patient recovered, but others haven’t been so lucky. Three patients of the practice, called Modera Clinic, have died of heart attacks since the COVID-19 pandemic began. After discussions with the families, Huber learned the patients were complaining of symptoms for weeks, but they went unaddressed. “It’s basically when they are collapsing, having a terrible heart attack, and having to run a code in the field” when they finally call for help, Huber said.

Experiences like Huber’s are becoming more common for providers across the country as research shows patients are ignoring symptoms and putting off needed care during the COVID-19 pandemic, largely out of fear of contracting the virus in the healthcare setting. Providers are worried as the pandemic stretches on—and worsens this fall and winter season—about the long-term implications for patients who continue to delay seeing their doctors and getting emergent services.

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12:01 PM CT on 12/1/20

(AP) Rhode Island has opened two field hospitals that combined have more than 900 beds to deal with an expected flood of COVID-19 patients that has already swamped the state's hospitals.

Care New England opened a field hospital with more than 300 beds in Cranston on Monday, the same day the state sent an emergency alert saying conventional hospitals had reached their coronavirus capacity.

A facility with nearly 600 beds opened Tuesday at the Rhode Island Convention Center in Providence. It is run by Lifespan, the state's largest hospital group.

There were 365 patients in the state's hospitals with the disease as of Saturday, the most recent date for which the information was available, according to the state Department of Health, down from a single-day high of 381 on Nov. 23.

The Lifespan facility expects to admit 24 to 48 patients on Tuesday, but may need more staff, Chief Nursing Executive Cathy Duquette said.

"We are prepared to take up to 100 patients with the staff we have been able to get. If we see demand increasing, we will certainly reach out to get more from our agency partners," she said.

Both field hospitals will take patients who are not critically ill.

9:35 AM CT on 12/1/20

(AP) A staggering rise in coronavirus cases could overwhelm California's health system within weeks and "drastic" action such as a widespread stay-at-home order may be needed to combat the threat, Gov. Gavin Newsom warned.

Hospitalizations from COVID-19 have increased nearly 90% and could triple by Christmas, officials said Monday.

"The red flags are flying in terms of the trajectory in our projections of growth," Newsom said.

The number of COVID-19 cases reported each day in California has been setting records, with the average daily case rate over the last week topping 14,000.

The levels are far above those recorded during a summer peak or even in March, when a state public health order restricted people from going outside except for the most essential reasons. That order was later eased.

Currently, 51 of 58 counties are in the "purple" tier of the state's COVID-19 system, meaning they are under the strictest business restrictions. Those counties account for most of the state's population. A recently imposed curfew in those counties bars most nonessential work, movement and gatherings but only overnight.

Although he supplied few details, Newsom said that unless the current trends slow, the surge in COVID-19 cases creates the potential for an order that could place further restrictions on businesses and keep the majority of people indoors in the most seriously-affected counties.

Hospitalizations in California have increased 89% over the past 14 days and nearly 7,800 coronavirus patients were hospitalized as of Monday. Public health officials warned that people ignoring distance and mask guidelines and gathering for Thanksgiving with non-household relatives could lead to a massive surge in coronavirus cases by Christmas.

About 12% of Californians testing positive are likely to need hospital care within the next two to three weeks.

The biggest concern is intensive care cases, which have increased 67% in the past two weeks. The state has around 7,700 ICU beds, and currently 75% are occupied. More than 1,800 ICU patients have COVID-19.

If the trend continues, ICU beds would reach 112% of capacity by mid-December.

"It's brutal. It's astoundingly bad. ... They're seriously, seriously bad numbers," Dr. George Rutherford, epidemiologist and infectious-diseases control expert at UC San Francisco, told the Los Angeles Times.

California can't even ship patients to ICU beds out of state "because stuff that's just as bad is going on in Oregon and Nevada and Arizona," Rutherford said. "We are here on our own, and this is a natural disaster."

8:22 PM CT on 11/30/2020

Dr. Scott Atlas, a science adviser to President Donald Trump who was skeptical of measures to control the coronavirus outbreak, is leaving his White House post.

A White House official confirmed that the Stanford University neuroradiologist, who had no formal experience in public health or infectious diseases, resigned at the end of his temporary government assignment. Atlas confirmed the news in a Monday evening tweet.

Atlas joined the White House this summer, where he clashed with top government scientists, including Dr. Anthony Fauci and Dr. Deborah Birx, as he resisted stronger efforts to contain the COVID-19 pandemic that has killed more than 267,000 Americans.

Atlas has broken with government experts and the overwhelming consensus of the scientific community to criticize efforts to encourage face covering to slow the spread of the virus. Just weeks ago on Twitter he responded to Michigan's latest virus restrictions by encouraging people to “rise up” against the state's policies.

His views also prompted Stanford to issue a statement distancing itself from the faculty member, saying Atlas "has expressed views that are inconsistent with the university’s approach in response to the pandemic."

“We support using masks, social distancing, and conducting surveillance and diagnostic testing,” the university said Nov. 16. “We also believe in the importance of strictly following the guidance of local and state health authorities.”

Atlas defended his role in his resignation letter, saying, "I cannot think of a time where safeguarding science and the scientific debate is more urgent."

Atlas was hired as a “special government employee," which limited his service to government to 130 days in a calendar year — a deadline he reached this week.

6:21 PM CT on 11/30/2020

The Association of American Medical Colleges on Monday called on providers to prepare immediately to implement their Crisis Standards of Care.

The AAMC’ is responding to reports of staffing shortages as frontline workers become infected and unable to work, as well as increasing shortages of available hospital beds, specialized equipment, and supplies for treating patients with COVID-19 infections.

Crisis care seeks to provide the best care possible to the largest number of people with the resources available. New guidance about Crisis Standards of Care is now available here.

“Patients who believe they need hospital or medical care in the coming weeks and months should not delay that care and should first contact their primary health care provider if they have one—or their local community health center if they don’t—to determine the best course of action,” said Janis M. Orlowski, MD, AAMC chief health care officer. “The new ‘Acute Hospital Care at Home’ program just announced by the Centers for Medicare and Medicaid Services may provide a home option for some patients needing hospital care.”  

4:23 PM CT on 11/30/20

(AP) Nevada health officials reported 1,642 new coronavirus cases and eight additional deaths on Monday, warning that the statewide surge shows few signs of slowing as the worst month of the pandemic comes to a close.

Nevada has reported 152,169 confirmed cases and 2,144 deaths since the start of the pandemic. Officials said the positivity rate, as measured by dividing new cases reported over the last 14 days by test encounters, had reached a record-high of 17.3% on Monday. Hospitalizations also peaked with 1,545 confirmed and suspected COVID-19 patients undergoing treatment.

Throughout the state, 76% of staffed hospital beds are occupied. In southern Nye County, all 25 staffed beds are occupied and in northern Churchill County, the hospital has 30 patients but only 28 beds.

Healthcare facilities in northern Nevada "are now showing signs of serious strain," the Nevada Hospital Association wrote in a daily bulletin.

The association added: "Patients are being treated within alternative care sites, hospitals are functioning under crisis standards of care and some intensive care level patients from rural communities are being transferred to hospitals in Idaho, Utah, California, or Arizona for definitive treatment."

Nevada COVID-19 response director Caleb Cage warned that colder weather, indoor activities and back-to-back holidays could exacerbate the spread of the pandemic. He said the state did not yet have data to evaluate if recent holiday gatherings had spread the virus.

"At this point, it's too soon to determine the impacts from the Thanksgiving holiday. It is possible that we may see an increase in testing numbers within the next week if people chose not to seek testing over the holiday or because locations were limited," Cage said.

2:14 PM CT on 11/30/20

(AP) St. Louis County Executive Sam Page warned area residents Monday that the county is in "crisis mode" as COVID-19 cases keep rising and hospitals strain to treat new patients.

Page said area hospitals could run out of intensive care beds sometime this week and the National Guard could be asked to help with response to the pandemic.

"We are in a crisis mode and the virus is winning," Page said.

On Sunday, the St. Louis region had 994 COVID-19 hospitalizations, with an average of 660 new cases per day. Area hospitals were using 77% of the total staffed beds and 89% of their intensive care beds, according to the St. Louis County Department of Public Health.

Statewide, Missouri reported 2,498 COVID-19 hospitalizations as of Friday, with 27% of inpatient beds still available, the latest hospitalization data available on the state's COVID-19 dashboard.

Missouri has reported 299,762 confirmed COVID-19 cases and 3,829 deaths since the pandemic began.

Page pleaded with residents to follow safety protocols to reduce the spread of the coronavirus.

He said it was too early to tell if restrictions imposed two weeks ago, including a ban on indoor restaurant dining and limits to outdoor dining, are working. The restrictions are scheduled to end Dec. 15, but Page said they could be extended if needed.

"These next few weeks are going to test everyone's mettle, everyone in the community," he said. "We don't want anymore restrictions, but we also don't want our hospitals to be in a position of choosing who gets care."

The strain on St. Louis-area hospitals prompted one doctor to start a petition to ask Gov. Mike Parson to impose a statewide ban, a move the Republican governor has consistently refused to consider.

Dr. Micah Luderer, an internal medicine resident at Barnes Jewish Hospital, said he started the petition after treating COVID-19 patients and watching his fellow doctors and nurses work to exhaustion, KMOV reported.

"We're drowning at the hospital," Luderer said. "People are dying every day from COVID-19 and we're not doing everything in our power to stop the virus."

11:56 AM CT on 11/30/20

(AP) A government watchdog agency says most states are concerned they won’t have adequate supplies to administer COVID-19 vaccines, which are expected to start becoming available for high-priority groups in the next few weeks.

The congressional Government Accountability Office said in a report Monday that 17 states are “greatly” or “completely” concerned about having adequate supplies to administer vaccines, while another 21 states said in an agency survey they were “moderately” concerned.

The federal government’s “Operation Warp Speed” campaign aims to start shipping vaccines within 24 hours of an emergency use approval from the Food and Drug Administration. But there’s concern about the final, local delivery links in getting vaccines finally into people’s arms, sometimes referred to as the “last mile” in the chain.

Initially vaccines are expected to go to health care workers, with nursing home staff and residents, and essential workers getting the next highest priority.

GAO said senior officials from six states stated they were specifically concerned about the federal government’s ability to supply needles given reports of shortages. Three of those states also said they were scrambling to maintain supplies of needles for flu vaccination.

The GAO report did not identify the states.

9:45 AM CT on 11/30/20

(AP) Rhode Island's hospitals reached their COVID-19 capacity on Monday, the same day the state's two-week pause meant to control the rise in new cases took effect.

"Hospitals at capacity due to COVID," the state said in a statewide emergency alert. "Help the frontline by staying home as much as possible for the next two weeks."

Under the restrictions announced earlier in November by Gov. Gina Raimondo, some businesses will be required to shut down for two weeks, while others are restricted.

Recreational businesses including bowling alleys, theaters, and casinos, as well as indoor sporting facilities and gyms must close. Bars and bar areas in restaurants are also required to close, while restaurants are limited to 33% of indoor capacity and only people in the same household at a table.

Residents are also asked to close their social circles to only people in their own household.

"This will not be easy, but I am pleading with you to take it seriously," Raimondo said in a statement. "Choosing to gather with those outside your household will have ripple effects that will increase the strain on our hospitals and put lives at risk."

Raimondo did not rule out another economic shutdown if the pandemic gets worse.

Children up to eighth grade will continue going to school, and child care centers are allowed to remain open.

Superintendents have been given the option to switch high school to mostly remote classes.

Manufacturing and construction jobs, as well as personal services businesses, such as hair salons, are also allowed to stay open with proper precautions.

Houses of worship are limited to 25% capacity.

To help businesses and workers affected by the pause, the Democratic governor last week announced $100 million in aid.

8:38 PM CT on 11/29/20

(AP) Nevada health officials say the number of confirmed coronavirus cases statewide has surpassed 150,000.

Nevada's coronavirus dashboard on Sunday reported 150,527 cases of COVID-19 since the outset of the pandemic. There have been more than 2,100 related deaths.

Concerned by the virus' continued spread, Gov. Steve Sisolak on Nov. 22 announced the state’s most expansive mask mandate to date and reduced the capacity at casinos, restaurants, bars and many other businesses from 50% to 25%.

The number of infections is thought to be far higher than reported because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

5:22 PM CT on 11/29/20

(AP) California broke a record Sunday with more than 7,400 coronavirus hospitalizations as counties statewide prepared for stricter COVID-19 restrictions to take effect amid surging cases and Thanksgiving travel.

Health officials are preparing for a wave of cases in the next two or three weeks that could be tied to Thanksgiving gatherings. Authorities had urged residents to stay home and keep their interactions with others limited, yet millions nationwide defied that advice.

As of Sunday, California has had nearly 1.2 million confirmed coronavirus cases since the pandemic began. The state reported around 15,600 new cases on Saturday. There have been 19,121 virus-related deaths in California during the pandemic.

The state reported 7,415 coronavirus hospitalizations on Sunday, citing the most recently available data from the previous day. More than 1,700 of those patients are in intensive care units. The new total hospitalizations breaks the state's previous record of 7,170 in July.

The figures are expected to rise in the coming days as similar trends are echoed nationally.

The number of new COVID-19 cases reported in the United States topped 200,000 for the first time Friday. The highest previous daily count was 196,000 on Nov. 20, according to data from Johns Hopkins University. Since January, when the first infections were reported in the U.S., the nation’s total number of cases has surpassed 13 million. More than 265,000 people have died.

“The big unknown here is what actions were people taking over this long holiday weekend,” Los Angeles County Public Health Director Barbara Ferrer said.

If people engaged in high-risk activities, she said, “we’re in for a very rough time because we will have a surge on top of a surge.”

2:22 PM on 11/29/20

(AP) The number of people hospitalized with the coronavirus in the St. Louis area set another new record Sunday even as the most-recent statewide hospitalization numbers declined slightly.

The St. Louis Metropolitan Pandemic Task Force said the seven-day average of new patients in the area increased by 13 to 897 Sunday to set a record for the third day in a row. The data includes patients from BJC HealthCare, Mercy, SSM Health and St. Luke’s Hospital facilities in the St. Louis area.

The total number of COVID-19 patients in the area increased to 994 on Sunday, up 11 from the previous day. Area hospitals said they are currently using 77% of the total staffed beds and 89% of their intensive care beds.

Statewide, the number of hospitalizations dropped to 2,654 from 2,813 on Thursday, which was the most-recent data available.

Missouri reported 3,193 new virus cases Sunday to give the state a total of 295,933 cases. The state also reported six new deaths for a total of 3,823.

The seven-day rolling average of daily new cases in Missouri decreased over the past two weeks, going from 4,379.43 new cases per day on Nov. 14 to 3,632.57 new cases per day on Saturday, according to data from Johns Hopkins University.

11:58 AM on 11/29/20

(AP) New York City will reopen its school system to in-person learning and increase the number of days a week many children attend class even as the coronavirus pandemic intensifies in the city.

Mayor Bill de Blasio announced Sunday that some elementary schools and pre-kindergarten programs will resume classes Dec. 7. Others will take longer to reopen their doors. The announcement marks a major policy reversal for the nation’s largest school system.

It comes just 10 days after de Blasio announced that schools were shutting down because of a rising number of cases. The plan for reopening middle and high schools is still being developed.

Some elementary schools and pre-kindergarten programs will resume classes Dec. 7, a week from Monday, the mayor said. Others will take longer to reopen their doors.

9:05 AM on 11/29/20

(AP) When Turkey changed the way it reports daily COVID-19 infections, it confirmed what medical groups and opposition parties have long suspected — that the country is faced with an alarming surge of cases that is fast exhausting the Turkish health system.

In an about-face, President Recep Tayyip Erdogan’s government this week resumed reporting all positive coronavirus tests — not just the number of patients being treated for symptoms — pushing the number of daily cases to above 30,000. With the new data, the country jumped from being one of the least-affected countries in Europe to one of the worst-hit.

That came as no surprise to the Turkish Medical Association, which has been warning for months that the government’s previous figures were concealing the graveness of the spread and that the lack of transparency was contributing to the surge. The group maintains, however, that the ministry’s figures are still low compared with its estimate of at least 50,000 new infections per day.

No country can report exact numbers on the spread of the disease since many asymptomatic cases go undetected, but the previous way of counting made Turkey look relatively well-off in international comparisons, with daily new cases far below those reported in European countries including Italy, Britain and France.

That changed Wednesday as Turkey’s daily caseload almost quadrupled from about 7,400 to 28,300.

The country’s hospitals are overstretched, medical staff are burned out and contract tracers, who were once credited for keeping the outbreak under check, are struggling to track transmissions, Sebnem Korur Fincanci, who heads the association, told The Associated Press.

“It’s the perfect storm,” said Fincanci, whose group has come under attack from Erdogan and his nationalist allies for questioning the government’s figures and its response to the outbreak.

Even though the health minister has put the ICU bed occupancy rate at 70%, Ebru Kiraner, who heads the Istanbul-based Intensive Care Nurses’ Association, says intensive care unit beds in Istanbul’s hospitals are almost full, with doctors scrambling to find room for critically ill patients.

There is a shortage of nurses and the existing nursing staff is exhausted, she added.

“ICU nurses have not been able to return to their normal lives since March,” she told the AP. “Their children have not seen their mask-less faces in months.”

7:31 PM CT on 11/28/20

(AP) More counties in California announced new COVID-19 restrictions on Saturday to prevent rising caseloads from spiraling into a hospital crisis.

San Francisco is joining a statewide curfew and Silicon Valley is banning all high school, collegiate and professional sports and imposing a quarantine for those traveling into the region from more than 150 miles away. Santa Clara County has the highest case rate in the Bay Area, leading to the stricter rules, said Santa Clara County Health Officer Dr. Sara Cody.

"This pandemic is like a high-speed train, and our projections tell us that we are on target to derail by around the third week of December if we don't apply the brakes right now with all our collective might," she said.

The changes in Santa Clara County are less strict than a statewide lockdown issued in March by Gov. Gavin Newsom but still ratchet up measures that aim to slow the exploding number of people who have become infected with COVID-19 and those winding up in hospitals. It stops short of a full business shutdown that could cripple the holiday sale season by reducing the number of people allowed in stores to 10% capacity.

The order, which takes effect Monday and will last until at least Dec. 21, exempts church services and protests, which county health officials said are constitutionally protected.

Meanwhile, an alarming surge of newly reported coronavirus cases pushed San Francisco and San Mateo counties to the most restrictive purple tier in the state's pandemic blueprint for the economy, forcing most indoor activities to close by noon Sunday and placing the counties' residents under curfew starting Monday night.

The new restrictions came a day after Los Angeles County imposed a lockdown calling for 10 million residents to stay home "as much as possible," prohibiting them from gathering with people outside of their household for public or private occasions, except for faith-based services and protests.

The state's top public health official has referred to "COVID fatigue" by people who are becoming lax about safety precautions after having been hit with sometimes confusing state and local health orders as the pandemic waxed and waned.

Meanwhile, health officials are bracing for a wave of cases in the next two or three weeks that could follow gatherings at Thanksgiving. Officials have estimated that 1 in 145 Los Angeles County residents is infected with COVID-19. About 12% of those infected could wind up in hospitals, authorities say.

"The big unknown here is what actions were people taking over this long holiday weekend," county Public Health Director Barbara Ferrer said Saturday.

If people engaged in high-risk activities, she said, "we're in for a very rough time because we will have a surge on top of a surge."

4:59 PM CT on 11/28/20

(AP) Texas health officials reported more than 3,900 new cases of COVID-19 Saturday, as the disease caused by the novel coronavirus continued to put pressure on hospital systems around the state.

State health authorities reported more than 8,500 Texans hospitalized with COVID-19 Saturday, roughly in line with the Friday count. Texas added 3,954 confirmed cases of the virus and 102 fatalities Saturday, according to the Texas Department of State Health Services.

Texas has had more than 1 million confirmed COVID-19 cases and 21,309 fatalities. The actual number of cases is believed to be far higher because many people haven't been tested and some who get the disease don't show symptoms.

Over the last seven days, more than one in 10 coronavirus tests in Texas have come back positive, according to data from Johns Hopkins University.

In the El Paso and San Antonio areas local leaders have issued partial curfews through Monday morning in an effort to limit the spread of the virus.

For most people, the coronavirus causes mild or moderate symptoms that clear up within weeks. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms and be fatal. The vast majority of people recover.

3:34 PM CT on 11/28/20

(AP) The coronavirus outbreak's current surge will present Arizona with a hospital crisis that could become a disaster unless the state takes steps such as ordering a three-week stay-home shutdown and implementing a statewide mask mandate, university researchers said.

Without such steps, "it would be akin to facing a major forest fire without evacuation orders," members of the COVID Modeling Team at the University of Arizona said in a letter Friday to the state Department of Health Services. The team has tracked the outbreak since last spring.

Many local governments have imposed mask mandates since Gov. Doug Ducey last summer lifted a prohibition on such orders. The local mandates cover an estimated 90% of the state's population but enforcement is lax or non-existent in some places. A statewide measure, the modeling team wrote, "ensures consistency and strengthens compliance."

As in many states, cases and hospitalizations in Arizona have again surged in the wake of school and business reopenings and public weariness with COVID-19 restrictions.

Arizona State University researchers on Nov. 19 projected that hospitals in the state will exceed their capacities unless steps are taken.

While not again imposing new general shutdown mandates, Ducey has taken steps to require masks in schools and help hospitals. He also has repeatedly urged Arizonans to wear masks and take other precautions against COVID-19 spread.

State Sen. Martin Quezada, D-Phoenix, endorsed the modeling team's recommendations. "State leaders should have political courage and protect public health by enacting them now," he said on Twitter. "These aren't unreasonable requests."

Asked for comment on the modeling team's letter, which was reported first by KNXV-TV, Department of Health Services spokesman Steve Elliott said the agency was viewing the universities' forecasts and monitoring information from hospitals, local health departments and other sources.

"We are on high alert," Elliott said in an email, adding that mitigation measures such as limits on business occupancy restrictions remain in place.

The DHS director, Dr. Cara Christ, on Friday said in a video that Arizona faces significant spread and the holidays "have the potential to further increase spread."

"All of the metrics continue heading in the wrong direction," she said. "To put it simply, people are letting down their guard."

The state on Saturday reported reported 4,136 additional known COVID-19 cases and 36 more deaths, increasing the state's totals to 322,774 cases and 6,624 deaths.

Hospitalizations related to COVID-19 continue to increase, reaching 2,383 as of Friday, including 553 patients in beds in intensive care units, according to the state's dashboard.

1:19 PM CT on 11/28/20

(AP) Indiana's hospitalizations for COVID-19 patients has remained at record levels during the Thanksgiving weekend as the statewide daily average of coronavirus-related deaths continues its two-month stretch of steep increases.

The Indiana State Department of Health's daily update on Saturday reported 69 more coronavirus deaths occurring over the past several days.

Those raised the state's seven-day rolling average of COVID-19 deaths to 56 per day — more than five times the rate in late September and pushing it well ahead of the early pandemic peak of 42 a day in April.

November has been Indiana's deadliest COVID-19 month and health officials have repeatedly raised concerns about Thanksgiving gatherings leading to another surge in cases. Hospital officials across the state are worried about not having enough health care workers to care for the quickly growing number of severely ill patients.

Indiana hospitals were treating 3,381 COVID-19 patients as of Friday — about a 350% increase since late September when Gov. Eric Holcomb lifted nearly all business and crowd size restrictions before reinstating some limits this month.

About 43% of the state's intensive care unit patients had the coronavirus on Friday, about four times September's rate.

Indiana has now recorded 5,663 coronavirus deaths, including both those with confirmed and presumed infections.

11:17 AM CT on 11/28/20

(AP) People who have suffered through COVID-19 have a valuable weapon for those fighting the coronavirus now: antibodies.

The (Springfield) State Journal-Register reports that the Central Illinois Community Blood Center is collecting plasma from the blood of recovered COVID-19 patients.

Kristi White of Springfield said although COVID-19 prompted coughing fits and sapped her energy for weeks, she was not hospitalized. And she remembered hearing about a co-worker's friend who was seriously ill with COVID-19. Treatment with antibodies from donated plasma saved him.

"I've never done blood donation, but I felt like this was important enough that if you can help, you kind of need to," she said.

The fall surge in the virus has pushed up demand. Memorial Health System says that nearly one-third of the patients in its five central Illinois hospitals has COVID-19.

Donors can give blood multiple times while they retain antibodies. Donors sit beside a machine that separates plasma from donated blood and returns the remaining components to the donor.

"The need for convalescent plasma, it's very high, and we really need the donors to come up and help us out," blood center medical director Ruchika Goal said. "So they can really do a selfless, heroic act to save someone's life."

9:19 AM CT on 11/28/20

(AP) Health officials in rural communities in Washington state are worried that Thanksgiving gatherings could take the COVID-19 pandemic from bad to worse and, in some places, overwhelm already strained health systems.

The Spokesman-Review reports the small towns surrounding Spokane County have experienced a surge in cases in recent weeks, mirroring trends seen statewide.

In the past two weeks, the Northeast Tri County Health District, which covers Ferry, Stevens and Pend Oreille counties, reported more than 300 new COVID-19 cases, a record number accounting for a third of their total cases confirmed thus far in the pandemic.

Similarly, Lincoln County has seen more than 50 cases in the past few weeks, which account for a third of the total cases recorded in the county.

"What we're finding is a lot of our cases that we've identified here, we can track back to people in Spokane," said Ed Dzedzy, public health administrator in Lincoln County. "It's just the nature of the beast, and it's not pointing a finger at anybody, but the virus is going to do what it does; People move from rural to urban to buy goods and go to work."

Lincoln County experienced a few larger outbreaks this month in long-term care settings and one larger family cluster. In the three counties north of Spokane County, outbreaks at social gatherings, workplaces, restaurants, bars and churches have led to a surge in cases.

The Northeast Tri County Health District had to stop contact tracing last week due to so many cases, particularly in Stevens County, which is seeing the highest increase of cases it's had in all the pandemic. The district is focusing its resources on doing case investigations, reaching out to all people confirmed to have COVID-19, and asking them to reach out to their close contacts.

The Washington Department of Health announced this week that it's hiring 350 more contact tracers and investigators to support local health jurisdictions by mid-December, which could help smaller health departments meet the challenge of tracing all contacts with cases surging.

9:07 PM CT on 11/27/20

(AP) Los Angeles County announced a new stay-home order Friday as coronavirus cases surged out of control in the nation’s most populous county, banning most gatherings but stopping short of a full shutdown on retail stores and other non-essential businesses.

The three-week “safer at home” order takes effect Monday. It came as the county of 10 million residents confirmed 24 new deaths and 4,544 new confirmed cases of COVID-19. 

The county had set a threshold for issuing the stay-home order: an average of 4,500 cases a day over a five-day period, but hadn’t expected to reach that level until next month. 

However, the five-day average of new cases reported Friday was 4,751.

“We know we are asking a lot from so many who have been sacrificing for months on end,” Public Health Director Barbara Ferrer said. “Acting with collective urgency right now is essential if we want to put a stop to this surge.”

The order advises residents to stay home “as much as possible” and to wear a face covering when they go out. It bans people from gathering with others who aren’t in their households, whether publicly or privately.

However, exceptions are made for church services and protests, “which are constitutionally protected rights,” the county Department of Public Health said in a statement.

Indoor retail businesses, which make much of their profits during the Thanksgiving and Christmas holiday seasons, are allowed to remain open but with just 20% of capacity, including nail salons and other personal care services.

Stores considered essential will be allowed 35% capacity. Outdoor fitness centers, museums and outdoor amusements such as mini-golf can operate at 50% of capacity.

Restaurants in the county already were recently barred from in-person dining. They can still offer pickup, delivery and takeout services.

Beaches, trails, and parks will remain open, with safety requirements.

Schools and day camps can remain open except for those that have three or more COVID-19 cases over 14 days. Those should close for 14 days, the order said.

The order, which runs through Dec. 20, is more modest than a statewide closure order issued by Gov. Gavin Newsom in mid-March. That order closed schools and most businesses and severely restricted movement except for essential workers or to perform essential chores such as buying groceries or picking up medications.

Daily cases numbers in California have set records in recent days. Hospitalizations statewide have increased more than 80% in the last two weeks. Nearly 2,000 people in the county are now hospitalized and the new order is part of an effort to prevent the county’s health system from being overwhelmed.

Meanwhile, public health officials are bracing for a wave of cases that could follow gatherings at Thanksgiving. Officials say it usually takes two to three weeks for such serious cases to show but about 12% of those infected could wind up hospitalized.

8:13 PM CT on 11/27/20

(AP) A panel of U.S. advisers will meet Tuesday to vote on how scarce, initial supplies of a COVID-19 vaccine will be given out once one has been approved.

Experts have proposed giving the vaccine to health workers first. High priority also may be given to workers in essential industries, people with certain medical conditions and people age 65 and older.

Tuesday's meeting is for the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention. The panel of experts recommends who to vaccinate and when -- advice that the government almost always follows. The agenda for next week's emergency meeting was posted Friday.

Pfizer and its German partner BioNTech have asked the Food and Drug Administration to allow emergency use of its COVID-19 vaccine candidate. Moderna Inc. is expected to also seek emergency use of its vaccine soon.

FDA's scientific advisers are holding a public meeting Dec. 10 to review Pfizer's request, and send a recommendation to the FDA.

Manufacturers already have begun stockpiling coronavirus vaccine doses in anticipation of eventual approval, but the first shots will be in short supply and rationed.

5:13 PM CT on 11/27/20

(AP) The number of Connecticut residents hospitalized with COVID-19 topped 1,000 on Friday, the first time it has been that high since mid-May.

The new data also showed the number of nursing home residents who have been infected since the pandemic began has topped 10,000.

The state reported 49 more people were in the hospital compared with Wednesday, bringing the total to 1,017. During the first wave, hospitalizations reached a peak of 1,972 on April 22.

Gov. Ned Lamont has said the number of people in the hospital is one of the most important metrics he is watching when considering whether to impose more virus-related restrictions, with concerns about hospitals running out of space and staffing being inadequate.

The Democratic governor said he would consider reimposing restrictions that were in place during the first wave in the spring “if I heard from the leading hospital executives that we’re getting close” to full capacity.

Yale New Haven Health, which operates several hospitals in southern Connecticut, reported recently that only about 20% of its intensive care unit capacity was available.

Also Friday, the state reported 3,429 more people had tested positive and 35 more had died since Wednesday, bringing total infections to 112,581 and total deaths to 4,961. The positive test rate was 4.8%.

The seven-day rolling average of the positivity rate has risen over the past two weeks from 4.3% on Nov. 12 to 5.26% as of Thursday, compared with positive rates of less than 1% over much of the summer.

Also over the past week, 413 more nursing home residents in Connecticut tested positive for the virus and 68 more residents died. Total nursing home infections now number 10,280 and deaths total 3,086. In the previous week, 306 more residents tested positive and 39 died.

Lamont on Friday also cautioned state residents about thieves trying to cash in by setting up fake COVID-19 testing sites. Official testing sites are listed on the state's coronavirus website at www.ct.gov/coronavirus. Bogus sites were recently reported in Bridgeport.

“It’s troubling that scam artists would try to capitalize on that, but I know our municipalities — with our support — will continue to act quickly to stop these bad actors,” the governor said in a statement.

2:41 PM CT on 11/27/20

(AP) Prime Minister Justin Trudeau said Friday he expects more than half of Canadians to receive a COVID-19 vaccine by next September after he came under criticism for saying Canadians won’t be among the first to get doses.

Trudeau said earlier this week Canada will have to wait for a vaccine because the first ones are likely to be given to citizens of the countries they are made in. He noted the United States, the United Kingdom and Germany have mass vaccine-production facilities but Canada does not.

Opposition parties criticized Trudeau for not ensuring Canadians get priority access to vaccines.

Trudeau said Friday he expects vaccines to start arriving early next year — but what month Canadians will get the first doses remains an open question.

“The race to get to the starting line first, I can understand, but this pandemic doesn't get over until we reached the finish line,” Trudeau said.

“What really matters is when we get to cross the finish line and the fact that the doctors highlighted that if all goes according to plan, we should be able to have a majority of Canadians vaccinated by next September, puts us in a very good stead.”

Dr. Howard Njoo, Canada's deputy chief medical officer, said it would be by the end of next year but said Trudeau's timeline “is in the same ballpark.”

Top Canadian health officials said Thursday Pfizer’s COVID-19 vaccine candidate could be approved in Canada next month and if all goes according to plan 3 million Canadians could get shots by the end of March. The U.S. Food and Drug Administration is meeting Dec. 10 to consider whether to give the go-ahead to Pfizer.

Canada has a purchase deal to buy at least 20 million doses of Pfizer’s vaccine.

Ontario Premier Doug Ford hopes to get the first doses in January.

“I can’t emphasize enough with the prime minister that the clock is ticking,” Ford said.

Toronto is on lockdown and the country’s largest province of Ontario reported a record 1,855 cases on Friday.

“We’re in for some of the toughest days of this pandemic,” Trudeau said

Trudeau said Canada, which has a population of 37 million, has signed deals that could give Canada the most per capita vaccines in the world. And he said the Canadian military will play a role in distribution of the vaccine. An army general will oversee it.

“This will be the biggest immunization in the history of the country,” Trudeau said.

1:16 PM on 11/27/20

(AP) The World Health Organization’s top scientist says more data is needed to determine if the coronavirus vaccine developed by Oxford University and AstraZeneca works.

Oxford and AstraZeneca reported Monday that their vaccine appeared 62% effective in people who received two doses and 90% effective when volunteers were given a half dose followed by a full dose. They later acknowledged a manufacturing issue had resulted in a half dose mistakenly being administered as the first dose to some participants.

Dr. Soumya Swaminathan, WHO’s chief scientist, said at a Friday news conference that “the numbers are still too small to really come to any definitive conclusions.”

In the study, 2,741 people got a half dose followed by a full dose while 8,895 people got two full doses. None of the people in the half-dose regimen were over age 55.

“It’s very hard to compare these two groups,” Swaminathan said.

Swaminathan said the agency had heard AstraZeneca would like to conduct a full study testing the half dose followed by a full-dose regimen, noting that the other ongoing research evaluating the vaccine uses two full doses.

10:58 AM CT on 11/27/20

(AP) Brazilian President Jair Bolsonaro says he won’t take any working COVID-19 vaccine himself and calls the use of masks to limit the spread of the disease “the last taboo to fall.”

Bolsonaro’s comments, broadcast on his social media channels Thursday night, alarmed health experts who said they could undermine efforts to achieve vaccination levels essential to halting the pandemic and might scare off vaccine makers negotiating with local authorities.

Bolsonaro also said, however, that any shot that is certified by Brazil’s health agency will be available for free to the public.

The Brazilian president, who contracted the virus in July, has long resisted the advice of most scientists and health experts to restrict social and economic activity, arguing that damage from a lockdown would be worse than the pandemic.

Balsonaro says: “I tell you; I will not take (any vaccine). It is my right and I am sure that Congress will not create difficulties for whoever doesn’t want to take a vaccine.”

A study published July 15 in the American Journal of Preventive Medicine found that social distancing measures can safely be halted if at least 75% of the population gets a vaccine that is more than 70% effective. Tests have shown some vaccine candidates have a potential efficacy higher than that.

8:03 AM on 11/27/20

(AP) Thailand on Friday signed a $200 million deal to procure 26 million doses of a trial coronavirus vaccine developed by pharmaceutical firm AstraZeneca in collaboration with Oxford University. It is expected to be delivered in mid-2021.

The doses would cover 13 million people in a population of about 69 million.

Thailand’s National Vaccine Institute signed a non-refundable advance market commitment contract worth 2.38 billion baht ($79 million) with AstraZeneca to reserve the supply of the vaccine candidate. Another 3.67 billion baht ($121 million) agreement for the purchase of the trial vaccine, known as AZD1222, was signed by the Health Ministry’s Disease Control Department.

“We have followed the vaccine manufacturers globally, but this group has achieved very high progress,” Thai Prime Minister Prayuth Chan-ocha said at the signing. “They are likely to be able to produce the vaccine early next year. Most importantly, we have to get ourselves ready for the domestic process including packaging and logistics.”

Government spokesperson Anucha Burapachaisri said officials are still considering how to prioritize vaccine recipients. “Those who work closely with COVID-19 patients, for example, doctors and nurses, should be among the first people. But this needs further discussion,” he said.

Oxford and AstraZeneca reported Monday that their trial vaccine appeared to be 62% effective in people who received two doses, and 90% effective when volunteers were given a half dose followed by a full dose.

They did not mention at the time, but later acknowledged, that a manufacturing issue had resulted in “a half dose of the vaccine being administered as the first dose” to some participants, a development that led to criticism that its test results were flawed.

AstraZeneca has said it plans to conduct a new global clinical trial to make a fresh assessment of the vaccine’s efficacy.

The AstraZeneca trial vaccine is regarded as having several advantages over rival vaccines being developed so far for less-developed countries, including cheaper cost and the ability to be stored at temperatures not as cold as the others.

Under a separate deal in October, the Health Ministry, Siam Bioscience Co. and the SCG business conglomerate signed a letter of intent with AstraZeneca on the manufacturing and supply of the AZD1222 vaccine candidate. It would allow Siam Bioscience to produce the vaccine at its own plant, with a starting date targeted for the middle of next year.

2:47 PM CT 11/26/20

(AP) Spain’s infection and fatality figures in the resurgence of COVID-19 are continuing to edge down, with the country posting 12,289 new cases and 337 deaths.

The 14-day cumulative number of COVID-19 cases per 100,000 of population, a recognized measure of the pandemic’s spread, also fell Thursday, to 325.

That is far off the Nov. 9 peak during the resurgence, when it stood at 529, and comes amid nationwide measures restricting movement and social gatherings.

The government admits the trend is favorable but wants to maintain caution until its target rate of 25 cases per 100,000 of population is reached.

Spain’s total number of new confirmed coronavirus cases stands at 1.6 million, with more than 44,000 deaths.

10:08 AM CT 11/26/20

(AP) As coronavirus cases surge again nationwide the Supreme Court late Wednesday barred New York from enforcing certain limits on attendance at churches and synagogues in areas designated as hard hit by the virus.

The justices split 5-4 with new Justice Amy Coney Barrett in the majority. It was the conservative’s first publicly discernible vote as a justice. The court’s three liberal justices and Chief Justice John Roberts dissented.

The move was a shift for the court. Earlier this year, when Barrett’s liberal predecessor, Justice Ruth Bader Ginsburg, was still on the court, the justices divided 5-4 to leave in place pandemic-related capacity restrictions affecting churches in California and Nevada.

The court’s action Wednesday could push New York to reevaluate its restrictions on houses of worship in areas designated virus hot spots. But the impact of the court’s action is also muted because the Catholic and Orthodox Jewish groups that sued to challenge the restrictions are no longer subject to them. 

The Diocese of Brooklyn and Agudath Israel of America have churches and synagogues in areas of Brooklyn and Queens previously designated red and orange zones. In those red and orange zones, the state had capped attendance at houses of worship at 10 and 25 people, respectively. But the those particular areas are now designated as yellow zones with less restrictive rules neither group challenged. 

The justices acted on an emergency basis, temporarily barring New York from enforcing the restrictions against the groups while their lawsuits continue. In an unsigned opinion the court said the restrictions “single out houses of worship for especially harsh treatment.”

“Members of this Court are not public health experts, and we should respect the judgment of those with special expertise and responsibility in this area. But even in a pandemic, the Constitution cannot be put away and forgotten. The restrictions at issue here, by effectively barring many from attending religious services, strike at the very heart of the First Amendment’s guarantee of religious liberty,” the opinion said.

The opinion noted that in red zones, while a synagogue or church cannot admit more than 10 people, businesses deemed “essential,” from grocery stores to pet shops, can remain open without capacity limits. And in orange zones, while synagogues and churches are capped at 25 people, “even non-essential businesses may decide for themselves how many persons to admit.”

7:58 PM CT 11/25/20

(AP) California reported a record number of coronavirus cases Wednesday as Los Angeles restaurants prepared to close for three weeks and firefighters in Silicon Valley were being enlisted to enforce public health rules to try to halt the spread of infections.

Cases of COVID-19 have been climbing at an alarming rate for weeks and hit a new high of 18,350 recorded Tuesday, surpassing a previous record of more than 15,000 cases announced Saturday, state officials said.
The seven-day average of positive tests has gone from 5.3% to 6.5% in the past week. The 14-day average has gone from 4.8% to 5.9%.

Officials have been discussing the rise in cases with increasing alarm in recent days and urging people to stay home and reconsider Thanksgiving gatherings with people from outside their homes.

"We are really, really concerned," said Dr. Marty Fenstersheib, COVID-19 Testing Officer for Santa Clara County. "All of the metrics that we have been following, that have done well in previous months, are now going up very steeply. Our positivity rate in our county is rising and especially in our most affected communities."

Nearly all of the state is now under a 10 p.m. to 5 a.m. curfew and subject to the strictest regulations for businesses to operate, including a ban on indoor dining and limited capacity in stores.
In Los Angeles, Dr. Christina Ghaly, the health services director, said infections were spreading at the rate where they would double every two weeks and quadruple over a month.

She said that multiplier was particularly troubling with thousands of cases being detected each day and the looming crisis with a dwindling number of hospital beds.

6:04 PM on 11/25/20

(AP) AstraZeneca and Oxford University on Wednesday acknowledged a manufacturing error that is raising questions about preliminary results of their experimental COVID-19 vaccine.

A statement describing the error came days after the company and the university described the shots as "highly effective" and made no mention of why some study participants didn't receive as much vaccine in the first of two shots as expected.

In a surprise, the group of volunteers that got a lower dose seemed to be much better protected than the volunteers who got two full doses. In the low-dose group, AstraZeneca said, the vaccine appeared to be 90% effective. In the group that got two full doses, the vaccine appeared to be 62% effective. Combined, the drugmakers said the vaccine appeared to be 70% effective. But the way in which the results were arrived at and reported by the companies has led to pointed questions from experts.

The partial results announced Monday are from large ongoing studies in the U.K. and Brazil designed to determine the optimal dose of vaccine, as well as examine safety and effectiveness. Multiple combinations and doses were tried in the volunteers. They were compared to others who were given a meningitis vaccine or a saline shot.

Before they begin their research, scientists spell out all the steps they are taking, and how they will analyze the results. Any deviation from that protocol can put the results in question.

In a statement Wednesday, Oxford University said some of the vials used in the trial didn't have the right concentration of vaccine so some volunteers got a half dose. The university said that it discussed the problem with regulators, and agreed to complete the late stage trial with two groups. The manufacturing problem has been corrected, according to the statement.

Experts say the relatively small number of people in the low dose group makes it difficult to know if the effectiveness seen in the group is real or a statistical quirk. Some 2,741 people received a half dose of the vaccine followed by a full dose, AstraZeneca said. A total of 8,895 people received two full doses.

3:03 PM on 11/25/20

(AP) The number of confirmed COVID-19 infections in Wisconsin continued to tick downward Wednesday, a rare bit of good news for health officials as they struggle to contain the deadly disease.

The state Department of Health Services reported 5,469 confirmed cases Wednesday. The number of confirmed cases has now declined for five days, an encouraging sign after the state saw a record-high 7,989 cases on Nov. 18.

What's more, the seven-day average of positive tests was 28.3% as of Tuesday, continuing a downward trend from a record-high 36.6% on Nov. 11.

But the disease is still running rampant across the state.

According to DHS, the total number of confirmed infections stood at 369,442 as of Wednesday. The disease was a factor in 63 more deaths, bringing the death toll to 3,178, according to the department. Wisconsin remains sixth in the nation in per capita infections, according to Johns Hopkins University.

And any progress against the disease appears fleeting. Health officials are bracing for another surge in infections and deaths stemming from Thanksgiving gatherings.

1:05 PM on 11/25/20

(AP) New Hampshire legislators are working on a bill to offer price protections for adult vaccines, such as those pending for COVID-19.

Rep. Jerry Knirk, a Democrat from Freedom, tells WMUR-TV that by expanding a New Hampshire nonprofit association that pools insurance company money to buy vaccine doses in bulk, the savings to the state and patients could be immense.

The process is already done in New Hampshire for pediatric vaccines, he said. The bill would expand the New Hampshire Vaccine Association, which purchases vaccines for children under 19, to all adults.

“In the pediatric program, we purchase about $38 million worth of vaccines for about $28 million,” Knirk said. “The savings is roughly about 26%. For the adults, it is estimated it should be very similar in terms of the degree of savings.”

The state Health Department provides oversight to about 250 provider offices for the children’s program; an additional 350-400 would be enrolled to accommodate adults, according to a similar bill that passed the House this year, but didn't go any further.

The federal government is expected to pay for a COVID-19 vaccination, but the bill could come in handy if gaps in funding arise next year or suddenly states find themselves in the position of trying to obtain more vaccine.

11:10 AM on 11/25/20

(AP) A state-run psychiatric hospital in Rhode Island has allowed “close contacts" of coronavirus-infected patients and staff to continue working, officials said.

A spokesperson for the state-run Eleanor Slater Hospital in Cranston acknowledged in an email to The Providence Journal that exposed workers were still on the job while awaiting their own test results, the newspaper reported Tuesday.

As of Tuesday, there were 14 positive patients at Slater, including one who was taken to another hospital, and 35 infected staffers, spokesperson Randal Edgar said.

Exposed staff are allowed to work while awaiting their own test results, per state Department of Health guidelines, he said.

“Per RIDOH, health care workers are considered critical infrastructure workers. They can work after being a close contact, provided that they take certain measures," he said.

Those include wearing a surgical mask, monitoring for symptoms and taking their temperature every four hours while at work. They are also not allowed to participate in any activities outside of work.

9:16 AM on 11/25/20

(AP) China is stepping up virus inspections on imported food packaging as cooler weather brings new waves of coronavirus infections in several overseas countries, Chinese officials said Wednesday.

Packaging is “not exempt" from carrying the virus, deputy director of the National Food Safety Risk Assessment Center Li Ning told reporters.

While the coronavirus positivity rate for tests on packages was just 0.48 per 10,000, that proportion is increasing along with the number of tests being conducted, Li said.

She said the virus could “to some extent” be passed to humans from packaging, although neither Li or any other official at Wednesday’s news conference mentioned any such confirmed cases.

Chinese testing of packaging has stirred some controversy, with exporters of frozen food items questioning the science behind it and whether it amounts to an unfair trade barrier. China has defended the practice as an additional measure to prevent the virus's spread.

Through mask mandates, mass testing, lockdowns and case tracing, China has largely eliminated cases of local transmission, causing it to place extra attention on infection threats from outside the country. China's National Health Administration on Wednesday reported five new cases, all imported, bringing China's total to 86,469, including 4,634 deaths.

Stopping the virus's spread is “like fighting a war," demanding fast, decisive action, CDC Chief Epidemiologist Wu Zunyou said.

“Victory only comes after the entire country is united in its efforts. On this front, technical strategy, strong leadership and coordinated action all play important roles," Wu said.

The coronavirus is known to be more stable in colder, dryer conditions, and disinfecting packaging at freezing temperatures creates “special challenges," said Zhang Liubo, chief disinfection officer for the Center for Disease Control.

Even when disinfection works and the virus is no longer infectious, remnants can remain on the packaging, leading to a positive test, Zhang said.

However, “as of present, we have yet to discover any infection caused by direct consumption of products from this cold chain," Zhang said.

8:24 PM on 11/24/20

(AP) Tennessee’s governor says that once coronavirus vaccines become available, they will be optional in the state’s K-12 public schools.

Gov. Bill Lee said Tuesday that vaccines will be very important for Tennessee to “ultimately really be able to handle” the pandemic. But he says he doesn’t foresee vaccine mandates for school districts in Tennessee.

In his words, “Vaccines are a choice and people have the choice and will have the choice in this state as to whether or not they should take that vaccine.”

The state’s health commissioner says the first doses could arrive in Tennessee around Dec. 15. The first wave will be reserved for frontline health care workers and first responders. She says widespread availability would likely be in late spring or early summer.

7:23 PM on 11/24/20

The American Hospital Association, American College of Surgeons, American Society of Anesthesiologists, and Association of periOperative Registered Nurses Tuesday updated their “Joint Statement: Roadmap for Maintaining Essential Surgery during COVID-19 Pandemic.”  

The document offers guidance for organizations as they try to balance the need to care for COVID-19 patients and resume other service lines. The groups focused on eight principles: 
1. Regional Cooperation Critical to Continuing to Provide Essential Surgery
2. Supply Chain
3. COVID-19 Testing within a Facility
4. Personal Protective Equipment 
5. Case Prioritization and Scheduling
6. COVID-19 Issues for the Five Phases of Surgical Care
7. Collection and Management of Data 
8. COVID-related Safety and Risk Mitigation 

The full document is available here.

3:18 PM on 11/24/20

(AP) Ford Motor Co. bought a dozen ultra-cold freezers to store a COVID-19 vaccine that —once available— will be distributed to employees on a voluntary basis.

The Dearborn-based automaker said the freezer purchase is the first step in a broader vaccine distribution plan, The Detroit News reported Tuesday.

“The health and safety of our workforce is our top priority,” Ford spokeswoman Kelli Felker said Tuesday.

“We’ve got a lot of safety protocols we have in place right now that are requirements in our plants and facilities,” Felker added. “This would be another layer on top of what we’re already doing to help keep our employees safe. We do take COVID very seriously.”

General Motors hasn’t bought any freezers for vaccine storage but said it’s taking steps to make a vaccine available to its employees, according to The Detroit News.

At least three major drug companies have reported late-stage data for a potential COVID-19 vaccine as the world waits for scientific breakthroughs that will end a pandemic that has pummeled the world economy and led to 1.4 million deaths.

Ford worker Dvaughn Fisher, 25, of Monroe told The Detroit News that he’s not yet ready to trust any COVID-19 vaccine.

“It’s too soon,” said Fisher, who works the line at Ford’s Dearborn truck plant. “I won’t be taking it from Ford. Ford owns a truck plant. It’s not a hospital or a medical center. I keep my distance, keep my mask on, glasses, and clean up when I get home.”

Having a plan to administer vaccines once they’re available makes “a lot of sense— to keep the assembly line and development processes rolling along,” Ann Arbor-based Center for Automotive Research President Carlo Bailo told the Detroit Free Press.

“This is not the first time that the companies have done health checks or even offered health facilities on site. It used to be standard,” Bailo said.

1:59 PM on 11/24/20

(AP) Arizona on Tuesday reported more than 4,000 new COVID-19 cases for the fourth time within six days as the surge in the outbreak doubled the state's seven-day rolling average of new cases in the past two weeks.

The Department of Health Services reported 4,544 new cases and 51 new deaths, bringing the state’s totals to 306,868 cases and 6,515 deaths.

The seven-day rolling average of new cases went from 1,651 on Nov. 9 to 3,630 on Monday. according to data from The COVID Tracking Project.

The number of known infections is thought to be far higher because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

Virus-related hospitalizations also continued to increase, reaching 2,084 as of Monday, including 474 patients in intensive care unit beds.

State data indicated that 11% of ICU beds were vacant Tuesday, up from 10% on Sunday and Monday, but far below the 26% that were empty on Sept. 26 before the surge.

11:31 AM on 11/24/20

(AP) Indian Prime Minister Narendra Modi has urged states that are witnessing a surge in coronavirus cases to establish cold storage facilities for COVID-19 vaccines.

Modi’s Tuesday meeting with state leaders came as India’s total infections soared past 9.18 million. More than 134,000 Indians have died due to COVID-19.

Modi said his government is keeping track of vaccine development in the country and is in touch with vaccine developers across the world. He says “our priority is to make the vaccine available for all,” Modi said.

India is home to some of the world’s biggest vaccine makers and there are five vaccine candidates under different phases of trial here. But the state-run cold chain facilities used to keep some vaccines consistently refrigerated would be inadequate for the enormous challenge of rolling out a COVID-19 vaccine.

To address this issue, Modi’s government is augmenting the cold chain and transport mechanism for the vaccines. It is also readying a database of healthcare and frontline workers who will be inoculated first.

9:07 AM on 11/24/20

(AP) A Maine medical supplies manufacturer has been awarded more than $11 million from the federal government to produce millions more testing swabs.

Puritan Medical Products of Guilford received the money through the federal Paycheck Protection Program and Health Care Enhancement Act, said Republican Sen. Susan Collins on Monday. The company will increase its production of swabs by three million per month, Collins said.

Puritan has played a major role in the U.S.'s efforts to conduct enough testing to help corral the coronavirus pandemic. The White House announced in June that the federal government was providing more than $75 million for Puritan to double its production to 40 million swabs per month.

The company's total production of flock tip swabs and foam swabs is at least 90 million per month now, Collins said.

“Increased testing is crucial to tracking and slowing the spread of COVID-19 and keeping our communities safe," she said.

9:09 PM CT on 11/23/20

(AP) New Mexico on Monday started offering limited saliva testing as health officials look to boost the state's capacity for COVID-19 testing while spread of the virus remained unchecked and hospital administrators renewed their pleas for people to stay home for the holidays and refrain from family gatherings.

The Health Department rolled out the FDA approved testing method at one of Albuquerque's largest testing sites Monday. The agency expects about 2,000 of the tests to be done per day at the site once the program is underway and it could be expanded to several other locations in the coming weeks based on the level of positivity and demand.

The method — recommended for asymptomatic individuals — involves swabbing the mouth to collect a saliva sample. The tests will be self-collected, with trained personnel present to ensure samples are properly collected.

Acting Health Secretary Billy Jimenez said the state is looking for better and more innovative ways to serve New Mexicans amid the pandemic.

“We are excited to provide faster, more convenient methods of COVID-19 testing to the public," he said. "The saliva test is less invasive to clients, reduces exposure to healthcare workers, alleviates some of the strain on our labs and will hopefully reduce the burden of PPE usage in our state.”

The state for the past week has been averaging close to 12,000 tests per day but officials have said that would need to double in order to get a better handle on limiting spread. New testing sites have opened up, but Gov. Michelle Lujan Grisham warned during a recent briefing that there aren't enough medical professionals to administer tests as more New Mexicans request them.

State agencies have put out the call for volunteers to help with duties such as opening test kits, running test results to medical personnel and managing traffic at testing sites. In Albuquerque, the fire department has regularly been seeking volunteers from its ranks to work at test sites.

State officials on Monday also acknowledged the lag in the turn-around time for results. Whether positive or negative, they're planning to notify people via text and email to close the gap.

In the past, only those who tested negative and opted into receiving test results via text and or email were notified in this manner. Those who tested positive received a phone call.

Jimenez said people who have been exposed need to isolate themselves until they get their results.

“The virus is so widespread in our state right now that everyone should assume they — and everyone they come into contact with — has been infected,” he said.

8:05 PM on 11/23/20

(AP) The federal prison system will be among the first government agencies to receive the coronavirus vaccine, though initial allotments of the vaccine will be given to staff and not to inmates, even though sickened prisoners vastly outnumber sickened staff, according to documents obtained by The Associated Press.

Officials at the federal Bureau of Prisons have been instructing wardens and other staff members to prepare to receive the vaccine within weeks, according to people familiar with the matter. The people could not discuss the matter publicly and spoke to the AP on condition of anonymity.

The internal Bureau of Prisons documents, obtained by the AP, say initial allotments of the vaccine “will be reserved for staff.” It was not immediately clear how many doses would be made available to the Bureau of Prisons.

As of Monday, there were 3,624 federal inmates and 1,225 Bureau of Prisons staff members who have tested positive for COVID-19.

Since the first case was reported in March, 18,467 inmates and 1,736 staff have recovered from the virus. So far, 141 federal inmates and two staff members have died.

There have been more than 12 million cases in the U.S. and over 257,000 deaths. But prisons are a particular concern because social distancing is virtually nonexistent behind bars, inmates sleep in close quarters and share bathrooms with strangers. In the early days of the pandemic, prisoners and staff members said the Bureau of Prisons had run short of even the most basic supplies, like soap.

The internal Bureau of Prisons records obtained by the AP also detail how the agency has been working with the Centers for Disease Control and Prevention and the Trump administration’s vaccine program, known as “Operation Warp Speed,” to secure the vaccines. The documents say the administration’s initial distribution will include the federal prison system.

Health officials have been warning for more than a decade about the dangers of epidemics for those incarcerated.

Nearly 25% of all inmate cases and 30% of the staff cases have been reported within just the last month. Some staff members said they are apprehensive about receiving the vaccine because of what they feared was a lack of long-term testing and possible side effects.

Though the virus is also rising in state prisons nationwide, any plans for administering doses in those prisons would be handled by the states.

5:14 PM CT on 11/23/20

(AP) More than 100 contracted medical staff have arrived in Montana to assist hospitals in responding to the spike in COVID-19 cases, Gov. Steve Bullock announced Monday.

The 110 healthcare workers are part of an anticipated total of 200 to be deployed in the state before Thanksgiving and who will remain until the end of the year. The governor's office requested a total of 278 medical staff, spokesperson Marissa Perry said.

The workers, including registered nurses and respiratory therapists from around the country, will aid hospitals that are at or near capacity as part of a contract between the state and NuWest, which provides traveling healthcare workers.

Nurses are being paid $88 an hour along with $1,057 for expenses each week and a $500 relocation payment, according to NuWest’s ad for nurses in Montana.

The total cost of the contract will be driven by need, and the expense may be eligible for reimbursement from the Federal Emergency Management Agency. The governor's office anticipated 75% of the costs to be reimbursed by FEMA while the remaining 25% will be covered by federal coronavirus relief funds, Perry said.

“The situation in Montana is serious. Hospital capacity is stressed and our health care workers are exhausted, with many unable to work from being exposed to the virus,” Bullock said in a statement.

Most nurses are assigned to Benefis Health System in Great Falls, Billings Clinic and St. Vincent Healthcare in Billings, and Kalispell Regional Medical Center. Medical staff are also being deployed to hospitals in Bozeman, Missoula, Great Falls, Livingston and Butte.

Hospitals in Great Falls were at 82% capacity and those in Billings were at 88% capacity, the state reported. Last week, hospitals in those cities were above 90% capacity.

The workers will help fill in for nurses who are ill or in quarantine due to exposure to the virus, Perry said.

State health officials reported 677 new cases of COVID-19 Monday, bringing the total number of confirmed cases since the onset of the pandemic to more than 56,000. Over 460 people were hospitalized Monday.

It is likely there are far more cases because not everyone is tested and studies show some people can have COVID-19 without having symptoms. The state has seen at least 614 deaths, officials reported.

4:23 PM CT on 11/23/2020

(AP) Hospital beds across Missouri are nearly four-fifths full, and capacity is even more limited in intensive care units as the coronavirus pandemic continues its autumn surge.

The Missouri Department of Health and Senior Services on Monday cited 2,805 hospitalizations statewide -- double the number from a month ago. The state’s COVID-19 dashboard notes that just 21% of capacity remains at hospitals, and ICU capacity is down to 17%.

Healthcare leaders across the state are urging Missourians to wear masks, and many are warning that people should avoid large gatherings -- even family gatherings -- on Thanksgiving.

The pandemic is taking a toll on travel. While Lambert Airport in St. Louis is seeing increased passengers this week, overall numbers are expected to fall well short of what is typical for the days around Thanksgiving.

The state reported 3,370 new confirmed cases and two more deaths on Monday. All told, Missouri has reported 274,897 confirmed cases and 3,561 deaths since the pandemic began. The seven-day positivity rate is 20.4%.

2:01 PM CT on 11/23/2020

(AP) The head of emergencies at the World Health Organization says it’s “extremely important” for its international team to visit China to look into the origins of the coronavirus, saying the U.N. health agency has been reassured such a trip will happen “as soon as possible.”

Dr. Michael Ryan said such a visit is needed so that “the international community can be reassured of the quality of the science” that he lamented has been increasingly questioned for political ends — including pressure and threatening e-mails against scientists.

“Clearly, we all need to understand the origin of the virus. We all need to understand where it has come from, not least to understand where it may re-emerge in the future,” Ryan told a news conference from Geneva. “I believe our Chinese colleagues are just as anxious to find those answers as we are.”

Ten months after its declaration that COVID-19 represented an international public health emergency, WHO is still working to deploy an international team of experts to China to visit the suspected epicenter in the city of Wuhan and surrounding Hubei province.

11:10 AM CT on 11/23/2020

(AP) Chinese authorities are testing millions of people, imposing lockdowns and shutting down schools after multiple locally transmitted coronavirus cases were discovered in three cities across the country last week.

As temperatures drop, widescale measures are being enacted in Tianjin, Shanghai and Manzhouli, even though the number of new cases remains low compared to the United States and other countries that are seeing new waves of infections.

Experts and government officials have warned that the chance of the virus spreading will be greater in cold weather. Recent flareups have shown that there is still a risk of the virus returning, despite being largely controlled within China.

On Monday, the National Health Commission reported two new locally transmitted cases in Shanghai over the previous 24 hours, bringing the total to seven since Friday. China has recorded 86,442 cases overall and 4,634 deaths since the virus was first detected in the central Chinese city of Wuhan late last year.