Coronavirus outbreak: 'Chaotic': Oregon braces as COVID vaccine opens for elderly

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4:16 PM on 2/5/21

(AP) Oregon health officials say they are expecting chaos next week, when about 167,000 people who are 80 years or older will become eligible for the COVID-19 vaccine.

In preparation for the drastic increase of eligible people, Gov. Kate Brown announced Friday that 30 additional National Guard members will be deployed to help field calls and texts from seniors signing up and seeking information on vaccinations.

“It’s probably going to be pretty chaotic here,” Director Patrick Allen told The Associated Press Thursday night. “We are probably going to have phone lines that are hard to get through on. We are going to have scheduling systems that are going to be hard to get appointments.”

Beginning Feb. 8, Oregonians who are 80 or older will be eligible for the vaccine. The week of Feb. 15, seniors 75 and older will be eligible eligible. The week of Feb. 22, seniors 70 and older will be eligible. Lastly, the week of March 1, seniors 65 and older will be eligible.

Oregon officials opted to prioritize teachers before the elderly for COVID vaccinations in an attempt to get children back to in-person learning faster.

Gov. Brown said Oregon's phased approach for the elderly will help avoid the “nightmare” of extensive lines and wait times occurring in other states.

“Every state has had challenges with the vaccine rollout,” Brown said. “In New York seniors who signed up for vaccine appointments had them rescinded due to lack of supply.”

In total by early March, around 700,000 seniors in Oregon will be eligible for the vaccine.

Allen said the Oregon Health Authority has been working with counties to make sure seniors have access to the vaccine, although signing up for an appointment will vary from community to community.

While 211info, Oregon and Southwest Washington’s information referral line for health and human services, is available, the health authority is launching an additional online tool on Monday.

The online tool is where caregivers or family members of Oregon seniors can to sign up their elderly family member for a vaccine.

“We are trying to surround the people, who help seniors, with the information they need so that if the seniors themselves aren’t able to navigate the systems – the people around them know what to do,” Allen said.

In addition, health officials are distributing information to clinics, home care agencies and advocacy groups. Along with mass vaccination sites, vaccines will also be administered to local practices and public health facilities, drive-thru centers and mobile sites.

While Feb. 8 may draw pandemonium, health officials did have good news — the state is ahead of the original projected vaccine timeline projection.

“The fact of the matter is the federal supply has now improved such that we think we are going to be able to be through 75% of everybody who is eligible now, including seniors, which is about 1.3 million people by early April,” Allen said.

2:20 PM CT on 2/5/2021

(AP) The NFL is telling the federal government it will make the remaining of the league's 30 stadiums available as COVID-19 vaccination sites, joining the seven facilities already administering the vaccine.

In a letter to President Joe Biden obtained by The Associated Press on Friday, NFL Commissioner Roger Goodell said many of the stadiums should be able to get vaccination efforts moving quickly because of previous offers to use stadiums as virus testing centers and election sites.

The seven clubs already using their stadiums as vaccine sites are Arizona, Atlanta, Baltimore, Carolina, Houston, Miami and New England.

“We look forward to further discussion with your administration as well as your partners in state and local governments to advance this effort,” Goodell wrote to Biden in a letter dated Thursday.

Goodell said the offer on vaccination sites was made in conjunction with the NFL inviting 7,500 vaccinated health care workers to attend the Super Bowl for free Sunday. Kansas City is playing Tampa Bay in the Buccaneers' home stadium.

“Our efforts will not stop there,” Goodell wrote to Biden in extending the offer on stadiums.

Biden took office last month with a goal of vaccinating 100 million people in the first 100 days of his administration.

11:11 AM CT on 2/5/21

(AP) The U.K. government announced Friday that it plans to work with a German biopharmaceutical company to develop vaccines targeting emerging variants of COVID-19 as public health officials call for new tools to keep the virus in check as it mutates.

As part of the deal, Tuebingen, Germany-based CureVac said it would supply the U.K. with 50 million doses of the vaccines if they are approved by regulators and that it would manufacture the shots in Britain. The government didn't say how much it was investing in the project.

The announcement comes as public health officials around the world raise concerns about new virus variants that are more contagious or resistant to existing vaccines. While viruses mutate constantly, most of the changes cause little concern. But scientists are closely tracking these mutations to make sure they quickly identify variants of concern.

“While the vaccines currently being deployed in the U.K. appear to work well against the COVID-19 variants currently dominant in the UK, the virus continues to mutate and it is likely that our vaccines will have to adapt to continue to offer the best possible protection,″ said Jonathan Van-Tam, England's deputy chief medical officer.

“Being able to create these new vaccines at speed will allow our scientists to keep ahead of the virus as they do every year with the influenza vaccine.”

Earlier this week, drugmaker GlaxoSmithKline said it planned to invest 150 million euros ($181 million) in CureVac's effort to target new variants of COVID-19 using its messenger RNA technology. CureVac said Friday that its collaboration with the U.K. will support both its work with GSK and the vaccine candidate it is developing with Bayer that is already in human trials.

The U.K. has aggressively supported the development of potential vaccines as it battles Europe's deadliest COVID-19 outbreak. The government has invested over 300 million pounds ($410 million) in vaccine development and acquired 407 million doses of seven different vaccines.

CureVac said its collaboration with the British government will help the company quickly identify new variants and design vaccines to combat them. The U.K. is a leader in identifying and tracking new variants, sequencing the genetic code of 10% of positive COVID-19 specimens, compared with about 1% in the U.S.

“One of the biggest challenges we continue to face in combatting COVID-19 is the emergence of multiple variants, each of which poses a potentially significant threat to public health," Dr. Antony Blanc, CureVac's chief commercial officer, said in a statement.

“The U.K. government and it's Vaccines Taskforce has been at the forefront of surveillance, vaccine development and delivery of vaccines for deployment during this pandemic."

9:19 AM CT on 2/5/21

(AP) Desperation mounted in Mexico Thursday as the country runs out of coronavirus vaccines, a government registration website crashed for a third straight day and restaurant workers protested virus restrictions they say are driving them into poverty.

Hundreds of cooks, waiters and other restaurant employees gathered at Mexico City's Revolution Monument in their uniforms Thursday, banging cooking pots and chanting “Either we open, or we die!”

Mexico City allows only take-out service, with open air-dining allowed at some restaurants that have outside space. But employees say that business isn’t enough to keep them going.

Hospitals in Mexico City are over 80% full, and many people are dying because ambulance drivers say it takes them hours to find an available bed. Many families are treating sick relatives at home.

The Mexican Social Security Institute said Thursday it is investigating a disturbing video purportedly showing a man dying outside the closed glass doors of a public hospital this week as relatives fruitlessly beg staff to help him.

It said three employees are under investigation for the apparent refusal to provide care. The man did not appear to have COVID-19, but the overload of coronavirus cases has affected care for people suffering from other illnesses.

The country posted a near-record daily COVID-19 death toll of 1,682 Thursday, bringing the total to 162,922. Authorities also announced that about five cases of the U.K. variant had been found in Mexico, some apparently through local transmission.

The one bit of good news was that President Andrés Manuel López Obrador posted a video Thursday saying he had tested negative on an antigen test, after testing positive for COVID-19 about 12 days ago.

“I am well now,” López Obrador said, walking down a flight of stairs in the National Palace to prove his point. He did not say when he would end his isolation and return to public appearances.

Mexico is scrambling to line up shipments of the Pfizer and Russian Sputnik vaccines, but no new doses are expected to arrive until mid-month.

For the third straight day, millions of Mexicans who tried to register for vaccines when they do arrive were met with a non-functional website. Authorities have said the number of people seeking to register overloaded the government web page and its servers.

The official advice since the site was launched Tuesday has been to keep trying.

But even to find out the site wasn’t working, Mexicans still had to pass a Captcha “I am not a robot” test in English, asking them to pick out photos of objects like curbside fire hydrants that don’t exist in Mexico, or objects like chimneys that look very different in Mexico.

While the site at least now loads — on Wednesday it simply returned a server error message — the holdup now appears in the link to another government agency that has to check official ID numbers. That agency spends hours “checking” registration requests, only to return a message of “no response.”

“They had months to prepare for the demand that would happen, but as always, they didn't do it,” columnist Hectór de Mauleón wrote in the newspaper El Universal, describing his 20-hour ordeal of trying to get the page to work.

8:25 PM CT on 2/4/21

(AP) The long-term care industry is calling on Pennsylvania to devote more of the state’s share of COVID-19 vaccine to nursing homes, personal care homes and assisted living facilities, saying the Wolf administration isn’t moving quickly enough to vaccinate the state’s most vulnerable residents.

Appearing at a state Senate hearing Thursday, industry representatives said the Health Department is directing less than 20% of the state’s weekly allotment to facilities that care for older adults, forcing many desperate residents to wait weeks or months for the vaccine.

Residents of long-term care facilities — along with health care workers — are supposed to be at the front of the line to get vaccinated, but the state projects it could be mid-April before that mission is complete.

Elder-care executives said that's not good enough, noting that people who live in congregate care settings have borne the brunt of the coronavirus pandemic.

“We live in fear every day, because every day has the potential of being another outbreak. The vaccine is our hope,” said Suzanne Owens, president and CEO of Peter Becker Community, a retirement community outside Philadelphia.

“We need an increased, ongoing allocation,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, an industry group representing more than 500 elder-care providers. “Because 20% just doesn't cut it.”

Across Pennsylvania, nearly 64,000 residents of nursing and personal care homes have contracted the virus to date. About 11,500 have died, representing more than 50% of the statewide toll, according to the Health Department.

Sen. John Yudichak of Luzerne County, an independent who caucuses with the GOP, complained that neighboring Ohio and New York have each vaccinated tens of thousands more long-term care residents than Pennsylvania, whose population is one of the oldest in the nation.

“The numbers here in Pennsylvania do not tell a good tale,” he said.

Alison Beam, recently tapped by Democratic Gov. Tom Wolf as acting health secretary, replied to Yudichak that vaccinating residents of long-term care facilities “has come first and foremost" since the shots became available in December.

Like nearly every other state, Pennsylvania relies on a federal government partnership with CVS and Walgreens to administer the vaccine at long-term care facilities.

Beam said the state is directing as many doses to the drugstore chains as they say they need, suggesting those companies are not devoting sufficient resources to the effort. She pledged to exert pressure on CVS and Walgreens to go faster.

“If they're not going at the pace that Pennsylvania requires and really should rise to the challenge of, then we are the ones who can hold them ultimately accountable for that,” Beam told senators.

She added the Health Department is meeting with the chains to “outline our expectations, our accountability, and make sure that they move as quickly as possible to deliver on that mission.”

Walgreens had no immediate comment.

In a statement, CVS spokesperson Matt Blanchette said that “criticism that our long-term care vaccination program is slow or behind schedule in the state of Pennsylvania is misinformed and not accurate.”

CVS has met targets agreed to by the state, completing 92% of second doses at nursing homes and 71% of first doses at assisted living and other long-term care facilities, Blanchette said.

While CVS began giving shots at nursing homes in December, Blanchette noted that Pennsylvania only began allowing the pharmacy chain to start holding vaccine clinics at other types of long-term care facilities on Jan. 18 — three weeks later than in other states.

6:15 PM CT on 2/4/21

(AP) Desperation mounted in Mexico Thursday as the country runs out of coronavirus vaccines, a government registration website crashed for a third straight day and restaurant workers protested virus restrictions they say are driving them into poverty.

Hundreds of cooks, waiters and other restaurant employees gathered at Mexico City's Revolution Monument in their uniforms Thursday, banging cooking pots and chanting “Either we open, or we die!”

The city — where hospitals are over 80% full — allows only take-out service, with open air-dining allowed at some restaurants that have outside space. But employees say that business isn't enough to keep them going.

Even as Mexico scrambles to line up shipments of Russia’s Sputnik vaccine, no new doses are expected to arrive until mid-month.

Millions of Mexicans who tried to register for vaccines when they do arrive were met with a non-functional website. Authorities have said the number of people seeking to register overloaded the government web page and its servers.

The official advice since the site was launched Tuesday has been to keep trying.

But even to find out the site wasn’t working, Mexicans still had to pass a Captcha “I am not a robot” test in English, asking them to pick out photos of objects like curbside fire hydrants that don’t exist in Mexico, or objects like chimneys that look very different in Mexico.

While the site at least now loads — on Wednesday it simply returned a server error message — the holdup now appears in the link to another government agency that has to check official ID numbers. That agency spends hours “checking” registration requests, only to return a message of “no response.”

“They had months to prepare for the demand that would happen, but as always, they didn't do it,” columnist Hectór de Mauleón wrote in the newspaper El Universal, describing his 20-hour ordeal of trying to get the page to work.

Interior Secretary Olga Sánchez Cordero, who is filling in for President Andrés Manuel López Obrador while he recovers from COVID-19, acknowledged Thursday that “the service has experienced an overload, due of course to the great hopes of getting registered for a vaccine.”

“This overload of course will not affect the vaccination, but its is important that we continue with the registration,” she said.

3:00 PM CT on 2/4/21

(AP) The state said no Thursday to New York City's bid to start vaccinating more people against COVID1-9 by using shots reserved for second doses.

Mayor Bill de Blasio has repeatedly suggested the idea and formally asked the state Wednesday for permission. He argues the strategy would provide more people at least some protection, even if it meant delaying the second part of the two-shot regimen for some people.

“Isn’t it the moral thing to do to maximize first doses? And then we’ll double back on second doses, for sure, even if we stretch out the timeline at little bit,” the Democratic mayor said at a virtual news conference Thursday. He said the city would nonetheless ensure it kept “the supply necessary to keep up with those second doses."

State Health Commissioner Dr. Howard Zucker quickly turned de Blasio down.

The federal Centers for Disease Control hasn't recommended it, and it would “create undue anxiety” for people awaiting second doses, Zucker said in a letter to de Blasio.

“People have worked very hard to get a vaccination appointment, and there is much public anxiety that second doses will not be available on their appointment date,” the commissioner wrote Thursday.

New York City had roughly 140,000 first-dose shots and 321,000 second doses on hand Thursday, according to city statistics. As many as 220,000 doses a week were administered during a peak point last month, but the mayor has said the number could rise to 500,000 if enough supply was available.

The British government has delayed second doses in order to get more first shots into arms, as the U.K. tries to contain a new, more transmissible virus variant first identified in southeast England. Other European countries have criticized Britain's approach as risky.

Some health experts in the U.S. have suggested officials should at least consider the British strategy, but there is debate among experts. Dr. Anthony Fauci, the nation's top infectious disease expert, was cool to the idea in a CNN interview Thursday.

The federal CDC said last month that doses could be given up to six weeks apart if the recommended interval — three weeks for Pfizer's vaccine, four weeks for Moderna's — isn't feasible. The CDC said it continued to recommend that people get the second dose as close as possible to the recommended time.

If the CDC at some point does recommend tapping second dose stockpiles to extend first shots to more people, Gov. Andrew Cuomo will put that into practice in New York, Zucker wrote.

Statewide, New York has used about 62% of the vaccine doses delivered to the state, according to federal data. About 8% of New York residents have received at least a first dose, according to the CDC.

Both numbers are in line with the national averages.

1:35 PM CT on 2/4/21

(AP) Dr. Amy Acton, the former state health director who became the face of Ohio's early pandemic response, has stepped down from her nonprofit position to “carefully explore” running as a Democrat for the U.S. Senate, she said Thursday.

Acton would be vying for a coveted open seat being vacated by Republican U.S. Sen. Rob Portman, who cited divisive national politics in a decision not to seek reelection next year after twice comfortably winning the seat by double-digit margins.

“Many Ohioans have shared with me their concerns and the daily challenges they face,” Acton said in a statement. “They have expressed a need for a new approach that can help them, and their communities thrive. I am humbled by the outpouring of interest and support. For that reason, I am stepping down from my role at The Columbus Foundation in order to carefully consider how I can best be of service at this crucial time.”

Acton's leadership working with Republican Gov. Mike DeWine in the state’s response to the COVID-19 pandemic made her something of a folk hero and role model for Ohio girls.

She also faced intense backlash over the restrictive health orders she signed, including having armed protesters show up outside her suburban home, and resigned in June. But Democratic insiders say she polls well as a possible statewide contender.

DeWine declined to comment on her potential candidacy while taking questions Thursday after a COVID-19 response update.

“I'm gonna stay out of Democrat primaries,” DeWine replied.

Portman’s surprise announcement Jan. 25 has triggered a frenzy among potential contenders — both Democratic and Republican — for what could have been a tough race against a well-funded GOP incumbent. A dozen or so Ohio politicians have already expressed interest in the 2022 Senate race, and some Democrats are advocating for the party to field a candidate who is a person of color, a woman or both.

Some influential Democrats are urging Acton to run even as early momentum appears to be building for the candidacy of veteran U.S. Rep. Tim Ryan, who represents Ohio’s blue-collar Steel Valley. Former Democratic Gov. Ted Strickland is solidly behind Ryan and Hillary Clinton, the party's 2016 presidential nominee, has also signaled her support for him on Twitter.

11:56 AM CT on 2/4/21

(AP) World Health Organization investigators looking for clues into the origin of the coronavirus in the central Chinese city of Wuhan said that the Chinese side has provided a high level of cooperation, but cautioned against expecting immediate results from the visit.

“I keep saying that we need to be realistic, a short mission like this one will not have all the answers but it helps advance the understanding of the #virusorigin #wuhan," Hung Nguyen-Viet, co-leader of the Animal and Human Health Program of the International Livestock Research Institute in Nairobi, Kenya, said in a tweet Thursday.

In an earlier tweet, zoologist and team member Peter Daszak praised Wednesday’s meetings with staff at the key Wuhan Institute of Virology, including with Deputy Director is Shi Zhengli, a virologist who worked with Daszak to track down the origins of SARS that originated in China and led to the 2003 outbreak.

“Extremely important meeting today with staff at WIV including Dr Shi Zhengli. Frank, open discussion. Key questions asked & answered.,” Daszak tweeted.

The team on Thursday spent around two hours meetings with managers and residents at the Jiangxinyuan community administrative center in Wuhan's Hanyang District. No details were given.

Official statistics shows that there were at least 16 confirmed COVID-19 cases in the community last year among nearly 10,000 people living there when the virus broke out.

Earlier, Daszak tweeted images of media outside the virology institute, saying: “Thanking the press for their patience and interest in getting this news out to the world. The work is moving ahead & we look forward to being able to talk about the results as soon as possible."

The Wuhan Institute of Virology has collected extensive virus samples, leading to unproven allegations that it may have caused the original outbreak by leaking the virus into the surrounding community. China has strongly denied that possibility and has promoted unproven theories that the virus may have originated elsewhere.

Along with the institute, the WHO team that includes experts from 10 nations has visited hospitals, research institutes, a traditional market tied to the outbreak and other sites.

Members of the team have met with institute researchers and management, experts, vendors, residents and media representatives, the spokesperson for China's National Health Commission, Mi Feng, told reporters at a briefing Thursday.

It is likely to take years and multiple investigations in many parts of the globe to confirm the origins of the virus because of the exhaustive research, including taking animal samples, genetic analysis and epidemiological studies required to pin down an outbreak’s animal reservoir. One possibility is that a wildlife poacher might have passed the virus to traders who carried it to Wuhan but that has yet to be proven.

9:44 AM CT on 2/4/21

(AP)  The Republican-controlled Wisconsin Assembly is scheduled Thursday to vote on repealing the statewide mask mandate issued by Democratic Gov. Tony Evers, but the order will remain in effect until the state Senate concurs.

That could happen as soon as Feb. 16, although Senate leaders have not said yet when or whether the vote will happen. The Senate voted last week to repeal the measure, as Republicans who control the Legislature continue to defy doctors, nurses, hospitals, schools, chambers of commerce and scores of others who have begged them to keep the mandate in place.

Republicans say the issue isn't about masks, but whether Evers can legally issue multiple emergency health orders during the pandemic. The Legislature argues he can’t and must get their approval every 60 days. Evers contends the changing nature of the pandemic allowed him to issue multiple orders and mask mandates.

Even if current emergency health order is repealed, Evers could issue a new one and another mask mandate.

The Supreme Court could end the legislative back and forth with a ruling that says Evers must get lawmakers’ approval every 60 days. The court could also say he doesn’t need approval, which would then force the Legislature to repeal every order Evers issues if Republicans disagree with it.

8:18 PM CT on 2/3/21

(AP) A state judge ordered New York's Department of Health to release records about nursing home residents who died of COVID-19 in a Wednesday ruling that said the agency's failure to do so already was a "violation" of New York's open government law.

Albany County Acting Supreme Court Justice Kimberly O'Connor also ordered Gov. Andrew Cuomo's administration Wednesday to pay legal fees for The Empire Center for Public Policy, a conservative-leaning, nonprofit think tank that filed suit demanding the release of the records last fall.

New York regularly releases the number of residents who died at individual nursing homes and assisted living homes after testing positive for COVID-19. But, unlike other states, it does not regularly give out that information for those residents who died at hospitals.

The Empire Center filed an Aug. 3 request for records about all long-term care residents who died of COVID-19.

Even though nursing homes have to file daily reports of all resident deaths, regardless of location, the Department of Health argued it needed months to compile records about long-term care residents who died at hospitals.

The judge ordered the Department of Health to release the information within five business days, and said the agency violated the state's Freedom of Information law by failing to provide a reasonable date to grant or deny the Empire Center's request.

6:28 PM CT on 2/3/21

(AP) — Missouri senators on Wednesday advanced a bill that would shield hospitals, manufacturers and other businesses from lawsuits over alleged wrongdoing during the coronavirus pandemic.

Senators gave the measure initial approval after hours of debate and negotiations.

The bill would prevent lawsuits against businesses unless someone can prove they were exposed there and sickened by the coronavirus and that the business was acting recklessly or committed willful misconduct.

Hospitals also would be shielded from lawsuits unless doctors commit "recklessness or willful misconduct," which is a legal standard that's more difficult to prove in court than the current liability standard they face.

The bill also would shield churches and other religious organizations from any lawsuits over exposure to COVID-19 unless the person who got sick can prove the organization committed intentional misconduct.

People hurt by defective masks or other virus-related products couldn't sue unless they prove the manufacturer acted with recklessness or committed willful misconduct that injured them.

Lawsuits for potential COVID-19 exposure or poor products would have to be filed within two years after someone is injured.

Proponents said hospitals overrun with sick patients and manufacturers that stepped up to make masks shouldn't be penalized for doing their best to help during a crisis.

"This bill ensures these businesses are protected, not punished, for their role in helping us weather this pandemic," said bill sponsor Sen. Tony Luetkemeyer, a Parkville Republican.

But bipartisan critics said the measure is aimed at helping big business owners and would hinder people's access to the courts if they were hurt by poorly made masks or other pandemic-related issues.

"We've got to make sure that we not create any law that prohibits someone's right to be heard in court," said Republican Sen. Bill Eigel, of Weldon Spring.

The measure needs another vote of approval in the Senate to advance to the House.

4:20 PM CT on 2/3/21

(AP) A U.N.-backed program to deploy COVID-19 vaccines to the neediest people worldwide, especially in poor countries, announced plans Wednesday for an initial distribution of 100 million doses by the end of March and 200 million more by July — hoping to catch up with rich countries that are already deep into rollouts.

Leaders of the COVAX Facility, which seeks a fair distribution of vaccines at a time of short supply, said nearly all of the doses expected for the initial-phase rollout are to come from British-Swedish drugmaker AstraZeneca and its partner, the Serum Institute of India.

Frederik Kristensen, deputy CEO for the Coalition for Epidemic Preparedness Innovation, a co-leader of the program, told a video news conference that the plans come at a "critical moment" in the fight against the virus as new variants emerged and a lopsided vaccine rollout so far — favoring rich countries.

"We are on a path to really start balancing out a global map, which so far has shown how many lower-income countries are yet to start vaccinating a single person, while other, wealthier countries go ahead towards mass vaccination," he said.

Dr. Seth Berkley, the CEO of GAVI, the Vaccine Alliance, said COVAX plans for the initial distribution of 336 million doses of the vaccine, which AstraZeneca developed with Oxford University, through June to dozens of countries.

GAVI expects that nearly one-third of those doses — nearly 100 million — will start being delivered to targeted countries by the end of March, officials said.

Another 1.2 million doses of the vaccine from U.S.-based Pfizer and German partner BioNTech are expected to be shared by 18 countries during the first quarter of the year. Those companies have already been selling and distributing their vaccine by the tens of millions to rich countries.

2:20 PM CT on 2/3/21

(AP)  President Joe Biden told House Democrats on Wednesday he's "not married" to an absolute number on his $1.9 trillion COVID rescue plan but Congress needs to "act fast" on relief for the pandemic and the economic crisis.

Biden also said he doesn't want to budge from his proposed $1,400 in direct payments that he said were promised to Americans.

"Look, we got a lot of people hurting in our country today," Biden said. "We need to act. We need to act fast. We need to restore the soul of the country."

On the direct payments, he said, "I'm not going to start my administration by breaking a promise to the American people."

The meeting with House Democrats and another later with Democratic senators came as the president steps up his public engagements with lawmakers on pandemic aid and an economic recovery package, together his first legislative priority and a test of the administration's ability to deliver. Biden's remarks to the Democratic House caucus were relayed by two people who requested anonymity to discuss the private conference call.

While Biden is trying to build bipartisan support from Republicans, he is also prepared to rely on the Democratic majority in Congress to push his top agenda item into law. Republicans object to his package as excessive, preferring a $618 billion alternative, but Biden panned that as insufficient even as he continues private talks with Republicans on potential areas of compromise.

With a rising virus death toll and strained economy, the goal is to have COVID-19 relief approved by March, when extra unemployment assistance and other pandemic aid measures expire. Money for vaccine distributions, direct payments to households, school reopenings and business aid are at stake.

House Democrats were told on the call with the president that they could be flexible on some numbers and programs, and could "better target" the direct payments, but should not back down on the size or scope of the aid.

"We have to go big, not small," Biden told the Democrats. "I've got your back, and you've got mine."

2:20 PM CT on 2/3/21

The California Department of Public Health on Monday imposed stricter requirements on its staffing waiver requirements.

Effective Feb. 1, the state's public health department stopped accepting expedited requests for staffing waivers, instead requiring hospitals to follow the standard waiver process. All existing staffing waivers will expire Feb. 8, unless the public health department deems there is an "unprecedented circumstance" for that hospital, according to a letter sent to general acute care hospitals.

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11:49 AM CT on 2/3/21

(AP)  Coronavirus infections and hospitalizations in California are plummeting weeks after it appeared some hospitals were so overwhelmed they might have to start rationing care, and the state's top health official said Tuesday if the trends continue by early March the number of hospital patients will fall by half.

When cases were surging at an unprecedented rate in early December state officials used plunging intensive care unit capacities to issue stay-home orders for most of California. The situation was the most dire in Southern California and the San Joaquin Valley regions, which exhausted all their regular ICU beds and stayed at 0% capacity through January.

But the capacity now has reached 9% in Southern California and 11% in the San Joaquin Valley and in four weeks the state projects the rates will increase to 44% and 35%, respectively. The other three regions of the state are in even better shape now.

All stay-home orders have been lifted, though all but four rural counties continue to be in the strictest of four tiers for reopening. Mountainous, sparsely populated Alpine and Trinity counties moved Tuesday to the tier for a "moderate" level of new transmissions.

California's worst surge of the pandemic started in mid-October and accelerated through the end-of-year holidays before peaking in early January and then starting a steep decline.

In just over three weeks, the number of statewide ICU patients has fallen from a record of just under 4,900 to about 3,800, while overall hospitalizations have dropped by a third. State models project that at this rate, the number of hospitalizations will fall from about 14,000 to around 6,500 a month from now.

In the last week, the state's rate of positive tests dropped to 6.4%, which Health and Human Services Secretary Dr. Mark Ghaly termed another "positive sign about the trajectory of transmission across the state."

9:30 AM CT on 2/3/21

(AP) Britain's health chief has hailed a new study suggesting that a single dose of the Oxford-AstraZeneca COVID-19 vaccine provides a high level of protection for 12 weeks, saying it supports the government's contentious strategy of delaying the second shot so it can protect more people quickly with a first dose.

Britain's decision has been criticized as risky by other European countries, but Health Secretary Matt Hancock said Wednesday that the study "backs the strategy that we've taken and it shows the world that the Oxford vaccine works effectively."

Hancock's comments came after Oxford University released a study showing the vaccine cut transmission of the virus by two-thirds and prevented severe disease.

Mene Pangalos, executive vice president of biopharmaceuticals research and development at AstraZeneca, said no patients experienced severe COVID-19 or required hospitalization three weeks after receiving a first dose, and that efficacy appeared to increase up to 12 weeks after the initial shot.

"Our data suggest you want to be as close to the 12 weeks as you can" for the second dose, Pangalos said during a news conference.

The study has not been peer-reviewed yet, and it did not address dosing of the Pfizer-BioNTech vaccine, the other one currently in use in the U.K. Pfizer recommends that its shots be given 21 days apart and has not endorsed the U.K. government's decision to lengthen the time between doses.

8:33 PM CT on 2/2/21

(AP) World Health Organization investigators on Wednesday visited a research center in the Chinese city of Wuhan that has been the subject of speculation about the origins of the coronavirus.

The WHO team's visit to the Wuhan Institute of Virology is a highlight of their mission to gather data and search for clues as to where the virus originated and how it spread.

One of China’s top virus research labs, the institute built an archive of genetic information about bat coronaviruses after the 2003 outbreak of Severe Acute Respiratory Syndrome. That has led to unproven allegations that it may have a link to the original outbreak of COVID-19 in Wuhan in late 2019.

China has strongly denied that possibility and has promoted theories that the virus may have originated elsewhere or even been brought into the country from overseas with imports of frozen seafood tainted with the virus, a notion roundly rejected by international scientists and agencies.

The institute's deputy director is Shi Zhengli, a virologist who worked with Peter Daszak, a zoologist on the WHO team mission, to track down the origins of SARS that originated in China and led to the 2003 outbreak. She has published widely in academic journalists and worked to debunk theories espoused by the former Trump administration and other American officials that the virus is either a bioweapon or a “lab leak” from the institute.

Following two weeks in quarantine, the WHO team that includes experts from 10 nations has visited hospitals, research institutes and a traditional wet market linked to many of the first cases. Their visit followed months of negotiations as China seeks to retain tight control over information about the outbreak and the investigation into its origins, possibly to avoid blame for alleged missteps in its early response.

Confirmation of the origins of the virus is likely to take years. Pinning down an outbreak’s animal reservoir typically requires exhaustive research including taking animal samples, genetic analysis and epidemiological studies. One possibility is that a wildlife poacher might have passed the virus to traders who carried it to Wuhan.

The first clusters of COVID-19 were detected in Wuhan in late 2019, prompting the government to put the city of 11 million under a strict 76-day lockdown. China has since reported more than 89,000 cases and 4,600 deaths, with new cases largely concentrated in its frigid northeast and local lockdowns and travel restrictions being imposed to contain the outbreaks.

New cases of local transmission continue to fall with just 15 reported on Wednesday as Chinese heed government calls not to travel for the Lunar New Year holiday later this month.

6:49 PM CT on 2/2/21

(AP) Idaho Gov. Brad Little is moving the state into Stage 3 of his coronavirus reopening plan, lessening restrictions on the size of group gatherings as the rate of COVID-19 infections continues to drop statewide.

Little made the announcement Tuesday, urging residents to stay vigilant in working to slow the spread of the virus.

“When we moved back to Stage 2 in November, case counts were spiking and hospitals were bracing for the worst,” Little said in a prepared statement. “Today, thanks to our collective good efforts, those case counts are much lower and trending downward. Idaho now has one of the lowest rates of spread in the nation.”

There were just under 434 new cases for every 100,000 Idaho residents in the past two weeks, ranking the state 35th in the country for new cases per capita, according to numbers from John Hopkins University. One in every 560 people in Idaho tested positive for COVID-19 in the past week.

The number of COVID-19 patients being admitted to intensive care units for treatment remains far higher than the 25-patient-per-day average that the Idaho Department of Health and Welfare has said would be needed to move the state out of Stage 2.

Currently, the state has 225 people hospitalized with COVID-19 related symptoms, according to The COVID Tracker, and the state averaged about 62 ICU coronavirus patients a day in the second half of January according to the most recent state data available.

Under Stage 3, gatherings should be limited to 50 or fewer people, instead of the previous 10-person limit. Political, religious, educational and health care related events are exempt from the size restriction, as are youth sports events as long as organizers follow guidelines set by the Idaho State Board of Education. Bars and nightclubs can continue to operate but patrons are expected to remain seated.

Masks are required at long-term care facilities, and are strongly recommended but not required elsewhere.

Idaho's vaccine allotment from the federal government remains lower than that of many other states, in part because the CDC is using older census data that doesn't reflect the state's dramatic recent growth, said Idaho Department of Health and Welfare Director Dave Jeppesen. He said state officials were talking to the federal government in hopes that Idaho's allocation will be increased to match the current population numbers.

“We're asking that as we go forward Idaho is getting its fair share of doses,” Jeppesen said during a media briefing Tuesday.

Demand for the vaccine remains high, with more than 265,000 Idaho residents 65 and older now eligible to be vaccinated. But the state is currently only getting about 25,000 “first doses” of the two-dose vaccine a week, and some older residents spent hours on hold with vaccine providers or repeatedly tried to set up appointments online, to no avail.

“Everyone 65 and older who wants the vaccine will be able to do so,” but it will take months to get everyone fully vaccinated, Jeppesen said.

Some of Idaho's vaccine allotment was given to pharmacy companies CVS and Walgreens through a federal partnership program to vaccinate staffers at long-term care facilities and nursing homes. The pharmacies still have about 32,000 unused doses, apparently partly because demand for the vaccine among that group was lower than expected, Jeppesen said. About 12,000 of those doses are being transferred to the state's control and officials are working to get the rest of them made available for the current vaccination group, he said.

Idaho has seen 1,735 COVID-19 related deaths to date, according to researchers from Johns Hopkins. That death count is the 41st highest in the country overall and the 38th highest per capita at 98.9 deaths per 100,000 people.

Idaho has reported 162,683 positive tests out of 603,115 tests conducted since the pandemic began, giving a positivity rate of 27.0%, according to the COVID Tracking Project.

4:21 PM CT on 2/2/21

(AP)  France will only administer the AstraZeneca coronavirus vaccine to people under age 65, President Emmanuel Macron said Tuesday after the government's health advisory body cited a lack of sufficient data about its effectiveness in older people.

The decision could shake up the French vaccination strategy, because the country has prioritized nursing home residents and people over 75. France had counted on the AstraZeneca vaccine for a large part of its upcoming inoculations, until the company announced delays affecting countries around Europe and the world.

"For this AstraZeneca vaccine, we will not propose it to those older than 65," Macron told TF1 television Tuesday night.

Instead, the vaccine the British-Swedish company developed with Oxford University will be given to medical personnel under 65, individuals with health vulnerabilities or those facing high exposure, he said.

The French practice differs from the guidance given by the European Medicines Agency, which authorized AstraZeneca's vaccine for use in all adults throughout the European Union on Friday, amid criticism the bloc is not moving fast enough to vaccinate its population.

Health authorities in Germany and other countries have raised concerns that the Anglo-Swedish company didn't test the vaccine in enough older people to prove it works for them, and indicated they would not recommend it for people over 65.

2:45 PM CT on 2/2/21

(AP) Authorities in Washington state on Monday told hospitals and other COVID-19 vaccine providers not to provide special access to people or risk having their supplies of doses cut.

“VIP scheduling, reserving doses for inequitable or exclusive access, and similar practices are banned and will not be tolerated,” the state Department of Health said in a email to all enrolled vaccine providers. “If we find out a provider is giving out vaccine inequitably or is doing behaviors listed above or similar, we may reduce or stop allocations to that provider.”

The Seattle Times has reported that three medical systems in the region — Providence Regional Medical Center, Overlake Medical Center & Clinics and EvergreenHealth — gave special vaccine access to big donors or foundation members.

Hospital officials have said they were testing scheduling software or trying to fill vaccine appointments quickly by using familiar contacts. Two of the organizations acknowledged they’d made a mistake in prioritizing influential people.

Currently in Washington state people aged 65 and older, and all people 50 and older who also live in a multigenerational household, can apply for appointments to get vaccinated.

Seattle Mayor Jenny Durkan last week urged the state to reallocate vaccine doses to poor people and minorities, something a spokesperson for Gov. Jay Inslee’s office said Friday was already in progress.

According to the health department more than 728,000 vaccine doses have been administered in Washington and more than 130,000 people are considered “fully vaccinated.” Washington’s population is more than 7.6 million.

2:45 PM CT on 2/2/21

Optum accidentally charged 249 Medicare Advantage enrollees for the COVID-19 vaccine.

The New Mexico Superintendent of Insurance Office said that the UnitedHealth Group subsidiary accidentally charged enrollees $34 for the administration of the vaccine and $0.05 for the vaccine itself. An Optum spokesperson said the company is contacting anyone who was sent an invoice to tell them that they do not need to pay any fees associated with the coronavirus vaccine, and all members who have already paid the bill will receive a refund.

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11: AM CT on 2/2/21

The Healthcare Information and Management Systems Society said its five-day annual conference is on track for August, according to a message sent to exhibitors Feb. 2.

“Like you, we are operating in a world where information continues to evolve and future plans need to adjust to changing conditions,” the message reads. “At this point in time, with several vaccines approved, and in distribution, we are planning for an in-person event in Las Vegas in August 2021.”

The 2021 health information and technology trade show will be a “completely reimagined hybrid event” with options for attendees to participate in-person or virtually.

HIMSS in July pushed back the 2021 conference from March to August, after canceling the 2020 event just days before it was slated to start as COVID-19 related shutdowns began in March. HIMSS faced pushback over its decision to not refund exhibitors and sponsors, and instead offer partial credit on 2021 and 2022 conference participation.

HIMSS in its message said it doesn’t have a set date to make a “go/no go decision” regarding the in-person conference.

“In coming months, we will better understand the global vaccine distribution rates, infection rates and the status of government regulations and advice on how best to proceed with a substantial convening,” the message reads. “We will advise our stakeholders on our decision-making process as all this comes into focus.”

HIMSS21’s attendee registration so far is comparable to previous years, according to HIMSS.

HIMSS has received more than 700 proposals to speak at sessions and more than 300 applications for reviewers, comparable to years past.

More than 400 exhibitors have committed to attending HIMSS21, nearly 65% compared to the same timeframe in previous years.

Nearly 10,000 hotel room dates have been reserved. “We can see our community is hopeful for an in-person event,” HIMSS wrote.

9:28 AM CT on 2/2/21

(AP)  Russian scientists say the country's Sputnik V vaccine appears safe and effective against COVID-19, according to early results of an advanced study published in a British medical journal.

The news is a boost for the shot that is increasingly being purchased by nations around the world who are desperate to stop the devastation caused by the pandemic.

Researchers say, based on their trial that involved about 20,000 people in Russia last fall, the vaccine is about 91% effective and appears to prevent people from becoming severely ill with COVID-19. The study was published online Tuesday in the journal The Lancet.

Scientists not linked to the research acknowledged that the speed at which the Russia vaccine was made and rolled out was criticized for "unseemly haste, corner cutting and an absence of transparency."

"But the outcome reported here is clear," British scientists Ian Jones and Polly Roy wrote in an accompanying commentary. "Another vaccine can now join the fight to reduce the incidence of COVID-19."

"This is a great day in the fight against the COVID-19 pandemic," said Kirill Dmitriev, CEO of the Russian Direct Investment Fund that bankrolled the development of the shot.

The Sputnik V vaccine was approved by the Russian government with much fanfare on Aug. 11. President Vladimir Putin personally broke the news on national television and said one of his daughters had already been vaccinated with it. At the time, the vaccine had only been tested in several dozen people.

Some early results on it were published in September, but participants had only been followed for 42 days and there was no comparison group.

The latest study is based on research involving about 20,000 people over 18 at 25 hospitals in Moscow between September and November, of whom three-quarters got two doses of the Russian vaccine 21 days apart and the remainder got placebo shots.

8:22 PM CT on 2/1/2021

(AP) Montana House lawmakers voted Monday to advance a bill that would protect businesses and health care providers from coronavirus-related lawsuits, a step the Republican governor said was necessary to remove a statewide mask mandate.

Gov. Greg Gianforte endorsed the move last week during his State of the State address, saying it would allow businesses to safely open during the pandemic and move “away from impractical government mandates.” He has also said more vulnerable Montana residents would have to receive COVID-19 vaccines before he lifts the mask mandate put in place by his Democratic predecessor.

As of Monday, almost 27,000 Montana residents — representing 2.5% of the state population — had received both doses of the COVID-19 vaccine.

Under the bill, businesses could not be sued by individuals exposed to the coronavirus on their premises, except in cases of “gross negligence” or when businesses intentionally spread the virus. Business owners would not be required to uphold federal or state mask requirements or temperature-check requirements if they remain in place.

The bill was advanced by the Republican-dominated House in a preliminary 66-33 vote largely along party lines. The House will vote on the bill for a third and final time later this week. The measure has already passed a vote in the Senate and could land on Gianforte’s desk next week.

Montana joins at least 20 other states that are considering protections against liability claims related to COVID-19 for businesses, health care providers and educational institutions, according to the National Conference of State Legislatures.

Proponents of the bill say it is necessary in order to reopen businesses that have not operated during the pandemic out of fear of being sued over their handling of the pandemic.

Opponents said the bill would give businesses immunity even if they put their customers and employees in danger of contracting the virus.

“This bill actually lets folks who are bad actors evade accountability for creating an unsafe workplace. It undermines businesses that have been responsible, have spent time and money creating a safe workplace for their employees, and it leaves thousands of Montana workers vulnerable,” said House Minority Leader Kim Abbott, a Democrat from Helena.

Rep. Mark Noland, a Republican from Bigfork, said the bill would prevent frivolous lawsuit relating to the pandemic as long as businesses owners are “making good faith efforts.”

6:33 PM CT on 2/1/2021

Maryland’s acting health secretary says the state’s hospitals have received less than half of their expected allocations of second doses of the coronavirus vaccine for front-line health workers this week.

Dennis Schrader on Monday attributed the discrepancy to the transition between presidential administrations in Washington.

Schrader says state officials were talked with the federal Department of Health and Human Services all weekend trying to figure out what happened. He says that “they haven’t been able to put their finger on what the issue is.”

An HHS spokesman says that “no allocations provided to states have changed or lowered.”

4:18 PM CT on 2/1/21

(AP) The White House is tamping down expectations for a potential boost in vaccine distribution if Johnson & Johnson’s COVID-19 shot is approved by federal regulators.

Andy Slavitt, the White House’s deputy COVID-19 coordinator, told reporters that the single-dose shot would undoubtedly help the Biden administration meet its goal of 300 million vaccinated Americans by the end of summer. But he says: “The expectation should not be that there’s an immediate, dramatic shift.”

The pharmaceutical company reported strong results for the efficacy of its vaccine on Friday and is expected to file for emergency use authorization from the Food and Drug Administration in the coming days.

Johnson & Johnson is contracted to provide 100 million doses by the end of the second quarter.

Slavitt says he did not anticipate an even distribution, but that most doses “would come towards the end of that contract.”

2:19 PM CT on 2/1/21

(AP) President Joe Biden is to meet on Monday with a group of 10 Republican senators who have proposed $618 billion in coronavirus aid, about a third of the $1.9 trillion he is seeking as congressional Democrats are poised to move ahead without GOP support.

The Republican group's proposal focuses on the pandemic's health effects, tapping into bipartisan urgency to shore up the nation's vaccine distribution and vastly expanding virus testing with $160 billion in aid. That's the same as Biden's proposed total, while their slimmed down $1,000 direct payments would go to fewer households than the $1,400 Biden has proposed, and they would avoid costly assistance to states and cities that Democrats argue are just as important.

Gone are Democratic priorities such as a gradual lifting of the federal minimum wage to $15 an hour.

Engaging the White House in high-profile bipartisan talks is certain to appeal to Biden's wish to unify the nation. But Democrats are determined to push ahead with votes as soon as this week in the House and Senate on broader budget resolutions that will lay the groundwork for approving a COVID relief bill with their new majority in Congress.

The goal is for COVID passage by March, when extra unemployment assistance and other pandemic aid expires.

White House press secretary Jen Psaki said there is "obviously a big gap" between the $1.9 trillion package Biden has proposed and the $618 billion counteroffer.

Psaki said Monday that the meeting with Republican lawmakers would be an "exchange of ideas" but Biden would reiterate his stance that "the risk is not that it is too big, this package, the risk is that it is too small."

2:19 PM CT on 2/1/21

A congressional watchdog agency says the Trump administration failed to implement almost 90% of its recommendations for responding to the COVID-19 pandemic.

The U.S. Government Accountability Office says it is "deeply troubled" that federal agencies under the former administration did not apply 27 out of the 31 recommendations it made around fixing supply chain gaps and other areas of the pandemic that's killed more than 400,000 Americans. The agency's latest audit took place between August 2020 and Jan. 15, five days before President Biden took office.

READ MORE

11:28 AM CT on 2/1/21

(AP) About 2,700 people were able to use an online scheduling vulnerability to register out-of-turn for COVID-19 vaccinations, according to a Detroit-area healthcare system.

Beaumont Health said it has determined a user publicly shared an unauthorized pathway for scheduling.

“This allowed 2,700 people to ‘cut in line,’” the eight-hospital health system said Sunday in a release. “Beaumont is canceling all the appointments that used the unauthorized pathway. Individuals who scheduled an appointment using the unauthorized ‘backdoor’ pathway will be notified that their appointment has been canceled via the email they provided during the unauthorized scheduling process.”

Beaumont’s information technology team detected and shut down unusual activity Saturday on its Epic electronic medical record system. Personal medical records were not compromised, and users were not able to access hospital records, Beaumont said.

The issue will not affect properly scheduled vaccine appointments, it added.

Epic’s corporate office also was notified so it could communicate with other health systems to prevent this from occurring elsewhere.

“These appointments violate the ethical distribution framework Beaumont created based upon the state of Michigan’s mandatory vaccine guidelines,” said Hans Keil, Beaumont Health senior vice president and chief information officer. “We are also notifying the Michigan Hospital Association and other Michigan health systems about the issue.”

9:48 AM CT on 2/1/21

(AP)  Seeking to rebound from heavy criticism of its slow coronavirus vaccine rollout, the European Union said Monday that 18.5 million vaccine doses have been dispatched across the 27-nation bloc amid delays and disputes in the delivery schedule.

Speaking at a press conference, the EU Executive Commission's health policy spokesman, Stefan de Keersmaecker, said 17.6 million of the doses have been provided by Pfizer-BioNTech, with the remainder delivered by Moderna.

The EU, which has 450 million people, has signed deals for six different vaccines and invested 2.7 billion euros ($3.8 billion) in vaccine development as part of an "advanced purchase agreement" with drugmakers. In total, it has ordered more than 2 billion doses but is far behind Britain, the U.S. and Israel in getting its people vaccinated against the virus.

So far, only three vaccines — Pfizer-BioNTech, Moderna and Astra-Zeneca — have been approved for use in the bloc.

Officials in Brussels quarreled with AstraZeneca last week after the pharmaceutical company said it would deliver smaller-than-expected supplies to EU member nations. The EU ordered up to 400 million doses of the AstraZeneca vaccine but the Anglo-Swedish pharmaceutical company said last month it would only supply 31 million doses during the first quarter of the year due to production issues.

Following a heated dispute, the company agreed Sunday to supply 9 million additional doses to the EU before the end of March. The EU commission said it will continue discussions to try and get more doses from the drugmaker.

The shipment of vaccine shots was also disrupted by delays last month in the production of vaccines at a Pfizer plant in Belgium, which has now returned to normal.

According to the EU, a total of four million doses were delivered to EU countries last week — 3.5 million from Pfizer-BioNTech and 500,000 manufactured by Moderna.

Despite the repeated setbacks, the EU remains confident member states can achieve the commission's goal that 70% of the adult population across the bloc will be vaccinated by the end of the summer.

7:45 PM CT on 1/31/2021

McDonald’s is offering employees incentives to get the COVID-19 vaccine, promising four hours of paid time to those who receive the shot.

The news comes amid efforts from the new Biden administration to speed up the complicated vaccine effort, which is moving slower than expected.

On Jan. 25, Illinois began vaccinating front-line workers, such as teachers and grocery store employees, and people over age 65. Food service workers are expected to be part of the next vaccination phase, which is planned to start in March.

McDonald’s U.S. corporate employees and those who work at U.S. corporate-owned restaurants will be eligible for the vaccine incentive, the company’s U.S. chief people officer, Tiffanie Boyd, said in a statement. Read more here.

4:39 PM CT on 1/31/2021

(AP) — Pharmaceutical company AstraZeneca has agreed to supply 9 million additional doses of its coronavirus vaccine to the European Union during the first quarter, the bloc's executive arm said Sunday.

The new target of 40 million doses by the end of March is still only half what the British-Swedish company had originally aimed for, triggering a spat between AstraZeneca and the EU last week.

European Commission President Ursula von der Leyen said after a call with seven vaccine makers Sunday that AstraZeneca will also begin deliveries one week sooner than scheduled and expand its manufacturing capacity in Europe.

“Step forward on vaccines,” tweeted Von der Leyen, who has come under intense pressure over the European Commission's handling of the vaccine orders in recent days.

The EU is far behind Britain and the United States in getting its population of 450 million vaccinated against the virus. The slow rollout has been blamed on a range of national problems as well as delayed authorization of the vaccines compared to elsewhere and an initial shortage of supply.

The announcement last week that AstraZeneca would initially only supply 31 million doses to the EU's 27 member states due to production problems triggered a fierce dispute between the two sides, with officials in Brussels saying they feared the company was treating the bloc unfairly compared to other customers, such as the United Kingdom.

On Friday, hours after regulators authorized the vaccine for use across the EU, the commission announced that it was tightening rules on exports of COVID-19 vaccines, sparking an angry response from Britain. The commission has since made clear the new measure will not trigger controls on vaccines shipments produced in the 27-nation bloc to the small territory that is part of the United Kingdom bordering EU member Ireland.

Under the post-Brexit deal, EU products should still be able to travel unhindered from the bloc to Northern Ireland.

EU member states praised the bloc's executive branch last year for signing numerous deals with vaccine makers, saying the joint purchase using combined market weight of the entire bloc had ensured a fair distribution for all 27 countries at good prices.

In a statement, the European Commission said it plans to set up an specialized body to improve the bloc's response to health emergency and “deliver a more structured approach to pandemic preparedness.”

As part of the effort, together with industry, the EU said it will “fund design and development of vaccines and scale up manufacturing in the short and medium term, and also to target the variants of COVID-19.”

“The pandemic highlighted that manufacturing capacities are a limiting factor,” it said. “It is essential to address these challenges.”

1:50 PM CT on 1/31/2021

(AP) Biden wants most schools serving kindergarten through eighth grade students to reopen by late April, but even if that happens, millions of students, many of whom are minorities in urban areas, will be left out. Some argue powerful teachers unions are standing in the way of bringing back students with in-person learning, while the unions insist they are looking to protect the health and safety of teachers and students and their families. Dr. Anthony Fauci, the federal government’s top infectious disease expert, said reopening K-8 classrooms might not be possible across the country within Biden’s time frame.

11:33 AM CT on 1/31/2021

(AP) — A group of Senate Republicans called on President Joe Biden to meet them at the negotiating table as the newly elected president signaled he could move to pass a new $1.9 trillion coronavirus aid package with all Democratic votes.

Ten Senate Republicans wrote Biden in a letter released Sunday that their smaller counterproposal will include $160 billion for vaccines, testing, treatment and personal protective equipment and will call for more targeted relief than Biden’s plan to issue $1,400 stimulus checks for most Americans.

“In the spirit of bipartisanship and unity, we have developed a COVID-19 relief framework that builds on prior COVID assistance laws, all of which passed with bipartisan support,” the Republican lawmakers wrote. “Our proposal reflects many of your stated priorities, and with your support, we believe that this plan could be approved quickly by Congress with bipartisan support.”

The call on Biden to give bipartisanship negotiations more time comes as the president has shown signs of impatience amid growing calls from the more liberal wing of his party to pass his $1.9 trillion legislation through budget reconciliation, a process that would allow him to move the massive bill with only the support of his Democratic majority.

The Republican lawmakers did not provide many details of their proposal. One of the signatories, Louisiana Sen. Bill Cassidy, said that their package would cost a fraction, about $600 billion, of the Biden plan.

Winning the support of 10 Republicans would be significant for Biden. If all Democrats were to support an ultimate compromise bill, the legislation would reach the 60-vote threshold necessary to pass legislation under regular Senate procedures.

“If you can't find bipartisan compromise on COVID-19, I don't know where you can find it,” said Ohio Sen. Rob Portman, who also signed the letter.

The other GOP senators pushing the effort are Susan Collins of Maine, Lisa Murkowski of Alaska, Mitt Romney of Utah, Shelley Moore Capito of West Virginia, Todd Young of Indiana, Jerry Moran of Kansas, Mike Rounds of South Dakota, and Thom Tillis of North Carolina.

Brian Deese, the top White House economic adviser who has been leading the administration’s outreach to Congress, said administration officials were reviewing the letter. He did not immediately commit to Biden meeting with the lawmakers.

Deese signaled the White House could be open to negotiating with Republicans on their proposal on further limiting who would receive stimulus checks. Portman suggested on Sunday that the checks should be limited to individuals who make no more than $50,000 per year and families who make $100,000 per year.

Under the Biden plan, families with incomes up to $300,000 could receive some stimulus money.

“That is certainly a place that we’re willing to sit down and think about, are there ways to make the entire package more effective?” Deese said.

As a candidate, Biden predicted his decades in the Senate and his eight years as Barack Obama's vice president gave him credibility as a deal maker and would help him bring Republicans and Democrats to consensus on the most important matters facing the country.

But less than two weeks into his presidency, Biden showed frustration with the pace of negotiations for relief at a time when the economy is showing further signs of wear from the pandemic. Last week, 847,000 Americans applied for unemployment benefits, a sign that layoffs remain high as the coronavirus pandemic continues to rage.

“I support passing COVID relief with support from Republicans if we can get it. But the COVID relief has to pass — no ifs, ands or buts,” Biden said on Friday.

In the letter, the Republican lawmakers reminded Biden that in his inaugural address, he proclaimed that the challenges facing the nation require "the most elusive of things in a democracy: Unity.”

Cassidy separately criticized the current Biden plan as “chock-full of handouts and payoffs to Democratic constituency groups."

“You want the patina of bipartisanship ... so that’s not unity," Cassidy said.

Jared Bernstein, a member of the White House Council of Economic Advisers, said that Biden remains willing to negotiate but that White House officials needed to see more details from Republicans about their plan. At the same time, Bernstein pressed the Biden administration's argument that doing too little to stimulate the economy could have enormous impact on the economy in the near and long-term.

“Look, the American people really couldn’t care less about budget process, whether it’s regular order, bipartisanship, whether it’s filibuster, whether it’s reconciliation," Bernstein said. “They need relief, and they need it now.”

Both Portman and Deese spoke on CNN’s “State of the Union.” Cassidy and Bernstein spoke on ”Fox News Sunday."

9:21 AM CT on 1/31/2021

(AP) — Israel has agreed to transfer 5,000 doses of the coronavirus vaccine to the Palestinians to immunize front-line medical workers, Israeli Defense Minister Benny Gantz's office announced Sunday.

It was the first time that Israel has confirmed the transfer of vaccines to the Palestinians, who lag far behind Israel's aggressive vaccination campaign and have not yet received any vaccines.

The World Health Organization has raised concerns about the disparity between Israel and Palestinians living in the occupied West Bank and Gaza Strip, and international human rights groups and U.N. experts have said Israel is responsible for the well being of Palestinians in these areas. Israel says that under interim peace agreements reached in the 1990s it is not responsible for the Palestinians and in any case has not received requests for help.

Gantz's office said early Sunday the transfer had been approved. It had no further details on when that would happen. There was no immediate comment from Palestinian officials.

Israel is one of the world's leaders in vaccinating its population after striking procurement deals with international drug giants Pfizer and Moderna. The Health Ministry says nearly one-third of Israel's 9.3 million people have received the first dose of the vaccine, while about 1.7 million people have received both doses.

The campaign includes Israel's Arab citizens and Palestinians living in annexed east Jerusalem. But Palestinians living in the West Bank under the autonomy government of the Palestinian Authority and those living under Hamas rule in Gaza are not included.

The Palestinian Authority has been trying to acquire doses through a WHO program known as COVAX. But the program, which aims to procure vaccines for needed countries, has been slow to get off the ground.

The dispute reflects global inequality in access to vaccines, as wealthy countries vacuum up the lion’s share of doses, leaving poorer countries even farther behind in combating the public health and economic effects of the pandemic. It has also emerged as another flashpoint in the decades-old Mideast conflict, even as the virus has wreaked havoc on both sides.

8:23 PM CT on 1/30/21

(AP) The Los Angeles Times reports that one of the largest vaccination sites in the nation temporarily shut down Saturday because dozen of protesters blocked the entrance, stalling hundreds of motorists who had been waiting in line for hours.

Officials say the Los Angeles Fire Department shut the entrance to the vaccination center at Dodger Stadium about 2 p.m. as a precaution. The protesters had members of anti-vaccine and far-right groups.

Some of them carried signs decrying the COVID-19 vaccine and shouting for people not to get the shots. There were no incidents of violence.

5:27 PM CT on 1/30/21

(AP) The U.S. is backing off for now on a plan to offer COVID-19 vaccinations to the 40 prisoners held at the detention center at Guantanamo Bay, Cuba.

Pentagon chief spokesman John Kirby said in a tweet Saturday that the Defense Department would be “pausing” the plan to give the vaccination to those held at Guantanamo while it reviews measures to protect troops who work there.

Kirby said no prisoners had yet received the vaccination. The plan drew some criticism after The New York Times reported that the vaccination of prisoners would start in the coming days.

“We’re pausing the plan to move forward, as we review force protection protocols,” Kirby said. “We remain committed to our obligations to keep our troops safe.”

The U.S. military announced earlier this month that it planned to offer the vaccine to prisoners as it vaccinated all personnel at the detention center.

At the time, U.S. Southern Command said it expected to have enough vaccine for all of the approximately 1,500 personnel assigned to the detention center. It said that the vaccine would be offered to prisoners but did not plan to reveal how many actually received it because of medical privacy regulations.

There have been no reported cases of coronavirus among the detention center prisoners. Early in the pandemic the U.S. military stopped reporting cases at individual bases for security reasons.

The U.S. opened the detention center in January 2002 to hold detainees suspected of links to al-Qaida and the Taliban. Those who remain include five men facing a trial by military commission for their alleged roles planning and aiding the Sept. 11, 2001, attacks.

2:41 PM CT on 1/30/21

(AP) An Associated Press analysis shows that Black people in many parts of the U.S. are lagging behind whites in receiving COVID-19 vaccinations. Statistics released by 17 states and two cities tell the same story: Through Jan. 25, Black people were getting inoculated at levels below their share of the general population. The early look at the racial breakdowns of those getting the shots is particularly troubling given that the Centers of Disease Control and Prevention says Blacks, Hispanic and Native Americans are dying of the virus at nearly three times the rate of white people.

12:02 PM CT on 1/30/21

(AP) California surpassed 40,000 coronavirus deaths as the state’s steepest surge of cases begins to taper.

The tally by Johns Hopkins University shows the state passed the milestone Saturday with 40,240 deaths. The deaths are surging at a record pace after recent declines in cases and hospitalizations. It took six months for California to record its first 10,000 deaths, then four months to double to 20,000.

In just five weeks, the state reached 30,000 and needed only 20 days to get to 40,000.

New York leads the U.S. with more than 43,000 confirmed deaths, followed by California, Texas at 36,000 and Florida at 26,000.

9:53 AM CT on 1/30/21

(AP)  A racial gap has opened up in the nation’s COVID-19 vaccination drive, with Black Americans in many places lagging behind whites in receiving shots.

That’s according to an Associated Press analysis. An early look at the 17 states and two cities that have released racial breakdowns finds Black people are getting inoculated at levels below their share of the general population.

In North Carolina, Black people make up 22% of the population and 26% of the health care workforce but only 11% of the vaccine recipients so far. White people, a category in which the state includes both Hispanic and non-Hispanic whites, are 68% of the population and 82% of those vaccinated.

Among the reasons given: deep mistrust of the medical establishment among Black Americans because of a history of discriminatory treatment. The gap is deeply troubling to some, given the coronavirus has taken a disproportionate toll in severe sickness and death on Black people in the U.S.

4:25 PM CT on 1/29/21

(AP) New York's attorney general has joined calls for the state to loosen  partial immunity from lawsuits and criminal prosecutions it had granted to nursing homes at the height of the COVID-19 pandemic last spring.

In a report issued Thursday, Attorney General Letitia James, a Democrat, documented how a number of homes failed to follow proper infection-control protocols as the virus raged.

Patients with COVID-19 were mingled in some homes with residents who didn't yet have the virus. Staff members weren't properly screened for illness. Some homes made sick employees keep coming to work, even though they could potentially infect others on the job. Others maintained dangerously low staffing levels that endangered residents, the report found.

Yet despite those "disturbing and potentially unlawful findings," James said, "It remains unclear to what extent facilities or individuals can be held accountable if found to have failed to appropriately protect the residents in their care."

Nursing homes, hospitals and other healthcare facilities in New York were granted one of the broadest legal protections  from both lawsuits and criminal prosecutions in the nation by the state's lawmakers last spring. The healthcare industry's well-heeled lobbyists said they drafted the provision in the state budget to protect hospitals and nursing homes stretched to the limits, with volunteers and medical students caring for patients in makeshift hospitals.

Lawmakers partially rolled back that immunity last summer, saying it would no longer apply to suits or prosecutions over non-COVID-19 patients. It has never applied to instances of gross negligence, intentional criminal or reckless misconduct.

But they left in place provisions that protect certain healthcare providers from being sued or prosecuted over care "related to the diagnosis or treatment of COVID-19."

James called for New York to eliminate the immunity provisions, particularly as they applied to nursing homes that knowingly took on more patients than their staff could safely handle.

"While it is reasonable to provide some protections for healthcare workers making impossible healthcare decisions in good faith during an unprecedented public health crisis, it would not be appropriate or just for nursing homes owners to interpret this action as providing blanket immunity for causing harm to residents," she said.

2:19 PM CT on 1/29/21

(AP)  Regulators authorized AstraZeneca's coronavirus vaccine for use in adults throughout the European Union on Friday, amid criticism the bloc is not moving fast enough to vaccinate its population.

The European Medicines Agency's expert committee unanimously recommended the vaccine to be used in people 18 and over, although concerns had been raised this week that not enough data exist to prove it works in older people, and some countries indicated they may not give it to the elderly.

The shot is the third COVID-19 vaccine given the green light by the European Medicines Agency after ones by Pfizer and Moderna. The EMA's decision requires final approval from the European Commission, a process that occurred swiftly with the other vaccines.

Hours later, the EU gave its backing for the vaccine's use throughout its 27 nations.

"I expect the company to deliver the 400 million doses as agreed. We will keep on doing all we can to secure vaccines for Europeans, our neighbours & partners worldwide," tweeted EU Commission President Ursula von der Leyen.

With trials showing about 60% efficacy, the vaccine appears to offer less protection than ones already authorized, but experts have said any vaccine with an efficacy rate of over 50% could help stop outbreaks.

The agency recommended the vaccine's use by older people, despite limited data regarding its efficacy in people over 55, citing the immune responses seen and experience with other vaccines.

"At least some protection is expected," Bruno Sepodes, of the EMA's expert committee, said Friday at a briefing. He acknowledged that "the exact level of protection cannot be estimated for the time being."

2:19 PM CT on 1/29/21

HHS on Thursday made moves to rapidly grow the vaccination workforce and increase the public's access to COVID-19 vaccinations.

Under the amendment to the Public Readiness and Emergency Preparedness Act (PREP Act), all licensed and certified healthcare professionals are now authorized to prescribe, dispense and administer COVID-19 vaccines in any state or U.S. territory after completing the CDC's COVID-19 vaccine training, regardless of where they are licensed or certified.

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11:32 AM CT on 1/29/21

(AP) Dr. Anthony Fauci says the Biden administration hopes to begin vaccinating younger children by late spring or early summer.

The government’s top public health expert says clinical studies to determine whether approved coronavirus vaccines are safe for younger children will begin in the “next couple of months.”

The results could influence the debate over how to safely reopen public schools.

The Pfizer and Moderna vaccines currently given to healthcare workers, nursing home residents and older Americans weren’t tested on younger children.

Biden has set a goal of reopening most schools in his first 100 days in office or near the end of April.

9:10 AM CT on 1/29/21

(AP)  A World Health Organization team visited a hospital on Friday where China says the first COVID-19 patients were treated more than a year ago as part of the experts' long-awaited fact-finding mission on the origins of the coronavirus.

The WHO team members and Chinese officials earlier had their first in-person meetings at a hotel ahead of field visits in and around the central city of Wuhan in the coming days.

"First face to face meeting with our colleagues. Correction: facemask to facemask given the medical restrictions," Dutch virologist Marion Koopmans tweeted in the morning.

Members of the team left the hotel by car, and a short time later entered the gates of the Hubei Provincial Hospital of Integrated Chinese and Western Medicine. According to China's official account of its response to the initial outbreak, Dr. Zhang Jixian first reported cases of what was then known as "pneumonia of unknown origin" at the hospital on Dec. 27, 2019.

WHO said earlier on Twitter that the team requested "detailed underlying data" and planned to speak with early responders and some of the first COVID-19 patients. It also planned to visit markets such as the Huanan Seafood Market linked to many of the first cases, the Wuhan Institute of Virology, and laboratories at facilities such as the Wuhan Center for Disease Control.

The team's mission has become politically charged, as China seeks to avoid blame for alleged missteps in its early response to the outbreak.

"All hypotheses are on the table as the team follows the science in their work to understand the origins of the COVID19 virus," WHO tweeted.

Confirmation of the origins of the virus is likely to take years. Pinning down an outbreak's animal source typically requires exhaustive research including taking animal samples, genetic analysis and epidemiological studies.

One possibility is that a wildlife poacher might have passed the virus to traders who carried it to Wuhan. The Chinese government has promoted theories, with little evidence, that the outbreak might have started with imports of frozen seafood tainted with the virus, a notion roundly rejected by international scientists and agencies.

A possible focus for investigators is the virology institute in the city. One of China's top virus research labs, it built an archive of genetic information about bat coronaviruses after the 2003 outbreak of Severe Acute Respiratory Syndrome, or SARS.

8:20 PM CT on 1/28/21

(AP) Twenty-seven workers at a hospital in Astoria, Oregon have been sickened with the coronavirus since the end of November, according to state officials.

The cases at Columbia Memorial Hospital were detailed by the Oregon Health Authority in a weekly report on workplace outbreaks released Wednesday, The Astorian reported.

The most recent onset was Jan. 14. Hospital spokeswoman Nancee Long said five employees tested positive for the virus during the week of Nov. 27. The remaining 22 cases have occurred sporadically since the original cluster, spread throughout nine different departments and five separate buildings, she said.

Those affected have been quarantined to protect both caregivers and patients, officials said.

“Caregiver and patient safety is paramount," she said. "We are proud of our caregiver’s diligence and attention to constantly changing procedures and risks. We will continue to be a space where sick people can come for help and take our dedication to heal seriously.”

6:11 PM CT on 1/28/21

(AP) At Lisbon’s Military Hospital, hundreds of troops have spent frantic weeks rushing to turn every available space into makeshift COVID-19 wards, as Portugal scrambles to cope with a sudden deluge of cases engulfing its public health system.

The hospital’s waiting rooms, consulting rooms and atriums have been filled with beds. This week, the canteen is being sacrificed. It’s the last space left.

“In the first nine months (of the pandemic), we tripled our capacity” of beds, said Brigadier General Rui Sousa, a 20-year army doctor who heads the Military Hospital. In January, “we’ve had to triple that tripled capacity,” he told The Associated Press.

A January pandemic surge has stretched medical services in Portugal to a breaking point. By size of population, Portugal has been the worst-hit country in the world for more than a week in terms of daily new cases and deaths, according to data compiled by Johns Hopkins University.

Portugal is now facing an alarming problem: as soon as new beds come available, they are quickly filled and more are needed. And while extra beds and new wards are relatively quick to produce, trained medical staff aren’t.

On top of that, things are going to get worse. Experts predict the surge will peak only in mid-February, raising the specter of a collapse of the country's health system.

“Human resources are finite, and that is where the most critical situation is,” says Carlos Robalo Cordeiro, a member of the crisis committee at Portugal’s national association of doctors and vice president of the European Respiratory Society.

“Numbers (of patients) are overtaking the capacity of resources to respond,” he told The AP.

Portugal is reeling from the twin effects of a Christmas relaxation of restrictions on gatherings that coincided with the appearance of a fast-spreading new variant first identified in England.

Experts have chided the government for failing to respond more swiftly. Flights to and from the U.K. were banned only last weekend. Flights to and from Brazil, a country with close ties to Portugal where another worrying variant has been detected, will be banned beginning Saturday.

Ambulance drivers protested Wednesday night outside Lisbon’s biggest hospital, where in recent days ambulances have had to queue for hours to deliver COVID-19 patients. The overloaded hospital appealed for upset families to stay calm, saying that only 15% of those arriving in the ambulances required hospitalization.

The Portuguese government is turning to other European Union countries for help. Germany this week sent two doctors and a medevac specialist to Lisbon on a reconnaissance mission.

4:05 PM CT on 1/28/21

(AP) Earlier this week, there was only one patient in the COVID-19 intensive care unit at UW Medical Center-Montlake, a hospital near the University of Washington campus in Seattle. The unit had cared for as many as eight patients at a time during the heights of the pandemic.

The recent decrease, along with the vaccination of medical personnel and a dip in overall case numbers in King County, which includes Seattle, were giving a welcome boost to the staff at the hospital.

"I think overall the feeling here is hope," said Nichole Gogna, a nurse manager at the hospital, noting that most of her staff has gotten their second dose of vaccine. "I think it's brought some lightness to our workload to know we have an extra layer of protection."

King County has been on a downward trend of COVID-19 cases after two-and-a-half months of increases, said Dr. Jeff Duchin, the county's public health officer. County data show hospitalizations and deaths are down, too.

But some experts believe the current lull could be upended as more variants of the virus spread throughout the U.S. Washington state health officials previously confirmed the presence of the so-called UK variant just north of Seattle.

"The virus has been working out, it's gotten faster and more fit. We need to fight smarter and harder to beat it," Duchin said.

During the worst spike in cases, there were 120 COVID patients a day across UW Medicine hospitals. That number is now about 60, said Dr. Tim Dellit, chief medical officer.

"We are in a pretty good balance now in terms of patient load," he said.

2:09 PM CT on 1/28/21

(AP)  A new coronavirus variant identified in South Africa has been found in the U.S. for the first time, with two cases diagnosed in South Carolina, state health officials said Thursday.

The two cases were discovered in adults in different regions of the state and do not appear to be connected. Neither of the people infected has traveled recently, the South Carolina Department of Health and Environmental Control said.

"That's frightening," because it means there could be more undetected cases within the state, said Dr. Krutika Kuppalli, an infectious diseases physician at the Medical University of South Carolina in Charleston. "It's probably more widespread."

The arrival of the variant shows that "the fight against this deadly virus is far from over," Dr. Brannon Traxler, South Carolina's interim public health director, said in a statement. "While more COVID-19 vaccines are on the way, supplies are still limited. Every one of us must recommit to the fight by recognizing that we are all on the front lines now. We are all in this together."

Viruses are constantly mutating, and coronavirus variants are circulating around the globe, but scientists are primarily concerned with the emergence of three. Other variants first reported in the United Kingdom and Brazil were previously confirmed in the U.S. Researchers believe these three variants may spread more easily.

In South Carolina, the state health agency said the variant was found in one person from the state's coastal region and another in its northeastern corner. The state gave little other information, citing privacy concerns, though Traxler said neither of the people was contagious any longer.

"Both were tested very early in the month, and my understanding is that both are doing well," Traxler said.

2:09 PM CT on 1/28/21

Members of the White House COVID-19 task force on Wednesday said the administration has reached its initial target of averaging 1 million vaccinations a day but warned it could take months before everyone who wants a vaccine can get one.

In the first of the Biden administration's promised regular updates on the nation's pandemic response, Andy Slavitt, senior adviser to the task force, said 47 million doses have been distributed to states and long-term care facilities. But only 24 million have been administered, while an estimated 3.4 million people have received their second dose.

An average of 1.1 million vaccinations a day have been conducted since Jan. 21, according to figures presented by the response team. The daily vaccination rate declined over the past two days, averaging more than 845,000 doses from Jan. 25 through Jan. 26.

Slavitt said 1 million vaccinations a day represented reaching the "floor, not the ceiling" in terms of the administration's effort.

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12:04 PM CT on 1/28/21

(AP)  A World Health Organization team emerged from quarantine in the Chinese city of Wuhan on Thursday to start field work in a fact-finding mission on the origins of the virus that caused the COVID-19 pandemic.

The researchers, who were required to isolate for 14 days after arriving in China, left their quarantine hotel with their luggage in the midafternoon and headed to another hotel.

The mission has become politically charged, as China seeks to avoid blame for alleged missteps in its early response to the outbreak. A major question is where the Chinese side will allow the researchers to go and whom they will be able to talk to.

Former WHO official Keiji Fukuda, who is not part of the team in Wuhan, has cautioned against expecting any breakthroughs, saying it may take years before any firm conclusions can be made about the virus's origin.

"This is now well over a year past when it all started," he said earlier this month. "So much of the physical evidence is going to be gone. The memories of people are imprecise and probably the physical layouts of many places are going to be different than they were."

Among the places they might visit are the Huanan Seafood Market, which was linked to many of the first cases, as well as research institutes and hospitals that treated patients at the height of the outbreak.

"All hypotheses are on the table as the team follows the science in their work to understand the origins of the COVID-19 virus," WHO tweeted. It said the team had already requested "detailed underlying data" and planned to speak with early responders and some of the first COVID-19 patients.

9:46 AM CT on 1/28/21

(AP)  A draft recommendation from Germany's vaccination advisory committee calls for offering the AstraZeneca vaccine only to people aged 18-64 for now, citing what it says is insufficient data to judge its effectiveness for older people.

The European Medicines Agency is expected to approve the AstraZeneca vaccine for use in the 27-nation European Union on Friday. It would be the third cleared for use in the EU after the BioNTech-Pfizer and Moderna vaccines.

In a draft recommendation released on Thursday ahead of that decision, Germany's permanent vaccination commission called for using AstraZeneca's vaccine for the 18-64 age group on the basis of currently available information. It said that "there currently is not sufficient data to assess the vaccination effectiveness from 65 years."

AstraZeneca noted earlier this week that British regulators supported its use in the older age group despite lack of late-stage effectiveness data. The company pointed to earlier-stage data published in the journal Lancet in November "demonstrating that older adults showed strong immune responses to the vaccine, with 100% of older adults generating spike-specific antibodies after the second dose."

But questions remain about how well the vaccine protects older people. Only 12% of participants in the AstraZeneca research were over 55 and they were enrolled later, so there hasn't been enough time to see whether they get sick at a lower rate than those who didn't get the vaccine.

German Health Minister Jens Spahn stressed that the committee's recommendation isn't its final decision, and that will be made only after the vaccine is cleared for use.

But he said there had been a discussion since autumn about there being "few data — this isn't about bad data, but few data" in studies on the AstraZeneca vaccine's effectiveness in older groups.

8:04 PM CT on 1/27/21

(AP) States are loosening their coronavirus restrictions on restaurants and other businesses because of improved infection and hospitalization numbers but are moving gradually and cautiously, in part because of the more contagious variant taking hold in the U.S.

While the easing could cause case rates to rise, health experts say it can work if done in a measured way and if the public remains vigilant about masks and social distancing.

“If the frequency goes up, you tighten it up. If the frequency goes down, you loosen up. Getting it just right is almost impossible,” said Dr. Arnold Monto, a public health professor at the University of Michigan. “There’s no perfect way to do this.”

As Michigan’s coronavirus rate dropped to the nation’s fifth-lowest over the last two weeks, Gov. Gretchen Whitmer said bars and restaurants can welcome indoor customers next week for the first time in 2 1/2 months. But they will be under a 10 p.m. curfew and will be limited to 25% of capacity, or half of what was allowed the last time she loosened their restrictions, in June.

The state previously authorized the resumption of in-person classes at high schools and the partial reopening of movie theaters.

“We’re in a stronger position because we’ve taken this pause,” Whitmer said. “But we are also very mindful of the fact that this variant is now here in Michigan. It poses a real threat.”

The COVID-19 death toll in the U.S. has climbed past 425,000, with the number of dead running at close to all-time highs at nearly 3,350 a day on average.

But newly confirmed cases have dropped over the past two weeks from an average of about 248,000 per day to around 166,000. And the number of people in the hospital with COVID-19 has fallen by tens of thousands to 109,000.

At the same time, health experts have warned that the more contagious and possibly more lethal variant sweeping Britain will probably become the dominant source of infection in the U.S. by March. It has been reported in over 20 states.

Other mutant versions are circulating in South Africa and Brazil. The Brazil variant has been detected for the first time in the U.S., in Minnesota.

Chicago and surrounding suburbs allowed indoor dining over the weekend for the first time since October. Major cultural attractions including the Field Museum and Shedd Aquarium reopened with crowd limits.

Steve Lombardo III, an owner of a Chicago-area restaurant group, called being able to seat customers indoors a “huge boost.” One of its most famous restaurants, Gibsons Bar & Steakhouse, has been using hospital-grade air filtration systems in the hopes of staying afloat, he said.

“Will we be making money? Probably not,” Lombardo said. “But we won’t be hemorrhaging money like we have the last three months.”

Washington, D.C., also recently ended its monthlong ban on indoor dining, but one in New York City remains in effect.

California Gov. Gavin Newsom this week lifted stay-at-home orders he imposed last month when hospitals were so overwhelmed with virus patients that they were on the verge of rationing lifesaving care. Restaurants and places of worship will be able to operate outdoors, and many stores will be able to have more shoppers inside.

Jen Diaz, a 38-year-old technical writer from Santa Clarita, California, who works remotely and has not left her home since a trip to the supermarket in March, said she was “horrified” when she heard the governor’s announcement. She has rheumatoid arthritis, and her treatments suppress her immune system, but she has yet to receive a vaccination because she is under 65.

“I was really, really proud of California’s response at first” in the early months of the pandemic, she said. “Suddenly we’re just opening everything. `Let’s go to the mall!’”

She added: “The government doesn’t seem to be taking this as seriously as it once did, on a state level.”

In Oregon, Gov. Kate Brown announced that some indoor operations such as gyms and movie theaters can reopen Friday with limited capacity. Indoor dining is still banned in the hardest-hit counties.

Not all places are taking as cautious an approach.

After North Dakota dropped to the nation’s second-lowest case rate, Republican Gov. Doug Burgum this month not only relaxed limits on the number of people who can gather at restaurants and bars but also allowed a statewide mask mandate to expire last week.

“The fight is far from over, but we can certainly see the light of the end of the tunnel from here,” Burgum said.

Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at Johns Hopkins University and Maryland’s former health department chief, cautioned such a step can carry heavy risk.

“I don’t think it’s unreasonable to start to reopen, but if people think that’s the green light to pretend the virus doesn’t exist, then we’re going to be right back to where we were,” Sharfstein said. “If you do restrictions, the virus goes down. You can open up and see how it goes. But if the variants really take hold, that may not be so easy.”

Many restaurants say they cannot survive offering only takeout during the winter, when the cold makes it difficult if not impossible to offer outdoor dining.

Rick Bayless, one of the most decorated chefs in the U.S., said allowing indoor dining at his Mexican restaurants in Chicago may buy him some time.

“With 25% indoor we might be able to make it to the spring, when people will want to go outdoors,” he said.

Bayless said the business survived a previous shutdown only because his landlord allowed him to stay rent-free for three months. The uncertainty has taken a toll on his workers, he said.

“It’s been touch-and-go. When they allowed us to open up on Saturday, we had staff in here that were literally in tears,” Bayless said.

6:34 PM CT on 1/27/21

A coalition that includes Ohio State University Wexner Medical Center, the Ohio Department of Health Office of Health Equity, the Columbus Police Department, Columbus City Schools, and many more community organizations will help address public health disparities. 

The journal Population Health Management outlines how these partnerships can serve as a blueprint for addressing local public health crises like the COVID-19 pandemic. The article details how the organizations partnered to dispense face masks, soap, hand sanitizer, dental hygiene items and educational materials to more than 7,500 people who reside in areas disproportionally impacted by coronavirus.

According to a press release, the targeted approach identified the most vulnerable communities, pinpointing distribution locations within those communities, intentional notifications of distribution dates and locations, procurement of supplies by leveraging key partnerships, on-site distribution using volunteers and using interpreter services when needed.

4:27 PM CT on 1/27/21

(AP) Hospital administrators across Arizona warned residents Wednesday not to become complacent because of a noticeable decline in COVID-19 cases and hospitalizations, stressing the importance of wearing masks and social distancing.

“Mitigation and enforcement will be much more effective in reducing COVID cases and deaths in the coming months,” said Dr. Marjorie Bessel, the chief clinical officer for Banner Health. The healthcare company's hospital system is estimated to be caring for about half of the state's COVID-19 patients.

Bessel and other healthcare officials said even with statistics trending downward, Arizona is still recording figures higher than last July's virus surge. The state Department of Health Services reported 5,918 additional known cases and 195 deaths, increasing the state's pandemic totals to 738,561 cases and 12,643 deaths.

Arizona had the worst COVID-19 diagnosis rating among U.S. states over the past week when one in every 153 residents was reported to be newly infected. The diagnosis rate is a state’s population divided by the number of new cases over the past week.

Hospitals and public health experts are also worried that Arizona could experience another surge in March if reported variants of the virus surface in the state, said Dr. Michael White of Valleywise Health.

2:17 PM CT on 1/27/21

(AP)  The Oklahoma attorney general's office is attempting to return $2 million worth of a malaria drug once touted by former President Donald Trump as an effective treatment for COVID-19, a spokesman said Wednesday.

Alex Gerszewski, a spokesman for Attorney General Mike Hunter, said Hunter is attempting to negotiate a return of the 1.2 million hydroxychloroquine pills Oklahoma acquired in April from a California-based supplier, FFF Enterprises. He said the office was acting on a request from the Oklahoma State Department of Health, which authorized the purchase.

A spokeswoman for FFF Enterprises didn't immediately return a message Wednesday seeking comment.

The attempt by Oklahoma to return the hydroxychloroquine was first reported by the online news publication The Frontier.

Republican Gov. Kevin Stitt defended the purchase last year, saying the drug was showing some promise as a treatment in early March and he didn't want to miss an opportunity to acquire it.

"I was being proactive to try and protect Oklahomans," Stitt said at the time.

The drug has since been shown to have little or no effect on severe cases of COVID-19, and a former state health official chalked up Oklahoma's purchase to something that happens in "the fog of war."

While governments in at least 20 other states obtained more than 30 million doses of the drug through donations from the federal reserve or private companies, Oklahoma and Utah bought them from private pharmaceutical companies.

2:17 PM CT on 1/27/21

A little more than a month into the COVID-19 vaccination effort in long-term care facilities, only 8% of residents and staff have received the second dose of the vaccine, according to newly released federal data.

As of Jan. 24, 2,567,019 doses of the COVID-19 vaccines had been administered to staff and residents in long-term care facilities, according to the Centers for Disease Control and Prevention. Only 201,293 of those vaccinations were second doses. The federal Pharmacy Partnership for Long-Term Care Program, which pairs nursing facilities with either Walgreens or CVS for vaccine administration, has distributed more than 4.5 million COVID-19 vaccine doses so far.

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11:55 AM CT on 1/27/21

(AP)  In an unusual and potentially groundbreaking decision, French drugmaker Sanofi said Wednesday it will help bottle and package 125 million doses of the coronavirus vaccine developed by its rivals Pfizer and BioNTech, while its own vaccine candidate faces delays.

The announcement came as delays or production problems for the Pfizer-BioNTech vaccine and a vaccine from Britain's AstraZeneca have caused political uproar across the European Union. The EU's 27-nation vaccination effort has struggled to pick up steam, while more contagious virus variants are spreading fast and COVID-19 deaths are surging anew.

Sanofi's Frankfurt facilities will help with late-stage production of vaccines prepared by Germany-based BioNTech, including bottling and packaging, starting in the summer, according to a Sanofi official. Sanofi did not reveal financial details of the agreement.

According to Thomas Cueni, director of the International Federation of Vaccine Manufacturers, 76% of the world's major vaccine manufacturing capacity is in Europe.

The French government has pressed Sanofi to use its facilities to help make vaccines from its rivals, given the high demand and supply problems.

"We are very conscious that the earlier vaccine doses are available, the more lives can potentially be saved," Sanofi CEO Paul Hudson said in a statement.

10:20 AM CT on 1/27/21

(AP)  Several states are loosening their coronavirus restrictions on restaurants and other businesses because of improved infection and hospitalization numbers but are moving gradually and cautiously, in part because of the more contagious variant taking hold in the U.S.

While the easing could cause case rates to rise, health experts say it can work if done in a measured way and if the public remains vigilant about masks and social distancing.

"If the frequency goes up, you tighten it up. If the frequency goes down, you loosen up. Getting it just right is almost impossible," said Dr. Arnold Monto, a public health professor at the University of Michigan. "There's no perfect way to do this."

The COVID-19 death toll in the U.S. has climbed past 425,000, with the number of dead running at close to all-time highs at nearly 3,350 a day on average.

But newly confirmed cases have dropped over the past two weeks from an average of about 248,000 per day to around 166,000. And the number of people in the hospital with COVID-19 has fallen by tens of thousands to 109,000.

At the same time, health experts have warned that the more contagious and possibly more lethal variant sweeping Britain will probably become the dominant source of infection in the U.S. by March. It has been reported in over 20 states.

Other mutant versions are circulating in South Africa and Brazil. The Brazil variant has been detected for the first time in the U.S., in Minnesota.

Chicago and surrounding suburbs allowed indoor dining over the weekend for the first time since October. Major cultural attractions including the Field Museum and Shedd Aquarium reopened with crowd limits.

Washington, D.C., also recently ended its monthlong ban on indoor dining, but one in New York City remains in effect.
California Gov. Gavin Newsom this week lifted stay-at-home orders he imposed last month when hospitals were so overwhelmed with virus patients that they were on the verge of rationing lifesaving care. Restaurants and places of worship will be able to operate outdoors, and many stores will be able to have more shoppers inside.

In Oregon, Gov. Kate Brown announced that some indoor operations such as gyms and movie theaters can reopen Friday with limited capacity. Indoor dining is still banned in the hardest-hit counties.

Not all places are taking as cautious an approach.

After North Dakota dropped to the nation's second-lowest case rate, Republican Gov. Doug Burgum this month not only relaxed limits on the number of people who can gather at restaurants and bars but also allowed a statewide mask mandate to expire last week.

Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at Johns Hopkins University and Maryland's former health department chief, cautioned such a step can carry heavy risk.

"I don't think it's unreasonable to start to reopen, but if people think that's the green light to pretend the virus doesn't exist, then we're going to be right back to where we were," Sharfstein said. "If you do restrictions, the virus goes down. You can open up and see how it goes. But if the variants really take hold, that may not be so easy."

9:01 PM CT on 1/26/21

(AP) Mexico said Tuesday it is close to granting approval for Russia’s Sputnik V coronavirus vaccine, despite the fact that little public data is available.

The approval process described by Hugo López-Gatell, Mexico’s assistant health secretary, sounded like a Cold War spy thriller, and may not foment confidence in the shot.

López-Gatell said a Mexican technical committee on new medications has recommended approving the vaccine, adding only “some details” were lacking for COFEPRIS, the government medical safety commission, to give the final go-ahead.

“The technical part, the main part of COFEPRIS, particularly the committee on new medications, has given a favorable recommendation to authorize, that is to say, the crucial part has been solved,” López-Gatell said.

But he also said that despite weeks of conversations with Russian officials, he could not get his hands on the results of Phase 3 trials, which are normally published in international medical journals and indicate how effective the vaccine is.

Russian officials have given conflicting accounts, upping the supposed effectiveness of the Sputnik vaccine to higher levels every time a U.S. vaccine reports its results.

Desperate, but with no published data, Mexican President Andrés Manuel López Obrador ordered López-Gatell to fly to Argentina, which has already approved and is using Sputnik V, to see what information he could get.

The Argentines gave López-Gatell a closely-guarded copy of Phase 3 trial results and other data on the Sputnik vaccine which he spirited back to Mexico and then submitted the papers to Mexican regulatory officials.

Mexico has been unable to get more than about 750,000 doses of the Pfizer vaccine, about half the amount it needs just to inoculate just front-line health workers. Mexico and had pinned its hopes on China's CanSino vaccine.

But delays in approving that shot drove López Obrador to speak directly to Russian President Vladimir Putin on Monday to try to get the Russian vaccine, the first doses of which are expected to arrive next week.

It is unclear whether the lack of public data might affect Mexicans' willingness to get vaccinated, without knowing how effective or safe the Russian shot is.

“I do want vaccines, but ones that have been approved by the World Health Organization and the international scientific community,” wrote Sen. Lilly Téllez of the conservative opposition National Action Party. “The Russian vaccine does not have that yet.”

“It is the cheap vaccine, that is why the government chose it,” Téllez wrote in her Twitter account.

7:00 PM CT on 1/26/21

(AP) New Mexico’s weekly average for new confirmed COVID-19 cases is continuing its downward trend, as state health officials reported just over 600 additional cases Tuesday.

The death toll increased only slightly as 14 additional people succumbed to the virus, and hospitalizations due to the virus marked another decline.

Officials have said they’re encouraged by the latest numbers and are hopeful that the federal government will begin distributing more vaccine doses soon.

New Mexico’s allocation has remained steady, but with current supplies it could be weeks before more people become eligible.

So far, more than 90% of the 235,000 doses that have been delivered to New Mexico have been administered. State health officials say more than 750,000 people are eligible, and more than 522,000 people have registered online to get their shots.

New Mexico's nursing homes and assisted living facilities were part of the first phase of vaccinations, and officials announced Tuesday that all 309 such facilities in the state have had a vaccine clinic where the first dose was provided.

Gov. Michelle Lujan Grisham acknowledged in a statement that she knows people want the process to be faster and for vaccines to be accessible in more places.

State health officials said the nursing homes and other long-term care facilities are working with the Health Department and pharmacies to set up more clinics so that second doses can be provided and to give first shots to any residents or staff who missed the first round of clinics.

“It’s important to remember that you are not fully protected until you have had both doses of the COVID vaccine,” Health Secretary Dr. Tracie Collins. “We are very eager to see this vulnerable population fully vaccinated and better protected from COVID-19.”

In all, more than 12,000 long-term care staff and residents were vaccinated during the first clinics.

4:31 PM CT on 1/26/21

(AP) President Joe Biden is announcing that the U.S. is purchasing an additional 100 million doses each of the two approved coronavirus vaccines for delivery this summer, with the government expecting to be able to deliver enough of the two-dose regimens to states this summer to vaccinate 300 million people.

The additional purchases from drugmakers Pfizer and Moderna come as the Biden administration is trying to ramp up vaccine production and states’ capacities to inject them into arms. Biden is also announcing that vaccine deliveries to states and territories will be boosted to at least 10 million doses per week over the next three weeks.

Seeking to address concerns from state and local leaders that supplies have been inconsistent, prompting last-minute cancellations of booked appointments, the White House is also pledging to provide states with firm vaccine allocations three weeks in advance of delivery to allow for accurate planning for injections.

1:55 PM CT on 1/26/21

(AP)  The Republican-controlled Wisconsin Senate planned to vote Tuesday on a resolution to repeal Gov. Tony Evers' statewide mask mandate despite criticism from him and other Democrats, healthcare workers and public health leaders who say it would only worsen the coronavirus pandemic early in the vaccine rollout.

The Senate and Assembly would have to pass the resolution to undo Evers' mask order. The Assembly was meeting Tuesday, but its Republican leaders haven't said whether the resolution would get a vote. The measure has 29 Republican cosponsors in the Legislature and was the only item up for a vote in the Senate.

Fourteen groups, including the Wisconsin Medical Society, Wisconsin Hospital Association and public health organizations, registered their opposition to the measure.

"The Governor's mask mandate saves lives," the Wisconsin Council of Churches said in a statement opposing the repeal. "Ending it will cost lives."

No groups had registered in support of the resolution hours ahead of the vote.

"This clearly isn't about public health," Dr. Kristin Lyerly, an obstetrician from Green Bay, said at a news conference before the vote. "It's about political games, power and control."

Republican critics argue that Evers exceeded his authority by issuing multiple emergency declarations during the pandemic, which allowed him to extend the mask mandate beyond the 60 days allowed under the law without getting the Legislature's approval. Republicans say Evers had to seek such approval for any order to last beyond 60 days. Evers contends that the changing nature of the pandemic, and the ongoing response, warranted new emergency declarations.

Evers' mask mandate is also being challenged in the Wisconsin Supreme Court, which heard arguments in November and could issue a ruling at any point.

Wisconsin's mask mandate, which took effect in August, is slated to run until March 20. If the state order is repealed, local orders in place in many of the state's most populated areas, including Milwaukee and Madison, would remain in effect.

1:55 PM CT on 1/26/21

In the coming months, the selection of COVID vaccines is expected to be plentiful.

A total of 20 of the more than 60 vaccine candidates in development were in Phase 3 clinical trials as of Jan. 20, according to the World Health Organization. A number of those are likely to join the two currently in use and the most promising candidates from drugmakers like Johnson & Johnson and AstraZeneca that are only weeks away from gaining approval in the U.S.

But there’s one thing that’s missing.

Black patients represented 10% and Latinos 13% of participants in the Phase 3 clinical trial studies for the vaccine developed by Pfizer and BioNTech. Black patients also made up 10% of participants in the Moderna vaccine trial while Latinos accounted for 20%.

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12:01 PM CT on 1/26/21

Rhode Island's attorney general asked the state's two biggest hospital groups to explain their coronavirus vaccine distribution policies in light of reports that some board members, trustees and administrative staff have been receiving inoculations.

"Rhode Islanders need to have confidence that vaccine prioritization is guided by a public health rationale alone and that vaccines are going to those who need them most, and not those who are well-connected or better able to navigate the system," Attorney General Peter Neronha wrote in a letter Monday to the CEOs of Lifespan and Care New England.

Some people received the vaccine "despite the fact that they do not appear to fall within the Phase 1 category of individuals designated to receive the vaccine by the Rhode Island Department of Health," he said.

Both organizations have defended their vaccine distribution and promised to cooperate with the inquiry, which is not alleging wrongdoing.

Lifespan "will participate in the attorney general's office review of our vaccination distribution strategy to health care workers and our efforts to support the recommendations of" the state health department, spokesperson Kathleen Hart said in an email.

"We are happy to explain in detail our methodology, to include our continued and complete transparency regarding how the process of administering, handling and recording aligns with the guidance provided," Care New England spokesperson Jessica McCarthy said.

9:41 AM CT on 1/26/21

(AP) In the first week of December, Portugal's prime minister gave his pandemic-weary people an early Christmas gift: restrictions on gatherings and travel due to COVID-19 would be lifted from Dec. 23-26 so they could spend the holiday season with family and friends.

Soon after those visits, the pandemic quickly got out of hand.

By Jan. 6, Portugal's number of new daily COVID-19 cases surged past 10,000 for the first time. In mid-January, with alarm bells ringing as each day brought new records of infections and deaths, the government ordered a lockdown for at least a month and a week later shut the country's schools.

But it was too little, too late. Portugal has for almost a week had the most daily cases and deaths per 100,000 people in the world, according to statistics compiled by Johns Hopkins University.

Portugal's problems illustrate the risk of letting down pandemic guards when a new, fast-spreading variant is lurking unseen.

The pandemic's spread across Europe is increasingly being powered by an especially contagious virus mutation first detected last year in southeast England, health experts say. The threat is prompting governments to introduce harsh new lockdowns and curfews.

In Denmark, the variant is threatening to spin the pandemic out of control, despite relative early success in containing the spread of the virus. Prime Minister Mette Frederiksen said this month "it is a race against time" to get people vaccinated and slow the variant's progress because it is already too widespread to stop.

The National Institute for Public Health and the Environment in the Netherlands last week reported rising cases of the variant and warned it will push higher the number of hospital admissions and deaths.

"There are essentially two separate COVID-19 epidemics: one epidemic involving the 'old' variant, in which infections are decreasing, and another epidemic involving the (new) variant, in which infections are increasing," it said.

Other mutated versions of the virus have surfaced in Brazil and South Africa.

The British variant will probably become the dominant source of infection in the United States by March, experts say. It has so far been reported in more than 20 states.

The U.S. government's top infectious-disease expert, Dr. Anthony Fauci, says scientists are readying an upgrade for COVID-19 vaccines that will address the British and South African variants.

Moderna, the maker of one of the two vaccines being used in the U.S., says it is beginning to test a possible booster dose against the South African version — a variant Fauci said was "even more ominous" than the British one.

Pfizer, which makes a similar COVID-19 vaccine, says its shot appears effective against the strain from Britain, although questions remain about the South Africa variant.

8:15 PM CT on 1/25/21

(AP) President Joe Biden on Monday reinstated COVID-19 travel restrictions on most non-U.S. travelers from Brazil, Ireland, the United Kingdom and 26 other European countries that allow travel across open borders. He also added South Africa to the list.

White House press secretary Jen Psaki said South Africa was added to the restricted list because of concerns about a variant of the virus that has spread beyond that nation.

“This isn’t the time to be lifting restrictions on international travel,” Psaki said.

The prohibition Biden is reinstating suspends entry to nearly all foreign nationals who have been in any of the countries on the restricted list at any point during the 14 days before their scheduled travel to the U.S.

Top U.S. infectious disease expert Dr. Anthony Fauci called Biden’s decision to reinstate the travel restrictions—and add South Africa to the list— “prudent” in a round of television interviews Monday.

“We have concern about the mutation that’s in South Africa,” Fauci told “CBS This Morning.” “We’re looking at it very actively. It is clearly a different and more ominous than the one in the U.K., and I think it’s very prudent to restrict travel of noncitizens.”

Last week, Biden expanded on the CDC requirement and directed that federal agencies require international travelers to quarantine upon arrival in the U.S. and obtain another negative test to slow the spread of the virus. Those requirements also go into effect Tuesday.

The State Department said in a statement that U.S. citizens should reconsider non-essential travel abroad, noting that access to testing in some nations remains difficult. The agency also cautioned Americans to consider ahead of international travel how they’d pay for health care and additional lodging costs if they became infected or hospitalized while travelling.

The 26 European countries impacted by reinstatement of the ban are part of the border-free Schengen zone. They include Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland.

Biden’s team had announced that he would reimpose the travel restrictions, but the addition of South Africa to the restricted travel list highlights the new administration’s concern about mutations in the virus.

The South Africa variant has not been discovered in the United States, but another variant — originating in the United Kingdom — has been detected in several states.

Fauci said there is “a very slight, modest diminution” of the effectiveness of COVID-19 vaccines against those variants but “there’s enough cushion with the vaccines that we have that we still consider them to be effective against both the UK strain and the South Africa strain.”

Full Coverage: Coronavirus pandemic
But he warned that more mutations are possible and said scientists are preparing to adapt the vaccines if necessary.

“We really need to make sure that we begin, and we already have, to prepare if it’s necessary to upgrade the vaccines,” Fauci said. “We’re already taking steps in that direction despite the fact that the vaccines we have now do work.”

6:34 PM CT on 1/25/21

(AP) Gov. Gavin Newsom lifted stay-at-home orders across the state Monday in response to improving coronavirus conditions, a surprising move hailed by beleaguered businesses. But some local health officials worried could undo the recent sharp drop in cases and hospitalizations.

“We’re seeing a flattening of the curve — everything that should be up is up, everything that should be down is down — case rates, positivity rates, hospitalizations, ICUs," Newsom told reporters.

The turnaround came about a month after hospitals crafted emergency plans for rationing care and as intensive care unit capacity in the vast Southern California region currently stands at 0%. State data models forecast that the region's ICU capacity will rise to 33% — the highest of any of the state's five regions — by Feb. 21.

The lifting of the stay-at-home order allows restaurants and churches to resume outdoor operations and hair and nail salons to reopen in many areas, though local officials could choose to impose stricter rules. The state is also lifting a 10 p.m. to 5 a.m. curfew.

Most California counties will return to the most restrictive purple tier of a four-tier, color-coded system for determining what businesses can be open.

Northern California was never under the stay-at-home order and the Greater Sacramento region exited two weeks ago. Now, the San Francisco Bay Area, the San Joaquin Valley agricultural region and Southern California, covering the majority of the state’s counties, may exit the order.

The state predicted the following regional ICU capacity in four weeks: 25% for the Bay Area; 27.3% in Greater Sacramento; 22.3% in the San Joaquin Valley and 18.9% in Northern California.

After the stay-at-home order was lifted, elected officials in many counties announced they would move to allow the reopening of outdoor restaurant dining and other services.

“We will be moving forward with some limited re-openings, including outdoor dining and personal services,” San Francisco Mayor London Breed said in a tweet.

Heavily populated Orange County south of Los Angeles planned to lift some restrictions as well, said Jessica Good, a spokesperson for the county health agency.

In Los Angeles County, home to 10 million people, county Public Health Director Barbara Ferrer said outdoor dining will reopen Friday with capacity limits for restaurants.

Newsom imposed the stay-at-home order in December as coronavirus cases worsened.

Under the state-imposed system for closures, multi-county regions had to shut down most businesses and order people to stay home when ICU capacity dropped below 15%. The state makes its decisions based on four-week projections showing ICU capacity improving.

Officials have not disclosed the data behind the forecasts, though Dr. Mark Ghaly, secretary of the state's health and human services agency, said the state would make more data public later Monday.

Last weekend, San Francisco Bay Area ICU capacity surged to 23% while the San Joaquin Valley's ICU capacity increased to 1.3%.

Republicans said Newsom was relaxing the rules in response to political pressure and the threat of a recall. Republican organizers have until mid-March to gather 1.5 million signatures to force a recall vote against Newsom, who is halfway through his first term.

“This Governor’s decisions have never been based on science. Him re-opening our state is not an attempt to help working Californians, but rather an attempt to counter the Recall Movement. It’s sad and pathetic," California Republican Party Chairwoman Jessica Millan Patterson tweeted.

Jeff Smith, the Santa Clara County executive, said his county had no plans to impose stricter rules but criticized the state's decision.

“Essentially it’s a decision being made politically that puts people’s lives at risk, especially in Southern California,” he told The Mercury News.

The criticism wasn’t limited to Newsom’s partisan political opponents.

Democratic Assemblywoman Laura Friedman of Glendale said state lawmakers have been kept out of the loop on changing rules that Newsom's administration has used to impose COVID-19 restrictions.

“If you think state legislators were blindsided by, and confused about, the shifting & confusing public health directives, you’d be correct," she tweeted. “If you think we have been quiet about it in Sacramento, you’d be wrong."

Newsom said the appropriate people had been notified in advance and called the suggestion that he was lifting the order due to political pressure “nonsense."

The state's purple public health safety tier, which most counties will now be in, allows for outdoor dining, the openings of hair and nail salons and outdoor church services. Bars that only serve beverages cannot be open.

The county-by-county tier system uses various metrics to determine the risk of community transmission and applies color codes — purple, red, orange or yellow — which correspond to transmission risk levels.

As of last weekend, California has had more than 3.1 million confirmed COVID-19 cases and 36,790 deaths, according to the state’s public health website.

4:19 PM CT on 1/25/21

(AP) Coronavirus deaths and cases per day in the U.S. dropped markedly over the past couple of weeks but are still running at alarmingly high levels, and the effort to snuff out COVID-19 is becoming an ever more urgent race between the vaccine and the mutating virus.

The government's top infectious-disease expert, Dr. Anthony Fauci, said the improvement in numbers around the country appears to reflect a "natural peaking and then plateauing" after a holiday surge, rather than the arrival of the vaccine in mid-December.

The U.S. is recording just under 3,100 deaths a day on average, down from more than 3,350 less than two weeks ago. New cases are averaging about 170,000 a day after peaking at almost 250,000 on Jan. 11. The number of hospitalized COVID-19 patients has fallen to about 110,000 from a high of 132,000 on Jan. 7.

States that have been hot spots in recent weeks such as California and Arizona have shown similar improvements during the same period.

"I don't think the dynamics of what we're seeing now with the plateauing is significantly influenced yet—it will be soon—but yet by the vaccine. I just think it's the natural course of plateauing," Fauci told NBC's "Today."

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security, said too few people have been vaccinated so far for that to have had a significant impact on virus trends. She said she can't predict how long it will take for the vaccines' effects to be reflected in the numbers.

Rivers said she is concerned that the more contagious variants of the virus could lead to a deadly resurgence later this year.

"I think we were on track to have a good — or a better, at least — spring and summer, and I'm worried that the variants might be throwing us a curveball," she said.

2:00 PM CT on 1/25/21

(AP) Mayor Bill de Blasio says New York City could administer 500,000 COVID-19 vaccine doses a week if it had enough supply, but instead has been forced to put off opening mass vaccination sites as it waits for vaccine production to speed up.

The Democratic mayor said at his daily coronavirus briefing Monday that the city has “megasites like Citi Field and Yankee Stadium ready to go” as 24-hour operations, but doesn’t have the supply. City officials had set a goal of 300,000 vaccine doses last week but were only able to give 200,000 shots, de Blasio said as he urged President Joe Biden’s administration to use the Defense Production Act to spur vaccine production.

De Blasio said it will be “a game changer” if U.S. officials approve the Johnson & Johnson vaccine for emergency use because that vaccine requires just one dose, unlike the two vaccines that have been approved in the United States.

De Blasio said the city had 19,000 doses designated as first doses on hand as of Monday and expected to receive 107,000 more in the next few days. That’s not nearly enough to supply all of the city’s planned vaccination sites.

He said 628,831 doses have been administered in the city since the beginning of the vaccination effort last month.

2:00 PM CT on 1/25/21

Frank Hoerrle, a 92-year-old Coast Guard veteran, has had plenty of shots. The COVID-19 vaccine was no different.

"To me, it was another shot. In my life, I've had plenty of them," Hoerrle said.

The former retired pipefitter was born in Germany and came to the U.S. with his family as a child. He remembers the Great Depression and was married to his wife, Helen, for 67 years before she passed away four years ago. The pandemic, to him, is another hardship to overcome.

"You have ups and downs; you cope with them," Hoerrle said. "I believe my life in the last few months has been excellent."

Hoerrle lives at Brookdale Westlake Village, a nursing home west of Cleveland, and was one of the first residents to receive the COVID-19 vaccine there.

"I have no aftereffects. I feel just as good today as I did three to four months ago," Hoerrle said, adding that he is a 60-year-old in the body of a 92-year-old.

Residents like Hoerrle have eagerly stepped up for the shot, hopeful for what herd immunity will mean for their life. And long-term care providers have jumped at the chance to reduce resident mortality and allow their facilities to leave the many challenges of a pandemic that has reduced occupancy rates, worsened staffing struggles and left as many as two-thirds of nursing homes at risk of closure. Preliminary data shows it's working.

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12:05 PM CT on 1/25/21

(AP)  The European Union is pressuring the pharmaceutical company AstraZeneca to deliver more coronavirus vaccine doses to the bloc and to stick to its initial promises once the shot gets EU approval, especially since the bloc has already invested in enhancing production capacity.

Already facing criticism for a slow vaccine rollout around the 27 member nations, the European Commission also wants a transparency register to record and approve all export of vaccines out of EU nations to third countries.

"We, as the EU, must be able to know whether and what vaccines are being exported from the EU," German Health Minister Jens Spahn said. "Only that way can we understand whether our EU contracts with the producers are being served fairly. An obligation to get approval for vaccine exports on the EU level makes sense."

European Commission President Ursula von der Leyen held urgent talks Monday with company chief Pascal Soriot, and EU nations are also meeting with AstraZeneca to encourage the British-Swedish company to ramp up its vaccine production and meet its contractual targets.

The EU, with the economic and political clout of the biggest trading bloc in the world, is lagging badly behind countries like Israel and Britain in the rollout of vaccines for its most vulnerable population and healthcare workers. The bloc's leaders have faced strong criticism for moving so slowly.

The European Medicines Agency is scheduled to review the Oxford-AstraZeneca coronavirus vaccine Friday and its approval is hotly anticipated. The AstraZeneca vaccine is already being used in Britain and has been approved for emergency use by half a dozen countries, including India, Pakistan, Argentina and Mexico.

AstraZeneca's announcement that it will deliver fewer vaccines to the EU early on has only increased pressure on the 27-nation bloc, especially since Pfizer-BioNTech, the first vaccine to get EU approval, failed last week to keep up its promised deliveries to the EU. Pfizer has temporarily reduced vaccine deliveries to the EU and Canada as it revamps its plant in Belgium to increase overall production. Italy has threatened to sue Pfizer for the delays.

10:21 AM CT on 1/25/21

(AP) President Joe Biden on Monday will formally reinstate COVID-19 travel restrictions on non-U.S. travelers from Brazil, Ireland, the United Kingdom and 26 other European countries that allow travel across open borders, according to two White House officials.

The officials, who spoke on the condition of anonymity to discuss the order, also confirmed Sunday that South Africa would be added to the restricted list because of concerns about a variant of the virus that has spread beyond that nation.

Top U.S. infectious disease expert Dr. Anthony Fauci called Biden's decision "prudent" Monday in a round of television interviews.

"We have concern about the mutation that's in South Africa," Fauci told "CBS This Morning." "We're looking at it very actively. It is clearly different and more ominous than the one in the U.K., and I think it's very prudent to restrict travel of noncitizens."

Biden is reversing an order from President Donald Trump in his final days in office that called for the relaxation of the travel restrictions as of Tuesday. Trump's move was made in conjunction with a new requirement from the Centers for Disease Control and Prevention that all international travelers to the U.S. obtain a negative test for COVID-19 within three days of boarding their flight.

Biden's team had announced that he would reimpose the travel restrictions, but the addition of South Africa to the restricted travel list highlights the new administration's concern about mutations in the virus.

The South Africa variant has not been discovered in the United States, but another variant — originating in the United Kingdom — has been detected in several states.

Fauci said there is "a very slight, modest diminution" of the effectiveness of COVID-19 vaccines against those variants but "there's enough cushion with the vaccines that we have that we still consider them to be effective against both the UK strain and the South Africa strain."

9:56 PM CT on 1/24/21

(AP) Advocates for farmworkers, teachers, grocery store clerks and other essential workers are worried they will have to wait until this summer to be vaccinated against the coronavirus as California considers giving priority to older residents.

State officials said the move makes sense given older people have a much higher rate of hospitalization and death from COVID-19. But with California struggling to get and give the vaccine, it could take until June to vaccinate all Californians 65 and older, the Sacramento Bee reported Sunday.

That could mean teachers and school workers will probably not be vaccinated until this summer, said Debra Schade, a school board member at the Solana Beach School District in San Diego County and a director at the California School Boards Association.

“It will be a heavy lifting to get those districts open ... without risk mitigation that the vaccine would provide," she said.

Some local governments have already started vaccinating essential workers and Fresno County said it will begin offering vaccines on Monday to about 3,000 farmworkers. But Noe Paramo, an advocate at the California Rural Legal Assistance Foundation, said without clear guidance from the state to prioritize vaccinating farmworkers, counties could decide to leave them fall by the wayside.

Three-quarters of those who died from COVID-19 in California were 65 or older, according to data recently presented to a state vaccine advisory committee.

By vaccinating older adults first, the state could push down the number of those hospitalized, which could benefit the community as a whole, California Department of Public Health Director Dr. Tomás J. Aragón said at the meeting.

The rates of new coronavirus infections and hospitalizations are dropping across California, but health officials warn those trends are tempered by very high death rates.

The state reported 429 deaths on Sunday, two days after reaching a one-day record of 764, according to the Department of Public Health. California’s death toll since the start of the pandemic rose to 36,790, while total cases reached over 3.1 million.

Meanwhile, the number of people in the hospital with COVID-19 was 17,810 statewide, a drop of 17% in two weeks.

The positivity rate for people being tested has dropped by 10% statewide in the last week, which means fewer people will end up in hospitals.

6:07 PM CT on 1/24/21

(AP) Virginia is lagging behind when it comes to tracking COVID-19 vaccinations by race and ethnicity compared to other states, according to public health data.

Virginia is one of only 17 states that were publicly reporting COVID-19 vaccination data by race and ethnicity as of last week, but the state’s COVID-19 website indicates that race and ethnicity data has not been reported for more than half of the roughly 475,000 people who have received at least one dose of the vaccine.

Virginia public health officials have said they will distribute the vaccine equitably, but researchers say that goal will be difficult to achieve without accounting for demographic data.

Black and Latino workers make up nearly a third of the state’s healthcare work force, but account for only about 17% of vaccinations with race and ethnicity data reported as of Sunday. Whites accounts for about 71% of vaccinations for which race and ethnicity have been recorded.

The Richmond Times-Dispatch reported that The Virginia Hospital and Healthcare Association, whose 110 hospitals have doled out more than 230,000 vaccines, did not answer a query on whether doctors at hospitals are asking patients about race or ethnicity and instead referred questions to public health officials.

Virginia Department of Health spokeswoman Erin Beard said the agency will not require vaccinators to report some demographics like race and ethnicity because it could prevent a provider from reporting a shot given. Beard said that the more information needed to document a vaccine in the state’s tracking system, the more likely the vaccine cannot be reported.

“VDH’s goal is to vaccinate as many people as possible, and we do not want to turn away any person because they did not provide supplementary data,” Beard said.

While more than half of the reported vaccinations in Virginia do not include race or demographic data, the percentage is somewhat less in Delaware, with no such demographic data for 35% of doses administered. In Maryland, racial data is missing for about 6% of vaccinations administered, and ethnic data for about 13%. North Carolina, meanwhile, has recorded race and ethnicity data for all of its vaccinations, according to the state’s vaccine website.

Nakeina Douglas-Glenn, a professor at Virginia Commonwealth University who specializes in race and social equity, said the lack of data collection in Virginia shows why mistrust in healthcare systems and government agencies is so ingrained.

Virginia Health Secretary Dan Carey told lawmakers at a health committee meeting last week that he expects a “dramatic improvement” over the next two weeks and assured that Virginia is “walking the walk” in getting vaccines to historically discriminated-against groups.

3:21 PM CT on 1/24/21

(AP) A mass vaccination event in Lincoln that helped Nebraska record one of its most productive days in its campaign to distribute shots could serve as a model for future events.

Health officials in Lincoln said roughly 2,400 health care workers received the vaccine Friday at the event held at the Pinnacle Bank Arena. That helped the state administer 8,701 doses of the vaccine on Friday in what was the second-busiest day of the campaign so far.

Jan. 5 — when 13,660 doses of the vaccine were administered — is the busiest day so far. The state has been averaging about 4,500 shots a day over the past two weeks as it works to speed up distribution of the vaccine.

Pat Lopez, director of the Lincoln-Lancaster County Health Department, said Friday's mass vaccination event was successful with most people able to get their shots and get out of the arena in less than 30 minutes.

Currently, the state is receiving about 23,500 doses of coronavirus vaccines each week that are distributed statewide.

The state said 599 cases of the virus were reported Saturday. A total of 186,854 cases and 1,879 deaths have been recorded so far.

The number of people hospitalized with the virus dipped below 400 for the first time since October Saturday when 390 people were being treated.

1:14 PM CT on 1/24/21

(AP) The Miami Heat are bringing back some fans, with help from some dogs.

The Heat will use coronavirus-sniffing dogs at AmericanAirlines Arena to screen fans who want to attend their games. They’ve been working on the plan for months, and the highly trained dogs have been in place for some games this season where the team has allowed a handful of guests — mostly friends and family of players and staff.

Starting this week, a limited number of ticket holders will be in the seats as well, provided they get past the dogs first.

“If you think about it, detection dogs are not new,” said Matthew Jafarian, the Heat's executive vice president for business strategy. “You’ve seen them in airports, they’ve been used in mission critical situations by the police and the military. We’ve used them at the arena for years to detect explosives."

The first Heat game with ticket holders is set for Thursday against the Los Angeles Clippers. Monday is the first day that season ticket holders will be able to start securing their seats.

The Heat have sold out 451 consecutive games, the sixth-longest streak in NBA history. Sellouts obviously aren’t happening this year. The Heat will keep attendance under 2,000 for now, or less than 10% of the arena's typical capacity.

“Please note that seating will be very limited, as we will be observing proper physical distancing,” the team said in its letter to season ticket holders.

The coronavirus-sniffing dog idea has been put into place at airports in Dubai, United Arab Emirates, and Helsinki, Finland, in recent months. At Heat games, fans arriving for the game will be brought to a screening area and the detection dogs will walk past. If the dog keeps going, the fan is cleared; if the dog sits, that’s a sign it detects the virus and the fan will be denied entry.

Other protocols the Heat will use: A health screening questionnaire will be mandatory for all guests, masks must be worn continually and only soda and water will be sold. All transactions will be cashless and if a fan feels ill during a game, isolation rooms will be available.

And if a fan is allergic to or afraid of dogs, the Heat are offering an option to skip the dog screening and submit to a rapid antigen test instead. The Heat say those tests can be processed in less than 45 minutes.

The move comes at a time where some arenas in Florida — such as Amalie Arena in Tampa, home of the NHL's Tampa Bay Lightning and temporary home of the NBA's Toronto Raptors — are not allowing any fans, despite doing so earlier this season. The NHL's Florida Panthers, who play about a half-hour north of Miami, have allowed fans.

It also comes during a month when the NBA has postponed 19 games because of virus-related issues such as positive tests or multiple players on a team being flagged by contact tracing.

10:56 AM CT on 1/24/21

(AP) If Michigan could administer 50,000 coronavirus vaccine doses a day, it could hit its goal of inoculating 70% of people age 16 and older by August.

At the current rate, about 29,000 per day, it would not finish until a year from now.

The issue is limited supplies — something Gov. Gretchen Whitmer and health officials hope can be addressed as new President Joe Biden takes the helm amid the largest vaccination effort in U.S. history and as more contagious virus variants spread.

“That's our universal frustration,” the Democratic governor said. “We have the capacity and the plan to do a lot more vaccinations quicker. But the federal government ... it's been hard. They have not gotten us what we need.”

Whitmer said she is confident Michigan can do 50,000 vaccinations a day but is only getting about 60,000 doses a week of the Pfizer vaccine. The other COVID-19 vaccine, from Moderna, is going to residents and staff in long-term care facilities through a federal program. The state received permission to instead send 120,000 Moderna doses to hospitals and local health departments over this past week and the coming week.

Still, it is not enough. In the first six weeks of the monumental undertaking to inoculate 5.6 million residents, Michigan has gotten 182,000 doses a week on average — 52% of what is needed to inject 50,000 shots in arms per day. Both vaccines are designed to be given in two doses, three or four weeks apart.

In the last full week of President Donald Trump's term, Whitmer asked the U.S. Department of Health and Human Services for permission to buy 100,000 doses from Pfizer, which makes the vaccine at its plant in Portage. It was not clear if she will renew the request with the Biden administration. Whitmer spokesman Bobby Leddy said Biden is implementing a “clear national strategy” to increase production of vaccine supplies, and the governor is talking with his administration on how best to proceed.

Whitmer said she hopes two additional vaccines, from Johnson & Johnson and AstraZeneca, are authorized soon.

“Everyone who wants a vaccine is going to get one,” she said. “Depending on how quickly we get those vaccines to the state, that's what going to determine how quickly we're going to be able to get to everyone.”

Biden wants 100 million doses administered in his first 100 days in office. Some experts say his administration should strive for two or three times that number.

After a bumpy start, Michigan is vaccinating more people per capita than many states are. Its rate was 18th-highest Saturday, a marked improvement from when it was seventh-lowest less than three weeks ago.

Hospitals and local health departments, which are administering vaccines, say the process is going more smoothly, but demand far outpaces supply. Transitioning from Phase 1A, which includes 800,000 health care workers and long-term care staff and residents, to the elderly and frontline essential workers like teachers made nearly 1.7 million more people eligible.

“The biggest issue right now is getting more vaccine into our state,” said Ruthanne Sudderth, senior vice president of public affairs and communications for the Michigan Health & Hospital Association. Health systems, especially large ones, could have a much higher output if they had more doses, she said.

9:05 AM CT on 1/24/21

(Canadian Press) Canada's federal government has approved an Ottawa company's made-in-Canada rapid COVID-19 test, Health Canada confirmed Saturday as the nation's top doctor warned the virus's impact on the health-care system showed no signs of abating.

The test developed by Spartan Bioscience is performed by a doctor and provides on-site results within an hour, a spokeswoman for the federal agency said.

Spartan bills the test as the first "truly mobile, rapid PCR test for COVID-19 for the Canadian market."

"The Spartan system will be able to provide quality results to remote communities, industries and settings with limited lab access, helping relieve the burden on overwhelmed healthcare facilities," the company said in a news release Saturday.

The company originally unveiled a rapid test for COVID-19 last spring but had to voluntarily recall it and perform additional studies after Health Canada expressed some reservations.

At the time, Spartan said Health Canada was concerned about the "efficacy of the proprietary swab" for the testing product.

The new version uses "any nasopharyngeal swab" rather than one of the company's own design, Health Canada said, and meets the agency's requirements for both safety and effectiveness.

The Spartan COVID-19 System was developed through clinical evaluation completed in Canada and the U.S., with the University of Ottawa Heart Institute as one of the testing locations.

The company said it has already started production on the rapid tests.

8:54 PM CT on 1/23/2021

(AP) A Chinese city has brought 2,600 temporary treatment rooms online as the country’s north battles new clusters of coronavirus.

The single-occupancy rooms in the city of Nangong in Hebei province just outside Beijing are each equipped with their own heaters, toilets, showers and other amenities, the official Xinhua News Agency reported.

Special attention has been paid to Hebei because of its proximity to the capital and the province has locked down large areas to prevent further spread of the virus. The provincial capital Shijiazhung and the city of Xingtai, which encompasses Nangong, have been largely sealed off from the rest of the country. Community isolation and large-scale testing have also been enforced.

China on Saturday marked the anniversary of the start of a 76-day lockdown in the central city of Wuhan, where the virus was first detected in late 2019. A World Health Organization inspection team is in the city to probe the virus’ origins, amid stiff efforts by China to defend its response to the outbreak and promote theories that the virus might have come from elsewhere.

The National Health Commission on Sunday reported 19 additional cases had been detected in Hebei over the previous 24 hours. The far northeastern province of Heilongjiang reported another 29 cases, linked partly to an outbreak at a meat processing plant. Beijing, where around 2 million residents have been ordered to undergo new testing, reported two new confirmed cases.

China currently has 1,800 people being treated for COVID-19, 94 of them listed in serious condition, with another 1,017 being monitored in isolation for having tested positive for the virus without displaying symptoms.

6:13 PM CT on 1/23/2021

(AP) New York will be sending more vaccination preparation kits to senior housing complexes and churches in an effort to ensure fairness in vaccine distributions, Gov. Andrew Cuomo said Saturday.

The kits include syringes, vials, room dividers, privacy curtains, cleaning supplies, personal protective gear and other items. They also include instructions on how to set up a vaccination site.

New York deployed the first kits last week to five New York City Housing Authority senior citizen complexes and eight churches and cultural centers where nearly 4,200 people eligible to receive the vaccine were vaccinated, Cuomo said.

Kits are now being sent to four additional New York City senior complexes and eight other churches statewide, with plans to vaccine another 3,000 people at those locations by Tuesday. Locations in Brooklyn, the Bronx, Nassau County, Suffolk County, Rochester, Syracuse, Albany, and Buffalo will be receiving the kits.

The kits are part of an effort to ensure vaccinations in Black, Latino and other communities where COVID-19 has had a disproportionate impact, the governor said.

Also Saturday, the governor’s office reported 144 more deaths statewide from the coronavirus. More than 8,800 people were hospitalized, a drop of 44 compared with Friday’s data. 

3:35 PM CT on 1/23/2021

Walgreens has administered more than 1 million COVID-19 vaccinations across long-term care facilities, according to a press release from the company. 

The pharmacy chain began administering COVID-19 vaccinations as part of the Centers for Disease Control and Prevention (CDC) Pharmacy Partnership for Long-Term Care Program on Dec. 21.

“Thanks to the dedication of tens of thousands of Walgreens pharmacy team members, we have been able to provide 1 million COVID-19 vaccinations to those who need them most in just one month,” said Walgreens President John Standley. “This unprecedented effort has not been without challenges, but as federal, state and local jurisdictions continue to advance their prioritization and distribution plans, we have been able to rapidly expand vaccine access to our nation’s most vulnerable populations and help our communities begin to emerge from this pandemic.”

COVID-19 vaccines are not yet available to the general public. Eligible individuals vary based on state and jurisdiction guidelines and may include healthcare workers, people ages 65 and older and individuals with pre-existing conditions. 

1:15 PM CT on 1/23/2021

Pfizer will ship fewer COVID-19 vaccine vials, after learning that an extra dose could be squeezed out of vials that are supposed to contain only five each.

The drug company charges by the dose, and it had committed to deliver 200 million doses by the end of July.

Pfizer successfully petitioned the FDA to change the wording of its emergency use authorization to formally acknowledge that its vials contain six doses. As a result, Pfizer said it can now manufacture 2 billion doses this year instead of the 1.3 billion it had planned. That doesn't, however, mean that Pfizer is delivering those doses to American citizens as it has contracts with other foreign governments.

11:48 AM CT on 1/23/2021

The Minnesota Star Tribune reports that the coronavirus has wreaked havoc for the not-for-profit world, from large health systems to small arts and social service agencies and colleges. These organizations must now figure out how to rebuild after vaccines allow public spaces to open and people form new habits. 

8:58 AM CT on 1/23/2021

(AP) A year ago, a notice sent to smartphones in Wuhan at 2 a.m. announced the world’s first coronavirus lockdown, bringing the bustling central Chinese industrial and transport center to a virtual standstill almost overnight. It would last 76 days.

Early Saturday morning, however, residents of the city where the virus was first detected were jogging and practicing tai chi in a fog-shrouded park beside the mighty Yangtze River.

Life has largely returned to normal in the city of 11 million, even as the rest of the world grapples with the spread of the virus’ more contagious variants. Efforts to vaccinate people for COVID-19 have been frustrated by disarray and limited supplies in some places. The scourge has killed more than 2 million people worldwide.

Traffic was light in Wuhan but there was no sign of the barriers that a year ago isolated neighborhoods, prevented movement around the city and confined people to their housing compounds and even apartments.

Wuhan accounted for the bulk of China’s 4,635 deaths from COVID-19, a number that has largely stayed static for months. The city has been largely free of further outbreaks since the lockdown was lifted on April 8, but questions persist as to where the virus originated and whether Wuhan and Chinese authorities acted fast enough and with sufficient transparency to allow the world to prepare for a pandemic that has sickened more than 98 million.

Wuhan has been praised for its sacrifice in the service of the nation, turning it into a sort of Stalingrad in China’s war against the virus, commemorated in books, documentaries, TV shows and florid panegyrics from officials including head of state and leader of the Communist Party Xi Jinping.

“We think Wuhan is a heroic city. After all, it stopped its economy to help China deal with the pandemic. This is a noble act,” said resident Chen Jiali, 24, who works at an internet shopping company.

China on Saturday announced another 107 cases, bringing its total since the start of the pandemic to 88,911. Of those, the northern province of Heilongjiang accounted for the largest number at 56. Beijing and the eastern financial hub of Shanghai both reported three new cases amid mass testing and lockdowns of hospitals and housing units linked to recent outbreaks.

Authorities are wary of the potential for a new surge surrounding next month’s Lunar New Year holiday and are telling people not to travel and to avoid gatherings as much as possible. Schools are being let out a week early and many have already shifted to online classes. Mask wearing remains virtually universal indoors and on public transport. Mobile phone apps are used to trace people’s movements and prove they are both virus-free and have not been to areas where suspected cases have been found.

Since the end of the lockdown, Wuhan has largely been spared further outbreaks, something residents such as chemistry teacher Yao Dongyu attribute to heightened awareness resulting from the traumatic experience of last year.

“At that time, people were very nervous, but the government gave us huge support. It was a very powerful guarantee, so we got through this together,” said Yao, 24. “Since Wuhan people went through the pandemic, they’ve done better in personal precautions than people in other regions.”

China has doggedly defended its actions in the early days of the outbreak, saying it helped buy time for the rest of the world while pushing fringe theories that the virus was brought to the city from outside China, possibly from a laboratory in the U.S.

After months of negotiations, China finally gave permission last week for the World Health Organization to send a team of international experts to begin investigating the virus’ origins. They are currently undergoing two weeks of quarantine.

A panel of experts commissioned by the WHO criticized China and other countries this week for not moving to stem the initial outbreak earlier, prompting Beijing to concede it could have done better.

Meanwhile, in Hong Kong in southern China, thousands of residents were locked down Saturday in an unprecedented move to contain a worsening outbreak in the city.

Hong Kong has been grappling to contain a fresh wave of the coronavirus since November. More than 4,300 cases have been recorded in the last two months, making up nearly 40% of the city’s total.

Authorities said in a statement that an area comprising 16 buildings in the working-class Yau Tsim Mong district will be locked down until all residents have been tested.

8:55 PM CT on 1/22/21

(AP) Thousands of Hong Kong residents were locked down Saturday in an unprecedented move to contain a worsening outbreak in the city, authorities said.

Hong Kong has been grappling to contain a fresh wave of the coronavirus since November. Over 4,300 cases have been recorded in the last two months, making up nearly 40% of the city’s total.

Coronavirus cases in Hong Kong’s Yau Tsim Mong district – a working-class neighborhood with old buildings and subdivided flats – represent about half of infections in the past week.

Sewage testing in the area picked up more concentrated traces of the virus, prompting concerns that poorly built plumbing systems and a lack of ventilation in subdivided units may present a possible path for the virus to spread.

Authorities said in a statement Saturday that an area comprising 16 buildings in Yau Tsim Mong will be locked down until all residents have been tested. Residents will not be allowed to leave their homes until they have received their test results to prevent cross-infection.

“Persons subject to compulsory testing are required to stay in their premises until all such persons identified in the area have undergone testing and the test results are mostly ascertained,” the government said in a statement.

Hong Kong has previously avoided lockdowns in the city during the pandemic, with leader Carrie Lam stating in July last year that authorities will avoid taking such “extreme measures” unless it had no other choice.

The restrictions, which were announced at 4 a.m. in Hong Kong, are expected to end within 48 hours, the government said.

It appealed to employers to exercise discretion and avoid docking the salary of employees who have been affected by the restrictions and may not be able to go to work.

Hong Kong has seen a total of 9,929 infections in the city, with 168 deaths recorded as of Friday.

6:55 PM CT on 1/22/21

(AP) A bill that would protect businesses and health care providers from coronavirus-related lawsuits is advancing quickly through the Montana Legislature, after the state's Republican governor said the measure was necessary to remove a statewide mask mandate put in place by his Democratic predecessor.

Gov. Greg Gianforte also said more vulnerable Montana residents would have to receive COVID-19 vaccines before he lifts the mandate former Gov. Steve Bullock implemented in July.

Montana joins at least 20 other states that are considering liability protections against claims related to COVID-19 for businesses, health care providers or educational institutions, according to the National Conference of State Legislatures.

The House Businesses and Labor Committee held a hearing Friday on the bill after the Senate passed the bill in a 37-13 vote earlier this week.

Republican lawmakers, with majorities in both the House and Senate, say the measure is needed to reopen the state’s economy following an economic downturn induced by the pandemic.

Under the bill, businesses cannot be sued by individuals exposed to the coronavirus on their premises, except in cases of “gross negligence” or when businesses intentionally spread the virus. Business owners would not be required to uphold federal or state mask requirements or temperature-check requirements if they remain in place.

“This is not an immunity bill,” said bill sponsor Sen. Steve Fitzpatrick, R-Great Falls. “It's about people who are doing the best they can, and then still getting sued. We want to incentivize people to do the best they can, open their business and get going."

Fitzpatrick said the bill was written with support and guidance from the governor's office.

Gianforte said Friday that he’s encouraged by the progress on the bill, but would have to wait until it landed on his desk to see if it was sufficient to lift the mask requirement.

The governor also said not enough vulnerable residents had been vaccinated to remove mandate, and encouraged Montana residents to continue wearing masks to reduce the spread of the virus. As of Friday, only 14,000 Montana residents — less than 2% of the state's population — had received both doses of the COVID-19 vaccine necessary to achieve immunity.

The liability measure has wide support from industry groups in the state, which say it would allow their businesses to operate more confidently during the pandemic. Opponents of the measure say it would provide blanket protections for businesses and the medical industry from legitimate lawsuits.

Michelle Zizian, a resident of Gardiner, a gateway community to Yellowstone National Park, said the bill could hurt the town's economy by allowing employers in the tourism industry to “sidestep any consequences of putting employees in harm’s way."

As of a week ago, there were 32 lawsuits filed in the state related to COVID-19, but only two would be affected by the legislation, said Al Smith, executive director of the Montana Trial Lawyers Association. Both target long-term care facilities where residents have died from the virus.

Smith said existing Montana law already protects businesses from “frivolous” lawsuits, making this bill unnecessary.

“As far as an explosion of lawsuits – it just hasn’t happened in Montana,” he said.

4:36 PM CT on 1/22/21

(AP) President Joe Biden took executive action Friday to speed a stopgap measure of financial relief to millions of Americans affected by the coronavirus pandemic while Congress begins to consider his much larger $1.9 trillion package.

The two executive orders that Biden signed would increase food aid, protect job seekers on unemployment and clear a path for federal workers and contractors to get a $15 hourly minimum wage.

"This can help tens of millions of families — especially those who cannot provide meals for their kids," Biden said. "A lot of Americans are hurting. The virus is surging. ... No matter how you look at it, we need to act."

Biden described the pandemic situation in the U.S. as bleak, saying the virus could not be stopped in the next several months and predicting that well over 600,000 would die. The nation's death toll has just passed 400,000.

The administration has emphasized the orders are not substitutes for the additional stimulus that Biden says is needed beyond the $4 trillion in aid that has already been approved, including $900 billion this past December. Several Republican lawmakers have voiced opposition to provisions in Biden's plan for direct payments to individuals, state and local government aid and a $15 hourly minimum wage nationwide.

2:43 PM CT on 1/22/21

(AP) California Gov. Gavin Newsom has from the start said his coronavirus policy decisions would be driven by data shared with the public to provide maximum transparency.

But with the state starting to emerge from its worst surge, his administration won't disclose key information that will help determine when his latest stay-at-home order is lifted.

State officials said they rely on a very complex set of measurements that would confuse and potentially mislead the public if they were made public.

After Newsom, a Democrat, imposed the nation's first statewide shutdown in March, his administration developed reopening plans that included benchmarks for virus data such as per capita infection rates that counties needed to meet to relax restrictions.

It released data models state officials used to project whether infections, hospitalizations and deaths are likely to rise or fall.
As cases surged after Thanksgiving, Newsom tore up his playbook. Rather than a county-by-county approach, he created five regions and established a single measurement — ICU capacity — as the determination for whether a region was placed under a stay-at-home order.

In short order, four regions — about 98% of the state's population — were under the restrictions after their capacity fell below the 15% threshold. A map updated daily tracks each region's capacity.

At the start of last week, the four regions appeared unlikely to have the stay-at-home order lifted soon because capacity was well below 15%. But within a day, the state announced it was lifting the order for the 13-county Greater Sacramento region.

Suddenly, outdoor dining and worship services were OK again, hair and nail salons and other businesses could reopen, and retailers could allow more shoppers inside.

Local officials and businesses were caught off guard. It's a mystery how the state made the decision or how and when it will lift the most serious restrictions on the bulk of the population because the data is not being shared.

Public health officials relied on a complex formula to project that while the region's intensive care capacity was below 10%, it would climb above 15% within four weeks. On Thursday, it was at 8%, roughly the same as when the order was lifted.

"What happened to the 15%? What was that all about?" asked Dr. George Rutherford, an epidemiologist and infectious-diseases control expert at University of California, San Francisco. "I was surprised. I assume they know something I don't know."

State officials projected four weeks of ICU capacity using a combination of models to estimate infections.

"At the moment the projections are not being shared publicly," Department of Public Health spokeswoman Ali Bay said in an email.

California Health and Human Services Agency spokeswoman Kate Folmar said officials are committed to transparency, providing twice-weekly updates on whether certain regions can relax restrictions. But she said projected ICU capacity is based on multiple variables including available beds and staffing that change regularly.

"These fluid, on-the-ground conditions cannot be boiled down to a single data point — and to do so would mislead and create greater uncertainty for Californians," she said in a statement.

2:43 PM CT on 1/22/21

HCA Healthcare launched a joint venture to produce masks from Asheville, N.C., the hospital chain announced Thursday.

HCA has teamed up with A Plus International, a Chino, Calif.-based healthcare equipment manufacturer, to supply surgical and procedure masks in early 2021. The companies will equally fund the joint venture via the HCA Healthcare Mission Fund, which was created following HCA's acquisition of Mission Health to support healthcare-related businesses in Western North Carolina.

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11:34 AM CT on 1/22/21

(AP) Nearly 2,000 doses of a COVID-19 vaccine were spoiled at a Veterans Affairs hospital in Boston after a contractor accidentally unplugged a freezer, hospital officials announced Thursday.

Staff at the Jamaica Plain VA Medical Center discovered on Tuesday that a freezer had failed, compromising 1,900 doses of the Moderna COVID-19 vaccine.

The plug to the freezer was found to be loose after a contractor accidentally unplugged it while cleaning, according to a statement from Kyle Toto, a spokesman for VA Boston Healthcare System. The freezer had been in a safe location and had an alarm system, he said.

The system is investigating the cause of the incident and why the monitoring alarm system did not work. More doses are on the way, Toto said, and officials "do not foresee disruption" of the system's vaccination effort.

Temperature issues have caused problems for vaccine rollouts in other states.

Nearly 12,000 Moderna doses that were being shipped to Michigan on Sunday were spoiled after getting too cold. In Wisconsin, a pharmacist faces charges after authorities say he deliberately ruined hundreds of doses by removing them from refrigeration for two nights.

The Moderna vaccine needs to be stored at regular freezer temperatures, but not the ultra-cold required for Pfizer-BioNTech’s shot.

9:26 AM CT on 1/22/21

(AP) Dr. Anthony Fauci says a lack of candor and facts about the coronavirus pandemic under President Donald Trump “very likely” cost lives because it delayed getting sound scientific advice to the country.

“You know, it very likely did,” Fauci told CNN. “When you start talking about things that make no sense medically and no sense scientifically, that clearly is not helpful.”

Fauci didn’t single out failings by any individual or administration official, saying he didn’t want that to “be a sound bite.” But Trump frequently dismissed the advice of his administration’s scientists and claimed the virus would “fade away.”

President Joe Biden says restoring trust is a top goal of his coronavirus strategy. More than 410,000 people have died from the coronavirus in the U.S., the most in the world.

8:19 PM CT on 1/21/21

(AP) On the anniversary of the first confirmed COVID-19 case in the United States, Amazon said Thursday it will host a one-day vaccination drive in Seattle this weekend to inoculate as many as 2,000 people.

The tech giant, which has also offered its help to the new Biden administration as it tries to speed vaccine rollouts nationwide, said it would partner with Virginia Mason Medical Center on the effort Sunday.

“We think we can leverage our operations, our information technology, our logistics, our communications capabilities in ways that can help with this effort, and we want to be a part of it in any way that we can,” said Jay Carney, Amazon's senior vice president of global corporate affairs.

Anyone eligible for the vaccine — including those over 65 years old and front-line health care workers — will be able to attend the pop-up clinic at Amazon's South Lake Union campus after registering for a vaccine waitlist on Virginia Mason's website. Virginia Mason will provide the vaccine and volunteers and schedule people for their second shots before they leave.

Meanwhile, Washington state health officials are plowing ahead with plans to open four mass vaccination sites next week, despite logistical concerns that include questions about vaccine supply.

“When things move fast, nothing is perfect,” Dr. Umair Shah, secretary of the state Department of Health, said during an online news briefing.

Shah acknowledged leaders could face criticism for launching the mass vaccination sites on Monday without knowing when to expect a jump in vaccine shipments from the federal government. The state’s hospitals have warned that having to cancel appointments due to a lack of supply would frustrate patients and undermine trust in the system.

But Shah said it's crucial to build the state's vaccination capacity as quickly as possible. Washington is aiming to triple its current pace of administering the vaccines from about 15,000 a day to 45,000 a day; as of early this week the state had administered slightly less than half of the vaccination doses it had received, though that number could be artificially low due to lags in recordkeeping.

Some hospitals have had more vaccines than they've been able to administer quickly, while some vaccination clinics, including some in Snohomish County, have had to stop booking appointments due to a lack of the shots.

“We need a much more rapid delivery system,” Washington Gov. Jay Inslee said during a news conference Thursday. “We are asking — and frankly demanding — that our partners hustle up here.”

Shah said states are asking President Joe Biden's administration for earlier and more reliable predictions on vaccine supply deliveries. Biden has set a goal of having 100 million doses administered nationwide in his first 100 days in office.

"We have high hopes for new, effective federal leadership in the fight against COVID-19," Shah said.

The planned mass vaccination sites include Spokane Arena, the Benton County Fairgrounds in Kennewick, the Town Toyota Center in Wenatchee and the Clark County Fairgrounds in Ridgefield. Some or all will be staffed by the National Guard, but other details remain unanswered, including whether they will be first-come, first-served; how people will make appointments if not; and whether they will be drive-through or walk-up.

6:23 PM CT on 1/21/21

(AP) North Carolina's top public official acknowledged for the first time on Thursday that the state has seen a small number of coronavirus vaccine doses thrown out at a time when supplies remain limited.

Department of Health and Human Services Secretary Mandy Cohen also announced a new $2.5 million effort with the Department of Transportation to provide free transportation to and from vaccination clinics.

Still, North Carolina has seen an unspecified number of doses scrapped. The state has not publicly shared the number of wasted doses due to a vaccine being stored too long in a freezer or not being administered in a timely manner once it has been taken out of a freezer. Cohen estimated the waste is “in the tens of doses.”

The discarded supplies pale in comparison to the 573,130 doses administered by the end of Wednesday. The state is working to ramp up vaccination through its new transportation initiative.

People in need of rides to vaccination clinics are encouraged to reach out to their local transit agency. Each agency will get a set amount of money, and the program will continue until the Coronavirus Relief Funding is exhausted.

“Lack of transportation shouldn’t be the reason someone doesn’t get their shot,” Cohen said at a news conference.

Asked about vaccine supply shortages from the federal government, Cohen said she wants the existing supply of first doses to dwindle, which would demonstrate that the state is more efficiently utilizing its resources. “That is our goal. To run out of vaccines every week before the next shipment comes, and that's what we have directed our local health departments and hospitals. Yes, we are running out of vaccines in all places.”

Cohen wants the 136 different vaccine providers in the state to develop waiting lists for residents 65 years or older who are currently eligible to get vaccinated. Some Charlotte-area residents cancelled existing vaccine appointments after earlier ones became available.

In cases where wait lists aren't yet in place, she is urging vaccinators to grab someone off the street to ensure no additional doses go to waste.

“The supplies are truly limited, and everyone's going to have to have some patience here as we work to get more vaccine here into the state over a period of time," Cohen said.

The state health department is working to address concerns that the federal Centers for Disease Control and Prevention is not adequately representing the state's vaccine progress on a website where it releases vaccine data. The CDC data on Wednesday ranked North Carolina as the 11th slowest state in the country in administering doses per capita and underrepresented the number of doses North Carolina has administered to date by about 150,000.

4:29 PM CT on 1/21/21

(AP) A hospital in Central Oregon is reporting a COVID-19 outbreak among workers.

The St. Charles Redmond hospital said late Wednesday that 31 people have tested positive, and the Deschutes County Health Services and the Oregon Health Authority are investigating, KTVZ-TV reported.

It's unclear how the outbreak occurred. St. Charles Health System is headquartered in Bend. They own and operate St. Charles Bend, Madras, Prineville and Redmond.

Iman Simmons, St. Charles' chief operating officer, said Wednesday evening that 10 of the 31 caregivers had received the first of two doses of the Pfizer-BioNTech vaccine. She said some may have gotten the second dose, but could not confirm that.

She said the 31 people infected will be on paid furlough for two weeks, and that they must be symptom-free and test negative for the virus before returning to work.

New precautions are in place at the hospital, such as testing all caregivers and increasing air exchange. They are also limiting visitors.

2:10 PM CT on 1/21/21

(AP) The largest business lobbying group in the U.S. is supporting President Joe Biden’s early moves to confront the coronavirus pandemic.

The U.S. Chamber of Commerce chief policy officer Neil Bradley says Biden is correct in his assessment that controlling the coronavirus is the key to fully reopening the economy.

“America must return to health before we can restore economic growth and get the 10 million Americans who lost their jobs in the last year back to work,” Bradley said. “We support the new administration’s focus on removing roadblocks to vaccinations and reopening schools, both of which are important steps to accelerating a broad-based economic recovery for all Americans.”

Biden’s predecessor had put pressure on states to quickly reopen. The U.S. is facing its most deadly wave of the pandemic, with joblessness on the rise again.

The U.S. Chamber is particularly influential with Republican Congressional lawmakers, who hold sway over Biden’s proposed $1.9 trillion coronavirus package.

2:10 PM CT on 1/21/21

President Joe Biden on Wednesday signed several executive orders that would impact the healthcare industry.

In addition to several actions to address the COVID-19 pandemic, Biden ordered federal agencies to review and possibly revise policies to advance racial equity and prevent and combat discrimination based on gender identity or sexual orientation.

The orders define "equity as the consistent and systematic fair, just and impartial treatment of all individuals, including individuals who belong to underserved communities, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders, and other persons of color; LGBTQ+ persons; people with disabilities; religious minorities, persons who live in rural areas; and persons otherwise affected by persistent poverty or inequality," Biden's transition team said in a statement.

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12:05 AM CT on 1/21/21

(AP) Amazon is offering its colossal operations network and advanced technologies to assist President Joe Biden in his vow to get 100 million COVID-19 vaccinations to Americans in his first 100 days in office.

“We are prepared to leverage our operations, information technology, and communications capabilities and expertise to assist your administration’s vaccination efforts,” wrote the CEO of Amazon’s Worldwide Consumer division, Dave Clark, in a letter to Biden. “Our scale allows us to make a meaningful impact immediately in the fight against COVID-19, and we stand ready to assist you in this effort.”

Amazon said that it has already arranged a licensed third-party occupational healthcare provider to give vaccines on-site at its facilities for its employees when they become available.

Amazon has more than 800,000 employees in the United States, Clark wrote, most of whom essential workers who cannot work from home and should be vaccinated as soon as possible.

Biden will sign 10 pandemic-related executive orders on Thursday, his second day in office, but the administration says efforts to supercharge the rollout of vaccines have been hampered by lack of cooperation from the Trump administration during the transition. They say they don’t have a complete understanding of the previous administration’s actions on vaccine distribution.

Biden is also depending on Congress to provide $1.9 trillion for economic relief and COVID-19 response. There are a litany of complaints from states that say they are not getting enough vaccine even as they are being asked to vaccinate a broader swath of Americans.

According to data through January 20 from Johns Hopkins University, the seven-day rolling average for daily new deaths in the U.S. rose over the past two weeks from 2,677.3 on January 6 to 3,054.1 on Wednesday. More than 400,000 people in the U.S. have died from COVID-19.

10:04 AM CT on 1/21/21

(AP)  The United States will resume funding for the World Health Organization and join its consortium aimed at sharing coronavirus vaccines fairly around the globe, President Joe Biden's top adviser on the pandemic said Thursday, renewing support for an agency that the Trump administration had pulled back from.

Dr. Anthony Fauci's quick commitment to the WHO — whose response to the pandemic has been criticized by many, but perhaps most vociferously by the Trump administration — marks a dramatic and vocal shift toward a more cooperative approach to fighting the pandemic.

"I am honored to announce that the United States will remain a member of the World Health Organization," Fauci told a virtual meeting of the WHO from the United States, where it was 4:10 a.m. in Washington. It was the first public statement by a member of Biden's administration to an international audience — and a sign of the priority that the new president has made of fighting COVID-19 both at home and with world partners.

Just hours after Biden's inauguration Wednesday, he wrote a letter to U.N. Secretary-General Antonio Gutteres saying the U.S. had reversed the planned pullout from the WHO that was expected to take effect in July.

The withdrawal from the WHO was rich with symbolism — another instance of America's go-it-alone strategy under Trump. But it also had practical ramifications: The U.S. halted funding for the U.N. health agency — stripping it of cash from the country that has long been its biggest donor just as the agency was battling the health crisis that has killed more than 2 million people worldwide. The U.S. had also pulled back staff from the organization.

Fauci said the Biden administration will resume "regular engagement" with WHO and will "fulfill its financial obligations to the organization."

The WHO chief and others jumped in to welcome the U.S. announcements.

"This is a good day for WHO and a good day for global health," Director-General Tedros Adhanom Ghebreyesus said. "The role of the United States, its role, global role is very, very crucial."

8:52 PM CT on 1/20/21

(AP) President Joe Biden is reminding his federal appointees and staff that “we work for the people” and is calling on them to be “decent, honorable and smart.”

Biden swore in nearly 1,000 federal appointees and staff in a virtual ceremony in the State Dining Room at the White House on Wednesday evening. He spoke from behind a lectern, while the appointees appeared at the event via video streams set up on a series of television screens.

Biden said that if any of his appointees treat a colleague with disrespect, he will fire them “on the spot.” He said that mindset had been missing in President Donald Trump's White House.

The new president also told the group that “we have such an awful lot to do” and said that containing the pandemic and administering COVID-19 vaccines will be the “most consequential logistical thing that’s ever been done in the United States.”

He said he’s “going to make mistakes” but promised during their swearing-in that he will ”acknowledge them” when he does.

7:32 PM CT on 1/20/21

(AP) Kentucky's governor said Wednesday that he looks forward to working with President Joe Biden's administration to “overcome the challenges” of the coronavirus pandemic.

Gov. Andy Beshear offered his congratulations to the nation's new president a day after the governor said he had requested a doubling of Kentucky's COVID-19 vaccine allotment.

Beshear reported more than 3,400 new coronavirus cases and 49 more virus-related deaths in Kentucky. But he pointed to the state’s rate of positive COVID-19 cases as a positive sign. The positivity rate was 11.29% Wednesday — the fifth straight day it's been below 12%, he said.

“While there is still so much pain and darkness in our commonwealth due to this pandemic, we are beginning to see the light ahead of us,” Beshear said in a news release. “This plateauing positivity rate is great news for Kentucky, especially as we continue to bring more of these live-saving vaccines to our people each week."

The 3,433 new virus cases reported Wednesday pushed the statewide total past 334,000 since the pandemic began. The state's virus-related death toll reached at least 3,243.

More than 1,600 virus patients are hospitalized in Kentucky, including 399 in intensive care.

In a social media post congratulating Biden and Vice President Kamala Harris on their Inauguration Day, the Democratic governor said: “I look forward to working with your administration to better the lives for our people and to help us overcome the challenges of COVID-19. Together we can make a better country — a better Kentucky — for all."

Biden has pledged to boost supplies of coronavirus vaccine and set up new vaccination sites. Both Biden and Beshear stress the importance of mask-wearing to combat the virus's spread.

Warning that demand continues to outpace vaccine supplies in Kentucky, the governor said Tuesday he asked the federal government to double Kentucky’s vaccine allotment.

“We are proving that we can get it into people's arms," Beshear said Tuesday. “But right now, and moving into the future, we're going to be sitting around with entire days where we've already run out of vaccine, waiting to get more from the federal government. This is our major challenge moving forward.”

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.

5:24 PM CT on 1/20/21

(AP) North Dakota health officials on Wednesday reported a dramatic drop in hospitalizations because of the coronavirus, due mostly to finding and fixing a computer glitch.

The state Department of Health said in a release that the adjustment was made after officials resolved a problem with the flow of data in the last week from caseworkers to the state’s reporting system. The result was a drop from 88 hospitalizations to 55.

The last time hospitalizations were that low was late August.

The state's hospital tracker shows there are 48 staffed intensive care unit beds and 381 staffed inpatient beds available in North Dakota. There are 26 staffed ICU beds that are open at Fargo's three hospitals.

The update showed 158 new positive COVID-19 tests and one new death in the last day, increasing the totals to 96,222 cases and 1,387 deaths since the start of the pandemic.

Over the past two weeks, the rolling average number of daily new cases in the state has decreased by nearly 34%, according to Johns Hopkins University researchers. One in every 689 people in North Dakota tested positive in the past week.

For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.

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.’ ”

READ MORE

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.

READ MORE

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.

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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.

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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.

READ MORE...

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.

READ MORE

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.

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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 c