One moment Boston parents were looking forward to school doors reopening sooner or later for kindergartners and pre-kindergarteners. The next they were learning that those few students who had already been allowed back in person were being sent back home.
“I am heartbroken that today we have to close our doors to our highest-need students,” Boston’s schools superintendent, Brenda Cassellius, said Wednesday.
It was a microcosm of the disarray across the country as school districts try to get back to normal — or at least something vaguely resembling it.
In suspending their attempt to resume in-person learning in public schools, Boston officials cited the city’s rising tide of coronavirus cases.
After starting the school year remotely for all students last month, the city began a phased reopening on Oct. 1, allowing about 3,000 high-needs students to attend in-person classes at least two days a week. Those students include some with disabilities, as well as those who have experienced homelessness and those who are still learning English.
The next phase, which would have brought back kindergartners and pre-kindergarteners, had been scheduled for as soon as mid-October, but was recently delayed.
For now, all that is over — at least, in Boston.
Elsewhere in the country, more large districts are beginning to open schools, reassured by the fact that there is not clear evidence at this point of significant transmission in schools, especially among younger children.
In North Carolina, Charlotte-Mecklenburg Schools welcomed prekindergarten students back to classrooms last week and plans to bring in other students in phases over the coming weeks and months.
The San Diego Unified School District, the second-largest district in California, last week brought back students identified as needing in-person instruction or services.
In Texas, dozens of school districts are not just offering in-person instruction again, they are requiring it, to the concern of some parents.
In New York City, after reopening schools for in-person learning, officials began closing some in neighborhoods where cases were flaring up.
And in Los Angeles, the largest district in California and the second largest in the country, there is still no date set for a return to class because it has not yet met the standards set by the state for opening schools. San Francisco has met those standards — but the superintendent has said that schools will not be ready to open until 2021.
Boston’s decision to walk back its plans came after the city’s seven-day average positivity rate for coronavirus testing increased to 5.7 percent.
The city said that it would welcome back high-needs students when the positivity rate declined to 5 percent or below for two consecutive weeks, and that it would begin the phased return of other students when it declined to 4 percent or below for two consecutive weeks.
Ms. Cassellius, the schools superintendent, urged the community to comply with public health guidance to bring the infection rate down. “We need your help,” she said. “Our children are depending on all of us.”
Experts said that closing schools might have been the right decision, but questioned why the city was not closing anything else.
“Why would you ever have restaurants open for indoor dining while you’re closing schools? It’s wrong on so many levels,” said Dr. Benjamin P. Linas, an associate professor of medicine and epidemiology at Boston University.
“The evidence now is that restaurants drive transmission and schools do not,” he said.
Brooke Nichols, an infectious disease modeler and assistant professor at the Boston University School of Public Health, criticized the city for delaying the opening of schools for most students until late October, given that many epidemiologists had predicted a surge in cases as the weather cooled.
“We’ve squandered the opportunity to have kids in school and feel comfortable about it by delaying school until the end of October,” she said. “I’m just so mad.”
The coronavirus reached into the upper levels of New Jersey’s government on Wednesday: Two members of Gov. Philip D. Murphy’s senior staff tested positive and the governor announced that he would quarantine himself through the end of the weekend after recently being exposed to at least one of them.
Mr. Murphy made the abrupt announcement about his quarantine in the middle of a news conference, saying he had learned just minutes before about one of the staff members’ positive test results. The governor said he had been in “close proximity” to that staff member on Saturday before the individual tested positive, adding that he had not experienced any symptoms of Covid-19.
Mr. Murphy tested negative for the virus on Monday and Wednesday, according to a statement from his office that did not specify the kind of tests he took. The statement also said that both Mr. Murphy and his wife, Tammy Murphy, would cancel their in-person events and quarantine through the end of the weekend and take another test “before they resume any in-person engagements.”
The negative virus test results so far do not rule out the possibility that Mr. Murphy was infected, as levels of the virus can take days to build in the body. Symptoms of Covid-19 may take up to 14 days to appear.
The staff member who Mr. Murphy was exposed to on Saturday was his deputy chief of staff for intergovernmental affairs, Mike DeLamater, according to Michael Zhadanovsky, a spokesman for the governor. Mr. DeLamater did not immediately respond to a request for comment.
“We have begun the contact tracing process to notify everyone who may have come into contact with our colleague during the potential infection window,” Mahen Gunaratna, a spokesman for Mr. Murphy, said in the statement on Wednesday afternoon.
Hours after that announcement, the governor’s office said in another statement that another staff member, Daniel Bryan, senior adviser to the governor for strategic communications, had also tested positive on Wednesday afternoon. Mr. Bryan took the test “out of an abundance of caution,” the statement said. It added that he had not shown symptoms and that others who might have been exposed, including journalists, would be notified.
It was not immediately clear whether Mr. Bryan had recently been in contact with Mr. Murphy or Mr. DeLamater. Mr. Bryan did not immediately respond to a request for comment.
The announcement came as New Jersey, an early center of the pandemic that appeared to have brought the virus under control, is once again seeing a spike in the number of cases. The state over the past week has seen an average of more than 1,000 cases per day, an increase of 49 percent from the average two weeks earlier, according to data compiled through Tuesday.
Several global leaders have been exposed and some tested positive during the pandemic. Earlier this month, President Trump revealed that he had contracted the virus and was subsequently hospitalized with Covid-19. He was just one of an outbreak linked to an event at the Rose Garden that infected other White House officials, senators and members of the Republican Party and his campaign. Prime Minister Boris Johnson of Britain was in intensive care in April with the virus and has since returned to work. The leaders of Brazil, Honduras, Guatemala and Bolivia have also contracted the virus.
Mr. Murphy, a Democrat, had previously criticized Mr. Trump’s decision to hold a fund-raiser at Bedminster, N.J., after a senior Trump aide, Hope Hicks, had tested positive. On Wednesday, Mr. Murphy recalled that criticism after he announced he had been exposed.
“I can’t ask President Trump not to come to Bedminster and do a fund-raiser and have me sit here,” he said.
Amtrak’s chief executive warned federal lawmakers on Wednesday that the rail agency would have to continue steep cuts to its work force and delay infrastructure improvements — including high-profile projects in New York and New Jersey — if it does not receive $2.8 billion in emergency funding by December.
In a hearing before the Senate Committee on Commerce, Science and Transportation, William J. Flynn said his agency might have to cut an additional 2,400 jobs and divert funding from critical capital projects, such as the multibillion-dollar tunnel between New York and New Jersey — called the Gateway program — and improvements to New York Penn Station.
His total budget request to Congress is $4.9 billion. That includes the rail agency’s $2 billion standard appropriation.
Mr. Flynn urged Senate lawmakers to pass a version of the Heroes Act, which cleared the House on Oct. 1 and includes $2.4 billion in emergency funding for Amtrak.
The coronavirus has wreaked havoc on Amtrak since March. Shortly after the pandemic began in the spring, ridership on the train service plummeted 97 percent. Projected revenue for 2020 has declined by 53 percent, according to Amtrak data.
In response, Congress bailed out the rail network in March with $1 billion in emergency funds. Most of that has been spent, Mr. Flynn said on Wednesday.
As of this month, over 2,000 Amtrak workers have been furloughed, representing nearly 10 percent of the agency’s approximately 20,000-member work force. In September, Mr. Flynn warned House lawmakers that additional cuts to service and the work force would continue in order to “stave off bankruptcy” if the rail agency did not receive its requested $4.9 billion.
The rail agency’s request for more aid is echoed by leaders across the transportation sector. Public transit agencies are requesting $36 billion in addition to the $25 billion received in March. Privately owned school bus and motor coach companies are requesting $15 billion in support. Airport leaders are asking for an additional $10 billion in aid, while passenger airlines are requesting $25 billion in payroll relief.
Thousands of Covid-19 patients have been given a drug that doctors hoped would prevent deadly complications. But three rigorous studies published this week have cast doubt not just on the drug but on the hypothesis underlying its use.
The hypothesis that led to the use of the drug, tocilizumab, for those sickened by the coronavirus made so much sense.
Tocilizumab is used for rheumatoid arthritis because it suppresses part of the immune response.
Patients who die from Covid-19 usually have little or no virus left in their bodies. Their immune systems have gotten rid of it. But in doing so, their immune systems went rogue, spewing out powerful compounds — cytokines — that fatally damaged tissues and organs in what is known as a cytokine storm.
Prominent among those cytokines is one called interleukin-6, or il-6 — the very cytokine that tocilizumab blocks. The drug also stops cytokine storms in patients treated with cancer immunotherapies.
So doctors began trying the drug on coronavirus patients, and it was soon considered a standard of care for severely ill Covid-19 patients.
But the new studies — two published Tuesday in JAMA Internal Medicine and one Wednesday in The New England Journal of Medicine — found that tocilizumab did not reduce the death rates of Covid-19 patients.
It is not clear why the drug failed.
Perhaps, wrote Dr. John H. Stone of Massachusetts General Hospital and his co-authors in The New England Journal of Medicine study, elevated levels of il-6 are something that goes along with Covid-19 infections, but that may not themselves cause the tissue and organ damage. In other words, they may be a correlation, not a cause, the way gray hair is a correlation of aging, not a cause of it.
There is a lesson here, said Dr. Jonathan Parr, an infectious disease expert at the University of North Carolina at Chapel Hill, who wrote an editorial accompanying the studies in JAMA Internal Medicine. Observational studies — which report outcomes in patients who have taken a drug but do not have a comparison group randomly assigned not to take it — are insufficient, he said.
Doctors “desperate to find treatments” are struggling to keep up with the torrent of Covid-19 studies, Dr. Parr said.
“We really need randomized trials to answer these hard questions,” he said.
A California appellate court has ordered San Quentin State Prison, California’s oldest penitentiary, to reduce the number of inmates it holds by 50 percent, after the coronavirus tore through the facility this summer, infecting more than 2,200 inmates and killing 28.
The state prison system showed “deliberate indifference” to the safety and health of San Quentin inmates by taking inadequate steps to protect them from the coronavirus, the First District Court of Appeal said Tuesday in a unanimous opinion.
The ruling requires San Quentin to reduce its population by half — to about 1,700 inmates — as a way to protect prisoners from infection. But because nearly all of the state’s prisons are overcrowded, it remains unclear where San Quentin inmates could be sent.
In a statement on Wednesday, a California Department of Corrections spokeswoman said “we respectfully disagree with the court’s determination” and added that the prison system had sought to stem the virus in a number of ways, including by releasing more than 21,000 inmates.
Inmate transfers appear to be what created the problem in San Quentin to begin with. The prison was free of the coronavirus until late May, when state officials ordered 121 inmates moved there from another state prison, the California Institution for Men in Chino, Calif.
Officials have acknowledged that few if any of those inmates were tested for the coronavirus in the three weeks before the move, and that they were not tested on arrival at San Quentin.
Within weeks, San Quentin had a surging virus outbreak, and for several months the prison had the largest coronavirus cluster in the nation, according to a New York Times database.
A group of conservative health care advocates, policy experts and economists is pressing President Trump to modernize the nation’s public health data infrastructure so that the Centers for Disease Control and Prevention can once again be the primary collector of information about Covid-19.
In a letter sent to the White House on Monday, the group, which includes former Senator Rick Santorum, took aim at the C.D.C., saying that the agency had failed to “modernize its antiquated and burdensome public health data systems,” despite a series of laws passed by Congress in 2006, 2013 and 2019 requiring it to do so.
“It is shocking that C.D.C. has failed to comply with these laws,” the letter said. “Despite fourteen years and billions of dollars spent, C.D.C. has yet to implement a nationwide, modern and uniform information-management and reporting system to help guide policymakers, public health officials and front-line health care workers.”
The letter grew out of a report published in September by the Heritage Foundation, a conservative research organization.
Neither the C.D.C. nor the White House responded to a request for comment. The agency does have a data modernization plan, according to its website.
During a Senate hearing in April, Dr. Robert R. Redfield, the agency’s director, was pressed on the issue by Senator Richard Burr, Republican of North Carolina. Dr. Redfield was unable to answer whether the C.D.C. had filled any of 30 staff positions created to develop the agency’s disease and public health surveillance capabilities.
The reliability of health care data has become a politically charged issue during the coronavirus pandemic. Earlier this year, the Department of Health and Human Services, the C.D.C.’s parent agency, stripped the C.D.C. of control over the gathering of hospital information and turned the job over to a private contractor, TeleTracking Inc.
Health experts, including outside advisers to the C.D.C., warned that the move would have “serious consequences on data integrity.” But the department recently extended TeleTracking’s initial $10.2 million, six-month contract.
The Heritage report described the private data collection as a “stopgap measure” that was important but “incomplete.” Joel C. White, an author of the report and a driving force behind the letter, said both “grew out of frustration” that public health officials, policy experts and journalists were relying on nongovernmental sources, like Johns Hopkins University’s Covid-19 dashboard, for coronavirus data.
“Lots of people kept pointing to the C.D.C. as the source of knowledge and truth for the pandemic,” he said, “but no one was pointing to the C.D.C.’s statistics.”
Gov. Andrew M. Cuomo of New York announced on Wednesday that some lockdowns in New York City neighborhoods with rising coronavirus cases would be eased, allowing the reopening of schools and businesses that had been shuttered.
But stringent restrictions remained in place for other neighborhoods at the heart of the outbreaks in Brooklyn, as well as for several communities in Rockland and Orange Counties. Another neighborhood, Ozone Park in Queens, was added to the list requiring limitations on activity.
It was an acknowledgment that while progress had been made during two weeks of lockdowns, targeted restrictions — which include attendance limitations at mass gatherings and houses of worship — remained necessary to keep isolated outbreaks from engulfing New York City, a former center of the pandemic.
The changes seemed bound to add more confusion over the tiered, three-color system of zoned restrictions, a classification that was additionally complicated on Wednesday when the governor unveiled a new “microcluster strategy.”
It included a four-region statewide system, and officials said they would consider population and geography along with rates of infection and other factors to determine when areas would enter and exit levels of restrictions.
Regardless of that complexity, the governor insisted that his plan to tackle the state’s outbreaks was effective.
The governor said that if a neighborhood’s positivity rate remained under 3 percent after 10 days, the most serious restrictions could be lifted. Less populous areas would have slightly more relaxed standards for lifting the most serious restrictions: under 4 percent over 10 days.
Those “red zone” restrictions include closing schools, shuttering nonessential businesses, banning mass gatherings, limiting restaurants to delivery and takeout and restricting houses of worship to 25 percent of capacity or a maximum of 10 people.
But in some cases, the governor said more amorphous considerations would be taken into account, such as whether communities were “cooperating,” or whether local governments had engaged in “effective compliance.”
The changes should allow thousands of children in Queens and Brooklyn to return to school as soon as Monday, according to state officials, while some businesses shuttered by the harshest restrictions can reopen as soon as Thursday.
Avery Cohen, a spokeswoman for Mayor Bill de Blasio, said that the mayor was “encouraged by the progress we’re seeing and will continue our work with the state to drive transmission down.”
On Tuesday, Mr. Cuomo excluded Pennsylvania, New Jersey and Connecticut from New York’s quarantine list, saying there was “no practical way” to enforce such a limitation on travelers from those states entering New York. He said on Wednesday that the state was working to see if a different approach to the quarantine rules involving rapid testing was possible.
In New York City, the citywide seven-day average positivity rate was 1.68 percent, Mayor Bill de Blasio said Wednesday.
Overwhelmed by a flood of new coronavirus cases, North Dakota is halting its contact tracing efforts, and will instead ask people who test positive to put out the word themselves to their close contacts.
The office of Gov. Doug Burgum said in announcing the move that the state needed to reassign 50 National Guard soldiers from contact tracing to help clear a three-day backlog of people who have tested positive but have not yet been notified or assigned to a case investigator.
“In addition, significant community spread of coronavirus and a lack of compliance with close contact investigations have diminished the effectiveness of contact tracing,” the statement from the governor’s office said.
North Dakota, which had very few coronavirus cases in the spring and summer and never imposed a mask mandate, is being walloped now by the virus. For weeks, it has reported more new cases than any other state, relative to its population, and its hospitals and public health resources have swiftly come under enormous strain.
Other states have also backed away from contact tracing efforts in the face of major surges in infection, said Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security.
“They may be the only one that announced it so overtly,” Dr. Nuzzo said. “But this really speaks to the unfortunate truth that when the case numbers get high, it’s not possible for contact tracers to keep up.”
Contact tracing is considered a crucial tool in containing the spread of infectious diseases. But Dr. Nuzzo said the job, which requires a lot of resources, had become significantly harder as states reopened.
In the spring, when schools were closed and much of the economy was shut down, each infected individual had only about six contacts that investigators needed to reach. But now, with schools and workplaces reopened and people gathering socially, each new case might require 20 or more calls, she said.
On top of that, many people are deeply reluctant to be identified as a contact and go into quarantine, because of the prospect of losing two weeks’ wages and having to scramble for child care and elder care.
“All of these disincentives exist that we have not even begun to try to address,” Dr. Nuzzo said.
The governor’s office said the suspension of contact tracing was intended to be temporary. The state will still conduct case investigations to identify superspreader events and other specific sources of infection, the statement said.
The idea came from a new study that found that a coronavirus that causes common colds — not the one that causes Covid-19 — could be killed in a laboratory by dousing virus-infected cells with mouthwash. The study’s authors concluded that the products they tested “may provide an additional level of protection against” the new coronavirus.
But outside experts warned against overinterpreting the study’s results, which might not have practical relevance to the new coronavirus that has killed more than 220,000 Americans. Not only did the study not investigate this deadly new virus, but it also did not test whether mouthwash affects how viruses spread from person to person.
“I don’t have a problem with using Listerine,” said Angela Rasmussen, a virologist at Columbia University. “But it’s not an antiviral.”
The study, which was published last month in the Journal of Medical Virology, looked only at a coronavirus called 229E, which causes common colds — not the new coronavirus.
The researchers flooded 229E coronaviruses grown in human liver cells in the lab with several types of mouthwash and nasal rinses for 30 seconds, one minute or two minutes — longer than the typical swig or spritz into a nose or mouth. Around 90 to 99 percent of the viruses could no longer infect cells after this exposure, the study found.
But because the study didn’t recruit any human volunteers to gargle the products in question, the findings have limited value for the real world, other experts said. The human mouth, full of nooks and crannies and a slurry of chemicals secreted by a diverse cadre of cells, is far more complicated than the inside of a laboratory dish.
Researchers warn people not to misuse mouthwash or nasal rinses or ingest large quantities of the liquids, because they can be dangerous.
A far-right party in Spain led a no-confidence motion against the government over its management of the coronavirus on Wednesday. While the effort is almost certain to fail in Parliament, the vote underlined the deep political tensions exacerbated by the pandemic.
The party, Vox, is the country’s third-largest and has long opposed the left-wing coalition government. The main opposition, the Popular Party, said on Wednesday that it would not support the motion, which is expected to be voted on Thursday.
Spain exceeded one million reported virus cases on Wednesday amid a second wave that has surged despite lockdown orders around Madrid, the center of the outbreak. The orders have generated a backlash from business owners and residents.
Spain is the second European country to reach that threshold, after Russia, which has recorded 1.4 million cases, according to a Times database.
Leaders from Vox argued on Wednesday that Spain needed to remove a government that they accused of driving the country toward levels of poverty not seen since the late 1930s, when Spain emerged from its civil war.
Prime Minister Pedro Sánchez dismissed Vox as a party of hate in his remarks before Parliament and said the vote would fail.
“You will see that the Spanish, fortunately, reject your proposal of hate, rage and conflict,” Mr. Sánchez said.
In other developments around the world:
Germany’s health minister, Jens Spahn, tested positive for coronavirus on Wednesday, hours after he met with Chancellor Angela Merkel and other ministers in her cabinet, his ministry said. He is the first member of the German government to be infected with the virus since the start of the pandemic. Mr. Spahn was in isolation with cold-like symptoms, the ministry said. The chancellor’s office said that Ms. Merkel and the rest of her ministers will not have to quarantine, as they were all masked and sitting at a safe distance from one another. Germany has been experiencing a spike in the spread of the virus since the start of October. On Wednesday, the public health authority reported 7,595 new cases of infection.
Thailand welcomed its first group of foreign tourists in more than six months. The group of 39 arrived from Shanghai on Tuesday and went directly into quarantine, at their own expense, in a Bangkok hotel. The governor of the Tourism Authority of Thailand, Yuthasak Supasorn, said in an interview on Wednesday that he hopes the group’s arrival will open the door to travelers from other low-risk countries, such as Australia, Japan, New Zealand and South Korea.
The European Union has reached a deal with Johnson & Johnson that will allow the bloc to buy up to 400 million doses of the pharmaceutical company’s coronavirus vaccine. “As coronavirus spreads rapidly across Europe, we are securing doses of future vaccine to protect citizens,” Ursula von der Leyen, the president of the European Commission, the bloc’s administrative branch, announced on Wednesday. The European Union has also signed contracts with Sanofi and AstraZeneca for up to 300 million doses of each company’s vaccine.
About seven million people in the north of England will soon be living under the country’s toughest virus restrictions as large parts of the region are moved to the highest alert level in Britain’s new tiered response system. South Yorkshire will rise to the “very high” alert starting this weekend, a local official announced on Wednesday. Greater Manchester, Britain’s second-largest urban area, will also move to the highest alert level starting Friday.
President Trump cast doubt Wednesday on the prospects of a bipartisan, multi-trillion-dollar stimulus deal before Election Day, as Senate Republicans continued to resist a compromise they called too costly and politically fraught.
Mr. Trump blamed Democrats, citing their push to give billions of dollars in aid to state and local governments as a reason an agreement is unlikely before Nov. 3.
“Just don’t see any way Nancy Pelosi and Cryin’ Chuck Schumer will be willing to do what is right for our great American workers, or our wonderful USA itself, on Stimulus,” Mr. Trump posted to Twitter.
The president’s tweet came just hours after Speaker Nancy Pelosi and Mark Meadows, the White House chief of staff, said that they were continuing to narrow their differences on a plan. Ms. Pelosi had also conceded that a deal might not be possible before the election.
A nearly one-hour conversation between Ms. Pelosi and Steven Mnuchin, the Treasury secretary, brought the pair “closer to being able to put pen to paper to write legislation,” a spokesman for Ms. Pelosi said Wednesday afternoon. Separately, Mr. Meadows said that he was “still very hopeful and very optimistic that we’re making progress.”
But with time waning to cement an agreement, both sides also were wary.
Mr. Meadows, who met with Senate Republicans on Capitol Hill on Wednesday, told reporters that lawmakers in his party had grown suspicious of Ms. Pelosi’s tactics and were “starting to get to a point where they believe that she is not negotiating in a fair and equitable manner.”
Ms. Pelosi said she remained upbeat about the prospects for a compromise but allowed for the possibility that it would wait until after the election.
“I’m optimistic that there will be a bill,” she said in an interview on MSNBC. “It’s a question of, is it in time to pay the November rent, which is my goal, or is it going to be shortly thereafter and retroactive.”
On the other side of the Capitol, Senate Democrats blocked a move by Republicans to advance a $500 billion plan that would have revived lapsed federal unemployment benefits and a popular federal loan program for small businesses, as well as provide additional money for testing.
Democrats, who have argued the package falls far short of the level of aid needed, unanimously opposed it, and it fell short on a party-line vote of 51-44, failing to clear the 60-vote threshold required to move forward.
Mr. Meadows said earlier Wednesday that the toughest obstacles to a bipartisan stimulus deal were a push by Democrats for hundreds of billions of dollars more in federal aid for states and cities and their resistance to a liability shield for businesses. The White House has proposed providing $250 billion to states and municipalities, Mr. Meadows said, while House Democrats have called for double that.
“The biggest issue remains state and local assistance,” Mr. Meadows said on the Fox Business Network. “That remains a stumbling block.”
Ms. Pelosi and Mr. Mnuchin are expected to speak again on Thursday.
A Brazilian volunteer in a coronavirus vaccine trial run by AstraZeneca died last week, Brazil’s health regulatory agency disclosed on Wednesday. A Brazilian newspaper, O Globo, reported that the man had died of Covid-19.
It was unclear whether the volunteer received the experimental vaccine or a placebo, but several experts said that if a volunteer had died after receiving the experimental vaccine, the company would have halted the trial to look into safety concerns. Since the trial has not been paused, it is likely that he received a placebo, they said.
The trial’s sponsors “wouldn’t have let the trial go straight forward” if the volunteer had received the vaccine, said Dr. Eric Topol, a clinical trials expert at the Scripps Research Institute. “That’s my interpretation.”
Mark Slifka, a vaccine expert at Oregon Health and Sciences University, agreed. “If they are saying that this is not a safety concern, then it would seem likely that the death occurred in the placebo group,” he said.
The health agency, Anvisa, said that an international safety board monitoring the vaccine study gave notice of the death earlier this week. Gustavo Mendes, a manager at Anvisa, said the agency decided along with its United Kingdom counterpart not to halt the study because an assessment by the independent safety board overseeing it showed the volunteer’s death was not related to the vaccine.
“The death outcome in a Covid-19 clinical study is what we call an expected outcome because Covid can cause death,” he said.
Instituto D’Or, a Brazilian medical research facility that served as a local partner for the study, said in a statement that approximately 8,000 Brazilians have participated in the trial. No safety issues have been reported, the institute said.
An AstraZeneca spokesman, Brendan McEvoy, said that he could not comment on the case, citing medical confidentiality, but that all required review procedures had been followed. “These assessments have not led to any concerns about continuation of the ongoing study,” he said.
Dr. Luciana Borio, a former acting chief scientist at the U.S. Food and Drug Administration, cautioned against reading too much into the news. “We cannot be reacting to information that is given in isolation,” she said.
The news of the death comes just weeks after AstraZeneca instituted a global halt to its trials after a participant who had received its experimental vaccine fell ill with severe neurological symptoms. The company disclosed few details about the nature of the volunteer’s sickness, stressing repeatedly that no diagnosis had been confirmed. But within days, AstraZeneca had resumed several of its trials, having concluded that there was not enough evidence to link the event to their product. American study sites, however, have yet to restart.
Earlier this month, another vaccine front-runner, Johnson and Johnson, also paused its trials because of an illness in one of its volunteers. The company has so far not disclosed any details about the sickness.
Details about these pauses often trickled out from anonymous sources, rather than the companies themselves, raising concerns.
“These vaccine companies should know that trust in new vaccines is predicated on the utmost transparency,” Dr. Topol said. “I hope AstraZeneca will be more forthcoming.”
According to the O Globo report, the deceased volunteer graduated from medical school at the Federal University of Rio de Janeiro. Last Friday the school’s student association published a tribute to the physician, quoting a message he posted on social media that described his work treating Covid-19 patients.
“The most draining part of working with Covid-19 is certainly having to deal with the suffering, fear and anguish of those who are confined and without close contact with their loved ones,” the doctor wrote. “It is almost inevitable to take this weight home when we leave the hospital.”
Mayors from the surrounding areas of nine Big Ten schools raised concerns about potential coronavirus outbreaks linked to the league’s debut this weekend as cases rise in parts of the country.
In a letter to the conference on Monday, which encompasses football powerhouses like Ohio State and Michigan State, 12 mayors noted that watch parties and gatherings of fans could increase the spread of the virus. Those types of unofficial gatherings cannot be stopped by preventing fans from entering the stadium, which the Big Ten has already committed to do.
“We know the history of football games within our cities,” the mayors wrote in the letter. “They generate a lot of activity, social gatherings and consumption of alcohol.”
The Big Ten promised football’s return in October so long as the schools’ football programs keep positive coronavirus tests low throughout the season. Mayors requested the conference also factor in case counts of surrounding communities when deciding whether or not to stall games.
Schools in the Big Ten, which is actually made up of 14 universities, are spread across the Midwest, and reach New Jersey and Maryland. Mayors from many of the areas around the schools’ campuses — except for the University of Illinois at Urbana-Champaign, University of Nebraska and Rutgers University — signed on.
Many schools responding to the pandemic have asked students to stay inside or have shifted back to remote classes after reports of outbreaks, and some schools or local agencies have issued punishments to students caught gathering at parties or violating restrictions. Ann Arbor, Mich., home to the University of Michigan, issued an emergency stay-at-home order Tuesday for the college, effective until Nov. 3. The university allowed students to return to campus this fall with bans on large gatherings and mandatory mask wearing. Athletics were exempt from Tuesday’s stay-at-home order.
The Big Ten was the first conference to postpone football this summer, only to reverse its decision in September. The conference’s season kicks off Friday with the University of Illinois against the University of Wisconsin-Madison.
The Centers for Disease Control changed its definition of what it means to be in close contact with an infected person and therefore at risk of contracting the coronavirus. The agency made the update in its published guidance for coronavirus contact tracing on Wednesday.
The new guideline says close contact means being within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period. The previous guideline said a person was at risk after 15 minutes of exposure within 6 feet of an infected person. One school district in Montana interpreted that to mean that if students moved every 15 minutes, the risk of infection was mitigated.
The change could mean that when contact tracers speak to people who were close to an infected person, they could consider more of them at risk of also becoming infected.
In the guidance, the agency notes that it does not have much data on what actually constitutes “close contact.” But it added that a total of 15 minutes of exposure to an infected person “can be used as an operational definition for contact investigation.”
The C.D.C. added that the closer the contact, the greater the risk. Risk also increases over more time in contact with someone infected and from contact with an infected person who has symptoms. Someone who is coughing, singing or shouting is more likely to spread the virus, the C.D.C. said.
The Czech Republic on Wednesday, responding to an influx in cases that in mid-October made it the country with the highest coronavirus transmission rates in Europe, announced plans to close most shops and further tighten restrictions on movement.
Last week, the country closed schools, bars, restaurants and clubs. Places serving takeout food could do so only until 8 p.m., and just through windows. Beginning Thursday and lasting until at least Nov. 3, nonessential shops will also be closed and people will be urged to keep contact to a minimum.
But despite the strict new rules, the government has shied away from calling the measures a lockdown. Prime Minister Andrej Babis, speaking to the news media after a special cabinet meeting on Wednesday, apologized to the nation, saying the steps were necessary to prevent the health system from being overwhelmed.
“Even though we have one of the most robust health care systems in Europe, if we did not take action, the health care system would collapse around November 7 to 11,” he said, according to Czech Television, the public broadcaster.
The minister of health, Roman Prymula, who is an epidemiologist, noted during the same briefing that people should restrict their movements and contact with other people and only make necessary trips out for doctor’s appointments and essential supplies.
The new measures are a stark turn from the country’s approach this spring and summer, when it appeared to have been spared the worst of the first wave of the pandemic and was able to quickly loosen restrictions. In June, 2,000 people celebrated what they saw as victory over the virus with a feast on Prague’s Charles Bridge.
More than seven months into the nation’s coronavirus crisis, access to testing remains inconsistent, except among America’s elite. Count the University of Alabama’s football program and its coach, Nick Saban, among that elite.
Anchored by one of the most celebrated brands in college football — the university claims 17 national championships, including five during Saban’s tenure — Alabama’s athletic department is among the country’s wealthiest.
So at daybreak on Saturday, a private jet, the crimson “A” of the University of Alabama painted on its tail, lifted off from Tuscaloosa, Ala., en route to a testing lab in Mobile, with extraordinary cargo: cellular debris collected from Saban’s nose.
Three days earlier, the coach had announced that he had tested positive for the coronavirus.
With the case count around the football complex low and Saban an evangelist for masks and physical distancing, people in Tuscaloosa wondered whether that Wednesday test was flawed.
Possibly. Alabama’s football program is administering at least 120 screenings a day, Saban suggested on ESPN on Saturday.
“I’m not saying it’s inevitable, but when groups like this test a lot, the chances for a situation like this to occur increase,” said Dr. Sarah Jung, the scientific director of clinical microbiology at Children’s Hospital Colorado.
On Saturday morning, still in isolation hours before second-ranked Alabama was to play third-ranked Georgia, Saban knew the specimen aboard the plane was his diagnostic lifeline to the sideline. If the Mobile lab reported that the sample was negative for the virus, Saban, who had asserted that he had no symptoms and had repeatedly tested negative after his initial result, would be allowed to leave isolation a week early and coach in the prime-time game.
And so it was. Hours after a final negative result — and with no small help from a rule change that Southeastern Conference leaders approved six days before the positive test that shocked Alabama — millions of people watched on television as Saban led the Crimson Tide to a 41-24 victory.
The idea of vaccinating healthy volunteers and then deliberately infecting them with the coronavirus — a plan set in motion for the first time by scientists in London this week — carries enormous ethical difficulties.
Even though young, healthy participants are unlikely to be seriously sickened or killed, the virus is unpredictable and the long-term consequences of an infection are unknown, with the pandemic having started only months ago.
Beyond the ethical reservations, scientists also posed practical questions about the London researchers’ plan to compare vaccines by inoculating people and then dripping virus into their noses.
For one thing, scientists stressed that several vaccine makers had already distanced themselves from the idea, known as a human challenge trial. The researchers — working with Imperial College London and hVivo, a company specializing in such studies, with backing from the British government — have not said what vaccines they will test.
There are also steep limits to what scientists can learn about real-world transmission from exposing people in secure isolation units. Does a vaccine that protects healthy, younger volunteers — the only group eligible for deliberate infection — also help the people most endangered by the coronavirus, older adults or people with pre-existing conditions?
And is dripping virus into a volunteer’s nose anything like the exposure people receive at work or in their homes?
“Is it breathed out, sneezed out, do you sniff it all in one fell chunk of virus coming at you?” said John Moore, a professor of microbiology and immunology at Weill Cornell Medical College. “No one really knows. It’s so hard to model.”
For now, scientists overseeing the trial, scheduled to begin in January, said they would use the antiviral medicine remdesivir to treat volunteers before the onset of symptoms. The British government, under fire for its pandemic response, hopes the trial will accelerate the development of vaccines. But scientists questioned whether the fierce race for immunization had unduly influenced plans for a human challenge trial.
“It’s a race for money and glory,” Prof. Moore said. “That’s the reality of it.”
A stampede in a crowded stadium in eastern Afghanistan on Wednesday left at least 12 women dead, officials said. The women were among thousands of people hoping to get visas to enter Pakistan for medical treatment.
Many people in Afghanistan, a war-ravaged country with minimal health care facilities, cross the border into Pakistan for treatment. But since the spring, Pakistan had drastically reduced the number of visas that it issued to Afghans, hoping to minimize the spread of the coronavirus.
Pakistan recently announced that it would resume issuing visas at a more normal rate. But there was so much pent-up demand that thousands of people gathered before dawn at the soccer stadium, in the city of Jalalabad, waiting for tokens to be given out that would enable them to apply for visas. Just 1,000 visas were to be processed that day.
About 10,000 people were in the stadium when the stampede occurred, said Attaullah Khogyani, a spokesman for the governor of Nangarhar Province, which includes Jalalabad. The stampede began as the tokens were being distributed to the crowd, Mr. Khogyani said.
— Zabihullah Ghazi and
More than 240 people who were quarantined for the coronavirus in hotels in the Australian state of Victoria are being contacted for testing for blood-borne viruses including H.I.V., after it was found that single-use blood testing devices were used on multiple people.
The revelation is part of the fallout of a failed program to quarantine Australians returning to the country in state-run hotels. The mismanagement of the scheme is widely regarded to have led to a second wave of the virus in Victoria. The outbreak put Melbourne, which is in the state of Victoria and is the second-largest city in Australia, into lockdown for over three months.
On Monday, the authorities said that blood glucose monitoring devices intended for use by one person were used on multiple guests held in the hotels between March and August. The tests were used by people with diabetes to monitor blood sugar levels. (An earlier version of this post misstated where the authorities made their comments.)
“Blood glucose level testing devices intended for use by one person were used across multiple residents,” Safer Care Victoria, the state’s health care quality assurance agency, said in a statement. “This presents a low clinical risk of cross-contamination and blood borne viruses — Hepatitis B and C, and H.I.V.”
The agency said it did not believe the needles used for the finger-prick tests were used multiple times but said the bodies of the devices can retain microscopic amounts of blood, creating a low risk of transmission.
Victoria has reported at least 20,000 coronavirus cases and more than 800 deaths, with the majority of these occurring in its second wave. The state is currently easing out of its strict lockdown as daily infection numbers drop into the single digits.
In the past seven days, seven countries — Argentina, Brazil, the United Kingdom, France, India, Russia and the United States — have reported at least 100,000 new cases of the coronavirus, helping to push total cases worldwide to more than 40.7 million, according to a New York Times database.
In many cases, these countries are seeing numbers that are much higher than they were during the height of the pandemic in the spring. At that point most countries locked down, stopping movement and much interpersonal contact. Strategies have changed, and today local lockdowns are the way forward for most. There is more testing, giving a clearer picture of the pandemic. But the numbers continue to grow.
Over the past week in the United States, there have been 421,114 new cases, illustrating that the long-predicted fall wave of the virus is well underway. Midwestern and Rocky Mountain states are struggling to control major outbreaks. And the national trajectory is worsening by the day, as the cooler weather drives more people to stay indoors where the virus spreads easily. In some states, hospitals are almost full.
India reported 411,718 over the past seven days, but numbers have been falling since mid-September. On Monday, the country recorded fewer than 50,000 cases, the lowest number since July, the government said. But the lower numbers, which would seem at first glance to be good news, have raised questions. The government recently approved the use of rapid coronavirus testing based on gene-editing technology, hoping to increase its testing capabilities. But experts question the reliability of rapid tests.
In France, which has added 174,273 cases in the past seven days, a curfew has been implemented in Paris and eight other regions. Still, more than 11,000 virus patients are hospitalized, and 2,000 are in intensive care, a threshold that had not been reached since May. (The country currently has 5,800 intensive care beds.)
Brazil, which has reported 160,326 cases in the past seven days, is among the countries with the lowest testing rates and still lacks a clear contact tracing policy. Despite being the country with the second-highest death toll, about eight million Brazilians had received laboratory tests by mid-October, according to the Ministry of Health, less than a tenth of the number of people tested in the United States.
But, as in India, the disease has been trending downward in Brazil since early August. The country is now reporting an average of 500 deaths a day, half of the daily toll it reported two months ago. Most big cities have eased social-distancing measures and opened some schools, restaurants, and beaches.
The number of daily recorded infections in the United Kingdom has nearly tripled since the beginning of October. In the past seven days, the U.K. has reported 127,622 new cases. Hospitalizations and deaths are also rising, and in some parts of the country, intensive care units are being stretched to their limits. The countries that make up the U.K. are each forging their own paths: England has implemented a tiered alert system; Northern Ireland is ramping up restrictions for pubs and restaurants, and closing schools; Scotland implemented a two-week tightening of restrictions; and Wales was preparing to enter a two-week national lockdown.
Russia has added 103,992 new cases in the past seven days.. The government, however, has resisted imposing even local lockdowns, although it has started to enforce mask-wearing requirements The capital, Moscow, is recording about one-third of the country’s daily new cases. Health authorities there have opened temporary hospitals in a city park and in a large car-dealership center. But Mayor Sergei Sobyanin said curfews and business closings are “absolutely unacceptable and impossible for us.”
Argentina has reported 101,964 cases in the past seven days. It is the fifth country to surpass one million total cases. The country received praise early in the pandemic for imposing a strict quarantine in mid-March, and although certain restrictions have been relaxed, much of the country is still under some type of lockdown order. Still, the virus, which was once concentrated in the Buenos Aires area, has since expanded to much of the country, including remote areas with scarce medical resources.
Thailand welcomed more than 10 million tourists from China last year. This week, tourism officials were pleased to announce the arrival of 39.
It was the first group of foreign tourists to arrive in the kingdom in more than six months.
Thailand took a big hit to its economy after it closed its borders to foreign tourists in April to contain the coronavirus. Officials have been trying for months to bring back tourists through a special visa and quarantine program and, after several false starts, the group of 39 arrived from Shanghai on Tuesday.
The travelers went directly into quarantine at a Bangkok hotel, where they will remain for 14 days at their own expense.
The governor of the Tourism Authority of Thailand, Yuthasak Supasorn, said in an interview on Wednesday that he hopes the group’s arrival will open the door to travelers from other low-risk countries, such as Australia, Japan, New Zealand and South Korea. The new visa allows stays of up to 270 days.
Thailand was the first country after China to report a case of coronavirus, which was brought by a tourist from Wuhan in January. But the kingdom has been among the most successful in containing the virus, reporting only 3,709 cases and 59 deaths.
The challenge now is to revive the economy.
During the second quarter of this year, Thailand suffered its biggest contraction since the late 1990s as the economy shrank by 12.2 percent, according to the state planning council.
Although tourists were barred, thousands of Thais returned from abroad and went through quarantine. Hundreds have tested positive without any reports of the virus spreading into the community.
“That is why we are confident in bringing tourists in at this time,” Mr. Yuthasak said.
For now, the arrivals may throw a lifeline to a few hotels that have set themselves up as quarantine centers, but it will do little to help the struggling tourist economy. Many hotels are closed, and others are operating at a loss to satisfy demands from their lenders.
This past summer, Alaska recorded some of the fewest coronavirus cases per capita in the nation. Credit isolation and wide-open spaces. But officials had also done more testing than almost every other state and then tracked every person who came back positive with an army of contact tracers.
Now, as temperatures begin dipping back below freezing, the virus has seized new opportunities.
Alaska’s struggles provide an early warning that winter could bring the most devastating phase of the pandemic. On Friday, the weekly case average in the state reached its highest point of the year.
Along with cold-season gatherings moving into more confined spaces, there is evidence that the coronavirus is more virulent in colder weather and lower relative humidities.
The state also faces some particular challenges, with officials fearing outbreaks in remote villages. Dr. Anne Zink, Alaska’s chief medical officer, described one small community with no running water that is currently dealing with an outbreak, and weather has prevented officials from getting supplies in.
One of the challenges that Dr. Zink has consistently faced is convincing residents to wear masks and stay distanced. In May, when Gov. Mike Dunleavy lifted statewide restrictions, he left decisions about how to manage the pandemic to local jurisdictions.
In the town of Wasilla over the weekend, people gathered at a bar for an Oktoberfest celebration. While the outdoor seating offered views of snow-capped mountains, the weather was near freezing, so people crowded inside, where no one was wearing masks.
And at a youth hockey tournament this month in Anchorage, videos showed some parents watching from the stands without masks. When the tournament was over, the Anchorage Health Department announced it was investigating a “cluster” of cases linked to the games.
In other developments around the United States:
The National Cherry Blossom Festival’s parade — held annually in Washington, D.C., during March or April and often considered the first sign of spring in the region — has been canceled for 2021 because of virus concerns. The organization that runs the event said plans for the festival will proceed “but with changes due to ongoing restrictions caused by Covid-19.”
As New York City faces its first notable increase in coronavirus cases since a springtime surge killed more than 20,000, residents are again looking at their neighborhoods and wondering, after each rise in numbers, each passing siren: Is this a second wave?
The recent increase prompted Mayor Bill de Blasio and Gov. Andrew M. Cuomo to order lockdowns in several parts of Brooklyn and Queens where the rate of positive test results has risen most sharply. The restrictions mostly affected neighborhoods with large Orthodox Jewish populations. But other neighborhoods faced partial lockdowns, including the canceling of indoor dining. On Wednesday, Mr. Cuomo announced that restrictions would be eased in some hot spots in New York City, while rules would be tightened in other areas.
The increases have rattled many people in those neighborhoods and beyond, reminding them of the dark days of March and April when it was impossible to meet friends, eat out at a restaurant, go to church or visit parents. Some residents are back to stockpiling medicine and rubbing alcohol, while others are putting their plans to return to their offices on indefinite hold.
Some New Yorkers see the rise in cases as a harbinger, the footfalls that announce an intruder’s arrival.
“I feel like the second wave is here — that same kind of doomsday feeling,” said Anya Ferring, 40, a fashion production consultant who lives in Far Rockaway, Queens, one of the neighborhoods experiencing a partial lockdown.
In several interviews in the past several weeks, city residents shared deep frustrations with their fellow New Yorkers who don’t appear to be following the same rules on wearing masks and social distancing. The solidarity forged in the springtime outbreak appears, in some neighborhoods, to have fractured in the fall.
Zoe Neuschatz, in Bedford-Stuyvesant, said she and her boyfriend have been mostly staying at home since the pandemic began, and they have no plans of letting up and have even considered stockpiling supplies.
“Maybe it’s my post-trauma stress from the spring,” she said. “I’m a nerd about it. I take it seriously, always.”
Senator Mitch McConnell, the majority leader, privately told Republican senators on Tuesday that he had warned the White House not to strike a pre-election deal with Speaker Nancy Pelosi on a new round of stimulus, moving to head off an agreement that President Trump has demanded but most in his party oppose.
Mr. McConnell’s remarks, confirmed by four Republicans familiar with them, threw cold water on Mr. Trump’s increasingly urgent push to enact a new round of pandemic aid before Election Day. They came just as Ms. Pelosi offered an upbeat assessment of her negotiations with Steven Mnuchin, the Treasury secretary, telling Democrats that their latest conversation had yielded “common ground as we move closer to an agreement.”
The cost of their emerging compromise on a new round of aid to hard-pressed Americans and businesses has steadily climbed toward $2 trillion, inching closer to Ms. Pelosi’s demands even as it far exceeds what most Senate Republicans have said they can accept.
With coronavirus cases continuing to rise across the country and tens of millions of American families and businesses going without critical federal benefits they relied on for much of the year, economists and the chair of the Federal Reserve have said now is the time for a substantial infusion of federal money to fuel a still-shaky economic recovery.
A majority of voters agree, saying they would support a $2 trillion stimulus package. And Mr. Trump, who only two weeks ago scuttled the bipartisan talks, is now also pushing urgently for Congress to “go big,” as he grasps for political advantage in the waning days of his re-election race.
The latest White House offer would cost nearly $1.9 trillion, White House officials said, nearly four times the size of the $500 billion package that Senate Republicans hoped to advance on Wednesday in a bid to show voters that they were willing to provide some aid — just not what Democrats and Mr. Trump have been discussing. (Democrats were likely to object to the package as inadequate and prevent it from clearing the 60-vote threshold it would need to advance.)
Nearly two weeks ago, President Trump told Americans that they would soon be getting an antibody treatment that he had promoted, without evidence, as a “cure” for the coronavirus. Last weekend, as the country braced for another major wave of coronavirus infections, Mr. Trump’s health secretary promised such therapies were just around the corner.
But these statements are misleading, at best. Even if the drugs are proven to work — still a big if — there’s little chance that they will soon be widely available. A smooth distribution of the antibody treatments will be dependent on the very same factors that have so far bedeviled the country’s response to Covid-19: fast and plentiful testing, coordination between state and federal officials, and equitable access to health care.
Supply will be extremely limited at first, even though the pool of patients who might benefit is vast, raising messy questions about who should be first in line for treatment. The drugs are believed to work best in people who have recently been infected and are not yet very sick.
Roughly 60,000 Americans are testing positive for the coronavirus every day, yet the company that provided the president’s antibody treatment, Regeneron, has said it will have only 50,000 doses initially. Eli Lilly, which is developing a similar product, has said it will have 100,000 doses at first. Regeneron will eventually have 300,000 doses, and Eli Lilly will have up to one million before the end of the year. Both companies have applied to the Food and Drug Administration for emergency authorization of their products.
Cathay Pacific, Hong Kong’s major airline, on Wednesday said it would slash thousands of jobs and scrap its subsidiary carrier, Cathay Dragon, in a major restructuring intended to cope with the continued impact of the coronavirus pandemic on the airline industry.
About 8,500 jobs, or 24 percent of the company’s head count, would be cut under the new plan. Of those, about 5,300 Hong Kong employees would be laid off. Executives would also take pay cuts, and company will also suspend salary raises next year.
“The global pandemic continues to have a devastating impact on aviation and the hard truth is we must fundamentally restructure the group to survive,” Augustus Tang, the chief executive of the company said in a statement.
“We have to do this to protect as many jobs as possible,” he said, adding that the company had already scaled back capacity, frozen recruitment and cut executives’ salaries, but was still burning up to about $260 million monthly. Mr. Tang said he hoped to reduce that to about $65 million under the restructuring, which will begin to take effect immediately.
So far, the pandemic has slashed more than 90 percent of international flights, and it could take until 2024 for passenger traffic to reach pre-Covid-19 levels, according to the International Air Transport Association. Internationally, a number of airlines have canceled routes and cut budgets, while some regional carriers have shuttered completely.
Even before the pandemic, Cathay Pacific was grappling with a drop-off in Hong Kong tourism because of last year’s sometimes violent pro-democracy demonstrations. Many mainland Chinese passengers avoided the airline because of the perception that some Cathay Pacific employees supported the pro-democracy movement.
In what might be the final months of the Trump administration, Dr. Stephen M. Hahn, the head of the Food and Drug Administration, seems to be trying to save the agency from the fate of the Centers for Disease Control and Prevention, whose scientists have been stripped of much of their authority and independence in responding to the pandemic.
To many F.D.A. scientists, Dr. Hahn has been a disappointment. Under his leadership, the F.D.A. authorized hydroxychloroquine for hospitalized Covid-19 patients despite a lack of evidence, only to reverse the decision once the drug was tied to severe side effects.
In late August, Dr. Hahn made a significant error at a news conference with the president announcing the approval of plasma treatments for Covid-19, greatly exaggerating its benefits. He later publicly corrected the record.
That debacle seems to have been a turning point for Dr. Hahn and agency scientists.
On Sept. 10, F.D.A. directors wrote a joint statement, warning that political interference could destroy the agency’s credibility. Dr. Hahn tweeted his support of the statement, and later that day noted that new vaccine guidelines were coming.
Experts in the Office of Vaccines Research and Review drafted new guidelines, to make its standards unmistakable to drugmakers and reassure jittery Americans that the agency would not cut corners when assessing a vaccine’s safety and effectiveness.
Within days of submitting the guidelines to the White House, F.D.A. scientists, fearing they would never be made public, decided to include them in the briefing materials for an outside group of vaccine experts scheduled to meet on Oct. 22. They slipped a version into the appendix of the committee’s briefing materials, with a new title.
Executives from Johnson & Johnson and Merck, each with vaccine candidates, called for the guidelines’ release. Dr. Albert Bourla, Pfizer’s top executive, wrote on Twitter that he had faith in the F.D.A.’s ability to set standards.
The same morning, the materials were quietly posted online. The White House was given about an hour’s notice, according to a senior administration official. Later that day, the White House abruptly cleared the guidelines, which were then posted to the F.D.A. website.
The pandemic has caused nearly 300,000 deaths in the United States through early October, the Centers for Disease Control and Prevention said in a report released Tuesday. The tally includes not only deaths directly caused by the coronavirus but also nearly 100,000 fatalities that are indirectly related but would not have occurred if not for the virus.
The study is an attempt to measure excess deaths — fatalities from all causes that statistically exceed those normally occurring in a certain time period.
Many experts believe this measure tracks the pandemic’s impact more accurately than the case fatality rate. The figure includes deaths from Covid-19 that were misclassified or missed and deaths from emergencies like heart attacks that went untreated because people were afraid to go to the hospital.
Hidden in the new numbers from the C.D.C. is a statistic that may not mean as much as it appears: While the pandemic has taken the greatest toll on older citizens, the biggest percentage increase in excess deaths has occurred among young adults ages 25 to 44, among whom there was a 26.5 percent increase — as compared with an increase of 14.4 percent in those over 85, a group with a large proportion of the nation’s excess deaths.
But in nonpandemic times, the death rate among people in that age group is very low, so a disaster such as Covid-19 can easily bump up their death statistics without adding up to large numbers of excess deaths.
Excess deaths among Black people and Hispanics of all age groups also rose compared with previous years, the C.D.C. reports. Hispanics experienced a 54 percent increase, while Black people saw a 33 percent rise.
By comparison, the increase for white Americans was 12 percent, according to the C.D.C.
Another report, published in the Proceedings of the National Academy of Sciences, found that in April nearly half of the nation’s excess deaths were in New York and New Jersey. A third were in people over age 85.
But excess deaths are only part of the story, noted the authors of that paper, led by Amy Finkelstein, a professor of economics at M.I.T. While deaths last spring were concentrated in New York and New Jersey, the economic ravages from the pandemic extended nationwide, even in states with almost no deaths.
Job losses in New York and New Jersey were just a small fraction — 7 percent — of job losses throughout the country. And while deaths were concentrated in older people, half of those who lost their jobs nationwide were ages 25 to 44.
Concentrating on case counts or death counts, they conclude, provides only a partial picture of the pandemic’s devastation.
“Health crises concentrated in one part of the country and one age group may have substantial economic spillovers that are felt throughout the rest of the country and on other age groups,” the authors wrote.
Reporting was contributed by Monika Pronczuk, Anna Schaverien and Eileen Sullivan.