Covid-19: U.S. Air Travel Is Highest Since March, Despite Warnings

Holiday travelers at Hartsfield-Jackson International Airport in Atlanta on Dec. 23.
Credit…Nicole Craine for The New York Times

Sunday was the busiest day for U.S. airports since mid-March, underscoring concerns that a spike in holiday travel may contribute to the spread of the coronavirus, even as new cases remain alarmingly high and officials plead with Americans to avoid taking unnecessary risks.

The Transportation Security Administration screened nearly 1.3 million people on Sunday, the most since March 15, when airline passenger numbers were in free-fall as the pandemic began to take hold within the United States.

Since then, the number of travelers screened at airports has exceeded one million fewer than a dozen times, including around Thanksgiving and Christmas.

About 3.8 million people passed through T.S.A. travel checkpoints between Dec. 23 and Dec. 26, compared with 9.5 million on those days last year.

The surge in holiday travel compared with previous months comes despite warnings from federal officials and soaring U.S. case numbers.

Total infections surpassed 19 million on Saturday, meaning that at least 1 in 17 people have contracted the virus over the course of the pandemic. And the virus has killed more than 333,000 people — one in every thousand in the country. Hospitalizations are hovering at a pandemic height of about 120,000, according to the Covid Tracking Project.

Holiday reporting anomalies may obscure any post-Christmas spike until the second week of January. Testing was expected to decrease around Christmas and New Year’s, and many states said they would not report data on certain days.

The lessons learned from Thanksgiving are mixed. Case numbers and deaths have continued to rise since, but the patterns look more like a plethora of microspreads than a mass superspreader event.

Over all, experts have told The Times, areas of the U.S. that were improving pre-Thanksgiving — like the Midwest — continued to do well afterward, while regions that were seeing higher numbers before the holiday continued to worsen.

It is difficult to trace precisely where infections may occur in a journey — be it in flight, at the airport or at the destination, but travel is a critical factor in the spread of the virus.

U.S. officials said last week that passengers arriving from Britain would be required to test negative for the virus before departing. The new rule came after a new highly transmissible variant of the virus was discovered in that country.

The federal government has imposed some limits on passengers arriving from other countries, but states have largely been left to impose such restrictions domestically and have done so with mixed results. Hawaii, for example, has had relative success in maintaining quarantine restrictions. But most states and the District of Columbia have struggled to keep out travelers or require them to quarantine themselves upon arrival.

United States › United StatesOn Dec. 28 14-day change
New cases 189,044 –13%
New deaths 1,899 –10%

World › WorldOn Dec. 28 14-day change
New cases 490,470 –8%
New deaths 9,465 –4%

Where cases per capita are

The Life Care Center of Kirkland, a nursing home near Seattle, was the site of the first U.S. coronavirus outbreak. Residents and staff members received vaccinations on Monday.
Credit…Karen Ducey/Getty Images

A nurse at the suburban Seattle nursing home that was ravaged by the first U.S. cluster of coronavirus cases sat down beside a visiting pharmacist on Monday, pulled up her blue shirtsleeve and received the first dose of the Covid-19 vaccine administered at the facility.

It was the beginning of what residents, families and employees hope will be a turning point in a pandemic that has killed tens of thousands of people in long-term care facilities. Vaccination teams from Walgreens and CVS were fanning out to facilities across the country on Monday, the start of a long, difficult campaign to vaccinate some of the country’s most vulnerable people.

At the facility near Seattle, the Life Care Center of Kirkland, which is connected with 46 coronavirus deaths, relatives of residents got a text message on Monday morning alerting them that vaccinations were beginning.

Colleen Mallory had been waiting for this moment. Her mother has severe dementia, and since Life Care was locked down last winter, her family has visited her mostly by standing outside her window, waving and saying “I love you.”

Ms. Mallory’s family gave Life Care permission to vaccinate her mother, and Ms. Mallory said she had been calling and calling, anxious to know whether it had actually happened. “I can’t get a hold of anyone,” she said. “It would be nice to know.”

Alice Cortez, the first nurse vaccinated at the facility, said she felt “a new life, a new beginning, but a better life,” The Seattle Times reported. There were roses and cheers as she was injected just outside the facility, with cameras rolling.

The scene was starkly different last winter, when the quiet, shaded nursing home became a scene of grim vigil and daily updates about deaths and case counts. Journalists crowded outside the locked-down facility as ambulances whisked residents to the hospital and families peered through windows to check on parents and grandparents.

Life Care officials did not immediately reply to inquiries about how many staff members and residents were vaccinated on Monday, or how long it would take to vaccinate them all.

Officials in Los Angeles County, the most populous in the nation, estimate that 1 out of 95 people is contagious with the coronavirus.
Credit…Damian Dovarganes/Associated Press

Stringent orders requiring most residents of California to stay at home, except for some essential activities, are all but guaranteed to be extended, Gov. Gavin Newsom said on Monday, when some were eligible to end.

“Things, unfortunately, will get worse before they get better,” the governor said at a news conference.

Hospitals — already overwhelmed across much of the state — must prepare for what experts project will be a “surge on top of a surge, arguably on top of another surge,” stemming from travel and socializing over the holidays, Mr. Newsom said.

The state has sent an emergency team to Los Angeles County to help address an influx of patients, who were being turned away from emergency rooms for lack of space at alarming rates over the weekend.

“Routine E.R. care is being slowed,” Mr. Newsom said. “The impact of this pandemic is being felt on the entire hospital system, and could impact each and every one of us — God forbid.”

California has become the epicenter of the pandemic in the United States in recent weeks. The state has reported more than 2 million confirmed coronavirus cases and 24,331 deaths this year, according to a New York Times database.

Intensive care units have been at or near capacity for weeks in Southern California and the Central Valley of the state. Doctors and nurses have been treating some patients in lobbies and hallways. Tents have been erected as waiting rooms, and in some cases, as free-standing field hospitals.

Though most hospitals have not yet formally begun to ration care, experts have said that crowding at the hospitals is likely to result in fewer people seeking care they need, which is probably already causing more deaths.

The current tidal wave of infections in the nation’s most populous state started rising before Thanksgiving. In early December, state leaders announced a plan for regional stay-at-home orders tied to how full intensive care units had become.

The restrictions could expire after three weeks, officials said at the time, if intensive care units in the region were projected to be less than 85 percent full. The idea that the worsening trends in testing and hospitalizations would reverse, or at least level off, within three weeks seemed optimistic, but theoretically possible.

But the Southern California region, which includes Los Angeles, Orange and San Diego counties, exceeded the threshold almost immediately after the plan was announced. So did capacity in the San Joaquin Valley, which has been particularly hard-hit throughout the pandemic. And the situation has not improved.

Now, some 98 percent of Californians across the vast state are living under the restrictions, which prohibit gatherings of people from different households and require restaurants to serve only takeout.

When the orders affecting Southern California and the San Joaquin Valley reached the three-week mark on Monday, Mr. Newsom said it was “self-evident” that they would need to be extended, but that officials were still putting together detailed data.

He said the state secretary of health and human services, Dr. Mark Ghaly, would probably make the extensions official on Tuesday.

Housing activists gathered to call for cancellation of rent in Brooklyn in July.
Credit…Scott Heins/Getty Images

The New York Legislature on Monday overwhelmingly passed one of the most comprehensive anti-eviction laws in the United States, as the state contends with high levels of unemployment caused by a pandemic that has taken more than 330,000 lives nationwide.

Tenants and advocacy groups have been dreading the end-of-year expiration of eviction bans that have kept people in their homes even as they fell months behind in their rent. Under the new measure, landlords will be barred from evicting most tenants for at least another 60 days in almost all cases.

The bill would not only block landlords from evicting most tenants but would also protect some small landlords from foreclosure and automatically renew tax exemptions for homeowners who are elderly or disabled.

The Legislature convened an unusual special session between Christmas and New Year’s to pass the measure, acting quickly because the governor’s executive order barring many evictions was slated to expire on Dec. 31. The legislators’ urgency reflected a national concern over the fate of millions of people without jobs and access to job opportunities, as the pandemic continues to eat away at the economy.

Gov. Andrew M. Cuomo on Monday said he would sign the bill, which will then go into effect immediately.

The passage of the bill comes as a relief for renters like Vincia Barber, a 40-year old tenant in Crown Heights, Brooklyn, who said she lost her job as a nanny and hasn’t paid rent in months.

“This is the best thing they could do for us today,” said Ms. Barber, who added that two of her relatives had died of the Covid-19.

Once the bill becomes law in New York, tenants like Ms. Barber can protect their homes by submitting a document stating financial hardship related to the coronavirus. As many as 1.2 million New York households are at risk of being removed from their homes, according to a database maintained by Stout, a consulting firm.

For eviction cases that are already working their way through the courts, the law will halt proceedings for at least 60 days. Landlords would not be allowed to begin new eviction proceedings until at least May 1.

Some landlords resisted the measure, arguing that the law didn’t adequately distinguish between tenants with resources and those without. They said the new law paid too little heed to property owners who are themselves grappling with diminished financial resources, as tenants fall behind on rent and ground-floor retail tenants go out of business.

The legislation attempts to address those concerns by making it harder for banks to foreclose on smaller landlords who are themselves struggling to pay bills.

global roundup

Workers at a funeral home in Barcelona prepared the body of a coronavirus victim for burial this month.
Credit…Samuel Aranda for The New York Times

Coronavirus deaths in Spain reached 50,000 the fourth European nation to do so, after Italy, Britain and France.

Spain undertook one of the most restrictive lockdowns in the spring. It ended its first state of emergency in June, but a merciless second wave that began in August has continued through the fall and into the winter, even as Spain returned to a state of emergency in October.

The health ministry said on Monday that it had registered 50,122 dead since the start of the pandemic, after adding 298 fatalities since its last count last week.

More than one-fifth of Spain’s deaths occurred this year in the capital region of Madrid, where the regional authorities have this week put 10 areas under tighter lockdown rules, amid concerns over another increase in infections. Regions like the Balearic Islands and Navarra are also tightening restrictions this week, while the health authorities in Andalusia said on Monday that they had detected five cases of the new coronavirus variant originating from Britain.

Alongside other European Union countries, Spain started its mass vaccination program on Sunday, with the goal of inoculating 2.5 million people between January and March. The first shots went to residents of nursing homes and the health care professionals who look after them.

Spain plans to collect and share with other E.U. nations information about residents who decide not to get vaccinated for Covid-19, the country’s health minister said on Monday. Spain’s health minister, Salvador Illa, stressed that vaccination would not be made compulsory, but, he said, a register would be set up that would include all the people who turned down the vaccine after being called up for vaccination by Spain’s public health service.

“Vaccination refusals will be kept in a register,” Mr. Illa said in an interview with La Sexta, a Spanish television channel. “This is not a public document and it will be done with the highest respect of data privacy.”

On Monday, José Luis Martínez-Almeida, the mayor of Madrid and spokesman of the main opposition Popular Party, blamed the government for “a shortage of information” about the vaccine, which has meant that many people are still reluctant to get it.

The vaccination plan should be “an exercise in transparency, not propaganda,” Mr. Martínez-Almeida said in an interview with Spanish national radio.

In other developments around the world:

  • Not wearing a mask in public is now a criminal offense in South Africa, as recorded coronavirus infections have surged to over one million since the start of the pandemic. Offenders face up to six months in prison, a fine or both. “This is a drastic measure, but is now necessary to ensure compliance with the most basic of preventive measures,” President Cyril Ramaphosa said on Monday. Scientists discovered a variant of the virus that accounts for the vast majority of samples tested in the current wave. Mr. Ramaphosa also announced a national curfew from 9 p.m. to 6 a.m., the closure of the country’s beaches and the prohibition of gatherings. South Africa will likely gain access to a Covid-19 vaccine in the second quarter of 2021, he said.

  • China warned against Lunar New Year travel in February after finding cases in Dalian, a northern port city, and Beijing, the capital. After months of near-zero case numbers that have allowed life to largely return to normal, the country of 1.4 billion people has recorded 42 locally transmitted cases in the past week, many of them were of unknown origin. In line with the government response to previous outbreaks this year, officials have been testing hundreds of thousands of people in Beijing and millions in Dalian, and residents of Dalian have been advised not to leave the city. China plans to vaccinate 50 million people.

  • At a news conference on Monday, Alain Berset, the health minister of Switzerland, responded to reports of British tourists fleeing the ski resort of Verbier in the middle of the night to avoid being quarantined for the holidays. “I don’t know where they went,” he said. “I think they just went home.” The Swiss government has imposed a 10-day quarantine on anyone who arrived in Switzerland from Britain after Dec. 13, so British tourists already in the country faced the prospect of spending the rest of their holidays watching people ski from their hotel rooms, rather than skiing themselves. Switzerland is one of the only places in Europe where ski slopes are open.

  • Indonesia will bar entry to international visitors for two weeks from New Year’s Day to stem the spread of new, potentially more contagious strains of the coronavirus, Reuters reported, with an exemption only for high-level government officials. The country barred travelers from Britain a few days ago, and tightened rules for those arriving from Europe and Australia, expanding on an earlier tourism ban.

  • South Korea has discovered three cases of the virus variant first detected in Britain, officials said on Monday. All were in members of a London-based family who arrived in the country on Dec. 22, according to the Korea Disease Control and Prevention Agency. All three have been in isolation since testing positive on arrival. South Korea, which is struggling to contain a third wave of infections, is among dozens of countries that have temporarily banned flights from Britain. The country of about 50 million people reported 808 new cases on Monday, bringing the national total to 57,680, with 819 deaths.

  • Health officials in Finland said on Monday that there have been two cases reported in the country of the variant first detected in Britain, and one case of the variant that was detected in South Africa, Reuters reported. A case of the South Africa variant was found in Japan in a woman in her 30s who arrived to Japan on Dec. 19, health officials said on Monday, according to Reuters, the same day Japan halted entry by non-resident foreign nationals in an effort to limit the spread of the new variants.

  • Frontline workers in Sydney, Australia, will not be allowed to watch the New Year’s Eve firework display from the city’s harbor as planned, Gladys Berejiklian, premier of the state of New South Wales, said Monday, citing a growing coronavirus outbreak in the city’s northern suburbs. Other restrictions announced for Dec. 31 include lowering a limit on outdoor gatherings to 50 from 100 and barring people who live outside the central business district from entering unless they have a venue booking and an entry permit. Separately, Australiathreatened to cancel the visas of backpackers caught partying at Sydney’s Bronte Beach earlier this month in breach of coronavirus restrictions.

    Correction: Dec. 28, 2020
    An earlier version of this article misstated that Spain was the third European nation to reach 50,000 coronavirus deaths. Spain is the fourth E.U. nation to do so, after Italy, Britain and France.

Dr. Hisam Goueli treated several psychotic patients who had never had mental health issues before, including a woman who told him she kept visualizing her children being murdered.
Credit…Jovelle Tamayo for The New York Times

Almost immediately, Dr. Hisam Goueli could tell that the patient who came to his psychiatric hospital on Long Island this summer was unusual.

The patient, a 42-year-old physical therapist and mother of four young children, had never had psychiatric symptoms or any family history of mental illness. Yet there she was, sitting at a table in a beige-walled room at South Oaks Hospital in Amityville, N.Y., sobbing and saying that she kept seeing her children, ages 2 to 10, being gruesomely murdered and that she herself had crafted plans to kill them.

“It was like she was experiencing a movie, like ‘Kill Bill,’” Dr. Goueli, a psychiatrist, said.

The only notable thing about her medical history was that the woman had become infected with the coronavirus in the spring. She had experienced only mild physical symptoms from the virus, but, months later, she heard a voice that first told her to kill herself and then told her to kill her children.

Dr. Goueli was unsure whether the coronavirus was connected to the woman’s psychological symptoms. “But then,” he said, “we saw a second case, a third case and a fourth case, and we’re like, ‘There’s something happening.’”

Indeed, doctors are reporting similar cases across the country and around the world. A small number of Covid patients who had never experienced mental health problems are developing severe psychotic symptoms weeks after contracting the coronavirus.

Beyond individual reports, a British study of neurological or psychiatric complications in 153 patients hospitalized with Covid-19 found that 10 people had “new-onset psychosis.” Another study identified 10 such patients in one hospital in Spain. And in Covid-related social media groups, medical professionals discuss seeing patients with similar symptoms in the Midwest, Great Plains and elsewhere.

“My guess is any place that is seeing Covid is probably seeing this,” said Dr. Colin Smith at Duke University Medical Center in Durham.

Medical experts say they expect that such extreme psychiatric dysfunction will affect only a small proportion of patients. But the cases are considered examples of another way the Covid-19 disease process can affect mental health and brain function.

Prudence Dudu Khumalo, 39, of Soweto, South Africa, participated in the Novavax Covid-19 vaccine trials on Dec. 8.
Credit…Joao Silva/The New York Times

The Maryland biotech Novavax is starting a final, so-called Phase 3 clinical trial in the United States and Mexico for its experimental coronavirus vaccine, the company announced on Monday.

The little-known firm, which has never brought a vaccine to market before, received up to $1.6 billion from the federal government’s Operation Warp Speed this summer to expedite development. The company reported robust results in earlier phases of its trial, showing that the vaccine prompted strong immune responses in monkeys and people.

The company began a Phase 3 trial of 15,000 people in Britain in September and expects to report preliminary results from that study in the first quarter of next year. It had intended to start its U.S. trial in October but delayed it because of manufacturing problems.

The Novavax vaccine, known as NVX-CoV2373, works differently than the ones by Pfizer and other companies that have already been shown to be effective. It contains artificially produced viral proteins, along with an immune-boosting compound derived from the soapbark tree.

The vaccine, given in two doses, three weeks apart, is designed to teach the immune system to recognize the protein. Later, if vaccinated people get infected with coronaviruses, their antibodies can attack them, while immune cells can destroy virus-harboring cells.

NVX-CoV2373 must be kept refrigerated but does not require freezing, making its storage easier than the vaccines from Moderna and from Pfizer and BioNTech, which have to be transported at ultracold temperatures.

Three other protein-based coronavirus vaccines are also in Phase 3 trials in Australia, Canada and India.

Novavax will run its trial at 115 sites in the United States and Mexico, enrolling as many as 30,000 people. Two-thirds will receive the experimental vaccine, and the rest a placebo. Novavax said it would recruit a diverse group, including Black and Latino volunteers. They plan for one-quarter of their participants to be older than 65.

“With the Covid-19 pandemic raging around the globe, this trial is a critical step in building the global portfolio of safe and effective vaccines to protect the world’s population,” Stanley C. Erck, the president and chief executive of Novavax, said in a statement.

A doctor getting a shot of the Moderna coronavirus vaccine in Fort Lauderdale, Fla., last week.
Credit…Joe Raedle/Getty Images

The sight of lines of people camped on the sidewalk overnight used to mean that playoff tickets or a new sneaker would be going on sale in the morning. But in one southwest Florida town, it was not trend-chasing teenagers or rabid sports fans this time, it was seniors, and the scarce commodity they were after was a coronavirus vaccine.

The Florida Department of Health in Lee County announced on Sunday that the Moderna vaccine would be available at the parks building in Estero, Fla., starting at 2 p.m. Monday to people 65 and older, as well as “high-risk frontline health care workers.” There was no list, no appointments were scheduled — the first 300 qualified people who showed up would get a shot.

People started lining up within hours, The News-Press newspaper in Fort Myers, Fla., reported. They brought lawn chairs, blankets and thermos bottles.

One woman in the line told The News-Press that her granddaughter, who just turned 1, was on her mind as she waited to get a shot.

“This is my birthday present to her,” she said. “I’ve never been able to see her.”

The first-come, first-served method stood in contrast to the carefully orchestrated approach at most settings where the two authorized Covid-19 vaccines have been doled out so far. The first hospitals to administer the vaccine have generally been drawing up prioritized lists and assigning appointed times.

But as the nationwide vaccination effort expands, scenes like the one outside the Estero Park and Recreation Center on Monday will surely grow more common. Six more sites in Lee County plan to give the vaccine in the same manner on Tuesday and Wednesday.

More than 1.9 million people across the United States have received the vaccine as of Saturday, and the federal government said it shipped at least 9.5 million doses to states, territories and government agencies, each with its own distribution plan.

The Centers for Disease Control and Prevention recommended last week that after health care workers and nursing home residents, the next groups to be vaccinated should be people older than 74 and “frontline essential workers,” followed by people 65 to 74 and anyone with serious underlying medical conditions regardless of age.

But Gov. Ron DeSantis of Florida issued an executive order the next day allowing health care providers to vaccinate anyone older than 65 right away.




New York to Investigate Rise in Virus Positivity Rate

Gov. Andrew M. Cuomo of New York announced on Monday that the state’s coronavirus positive test rate had surpassed 8 percent, the highest daily figure in months, but said there were anomalies in testing and reporting around the holidays.

This is what the numbers say today, which we’re not quite sure what it means. But we’re studying it. Statewide positivity without microclusters, 7.8. Statewide positivity with microclusters, 8.3. That is an increase from the 5.9 seven-day average. This is a jump from Friday, Saturday to Sunday. We have been talking about potential for spread during Christmas. For it to go up in two days is dramatic and very, very fast. So we’re not, we’re studying what the uptick in that number actually means. So one of the theories that we’re going to look at is people who were going to get a test because they were traveling, because they were concerned about spreading the virus, were getting tested up until Christmas. And anyone who went and got tested post-Christmas over the weekend was a person who was showing symptoms and thought they might be positive. So the sample is artificially skewed.

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Gov. Andrew M. Cuomo of New York announced on Monday that the state’s coronavirus positive test rate had surpassed 8 percent, the highest daily figure in months, but said there were anomalies in testing and reporting around the holidays.CreditCredit…James Estrin/The New York Times

Gov. Andrew M. Cuomo of New York announced on Monday that the state’s positive test rate had surpassed 8 percent, the highest daily figure since May and a sharp rise even as officials anticipate a larger spike after the holiday season.

Still, Mr. Cuomo was reluctant to raise alarms about the metric, which was at 8.3 percent on Sunday, because of anomalies in testing and reporting around the holidays.

In the days before Christmas, more New Yorkers were tested across the state than usual, most likely in preparation for small gatherings and holiday travel. The number of tests then fell by more than 75,000 over the weekend, and Mr. Cuomo said officials are looking at whether that too affected the metric.

“The sample is artificially skewed,” Mr. Cuomo said.

After Christmas Day, a higher proportion of tests came from urgent care clinics, he said, which may indicate that the people seeking a test were more likely to have symptoms, as opposed to those who generally go for precautionary tests.

Officials will continue monitoring the state’s progress over the next few days, he added, to further determine whether the rise was an aberration or an indication that the coronavirus is measurably advancing.

Since the start of the pandemic, New York has recorded nearly 930,000 cases, and 37,000 people have died, according to a New York Times database.

Weeks ago, New York officials were most concerned about containing the spread in Buffalo and its surrounding suburbs, where, in November, hospitalizations surpassed the extreme levels seen in the spring. But since then, Mr. Cuomo said, the area “has actually made good progress.”

The communities surrounding Albany in upstate New York, the Finger Lakes region and the Mohawk Valley area — where the seven-day average positive test rate was 8.46 percent — are sparking the most concern. “You bring it down in one region, it pops up in another,” he said.

In New York City, Staten Island continues to raise the greatest worries. The seven-day positive test rate in the borough, which has been one of the centers of rebellion in the city over local and state virus-related restrictions since the spring, was 5.44 percent. Residents have pushed back against the city’s restrictions and appeals to wear masks.

“This is just pure people’s behavior and people’s attitude — and the community’s attitude,” Mr. Cuomo said.

Workers loading up cars at the Vida Life Ministries food distribution center in Bloomington, Calif., on Dec. 19. The pandemic relief bill was welcome news in a tough holiday season for many Americans.
Credit…Alex Welsh for The New York Times

President Trump signed a $900 billion pandemic relief bill on Sunday and funded the government through September. The measure restarts unemployment benefits that had lapsed on Saturday, extends an eviction moratorium, provides money to states for vaccine distribution and replenishes a loan program for small businesses.

It will also provide stimulus checks of $600 for most Americans, a bit of welcome news in a tough holiday season. For months, Americans, like people everywhere, have had to make difficult choices about where to go and whom to see, as the coronavirus pandemic rages across the globe. Those narrowing choices, hard even during times of lower infection rates, have been especially amplified as the holidays have coincided with record-shattering numbers.

Adding to the physical toll of the virus are the economic repercussions, as the millions who lost their jobs this year can so readily attest. Mr. Trump had withheld his support of the bill in part because he said the direct payments to many Americans should be $2,000, and not the $600 provided in the legislation.

The United States reported 225,930 new cases on Dec. 26, according to a New York Times database, continuing a slight downward trend in the numbers, but still a staggering figure. As case counts remained steady, and hospitalizations increased, California’s worsening outbreak muffled progress in other parts of the country. In parts of the state — the wealthiest and most populous in the country — every I.C.U. bed is filled.

Dr. Anthony Fauci warned again of especially challenging months ahead. “We very well might see a post-seasonal — in the sense of Christmas, New Year’s — surge,” Dr. Fauci said on the CNN program “State of the Union.”

“We’re really at a very critical point,” he said. “If you put more pressure on the system by what might be a post-seasonal surge because of the traveling and the likely congregating of people for, you know, the good warm purposes of being together for the holidays, it’s very tough for people to not do that.”

And while many people reduced the size of their gatherings or gave up travel this year, others defied the pleas of public health experts and the Centers for Disease Control and Prevention.

Several days around the Christmas holiday saw some of the busiest air travel of the pandemic, according to data from the Transportation Security Administration. More than one million people passed through T.S.A. checkpoints each day of the weekend before Christmas, and again on Dec. 23 and the day after Christmas — a number reached only a few times since March, including during the Thanksgiving holiday week.

Gravediggers at a cemetery in São Paulo, Brazil, in May.
Credit…Victor Moriyama for The New York Times

Since surfacing in a seafood and poultry market in China in December 2019, the coronavirus has spread to nearly every country, upended daily life and derailed the global economy. It has killed more than 1.6 million people and sickened more than 76 million worldwide over the last year. The World Health Organization has declared the situation a pandemic.

Several world leaders, including President Trump and Prime Minister Boris Johnson of Britain, contracted the virus as they worked to mitigate its spread within their borders, proving even the most powerful could fall to the virus’s grip.

Scientists around the world moved quickly to produce an effective vaccine, and by this month several nations had started administering inoculations to their most vulnerable residents in an effort to bring the virus under control.

We’ve put together a timeline, charting the pandemic’s course over the past year.

then & now


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CreditCredit…Justin Hamel for The New York Times

As 2020 comes to a close, we are revisiting subjects whose lives were affected by the pandemic. When Manny Fernandez first encountered Holly Montoya in November, he wasn’t able to catch her name or talk to her. Later, she reached out and shared her story.

Families of those infected with the virus stood outside a New Mexico hospital that November night, staring in pain through windowpanes. This was as close as they could get to their loved ones at Memorial Medical Center in Las Cruces. I watched as they put their palms and crucifixes against the glass, Duct-taped crosses in the City of Crosses.

A stranger approached on the sidewalk.

She hardly said a word as she walked up behind two families. She carried two pizza boxes. She handed a pizza to one family and the second pizza to the other. She wore a mask, but her eyes were filling with tears. She was gone in seconds, walking quickly back down the sidewalk.

One of the families, the relatives and friends of Sylvia Garcia, 60, turned around, stunned, their focus on the I.C.U. windows interrupted by a warm gift on a cold night from an anonymous stranger.

I never caught the woman’s name. After we wrote about that moment in Las Cruces, she contacted me and my colleague, Jack Healy.

Her name is Holly Montoya, 55. She and her husband had driven by the hospital the night before. They saw the families huddled outside the windows.

“I just wanted to do something nice for them,” she told me recently. “I knew how they felt.”

Ms. Montoya’s mother, Sherry Baca, 78, had Covid-19, too.

“I feel kind of silly because it was such a little thing,” Ms. Montoya said. “I’m reading about all these people giving out 1,500 meals. I wanted to tell them why I was doing it and about my mom and all that, but I just couldn’t. I’m not a good cry talker. My eyes hopefully told them my story.”

It was Nov. 18 when I saw Ms. Montoya outside the hospital. She lost her mother to the coronavirus soon after, on Nov. 22. Ms. Garcia died days later, on Nov. 29.

We are a divided country, in the grip of a deadly pandemic. But our unspoken connections outnumber our spoken divisions. We stand suffering at our individual walls, until strangers approach from behind, bearing love and pizza.

Pfizer factory in Puurs, Belgium, this month. The vaccine delivered from there has to be kept at minus 70 degrees Celsius.
Credit…Ksenia Kuleshova for The New York Times

The delivery of a small number of vaccine doses from Pfizer to several countries in the European Union suffered a minor delay after concerns about the temperature controls being used to keep the doses super cold. The issue forced shipments from a factory in Belgium to be pushed back a day, according to the Spanish health authorities.

Pfizer’s factory in Puurs, Belgium, told the company’s Spanish division on Monday night that shipments to eight European countries would be delayed “because of a problem in the process of loading and sending,” the Spanish ministry said in a news release.

The release did not specify which countries beside Spain were affected. When asked about the delay on the Spanish radio broadcaster Ser, Salvador Illa, the health minister, said that the problem was linked to the “control of the temperature” of the shipments and had been resolved.

The doses, he said, should arrive on Tuesday, one day late.

A Pfizer spokeswoman, however, said that while there was a “minor logistical issue,” there were “no manufacturing or temperature control issues to report.”

The delay underscored the logistical challenges of speeding millions of doses of vaccine that need to be kept at minus 70 degrees Celsius around the world as fast as possible.

On Sunday, the first day of the vaccination campaign in Europe, there was also a minor problem with the cold-chain process in Germany: Concerns about 1,000 shots not being cold enough delayed efforts around Lichtenfels, in Bavaria.

“When reading the temperature loggers that were enclosed in the cool boxes, doubts arose about the compliance with the cold chain requirements,” the district of Lichtenfels said in a statement.

By late Sunday, the problems were resolved and the campaign commenced.

Dr. Matthew Harris reported a fever and joint pain after receiving the vaccine.
Credit…via Matthew Harris

As tens of millions of Americans await their turn for a shot, many are hungering for details about what to expect. Some who have been part of the biggest vaccination program in U.S. history spoke to The New York Times.

They recounted a wide spectrum of responses, from no reaction at all — “Can’t even tell I had the shot,” said a hospital worker in Iowa City — to symptoms like uncontrolled shivering and “brain fog.” A nurse assistant in Glendora, Calif., wondered whether the fever he ran was a side effect of the vaccine or a sign that he had been infected by one of his patients.

And there was a dizzying variety of sore arms. Some likened the pain to that from a flu shot; for others, it was considerably worse.

Dr. Matthew Harris, 38, an emergency medicine doctor in Great Neck, N.Y., was up all night with a fever, shivering underneath a blanket, after receiving the first shot. He had joint pain in his wrists and shoulders that lasted into the next day.

The next day, he posted about his reaction, with the hashtag #stillworthit. “Everyone has read, ‘This is the light at the end of the tunnel,’” Dr. Harris said in an interview. “But are people going to feel great 100 percent of the time after this vaccine? No. And if we’re not honest with them, how can we expect them to trust us?”

Most vaccine recipients who spoke to The Times for this article stressed that they had no regrets about getting the shot. The Food and Drug Administration has found the vaccines to be safe and remarkably effective. And public health leaders say mass vaccination is the only hope for controlling the virus that is now claiming the lives of close to 3,000 Americans a day.

But in these first weeks of vaccination, there is an inescapable element of suspense.

For infectious disease experts, a nation down for the count with post-vaccine malaise would be the best news in a long time. The side effects dissipate within a few days, and they are a signal, the experts say, that the vaccine is working.

Mass testing in Dalian, China, last week. The virus is once again set to interrupt Lunar New Year celebrations.
Credit…Agence France-Presse — Getty Images

Last January, when the government of China imposed an unprecedented lockdown on the city of Wuhan in a belated effort to contain the spread of the coronavirus, it was right before the start of the Lunar New Year, the country’s most important holiday. Soon the shutdown was extended to encompass all 60 million people in the surrounding province of Hubei, and fear of the virus led millions more to cancel their holiday plans. Now the virus is likely to disrupt the holiday for a second year, with officials advising the public not to travel as they battle outbreaks in two major cities.

After months of near-zero case numbers that have allowed life in China to largely return to normal, the country of 1.4 billion people has recorded 42 locally transmitted cases in the past week, many of them of unknown origin. Most appeared in Dalian, a northern port city, but there have also been a few in Beijing, the capital.

In line with the government response to previous outbreaks this year, officials have been testing hundreds of thousands of people in Beijing and millions in Dalian, and residents of Dalian have been advised not to leave the city.

Officials in Beijing are looking even further ahead to the Lunar New Year, during which hundreds of millions of Chinese travel to their hometowns in what has been called the world’s largest annual human migration. Citing concerns that holiday travel could spread the virus, the government is discouraging Beijing residents from traveling and gathering for the holiday, especially the elderly, pregnant women and people with chronic conditions. Travel companies have also been told not to organize any group tours to Beijing during the holiday, which this year falls on Feb. 12.

Other parts of the country are taking precautions as well. Anhui Province, home to many of China’s migrant workers, plans to test and monitor all those who return for the holiday. The governments of Anhui Province and Shanxi Province have also advised residents to limit private gatherings to 10 people during the holiday period.

Chinese officials and health experts say they are confident that China will not have a major outbreak in the new year, citing plans to vaccinate 50 million people before the Lunar New Year as well as the greater experience they have in testing and contact tracing compared with a year ago.

Since the pandemic began, China has reported almost 97,000 coronavirus cases and 4,634 deaths.


A doctor examining a coronavirus patient at at a hospital in Neave, just outside Port Elizabeth, South Africa, in late November.
Credit…Samantha Reinders for The New York Times

On Sunday, reported coronavirus infections in South Africa surpassed one million since the start of the pandemic.

The country has now recorded 1,004,413 cases and 26,735 deaths.

With one of the strictest initial lockdowns in the world, South Africa avoided the high death toll that many experts feared. As restrictions eased in the last quarter of the year, however, the death toll climbed steadily, beginning to spike as the holiday season approached.

Many South Africans also traveled from cities to more rural provinces to celebrate the holidays. Officials recorded a daily increase of more than 14,000 cases on Christmas Day and the two days before, though the number fell to 9,502 on Sunday.

Physicians and nurses described overwhelmed hospitals. “For many of the young doctors at the front line, it’s an incredibly traumatic experience, the moral trauma of having to, if you will, decide who lives and dies,” said Dr. Ntobeko Ntusi, chair and head of medicine at Groote Schuur Hospital, a large public institution in Cape Town.

Dr. Ntusi said there had been some patients who were “28, 32 years old” without other health conditions who had extremely low oxygen levels from Covid-19 pneumonia. But because of the overwhelming demand for resources, “We are not able to offer them the treatment that we know can save their lives.”

Some medical professionals urged the government to return to stricter lockdown measures and restrict gatherings. “There’s a huge problem regarding adequate staff, nurses as well as doctors,” Dr. Angelique Coetzee, the president of the South African Medical Association, told SABC News, the public broadcaster, on Sunday.

As the number of infections climbed, President Cyril Ramaphosa held an emergency meeting with the National Coronavirus Command Council and would be submitting their proposals to the country’s Cabinet, according to local news reports. Mr. Ramaphosa is expected to announce new measures soon.

Early in December, South Africa tried to curb the spread of infections in hot spots by imposing a curfew, banning the sale of alcohol on weekends and closing beaches. Masks were made mandatory at all gatherings.

Scientists from the Nelson R. Mandela School of Medicine at the University of KwaZulu-Natal discovered a variant of the virus that accounts for the vast majority of samples tested in the current wave. It has one change in common with a distinct variant recently discovered in Britain that has led to travel bans; scientists believe both new lineages may be more easily transmissible. So far there is no evidence that they are associated with more severe disease.

Doctors began noting an increased number of younger patients who had no vulnerabilities, or comorbidities, Zweli Mkhize, the minister of health, said in a statement announcing the discovery earlier this month. That may be at least in part related to large gatherings of young people, including student parties, that officials say have been amplifying the spread of the virus.

South Africa does not have access to any vaccines yet, but Mr. Ramaphosa has said that the country will have soon enough vaccines for 10 percent of the population. They will arrive via an agreement with Covax, an international body established to promote equitable access to vaccines. Unlike 92 low- and middle-income countries, which will be receiving support to make their purchases, as a higher-middle income country, South Africa will finance its doses.

In other developments around the world:

  • Indonesia will bar entry to international visitors for two weeks from New Year’s Day to stem the spread of new, potentially more contagious strains of the coronavirus, Reuters reported, with an exemption only for high-level government officials. The country barred travelers from Britain a few days ago, and tightened rules for those arriving from Europe and Australia, expanding on an earlier tourism ban.

  • South Korea has discovered three cases of the variant first detected in Britain, officials said on Monday. All were in members of a London-based family who arrived in the country on Dec. 22, according to the Korea Disease Control and Prevention Agency. All three have been in isolation since testing positive on arrival. South Korea, which is struggling to contain a third wave of infections, is among dozens of countries that have temporarily banned flights from Britain in response to the new variant. The country of about 50 million people reported 808 new cases on Monday, bringing the national total to 57,680, with 819 deaths.

  • Frontline workers in Sydney, Australia, will not be allowed to watch the New Year’s Eve firework display from the harbor as planned, Gladys Berejiklian, premier of the state of New South Wales, said Monday, citing a growing coronavirus outbreak in the city’s northern suburbs. “We’ll find another opportunity during the year to recognize what you’ve done,” Ms. Berejiklian said to the workers, about 5,000 of whom would have been invited. Other restrictions announced for Dec. 31 include lowering a limit on outdoor gatherings to 50 from 100 and barring people who live outside the central business district from entering unless they have a venue booking and an entry permit. The city reported five locally transmitted cases on Monday, bringing the total in the cluster to 126.

A nearly empty street before a curfew in Istanbul this month.
Credit…Chris Mcgrath/Getty Images

The coronavirus did not start Turkey’s economic ails, but it greatly worsened them.

The country had been grappling with a falling currency and double-digit inflation for two years when the pandemic hit in March, adding to a deep recession. Nine months in, as a second wave of the virus sweeps through Turkey, there are signs that a significant portion of the population is overwhelmed by debt and increasingly going hungry.

For President Recep Tayyip Erdogan, who drew attention this year at home and abroad with an aggressive foreign policy and military interventions, things suddenly came to a head in November.

The government admitted that it had been understating the extent of Turkey’s coronavirus outbreak by not recording asymptomatic cases, and new data revealed record infection levels in the country.

Hacer Foggo, founder of the Deep Poverty Network, a group that helps street traders and informal workers, said that in her nearly 20 years of working to alleviate urban poverty in Turkey she had never seen such distress.

Ms. Foggo laid the blame squarely on local and national governments for their lack of strategy for confronting growing poverty and failing to improve social services.

Indeed, the economic tailspin came after Mr. Erdogan tightened his reins on the country, including over the economy, by acquiring sweeping powers under a new presidential system inaugurated in 2018. International monitors cite those changes as a main reason for their alarm about the country’s economic plunge.