Damian Dovarganes/Associated Press
Mario Tama/Getty Images
Mario Tama/Getty Images
Mario Tama/Getty Images
Ariana Drehsler for The New York Times
Ariana Drehsler for The New York Times
California Office of Emergency Services, via Associated Press
Just two weeks ago, Gov. Gavin Newsom warned Californians that the state’s intensive care beds might be full before Christmas.
Now, it appears that this dire projection is being borne out.
How bad is the coronavirus surge in California?
In Los Angeles County, officials say, an average of two people are dying every hour. And one in every 80 people there is thought to be infected.
“Our hospitals are under siege, and our models show no end in sight,” Dr. Christina Ghaly, the director of health services in Los Angeles County, said on Thursday.
Statewide, California reported 3 percent availability of I.C.U. beds on Thursday.
But the problem is most severe in the southern part of the state. Within the month, Dr. Ghaly said, the number of patients requiring I.C.U. care in Los Angeles County “could easily exceed” the 2,500 licensed adult beds by 1,000 or more.
California continues to shatter records. On Thursday, the state reported more than 45,000 new cases and over 260 deaths. That made it the second-worst day in terms of daily reported cases and the third-worst for a single-day death toll.
And it is hardly alone. More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show. A recent New York Times analysis found that 10 percent of Americans — across a large swath of the Midwest, South and Southwest — live in areas where I.C.U.’s are either completely full or have under 5 percent of beds available.
The total number of confirmed infections in the United States since the pandemic began passed 17.2 million on Thursday, just five days after eclipsing the 16-million mark. There have been at least 310,900 deaths. On Thursday alone, there were at least 238,100 new cases and at least 3,290 new deaths reported.
In California, the authorities have ordered an extra 5,000 body bags, activated an aid network for morgues and coroner’s offices, and stationed 60 refrigerated storage units in counties around the state to handle remains. Health officials in Orange County said they would roll out three field hospitals.
Hospitals are particularly overwhelmed in San Joaquin Valley, where many low-wage essential workers live without good access to health care even in the best of times.
Even the Bay Area, which for a time managed to stave off the worst of the surge, has not been spared. I.C.U. capacity there has dropped below 15 percent, leading to a new regional stay-at-home order.
The ever-climbing numbers are all the more demoralizing for Californians, because they have endured some of the most stringent pandemic restrictions in the country. But health officials said that now more than ever, they need to keep hunkering down.
”It’s going to be a wild ride probably for another four, five or six weeks,” said Dr. Nancy Gin, Kaiser Permanente’s medical director for Southern California. She urged Californians to stay home and not give in to temptation to travel as the holidays near.
The arrival of vaccinations has buoyed people’s spirits, but many health care workers are exhausted.
“It’s really hard to put all of it into words,” said Helen Cordova, an I.C.U. nurse who was the first person in California to receive a vaccine shot. “This is a very real disease — those images of inside of hospitals, that’s very accurate.”
A Belgian government minister released, and then quickly deleted, a Twitter post late Thursday containing prices that the European Union has negotiated to pay pharmaceutical companies for coronavirus vaccines.
The prices had been kept secret by the European Commission, the bloc’s executive, which is negotiating on behalf of its 27 member states and ordering doses for the 410 million people living in the vast region.
The new information comes days before the bloc is expected to approve its first vaccine for use across the region, which will set off an ambitious and logistically challenging inoculation campaign, as cases surge across much of the European Union.
The price list, briefly released by Belgium’s budget state secretary, Eva De Bleeker, showed that the Pfizer-BioNTech vaccine, which is set for approval on Monday in the bloc and is being administered in the United States and Britain, will cost 12 euros, or $14.7, per dose, bringing the cost per person to €24, as each person is supposed to receive two doses.
That is markedly lower than the company’s official price, which has been announced at $19.5 per dose.
The Moderna vaccine, which is the next in line for E.U. approval, on Jan. 6, and is expected to receive authorization from the U.S. Food and Drug Administration for emergency use on Friday, is costing the E.U. $18 per dose, the table showed. The company had said it was looking to charge $25 to $37 per dose.
A European Commission spokesman declined to comment on the price list, saying that the negotiated agreements were “covered by confidentiality,” but did not dispute the pricing.
A spokesman for Ms. De Bleeker said that she had tweeted the details to settle a political debate in Belgium, where opposition politicians are accusing the government of not setting aside enough money to buy the vaccines.
“We were trying to be transparent, but it seems we were a bit too transparent,” Bavo De Mol, the spokesman, said.
After accelerating through the fall, the coronavirus is spreading in the United States at a consistently rapid rate, with each day bringing an average of more than 200,000 new reported cases. Progress in some regions is roughly counteracted by deterioration in others. And while the rate seems to have steadied, ominous milestones are flying by.
The total number of confirmed infections surpassed 17 million on Thursday, five days after eclipsing the 16-million mark.
The increased availability of testing and growing public awareness have undoubtedly contributed to the pace at which cases are being confirmed. But testing doesn’t cause Covid-19 cases — it merely detects them. And the velocity of the pandemic that tests are detecting now continues to be high.
After the country’s first case was confirmed on Jan. 21, it took more than three months to reach a million cases. Even at the previous peak in July, when testing had become more readily available, it took 16 days to go from three million confirmed cases to four million.
The progress that the nation as a whole made by late summer in slowing the virus’s spread has been wiped out, and then some. Three months ago, new cases were trending downward and death reports were flat. But now there are nearly six times as many cases being reported each day, and three times as many deaths.
The virus has spread so widely now that in some communities nearly one in five residents has tested positive.
One state that has been through the wringer, North Dakota, had the highest Covid-19 mortality rate in the world at one point. After resisting doing so for months, Gov. Doug Burgum announced a mask mandate and restrictions on businesses in mid-November, and new cases have started ticking downward, although deaths have yet to subside.
Eddy and Foster counties, neighbors in the rural east central part of the state, are among the places where the pandemic is highly pervasive. Choose six people in those counties, and the odds are that at least one has tested positive.
“It’s terrifying,” said Tanis Walch, an associate professor of public health education at the University of North Dakota.
Dr. Walch said her students tallied how many people wore masks into grocery stores in a study over the summer, when the state had no mask requirement. They found that 34 percent of people did so — but the proportion almost doubled when the grocery chain said it would start requiring masks, even before the rule took effect.
More recently, the students have been monitoring mask wearing at gas stations. Many more people are wearing them now, she said, but compliance remains spotty.
Dr. Walch said she still heard a sentiment among fellow North Dakotans that they do not want anything to impinge on their personal freedom. She said a friend of hers had ignored warnings and held a Thanksgiving gathering with 22 family members. Eighteen have since tested positive, she said.
Now Dr. Walch is worried about Christmas. “It’s not a good time in North Dakota right now,” she said.
The coronavirus struck in a country already chronically short of affordable housing. In September, the Trump administration announced a four-month halt in eviction proceedings, put forward by the Centers for Disease Control and Prevention.
Now, after a summer of catastrophic job loss, 6.7 million adults are likely to face eviction or foreclosure in the next two months, according to the Census Bureau’s Household Pulse Survey.
But evictions are resuming under unprecedented scrutiny. If displacing households was considered unsafe in September, when contagion rates were lower, many ask why it would be acceptable at this point. Won’t the virus spread faster if evicted tenants end up in shelters?
One person grappling with these questions is Nicholas Cocchi, the sheriff of Hampden County in western Massachusetts.
Sheriff Cocchi presides over Springfield, a city where nearly 27 percent of the population lives below the poverty line. His predecessor was a former social worker, and Sheriff Cocchi has carried on that progressive tradition, branching out into services to reintegrate former inmates and treat addiction. Last year, his department carried out 724 evictions, two or three a day.
Sheriff Cocchi has worried for weeks about resuming evictions, searching for ways to make them “respectful and humane.”
“As a human, not a sheriff — not as an elected official but as a human being — if it is part of the ecosystem, I get it, but that doesn’t mean we let people decay and rot,” Sheriff Cocchi said.
His main idea is to work intensively with tenants his department is preparing to evict, offering a last big push to find them alternative housing. If worse comes to worst, he said, he would provide them with short-term shelter.
“You’re not going to sleep in your car tonight,” he said. “I can give you a place that night. So you’re not outside in the cold, in the rain, in your car or a park bench. I can do that. It’s my job. I believe I owe that to you.”
Chancellor Angela Merkel of Germany paid a virtual visit on Thursday to the headquarters of BioNTech, the German company behind the mRNA vaccine created in partnership with Pfizer. Their coronavirus vaccine is the first to be approved for emergency use in countries including the United States, Britain and Canada.
“We are incredibly proud to have such researchers in our country,” Ms. Merkel, herself a quantum chemist by training, said in her opening remarks, which were delivered by video. She also congratulated Ugur Sahin and Ozlem Tureci, the husband-and-wife team that founded BioNtech, and their team on their accomplishment.
The event was a point of light on an otherwise somber day in Germany as the health authorities registered 33,777 new coronavirus infections, a daily record. There were also 813 daily deaths recorded, the second worst daily toll since the pandemic began.
The European Union is expected to approve a vaccine next week, with initial doses available as early as Dec. 27, officials said on Thursday.
“We are already looking forward to the day when vaccination can begin,” Ms. Merkel told the researchers.
Germany will begin by vaccinating the country’s vulnerable, starting with people over 80 and residents of nursing homes, followed by the nurses and doctors who care for them, the country’s health minister, Jens Spahn, said on Friday. The country expects to receive 11 million to 13 million doses of the Pfizer-BioNTech vaccine once it is approved and will begin administering doses on Dec. 27, Mr. Spahn said.
Vaccinations will be voluntary, and Mr. Spahn said that officials would like to see as many people as possible accept the jabs. He urged people to be patient, however, and to continue following regulations on wearing masks, washing hands and keeping a safe distance from others.
Other coronavirus news from around the world:
India was about 20,000 cases away on Friday from recording its 10 millionth coronavirus infection. The country’s total caseload is the world’s second-largest after the United States. Tens of millions of migrant workers were stranded after Prime Minister Narendra Modi imposed a national lockdown in March, and the emergency trains that carried them back to their villages spread the coronavirus across the country. India has reported 144,789 Covid-19 deaths, the third-largest toll after the United States and Brazil.
Spain’s northeastern region of Catalonia on Friday announced a tightening of lockdown restrictions as coronavirus cases skyrocket. The rules, which will be in effect from Monday through at least Jan. 11, limit the size of groups allowed to gather and tighten restrictions on restaurants and bars. Several other Spanish regions have also introduced new measures in recent days. On Thursday, Valencia limited family gatherings to six people, while the Balearic archipelago said it would require visitors from the Spanish mainland to produce a negative coronavirus test result before arrival.
Members of Congress and the Supreme Court will begin receiving coronavirus vaccinations in the coming days in an effort to safeguard the functioning of the government.
Among the first in line will be the House speaker, Nancy Pelosi, and the Senate majority leader, Mitch McConnell, their offices said.
All 535 members of Congress and the nine justices are eligible under plans circulated on Thursday by Dr. Brian P. Monahan, the Capitol’s attending physician. A limited number of support staff workers deemed “continuity essential” may follow.
Dr. Monahan urged lawmakers to take advantage of the opportunity.
“My recommendation to you is absolutely unequivocal: There is no reason why you should defer receiving this vaccine,” he wrote. “The benefit far exceeds any small risk.”
The drive to vaccinate the nation’s elected and unelected leaders is part of a presidential directive meant to ensure that officials across the government are able to continue their work with minimal interruption.
Select executive branch officials are also expected to receive doses in the coming weeks, among them Vice President Mike Pence, who plans to be publicly vaccinated on Friday.
With members flying in and out each week and congregating indoors, Congress has struggled to keep its members — many of whom are 65 or older — healthy. About 50 lawmakers have tested positive for the virus, at times forcing the House and Senate to adjust or curtail its operations.
Dr. Monahan indicated the congressional vaccinations would take place in medical offices outside the public eye. It was not immediately clear how many doses will be sent to Capitol Hill or how the vaccination program for the Supreme Court justices will work.
Lawmakers said they hoped their high-profile vaccinations would persuade skeptical Americans of all political affiliations to get a shot.
“With confidence in the vaccine and at the direction of the attending physician, I plan to receive the vaccine in the next few days,” said Ms. Pelosi, 80, a California Democrat.
Mr. McConnell, a 78-year-old Kentucky Republican, has been one of the most outspoken members of his party in favor of following government health guidelines.
“As a polio survivor, I know both the fear of a disease and the extraordinary promise of hope that vaccines bring,” he said in a statement. “I truly hope all Kentuckians and Americans will heed this advice and accept this safe and effective vaccine.”
With more than 500,000 people across Europe dead as a result of the coronavirus, and a growing mental health crisis on the continent, a World Health Organization official had a message for Europeans on Friday ahead of the Christmas holiday time: Stay at home.
Dr. Hans Henri P. Kluge, the agency’s regional director for Europe, reflected on the “far-reaching and relentless fallout from the pandemic” and said in a statement that now was not the time to loosen restrictions.
“While families debate how to spend their holidays, I have a final appeal to make. There remains a difference between what you are being permitted to do by your authorities and what you should do,” he said. “The safest thing right now is to remain at home.”
He also addressed concerns around mental health during the pandemic, emphasizing that the psychological impact of lockdowns and the knock-on effects of unemployment and financial worries would be “long-term and far-reaching.”
“The mental health toll of Covid-19 will be compounded by anxieties that often present during the winter and holiday season,” he said. “We cannot underestimate the impact this can have on our friends, our families and our own mental health.”
A patchwork of policies are in place across Europe in the lead-up to Christmas as nations struggle to cope with a surge of new coronavirus infections while also contending with a two-week period that is traditionally a time for large family gatherings, travel and celebrations. Germany has introduced a strict lockdown for Christmas week, and the Netherlands and Italy will have more stringent measures in place over the holiday.
France and Spain have some restrictions in place, but have resisted full new national lockdowns. In Britain, Prime Minister Boris Johnson has been criticized for lifting restrictions on Christmas gatherings even as new infections spike.
Looking ahead to 2021, Dr. Kluge said there was “much to look forward to” with the early stages of vaccine rollout on the horizon, although he said that there would be “a few more months of sacrifice ahead.”
“When we look back on these unprecedented times,” he said, “I hope we all feel that we acted with a spirit of shared humanity to protect those in need.”
When the pandemic exploded in March, British officials embarked on a desperate scramble to procure the personal protective equipment, ventilators, coronavirus tests and other supplies critical to containing the surge. In the months following those fevered days, the government handed out thousands of contracts to fight the virus, some of them in a secretive “V.I.P. lane” to a select few companies with connections to the governing Conservative Party.
To shine a light on one of the greatest spending sprees in Britain’s postwar era, The New York Times analyzed a large segment of it, the roughly 1,200 central government contracts that have been made public, together worth nearly $22 billion. Of that, about $11 billion went to companies either run by friends and associates of politicians in the Conservative Party, or with no prior experience or a history of controversy. Meanwhile, smaller firms without political clout got nowhere.
“The government had license to act fast because it was a pandemic, but we didn’t give them permission to act fast and loose with public money,” said Meg Hillier, a lawmaker with the opposition Labour Party and chair of the powerful Public Accounts Committee. “We’re talking billions of pounds, and it’s quite right that we ask questions about how that money was spent.”
The procurement system was cobbled together during a meeting of anxious bureaucrats in late March, and a wealthy former investment banker and Conservative Party grandee, Lord Paul Deighton, was later tapped to act as the government’s czar for personal protective equipment.
Eight months on, Lord Deighton has helped the government award billions of dollars in contracts — including hundreds of millions to several companies where he has financial interests or personal connections.
The contracts that have been made public are only a part of the total. Citing the urgency of the pandemic, the government cast aside the usual transparency rules and awarded contracts worth billions of dollars without competitive bidding. To date, just over half of the contracts awarded in the first seven months remain concealed from the public, according to the National Audit Office, a watchdog agency.
They come in an astonishing variety of colors, designs and materials, but what the 100,000-plus face masks that have hit the market don’t come with is a label that says how well they block infectious particles — which is sort of the point.
That could soon change.
A set of federal standards for minimum filter efficiency and labels indicating which products meet them are being developed for the bewildering marketplace for masks and other face coverings.
Guidelines are expected to be made public in January, after months without federal oversight of the quality of the masks and face coverings that have become critical to the fight to prevent the spread of the coronavirus.
The National Institute for Occupational Safety and Health has been creating guidelines with the industry standards organization, ASTM International (formerly the American Society for Testing and Materials). The institute is a division of the Centers for Disease Control and Prevention.
“By having a standard in place, you will be able to know what level of protection is being achieved, and you’ll have a consistent way of evaluating these products,” said Maryann D’Alessandro, the director of the institute’s National Personal Protective Technology Laboratory.
Critics say the Food and Drug Administration could have done more to regulate the market.
“The F.D.A. could have issued a guidance that masks should be fitted, at least two layers of cloth, not made of stretchy materials, etc. Instead, there was a free-for-all,” said Diana Zuckerman, the president of the National Center for Health Research, a nonprofit health policy group.