The drugmaker AstraZeneca announced on Monday that an early analysis of some of its late-stage clinical trials, conducted in the United Kingdom and Brazil, showed that its coronavirus vaccine was 70.4 percent effective in preventing Covid-19, suggesting that the world could eventually have at least three working vaccines — and more supply — to help curb the pandemic.
The British-Swedish company, which has been developing the vaccine with the University of Oxford, became the third major vaccine developer this month to announce encouraging early results, following Pfizer and Moderna, which both said that their vaccines were about 95 percent effective in late-stage studies.
AstraZeneca’s results are a reassuring sign of the safety of the vaccine. It came under global scrutiny after AstraZeneca temporarily paused its trials in September to investigate potential safety issues after a participant in Britain developed a neurological illness.
Oxford and AstraZeneca said they would submit their data to regulators in Britain, Europe and Brazil and seek emergency authorization.
The company said its early analysis was based on 131 coronavirus cases. The trials used two different dosing regimens, one of which was 90 percent effective in preventing Covid-19 and the other of which was 62 percent effective.
The regimen that was 90 percent effective involved using a halved first dose and a standard second dose. Oxford and AstraZeneca also said that there were no hospitalized or severe cases of the coronavirus in anyone who received the vaccine, and that they had seen a reduction in asymptomatic infections, suggesting that the vaccine could reduce transmission.
AstraZeneca’s vaccine is expected to come with relatively simple storage requirements, which would be an asset once it gets rolled out. The company has said it anticipates the vaccine will require refrigeration, though it has not provided details about how long and at what temperature it can be kept. Moderna’s vaccine can be kept for up to a month at the temperature of an ordinary refrigerator. Pfizer’s can be kept for up to 5 days in conventional refrigerators, or in special coolers for up to 15 days, but otherwise needs ultracold storage.
AstraZeneca has said it aims to bring data from its studies of its vaccine being conducted overseas to the Food and Drug Administration — which would mean that the agency will likely review and authorize a vaccine before late-stage data are ready on how well the vaccine works in American participants. British regulators already have been conducting a so-called rolling review of the vaccine.
“Today marks an important milestone in our fight against the pandemic,” AstraZeneca’s chief executive, Pascal Soriot, said. “This vaccine’s efficacy and safety confirm that it will be highly effective against Covid-19 and will have an immediate impact on this public health emergency.”
Professor Andrew Pollard, the chief investigator of the Oxford Vaccine Trial, said that “these findings show that we have an effective vaccine that will save many lives.”
AstraZeneca’s results could significantly strengthen the global effort to produce enough vaccine to create population immunity: The price of the shot, at $3 to $4, is a fraction of that of some other potential vaccines, and AstraZeneca has pledged to make it available at cost around the world until at least July 2021 and in poorer countries in perpetuity.
As Thanksgiving approaches, Gov. Andrew M. Cuomo of New York on Monday announced new restrictions in parts of the state where virus cases are rising, including New York City, and issued a grim warning that the state was on track for a further resurgence of the virus.
The new restrictions included a zone in Upper Manhattan, the first time the state has rolled back reopening in the borough under its program of targeting so-called microclusters.
“These are dangerous times that we’re in,” Mr. Cuomo said at a news conference in New York City.
Over the last three weeks, the number of people hospitalized with the virus in the state has more than doubled, to 2,724 on Monday from 1,227 on Nov. 2. The number is a far cry from the peak of the pandemic in the spring, when more than 18,000 people were hospitalized.
But Mr. Cuomo warned that if current patterns held, the state would hit 6,000 hospitalizations in another three weeks. The increase could become steeper, he said, if people continued gathering for Thanksgiving and Christmas in the coming weeks, which he called “37 days of the highest socialization of the year.”
The governor again warned residents not to travel for the holidays. The state has currently imposed a 10-person limit on private gatherings in hopes of limiting small parties that he has said have contributed to the resurgence of the virus in the state this fall.
Parts of Upper Manhattan, including Washington Heights, will now be a yellow zone under the state’s tiered, color-coded restriction system. Gatherings will be limited to 25 people, with houses of worship limited to 50 percent capacity. Restaurants can serve only up to 4 people at a table.
Mr. Cuomo also announced an orange zone, the second level of limits, in southern parts of Staten Island. In those areas, indoor dining will close, as will some nonessential businesses deemed to be high risk, such as gyms and personal-care services. All gatherings will be limited to 10 people, with houses of worship limited to 33 percent capacity and 25 people maximum. Other parts of the borough will become a yellow zone.
“Staten Island is a problem,” Mr. Cuomo said.
The borough has been a hot spot for the virus in the city in recent months. Mr. Cuomo said that hospitalizations there had increased enough that Staten Island was facing a capacity issue. As a result, the state will open an emergency coronavirus patient facility in the South Beach neighborhood, a move reminiscent of field hospitals set up in the spring, when New York City was one of the hardest hit places in the country.
The state also announced new yellow zones in parts of Long Island, including Great Neck, Riverhead and Hampton Bays, and expanded yellow and orange zones upstate, around the cities of Rochester and Syracuse.
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transcript
England Will Lift Coronavirus Restrictions
The British Prime Minister Boris Johnson announced on Monday that England would return to a tiered system of coronavirus restrictions, and would reopen gyms, stores, and hair salons across the country after the lockdown ends.
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The national restrictions in England will end on the 2nd of December, and they will not be renewed. From next Wednesday, people will be able to leave their home for any purpose, and meet others in outdoor public spaces subject to the Rule of 6. Collective worship, weddings and outdoor sports can resume, and shops, personal care, gyms and the wider leisure sector can reopen. But without sensible precautions, we would risk the virus escalating into a winter or new-year surge. The incidence of the disease is, alas, still widespread in many areas. So we’re not going to replace national measures with a free for all — the status quo ante-Covid — we’re going to go back instead to a regional tiered approach, applying the toughest measures where Covid is most prevalent. I can’t say that Christmas will be normal this year. But in a period of adversity, time spent with loved ones is even more precious for people of all faiths and none. We all want some kind of Christmas. We need it. We certainly feel we deserve it. But what we don’t want is to throw caution to the winds and allow the virus to flare up again, forcing us all back into lockdown in January.
Gyms, stores and hair salons will be allowed to reopen in England next week, Prime Minister Boris Johnson said Monday, telling lawmakers that for the first time since the spread of the coronavirus the country could “see a route out of the pandemic.”
Speaking to Parliament by video link, Mr. Johnson said that he would lift a national lockdown on Dec. 2, as expected, and that England would then return to a regionalized system of restrictions based on three tiers of controls.
However, the new plan will keep substantial restrictions on pubs and restaurants — a move that risks friction with some of Mr. Johnson’s own lawmakers, who fear that the hospitality trade will be hit hard by the limitations.
Crucially, the government has not yet announced which parts of the country will be subjected to which set of restrictions, though that information is expected later this week.
Mr. Johnson, who has been quarantining since last week after being exposed to a member of Parliament who tested positive, hailed the progress announced by the team at Oxford University developing a vaccine with the British-Swedish drugmaker AstraZeneca, adding that the “scientific cavalry is in sight.”
There have been at least 1.5 million confirmed cases of coronavirus in the United Kingdom, according to Public Health England. As of Monday morning, 55,024 people had died.
Under the plan to ease restrictions, gyms, stores and hair salons will reopen and collective worship, weddings and outdoor sports will be allowed to resume in all parts of England.
But in the worst-affected parts of the country, pubs and restaurants will stay closed except for takeout service.
In some other areas, people will only be able to drink in pubs if they are also eating a meal. Those pubs will, however, be allowed to stay open until 11 p.m., an hour later than had been allowed immediately before the lockdown began, though the bars will have to take last orders for alcohol at 10 p.m.
Some spectators will be allowed into sports events, though even in the least-affected parts of England, crowds will be limited to a maximum of 4,000, and in some parts of the country none will be allowed.
The package outlined by Mr. Johnson reflected his desire to prevent another surge in virus cases while seeking not to antagonize his backbench lawmakers, who have threatened to rebel over lockdown measures.
Gov. Gavin Newsom of California has gone into quarantine, along with his family, after three of the governor’s children were exposed to a state highway patrol officer who later tested positive for the coronavirus.
The governor’s whole family — Mr. Newsom; his partner, Jennifer Siebel Newsom; and their four children — tested negative for the virus on Sunday, but will stay apart from other people for two weeks anyway, in compliance with state guidelines, his office said.
“We are grateful for all the officers that keep our family safe and for every frontline worker who continues to go to work during this pandemic,” the governor said on Twitter.
The Newsoms learned of the exposure on Friday evening, the governor’s office said. The whole family waited until Sunday to be tested in order to reduce the likelihood of a false negative result (it can take time for the virus to build up to detectable levels after infection). The governor and his partner did not come in direct contact with the officer.
One of the Newsom children was already in quarantine after a classmate tested positive, Politico reported on Friday. The governor has come under fire for sending his children back to their private school classrooms while many public schools in the state remained closed and most families had to adapt to at-home learning.
Mr. Newsom has also faced outrage over his recent decision to attend a birthday dinner at a restaurant in Napa Valley with members of several other households.
With infections and hospitalizations each rising at an alarming rate in the state, officials announced a curfew last week, and some counties and the state have reimposed sweeping restrictions they had been gradually lifting.
According to a New York Times database, the state has reported an average of 11,802 new cases a day over the last week, a sharp increase from a month ago. The figure exceeds the state’s earlier peak of just over 10,000 new cases a day in late July.
The curfew bars nearly all Californians from being away from their homes from 10 p.m. to 5 a.m. except for essential purposes, and is scheduled to last through Dec. 21.
In Los Angeles County, where indoor dining has been shuttered for months and virus cases are still surging, health officials took the additional step on Sunday of closing down outdoor dining “to reduce the possibility for crowding and the potential for exposure.” That order takes effect on Wednesday, just before Thanksgiving.
U.S. ROUNDUP
With coronavirus cases on the rise, a marketing push is underway to persuade skeptical Americans to immunize themselves once vaccines are ready.
The federal government, which has sent mixed messages about a pandemic that has caused more than 250,000 deaths nationwide, is not leading the charge. Instead, the private sector is backing a planned $50 million campaign.
The Ad Council, a nonprofit advertising group, led a similar effort in the 1950s, when it urged Americans to get vaccinated against polio. The White House has collaborated with the Ad Council on previous public health efforts, but it is not currently involved in this one.
President-elect Joseph R. Biden Jr. has blamed President Trump for causing anxiety about the safety of potential immunization efforts. Anti-vaccine sentiment has been growing for decades, driven in part by a backlash against pharmaceutical companies.
Fifty-eight percent of American adults said they were willing to take a coronavirus vaccine, according to a Gallup poll conducted between Oct. 19 and Nov. 1. Another poll, conducted last month by Ipsos and the World Economic Forum, found that 85 percent of Chinese adults, 79 percent of British adults and 76 percent of Canadian adults plan to be vaccinated, compared to 64 percent of Americans.
The Ad Council has joined with a coalition of experts known as the Covid Collaborative, which concluded through its own survey that only one-third of Americans plan to get vaccinated.
Research by the Covid Collaborative also suggests that less than 20 percent of Black Americans believe that a vaccine will be safe or effective. Many respondents said they had little faith in the government’s ability to look after their interests or cited distrust stemming from past ethics violations, like the infamous Tuskegee study, which tracked Black men infected with syphilis but did not treat them.
In other developments around the country:
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Mayor Bill de Blasio outlined an approach — but not a timeline — for reopening New York City’s public schools, which shifted fully to remote learning last week after the city’s seven-day average positive test rate hit 3 percent. At a news conference on Monday, the mayor said the city would focus first on reopening schools for students with disabilities, then early childhood education programs and elementary schools. Mr. de Blasio also said that the city’s seven-day average positive test rate was at 3.06 percent.
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The Puerto Rican singer Bad Bunny canceled an in-person performance at the American Music Awards on Sunday night after he tested positive for the coronavirus, his publicist announced on Monday. He had appeared virtually at the ceremony to present an award and accept two of his own, for favorite male Latin artist and favorite Latin album for “YHLQMDLG.”
After suffering through two big outbreaks of the coronavirus, many people in Italy greeted news that a vaccine could be available by early next year with some optimism.
But one of the country’s most renowned virologists and Covid-19 experts has provided a reality check about the country’s ability to carry out a mass vaccination drive.
He says he hasn’t even been able to get a simple flu shot.
“It’s a real scandal,” Dr. Massimo Galli, the director of the infectious disease department at the Sacco hospital in Milan, said Sunday on Italian television. He said that while he hoped the country would eventually be able to distribute a coronavirus vaccine to its citizens, the outlook was “ghastly.”
That Dr. Galli, who is 69 and among the most recognizable coronavirus experts in the country, could not get his hands on a simple flu vaccine renewed concerns about a potential lack of preparedness to procure and distribute coronavirus vaccines.
Flu shots are far less common in Italy than in the United States, but Italy’s health authorities had urged people to get them this year, both to keep healthy and to allow doctors to focus on Covid-19 patients.
But five months later, flu shots are few and far between, and millions of Italians, including older adults and patients with pre-existing conditions, haven’t been able to get them.
Some experts say that Italy’s regions, which control health care systems within their borders, placed their orders too late amid enormously high demand in the international marketplace. Regional authorities have instead attributed the shortage to delays by the providers.
In the hard-hit Serio valley in northern Italy, Dr. Mario Sorlini said a much higher than usual number of patients asked to be vaccinated for the flu. But the region only sent him about half the doses he received last year.
“We were the hardest hit province by Covid, and I was only able to do 25 percent of the flu vaccines I have to do,” Dr. Sorlini said, adding that if he and his colleagues did not receive the doses before the flu comes, it will be a “disaster on top of a disaster.”
Bulgaria, after enforcing a strict lockdown in the spring and largely containing the spread of the coronavirus, is now confronting a surge in infections that is straining an already underfunded health care system.
The surge has led the Balkan country to have one of the highest coronavirus death rates in Europe, with more than 15 people of every one million dying from the virus, according to the European Center for Disease Prevention and Control, which gathers data from national agencies. In the past week, the percentage of positive tests was between 37 and 44 percent.
Dr. Peter Markov, an epidemiologist and lecturer at the London School of Hygiene and Tropical Medicine, said the rate would continue to climb if Bulgaria did not take more restrictive measures to curb its spread.
“Given the very high mortality in Bulgaria, some form of a lockdown or closing down of schools becomes increasingly important at least for a month or two until the rates of infection go down,” Dr. Markov said.
During a meeting with senior health officials on Monday, Prime Minister Boiko Borisov, who recently recovered from Covid-19, said, “No single measure should be taken to an extreme” and stressed that the country needed “a working economy.”
Kostadin Angelov, Bulgaria’s health minister, seemed to push back on the prime minister’s comments by proposing a package of measures to tackle the outbreak, amid calls from medical professionals for further restrictions.
During a news briefing on Monday, Mr. Angelov suggested that Bulgaria close most nonessential businesses — including shopping malls, restaurants and bars — shut down in-person learning in schools and universities, as well as ban sporting events, conferences and private parties. His proposal will be discussed by the cabinet later this week. If approved, the measures will start on Friday.
Bulgaria’s strained health care system, overwhelmed by an influx of patients, has faced acute shortages of hospital beds and medical workers, many of whom have fallen ill themselves.
Last week, two men died at the steps of a hospital in Plovdiv, Bulgaria’s second largest city, while waiting to be admitted after being transferred from another medical facility. At the end of October, a 33-year-old man died after waiting for hours for an ambulance in Bulgaria’s capital, Sofia.
As many hospitals across the country ran out of beds, the government ordered them to open additional wards for coronavirus patients, despite the strain on resources and staff.
The government has refused to issue the kind of broad stay-at-home orders that were enforced in the spring, but it has introduced some restrictive measures to control the spread of the virus, including ordering nightclubs to shut and forcing bars and restaurants to close at 11:30 p.m.
But even the limited measures have been met by resistance. Over the weekend, officials found a number of businesses in Sofia that had violated restrictions and were open well into the early hours of the morning. Some establishments refused to let the inspectors in.
More travelers were screened at airport security checkpoints on Sunday than on any day since the pandemic took hold in March, a worrying sign that people flying to visit their families for Thanksgiving could increase the spread of the coronavirus.
A little more than one million people were screened by the Transportation Security Administration on Sunday, according to federal data published on Monday. That number is about half of what it was in 2019, but it represents a big increase from the spring, when less than a half a million people flew on any given day.
The Centers for Disease Control and Prevention and Dr. Anthony Fauci, the country’s top infectious disease expert, have been strongly discouraging holiday travel for fear that it would increase the number of new infections, which have surged in recent weeks as the weather turns colder and more people spend time indoors.
Airlines have said that flying is safe because of the precautions the industry has put in place, like high-end air filtration. They also point to the relatively few published cases of the coronavirus being spread during a flight. But the science on in-flight safety is far from settled, and travelers would still be at risk of contracting or spreading the virus at airports and once they are at their destination.
The increase in travel during the holidays has been encouraging for airlines. But it won’t be enough to offset the deep losses they have suffered during the pandemic. The nation’s largest airlines have collectively reported tens of billions of dollars in losses so far this year, and analysts expect demand to remain weak for a couple of years or more. The industry is hoping that the incoming Biden administration and Congress will give airlines more aid early next year.
Global Roundup
The Seoul city government said on Monday that it was closing nightclubs and banning late-night restaurant dining starting Tuesday as South Korea tightened guidelines to battle a surge in coronavirus infections.
South Korea’s daily caseload rose above 300 for five straight days before dropping to 271 on Monday. Most of the new cases in the recent spike were reported in Seoul, the capital, and in nearby cities.
Unlike the earlier waves of infections that had been clustered around several churches and outdoor rallies, the current surge was more widespread, originating in gatherings of family and friends where people took off their masks, health officials said. On Monday, the military said that 36 service members had tested positive in an artillery unit near the border with North Korea.
The new restrictions in Seoul include a ban on gatherings of more than 100 people and mandate that nightclubs, dance halls, casinos and other high-risk entertainment facilities shut. No more than 10 people can attend outdoor rallies.
Restaurant dining will be allowed until 9 p.m., and museums, schools, churches, stadiums and other public facilities must reduce the number of visitors and students they can accept between 20 and 67 percent of capacity, depending on the type of facility. The city will also reduce the number of buses and subways that run late at night.
“The third wave of the pandemic is underway because of a silent spread of the virus in our daily lives, leading to over 2,000 additional cases in a week,” said Kang Do-tae, South Korea’s vice health minister.
In other developments around the world:
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Parts of Southern Ontario, including Toronto, entered the strictest phase of Canada’s tiered system of restrictions on Monday. Under the new restrictions, indoor gatherings are not allowed, outdoor gatherings are limited, and in-person dining and in-person retail shopping at businesses other than select stores, including supermarkets, is prohibited.
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Turkey recorded its highest daily number of cases, 6,017, on Sunday, according to the country’s health ministry. Critics have repeatedly challenged the government’s coronavirus figures as an undercount.
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The French agriculture ministry said on Sunday that 1,000 minks had been slaughtered at a farm south of Paris after some of the animals tested positive for the coronavirus, and that minks were being tested at two other farms. France is the second European country, after Denmark, to cull farmed mink because of the virus.
Hong Kong’s government said on Sunday that it would give cash payments of about $650 to residents who tested positive for the coronavirus, a policy designed to encourage people to get tested.
Sophia Chan, Hong Kong’s health secretary, said the policy was aimed at people who had avoided getting tested because they were afraid of the financial consequences of being forced to stay home from work if they tested positive.
“We hope they don’t avoid it for income reasons, for fear of halting work and losing income,” she told reporters on Sunday.
Critics said the policy would give people an incentive to intentionally infect themselves, and that the payment of 5,000 Hong Kong dollars was not enough to make up for wages lost by people who tested positive and could not go to work.
“Now, if you catch this lethal disease that has already killed over 1.38 million people worldwide, you get paid by the Hong Kong government: precisely not enough for meaningful relief but just enough to give the impression of a reward,” Jeffrey Ngo, a pro-democracy activist from Hong Kong, tweeted.
Government officials defended the move, saying it was unlikely that people would try to deliberately catch the coronavirus to get the government money because the symptoms of the disease could be serious.
“I can’t see anyone who would abuse this scheme because this virus could be mild or serious,” Ho Kai-ming, the deputy secretary for labor and welfare, told reporters, according to the public broadcaster. “It’s a priority for everyone in Hong Kong to end the spread of the virus, and people should not make jokes.”
Ventilators, the sophisticated breathing machines used to sustain the most critically ill patients, are far more plentiful than they were eight months ago, when New York, New Jersey and other hard-hit states were desperate to obtain more of the devices, and hospitals were reviewing triage protocols for rationing care. Now, many hot spots face a different problem: They have enough ventilators, but not nearly enough workers with the years of training to operate them.
Since the spring, American medical device makers have radically ramped up the country’s ventilator capacity by producing more than 200,000 critical care ventilators, with 155,000 of them going to the Strategic National Stockpile. At the same time, doctors have figured out other ways to deliver oxygen to some patients struggling to breathe — including using inexpensive sleep apnea machines or simple nasal cannulas that force air into the lungs through plastic tubes.
But with new cases in the United States approaching 200,000 per day and a flood of patients straining hospitals across the country, public health experts warn that the ample supply of available ventilators may not be enough to save many critically ill patients.
“We’re now at a dangerous precipice,” said Dr. Lewis Kaplan, president of the Society of Critical Care Medicine. Ventilators, he said, are exceptionally complex machines that require expertise and constant monitoring for the weeks or even months that patients are tethered to them. The explosion of cases in rural parts of Idaho, Ohio, South Dakota and other states has prompted local hospitals that lack such experts on staff to send patients to cities and regional medical centers, but those intensive care beds are quickly filling up.
Public health experts have long warned about a shortage of critical care doctors, known as intensivists, a specialty that generally requires an additional two years of medical training. There are 37,400 intensivists in the United States, according to the American Hospital Association, but nearly half of the country’s acute care hospitals do not have any on staff, and many of those hospitals are in rural areas increasingly overwhelmed by the coronavirus.
