Moderna Could Boost Vaccine Supply by Adding Doses to Vials

A vial of the Moderna Covid-19 vaccine with 10 doses. Moderna is seeking to pack 15 doses into a vial in the future.
Credit…Jean-Francois Badias/Associated Press

U.S. regulators could decide within a few weeks whether to allow Moderna, the developer of one of the two federally authorized Covid-19 vaccines, to increase the number of doses in its vials — which could accelerate the nation’s vaccination rate.

Moderna is hoping to raise the number of doses in its vials to as many as 15 from the current 10 doses, a potential 50 percent increase. The proposal reflects the fact that the company has been ramping up production of its vaccine to the point where the final manufacturing stage, when it is bottled, capped and labeled, has emerged as a roadblock to expanding its distribution.

If the change does go through, it could be hugely welcome news to Americans desperate to curb a pandemic that has killed more than 440,000 people in the United States. In a statement late Monday, Ray Jordan, a Moderna spokesman, said the constraint on dosage per vial was limiting Moderna’s output.

The Moderna proposal is part of a broader push by the Biden administration to speed vaccine distribution, including by clearing away obstacles in the “fill and finish” phase of manufacturing. Although that nuts-and-bolts stage receives less attention than vaccine development, it has been identified for years as a constraint on vaccine production.

Moderna has discussed the possible change with the Food and Drug Administration but has not yet submitted manufacturing data to support it, people familiar with the discussions said. Federal regulators may be receptive to the idea of more doses in each vial, but could balk at the notion of a 50 percent increase.

The industry standard has long been 10 doses per vial, and federal regulators may be concerned that the extra punctures by needles of the rubber covering of the vial and the time required to extract more doses could increase the risk of contaminating the vaccine with bacteria.

At some point, too much liquid can cause a vial to break. Moderna has tested what happens when it adds additional doses, and determined that the limit is 15 doses, according to people familiar with the company’s operations who were not authorized to speak publicly. Moderna’s proposal to the F.D.A. for the dose increase was first reported by CNBC.

Possibly packing more vaccine into each Moderna vial is one of a number of options White House and health officials are exploring as they push to expand production before the spring, when officials are expecting a renewed surge of infections from emerging variants of the virus. Some proposals have already been considered and dismissed, including a suggestion to combine fractions of doses left over in vials.

The maker of the other federally approved vaccine, Pfizer, is unable to increase the amount of vaccine in its vials because its manufacturing is geared toward a particular size of vial that can hold only about six doses. But Moderna’s vial is big enough to hold even more than the 10 doses now allowed.

Asked about Moderna’s proposal, a White House spokesman on Monday said that “all options are on the table.”

Prashant Yadav, who studies health care supply chains with the Center for Global Development in Washington, said Moderna might be able to “relatively quickly” make more of its vaccine if it received the green light to add doses to each vial.

But he said it would not be an instant change. “I don’t think Moderna has a surplus sitting around,” he said.

Mr. Yadav said the finish-and-fill process is intensely automated, devoted to warding off contamination and precise to the microgram. At top speed, as many as 1,000 vials of vaccine can be filled per minute, he said.

He said a 15-dose vial carries a trade-off: It could lead to more wasted doses if the health care professional runs out of people to get inoculated and has to throw out the rest of the doses. But in the midst of a raging pandemic, experts said, that may well be a risk that federal health officials would be willing to take.

Sonya Havard, a nurse, prepared a dose of the Moderna Covid-19 vaccine at the Delta Health Center in Mound Bayou, Miss., on Saturday.
Credit…Rory Doyle for The New York Times

In a study posted online on Monday, researchers found Covid survivors had far higher antibody levels after both the first and second doses of the vaccine and might need only one shot.

“I think one vaccination should be sufficient,” said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai and an author of the study. “This would also spare individuals from unnecessary pain when getting the second dose, and it would free up additional vaccine doses.”

While some scientists agree with his logic, others are more cautious. E. John Wherry, director of the University of Pennsylvania’s Institute for Immunology, said that before pushing for a change in policy, he would like to see data showing that those antibodies were able to stop the virus from replicating. “Just because an antibody binds to a part of the virus does not mean it’s going to protect you from being infected,” he said.

The study also found that people who had previously been infected with the virus reported fatigue, headache, chills, fever, and muscle and joint pain after the first shot more frequently than did those who had never been infected.

Side effects after vaccination are entirely expected. The clinical trials of the authorized vaccines from Pfizer and Moderna, which included more than 30,000 participants each, suggest that most people experience the worst side effects after the second jab. And in the Moderna study, people who had previously been infected actually had fewer side effects than those who hadn’t.

But anecdotally, researchers are hearing from a growing number of people who felt ill after one shot.

That matches what Dr. Krammer and his colleagues found in their new study, which has not yet been published in a scientific journal. The researchers assessed symptoms after vaccination in 231 people, of whom 83 had previously been infected, and 148 had not. Both groups widely reported experiencing pain at the injection site after the first dose. But those who had been infected before more often reported fatigue, headache and chills.

The team also looked at how the immune system responded to the vaccine in 109 people — 68 of whom had not previously been infected and 41 who had — and found a more robust antibody response in the latter group. The numbers, however, are small, and so the study’s conclusions will need to be further investigated with more research, experts said.

Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, speaking during a White House briefing in Washington last week.
Credit…The White House, via Associated Press

Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on Monday that the ability of the United States to detect new, more contagious coronavirus variants had increased tenfold, even as those efforts remain well behind levels experts have said are needed.

At a White House Covid-19 briefing, she said labs were aiming to sequence 7,000 samples of the virus per week, a significant increase from the week of Jan. 10, when she said that only 251 samples had been sequenced. Last week, 2,238 samples were sequenced for the virus mutations, she said.

The C.D.C.’s system for sequencing the virus to detect mutations — nicknamed “NS3” — was still being scaled up with large commercial lab partners, who were analyzing 3,000 samples per week and had committed to analyze 6,000 per week by the middle of this month, Dr. Walensky said.

Those numbers, however, still appear to be inadequate for understanding how widely and quickly the variants are spreading as they threaten to sweep the nation. At around one million coronavirus cases per week in the United States, experts say that at least 1 percent of samples should be sequenced for variants, and that 5 percent is preferable, leaving the 6,000 number short of what is considered by some as a bare minimum.

Jeffrey D. Zients, the White House’s Covid-19 response coordinator, said last week that the nation’s global standing with its sequencing efforts was “totally unacceptable.”

As of Sunday, 471 cases of variants first identified in the United Kingdom, South Africa and Brazil had been located in the United States, 467 of which were the variant found in Britain, Dr. Walensky said on Monday.

She said the increase in sequencing activity was a “good start,” but that “more resources and capacity are needed to increase our country’s sequencing surveillance and outbreak analytics capacity at the levels demanded by this crisis.”

Andy Slavitt, a White House pandemic adviser, announced at the briefing Monday that the Department of Health and Human Services and Defense Department had finalized a $232 million contract with the Australian company Ellume for its over-the-counter, at-home coronavirus antigen tests, which received emergency approval from the Food and Drug Administration in December.

The company was ramping up manufacturing and planned to ship 100,000 test kits per month to the United States from February through July, Mr. Slavitt said, and would be able to produce 19 million test kits per month by the end of the year, 8.5 million of which would be guaranteed to go to the nation. The Defense Department said in a news release that the deal would increase domestic production of the tests by 640,000 tests per day by December 2021.

The nasal swab test detects bits of coronavirus proteins called antigens and is slightly less sensitive than laboratory tests designed to look for coronavirus genetic material with a technique called polymerase chain reaction, or P.C.R. It takes about 15 minutes, and results are reported on a smartphone app.

The cost of the test, at around $30 each, could still be prohibitively expensive for some Americans who would want to use them regularly, a challenge Mr. Slavitt acknowledged.

Dr. Marcella Nunez-Smith, the chair of the Biden administration’s Covid-19 health equity task force, also spoke at the briefing, displaying a chart that showed a substantial hole in race and ethnicity data collected for Americans who have been vaccinated so far — 47 percent of vaccinations were missing that data as of Jan. 30.

“We cannot ensure an equitable vaccination program without data to guide us,” she said.

She added that lack of federal coordination and an uneven rollout of the vaccine without enough emphasis on vaccinating equitably “don’t just hurt our statistics — they hurt the communities that are at the highest risk and have been the hardest hit.”

Black and Latino people are more likely to be affected by the virus than white people, and many communities of color have been hesitant or suspicious of taking the vaccine in light of the history of unethical medical research in the United States. Officials have stressed the importance of making vaccines accessible to underserved communities.

Researchers at Aalborg University in Denmark analyze all positive coronavirus samples for the variant B.1.1.7.
Credit…Ritzau Scanpix/via Reuters

A fast-spreading coronavirus variant first observed in the United Kingdom has gained a new mutation that could potentially make it harder to control with vaccines, Public Health England reported on Monday. It is the latest evidence that the virus is undergoing a worrisome evolution worldwide.

The variant, known as B.1.1.7, first came to light in December. Researchers determined that it had rapidly became more common across the United Kingdom in just a couple of months.

Experiments in test tubes suggest that some of its mutations allow the coronavirus to hold onto cells more tightly.

Since B.1.1.7’s discovery in the United Kingdom, the variant has been reported in 72 other countries. The United States confirmed its first case of B.1.1.7 on Dec. 29. Since then, the Centers for Disease Control and Prevention has recorded 467 samples of the variant in 32 states.

In its latest analysis, Public Health England estimated that the variant’s rate of infection is 25 to 40 percent higher than that of other forms of the coronavirus. Some preliminary evidence suggests that it may also cause more deaths.

Several lines of evidence suggest that vaccines will work against B.1.1.7. On Thursday, the vaccine maker Novavax announced that its British trial found no evidence that B.1.1.7 could evade the vaccine’s defenses.

But in South Africa, where a variant called B.1.351 has surged to dominance, the Novavax and Johnson & Johnson vaccines have both been less effective in trials.

That variant has been reported in 31 countries so far. In the United States, it has turned up in South Carolina and Maryland.

Whenever these variants infect a new host and multiply, there’s a small chance that they will gain yet another mutation. Most of the mutations are of little concern, but scientists have worried that by mutating, these already dangerous variants could evolve into more fearsome forms.

Even if a mutation alters a coronavirus variant, that’s no guarantee it will have the same effect in another variant. The effect of each new mutation depends on all the other mutations carried by the virus.

Public Health England said that the worrisome mutation known as E484K appears to have arisen more than once in the B.1.1.7 coronavirus variants in the United Kingdom. Two variants in Brazil have also been discovered to have independently gained the same mutation.

Moderna and other companies are already preparing by developing vaccines to work against the E484K mutation. Kristian Andersen, a virologist at Scripps Research Institute in La Jolla, Calif., said that while seeing the mutation known as E484K spread was not good, it was impossible yet to say whether it would make these coronaviruses not only more contagious but more resistant to vaccines. “We’ll have to wait for data,” he said.

Last week, scientists reviewed all the coronavirus genomes sequenced in the United Kingdom. They discovered 11 coronavirus variants that belong to the B.1.1.7 lineage that also carried the worrying mutation.

Exactly why the E484K mutation turns up so often remains a mystery. Nicholas Davies, a mathematical biologist at the London School of Hygiene and Tropical Medicine, said it was possible that it enabled the coronavirus to evade antibodies created by previous infections from other variants. “E484K may well convey a fitness advantage in settings where there is existing immunity,” he said.

But he cautioned that the 11 variants out of over 200,000 samples were exceedingly rare, and it was possible that they might actually lose against other B.1.1.7 viruses without the mutation. “I think it’s potentially concerning, but hard to tell from the report what it means,” he said.

Signs at the Miami International Airport notified travelers on Monday of mask requirements already in effect at the airport. New federal mask rules are due to take effect late Monday night.
Credit…Joe Raedle/Getty Images

A federal order requiring passengers and crew to wear masks on most modes of shared transportation in the United States — including planes, trains, ferries, buses and other public transit — will take effect Monday at 11:59 p.m. Eastern time, as part of the Biden administration’s broader effort to stop the spread of the coronavirus.

However, the sweeping order, issued by the Centers for Disease Control and Prevention, may merely put a kind of federal exclamation point on mask mandates that are already in place across large parts of the transportation sector. For example, U.S. airlines began requiring passengers to wear masks in flight last spring.

Even so, the industry group Airlines for America asked for a federal mask mandate in a letter to President Biden in mid-January, a week before he was sworn in. The letter noted that thousands of passengers were not complying with the airlines’ rules about wearing masks on planes, and were being barred from flying by individual airlines as a result.

A federal mandate, the group said, “would strengthen our flight crews’ ability to enforce requirements with the goal of achieving universal compliance.”

The C.D.C.’s order notes that it is often difficult to maintain social distancing on trains, planes and buses. The mask mandate will also apply to transportation hubs like train stations, bus stations and airports.

The Transportation Security Administration announced that its officers would be involved in carrying out the order, which could lead to civil penalties if not heeded. In a news release, the T.S.A. noted that all passengers who appear to be over the age of 2 will be required to wear a mask “throughout the security screening process.”

As part of airline security checks, the release said, officers “will request that travelers temporarily lower the mask to verify their identity,” and added, “Passengers who refuse to wear a mask will not be permitted to enter the secure area of the airport, which includes the terminal and gate area.”

As a presidential candidate, Mr. Biden called for a “national mask mandate,” but eventually set aside the idea, which would probably have faced strong legal challenges. Instead, his new administration issued a host of coronavirus-related orders, including one requiring mask wearing and social distancing on all federal property, and mask wearing by all federal employees while on the job. Various federal agencies are responsible for taking steps to enforce those requirements.

Mr. Biden has also urged all Americans to wear masks in public, even if no mandate is in effect where they live.

Some staff at nursing homes across the country are electing not to take a Covid-19 vaccine.
Credit…Matthew Staver for The New York Times

New data from the Centers for Disease Control and Prevention confirms what anecdotal reports from nursing home administrators around the country have been suggesting for weeks: that a significant number of their workers are refusing the Covid-19 vaccine, at least when they are initially offered it.

The C.D.C. reported Monday that among 11,460 nursing homes where pharmacists from CVS and Walgreens held vaccination clinics between mid-December and mid-January, 78 percent of residents got immunized on average, but only 37.5 percent of staff members did.

The federal government contracted with the two pharmacy chains to deliver shots to residents and workers at most of the nation’s long-term-care facilities. To date, the companies have administered more than 3.1 million first doses and almost 600,000 second doses.

They are generally making three visits to each nursing home and assisted living residence, and some are reporting that staff members who declined to get vaccinated during the first visit agree to do so on the second.

Inoculating people who live and work in long-term-care facilities is particularly urgent because deaths related to Covid-19 in the facilities account for nearly 40 percent of the country’s pandemic fatalities.

Emma Fields receiving a Covid-19 vaccination in Mound Bayou, Miss., on Saturday.
Credit…Rory Doyle for The New York Times

Vaccinations in the United States are slowly picking up speed as the Biden administration pushes to accelerate inoculations and blunt the spread of more contagious virus variants.

The United States has administered about 30 million doses, and, as of Sunday, is averaging more than 1.3 million doses administered over the past seven days, compared with an average of less than one million per day two weeks earlier, according to a New York Times vaccine tracker.

President Biden, under pressure to speed up coronavirus vaccinations, has recently suggested the nation could soon reach an average of 1.5 million shots a day.

But just as there are signs of progress, another problem has taken root: the spread of the variants, which scientists warn must be contained before they become dominant. Several hundred cases of the more contagious variant discovered in Britain, which experts have said could be the dominant form in the United States by March, have already been confirmed.

The country has also recorded its first two cases of the variant spreading rapidly in South Africa, which has proved to reduce the effectiveness of vaccines.

“If we didn’t have these variants looming,” we would be in a good place, said Dr. Peter Hotez, a vaccine scientist and pediatrician at Baylor College of Medicine in Houston. If those variants take over by spring, “as many of us are predicting,” he said, “it changes everything. Now, we really have to vaccinate the American population by late spring, early summer.”

Two key challenges in the weeks ahead are “increasing the supply of vaccines” and “speeding up the time it takes to administer them,” Andy Slavitt, a White House adviser, said in a news briefing on Friday. Many experts have pushed for bringing other vaccine options out and releasing the first doses more widely.

The most effective state programs, said Dr. Ashish Jha, the dean of the Brown University School of Public Health, are “very simple, age-based, not a lot of complex rules. They focus on getting the vaccines out.”

Here is a snapshot of how five of the best-performing states are doing:

  • West Virginia has given at least one dose to 10.7 percent of its population, second only to Alaska, and leads the nation in the percentage of its population that has received two doses (3.7 percent). Early on, the state got a head start because it opted out of a federal program to vaccinate people in nursing homes and other long-term care facilities. While other states chose the federal plan, which teamed with Walgreens and CVS, officials decided the idea made little sense in West Virginia, where many communities are miles from the nearest chain store, and about half of pharmacies are independently owned. Instead the state created a network of pharmacies, pairing them with about 200 long-term care facilities.

  • According to health officials in Alaska, there are several reasons behind the state’s relatively high vaccination rate, The Anchorage Daily News has reported. Those factors include: the state’s having received a high number of doses through the Indian Health Service; the decision to receive doses monthly, versus weekly, as most states do; and declining virus caseloads, which has allowed health care workers to focus on inoculations. The state has vaccinated 13 percent of its population, according to a Times database.

  • North Dakota has used 91 percent of the vaccines distributed to the state, according to the Times vaccine tracker. It is the only state above 90 percent; more populous states like California (58 percent) and New York (64 percent) have used less, proportionally. North Dakota was among the first states to lower the minimum age eligible for vaccination, from 75 to 65.

  • In a recent interview with the American Medical Association, health officials in New Mexico attributed part of the state’s success to its “data-oriented and science-oriented” governor, Michelle Lujan Grisham, and to an app that allowed easy registration and close coordination among hospitals and providers. The state has given 9.8 percent of residents at least one shot, and has used 83 percent of its doses.

  • Connecticut got mass vaccination sites up and running early, and uses an inventory system that allocates unused doses to places that need them. But older residents have complained about long waits.







N.Y.C. Snowstorm Delays Vaccinations

On Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.

The storm is disrupting our vaccination effort, and we need to keep people safe. We don’t want folks, especially seniors, going out in unsafe conditions to get vaccinated. We know we can reschedule appointments very quickly because, of course, we have supply. We’re going to use the supply we have. Our problem is lack of supply. So we can take the supply we have and distribute it very quickly in the days to come, and make sure everyone gets the appointments. But it’s not safe out there today. So vaccinations are canceled today. They’re also going to be canceled tomorrow. Based on what we are seeing right now, we believe that tomorrow, getting around the city will be difficult, it’ll be icy, it’ll be treacherous. We do not want seniors, especially, out in those conditions. So we’re going to have vaccinations off for today and tomorrow, come back strong on Wednesday. We’ll be able to catch up quickly because, again, we have a vast amount of capacity. We don’t have enough vaccine. So we’ll simply use the days later in the week. Crank up those schedules, get people rescheduled into those days.

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On Monday, Mayor Bill de Blasio of New York postponed coronavirus vaccinations to prevent older residents from traveling to appointments in blizzard-like conditions.CreditCredit…James Estrin/The New York Times

With snow continuing to fall into the evening and a winter storm warning extended into early Tuesday, New York officials said on Monday that coronavirus vaccinations scheduled for Tuesday at government-run sites would be postponed for a second straight day.

Heavy snow was also complicating vaccination efforts in Washington, Philadelphia, New Jersey and elsewhere. New Jersey planned to close six state-run vaccination sites on Tuesday.

At a news conference on Monday, Mayor Bill de Blasio of New York said he did not want older residents traveling to vaccine appointments on slippery roads and sidewalks amid blizzard-like conditions with gusty winds.

“Based on what we are seeing right now, we believe tomorrow, getting around the city will be difficult,” Mr. de Blasio said. “It will be icy, it will be treacherous.”

He said he believed that the city could make up the appointments later in the week.

“We have a vast amount of capacity; we don’t have enough vaccine,” he said. “We’ll simply use the days later in the week, crank up those schedules, get people rescheduled into those days.”

The delays caused by the storm were yet another hiccup in a vaccine rollout that has been plagued by inadequate supply, buggy sign-up systems and confusion over New York State’s strict eligibility guidelines. The vaccine is available to residents 65 and older as well as a wide range of workers designated “essential.”

About 800,000 doses had been administered in the city as of Monday, Mr. de Blasio said.

In a similar move, Gov. Andrew M. Cuomo’s office announced later on Monday that several state-run vaccination sites in and around the city — including at the Jacob K. Javits Convention Center in Manhattan; Aqueduct Racetrack in Queens; Jones Beach and Stony Brook University on Long Island; and the Westchester County Center in White Plains — would be closed for a second straight day on Tuesday.

Mr. Cuomo said at a news conference on Monday that New York’s seven-day average positive test rate was 4.8 percent, the 24th straight day it had declined. He added that the state had administered about 1.96 million doses of the vaccine.

In the Philadelphia area, city-run testing and vaccine sites were closed on Monday. Connecticut, New Jersey, Rhode Island and parts of the Washington area were following suit. Some areas away from the center of the storm were expected to remain open for vaccinations, including parts of Massachusetts and upstate New York.


Workers loading South Africa’s first coronavirus vaccine doses at OR Tambo International Airport in Johannesburg on Monday.
Credit…Elmond Jiyane for GCIS, via Reuters

A million doses of the Oxford-AstraZeneca coronavirus vaccine arrived in South Africa on Monday, paving the way for the country to begin vaccinating its population of nearly 60 million. Health care workers will be the first to be offered the shots, officials said.

The country has reported by far the most cases and deaths from the coronavirus on the African continent. It has participated in clinical trials of several vaccines.

The plane delivering the eagerly awaited doses from the Serum Institute of India, which produced them, was met at OR Tambo International Airport in Johannesburg by President Cyril Ramaphosa. The president has come under criticism over the country’s lagging start to widespread vaccination, with many countries in Asia and the West able to begin immunizing their populations weeks before South Africa could secure a supply of vaccines.

Health officials have said that it could take up to two more weeks before the country starts widely administering the doses that arrived on Monday.

South Africa experienced a surge in new cases around the turn of the year, fueled by a more transmissible variant of the virus that was first detected in the country. But the surge has begun to ease in recent weeks. Information has not yet been released on the AstraZeneca vaccine’s effectiveness against the variant, which is now predominant in the country.

Over the course of the pandemic, South Africa has reported about 1.45 million cases, and has lately been averaging about 5,800 new cases a day, according to a New York Times database.

In other developments around the world:

  • The Palestinian territories received 2,000 doses of the coronavirus vaccine on Monday, the first major shipment of an expected total of 5,000 doses from Israel, The Jerusalem Post reported. A shipment of 100 doses was sent to the West Bank and Gaza from Israel two weeks ago as a one-time humanitarian gesture, an Israeli official told The Wall Street Journal. Palestinian officials told The New York Times early last month that they had asked Israel for 10,000 doses but that Israel had refused. The United Nations has called on Israel to provide the Palestinians with equal access to the vaccine.

  • Seeking a better understanding of the pandemic’s origins, a team of 15 World Health Organization experts is visiting some of the places first hit by the coronavirus in the Chinese city of Wuhan, including a live animal market, a hospital and a disease control center. The inquiry is expected to take months to complete. Scientists initially believed the outbreak began at the Huanan Seafood Wholesale Market in Wuhan, but many experts now doubt that theory.

  • After implementing a harsh lockdown in December, health officials in Denmark said on Monday that the country’s schools would open next Monday for students in first to fourth grade, Reuters reported.

  • The European Union will get 75 million additional doses of vaccine in the next few months, the German pharmaceutical company BioNTech announced on Monday. The vaccine jointly developed by the company and Pfizer was the first to be authorized for use in the E.U., but supplies have been limited by production issues in the early going, and several countries, including Germany, are off to slower than expected starts in vaccinating their populations.

  • The police in China said they had broken up a criminal ring that manufactured and sold more than 3,000 fake coronavirus vaccine doses, Xinhua, the state-run news agency, reported on Monday. More than 80 people were arrested, the agency said. According to Xinhua, the police said that since September, the main suspect had been selling vials of “vaccine” that was really just saline solution.

  • Officials in Spain’s Madrid region said they would loosen coronavirus restrictions this week, allowing groups of six to gather for outdoor dining, up from four, Reuters reported. A 10 p.m. curfew may be extended to midnight.

A shopping mall in Cergy-Pontoise, near Paris, on Sunday. France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed.
Credit…Andrea Mantovani for The New York Times

PARIS — Public frustration with lockdowns is palpable across Europe, with retirees protesting this weekend in Vienna, restaurateurs taking to the streets in Budapest and demonstrators clashing with the police in Belgium, prompting dozens of arrests. The Dutch authorities fined more than 10,000 people last week for violating the national curfew.

While none of the protests resulted in the kind of violence seen in the Netherlands in recent weeks, they reflect a growing impatience as political leaders extend restrictions to guard against a resurgence of the virus fueled by new variants.

In France, President Emmanuel Macron has resisted a full lockdown, making a calculated gamble that his government can tighten the rules just enough to avoid a new wave of infections.

Prime Minister Jean Castex appeared in front of television cameras for an unexpected statement on Friday night, announcing a handful of new curbs, including strict border closures.

“Even if the path is very narrow, we must take it,” Mr. Macron was reported to have said at a cabinet meeting last week, according to The Journal du Dimanche, pushing back against the advice of several senior aides. According to the newspaper, he added: “When you are French, you have all you need to get by, as long as you dare to try.”

Polls in France have shown weariness with restrictions, and grumbling about the rules is growing in some quarters.

France is still under a 6 p.m. to 6 a.m. curfew, and places like cafes, museums and theaters are closed. Schools and shops are open.

After a widely publicized breach of the rules at a restaurant in the southern city of Nice last week and a call to “civil disobedience” by some restaurant owners, the French economy minister, Bruno Le Maire, warned on Monday that any establishments that flouted the rules would be cut off from coronavirus aid.

In the French Alps, protesters blocked roads on Monday to demand that ski lifts reopen.

Critics say that Mr. Macron’s approach may simply be delaying the inevitable and that he could be forced to change course if cases started to surge.

“It’s a risk, I’m hoping it was a calculated risk,” Karine Lacombe, an infectious-disease specialist, told the French news channel LCI on Sunday.

Mr. Macron’s plan is rooted partly in the relative stability of the pandemic in France. The number of new daily cases has inched up only slowly and while hospitalizations remain high, there has been no sudden surge. More contagious variants of the virus have been registered in the country, but the authorities say they believe that their spread, so far, is under control.

“Everything suggests that a new wave could occur because of the variant,” Olivier Véran, the French health minister, told The Journal du Dimanche. “But perhaps we can avoid it thanks to the measures that we decided early and that the French people are respecting.”

Aurelien Breeden reported from Paris, and Marc Santora from London.

Supporters of the Chicago Teachers Union during a car caravan on Saturday. Negotiations over how to resume in-person learning in the country’s third-largest school district have been among the most contentious in the United States.
Credit…Eileen Meslar/Reuters

Mayor Lori Lightfoot of Chicago and the city’s teachers’ union declared a 48-hour “cooling off period” Monday evening in what has been a tense confrontation over the city’s plan to reopen school buildings.

The city had planned to welcome thousands of students from kindergarten through eighth grade back to classrooms on Monday for the first time since March. But the union opposes the plan as unsafe and had instructed its members to refuse to report to work in person until the union’s concerns were addressed.

On Sunday night, with the district and union still at an impasse, the district postponed the start of in-person instruction for those students by a day. Still, the mayor said that teachers were expected to report to school buildings and warned that those who did not would be locked out of the district’s virtual teaching system and stop being paid until they came to work in person. The union, for its part, had threatened that retaliation against teachers for staying home would trigger a strike.

But on Monday, the two sides de-escalated. The mayor and the chief executive of the school system, Janice K. Jackson, said in a statement that the sides had made “substantial progress” in talks and were now “calling for a 48-hour cooling off period that will hopefully lead to a final resolution on all open issues.”

As a result of the progress, they said, and “as a gesture of good faith,” teachers would for now retain access to the virtual teaching systems. In the meantime, all students would continue learning remotely through Wednesday.

The union’s president, Jesse Sharkey, called the district’s decision to continue negotiating “heartening.”

The fight in Chicago, the nation’s third-largest school district, has been one of the most intense battles over school reopening anywhere in the United States. The majority of the district’s mostly Black and Hispanic families have chosen to keep their children learning virtually for now, while white parents have mostly opted to send their children back at high rates, a fact the union has cited in arguing that reopening does not serve the interest of the city’s most disadvantaged students.

Gov. Pete Ricketts of Nebraska at the State Capitol in Lincoln on Wednesday.
Credit…Gwyneth Roberts/Lincoln Journal Star, via Associated Press

Gov. Pete Ricketts of Nebraska will complete a seven-day quarantine after he was in “close contact” with a person who has since tested positive for the coronavirus, his office said on Monday.

The exposure, which was “work-related,” occurred on Saturday, according to a statement from his office; Mr. Ricketts had not shown any symptoms.

Mr. Ricketts “will get tested at the appropriate time,” the statement said. It was not immediately clear when he began to quarantine and when he will be tested. A spokesman for Mr. Ricketts did not specify, but referred to the statement released by his office.

The Centers for Disease Control recommends that a person who has been exposed should ideally get tested five to six days after a potential exposure to give the virus the opportunity to build up to detectable levels in the body.

C.D.C. guidelines also include recommendations that people should quarantine for at least seven days after a possible exposure and receive a negative test result before returning to normal activity.

“It really is a good reminder for all of us, that we want to make sure that we’re taking all the steps we can to slow down the spread of the virus,” Mr. Ricketts said at a news conference, speaking from a video screen. He urged people to continue wearing masks and practicing social distancing even though hospitalizations and positivity rates in Nebraska have dropped.

Mr. Ricketts has been outspoken about his opposition to mask mandates in the past. In July he threatened to withhold $100 million in federal relief funds to municipalities that mandated mask wearing in government offices. In November, a video spread on social media that appeared to show him taking pictures with people in a restaurant while not wearing a mask.

This is the second time Mr. Ricketts has quarantined after possible exposure.

Mr. Ricketts joins other governors who have quarantined after possible exposure, including Gov. Gavin Newsom of California, who quarantined twice last year. Others, including Gov. Tom Wolf of Pennsylvania and Gov. Henry McMaster of South Carolina, have tested positive, part of a fast-growing list of federal and local officials. Governors Kevin Stitt of Oklahoma, Mike Parson of Missouri and Ralph Northam of Virginia also tested positive last year.

A medical technician at a coronavirus testing site in Austin, Texas, last month.
Credit…Tamir Kalifa for The New York Times

The past few weeks in the United States have been the deadliest of the coronavirus pandemic, and residents in a majority of counties remain at an extremely high risk of contracting the virus. At the same time, transmission seems to be slowing throughout the country, with the number of new average cases 40 percent lower on Jan. 29 than at the U.S. peak three weeks earlier.

Other indicators reinforce the current downward trend in cases. Hospitalizations are down significantly from record highs in early January. The number of tests per day has also decreased, which can obscure the virus’s true toll, but the positivity rate of those tests has also gone down, indicating that the slowed spread is real.

Still, the average reported daily death rate over the past seven days remains above 3,000, compared with less than 1,000 per day in September and October.

Experts say the decrease could mark a turning point in the outbreak after months of ever-higher caseloads. But new, more contagious variants threaten to upend progress and could even send case rates to a new high if they take hold, especially if the national vaccine rollout faces hurdles.

President Biden and Vice President Kamala Harris met with Republican senators on Monday about a stimulus plan.
Credit…Doug Mills/The New York Times

A coalition of 10 Republican senators took a stimulus counterproposal to the White House on Monday evening, urging President Biden to scale back his ambitions for a sweeping $1.9 trillion pandemic aid package in favor of a plan less than one-third the size that they argued could garner the bipartisan consensus the new president has said he is seeking.

After a two-hour closed-door meeting, Senator Susan Collins of Maine, the leader of the Republican group, said the discussion had been excellent, though “I wouldn’t say that we came together on a package tonight.” She said Mr. Biden and the senators had agreed to continue their talks.

The discussions took place as Democrats prepared to push forward on Mr. Biden’s plan with or without Republican backing, and as the president faced a test of whether he would opt to pursue a scaled-back measure that could fulfill his pledge to foster broad compromise, or use his majority in Congress to reach for a more robust relief effort enacted over stiff Republican opposition.

At the end of a lengthy statement hailing a “substantive and productive” meeting, Jen Psaki, the White House press secretary, indicated that the president would not be giving much ground.

Mr. Biden reiterated, she said, “that he will not slow down work on this urgent crisis response, and will not settle for a package that fails to meet the moment.”

Still, the president appeared eager to signal an openness to negotiating, telling Ms. Collins that he was “anxious” to hear what the senators had to say as they chatted in the Oval Office before the beginning of what both sides described as a cordial and productive session.

“All of us are concerned about struggling families, teetering small businesses, an overwhelmed health care system, getting vaccines out and into people’s arms, and strengthening our economy and addressing the public health crisis that we face,” Ms. Collins said.

There was scant evidence, for now, that any Democrats were seriously considering embracing a proposal as limited as the one the Republicans have laid out. And the Republicans, too, were facing a test of whether they could hold together and forge a compromise that would ultimately be seen as a sufficient response to the public health and economic toll of the pandemic.

The Republicans’ $618 billion proposal would include many of the same elements as Mr. Biden’s plan, with $160 billion for vaccine distribution and development, coronavirus testing and the production of personal protective equipment; $20 billion to help schools reopen; more relief for small businesses; and additional aid to individuals. But it differs in ways large and small, omitting a federal minimum wage increase or direct aid to states and cities.

It would slash the direct payments to Americans, providing $1,000 instead of $1,400 and limiting them to the lowest income earners, excluding individuals who earned more than $50,000. It would also pare back federal jobless aid, which is set to lapse in March, setting weekly payments at $300 through June instead of $400 through September.

Punxsutawney Phil last year during the 134th celebration of Groundhog Day on Gobbler’s Knob in Punxsutawney, Pa.
Credit…Barry Reeger/Associated Press

This Groundhog Day will not be at all like the others.

As far back as 1900, The New York Times was already referring to this annual “hoary superstition” as a tradition.

Like clockwork, the event draws the curious and worldwide attention. Will a portly groundhog named Punxsutawney Phil see his shadow? The feeling that this may never change was accelerated by a popular 1993 movie starring Bill Murray as a weatherman who is “inexplicably living the same day over and over again” as he covered the annual festivity in Punxsutawney, a bucolic borough in western Pennsylvania about 300 miles west of Midtown Manhattan.

Change does not come easy to this part of the world. Until, that was, the coronavirus pandemic.

The event will proceed on Tuesday in Punxsatawney, but it will be held virtually. The organizers of the event, the Punxsutawney Groundhog Club, said in a recorded message that “No in-person attendance or guests will be allowed on the ground.”

As for the massive snowstorm burying parts of the Northeast, organizers are, for now, forging ahead. Gobbler’s Knob, the groundhog’s home turf, will be closed on Monday at 5 p.m. but will reopen on Tuesday by 9 a.m. The livestream will begin that day at 6:30 a.m.

That dispatch was, itself, a hybrid of modernity and antiquity. It was posted on Instagram. But the words were printed on a sign, held by a man.

Congressman Adriano Espaillat of New York at the Capitol this month.
Credit…J. Scott Applewhite/Associated Press

The scattered reports from around the country can play like a cruel irony: Someone tests positive for the coronavirus even though they have already received one or both doses of a Covid-19 vaccine.

It’s happened to at least three members of Congress recently:

But it’s been reported in people in other walks of life too, including Rick Pitino, a Hall of Fame basketball coach, and a nurse in California.

Experts say cases like these are not surprising and do not indicate that there was something wrong with the vaccines or how they were administered. Here is why.

  • Vaccines don’t work instantly. It takes a few weeks for the body to build up immunity after receiving a dose. And the vaccines now in use in the U.S., from Pfizer-BioNTech and Moderna, both require a second shot a few weeks after the first to reach full effectiveness.

  • Nor do they work retroactively. You can already be infected and not know it when you get the vaccine — even if you recently tested negative. That infection can continue to develop after you get the shot but before its protection fully takes hold, and then show up in a positive test result.

  • The vaccines prevent illness, but maybe not infection. Covid vaccines are being authorized based on how well they keep you from getting sick, needing hospitalization and dying. Scientists don’t know yet how effective the vaccines are at preventing the coronavirus from infecting you to begin with, or at keeping you from passing it on to others. (That’s why vaccinated people should keep wearing masks and maintaining social distance.)

  • Even the best vaccines aren’t perfect. The efficacy rates for Pfizer-BioNTech and Moderna vaccines are extremely high, but they are not 100 percent. With the virus still spreading out of control in the U.S., some of the millions of recently vaccinated people were bound to get infected in any case.

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