A volunteer participating in the Oxford-AstraZeneca vaccine trial getting a shot in Oxford, England, in November.
Credit…Andrew Testa for The New York Times

A global push to accelerate vaccinations gathered steam on Wednesday, as Britain became the first country to give emergency authorization to the coronavirus vaccine developed by AstraZeneca and the University of Oxford and China announced that late-stage drug trials showed that one of its coronavirus vaccines was effective.

Britain’s approval of the AstraZeneca-Oxford vaccine opens a path for a cheap and easy-to-store shot that much of the world will rely on to help end the pandemic. Officials in India are meeting Wednesday to consider approving the vaccine.

For Britain, where hospitals are overwhelmed by a deluge of cases of a new, more contagious variant of the virus, the decision by its drug regulator offered some hope of a reprieve. The health service is preparing to soon vaccinate a million people per week at makeshift sites in soccer stadiums and racetracks.

The Oxford-AstraZeneca shot is poised to become the world’s dominant form of inoculation. At $3 to $4 a dose, it is a fraction of the cost of some other vaccines. And it can be shipped and stored at normal refrigeration temperatures for six months, rather than in the ultracold freezers required by rival vaccines from Pfizer-BioNTech and Moderna, making it easier to administer to people in poorer and harder-to-reach parts of the world.

When given in two, full-strength doses, AstraZeneca’s vaccine showed 62 percent efficacy in clinical trials — considerably lower than the roughly 95 percent efficacy achieved by Pfizer and Moderna’s shots. For reasons scientists don’t yet understand, AstraZeneca’s vaccine showed 90 percent efficacy in a smaller group of volunteers who were given a half-strength initial dose.

The news from China could pave the way for the global rollout of hundreds of millions of vaccine doses in the coming months.

The state-controlled firm Sinopharm said that a vaccine candidate made by its Beijing Institute of Biological Products arm had proved to be 79 percent effective in interim Phase 3 trials. Sinopharm said it had asked Chinese regulators to allow the vaccine to be used broadly.

A full breakdown of results for the Chinese trials was not immediately available. If supported, the results would bolster claims that Chinese officials have made in recent days that the country’s vaccines are safe and effective. The authorities have already moved ahead with plans to vaccinate 50 million people in China by mid-February, when hundreds of millions are expected to travel for the Lunar New Year holiday, according to a Chinese vaccine expert.

China’s drive to develop a homegrown vaccine speaks to the country’s technological and diplomatic ambitions. If Chinese vaccines stand up to global scrutiny, they would support the country’s claim as a peer and rival to the United States and other developed countries in biomedical sciences.

Vaccination programs have begun in the Britain, Canada, the European Union, Mexico and United States, among other countries. In Britain, the first patient to get the vaccine, got her follow-up shot on Tuesday.

Luke Letlow in July. He said on Dec. 18 that he was isolating at home after testing positive for the coronavirus.
Credit…Melinda Deslatte/Associated Press

Luke Letlow, a Republican who was elected to the House of Representatives this month to represent Louisiana’s Fifth Congressional District, died Tuesday evening of complications from Covid-19, a spokesman said. He was 41.

Mr. Letlow was set to take office on Sunday. His death was confirmed by several politicians, including Representative Garret Graves of Louisiana, who said in a Facebook post that the death of his friend and “former co-worker” was “a huge loss to Louisiana and America.” Mr. Letlow died at the Ochsner L.S.U. Health medical center in Shreveport, La., said the spokesman, Andrew Bautsch.

Mr. Letlow said on Dec. 18 that he was isolating at home after testing positive for the coronavirus. He was hospitalized a day later in Monroe, La., before being transferred to the hospital in Shreveport on Dec. 22. Mr. Bautsch said on Dec. 23. that Mr. Letlow had been receiving the antiviral drug remdesivir and steroids to treat his infection.

On Dec. 21, while he was hospitalized in Monroe, Mr. Letlow urged people who had recovered from Covid-19 to donate plasma. “Your plasma is ESPECIALLY needed by those who are suffering,” he wrote in a tweet. “I cannot stress this enough. Please consider saving lives by going out and donating at your local blood bank.”

He did not have any underlying conditions that would have increased his chances of dying from Covid-19, Dr. G.E. Ghali, a doctor at the Shreveport hospital, told The Advocate in Baton Rouge, La.

In a runoff this month against another Republican, Mr. Letlow was elected to succeed Representative Ralph Abraham, whom Mr. Letlow had served as chief of staff.

Mr. Letlow is survived by his wife, Julia, and their two children, Jeremiah and Jacqueline.

Speaker Nancy Pelosi said in a statement, “Tonight, the United States House of Representatives sadly mourns the passing of Congressman-elect Luke Letlow.

“Congressman-elect Letlow was a ninth-generation Louisianian who fought passionately for his point of view and dedicated his life to public service,” she said.

Kevin McCarthy, the House minority leader, said, “Our hearts break tonight as we process the news of Congressman-elect Luke Letlow’s passing.”

Gov. John Bel Edwards of Louisiana said Tuesday evening that Covid-19 had “taken Congressman-elect Letlow from us far too soon.” Mr. Edwards, a Democrat, said he had ordered flags to be flown at half-staff on the day of Mr. Letlow’s funeral.

Representative Mike Johnson, a Republican who represents the state’s Fourth Congressional District, issued a statement on behalf of the state’s six-member Congressional delegation: “We are devastated to hear of Luke Letlow’s passing. Luke had such a positive spirit, and he had a tremendously bright future ahead of him. He was looking forward to serving the people of Louisiana in Congress, and we were excited to welcome him to our delegation where he was ready to make an even greater impact on our state and our nation.”

Bobby Jindal, the former governor of Louisiana whom Mr. Letlow had previously worked for when Mr. Jindal was a congressional candidate, representative and governor, said the congressman-elect “had talked in recent days about his excitement about the opportunity to serve” his district.

“I first met Luke when he was still a college student, and spent countless hours with him in his truck driving the back roads of Louisiana,” Mr. Jindal said. “His passion for service has been a constant throughout his life.”

According to Ballotopedia, Mr. Letlow is the first elected federal official to die from the coronavirus; the first member of the federal government to die from it was a judge.

Other elected officials to die from Covid-19 include several state legislators: a Republican state senator from Minnesota, New Hampshire’s new Republican speaker of the House of Representatives, and in North Dakota, David Dean Andahl, a Republican known as Dakota Dave, who was elected posthumously to the State House of Representatives after dying from the virus.

Loretta Jones with her children, from left, Grenderline, 11, Christopher Michael, 4, and Frederick, 12. “By the grace of God, we’re making it through,” Ms. Jones said.
Credit…Cheriss May for The New York Times

Since the first coronavirus case was recorded in her neighborhood in Southeast Washington in the spring, 11-year-old Grenderline Etheridge has burst into tears many times for reasons she cannot explain. She has crawled into bed with her mother, something she had not done for a very long time.

Her siblings have also had trouble dealing with the pandemic: Her brothers, who are 12 and 4, have joined her in their mother’s bedroom, and the little one, who was nearly potty trained before his school shut down in March, recently went back to wearing diapers.

Grenderline’s mother, Loretta Jones, has tried over the past 10 months to keep the children focused on their studies and entertained with games, books and handprint art activities. In the early days of the pandemic, Ms. Jones often drove the family to a nearby park for exercise, but they stopped going once virus cases began rising again. A surge in gunfire this year in the neighborhood has also caused the family to stay mostly inside, confined to a crowded, three-bedroom apartment.

“By the grace of God, we’re making it through,” said Ms. Jones, 34, who has bipolar disorder and has had difficulty finding steady work.

As the virus advanced on the nation and spared not a single community, it also inflamed the difficulties that many families were already enduring in pre-pandemic times: gun violence, hunger, poverty.

The disruptions to daily life — and the associated stresses of lives on pause — have been perhaps most acutely felt by children from low-income families, experts said, many of whom live in predominantly Black and Latino neighborhoods that have been plagued by a rise in gun violence and disproportionately high coronavirus infection rates.

The pandemic has inflicted so much upheaval in Grenderline’s life — and the lives of many young people — that experts worry the devastating effects will be felt long after vaccines are distributed and some semblance of normalcy returns.

Workers from Landmark Signs installed a panel of Waterford crystal triangles on the New Year’s Eve ball on Sunday.
Credit…Kathy Willens/Associated Press

Every December, the eyes of the world are drawn to New York City, where a glittering crystal ball in Midtown Manhattan marks a communal chance for a new beginning. But this past spring, when the pandemic ravaged New York City, photos of an eerily vacant Times Square became a grim meme, the deserted plaza an enduring image of the crisis.

And this New Year’s Eve, for the first time in decades, Times Square will be closed to the public. Only production workers and dozens of selected frontline workers and their families will be permitted near the stage.

On the guest list are a pediatrician at Elmhurst Hospital, a public hospital that was overwhelmed by the pandemic; a pizza delivery driver who became ill with the coronavirus; and Ronald Colbert, a Staten Island Ferry operator who will be attending his 40th Times Square ball drop.

“I am just so honored and happy,” said Mr. Colbert, 66, who worked through the pandemic.

The outdoor concert will be staged according to state and industry guidelines for safe media productions. This year’s musical guests include Gloria Gaynor singing “I Will Survive,” a disco classic resurfaced as a pandemic anthem.

The TV networks will project the image of a Times Square transformed by the pandemic, one without the throngs of revelers in glittering gear. The sweeping shots showing a blocks-long street party will be axed. Close-ups won’t show smiles, said Jeff Straus, the president of Countdown Entertainment, which co-produces the Times Square event, because faces will be covered.

“We want to show a physically distanced Times Square,” Mr. Straus said. “We want to show a Times Square that is wearing masks.”

Still, both Mr. Straus and Tim Tompkins, the president of the Times Square Alliance, said it was important to them that an audience of some kind be present if circumstances allowed.

“So much of the energy comes from the hordes of people,” said Mr. Tompkins, who has been involved with the ball drop since 2002. “And so there will definitely be a different energy in Times Square.”

“We want to show a city with a heartbeat,” said Mr. Straus. “And a city that’s alive.”

Credit…Marta Monteiro

My 12-year-old daughter, Audrey, told me recently on one of our many walks around the neighborhood that she would never forget this pandemic, and that she never wanted to take for granted having friends over, visiting extended family or hugging her grandparents again. She wondered, though, whether people would really live with new appreciation. Over time, would we all forget? Would a hug or a handshake become commonplace again?

“Write down how you feel,” I suggested. “Record it so your future self will remember.”

The next day, I spotted this letter on my daughter’s desk.

“Open on New Year’s Day or Eve, starting when you are in high school or even 8th grade maybe,” she wrote.

Here’s part of her letter.

Dear Audrey,

You are much older now, and hopefully wiser, although sometimes that’s not the case. You have probably forgotten about me.

I’m 12-year-old you struggling with anxiety, hating virtual learning, in this nightmarish pandemic.

I’ve come from 2020 to remind you not to forget. I am sitting on my bed right now, tears still on my face from a fight with my mom (I love her more than anything or anyone, but we’ve spent too much time together), and aware of the light blue masks hanging on the hooks next to the door in my kitchen. In a way, it still feels like March, when this whole crazy thing started. I’m sick of it.

I didn’t get to spend Thanksgiving with my beloved grandparents, when I’d been waiting so long to act normally with them and pod up. Now, it looks like I won’t be spending Christmas with them normally either. In America (where I live), the Coronavirus numbers are higher than they’ve ever been.

I am struggling and would do anything to get out of 2020 and this pandemic, to see my friends and family normally. You are able to do that. You have what I want so badly. So please, I urge you to enjoy your life, your friends, your family, your experiences.

Remember — everything is replaceable and unimportant, but people are the only true thing that matter in this modern-day world.

Love your life, and be filled with joy this year.


You, age 12, Audrey in 2020, the Pandemic Year.

The Mexican Army set up a checkpoint in Celaya, Mexico, in August after an anti-drug operation.
Credit…EPA, via Shutterstock

Like a lot of businesses, the Sinaloa Cartel was knocked back on its heels as the coronavirus swept the globe and travel ground to a near halt.

Government measures to contain the virus had fouled up its operations, interrupting the supply of chemicals for manufacturing synthetic drugs like fentanyl and methamphetamine and cutting off trafficking routes across international borders.

But while many legitimate industries remain staggered by the pandemic, the cartel has adapted quickly, as have other organizations that dominate drug trafficking throughout the Americas, the source of nearly all of the world’s cocaine and most of the heroin consumed in the United States.

“The cartels have long demonstrated their resiliency,” said Scott Brown, the head of the Homeland Security Investigations office in Arizona. “They are going to continue to find new and innovative ways to try to move their product.”

The drug trafficking organizations have slashed payrolls and devised workarounds to traffic drugs and get them into the hands of consumers, according to interviews with sources close to the Sinaloa Cartel, law enforcement officials in the United States and Latin America, and security analysts.

During the year, some traffickers have increasingly relied on newer tools like drones and cryptocurrency and on creative uses of older approaches like underground tunnels and sea routes.

American officials have also detected a growing emphasis on the recruitment of impoverished or drug-addicted Americans to smuggle drugs in their body cavities.

The changes, sources said, have allowed the Sinaloa Cartel and the region’s other major drug trafficking groups to rebound quickly even as the pandemic continues to devastate economies.

And the challenges of getting drugs into the United States when travel routes shut down appears to have spurred the development of clandestine laboratories in the United States for the production of synthetic drugs, said Celina Realuyo, professor at the William J. Perry Center for Hemispheric Defense Studies at the National Defense University in Washington.

Law enforcement agencies around the world have also detected an acceleration in the use of cryptocurrency and the so-called dark web for drug transactions and money laundering during the pandemic, she said.

“They’re adjusting,” Ms. Realuyo said of the drug trafficking groups. “They already had kind of a wherewithal, and what they’re doing is they’re just adapting quicker to their context.”

Prisoners affected by the coronavirus in facilities like the Eastern Oregon Correctional Institution in Pendleton have the right to sue Oregon state officials over their handling of the pandemic, a federal judge has ruled.
Credit…Ricardo Nagaoka for The New York Times

Inmates in Oregon’s prisons, where coronavirus infections and deaths have been rising for months, have the legal right to sue state officials over their handling of the outbreaks, a federal court judge has ruled.

The ruling this month by Stacie Beckerman, a magistrate judge, is believed to be the first in the nation to allow state officials — including the governor and top prison officials — to be held accountable in court for failing to adequately protect prisoners from the virus.

If such lawsuits succeed, Oregon may ultimately be forced to pay damages, and prisoners in other states may follow the same legal road.

State prison officials around the nation have acknowledged that they have taken a trial-and-error approach to the pandemic, one that has failed to stop the virus from penetrating any state prison system in the nation, according to a New York Times database. As of Tuesday, there had been almost 265,000 confirmed infections and more than 1,600 Covid-19 deaths among inmates in state prisons, according to the database.

Indications that a prison took inadequate precautions might include anything from not requiring guards to wear masks to testing too few inmates, according to the court ruling.

In May, the Supreme Court denied a request from two inmates in a Texas geriatric prison to reinstate a trial judge’s order instructing officials to take steps to protect them from the coronavirus. But Juan Chavez, one of the lawyers representing prisoners in the Oregon lawsuit, said the Texas case was different.

The Texas prisoners were asking the court to order officials to act to prevent the spread of the virus, Mr. Chavez said. The Oregon lawsuit, however, includes a claim for money damages because the prisoners believe state leaders did too little to protect their health.

The Oregon Department of Corrections declined to comment on the lawsuit on Tuesday.

Advocacy groups and prisoners’ families have pressed the state to release many inmates to slow the spread of the virus, as some other states have done. But since March, only 247 people have had their sentences commuted, according to the department.

Bonnie Grady, whose son, Matthew Yurkovich, is incarcerated at the Snake River Correctional Institution in Ontario, Ore., said that prisoners slept within a few feet of one another and had limited access to cleaning supplies, and that guards did not always wear masks.

Ms. Grady said that in the spring, her son lost his sense of smell and taste, a symptom associated with the coronavirus, but that he was never tested. “If I did my job as poorly as the prison did their job with the virus, then I would have lost my job,” she said.

More than 2,000 prisoners and 500 correctional officers have been infected in Oregon state prisons, including more than 460 inmates at Snake River, according to state records. Twenty-one prisoners statewide have died. Coronavirus cases surged in the state prison system after wildfires in September forced the evacuation of several prisons.

Chris Long of Clarkston, Mich., has been in the hospital seven times since contracting the coronavirus.
Credit…Emily Rose Bennett for The New York Times

Nearly a year into the pandemic, it is clear that recovering from Covid-19’s initial onslaught can be an arduous, uneven journey. Now, studies reveal that a significant subset of patients are having to return to hospitals, sometimes repeatedly, with complications triggered by the disease or the body’s battle against it.

The routine of Chris Long, 54, used to include biking 30 miles three times a week and taking courses toward a Ph.D in eight-week sessions. But since getting sick with the coronavirus in March, Mr. Long has fallen into a distressing new cycle — one that so far has landed him in the hospital seven times.

Every few weeks since his initial five-day hospitalization, his lungs begin filling, he starts coughing uncontrollably and runs a low fever. Roughly 18 days later, he spews up greenish-yellow fluid, signaling yet another bout of pneumonia.

Soon, his oxygen levels drop and his heart rate accelerates to compensate, sending him to a hospital near his home in Clarkston, Mich., for several days, sometimes in intensive care.

Data on rehospitalization of coronavirus patients is incomplete, but early studies suggest that in the United States alone, tens or even hundreds of thousands could ultimately return to the hospital.

“It’s an urgent medical and public health question,” said Dr. Girish Nadkarni, an assistant professor of medicine at Mount Sinai Hospital, who, with another assistant professor, is studying readmissions of Covid-19 patients.

A study by the Centers for Disease Control and Prevention of 106,543 coronavirus patients, initially hospitalized between March and July, found that one in 11 was readmitted within two months of being discharged, with 1.6 percent of patients readmitted more than once.

Readmissions strain hospital resources, and patients can be exposed to new infections and develop muscle atrophy from being bedridden.

Some research suggests implications for hospitals currently overwhelmed with cases. A Mount Sinai Hospital study of New York’s first wave found that patients with shorter initial stays and those not sick enough for intensive care were more likely to return within two weeks.

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