Dr. Anthony Fauci, seen here in December, said the United States would re-engage at all levels with the World Health Organization. 
Credit…Hilary Swift for The New York Times

A day after President Biden reinstated American ties with the World Health Organization, Dr. Anthony S. Fauci told the organization that United States was committed to working closely with other nations to implement a more effective global response to the pandemic.

“Given that a considerable amount of effort will be required by all of us,” Dr. Fauci, the nation’s leading infectious disease expert, said via video link during a meeting of the group’s executive board, “the United States stands ready to work in partnership and solidarity to support the international Covid-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and well-being of all people throughout the world.”

Dr. Fauci said the United States would re-engage at all levels with the W.H.O. and intended to join Covax, a program set up by the agency to distribute vaccines to poorer nations.

His comments, which he said came exactly one year after the United States recorded its first Covid-19 case, underscored the alacrity with which the new administration is reversing both the substance and tone of the Trump administration’s approach.

“This is a good day for the W.H.O. and a good day for global health,” the agency’s leader, Dr. Tedros Adhanom Ghebreyesus, said, thanking President Biden for honoring his pledge to resume W.H.O. membership and Dr. Fauci for his personal support to the body over many years as well as his leadership in America’s response to the pandemic.

On Thursday, Mr. Biden put forward a 21-page national strategy that includes aggressive use of executive authority to protect workers, advance racial equity and ramp up the manufacturing of test kits, vaccines and supplies. The “National Strategy for the Covid-19 Response and Pandemic Preparedness” outlines the kind of muscular and highly coordinated federal response that Democrats have long demanded and that President Donald Trump rejected.

Since virtually the moment Mr. Biden was sworn into office, he announced a series of actions to try to blunt the pandemic, including restoring the National Security Council’s Directorate for Global Health Security and Biodefense, a group disbanded under Mr. Trump in 2018.

He is requiring social distancing and the wearing of masks by federal employees, contractors and others on federal property, and is starting a “100 days masking challenge” urging all Americans to wear masks and state and local officials to implement public measures to prevent the spread of the coronavirus.

His moves come in stark contrast to the response of President Trump, who announced the United States would pull out of the W.H.O. in May last year, accusing the organization of kowtowing to China. Mr. Trump had sought to blame China for not doing enough to stop the spread of the disease, and he accused Beijing of hiding the true scope of infections from the W.H.O., targeting the agency in the process.

On Thursday, addressing “my dear friend” Dr. Tedros, Dr. Fauci thanked the W.H.O. for its leadership of the global response to the pandemic. “Under trying circumstances,” he said, “this organization has rallied the scientific and research and development community to accelerate vaccines, therapies and diagnostics; conducted regular, streamed press briefings that authoritatively track global developments; provided millions of vital supplies from lab reagents to protective gear to health care workers in dozens of countries; and relentlessly worked with nations in their fight against Covid-19.”

The United States, he said, would fulfill its financial obligations to the W.H.O., halt the previous administration’s moves to draw down American staff seconded to it and saw technical collaboration at all levels as a fundamental part of its relationship with the agency.

Dr. Fauci also set out broader aims for increasing global pandemic preparedness, including developing an improved early warning and rapid response mechanism for dealing with biological threats, and strengthening pandemic supply chains.

“We will work with partners around the world to build a system that leaves us better prepared for this pandemic and for the next one,” he said.

Sheryl Gay Stolberg contributed reporting.

President Biden signed several executive orders on Wednesday, including a mask mandate.
Credit…Doug Mills/The New York Times

President Biden planned to use Thursday, his first full day in office, to go on the offensive against the coronavirus, with a 21-page national strategy that includes aggressive use of executive authority to protect workers, advance racial equity and ramp up the manufacturing of test kits, vaccines and supplies.

The “National Strategy for the Covid-19 Response and Pandemic Preparedness,” previewed Wednesday evening by Mr. Biden’s advisers, outlines the kind of muscular and highly coordinated federal response that Democrats have long demanded and that President Donald J. Trump rejected. Mr. Trump insisted that state governments take the lead.

Mr. Biden intends to make expansive use of his authority to sign a dozen executive orders or actions related to Covid-19 — including one requiring mask-wearing “in airports, on certain modes of public transportation, including many trains, airplanes, maritime vessels, and intercity buses,” according to a fact sheet issued by his administration.

With its nominees for top health positions not yet confirmed by Congress, the Biden team has asked Mr. Trump’s surgeon general, Dr. Jerome Adams, to stay on as an adviser and to help with the transition. But Mr. Biden’s advisers were not shy about taking aim at the former president, whose vaccine rollout has been the object of intense criticism.

“The cooperation or lack of cooperation from the Trump administration has been an impediment,” said Jeff Zients, the new White House Covid-19 response coordinator, adding, “We don’t have the visibility that we would hope to have into supply and allocations.”

The Biden team said it had identified 12 “immediate supply shortfalls” that were critical to the pandemic response, including N95 surgical masks and isolation gowns, as well as swabs, reagents and pipettes used in testing — deficiencies that have dogged the nation for nearly a year. Jen Psaki, the new White House press secretary, told reporters on Wednesday evening that Mr. Biden “absolutely remains committed” to invoking the Defense Production Act, a Korean War-era law, to bolster supplies.

Credit…Miles Fortune for The New York Times

One year ago today, health officials told Americans about a traveler who had just come home from Wuhan, China, sought treatment at an urgent-care clinic north of Seattle after falling ill — and set off alarm bells.

The man had the first confirmed coronavirus case in the United States.

In announcing the news, the officials struck a tone at once reassuring and worrisome. They said they believed the risk to the public was low. But they also cautioned that more cases were likely to come.

And come they did: The nation has now recorded more than 24 million cases and 400,000 deaths.

It began slowly.

In the first five weeks, American officials reported about 45 known cases and no known deaths from the virus.

But in the past five weeks, the country recorded over 7.4 million cases and close to 100,000 deaths. On Wednesday alone, officials recorded at least 184,237 new cases and at least 4,357 deaths. In terms of deaths, it was the second-worst day of the pandemic.

It was also a day on which a new president took office after ousting an incumbent widely derided for his handling of the pandemic — and vowed to do better.

The first known case, of the traveler from Wuhan, took place in Snohomish County, Wash., and it led to an extensive effort to isolate the patient and monitor the contacts he had encountered since returning from China.

Other travelers also ended up testing positive, and genomic sequencing showed that a different branch of the virus took root independently on the East Coast of the United States.

Although the Seattle area became the epicenter of an early outbreak at the end of February, researchers are not sure if the man who returned to the Seattle area set it off.

Genomic sequencing suggested that the man, who is now 36, was part of a virus branch that spread across the region. But researchers looking at timing and genetic variations across the region believe the outbreak may have begun with another, unknown person.

Washington’s early outbreak led the state to record 37 of the nation’s first 50 coronavirus deaths. But the state has since fared far better than the nation as a whole. If the United States had maintained a death rate comparable to Washington’s, there would be some 220,000 fewer coronavirus deaths.

A vaccination in Atlanta.
Credit…Nicole Craine for The New York Times

That Covid-19 vaccine appointment may not just be hard to get — it may not even be all that secure.

Thousands of people across the country learned that their appointments had been abruptly canceled in the last few days, after vaccine shipments to local health departments and other distributors fell short of what was expected.

The health department in Erie County, N.Y., which includes Buffalo, canceled seven days of appointments this week, affecting 8,010 people, saying the state had sent far fewer doses than the county ordered. All future appointments should be considered “tentative, and are subject to vaccine availability,” the department said in a statement on Wednesday.

“We made appointments based on our hope and expectation that we would be able to fill those,” said Kara Kane, a department spokeswoman. “There’s a lot of confusion, a lot of questions, a lot of concern.”

Dianne Bennett, 78, lost a first-dose appointment at the Erie County Medical Center because of the cancellations, as did her husband. They were told to try again later, but Ms. Bennett said they had no idea when another appointment would be available.

“It’s such a lottery,” she said. “I just think it’s outrageous.”

Similar issues have cropped up across the country, as demand far outpaces supply and vaccine providers struggle to predict how many doses will arrive.

At Beaufort Memorial Hospital in South Carolina, hospital officials canceled 6,000 scheduled appointments through March 30 after they were notified that thousands of vaccine doses they expected were not coming.

San Francisco’s public health department expects to run out of vaccine on Thursday, The Los Angeles Times reported, because the city’s allocation dropped sharply from a week ago and the state did not replace doses that had to be discarded.

Local health officials throughout California say they have trouble scheduling appointments because they are unsure how much vaccine they will receive from week to week, the paper said.

In New York City, 23,000 vaccination appointments scheduled for Thursday and Friday were postponed because of a shipping delay, Mayor Bill de Blasio said on Wednesday, a day after warning that the city’s supply would soon be exhausted.

“We already were feeling the stress of a shortage of vaccine,” the mayor said at a news conference. “Now the situation has been made even worse.”

Recent moves to open up eligibility have aggravated the situation.

After the state of Georgia announced that anyone 65 or older could get the vaccine, the 10-county Northwest Health District was swamped with more than 10,000 appointment requests in one weekend — far more than it could satisfy with the supply it had on hand. So it shut down its scheduling website, and told people to call their local health department to arrange an appointment instead, frustrating many people who thought they had already secured a slot.

“We’re having to schedule appointments at least a week out, based on anticipated delivery, but we don’t know what will show up on a daily basis,” said Logan Boss, the spokesman for the health district. “It’s difficult to explain that to the public.”

A police cordon on a street near Renji Hospital following a suspected Covid-19 infection in Shanghai, China, on Thursday.
Credit…China Daily, via Reuters

Three locally transmitted coronavirus cases were confirmed on Thursday in Shanghai, China’s largest city, as fears rose over another large-scale outbreak in the country where the virus was first detected.

The three cases, the first in the city in about two months, were connected to prominent hospitals in the city, China’s business capital. Two of the infected individuals worked at the hospitals, one at Fudan University Shanghai Cancer Center and the other at Renji Hospital. They lived in the same residential complex. The third person was a close contact.

The infections were found during routine nucleic tests for hospital employees. The positive results led to closures at the outpatient sections of both hospitals and a citywide campaign to test all hospital employees.

Shanghai is the latest Chinese city to experience a recent outbreak, the worst since the pandemic first emerged in late 2019.

Beijing, the capital, and the provinces of Hebei, Heilongjiang, Jilin, Shanxi and Shandong have all recently reported new infections. This week alone, China reported more than 400 local infections, a steep and sudden increase.

Beijing has implemented new rules restricting the number of passengers allowed on public transportation, and extended the quarantine period for travelers returning from overseas.

Schools have been closed and the authorities on Wednesday announced that travelers returning to rural areas for the Chinese New Year holiday, the largest annual human migration in the world, must test negative for the virus and quarantine at home for 14 days.

Ma Xiaowei, the National Health Commission minister, has blamed the recent outbreak on travelers returning from overseas and on workers handling imported food.

The authorities said on Wednesday that two cases recently found in Beijing were of the more contagious B.1.1.7 variant, first found in Britain.

Laura Lima watching the inauguration at Martin Luther King, Jr. Community Hospital in South Los Angeles.
Credit…Isadora Kosofsky for The New York Times

There is no shortage of screens in the intensive-care units treating Covid-19 patients, but at one I.C.U. in Los Angeles on Wednesday, some of the screens showed not blood pressure and oxygen levels but images of the 46th president of the United States being sworn in.

“I just wanted to see and listen,” said Laura Lima, a nurse watching the inauguration on an iPhone propped on her work station. “It’s important stuff.”

Ms. Lima works at Martin Luther King, Jr. Community Hospital in South Los Angeles, and as she watched President Biden address the nation, a monitor beeped. She put on an isolation gown and gloves and entered the room of one of her patients, a man in his early 60s on a ventilator whose intravenous line needed to be adjusted.

Ms. Lima took note of the new president’s statements about hastening the rollout of vaccines.

“I think this community should be prioritized,” she said.

The neighborhood around the hospital, filled with low-income workers who often have poor access to health care, has been one of the hardest hit in Southern California’s surge.

Mario Torres Hernandez, a 63-year-old being treated with oxygen for Covid-19, had his television tuned to Telemundo during Mr. Biden’s visit to Arlington cemetery. “I hope he does more for us,” he said.

But it was another busy day at the I.C.U., and so the vast majority of its staff members were not watching the proceedings in Washington. One respiratory therapist said he had forgotten the inauguration was happening.

Some did think it was a day of hope.

“I’m so tired of zipping black body bags,” another nurse, Amanda Hamilton, said as the ceremony continued. “It’s exciting we have a president who actually cares and might do something about it.”

Health workers tending to a Covid-19 patient in Port Elizabeth, South Africa, in November.
Credit…Samantha Reinders for The New York Times

Confirmed coronavirus cases from new variants found first in Britain, then in South Africa, Brazil and the United States have people worried about whether vaccines can protect against altered versions of the virus. Experts said in interviews that so far vaccines are capable of providing that protection.

But two small new studies, posted online Tuesday night, suggest that some variants may pose unexpected challenges to the immune system, even in those who have been vaccinated — a development that most scientists had not anticipated seeing for months, even years.

The findings result from laboratory experiments with blood samples from groups of patients, not observations of the virus spreading in the real world. The studies have not yet been peer-reviewed.

But experts who reviewed the papers agreed that the findings raised two possibilities. People who had survived mild cases may still be vulnerable to infection from a new variant; and the vaccines may be less effective against the variants.

Existing vaccines will still prevent serious illness, and people should continue getting them, said Dr. Michel C. Nussenzweig, an immunologist at Rockefeller University in New York, who led one of the studies: “If your goal is to keep people out of the hospital, then this is going to work just fine.”

But the vaccines may not prevent people from becoming mild or asymptomatic infections with the variants, he said. “They may not even know that they were infected,” Dr. Nussenzweig added. If the infected can still transmit the virus to others who are not immunized, it will continue to claim lives.

The studies published Tuesday night show that the variant identified in South Africa is less susceptible to antibodies created by natural infection and by vaccines made by Pfizer-BioNTech and Moderna.

Neither the South African variant nor a similar mutant virus in Brazil has yet been detected in the United States. The more contagious variant that has blazed through Britain does not contain these mutations and seems to be susceptible to vaccines.

Teresa Bautista, a student at the High School for Environmental Studies in Manhattan, collecting goose dropping samples at Van Cortlandt Park in the Bronx.
Credit…Christine Marizzi/BioBus

Over the next few months, New York area high school students will gather samples from the city’s birds as a part of the Virus Hunters program, hosted by the nonprofit science outreach organization BioBus. Their goal is to catalog the flu viruses that often lurk in urban fowl, some of which might have the potential to someday hop into humans.

The surveillance program, which was developed in partnership with virologists at the Icahn School of Medicine at Mount Sinai, is one of several outreach efforts that have emerged in recent years to equip young scientists with hands-on experience in outbreak preparedness — a quest that has only gained urgency since the new coronavirus started its tear across the globe.

For many months to come, Covid-19 will continue to shutter schools and thwart efforts to gather. The changes have forced educators and researchers to change their teaching tactics. But several groups have met the challenge head on, not merely weathering the pandemic’s inconveniences but transforming them into opportunities for scientific growth.

Flu viruses are fairly cosmopolitan pathogens that are capable of jumping into a wide range of animals, including birds, and changing their genetic material along the way. Only some of these viruses pose a possible threat to people, experts said. But which ones? Researchers won’t know unless they check.

Doses of the Moderna vaccine, which must be kept cold, had to be discarded in Ohio after SpecialtyRX found that it had not properly monitored or recorded storage temperatures.
Credit…Jae C. Hong/Associated Press

A pharmacy services company responsible for vaccinating residents at eight Ohio nursing homes allowed 890 doses of the Moderna vaccine — more than half its supply — to become spoiled by failing to make sure they were kept cold enough, state officials said.

The episode is being investigated by Ohio’s state Board of Pharmacy, and the state Department of Health has cut the company off from any more allocations of vaccine.

Before the new year, the company, SpecialtyRx, was given 1,500 doses to vaccinate residents at the eight facilities. After administering a first round of shots, the company found that it had not properly monitored or recorded the temperatures in its refrigerators and freezers where the remaining doses were stored.

State investigators determined that the 890 stored doses were no longer viable, the Department of Health said in a statement. The nursing home residents are still awaiting their second shots, and the facilities will have to arrange with another provider to obtain them.

The Moderna vaccine can be stored for up to 30 days if it is kept between 36 and 46 degrees Fahrenheit. Officials with SpecialtyRx could not be immediately reached for comment.

Like many other states, Ohio has gotten off to a slow start with its vaccination program. About 456,100 Ohioans — less than 4 percent of the population — had received first doses as of Wednesday, according to The Cincinnati Enquirer.

Gov. Mike DeWine said at a news conference on Tuesday that most of the state’s frontline health care workers and nursing-home residents had received a dose. “We are trying to juggle a lot of things and do a lot of things with not enough vaccines,” Mr. DeWine said.

The state plans to open up eligibility next week to all residents 75 years and older, as well as to younger people with certain severe illnesses and disorders.

The number of new cases reported in Ohio has been declining over the past week, but death reports have remained high after jumping upward after Christmas.

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