As many Americans are winding down for the holidays, an explosion of coronavirus cases and deaths across the nation is hitting with perilous force, particularly in the South, which avoided much of the fall surge.
Six Southern states have seen sustained case increases in the last week: Tennessee, Alabama, Georgia, South Carolina, Florida and Texas.
Tennessee reported the country’s most cases per 100,000 people on average over the last seven days, and Alabama set a single-day death record for the state on Wednesday, with 135, according to a New York Times database. In Florida, a virus surge in the past week means cases could soon surpass the state’s summer peak.
These increases are not just indicative of more testing. Florida’s more than 20 percent rise in cases over the last two weeks matches the growth in hospitalizations, although far fewer residents are hospitalized now than in the summer. In Texas, which has also had an upswing of more than 20 percent over the same time period, Dallas County has added more than 15,000 cases in the last week, a record.
A somber holiday season comes as the national death toll surpassed 326,000 on Thursday, more than any other country. More than 3,400 deaths were reported on Thursday, the second-highest daily total of the pandemic.
In Tennessee, home to six of the nation’s 20 metropolitan areas with the most recent cases per capita, frontline medical workers say hospitals are overwhelmed with virus patients.
Dr. Jason Martin, a critical care specialist outside Nashville, said the intensive care unit where he works has been at or near capacity for weeks, an unsustainable level compounded by lax state public health restrictions. Although Gov. Bill Lee recently placed some limitations on indoor public gatherings, he has refused to issue a statewide mask mandate. That has left many rural counties, where officials have resisted imposing mask requirements, more vulnerable to the virus.
But Dr. Martin said his patients have little doubt about the seriousness of the coronavirus. “The people who come in, they believe, by the time they’ve gotten to me,” he said. Many of his patients have expressed regret about their decisions, like going to a relative’s funeral or socializing with people who showed no symptoms.
“What makes this so maddening is that we know how to stop it,” Dr. Martin said, “and we choose not to.”
Seizing on President Trump’s implicit threat to reject a $900 billion stimulus compromise unless Congress more than than tripled the $600 direct payments, Democrats attempted to call his bluff on Thursday with legislation that would send Americans $2,000 checks.
Republicans rejected the move and tried to counter with a motion to force their own changes to foreign policy spending.
Attempted and rejected in less than two minutes, the efforts to amend a $2.3 trillion spending package that overwhelmingly passed both chambers on Monday after weeks of bicameral negotiations were more theater than legislating.
They came after Mr. Trump implicitly threatened to reject the measure in a four-minute video on Tuesday night, roiling Congress. Mr. Trump decamped for his Florida home in Mar-a-Lago on Wednesday without saying another word on the matter, leaving both parties to guess whether he really intends to veto the long-delayed measure, which includes the coronavirus relief as well as funding to keep the government funded past Monday.
The bill contains the first significant federal relief since April. If the president doesn’t sign it, millions of Americans on Saturday are set to lose access to two federal unemployment programs that were expanded under the $2.2 trillion stimulus law which passed in March. A series of additional relief provisions, including an eviction moratorium, are set to expire at the end of the month.
The Democratic gambit on the House floor was never meant to pass, but Democratic leaders had hoped to put Republicans in a bind — forcing them to choose between the president’s wishes for far more largess and their own inclinations for modest relief — while possibly flushing the president out on his intentions.
Representative Steny H. Hoyer of Maryland, the Democratic majority leader, attempted to approve a stand-alone bill that would provide for the $2,000 payments upon enactment of the behemoth package.
On behalf of Republicans, Representative Rob Wittman of Virginia, then tried to interject a separate request to revisit the annual spending for foreign policy matters, given that Mr. Trump had also objected to how those funds were being spent. Many of the foreign aid cuts that Mr. Trump angrily dismissed came directly from his own budget request.
But without the approval of the floor and committee leaderships of the other party, House rules prevented both requests for unanimous approval from being entertained on the floor.
On Thursday, the Government Publishing Office was expected to finish physically printing the nearly 5,600-page package, and send it to Capitol Hill for congressional officials to sign, a process called enrollment. By the afternoon, the legislation is to be sent to Mar-a-Lago for Mr. Trump to sign, according to two people familiar with the plans.
The House has now adjourned for Christmas, but will be back Monday. Speaker Nancy Pelosi of California, in a statement on Thursday, vowed to hold a roll-call vote on the direct payments legislation on Monday, declaring “to vote against this bill is to deny the financial hardship that families face and to deny them the relief they need.”
Republican leaders were left wondering aloud why Congress was even dealing with a matter — on Christmas Eve, no less — that they thought was finally put to rest days ago.
“He’s made it really hard to talk about the great advances we’ve made with health research and the vaccine, about what they’ve done with foreign policy, about what’s happened with trade,” Senator Roy Blunt of Missouri said of Mr. Trump.
“There’s a long list of positive things that we’d be talking about today if we weren’t talking about this. And I think that would be to the president’s advantage if we were talking about his accomplishments rather than questioning decisions late in the administration.”
Air travel in the week leading up to Christmas dropped nearly 60 percent in the United States compared with last year. But lots of Americans are still traveling: More than a million people passed through Transportation Security Administration checkpoints on Wednesday, the highest number since March.
The steady stream of travelers comes as cases soar in many states. Maine and Virginia set single-day case records on Wednesday; Alabama set a single-day death record; and California surpassed two million cases since the start of the pandemic, the first state in the country to do so, according to a New York Times database.
The Centers for Disease Control and Prevention urged people not to travel. The agency advised that “postponing travel and staying home is the best way to protect yourself and others.” It added: “you and your travel companions (including children) may feel well and not have any symptoms, but you can still spread Covid-19 to family, friends and community.”
A patchwork of state travel restrictions exists across the United States, with some states requiring travelers to quarantine, fill out mandatory health forms or provide proof of a negative coronavirus test, while other states have no such measures. That inconsistency, along with growing alarm that a more contagious variant of the virus is spreading through Britain and beyond, is adding to already existing confusion and anxiety.
On Thursday, Gov. Phil Murphy of New Jersey said that United Airlines would require that passengers on flights from the United Kingdom to the United States present a negative Covid-19 test taken within 72 hours of departure. The new policy will apply to all flights from London’s Heathrow Airport to Chicago, Newark, Washington Dulles and San Francisco beginning on December 28, United said in an emailed statement.
Recognizing that some people will not heed the warning to stay home for the holidays, the C.D.C. also suggested taking precautions before traveling, such as getting a flu shot, bringing extra protective supplies like masks and gloves, and getting tested.
A week after he first tested positive for the coronavirus, President Emmanuel Macron of France has stopped isolating himself because he no longer shows symptoms, a statement from the Élysée Palace, his official office, said on Thursday.
Throughout his quarantine, Mr. Macron — who had typical symptoms of Covid-19, such as fatigue, coughing and aches — “was able to remain mobilized on the main current affairs of our country and to hold meetings and councils as planned,” the statement read.
The statement urged members of the French public to limit their contacts and to remain vigilant by during the Christmas holidays by “ventilating rooms, wearing a mask, regularly washing hands.”
For the past week, daily updates on Mr. Macron’s condition were released to the public — by Mr. Macron himself, by his personal doctor or through official statements from the Élysée Palace — a departure from France’s tradition of secrecy around the health of its presidents.
Although it is still unclear how Mr. Macron became infected, the announcement last week that he had caught the illness prompted a cascade of leaders who had met him in the previous days to isolate themselves, including Prime Minister Pedro Sánchez of Spain; Prime Minister António Costa of Portugal; and the European Council president, Charles Michel.
With more than 60,000 deaths caused by the coronavirus and about 2.5 million Covid-19 infections reported, France has paid a heavy toll in the pandemic. While new infections had dropped below 10,000 per day by the end of November, they have recently rebounded to an average of 14,000 daily new cases over the past seven days, dashing hopes that the second wave was over.
Mexico began its coronavirus vaccination campaign on Thursday, becoming the first country in Latin America to do so, and providing a sliver of hope to the population amid a roaring resurgence of the virus.
María Irene Ramírez, 59, the head nurse at the Ruben Leñero hospital in Mexico City, was the first person in the country to get the Pfizer-BioNTech vaccine, as part of the government’s strategy to focus first on health care workers in December and January before moving on to the older Mexicans considered most at risk.
“This is the best gift that I could have received in 2020,” Ms. Ramírez said during the ceremony, which was broadcast on national television. “We are afraid, but we have to keep going because someone has to face this fight, and I am willing to continue in the line of fire.”
Latin America has become an epicenter of the pandemic, with inequality, a large informal work force, densely packed cities and a fragile health system hindering efforts to stop the spread of the virus and treat the sick.
Countries in the region, led by Brazil and Mexico, racked up some the of the world’s highest death tolls as economies crumbled under the weight of lockdowns and government mismanagement.
The first doses of the Pfizer-BioNTech vaccine also arrived in Costa Rica overnight, and Chile is expecting its first 10,000 doses vaccine on Thursday. In Argentina, the first 300,000 doses of Russia’s Sputnik V landed in Buenos Aires on Thursday morning.
The vaccination effort in Mexico is starting as a vicious new wave of the virus has packed hospitals and led authorities to call for a lockdown in the capital, Mexico City, and in four other states. More than 120,000 people have died nationwide, although limited testing means the true count could be much higher.
The massive campaign to vaccinate the United States against the coronavirus has gotten off to a slower start than federal health officials originally had hoped, but the odds are high that 100 million people will be vaccinated by March, an official said in a call with reporters on Wednesday.
As of Thursday morning, just over 1 million doses of vaccines had been administered out of the 9.5 million doses distributed across the country, according to a dashboard maintained by the Centers for Disease Control and Prevention. The first doses of Pfizer’s vaccine were given on Dec. 14, followed by the first doses of Moderna’s at the start of this week.
In recent weeks, federal officials had said they hoped for 20 million people to get their first of two required shots by the end of this year, though they walked back that target last week. On Wednesday, officials said that the federal government was still on track to make 20 million doses available to states and other jurisdictions by the end of the year, with the final deliveries of those doses coming in the first week of January.
“Exactly how fast the ramp-up of immunizations, of shots in arm, is happening is slower than we thought it would be,” said Moncef Slaoui, the scientific adviser of Operation Warp Speed, the Trump administration’s effort to fast-track the development and rollout of coronavirus vaccines.
“We’re here to help states to accelerate that appropriately,” Dr. Slaoui added.
Gen. Gustave Perna, Operation Warp Speed’s logistics lead, said that the reported figures on how many vaccines have been given likely lag the current number by 72 to 96 hours.
General Perna said that the federal government on Tuesday allocated 4.67 million more doses of vaccines — 2.67 million from Pfizer and 2 million from Moderna — and that states will be able to start ordering them on Thursday. The vaccines would then be delivered next week.
Late last week, the pharmacy giants CVS and Walgreens began a drive to vaccinate tens of thousands of nursing homes and other long-term care facilities across the country. This week, the companies are visiting 238 facilities in 12 states, and next week plan to visit an additional 1,000 facilities in 13 more states, General Perna said.
“We’re getting the vaccines out as fast as they are available,” he said.
After weeks of record case and death numbers, the United States is poised to see a steep drop in newly reported Covid-19 infections as the upcoming holidays introduce gaps in data.
Health departments in at least 15 states have said they will not publish statewide data on Christmas. Several, including Wyoming, Rhode Island and North Carolina, also plan to take off Christmas Eve. More states and counties are likely to join them.
Across the country, some testing sites will close or limit their hours, meaning fewer coronavirus cases may be identified even on days when data is reported. Winter weather has also forced some sites to close.
Heading into Christmas, there were signs that case numbers were finally leveling off after months of growth. But the picture was mixed: Progress in the Midwest and Mountain West was being offset by growth in California, Texas, Florida and the South.
It might be weeks before the country’s trendline becomes clear. The seven-day average for new cases, perhaps the best indicator of the national outlook, will be distorted by holiday reporting patterns until at least Jan. 8.
This will not be the first time a holiday has skewed the country’s data. Heading into Thanksgiving, the United States was averaging about 176,000 cases a day. But only 103,104 new infections were reported on the holiday, the lowest number in weeks. There was a slight rebound on the day after Thanksgiving, but not enough to offset a still-noticeable holiday dip in the national case curve.
This month, the data is likely to become even blurrier. While Thanksgiving was a one-day phenomenon, Christmas is followed by another holiday week.
Some states have already said they will not report new data on New Year’s Day. Michigan, and perhaps others, will also take off New Year’s Eve. Robert Gordon, the director of the Michigan Department of Health and Human Services, said public health workers had earned the time off after an exhausting year.
“They have shown incredible dedication this year and deserve a chance to rest and celebrate with their families,” Mr. Gordon said in a statement.
When Easter arrived in April, the United States was about a month into widespread shutdowns. Then, many pastors were still adjusting to pandemic restrictions, and working out the technological kinks of services streamed on Zoom or Facebook. But relatively few had been touched personally by the virus.
Now comes Christmas. Culturally, it is a time for family gatherings, cross-country travel, intergenerational gift exchanges and sprawling group meals — rituals made challenging or impossible by the pandemic. Spiritually, it’s a moment to celebrate the arrival of God in human form on earth.
“What was formerly an abstraction is now very real,” said George Williams, who will preside over Christmas Eve mass at St. Agnes Catholic Church in San Francisco.
The priest was diagnosed with the virus in June while he was serving as a chaplain at San Quentin State Prison, where more than 25 inmates died of the virus this year. Watching the virus spread through the prison was an experience of “real terror,” he said.
“How do we reconcile the hopeful theme of Christmas with the desolate year we just experienced?” Father Williams wondered. His homily at his new church on Thursday night will focus on “the heart of the Christmas message: the incarnation,” where God enters into the mortal experience of pain, grief and death.
Across the country, other Christian leaders were making similar attempts to reconcile spiritual hope and situational despair. “In my heart it really doesn’t feel like Christmas,” said Rev. James Riley, senior pastor at House of Prayer Baptist Church in Baton Rouge, La. “It’s hard to muster up that joy.”
Still, he plans to preach on God’s faithfulness even in bleak times at a brief Christmas service on Friday. Attendees will wear masks and be spaced out in the small sanctuary as they sing “Joy to the World.” Large white cardboard letters at the front of the pulpit, visible to those watching from home on Facebook, spell out “HOPE.”
Trucks began boarding ferries in Dover on Thursday to cross the English Channel for the first time in four days, a step toward ending a thousands-deep traffic jam that piled up at the border after France banned crossings from Britain to limit the spread of a coronavirus variant.
Sea, rail and air routes had been reopened more than 24 hours earlier, after London agreed to conduct virus tests for the drivers, but the backlog only began to clear on Thursday after the British authorities set up screening and started clearing the healthy to travel.
Members of the British military were dispatched to help test the thousands of drivers.
The magnitude of the task meant that movement remained slow on Thursday morning. It could take days to fully clear the logjam, officials said, meaning that many drivers were unlikely to make it home for Christmas Day.
Hordes of drivers have been left stranded after the border’s abrupt closure, leaving them with nowhere to go and little access to food or public facilities. Many have been forced to sleep in their rigs for several nights, and even with the route open, exasperation was on show on Thursday, with some truckers spelling out the word “HELP” with traffic cones, according to a picture in The Guardian.
“It’s like a horror movie,” said Ravinder Singh, chief executive of Khalsa Aid, which has been distributing meals to drivers stuck on the highway. “For them it’s a prison: They can’t go anywhere,” he added.
About 6,000 trucks remained stuck in Dover and on the approach to the port on Thursday, with 4,000 of them parked at a disused airport that has been turned into a holding area, the BBC reported.
The government in Kent, the county that includes Dover, has been working with aid organizations to provide food and water to drivers. Supermarkets and local businesses in the southeast of England have also made donations, council officials said, adding that more portable toilets had also been installed along the highway.
Roger Gough, the leader of the Kent council, said in a statement that he hoped the situation would steadily improve.
“I have, however, deep sympathy for those for whom this will come too late to spend Christmas with their families,” Mr. Gough said.
In other developments around the world:
Austria allowed ski hills to open on Thursday, but required all skiers age 14 and older to wear respirator masks in public areas and while riding gondolas. Hotels, restaurants and bars remain closed. Austria is easing its lockdown for the Christmas holiday starting Thursday, lifting a nightly curfew and allowing up to 10 people from 10 different households to meet. On Saturday, restrictions will tighten again through mid-January. The country of 8.8 million people recorded 2,131 new cases of infection on Thursday.
China will suspend direct flights to and from Britain indefinitely over concerns of the infectious variant spreading there, a Foreign Ministry spokesman said on Thursday. China has barred nonresident travelers from Belgium, Britain, France, India and the Philippines since November, but kept its borders open to Chinese nationals, including students studying in those countries.
Prime Minister Ana Brnabic of Serbia received the country’s first Covid-19 vaccine on Thursday, Reuters reported, kicking off a mass inoculation drive. Some 4,875 doses of the Pfizer-BioNTech vaccine were flown in on Tuesday, making Serbia the first Balkan nation to acquire shots. Ms. Brnabic said the country was also expecting shipments of China’s Sinopharm and Russia’s Sputnik V vaccines, and that President Aleksandar Vucic would most likely get the Sinopharm vaccine. “We agreed that the two us take shots from different producers,” she told reporters.
European Union member nations are set to begin vaccinations on Sunday. In France, where the National Authority for Health approved the Pfizer-BioNTech vaccine, the authorities have ordered about 200 million doses and have outlined a three-phase vaccination strategy, starting with retirement homes and hospitals. Spain’s first Covid-19 vaccination is to take place on Sunday in a nursing home in the central city of Guadalajara.
Melissa Eddy, Tiffany May, Raphael Minder, Constant Méheut and Eshe Nelson contributed reporting.
Scientists in Nigeria have discovered that two patients in the country were infected with a coronavirus variant sharing one change in common with the British lineage that has raised international concern.
However, unlike in Britain, there is, as of yet, no evidence to indicate that the Nigerian variant may be contributing to increased transmission. Nigerian scientists began their analysis after learning of the British variant.
The genetic sequences of viruses normally evolve as they pass through individuals and the population. The single mutation noted in Nigeria appears to have arisen separately from the British lineage and was found in two samples, one taken in August and the other in October. It is of interest because it occurs in a region of the genome that contains the genetic code for the portion of the virus that attaches to human cells, known as the spike protein.
“There’s a potential to change the structure of the protein,” said Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases in Ede, Nigeria, and an author of a paper, not yet peer-reviewed, describing the variant. “That’s what becomes biologically relevant.”
The genomics center, launched in 2014, is helping expand the use of molecular tools to fight infectious diseases on the African continent.
The variant in Nigeria does not share any of the worrisome mutations found in a variant that is now circulating widely in South Africa. Scientists have found preliminary evidence that may link this variant to increased transmissibility and viral loads. South African health officials have warned the public that coronavirus infections are spreading exponentially, and that they are expected to soon exceed the country’s first wave.
The Africa Centers for Disease Control and Prevention convened an emergency meeting on Monday to discuss the newly discovered British and South African variants, recommending against additional travel and trade restrictions.
“What we should focus on is really the measures that are in place to prevent transmission of Covid, not a specific variant,” Dr. John Nkengasong, the Africa C.D.C. director, said at a news conference.
When six-year-old Callum Thornhill heard that Pfizer had developed a coronavirus vaccine, he wrote to the company with an urgent request: to prioritize Santa Claus.
His mother, Paula Linehan, told the Irish Examiner that her son had heard about the vaccine on the car radio on the way to school in early November. When he got home from school that day, he wrote a letter to Pfizer congratulating the company.
“Dear Pfizer,” the letter began. “I heard you made a new vaccine for coronavirus. Good job.”
He continued: “Can you please send some to the North Pole for Santa and his elves? Please.”
Several weeks later, Callum received a response — from Pfizer’s chief executive, Albert Bourla, according to the Irish Examiner.
“Letters like these — from children brimming with compassion and hope — remind us of why the work we do every day is so important,” Mr. Bourla wrote on LinkedIn.
To Callum, he said: “I want you to know that we are doing everything we can to help bring hope to people around the world. And we will make sure to take care of Santa and his elves, too.”
The European Union approved the Pfizer-BioNTech vaccine on Monday, and member states are expecting to receive their first batches next week. The vaccine rollout comes as European leaders are struggling to contain a deadly second wave of the virus by tightening lockdown measures, including over Christmas.
More than 50 governments, including Ireland, shut down travel from Britain after British authorities said a new, highly transmissible variant of the virus was spreading rapidly in London and southeastern England.
Coronavirus: Then & Now
As 2020 comes to a close, we are revisiting subjects whose lives were affected by the pandemic. When Elizabeth Dias first spoke with Father Ryan Connors this past spring, he was among 21 priests in the Boston area appointed to administer last rites at hospitals to patients dying of Covid-19.
When Covid cases first spiked this spring, Father Ryan Connors went to hospitals almost every day, sometimes more, to anoint the dying with oil as part of the old Roman Catholic ritual known as last rites.
At the time, few hospitals allowed priests to visit the dying. But in Boston, Fr. Connors, 37, was part of a small team of 21 priests specially trained to safely anoint Covid-19 patients. For three months he lived in quarantine with two other priests, leaving only to go to the hospital.
But he does few anointings now. As time went on, and more PPE became available, many hospitals began to loosen restrictions. His special posting ended this summer, and he resumed his role teaching seminarians.
Still, older priests continue to call younger priests like him to anoint Covid-positive congregants, to protect priests more at-risk, he said.
This Christmas, he is back at a home parish in Rhode Island.
“It is a typical spiritual practice to look back and try to be grateful for what God has given you during that time,” he said. “Even if there are a lot of challenges, what are the things to be grateful for?”
He thought of his new friendships with the two other priests in his quarantine, how they prayed together and supported one another as they lived an almost monastic life with one intense purpose. He remembered the people he anointed hours before their deaths, and the gift of offering the sacrament to them.
This year for his Christmas homily, he hopes to track down a sermon that Saint Charles Borromeo preached the Christmas of 1576, the year a plague ravaged the city of Milan.
“The church has lived through pandemics before and had to figure out a better way to bring the sacrament to people,” he said. “Wherever people are who are suffering and dying, the Lord is with them.”