The first shots were given in the American mass vaccination campaign on Monday morning, opening a new chapter in the battle against the coronavirus pandemic, which has killed more people in the United States than in any other country.
Shortly after 9 a.m. on Monday, the first known clinically authorized vaccination took place in Long Island Jewish Medical Center in Queens. The pandemic has scarred New York State profoundly, leaving more than 35,000 people dead and severely weakening the economy.
“I believe this is the weapon that will end the war,” Gov. Andrew M. Cuomo said Monday morning, shortly before the shot was given to Sandra Lindsay, a critical care nurse at the center. State officials said the shot was the first to be given outside of a vaccine trial in the United States.
Ms. Lindsay, who has treated patients throughout the pandemic, said that she hoped her public vaccination would instill confidence that the shots were safe.
“I have seen the alternative, and do not want it for you,” she said. “I feel like healing is coming. I hope this marks the beginning of the end of a very painful time in our history.”
President Trump posted on Twitter: “First Vaccine Administered. Congratulations USA! Congratulations WORLD!”
Shortly afterward, Mayor Bill de Blasio of New York City said at a news conference: “To me, we were watching an incredibly historic moment, and the beginning of something much better for this city and this country.”
In Iowa City, Iowa, David Conway, a 39-year-old emergency room nurse, received the vaccine, and in Columbus, Ohio, Dr. Mark Conroy, 41, an emergency medicine physician, did, too.
“It was pure excitement on my part,” said Dr. Conroy, the medical director of the emergency department at Ohio State University Hospital, who added that he had lost friends to the virus.
The vaccinations started after the Food and Drug Administration’s emergency authorization of the Pfizer-BioNTech vaccine on Friday night, and as the U.S. coronavirus death toll approaches 300,000, with a steady surge in new cases daily.
On Sunday, trucks and cargo planes packed with the first of nearly three million doses of coronavirus vaccine had fanned out across the country, as hospitals in all 50 states rushed to set up injection sites and their anxious workers tracked each shipment hour by hour. But the rollout is less centralized in the United States than in other countries that are racing to distribute it.
Across the country, according to Gen. Gustave F. Perna, the chief operating officer of the federal effort to develop a vaccine, 145 sites are set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday.
A majority of the first injections given on Monday are expected to go to high-risk health care workers. In many cases, this first, limited delivery would not supply nearly enough doses to inoculate all of the doctors, nurses, security guards, receptionists and other workers who risk being exposed to the virus every day. Because the vaccines can cause side effects including fevers and aches, hospitals say they will stagger vaccination schedules among workers.
Residents of nursing homes, who have suffered a disproportionate share of Covid-19 deaths, are also being prioritized and are expected to begin receiving vaccinations next week. But the vast majority of Americans will not be eligible for the vaccine until the spring or later.
In an interview with MSNBC on Monday, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, laid out a timeline for a return to normalcy that stretched well into 2021. He stressed that until then, social distancing and masks will remain crucial in the fight to stop the spread of the virus.
He predicted that the average person with no underlying conditions would get the vaccine by the end of March or beginning of April. If the campaign is efficient and effective in convincing people to get the vaccine, most people could be vaccinated by late spring or early summer, he said.
“I believe we can get there by then so that by the time we get into the fall, we can start approaching some degree of relief, where the level of infection will be so low in society we can start essentially approaching some form of normality,” he said.
Until then, he stressed, the standard public health measures — distancing, masks, avoiding indoor gatherings — remain necessary.
“A vaccine right now is not a substitute for the normal standard public health measures,” he said, adding, “It’s not a substitute. It complements it. Only when you get the level of infection in society so low that it’s no longer a public health threat, can you then think about the possibility of pulling back on public health measures.”
On Monday afternoon at George Washington University Hospital, five of the first vaccinations are scheduled to take place at what the Department of Health and Human Services is calling a national ceremonial “kickoff event.”
The five people were selected by an algorithm the hospital is using to assign the first doses, the result of a survey hospital employees filled out that asked about age, underlying medical conditions and the risk they carry in their jobs, according to a federal health official familiar with the planning who was not authorized to speak publicly. The event is intended to demonstrate the way many health workers will be vaccinated this week, the official said.
The kickoff is part of what the official said will be a series of vaccination events featuring top health officials.
The moves come just six days after Britain became the first nation in the world to begin rolling out a fully tested vaccine. Since then, a handful of other nations have approved the same vaccine. In Canada, the first shipments of the Pfizer-BioNTech vaccine arrived on Sunday, Prime Minister Justin Trudeau announced on Twitter, and the first shots could be given as early as Monday. Among the first to receive the vaccine will be residents of nursing homes in Quebec and frontline health workers in Toronto.
Monday marked a turning point after so many months of misery for frontline health care workers as they began to receive the first clinically authorized vaccinations as part of America’s mass vaccination campaign.
“I’m so ecstatic,” said Angela Mattingly, a housekeeper at the University of Iowa Hospital, in Iowa City, who has been cleaning the rooms of people with Covid-19 since the beginning of the pandemic. “This is the marking of getting back to normal.”
On Monday morning, Ms. Mattingly was fifth in line as shots were dispensed. She was told to wait for 15 minutes in case she had an adverse reaction, and then headed back downstairs to finish her shift.
Many Americans breathed a sigh of relief as TV screens that for so long recounted the rising toll were filled with images of supply trucks fanning out and doses being administered.
In Ohio, pharmacists were greeted with cheering and applause as they carried in doses for about 30 physicians at Ohio State University’s Wexner Medical Center.
Dr. Mark Conroy, 41, the medical director of the Ohio State University Hospital emergency department, was one of the first to receive the vaccine.
“It’s been a long 10 months of work and protecting ourselves and protecting our patients, and so to have the opportunity to be a little bit safer going forward means a lot to me,” said Dr. Conroy, who said he had been anxious about the prospect of bringing the virus home to his family.
He added that he would continue to wear a mask and practice social distancing.
“We still are learning a lot about how this vaccine works and how people respond to it,” he said, “so I certainly don’t want to take any chances and see myself get sick.”
In Kentucky, Dr. Jason Smith, the chief medical officer at University of Louisville Health, was the first person in the state to receive the vaccine.
“Didn’t even feel it,’’ Dr. Smith said, laughing as a health care worker applied a smiley face Band-Aid to his arm.
President Trump said on Sunday night that he would delay a plan for senior White House staff members to receive the coronavirus vaccine in the coming days.
The shift came just hours after The New York Times reported that the administration was rapidly planning to distribute the vaccine to its staff at a time when the first doses are generally being reserved for high-risk health care workers.
Mr. Trump, who tested positive for the coronavirus in October and recovered after being hospitalized, also implied that he would get the vaccine himself at some point in the future, but said he had no immediate plans to do so.
“People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary,” Mr. Trump tweeted, hours after a National Security Council spokesman had defended the plan. “I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!”
It was not immediately clear why Mr. Trump decided to change the policy, or whether he had even been aware of it ahead of time. But White House staff members who work in close quarters with him had been told that they were scheduled to receive injections of the coronavirus vaccine soon, two sources familiar with the distribution plans said.
The goal of distributing the vaccine in the West Wing was to prevent additional government officials from falling ill in the final weeks of the Trump administration. The hope was to eventually distribute the vaccine to everyone who works in the White House, one of the people said.
It was not clear how many doses were being allocated to the White House or how many were needed, since many staff members had already tested positive for the virus and recovered. While many Trump officials said they were eager to receive the vaccine and would take it if it were offered, others said they were concerned it would send the wrong message by making it appear as if Trump staff members were hopping the line to protect a president who has already recovered from the virus and bragged that he is now “immune.”
IOWA CITY, Iowa — The vaccine arrived at the University of Iowa Hospital at 7:30 a.m. in a refrigerated FedEx truck, and it was not long before the first dose was injected into the arm of David Conway, 39, an emergency-room nurse.
“I am not nervous, I am very excited,” he said afterward. “I have been looking forward to the vaccine since March.”
Mr. Conway, who works directly with Covid-19 patients, said the shot was painless, but he was getting it at the start of a few days off, just in case there are any short-term side effects. Some recipients in clinical trials have reported feeling ill for a day or two, and Mr. Conway is not due back at work until Saturday.
“I look forward to when my wife and children can get the vaccine,” he said.
The hospital expects to vaccinate 130 people on Monday and keep going until it has used all 975 doses in the shipment, according to the hospital’s chief executive, Suresh Gunasekaran. Each recipient is observed for 15 minutes afterward to watch for allergic reactions.
Mr. Gunasekaran said the hospital wants to eventually vaccinate all 17,000 of its employees, but does not yet know when its next shipment will arrive from Pfizer. When a similar vaccine from Moderna is authorized, he said, the hospital expects to have access to many more doses.
Mr. Conway wore street clothes, a mask and plastic face shield, and said getting the shot was no reason to stop wearing a mask, washing hands frequently or maintaining social distance. “I won’t do anything different until everyone is vaccinated,” he said.
The New Zealand government intends to establish a travel bubble with Australia in the first quarter of next year, Prime Minister Jacinda Ardern announced on Monday.
The arrangement would allow people to travel freely between Australia and New Zealand without needing to quarantine for two weeks on arrival. Passengers arriving from New Zealand are already exempt from quarantine requirements in Australia.
The travel bubble was “pending confirmation” from Australian officials, Ms. Ardern said during a news conference, and would be contingent on “no significant changes in the circumstances of either country.”
New Zealand, population about five million, has managed to avoid the worst of the pandemic, with 2,096 cases and 25 lives lost, according to a New York Times database. In Australia, which has a population of about 25.5 million, 28,031 people have tested positive for the coronavirus, while 908 have died.
The governments of New Zealand and Australia announced in May that they had reached a formal agreement to form a travel bubble as soon as it was safe to do so. But surges in new cases, most notably in Victoria, Australia, left the plans suspended.
Here’s what else to know in coronavirus news from around the world:
Officials in South Korea have ordered schools in the Seoul metropolitan area to move all classes online starting Tuesday until at least the end of the year. Additional measures may be announced this week as the country struggles to contain its worst outbreak yet. South Korea, which has a population of about 50 million, reported 718 new cases on Monday, down from a record 1,030 the day before.
Japan is also struggling with an uptick in coronavirus cases and will hit pause on a nationwide campaign to encourage travel and tourism. With hospitals under increasing pressure from a recent, steady growth in new infections, the program, called “Go To Travel,” will be halted from Dec. 28 through at least Jan. 11, covering the most important holiday of the calendar, New Year’s, when many people travel home. The program had provided substantial discounts to consumers to encourage them to support the country’s beleaguered tourism and service sectors.
The Netherlands will lock down for at least five weeks to limit the spread of the virus, Mark Rutte, the prime minister, announced in a national address. The measures include the closure of schools, gyms, non-essential businesses, theaters and more until January 19. Medical offices will be allowed to stay open.
Singapore on Monday became the first Asian country to approve a coronavirus vaccine made by the American drug maker Pfizer, announcing that the first shipment would arrive this month and be given free to Singaporeans and long-term residents. Singapore has also agreed to buy vaccines from the American drug maker Moderna and the Chinese company Sinovac. “If all goes according to plan, we will have enough vaccines for everyone in Singapore by the third quarter of 2021,” Prime Minister Lee Hsien Loong said in an address to the nation.
Officials in Germany urged the public to not rush to stores to finish their Christmas shopping this week, as all but those selling essential goods prepared to close on Wednesday amid a heightened lockdown. Germany announced the stricter measures on Sunday after weeks of a partial lockdown that kept both schools and shops open but failed to adequately tackle the surging numbers of new coronavirus cases.
Austria wrapped up its first nationwide mass coronavirus testing on Sunday, turning up about 4,200 apparently symptomless infections. Slightly less than a quarter of the country’s population took part in the free screening, available to anyone more than 6 years old who had not been sick in the past three months. Rudi Anschober, the Austrian health minister, called it “not just a good start, but a successful step in containing the pandemic in Austria.”
The European Union launched a mobile app on Monday aimed at facilitating safe travel between its 27 member countries, as well as to Iceland, Liechtenstein, Norway and Switzerland, which belong to the bloc’s Schengen zone. The app, called Re-open EU, is intended to help residents of Europe navigate a patchwork of different national restrictions, as well as quarantine and testing requirements, and was introduced ahead of the busy holiday season.
Jennifer Jett, Ben Dooley and Monika Pronczuk contributed reporting.
There has never been a Monday quite like this one — an unmistakable, if unpredictable, coinciding pivot for the presidency and a pandemic that has killed nearly 300,000 Americans.
State by state, the typically unobserved clockworks of American democracy began to click into place as electors ratified the victory of the 46th president of the United States, Joseph R. Biden Jr., despite attempts by the 45th president to subvert the results by strong-arming local Republicans to overturn the will of voters.
Around 10 a.m. Eastern, electors in Indiana, New Hampshire, Tennessee and Vermont had gathered for the formal process of affirming Mr. Biden’s clear national victory. There was no doubt about the outcome — despite President Trump’s efforts to encourage the belief that there was — and the president-elect was expected to pass the necessary threshold by early evening.
In a sign of a new abnormal ushered in by Mr. Trump’s behavior, electors in some states have had to deliberate in tight security, sometimes in out-of-the-way locations, after they have been threatened for simply doing their constitutional duty.
At the same time, other machinery — more industrial than ceremonial — was set into motion as the first batches of Pfizer’s coronavirus vaccine, which left a plant in Michigan Sunday evening to the cheering of onlookers, began arriving in virus-ravaged cities around the country.
Federal officials said 145 sites were set to receive the vaccine on Monday, 425 on Tuesday and 66 on Wednesday. A majority of the first injections are expected to be given to high-risk health care workers on Monday, although the relatively small amount of vaccine delivered will fall short of offering protection to all those who are eligible to get it.
But it could signal the beginning of the end.
On Monday, Dr. Anthony S. Fauci, who will continue on as a central federal architect of the virus response under Mr. Biden, said he believed most Americans who wanted the vaccine could probably get it by later March or early April.
In an interview with MSNBC, Mr. Fauci said that plans to vaccinate Mr. Biden were “under discussion” amid reports that White House officials had planned to vaccinate top-level Trump administration officials.
Mr. Trump, whose efforts to downplay the severity of the pandemic were a focus of the election, began the day, as he often does lately, posting a tweet laden with falsehoods about the “Rigged Election.” The message was flagged by the social media platform.
Yet, the president, who remains eager to take credit for the unprecedented scientific effort to rush the development of the vaccine, could not deny himself a victory lap on the day his political defeat was to become formal.
“First Vaccine Administered. Congratulations USA! Congratulations WORLD!” he wrote.
Adding an arthritis drug called baricitinib to Covid-19 treatment regimens that include the antiviral drug remdesivir might shave a day or more off recovery times, especially for those who are seriously sick, according to a study published on Friday.
The findings of a government-sponsored clinical trial were made public more than three weeks after the Food and Drug Administration issued an emergency use authorization for the dual treatment.
Earlier this month, some experts said they were uncomfortable deploying drugs without the opportunity to vet the underlying data supporting their performance. Last month, the World Health Organization also recommended against remdesivir as a treatment for Covid-19 patients because evidence supporting its use was lacking.
Limited results earlier were announced via news releases, showing that hospitalized patients treated with baricitinib and remdesivir recovered one day faster than those who had received remdesivir alone.
Some questioned adopting the combination treatment given baricitinib’s hefty price tag — which may be about $1,500 per patient — and also cited side effects like blood clots. Several doctors also wondered whether adding baricitinib would be worthwhile because steroids like dexamethasone were cheap and widely available. Both baricitinib and dexamethasone are thought to act by tamping down excessive inflammation, which drives many severe cases of Covid-19.
The new paper, published in the New England Journal of Medicine, adds some granularity to the findings, showing that certain groups of patients benefited from the addition of baricitinib far more than others.
The trial enrolled more than 1,000 hospital patients with Covid-19, all of whom received remdesivir. People who were sick enough to require a high dose of supplemental oxygen or a noninvasive form of ventilation recovered eight days faster when baricitinib was included in their drug regimen.
By Sunday, deaths from the coronavirus were approaching 300,000 in the United States, a toll comparable to losing the entire population of Pittsburgh or St. Louis. Reports of new deaths have more than doubled in the last month to an average of nearly 2,400 each day, more than at any other point in the pandemic.
The deaths have been announced in the traditional fashion, in obituaries and notices on websites and in newspapers that have followed the same format for decades, noting birthplaces, family members, jobs and passions.
But in recent months, as the death toll from the coronavirus in the United States grows steadily higher, families who have lost relatives to the disease are writing the pandemic more deeply into the death notices they submit to funeral homes and the materials they share with newspapers’ obituary writers.
They are including pleas for mask wearing, rebuking those who believe the virus is a hoax, and describing, in blunt detail, the loneliness and physical suffering that the coronavirus inflicted on the dying.
Lida Barker, 92, a longtime resident of Gary, Ind., died on Nov. 20 after contracting the coronavirus in the nursing home where she lived. Her death devastated her children, three sisters who met on a Zoom call to write the obituary in the days after she died.
They wrestled with the wording of a mention of the coronavirus, settling on this: “In her memory, please wear a mask in public and take Covid-19 seriously. It is real; it hastened her death.”
Over decades, families have often declined to write in an obituary how their relative died when there was anxiety or fear attached to the cause, whether it was AIDS, an opioid overdose or suicide. But as the public has grown more aware of once-unfamiliar infectious diseases, mental illness and drug addiction, the tendency to conceal has slowly given way to candor.
And with funeral services postponed, and burials often happening without public eulogies or words spoken in memory, the obituary has taken on heightened importance, the family’s turn to deliver their own unfiltered message to the community.
Less than a week after Britain began to introduce the Pfizer-BioNTech coronavirus shot — becoming the first nation in the world to administer a fully tested vaccine to the public — primary care doctors in England will begin offering doses to their patients.
Beginning on Monday, the shots will be delivered to more than 100 vaccination centers in villages, towns and cities by groups of doctors, the National Health Service said. The injections will still be prioritized, with the staff and residents of nursing homes and those aged 80 and over among the first in line as the country expands its program.
The physicians, known in Britain as general practitioners, face an “enormous challenge” to implement the mass vaccination program while also offering their usual services for patients, Prof. Martin Marshall, chairman of the Royal College of General Practitioners, said in a statement.
But the primary care doctors take a major role in administering other vaccines, such as those for seasonal flu, and Professor Marshall said, “We want to use this experience to help protect people from Covid-19 and start getting life back to normal again.”
Tens of thousands of vaccinations have already been given since the campaign began last Tuesday in hospitals around Britain. But the country received an initial batch of just 800,000 doses — or enough to vaccinate 400,000 people, because each person requires two doses — and it is still unclear when more will become available. Britain has a population of about 66 million.
Vaccinations will also begin in nursing homes later this week, the health service said, after stringent policies around the delivery of the doses were finalized. More doctors and pharmacies in the country will join the program “on a phased basis” over the next few months, the health service added, urging patients not to request the vaccine because doctors would directly contact those in priority groups to offer them the shot.
The vaccine program comes as cases continue to surge in Britain, with 18,447 new infections reported on Sunday and 144 deaths according to a Times database. The nation has reported about 1.8 million total cases and some 64,000 deaths since the pandemic began.
As the need for social distancing forces governments around the world to reduce public transportation service, city dwellers are hopping on bikes instead. Global bicycle sales have surged to the point where even Giant, the world’s largest bike maker, has struggled to fill orders.
In Manila, the cycling surge is notable because the Philippines has not only one of the highest numbers of coronavirus infections in Asia — more than 445,000, according to a New York Times database — but also some of the region’s worst urban congestion.
Last year, a study by the Asian Development Bank found that metro Manila, an area roughly six times the size of Paris, was the most congested of 24 cities that it surveyed across South and Southeast Asia. Japan’s development agency estimates that the cost of traffic to Manila’s economy is more than $72 million, or 3.5 billion Philippine pesos, a day.
Metro Manila was closed in March as part of a wider lockdown of Luzon, the country’s most populous island, imposed by President Rodrigo Duterte. When stay-at-home orders began to lift a few months later, public transit was still operating at limited capacity.
Some bus and train commuters started driving instead. But for many Manila residents, walking or cycling became their only means of getting to work.
Biking on Manila’s snarled, potholed roads can be hazardous, in part because some drivers regard cyclists as obstacles. Sidewalks, too, are often clogged with street vendors and makeshift parking areas. The Manila metropolitan area had 19 bicycle-related fatalities last year, according to official figures. By comparison, New York officials counted 28.
The government has been gradually easing restrictions on public transit in metro Manila since June. But by now, many commuters are hooked on cycling, and some downtown streets where vendors once sold vegetables and electronics are filled with bikes and accessories for sale.
The biking boom prompted Philippine officials to announce a plan in August to build a 400-mile bike lane network that would be financed through a pandemic-related stimulus fund.
A surge in coronavirus infections prompted Gov. Andrew M. Cuomo to announce a ban on indoor dining in New York City restaurants, which goes into effect on Monday. Now, thousands of restaurants face an uncertain future as they brace for brutal winter months that could reduce business to new lows.
Restaurants across the city are moving to lay off waiters, servers and bartenders, throwing the workers’ lives in turmoil and presenting a new setback in New York’s economic recovery. Some restaurants will shut entirely for the season.
“Shutting indoor dining in the winter, when outdoor dining is less feasible, presents an extraordinarily challenging financial situation,” said Andrew Rigie, the executive director of the New York City Hospitality Alliance. He added that many have fewer resources than they did in the pandemic’s early months.
Even though he was optimistic about vaccinations, Mayor Bill de Blasio warned that the city still had difficult weeks and months ahead as it faces a second wave of the pandemic. On Monday, he reported a seven-day average positive test rate of 5.5 percent and an average hospitalization rate of 2.73 per 100,000 people.
Mr. Cuomo has said that the city’s hospitalization numbers were currently increasing at a rate that could lead to another shutdown of nonessential businesses. In an interview Friday, he said the city could see a broad shutdown “within a month.”
On Monday, Mr. de Blasio cited the governor’s comments and advised New Yorkers to prepare for that possibility.
“We need to recognize that that may be coming,” he said of a shutdown, “and we’ve got to get ready for that now.”
A survey from the New York State Restaurant Association of 6,000 restaurant operators in the state found that more than half said it would be unlikely their restaurants would still be in operation in six months without any government aid. The survey found 78 percent expected more layoffs over the next three months.
Serving customers at a reduced capacity provided a “sense of normalcy” for many restaurants, but it did not come close to making up for the amount of business lost in the pandemic, said Jonathan Forgash, the executive director of Queens Together, a restaurant group.
Sisay Kassa, the owner of Lalibela Ethiopian Restaurant in Harlem, said: “Nobody is going to make a profit right now. It’s just surviving.”