Nations Move to Isolate U.K. Over Virus Variant

The Moderna Covid-19 vaccine arrived at sites across the country Monday. Yanitza Reeves, a medical worker, received one of the first doses at Christ Hospital in Jersey City, N.J.
Credit…Bryan Anselm for The New York Times

Just one week after the first doses of a coronavirus vaccine were administered in the United States, a new batch of vaccines fanned out across the country on Monday, an urgently needed expansion of a vaccination effort that is expected to reach vulnerable populations and rural areas where hospitals are strained as soon as this week.

The vaccine, from Moderna, comes as the virus continues to spread virtually unabated: hospitalizations are over 115,000 for the first time, according to the Covid Tracking Project. Parts of California are down to their last I.C.U. beds and almost one-fifth of U.S. hospitals with intensive care units reported that at least 95 percent of their I.C.U. beds were full in the week ending Dec. 17. Nationwide, 78 percent of I.C.U. beds were full on average.

On Monday, confirmed cases in the country reached 18 million, just five days after surpassing 17 million on Dec. 16. The growth in cases appears to be leveling off: It took five days for the nation to go from 15 million to 16 million cases and then another four days to reach 17 million.

The total number of new cases on Monday was at least 201,720, with at least 1,960 new deaths.

And with Christmas and New Year’s on the near horizon, health officials fear that more travel will push those numbers even higher. More than a million travelers a day passed through American airport security checkpoints on each of the last three days, a spike in holiday travel that comes despite warnings from the Centers for Disease Control and Prevention.

Roughly six million doses of the newly authorized Moderna vaccine are being shipped to more than 3,700 locations around the country this week, adding to the nearly three million doses of the Pfizer-BioNTech vaccine that were dispatched mostly to health care workers starting last week. According to the Centers for Disease Control and Prevention, 614,117 doses had been administered as of Monday morning.

The Moderna vaccine, which can be stored in a normal freezer and comes in a smaller number of units than the Pfizer-BioNTech vaccine, offers particular hope for rural hospitals, which often do not have the ultracold equipment or staffing numbers to handle the Pfizer-BioNTech shipments. That vaccine requires an exceptionally low storage temperature of negative 70 Celsius and comes in units of 975 doses.

Many of the first vaccine shots went to health care workers. Joining them Monday were residents and staff members of hard-hit nursing homes, set to begin inoculating their residents through Walgreens or CVS this week, part of a deal struck with the federal government. These facilities have felt the brunt of the pandemic: At least a third of the nation’s deaths have been reported in nursing homes and long-term-care facilities, and many residents have been isolated from loved ones for much of the year.

OhioHealth, a hospital system in Columbus, Ohio, received 10,400 doses of the Moderna vaccine in ice-packed cardboard boxes on Monday. The hospital had already received nearly 2,000 doses of the Pfizer-BioNTech vaccine, and Dr. Joseph Gastaldo, an infectious disease specialist, rolled up his sleeve to get a dose of that vaccine on Monday morning. Not long afterward, he got the news that the Moderna shipment had arrived.

“We are all really exhausted both physically and mentally,” said Dr. Gastaldo, who said he asked to keep an empty vial of his vaccine as a keepsake. “Having everyone rally around being vaccinated offers a glimmer of hope.”

More than 70 rural hospitals in Texas are expected to receive the Moderna vaccine and start offering doses as soon as Tuesday.

“The burden is worse than it’s been in nine months,” said John Henderson, the chief executive of the Texas Organization of Rural & Community Hospitals. “Their staff is completely worn out,” he said. “The vaccine is the only optimistic news we’ve had in a few months.”

The Oregon State Hospital, a psychiatric hospital in Salem, also received its first shipment of the Moderna vaccine, and will begin vaccinating staff and patients next Monday, said Rebeka Gipson-King, hospital relations director.

Since the beginning of the pandemic, 11 patients and 65 staff members have tested positive for the virus at the state hospital. The hospital houses 579 patients on two campuses, and the pandemic has made many feel more isolated, said Ms. Gipson-King.

“This is a really big deal for us,” she added. “Just like everybody, the people who we serve at the state hospital, their lives have been disrupted.”

United States › United StatesOn Jan. 21 14-day change
New cases 190,630 –21%
New deaths 4,142 +11%

World › WorldOn Jan. 21 14-day change
New cases 663,029 –5%
New deaths 16,819 +21%

Where cases per capita are

The closed port at Dover, England, on Monday evening.
Credit…Andrew Testa for The New York Times

More than 40 governments have barred travelers from Britain, suspending flights and cutting off trade routes in scenes reminiscent of the frenzied early days of the pandemic.

The disruptions caused by the closing of borders stoked fears of panic buying in British supermarkets, as Britons, already rattled by a surge in infections and a hastily imposed lockdown in much of England, worried about running out of fresh food in the days before Christmas.

The current upheaval over the virus mutation grew after Prime Minister Boris Johnson of Britain said that it had been shown to be 70 percent more contagious than other variants. The 70 percent estimate of greater transmissibility is based only on modeling and has not been confirmed by lab experiments, said Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government. British officials said there was no reason to believe that the new variant caused more serious illness.

But the statistic raised alarm around the world. France imposed a 48-hour suspension of freight transit across the English Channel, leaving thousands of truck drivers stranded in their vehicles on Monday as the roads leading to England’s ports were turned into parking lots. Officials were working on Tuesday to end the impasse.

Austria, Belgium, Bulgaria, France, Germany, Ireland, Italy, the Netherlands and Poland are among the European nations that have announced restrictions on travel.

On Monday, the German authorities formalized a ban on planes, trains, buses and ships entering from Britain and South Africa, where a similar variant has emerged, until Jan 6. It will stay in place until more emerges about the virus mutations, said Jens Spahn, the German health minister. Some exceptions would be made for returning crews and freight shipments.

Spain announced that only citizens and residents would be allowed to fly into the country from Britain, and it implemented tighter border checks with Gibraltar, the British territory located at the southern tip of Spain. Greece has extended to 10 days the quarantine period for travelers flying in from Britain, a day after raising it to seven days, but has not suspended flights.

Israel is essentially closing its skies to most foreign nationals starting Wednesday afternoon. Saudi Arabia announced a one-week ban on all international travel, according to the Saudi Press Agency. Kuwait on Monday evening suspended all commercial international flights and closed its land and sea borders until Jan. 1.

In the Asia-Pacific region, South Korea announced it was suspending flights with Britain through the end of the year and Japan said travelers from the U.K. would barred starting Thursday. Hong Kong on Monday closed its borders to all travelers from Britain, including Hong Kong residents. India has suspended all flights between India and Britain until Dec. 31.

On Tuesday, Singapore said it would tighten its border restrictions starting Thursday, while the government of Fiji said all inbound passenger flights would be suspended starting Thursday until at least Dec. 28, citing the British variant.

In South America, Argentina and Colombia canceled flights to and from Britain and imposed a quarantine for travelers who had been there. Peru suspended all flights originating in Europe for two weeks and suspended indefinitely all flights from Britain, including those with layovers in the country. El Salvador enacted restrictions on entry for people who in the last 30 days had been to Britain or South Africa, where a different variant is also driving a new wave of infections.

Starting on Tuesday, Chile banned nonresident foreign nationals who have been in Britain in the last 14 days and suspended flights to and from the country.

Canada, Iran and Russia also issued new restrictions.

In the United States, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, told CNN that he would advise against suspending flights from Britain, but that officials should watch the variant closely.

“Follow it carefully, but don’t overreact to it,” he said.

The new variant, first detected several months ago, spread through southeastern England and has also been identified in small numbers in Denmark, the Netherlands and Australia, according to World Health Organization officials.

Reporting was contributed by Dan Levin, Marc Santora, Aurelien Breeden, Tiffany May, Juliana Kim, Raphael Minder, Marie Fazio, Christopher F. Schuetze, and Isabella Kwai.

A British Airways flight arrives in New York from London on Monday.
Credit…Eduardo Munoz/Reuters

Alarmed by the coronavirus variant spreading in Britain, Gov. Andrew M. Cuomo of New York announced on Monday that British Airways, Virgin Atlantic and Delta Air Lines have agreed to require a negative coronavirus test result from passengers boarding flights from Britain to New York.

Gov. Jay Inslee of Washington State ordered on Monday that travelers from Britain and South Africa undergo a 14-day quarantine. He said more countries may be added to the travel proclamation.

Mr. Inslee said he was hopeful that the rules would help limit the spread of the mutation and said acting quickly was needed to make the effort successful. Mr. Inslee said the virus mutation was a warning that the nation is perhaps months away from the worst of the pandemic being over. “It is a vivid reminder of the uncertainties and unpredictability of this pandemic,” Mr. Inslee said.

The governors were taking action as Americans are traveling for the holiday season, despite repeated pleas from scientists and public health officials. More than one million people traveled through the Transportation Security Administration checkpoints from Friday through Sunday, according to the agency. The last time passenger figures topped one million was during the last major holiday, Thanksgiving.

“I would not be doing my job as governor of New York if I sat here and let the federal incompetence create another emergency and disaster that cost the lives of New Yorkers,” Mr. Cuomo said, alluding to the thousands of travelers who arrived from Europe earlier this year and unknowingly spread the virus when the federal government’s focus was mostly on China.

States have little power to limit air travel, which is mostly regulated by the federal government, leaving Mr. Cuomo with few options but to pursue voluntary agreements with the airlines.

Mr. Cuomo later said that Virgin Atlantic had agreed to a similar requirement. The pre-boarding testing requirement for British Airways and Delta flights goes into effect Tuesday, he said, and the test result must be from within 72 hours before boarding.

“I am only a governor, but I will do anything I can and whatever I can to protect the people of the State of New York,” said Mr. Cuomo, a third-term Democrat. “That is my job and I know and I believe my intuition is correct that this is another disaster waiting to happen.”

Mayor Bill de Blasio of New York City also urged further restrictions. “In my view, it’s time for a travel ban from Europe,” Mr. de Blasio said at a news conference on Monday. “Or at minimum a requirement that anyone getting on a plane has proof that they have a negative test if they’re coming out of Europe.”

Speaker Nancy Pelosi in the Capitol on Monday. After months of gridlock and debate, the House and Senate approved the spending measures on Monday night.
Credit…Stefani Reynolds for The New York Times

Both houses of Congress on Monday night approved a $900 billion stimulus package that would send billions of dollars to American households and businesses grappling with the economic and health toll of the pandemic.

The House approved the package first, followed just before midnight by the Senate, which voted in favor 97-1.

Treasury Secretary Steven Mnuchin said hundreds of dollars in direct payments could begin reaching individual Americans as early as next week.

The long-sought relief package was part of a $2.3 trillion catchall package that included $1.4 trillion to fund the government through the end of the fiscal year on Sept. 30. It included the extension of routine tax provisions, a tax deduction for corporate meals, the establishment of two Smithsonian museums, a ban on surprise medical bills and a restoration of Pell grants for incarcerated students, among hundreds of other measures.

Though the $900 billion stimulus package is half the size of the $2.2 trillion stimulus law passed in March that provided the core of its legislative provisions, it remains one of the largest relief packages in modern American history. It will revive a supplemental unemployment benefit for millions of unemployed Americans at $300 a week for 11 weeks and provide for another round of $600 direct payments to adults and children.

“I expect we’ll get the money out by the beginning of next week — $2,400 for a family of four — so much needed relief just in time for the holidays,” Mr. Mnuchin said on CNBC. “I think this will take us through the recovery.”

President-elect Joseph R. Biden Jr., who received a coronavirus vaccine on Monday with television cameras rolling, has insisted that this bill is only the beginning, and that more relief, especially to state and local governments, will be coming after his inauguration next month.

Lawmakers hustled on Monday to pass the bill, nearly 5,600 pages long, less than 24 hours after its completion and before virtually anyone had read it. At one point, aides struggled simply to put the measure online because of a corrupted computer file. The legislative text is likely to be one of the longest ever, and it became available only a few hours before the House approved it. Now that the Senate passed the bill, it will go to President Trump for his signature.

But with as many as 12 million Americans set to lose access to expanded and extended unemployment benefits days after Christmas, passage was not in doubt. A number of other pandemic relief provisions are set to expire at the end of the year, and lawmakers in both chambers agreed that the approval of the $900 billion relief package was shamefully overdue.

Over the summer, Speaker Nancy Pelosi of California and Mr. Mnuchin inched toward a relief package of nearly $1.8 trillion. But after a significant infusion of federal relief in April, Senator Mitch McConnell, Republican of Kentucky and the majority leader, and several Senate Republicans initially balked at the prospect of another sweeping spending package. With Republicans reluctant to spend substantial taxpayer funds and mindful of remaining united before the November election, Mr. McConnell refused to indulge anything more than a narrow, $500 billion package.

Ms. Pelosi and top Democrats, for their part, refused to entertain the targeted packages Republicans eventually put forward, and pushed to go as big as possible in a divided government. The election hung over all of the talks, with both sides not wanting to deliver the other party a victory that could buoy their chances.

And Mr. Trump, fixating first on his campaign, then his effort to reverse the election’s results, did little to corral Congress toward an agreement.

In the end, congressional leaders agreed to punt the thorniest policy issues that had long impaired a final agreement — a direct stream of funding for state and local government, a Democratic priority, and a broad liability shield that Mr. McConnell had long fought for.

“A few days ago, with a new president-elect of their own party, everything changed,” Mr. McConnell said on Monday. “Democrats suddenly came around to our position that we should find consensus, make law where we agree, and get urgent help out the door.”

As the negotiations dragged on, millions of Americans slipped into poverty, thousands of small businesses closed their doors and coronavirus infections and deaths rose to devastating levels across the country.

But Ms. Pelosi vowed that with Mr. Biden in office, Congress would revisit the unresolved debates and push for even more relief to support the country’s economic recovery.

“It’s a whole different world when you have the presidency because you do have the attention of the public,” Ms. Pelosi said in an interview. “I’m very optimistic about that because the public wants us to work together.”

A traveler arrived at a deserted Kings Cross station in London on Monday.
Credit…Andrew Testa for The New York Times

When Prime Minister Boris Johnson of Britain announced that a new variant of the coronavirus might be 70 percent more contagious, the panicked reaction around the world was as swift as it was familiar.

Governments already struggling to control outbreaks of other virus strains sought to seal themselves off from the new danger. By Monday evening, more than 40 nations around the world had announced a ban on travel to and from the United Kingdom, according to the BBC.

The rush to try and beat the pathogen by closing borders was reminiscent of the reaction after the coronavirus first emerged broadly in the spring and global transit ground to a standstill.

But most of those travel bans, the world soon learned, had come too late, put in place after the virus had already seeded itself in communities far and wide.

While it is too soon to know whether governments have acted quickly enough this time, and many questions remain about how transmissible the newly discovered variant really is, it is clear that it has been spreading for some time.

The first case detected was in Kent, in southeast England, on Sept. 20. By November, around a quarter of cases in London — an international hub of commerce — involved the new variant. Just a few weeks later, the strain was estimated to be responsible for nearly two-thirds of cases.

That means that by the time Prime Minister Johnson addressed the nation on Saturday night to announce severe new lockdown measures for millions of people in and around London, the variant had been spreading for months.

It is impossible to know the impact the new round of border closures will have on the ability of the strain to take even greater hold — in part because it is simply not known how widely it is already circulating.

The United Kingdom has some of the most sophisticated genomic surveillance efforts in the world, which allowed scientists there to discover the strain when it might have gone unnoticed elsewhere. Even as the world was closing itself off from Britain, the scientific community in the country was continuing to study the mutation.

While there was no evidence to suggest that the variant causes more serious illness, officials said, the government’s New and Emerging Respiratory Virus Threats Advisory Group upgraded its assessment of the danger it poses.

A separate panel of British scientists, however, expressed only “moderate confidence” that the newly identified variant was more transmissible.

And in any case, scientists, noting that viruses commonly shift shape over time, have urged the public not to overreact to the new variant.

A mobile field hospital was set up at UCI Medical Center in Orange, Calif., on Monday.
Credit…Jae C. Hong/Associated Press

LOS ANGELES — As California’s new coronavirus cases, hospitalizations and deaths continue to soar, the nation’s most populous state has emerged as the epicenter of the pandemic heading into a dangerous holiday week.

With just 2.5 percent of the state’s overall intensive care capacity available, officials have been rushing to get more so-called field hospitals up and running. And discussions are underway about how to implement the state’s plans to ration care.

While Gov. Gavin Newsom did not officially extend what were supposed to be three-week stay-at-home orders affecting most of the state’s 40 million residents, he said on Monday that it was “self-evident” the orders would need to be in effect well into January, in light of projections that more than 90,000 people in California could be hospitalized with the virus in coming weeks.

The state added 295,000 cases over the past week, according to a New York Times database, and is likely to reach 300,000 new cases this week, given the virus’s trajectory. No other state has added even 150,000 cases in a week.

Mr. Newsom urged Californians to view their sacrifices as part of a massive effort to mitigate the worst surge the state has seen, even as hundreds of thousands of vaccine doses are rushed to health care providers.

“We have agency,” he said, repeating a point he has made at various times throughout the pandemic. “The future is not something to experience — it’s something to manifest.”

The governor spoke during a Monday news conference from his home, where he is in quarantine for the second time because of exposure to a state employee who tested positive.

Mr. Newsom has tested negative, but he said that he, like tens of thousands of other Californians, would spend Christmas isolated even from his family.

The governor and other state leaders have in recent days painted an increasingly dark picture of the fate of those who fail to heed guidelines.

Dr. Mark Ghaly, the state’s secretary of health and human services, said in a news conference that health care providers and state and local leaders were working frantically to prevent the state from tipping into what he and the governor described as crisis mode.

“We continue to build up our capacity,” he said. “When we look forward to that forecast of quite a few patients towards the end of January — that’s not a story that’s already been written.”

But as has been the case in the last couple of months, making sure health care facilities are sufficiently staffed has been the biggest hurdle. Nurses, doctors, janitors and so many others are exhausted. Aid from other states and the federal government is scarce.

In the next week or so, more Californians could hear that hospitals are simply full. Patients who are unable to avoid going to the hospital will wait in hallways for hours.

The mere possibility that California’s caseload could overwhelm even the state’s emergency surge capacity is likely to harm workers, said Joanne Spetz, a professor at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco.

“The term psychologists use is moral distress,” she said. “And that is a huge, looming and developing issue among health professionals.”

Opponents of virus restrictions clashed with police officers outside the Oregon State Capitol on Monday, while legislators met for an emergency session.
Credit…Brian Hayes/Statesman-Journal, via Associated Press

Armed protesters trying to force their way into Oregon’s State Capitol building on Monday were met by officers in riot gear, as lawmakers gathered for a one-day special session amid growing tension over coronavirus restrictions in the state.

The Oregon State Police declared the protest, which included dozens of people, an unlawful assembly, and officers fired pepper balls to drive the crowds away from the Capitol in Salem. Police arrested at least two people, including one person authorities said had used bear spray against officers. Later, some in the crowd smashed windows at an entrance to the Capitol.

Many in the crowd, which included people from far-right groups, carried weapons, wore body armor or held flags supporting President Trump.

Gov. Kate Brown had called a one-day special session of the Legislature to address issues related to the pandemic, including relief for landlords and tenants and funding for vaccine distribution, as well as efforts to address the state’s devastating wildfire season.

Protesters objected to restrictions imposed by Ms. Brown to limit the spread of the coronavirus, shouting about their impact on jobs and schools. “Arrest Kate Brown,” the crowd chanted at officers. One person carried a sign saying, “Politicians are the virus, revolution is the cure.”

Riot officers with batons, some wearing gas masks, later moved in large numbers to shove protesters out of an entranceway to the Capitol building. Many in the crowd yelled that they had long supported law enforcement officers, including at “Back the blue” rallies, but would no longer back them.

Oregon’s coronavirus infection numbers are at the highest point of the pandemic. Under the governor’s orders, many counties face mandatory restrictions, such as prohibitions on indoor dining at restaurants.

Rebekah Jones, a former health data analyst in Florida, considers the raid on her home and her arrest to have been politically motivated.
Credit…Aileen Perilla for The New York Times

The former health data analyst in Florida whose house was raided this month sued the state law enforcement agency, saying her constitutional rights were violated in a “sham” criminal case that was really aimed at squashing free speech.

Rebekah Jones, 31, worked at the Florida Department of Health, building its coronavirus dashboard. She was accused of making changes to the dashboard without approval and in May was fired for insubordination. She said the state was mishandling its health data and accused the agency of trying to silence a whistle-blower.

She built her own Covid-19 dashboard and got hundreds of thousands of dollars in donations as she went on a media tour.

Her home in Tallahassee was raided Dec. 7; video of the raid showed agents with their firearms drawn. One pointed his weapon upstairs, where Ms. Jones’s 11-year-old son and 2-year-old daughter had been sleeping.

The search was part of a criminal investigation into unauthorized messages sent last month to a group of health department employees using an internal emergency alert system.

On Sunday night, Ms. Jones sued the Florida Department of Law Enforcement, its top commissioner, Rick Swearingen, and two agents in Leon County. The lawsuit states the agency failed to consider that virtually anyone could have sent the alerts, because the passwords were listed publicly on the internet.

Mr. Swearingen has defended the raid.

“As I have said before, I am proud of the professionalism shown by our FDLE agents as they served a legal search warrant on the residence of Rebekah Jones,” he said in a statement. “Our criminal investigation continues, and while I have not seen this lawsuit, I believe the facts will come out in court.”

Ms. Jones accused the F.D.L.E. of using the case to ingratiate the agency with Governor Ron DeSantis, who was furious with her for speaking publicly about Florida’s alleged mishandling of data.

She accuses the agency of seizing her computers, drives and telephone in a quest to determine the identity of her sources. Ms. Jones is unable to work without her equipment, the lawsuit says, and it seeks the return of her property and at least $30,000 in damages.

Pope Francis extending Christmas greetings at the Vatican on Monday.
Credit…Maurizio Brambatti/EPA, via Shutterstock

The Vatican said Monday that it was “morally acceptable” to receive Covid- 19 vaccines tied to research involving fetal tissue derived from abortions, as long as there was no alternative.

The Vatican’s doctrinal watchdog, citing the severity of the pandemic, said that “all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive.”

A note signed by the top officials of the Congregation for the Doctrine of the Faith and approved by Pope Francis pointed to past Vatican pronouncements on vaccines made from cells derived from aborted fetuses.

The congregation said it had received “several requests for guidance” regarding the new vaccines.

Fetal tissue from abortions has long been critical to some scientific research, but the Catholic church teaches that abortion is a grave sin.

The Congregation for the Doctrine of the Faith’s note said that anyone who decided to refuse a vaccine “for reasons of conscience” was under obligation to “do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent.”

In its note, the congregation also said it was “a moral imperative” for the “pharmaceutical industry, governments and international organizations” to ensure that vaccines be made available to the poorest countries at accessible prices.




‘Nothing to Worry About,’ Biden Says After Coronavirus Vaccination

President-elect Joseph R. Biden Jr. received the first course of the Pfizer-BioNTech Covid-19 vaccine on live television at a hospital in Delaware on Monday.

“You’ve been awful busy, haven’t you?” “We have been.” [talking] Reporter: “Mr. Biden, do you expect that teachers will have early access to the vaccine?” “Well look, what I want to say is we owe these folks an awful lot. The scientists and the people who put this together, front-line workers, the people who were the ones who actually did the clinical work. It’s just amazing. It’s worth saying that this is great hope — I’m doing this to demonstrate that people should be prepared when it’s available to take the vaccine. There’s nothing to worry about.”

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President-elect Joseph R. Biden Jr. received the first course of the Pfizer-BioNTech Covid-19 vaccine on live television at a hospital in Delaware on Monday.CreditCredit…Amr Alfiky/The New York Times

President-elect Joseph R. Biden Jr. received the coronavirus vaccine on live television on Monday at Christiana Hospital in Newark, Del., sending a message to Americans across the country that the vaccine is safe to take.

“Left’s good,” he told the nurse practitioner who administered the vaccine, rolling up the sleeve of his black long-sleeve turtleneck and exposing his left arm. “You just go ahead anytime you’re ready.”

He credited the Trump administration for its work on Operation Warp Speed, which helped to deliver a quick vaccine.

“The administration deserves some credit getting this off the ground,” he said. “I’m doing this to demonstrate that people should be prepared when it’s available to take the vaccine.”

Mr. Biden, however, warned Americans that vigilance in the coming months was still necessary.

“It’s going to take time,” he said, encouraging people to continue to wear masks and socially distance. “If you don’t have to travel, don’t travel,” he said. “It’s really important.”

He thanked health care workers, calling them heroes, and ended with an awkward elbow bump with Tabe Mase, the nurse practitioner who administered to him the first course of the Pfizer-BioNTech Covid-19 vaccine. His wife, Dr. Jill Biden, received the vaccine privately, earlier in the day on Monday, according to a spokesman, and joined him at the hospital.

Since March, Mr. Biden’s team has been taking public health guidelines about social distancing and masks seriously, as President Trump and his aides have willfully disregarded them. But even Mr. Biden’s more careful circle has been infiltrated by the virus. Representative Cedric L. Richmond, Democrat of Louisiana and one of Mr. Biden’s closest advisers, tested positive for the coronavirus last week, the transition team announced.

Vice President-elect Kamala Harris is expected to receive her vaccine after Christmas, a spokeswoman said, following advice from doctors who recommended Mr. Biden and Ms. Harris stagger their first shots rather than receive them together.

Dr. Anthony S. Fauci, the government’s top infectious disease expert who will also be Mr. Biden’s chief medical adviser, will be vaccinated at 10 a.m. on Tuesday at what the National Institutes of Health is billing as a “kick off” event showcasing Moderna’s vaccine, which received emergency authorization from the Food and Drug Administration on Friday.

Dr. Fauci’s vaccination has been long-awaited by public figures and health experts. Former President Barack Obama recently said that if Dr. Fauci endorses a coronavirus vaccine, that will be a signal to him that it is safe.

Vice President Mike Pence, House Speaker Nancy Pelosi and Senator Mitch McConnell, the majority leader, all received the first dose of the vaccine on Friday.

Mr. Trump, however, has neither participated in nor supported the public health campaign to reassure vaccine skeptics worried about its dangers.

On Friday, he did nothing to promote Mr. Pence taking the vaccine, an event held at the White House that officials asked all of the television networks to carry live on TV for maximum exposure. Instead, Mr. Trump was tweeting out anti-mask claims minutes after Mr. Pence received his vaccine.

Some of Mr. Trump’s advisers have defended his decision to put off his own vaccination, arguing that he still has the protective effects of the monoclonal antibody cocktail that was used to treat him for the virus in October.

But doctors have said it would set a good example to Americans who have recovered from Covid-19 that they still should receive the vaccine.

“We know that infection doesn’t induce a very strong immune response and it wanes over time,” Moncef Slaoui, the chief adviser of Operation Warp Speed, said on CNN’s “State of the Union” on Sunday. “So I think, as a clear precaution, it is appropriate to be vaccinated because it’s safe. I think people should be vaccinated, indeed.”

A newly built coronavirus vaccination center in Hamburg, Germany, on Friday. The European Union is poised to start distributing shots to all 27 member nations.
Credit…Axel Heimken/Agence France-Presse — Getty Images

The European Union granted authorization on Monday for the Pfizer-BioNTech vaccine, paving the way for millions of doses to be transferred by Pfizer to the bloc’s 27 member states. Immunization is expected to begin in most countries over the next few days and gather speed in early January, the authorities have said.

The decision comes weeks after Britain granted emergency approval to the vaccine and began its rollout, quickly followed by the United States. The swifter authorization by the British and U.S. authorities created pressure for the European Union to expedite its own process, and the regulator changed its date for the decision, moving it to Monday from Dec. 29. The delay had been criticized, especially in Germany, where BioNTech is based and where the vaccine was developed.

The E.U.’s drug authority, the European Medicines Agency, is expected to give its decision on the Moderna vaccine authorization request on Jan. 6.

Pfizer declined to provide logistical details for its plans to transport the vaccines across the 27 E.U. countries, but said it was ready to begin distribution as soon as it got the green light from the bloc’s executive arm, the European Commission. The shots that will be distributed in Europe are manufactured in Pfizer factories in Puurs, Belgium, and in Mainz, Germany.

Shoppers at Toronto Eaton Centre during Boxing Day last year.
Credit…Cole Burston/The Canadian Press, via Associated Press

Ontario, Canada’s most populous province, announced that sweeping restrictions will come into effect this Saturday on Boxing Day, a holiday that is traditionally one of the biggest shopping days of the year.

Premier Doug Ford said that most stores, aside from pharmacies and those selling food, will be closed except for delivery and curbside pickup and that restaurants will be limited to takeout or delivery service. Indoor gatherings will be limited to groups made up of household members with the exception of weddings and religious services involving no more than 10 people. Otherwise, indoor activities will be banned.

The majority of students will shift to online learning after their holiday break and residents are being urged to avoid all but essential travel.

Mr. Ford announced the new restrictions after administrators of several hospital systems said that they were running out of capacity to treat Covid-19 cases. Hospitalizations and infections have been steadily increasing in most of Ontario with the exception of Ottawa, the national capital, and the vast but sparsely populated northern portion of the province. Some of the restrictions are already in effect in several communities, including Toronto, the largest city.

“If we fail to take actions now, the consequences will be catastrophic,” Mr. Ford said. “We need to do everything in our power to protect our hospitals and our most vulnerable.”

The province has reported that hospital admissions related to Covid-19 have gone up 69.3 percent and that there has been an 83.1 percent rise in the number of coronavirus patients needing intensive care.

Aside from the limits on schooling, the new restrictions will last until at least Jan. 23 in the southern part of the province, which is home to the overwhelming majority of its residents. In the north, they will expire on Jan. 9.

House Democrats issued subpoenas for Alex M. Azar II, the health and human services secretary, and Dr. Robert R. Redfield, the C.D.C. director.
Credit…Jenni Girtman/EPA, via Shutterstock

House Democrats investigating political interference at the Centers for Disease Control and Prevention on Monday issued subpoenas for Alex M. Azar II, the health and human services secretary, and Dr. Robert R. Redfield, the C.D.C. director, demanding they turn over documents showing how Trump administration appointees attempted to delay and alter guidance documents on the coronavirus.

Rep. James E. Clyburn, the chairman of a special select committee investigating the Trump administration’s pandemic response, described in a scathing 20-page letter how two top H.H.S. appointees loyal to President Trump attempted to edit or block at least 13 editions of the C.D.C.’s closely guarded Morbidity and Mortality Weekly Reports, which contained research on the spread of the coronavirus written by career agency scientists.

The appointees, Michael Caputo, the top public affairs official at the Department of Health and Human Services, and a scientific adviser he hired, Dr. Paul Alexander, targeted C.D.C. scientists they believed were intentionally publishing research unflattering to Mr. Trump and the White House, Mr. Clyburn wrote.

In one instance, Mr. Caputo and Dr. Alexander attempted to halt the publication of a report on how doctors were prescribing hydroxychloroquine, a malaria drug that became a right-wing cause after Mr. Trump praised, without evidence, its potential as a treatment against Covid-19.

Department officials even drafted a “rebuttal” to the report, saying it “presents factual information with an agenda” and could “prevent the news from giving the proper coverage of a true ‘miracle cure.’” The rebuttal called the authors of the M.M.W.R. “a disgrace to public service.”

The subpoenas escalated a bitter dispute between H.H.S., which is the C.D.C.’s parent agency, and Mr. Clyburn, who has accused the agency of blocking testimony from a group of top C.D.C. officials, including Dr. Redfield.

Earlier this month, the editor in chief of the reports told the committee that she was ordered to destroy an email showing that H.H.S. political appointees attempted to interfere with their publication. Mr. Clyburn wrote that the attempted interference occurred even as a top H.H.S. official, Bill Hall, warned Mr. Caputo and Dr. Alexander that the M.M.W.R. reports needed to remain independent.

The H.H.S. public affairs office is “not a science or medical program office and, as matter of longstanding policy, we do not engage in clearing scientific articles,” Mr. Hall wrote. Dr. Alexander then began contacting C.D.C. officials directly in an effort to continue meddling in at least 11 other reports, Mr. Clyburn wrote.

Hartsfield-Jackson International Airport in Atlanta on Nov. 25. The Thanksgiving holiday was the last time airport checkpoints handled more than one million passengers in a day.
Credit…Nicole Craine for The New York Times

More than a million travelers a day passed through airport security checkpoints on each of the last three days in the United States.

With Christmas on Friday, the numbers show that, despite warnings from the C.D.C., people are on the move. On Friday, 1,066,747 people traveled through the Transportation Security Administration checkpoints, according to the agency. On Saturday, the figure was 1,073,563 and on Sunday, it was 1,064,619.

The last time passenger figures topped one million was around the Thanksgiving holiday: On Nov. 25, a Wednesday, 1,070,967 people passed through checkpoints, and on Nov. 29, a Sunday, there were 1,176,091 passengers. The numbers were less than half of what they had been for the same days in 2019, when more than two million people passed through airport security checkpoints.

The spikes in holiday travel this year come despite warnings from the Centers for Disease Control and Prevention, which has urged people not to travel as Covid-19 cases continue to rise. The agency issued an advisory this month 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 after travel.”

The C.D.C. encourages anyone who decides to travel to get a flu shot, keep a distance of six feet at checkpoints, wear a mask throughout the trip, bring extra hand sanitizer and wash hands regularly.

United Airlines said on Friday that it was working with health officials to contact passengers who may have been exposed to the coronavirus by a man who died on a recent flight. Four flight attendants who responded to the emergency onboard the flight, United 591, went into quarantine for 14 days after the plane reached Los Angeles, the flight attendants’ union said.

Prime Minister Benjamin Netanyahu received the Covid-19 vaccine at Sheba Medical Center in Ramat Gan, Israel, on Saturday.
Credit…Amir Cohen/Reuters

JERUSALEM — Israel said on Monday it would close its skies to foreign nationals on Wednesday and would require Israelis arriving from abroad to quarantine in government-run hotels, as part of an effort to keep a new mutation of the coronavirus out of the country. Local airlines were laying on extra flights to whisk Israelis back from vacations abroad before the new quarantine restrictions come into force.

Alarm over an outbreak of a more contagious variant of the coronavirus in Britain spread throughout Europe on Monday, prompting more than 30 countries to ban travelers from the country and suspend flights.

“We have, at the moment, a new pandemic that is spreading, with a virus which we do not yet know about,” Prime Minister Benjamin Netanyahu said, adding, “This mutation could also be coronavirus 2.” The decision to enforce new travel restrictions was difficult, Mr. Netanyahu said, “but we have no choice.”

With one main international airport in operation and a few land crossings that can easily be sealed, Israel is well placed to self-isolate as a country, though its first attempt in the early stages of the pandemic did not last very long.

People arriving from Britain were already being bused directly from the airport to government-run hotels where they will have to quarantine for up to 14 days. Beginning Wednesday, Israelis arriving from any country will also have to quarantine in the repurposed hotels.

While many countries have closed their borders to Israelis because of high infection rates, tens of thousands have traveled to Dubai this month and others are vacationing in the Seychelles. With many now wanting to beat the Wednesday deadline, local airlines said they were scrambling dozens of planes to bring them home.

People walked along a crowded commercial street in downtown Mexico City on Saturday.
Credit…Gustavo Graf Maldonado/Reuters

Despite Covid-19 cases spiraling upward and hospitalizations surging, federal officials in Mexico reassured the public during a Dec. 4 briefing that Mexico City had not reached the critical level of contagion that, according to the government’s own standards, would require shutting down its economy.

In fact, Mexico’s capital had surpassed that threshold, an investigation by The New York Times has found. Yet the capital stayed open for business, its streets thronged with shoppers, its restaurants teeming with diners.

Instead of shutting down the economy, the federal government misled the public about the severity of the outbreak — and allowed Mexico City to remain open for two more weeks, according to officials and a review of government documents.

Mexico decides when to lock down the nation’s capital and each of its states based on a formula that considers the latest numbers of cases, hospitalizations and deaths. When the government introduced the system, officials told Mexicans that it would be a transparent and objective measure of the spread of the virus.

But this month, the government used in its calculation two numbers that were lower than figures it had made publicly available elsewhere, producing a result that would allow the capital, a city of nine million residents, to keep businesses open in the busy weeks of early December.

The government finally moved to shut the city down on Friday. By then, the capital’s hospitals were overflowing. More than 85 percent of hospital beds in the capital were occupied on Sunday, according to federal data, up from 66 percent when the government decided to delay the lockdown.

Federal health officials did not provide a response to requests for comment. The government of Mexico City pointed to recent public comments by the mayor, Claudia Sheinbaum, who said that her government had avoided a lockdown because “this time of year is really important in terms of families’ finances.”

Unlike many global leaders, the Mexican president has not used a stimulus program to support businesses and the unemployed during the pandemic. Without a safety net in place, closing down Mexico City in the middle of the holiday shopping season would inflict considerable pain on the nation’s economy.

But allowing Mexico City’s residents to crowd into stores, dine indoors and work in their offices for two weeks while the virus was known to be spreading rapidly has increased the burden on an already strained public health system, experts say.

A market in Kandahar, Afghanistan, last month. Many Afghans have chosen to go about their daily lives as if Covid-19 does not exist.
Credit…Jim Huylebroek for The New York Times

When the coronavirus pandemic first reached Afghanistan in March, the government struggled to shut down cities and persuade Afghans to wear masks, wash their hands and practice social distancing. The measures were haphazardly enforced for several weeks before citizens began to chafe under the restrictions.

Today, even as public health officials confirm a second deadly virus wave, Covid-19 is an afterthought. Afghans have embraced a culture of denial, where personal priorities triumph over public health experts whose pleas are drowned out by public apathy, skepticism and an enduring belief that Allah determines a believer’s fate.

“The mentality that Trump and his supporters have, it’s exactly the same for the Afghan people,” said Dr. Tariq Ahmad Akbari, until recently the head physician at Kabul’s only infectious disease hospital. “They think Covid is Western propaganda.”

But unlike in the United States, there is no political party or anti-government movement playing down the virus by spreading misinformation. Even the Taliban have distributed personal protection equipment and run public health information programs. They have allowed government health workers into areas they control, the health ministry said.

In cities across the country, people go about their daily lives as if the coronavirus never existed. Afghans cram into buses and taxis, eat shoulder to shoulder indoors in restaurants, pray in mosques, embrace in traditional Afghan greetings and cluster in sprawling bazaars.

On crowded city streets, few people wear masks. Ubiquitous public health posters warning of Covid-19 are routinely mocked as relics of a not-so-distant past when the coronavirus seemed terrifying and indomitable.

Afghans continue to contract the virus and die, but the scale of the epidemic is nearly impossible to measure. The Health Ministry’s reported coronavirus death toll is 2,074, with 50,677 positive cases, but Afghanistan’s testing capacity is severely limited — it has conducted just 180,000 tests since March. Its beleaguered health system cannot always distinguish Covid-19 from other causes of death in a country where disease and violence are endemic.

A relative attended to a patient at Kenyatta National Hospital in Nairobi, Kenya, on Monday as doctors across the country went on strike.
Credit…Thomas Mukoya/Reuters

Citing poor pay, lack of medical insurance and inadequate protective equipment, doctors across Kenya went on strike on Monday, setting off a public health crisis as coronavirus cases continued to rise nationwide.

The Kenya Medical Practitioners, Pharmacists and Dentists Union, which represents all Kenyan doctors, began the 21-day strike after eight months of negotiations with the government failed. A similar strike in November was suspended to continue deliberations.

For several months, medical practitioners have been asking the government to provide them with comprehensive medical insurance coverage, pay their salaries, enlist 2,000 doctors on “permanent and pensionable terms” and provide a dedicated facility to treat those who contract the coronavirus. But they accused the government of pressuring them to return to work or be fired rather than listening to their demands.

The latest strike comes just months after doctors in several counties, including the capital, Nairobi, put down their tools just as a local television investigation exposed the theft from government coffers of hundreds of millions of dollars of funds allocated to fight the pandemic.

Kenya has so far recorded 94,500 coronavirus infections and 1,639 deaths. The East African nation has seen a rise in cases since easing restrictions in October, raising fears that the country was experiencing a second wave.

More than a dozen Kenyan doctors have died of Covid-19. Among them was Dr. Stephen Mogusu, a 28-year-old who at the time of his death in early December had no insurance and had not received a paycheck for five months.

“Too steep a price for patriotism,” the doctors’ union tweeted at the time.

Passengers on a flight from Heathrow Airport were given field beds after landing in Hanover, Germany, on Sunday as they awaited coronavirus test results.
Credit…Sophie & Stefan from Hanover, via Reuters

BERLIN — Before taking off from London’s Heathrow Airport on Sunday evening, the cabin crew of the last Eurowings flight to Stuttgart, Germany warned its passengers that because of the new coronavirus mutation they risked spending the night at the airport.

“They are partitioning off a part of the airport — all I can say is cots,” the announcement said, according to a recording cited by German media.

Air passengers from the United Kingdom were detained at German airports on Sunday night after the country had decided to stop incoming flights in a bid to prevent the spread of a new mutation of the coronavirus.

While the German health minister confirmed an official stop to flights from the U.K. and South Africa starting at midnight, hundreds of travelers who touched down between the time the decision was communicated, in the late afternoon, and the official rule was in place had to wait for coronavirus test results before being allowed to leave airports.

Depending on scrambling local health authorities, the procedure varied from place to place.

In Hanover, where a flight from London landed at 6:45 p.m., all 63 passengers had to take a PCR test when stepping off the flight. One passenger refused to take the test and flew back to Britain. The others had to wait until the next morning, when the results were available. One positive case was found, according to health authorities.

“We tried to make the wait as comfortable as possible,” said Kristin Peschel, a spokeswoman for the airport.

Despite the food, bottled water and field beds provided by the airport, passengers demanded to speak with lawyers and even filmed a dramatic video which was broadcast by the country’s main tabloid, the Bild Zeitung. “We are held against our will,” one passenger identified as Manuela T. said in the clip.

At the country’s busiest airport in Frankfurt, roughly 100 passengers were still waiting for test results by midday, according to a spokesman. About 200 travelers had been detained overnight waiting for their test results. A Lufthansa flight from South Africa that had left before the rules were in effect arrived in Frankfurt on Monday morning. In accordance with local health rules, German passengers were allowed to go home to quarantine, while non-Germans were kept at the airport until negative test results were available.

At the new Berlin airport, German passengers were also allowed to go home to follow normal quarantine rules. After several hours, non-German passengers with residence in Germany were allowed to go home to quarantine. Foreign passengers without residence had to spend the night at the terminal to get in line for a coronavirus test when the center there opened at 7 a.m.

Despite the preflight warning, passengers arriving in Stuttgart might have had it the easiest. Local authorities had organized a coronavirus quick-test line. Within two hours all 150 passengers arriving were able to test and leave the airport, according to an airport spokesman.

A coronavirus testing center in Hong Kong, which has strict quarantine and isolation requirements for people who contract the virus.
Credit…Kin Cheung/Associated Press

A 63-year-old coronavirus patient has been arrested in Hong Kong after his escape from a hospital isolation ward set off a frantic manhunt across the city.

Hong Kong, a semiautonomous Chinese territory that is currently battling a fourth wave of infections, has strict quarantine and isolation requirements for people who contract the virus and their close contacts. Those who test positive, whether they are symptomatic or not, are sent to a hospital for treatment and monitoring until they test negative, while their close contacts are sent to quarantine camps for up to two weeks. Unbidden departures from quarantine and isolation facilities are illegal and can result in a two-month prison sentence and $645 fine.

The patient, Li Wan-keung, slipped away on Friday while doctors and nurses were occupied with other patients, the health authorities said. He evaded detection for 54 hours, even after the police released his name and photograph on their social media accounts.

Mr. Li was arrested on Sunday night and taken back to the hospital. A police representative said on Monday that the force received a tip about Mr. Li’s whereabouts and dispatched officers to arrest him.

Hong Kong courts have, as of Dec. 1, imprisoned or fined 76 people found guilty of violating quarantine orders. Government officials say that the prison sentences are intended to clearly signal their position of zero tolerance.

Hong Kong, a city of about 7.5 million people, has reported a total of 8,237 coronavirus cases and 130 deaths since the outbreak began.

Shanghai last month. China has set an ambitious goal to vaccinate 50 million people against the coronavirus before mid-February.
Credit…Aly Song/Reuters

China is preparing to vaccinate 50 million people against the coronavirus before Feb. 15, the Lunar New Year holiday when hundreds of millions of people are expected to travel, according to a Chinese vaccine expert.

China’s National Health Commission set the ambitious target with provincial officials in a teleconference with them on Dec. 15, Tao Lina, a vaccine expert based in Shanghai and a former immunologist with the city’s Center for Disease Control and Prevention, said in a telephone interview. He cited information given to him from officials who were on the call and minutes of the meeting that were provided to him. The National Health Commission did not immediately respond to a request for comment.

Mr. Tao said the 50 million figure was an estimate based on an initial assessment of the “key population targets” that would be first in line for the vaccines. He added that the provinces were in the process of tallying the total number of people. This month, the government said that it was prioritizing health care professionals, pilots, people who work in the food import industry and others at an elevated risk for contracting the virus.

China has not disclosed safety and efficacy data for any of its five vaccines that are in late-stage testing, but officials say several are on track for authorization. The state-run company Sinopharm, which has two vaccines in late-stage trials, has applied to China’s regulators for approval. The United Arab Emirates and Bahrain recently approved a vaccine made by Sinopharm after an early analysis found that it was effective.

The rapid rollout in China could cause some discontent among people who are reluctant to be vaccinated. Mr. Tao said he knew of several medical workers who were not eager to be inoculated because they were worried about the novel shots. Some of them are also less afraid of contracting Covid-19 because the pandemic appears to have been mostly stamped out in China, he said.

In other global developments:

  • Gatherings of more than five people will be banned in South Korea’s capital region as an elevated step to suppress what the authorities call an “explosive” surge in coronavirus infections, The Associated Press reported. The region around the capital, Seoul, is home to half of South Korea’s 51 million people and has been at the center of a recent viral resurgence. The acting mayor of Seoul, Seo Jung-hyup, said on Monday that the ban would apply to any type of gathering, including year-end parties, office dinners, birthday celebrations and picnics. Only weddings and funerals can follow the current rule of no more than 50 people.

In Berlin in March. With Germany once again under lockdown, shopping districts — long the favorite hunting grounds for feral pigeons — are deserted.
Credit…Odd Andersen/Agence France-Presse — Getty Images

With Germany in its first week of full lockdown, animal rights activists are drawing attention plight of city-dwelling pigeons, which have a harder time finding food scraps in empty city centers.

“We can’t allow pigeons to starve miserably in this acute emergency situation,” said Lea Schmitz, the spokeswoman for the German Animal Welfare Federation, an umbrella organization for smaller local animal welfare associations, said in an interview.

“We not saying private citizens should run out to feed the pigeons,” Ms. Schmitz said. “We’re asking for expert-led initiatives to get special permission to provide appropriate and controlled feedings.”

Under Germany’s new lockdown measures, shops that sell nonessential items are closed, meaning that shopping districts — long the favorite hunting grounds for feral pigeons — are deserted.

Because pigeons generally stay in one place and cannot find food in surrounding fields or forest, as they might do in summer, they are at risk of starvation, unless longstanding city bans on feeding are temporarily suspended, Ms. Schmitz said.

Germany’s current lockdown is expected to run until at least Jan. 10.

N95 masks being decontaminated in April in Ohio. Hospitals are still short on masks and other protective gear.
Credit…Brian Kaiser for The New York Times

As Americans celebrate the rollout of a Covid-19 vaccine, many of the doctors and nurses first in line for inoculation say a victory lap is premature.

They fear that the optimism stirred by the vaccine will overshadow a crisis that has drawn scant public attention in recent months: the alarming shortage of personal protective equipment, or P.P.E., that has led frontline medical workers to ration their use of the disposable gloves, gowns and N95 respirator masks that reduce the spread of infection.

At St. Mary’s Medical Center in Duluth, Minn., health care workers who treat Covid-19 patients are required to reuse their tightfitting respirator masks up to six times before throwing them away. Although soiled N95s are sterilized each day with ultraviolet light, Chris Rubesch, 32, a cardiac nurse, says the masks invariably sag after two or three shifts, leaving gaps that can allow the virus to seep through.

“Our days are filled with fear and doubt,” Mr. Rubesch said. “It’s like driving a car without seatbelts.”

Many of the shortages are the result of skyrocketing global demand, but supply chain experts and health care providers say the Trump administration’s largely hands-off approach to the production and distribution of protective gear over the past nine months has worsened the problem. That has left states and hospitals to compete for limited supplies. Price gouging has become the norm, and scores of desperate institutions have been duped into buying counterfeit products.

President Trump has made only sparing use of the Defense Production Act, a Korean War-era law that allows federal agencies to coordinate the distribution of scarce goods and force companies to prioritize government orders. The D.P.A. can also provide grants to companies that need help ramping up production.

With the White House largely disengaged from the crisis, medical workers, supply chain specialists and public health experts are urging President-elect Joseph R. Biden Jr. to make good on his campaign promises to use the Defense Production Act to increase domestic manufacturing of personal protective equipment, test kits, vaccines and the medical supplies needed to immunize hundreds of millions of Americans. They are also hoping the incoming administration will take over the distribution of scarce goods and put an end to profiteering and the mad scramble for P.P.E. that has pitted states and deep-pocketed hospital chains against nursing homes and small rural hospitals.