More than a year after a new coronavirus first emerged in China, a team of experts from the World Health Organization arrived on Thursday in the central city of Wuhan to begin hunting for its source.
But in a sign of Beijing’s continuing efforts to control the investigation, the team of scientists and W.H.O. employees almost immediately ran into obstacles. Two scientists were unable to enter China at the last minute and remained in Singapore because they had tested positive for coronavirus antibodies, the W.H.O. said on Twitter.
The Chinese authorities required the remaining 13 experts to undergo two weeks of quarantine in Wuhan, where the virus first emerged in late 2019.
The investigation, which aims to gain an understanding into how the virus jumped to humans from animals, is a critical step so that another pandemic can be avoided. But getting answers is likely to be difficult.
Here’s what to know about the investigation.
China set up hurdles and pushed for control.
Apparently worried about drawing renewed attention to the country’s early mistakes in handling the pandemic, Chinese officials have used a variety of tactics over the past year to hinder the W.H.O. investigation.
After resisting demands from other countries that it allow independent investigators onto its soil to study the origin of the pathogen, China let two W.H.O. experts visit in July to lay the groundwork. They were not allowed to visit Wuhan, where the virus first emerged.
For months, China delayed approving a visit by a full team of experts, frustrating the health agency’s leaders. When the visit seemed to be finalized this month, it fell apart when Beijing declined to provide visas for the visitors, according to the health agency.
Now that the investigators have arrived, critics say Beijing’s desire for control means the inquiry will probably be more political than scientific.
Tracing the virus will be a painstaking task.
The team that has come to Wuhan will face a city radically transformed from when the virus first emerged, in late 2019. The city, which went into lockdown on Jan. 23 last year and became a symbol of the virus’s devastation, has since been held up by Chinese officials as a success story in vanquishing the virus.
The W.H.O. experts have decades of experience plumbing the depths of viruses, animal health and disease control. But tracing the source of the virus that as of Thursday had killed almost two million people worldwide and infected more than 92 million will be painstaking. While experts believe the virus originated naturally in animals, possibly bats, little else is known.
How much access the team gets in China will be critical, public health experts say.
The team will have to sidestep attempts to politicize its inquiry.
The pandemic has hurt China’s reputation, with many foreign governments still angry that Beijing did not do more to contain the crisis in its earliest stages. So Chinese propagandists are trying to use the W.H.O. inquiry to help shore up China’s image and portray the country as a mature superpower.
Complicating that effort could be new virus flare-ups in recent weeks that have prompted fresh lockdowns in China. In all, more than 22 million people have been ordered to remain inside their homes — double the number affected a year ago in Wuhan. On Thursday, China’s National Health Commission reported a coronavirus death in the mainland for the first time since May.
“The major concern here is the origin of the outbreak has been so politicized,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “That has really narrowed the space for the W.H.O. to have an independent, objective and scientific investigation.”
President-elect Joseph R. Biden Jr. is expected to outline proposals on Thursday for trillions of dollars in government spending to combat the pandemic and its effects on the economy, with an initial focus on large-scale expansions of vaccinations and virus testing capacity.
The efforts will cover the pandemic, the economy, health care, education, climate change and other domestic priorities, Brian Deese, the incoming director of the National Economic Council, said at the Reuters Next conference on Wednesday.
Mr. Biden will detail his plans, which he and his economic team have been honing for weeks, in an evening speech in Delaware. Top Democrats in Congress have said in recent days that they are preparing for the initiatives to span two bills.
“At this moment the president-elect feels that we need to move aggressively on both rescue and recovery,” Mr. Deese said.
Money to complete $2,000 direct payments to individuals and aid to small businesses and local and state governments, components that Mr. Biden has stressed in recent weeks, will be part of the initial package, Mr. Deese said. Others briefed on Mr. Biden’s thinking said he would also call for the first piece of legislation to include an extension of supplemental federal unemployment benefits, which are set to expire in March for many workers, and more help for renters.
Plans for the first package also include a significant increase in spending on vaccine deployment, testing and contact tracing, Mr. Deese said, and Mr. Biden will seek enough money to allow most schools to open.
“We need to get the schools open,” Mr. Deese said, “so that parents, and particularly women, who are being disproportionately hurt in this economy, can get back to work.”
Transition team officials would not say on Wednesday how expensive Mr. Biden’s proposals were likely to be or whether he would announce a cost estimate on Thursday. Last week, Mr. Biden said he expected that his full agenda would cost trillions of dollars.
New claims for state unemployment benefits in the United States sharply increased last week as the pandemic continued to batter the economy.
A total of 1.15 million workers filed initial claims for state unemployment benefits during the first full week of the new year, the Labor Department said. Another 284,000 claims were filed for Pandemic Unemployment Assistance, an emergency federal program for freelancers, part-time workers and others usually ineligible for state jobless benefits. Neither figure is seasonally adjusted. On a seasonally adjusted basis, new state claims totaled 965,000.
Economists had been bracing for a fresh wave of claims as the coronavirus batters the service industry. The government reported last week that the economy shed 140,000 jobs in December, the first drop in employment since last spring’s steep losses, with restaurants, bars and hotels recording steep losses.
“We know that the pandemic is worsening, and with the jobs report last Friday, we can see that we’re in a deep economic hole and digging in the wrong direction,” said Daniel Zhao, a senior economist with the career site Glassdoor.
The labor market has rebounded somewhat since the initial coronavirus wave in the spring. But of the 22 million jobs that disappeared, nearly 10 million remain lost.
“Compared to then, we are doing better,” said AnnElizabeth Konkel, an economist at the career site Indeed, referring to the spring. “But compared to the pre-Covid era, we still have so far to go.”
Still, economists and analysts see better times ahead. As more people are vaccinated, cases will begin to fall, which will ease restrictions on businesses and could lead to a resurgence in consumer activity, helping to revive the service industry.
Perhaps more immediately, President-elect Joseph R. Biden Jr. has pledged to push a stimulus package through Congress that would provide relief to individuals, small businesses, students, schools and local governments.
Deaths from the coronavirus are skyrocketing in the United States, reaching levels never before seen, largely fueled by relentless surges in California and Arizona.
As the national death toll nears 400,000, weekly deaths in Maricopa County, Ariz., and in Los Angeles and Fresno Counties in California have reached new highs, according to data compiled by The New York Times.
The virus has been raging for weeks in California — especially in Los Angeles County, where Covid-19 has claimed one life about every eight minutes — although state officials said on Wednesday that they were seeing some encouraging signs.
In Arizona over the past week, state officials have recorded the highest number of new coronavirus cases per capita in the country.
Dr. Marjorie Bessel, chief clinical officer for the Banner Health hospitals in Arizona, warned on Wednesday that unless elected leaders and residents did more to stop the spread of the virus, five large health systems risked becoming overwhelmed with patients. More than two-thirds of the state’s intensive care units were full as of Monday, and the hospitals were preparing for a surge of 25 to 50 percent.
“We hope we do not get there,” Dr. Bessel said, adding, “We’re asking you — we’re imploring you — today to help us avoid that.”
She urged officials to adopt a statewide mask mandate and to ban indoor restaurant dining. Certain cities and counties, such as Maricopa and Pima, have full mask mandates, but Gov. Doug Ducey, a Republican, has resisted calls for a statewide order.
Nationwide, the numbers largely remained grim on Wednesday, though in the Northern Plains, cases this week were at about a quarter of their peak in mid-November, when the region was among the hardest hit in the country. There were at least 3,900 virus deaths in the United States on Wednesday, a day after the country hit a daily record of more than 4,400.
Earlier in the pandemic, cities bore the brunt of the virus. But now, although metropolitan areas are still suffering, rural communities are, too. Data compiled by The Times shows that deaths have spiked in less populous places, among them Butler County, Kan.; Sevier County, Tenn., and Etowah County, Ala.
“It’s taken a little while, but this highly contagious virus has now spread not only to the suburbs, but also to rural areas,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “In Tennessee, we have some very rural counties, and there’s no county that’s unaffected.”
The geographic diversity of the deaths makes clear that the virus has crushed the health care system in the state, Dr. Schaffner said. On Monday, nearly 90 percent of Tennessee’s intensive care units were full.
Yet it is still common in many rural areas to see people gather in large numbers, often not wearing masks. Some wind up in the hospital.
In regular circumstances, patients in rural areas who require a more sophisticated level of care — as gravely ill Covid-19 patients do — are sent to bigger hospitals in cities. But not all of those transfers are possible now.
“Now we can’t take referrals, because we’re full,” Dr. Schaffner said. “No wonder mortality is going up.”
The U.S. government, faced with an unrelenting surge in Covid-19 cases, issued recommendations this week regarding which people in the country should be vaccinated first. Here are answers to some common questions.
Who is now eligible to be vaccinated, according to federal guidance?
On Tuesday, Alex M. Azar II, the health secretary, urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19.
In all, that is more than 150 million people — almost half the population. They now join millions of health care workers and residents of long-term care facilities who previously qualified.
Mr. Azar did not specify which conditions would make someone eligible for vaccination now; presumably it will be up to governors to decide, as will the question of what documentation to require. But the federal Centers for Disease Control and Prevention has published a list of particularly high-risk conditions, including cancer, diabetes and obesity.
How does eligibility vary by state, and why?
Although the C.D.C. issued recommendations last month for which groups states should vaccinate initially while the vaccine supply is still relatively low, the priorities are not binding and each state has come up with its own groupings.
The federal government cannot require states to change the prioritization plans they have already announced, although the new pressure from Mr. Azar, along with growing public impatience as deaths from the virus continue to hit new peaks, may sway many to do so.
In coming up with priority groups, state officials considered criteria like who is most likely to die if they contract Covid-19 — including people of color, older people and people with underlying medical conditions — and which professions are critical to helping the economy fully reopen. Each state’s demographics also played a role.
I qualify now. How do I sign up?
This depends on what state or even what county you live in.
Some local public health departments have set up portals in which people can make appointments. Others are holding mass vaccination events and inoculating people on a first-come, first-served basis.
Generally, doctor’s offices and pharmacies have asked that patients and customers not call them seeking vaccine appointments just yet, and instead wait to be contacted.
Most pharmacies are not yet offering the vaccine, but CVS, Walgreens and a number of other chain pharmacies, including some in grocery and big-box stores, will soon start doing so through a partnership with the federal government.
With the federal government saying that older people and those with underlying medical conditions should be vaccinated next, what happens to essential workers whose jobs require them to come face to face with other people? Are they eligible now, too?
In some states, yes.
Health care workers in every state were the first to be offered the vaccine. And before Mr. Azar’s directive this week, several states had already opened vaccination to certain categories of “frontline” essential workers, such as police officers, firefighters, teachers, child-care workers and public transit employees.
But other states that had planned to start offering the vaccine to some essential workers in the coming weeks may reprioritize now based on Mr. Azar’s new guidance.
There is nothing stopping states from opening vaccination to a new priority group before they have reached everyone in an earlier group, but supply is an important consideration.
How many vaccine doses does the United States have access to?
Pfizer and Moderna, the two companies whose vaccines have been approved for emergency use in the United States, together have pledged to provide 400 million doses over the next seven months.
Both vaccines require two doses, so that will be enough for 200 million people, out of roughly 260 million who are currently eligible to be vaccinated. Children younger than 16 are not yet eligible for Pfizer’s vaccine, and those younger than 18 cannot yet take Moderna’s.
Johnson & Johnson, whose single-dose vaccine candidate is in late-stage clinical trials, has a contract with the U.S. government to provide 12 million doses by the end of February and a total of 100 million doses by the end of June. But the company has fallen behind on its production schedule.
How many people have been vaccinated so far?
The publicly available data lags by at least a few days, so it is hard to know for sure. But the C.D.C. reported on Wednesday that about 10.3 million people had received an initial dose, out of 29.4 million doses distributed around the country so far.
That includes nearly 1.1 million doses that have been given to residents and staff members in nursing homes and other long-term care facilities.
Europe has reached a tipping point as it grapples with the spread of new coronavirus variants, the World Health Organization’s top official in the region said on Thursday, calling for tighter public health controls to slow their transmission.
The new variants have been identified in 25 of the European region’s 53 nations, Hans Kluge, the W.H.O.’s regional director, told a virtual news conference.
“We were prepared for challenging times in 2021, and it has been just that,” he said.
The region had 26 million confirmed coronavirus infections last year and more than 580,000 related deaths, he said, and in the past week alone recorded 1.8 million new cases.
He said that the health authorities could not yet assess the full extent of a surge in infections resulting from increased social gatherings and relaxed precautions over the year-end holidays, because testing and reporting also dropped.
But he said that the availability of vaccines offered hope for the months ahead. “2021 will be another year with the virus, but it will be more manageable and more predictable,” Mr. Kluge said.
As the year began, over 280 million people in Europe were living under national lockdowns, and several countries are set to add new measures in the hope of reducing new infections and easing the pressure on strained health facilities.
In Switzerland, where the number of new Covid-19 infections has fallen in recent days, the authorities announced new restrictions that take effect next week because of the threat posed by the highly transmissible variants.
Restrictions on businesses and social life in the country had been limited, and ski resorts have been allowed to remain open in a bid to minimize the impact on the economy.
Switzerland is also keeping its schools open. But starting Monday, all shops selling nonessential goods will have to close, the limit on private gatherings has been cut to five people from 10, and the required closing of bars, restaurants, cultural centers and sports facilities has been extended until the end of February.
Anxious about taking a new vaccine and scarred by a history of being mistreated, many frontline workers at hospitals and nursing homes are balking at being inoculated against the coronavirus.
But hospitals and nursing homes, worried about their patients’ health and scarred by many thousands of deaths in the past year, are desperate to have their employees vaccinated.
These opposing forces have led to unusual measures: In addition to educating workers about the benefits of the vaccines, employers are dangling incentives like cash, extra time off and even Waffle House gift cards for those who get inoculated, while, in at least a few cases, threatening to fire those who refuse.
Officials at two large long-term care chains in the United States, Juniper Communities and Atria Senior Living, said they were requiring their workers, with limited exceptions, to be vaccinated if they want to keep their jobs.
“For us, this was not a tough decision,” said Lynne Katzmann, Juniper’s chief executive. “Our goal is to do everything possible to protect our residents and our team members and their families.”
Critics say it is unethical to strong-arm low-paid workers into being vaccinated.
“This is a population of people who have been historically ignored, abused and mistreated,” said Dr. Mike Wasserman, a geriatrician and former president of the California Association of Long Term Care Medicine. “It is laziness on the part of anyone to force these folks to take a vaccine. I believe that we need to be putting all of our energy into respecting, honoring and valuing the work they do and educating them on the benefits to them and the folks they take care of in getting vaccinated.”
A survey of about 5,900 employees at Jackson Health System in Miami found that only half wanted to get a vaccine immediately, a hospital spokeswoman said. Others said they would consider it later.
In Ohio, Gov. Mike DeWine said last month that roughly 60 percent of nursing home workers had declined vaccination. In New York City, at least 30 percent of health care workers said no to the shot in the first round, Mayor Bill de Blasio said on Monday.
Lebanon on Thursday began its strictest lockdown since the start of the pandemic, imposing a 24-hour curfew, shuttering nearly all businesses and restricting grocery stores to a delivery-only basis.
The lockdown, which is scheduled to last until Jan. 25, is intended to curtail a sharp rise in infections since the holidays that has outstripped the abilities of the health sector in the small Mediterranean country.
Thirty-five people died on Wednesday after falling ill with Covid-19, a new daily record, and nearly 5,000 new cases were reported. Lebanon, with a population of nearly six million, has recorded more than 231,000 infections and 1,740 deaths since the start of the pandemic, according to a New York Times database.
The caretaker health minister, Hamad Hassan, tested positive on Wednesday and was taken to a hospital. The state-run news media said his condition was “good.”
Lebanon’s ability to deal with the pandemic has been hampered by an acute economic crisis that has seen the country’s currency lose about two-thirds of its value and a huge explosion in the Beirut port in August that killed about 200 people, destroyed four hospitals and damaged a large swath of the city.
During the lockdown, people must obtain a one-hour permit to go out — even to buy bread or medicine or go to the airport, hospital or doctor’s office — or risk being fined. The caretaker prime minister, Hassan Diab, has called on the security forces to be strict with violators.
In other developments around the world:
The Food and Drug Administration in the Philippines said on Thursday that it had given emergency use authorization to the Pfizer-BioNTech coronavirus vaccine, making Pfizer the first foreign company to be granted permission to distribute its Covid-19 vaccine in the country.
The Vatican said on Thursday that Pope Francis, 84, and Pope Emeritus Benedict XVI, 93, had each received the first dose of a coronavirus vaccine “as part of the vaccination program of the Vatican City State.” Francis had called being vaccinated “an ethical action.”
New Zealand, which has kept its borders tightly controlled while largely vanquishing the coronavirus, will let 1,000 international students back into the country starting in April, Chris Hipkins, the education minister, announced on Thursday. The move applies to students already enrolled in an undergraduate or postgraduate course who were locked out of New Zealand when border restrictions were imposed.
Andy Murray, the former top-ranked tennis player, has reportedly tested positive for the virus, putting in doubt his participation in next month’s Australian Open. He had planned to fly to Melbourne this week to begin a two-week quarantine required by the tournament, which begins Feb. 8, three weeks later than usual because of the pandemic.
Airlines, workplaces and sports stadiums may soon require people to show their coronavirus vaccination status on their smartphones before they can enter.
A coalition of leading technology companies, health organizations and nonprofits — including Microsoft, Oracle, Salesforce, Cerner, Epic Systems and the Mayo Clinic — said on Thursday that they were developing technology standards to enable people to obtain and share their immunization records through health passport apps.
“For some period of time, most all of us are going to have to demonstrate either negative Covid-19 testing or an up-to-date vaccination status to go about the normal routines of our lives,” said Dr. Brad Perkins, the chief medical officer at the Commons Project Foundation, a nonprofit in Geneva that is a member of the vaccine credential initiative.
That will happen, Dr. Perkins added, “whether it’s getting on an airplane and going to a different country, whether it’s going to work, to school, to the grocery store, to live concerts or sporting events.”
Vaccine passport apps could fill a significant need for airlines, employers and other businesses.
In the United States, the federal government has developed paper cards that remind people who receive coronavirus vaccinations of their vaccine manufacturer, batch number and date of inoculation. But there is no federal system that people can use to get easy access to their immunization records online and establish their vaccination status for work or travel.
A few airlines, including United Airlines and JetBlue, are trying Common Pass, a health passport app from the Commons Project. The app enables passengers to retrieve their coronavirus test results from their health providers and then gives them a confirmation code that allows them to board certain international flights. The vaccination credentialing system would work similarly.
France said on Thursday that it planned to test up to a million school children and teachers every month for Covid-19 amid growing concern over the spread in schools of the coronavirus variant that was first detected in Britain.
Olivier Véran, France’s health minister, said tests would be carried out “everywhere where it makes sense” and would include schoolchildren age 6 and older.
“What we know so far is that indeed the virus seems more contagious among children,” Mr. Véran told reporters in Metz, in eastern France. Mr. Véran said the government was “closely” watching the spread of the variant, which was reported in about 1 percent of all positive Covid-19 tests in France over two days last week, according to the health authorities.
The French government is expected to announce new restrictions on Thursday night to keep the epidemic under control, including a possible nationwide curfew from 6 p.m. to 6 a.m. But the authorities have ruled out closing down schools, opting instead to tighten health measures and ramp up testing.
Jean-François Delfraissy, who heads the government’s scientific advisory council on Covid-19, said in an interview this week that the data from Britain on the spread of the variant among students was “insufficiently clear” to justify shutting schools down.
The average number of daily infections in France is still far above 5,000 — the target set by the government to loosen restrictions. Hospitalizations have stabilized at a high plateau, with nearly 25,000 Covid-19 patients around the country. Nearly 70,000 have died in France.
Mr. Véran also said that, starting on Friday morning, people 75 and older would be able to get vaccination appointments by phone or online, as the government tries to ramp up its vaccine rollout.
Nearly 250,000 people have been vaccinated in France, where the authorities are prioritizing retirement home residents, people older than 75, and essential workers like firefighters or health professionals who are older than 50.
Prime Minister Jean Castex told reporters in Metz that the rollout was going smoothly, but said people would have to be patient when once the appointment system is up and running, “because obviously it is going to set off a rush.”
After falling over the summer, coronavirus infections among children, teens and young adults rose steadily from September through mid-December, paralleling the virus’s trajectory among older adults in the U.S. population, the Centers for Disease Control and Prevention reported on Wednesday.
Of 2.8 million coronavirus infections diagnosed in children and young adults under the age of 25 between March 1 and Dec. 12 last year, the incidence was lowest among children ages 10 and younger, who accounted for 18 percent of the cases. Most infections in those under 25 — nearly 60 percent — were among young adults aged 18 to 24, the study found.
The authors said the findings lent support to the argument that child care centers and elementary schools can operate safely when community transmission rates are low and mitigation measures are followed.
“We’re recommending that child care centers and schools, especially elementary schools, be the last settings to close after all other mitigation measures are deployed, and the first to reopen,” said Erin K. Sauber-Schatz, an epidemiologist at the C.D.C.
The study was one of two published this week that also looked at how often children have been hospitalized.
In the C.D.C. study, which drew data from 44 states, the District of Columbia, two territories and an associated state, 2.5 percent of infected children and adolescents under 25 were hospitalized, compared with 16.6 percent of sick adults, and just 0.8 percent were transferred to intensive care.
The largest percentage of hospitalizations in this group occurred among children under 5 years old. About 650 patients under the age of 25 died, about 0.1 percent.
But another study of children, adolescents and young adults, published in JAMA Pediatrics on Monday, has come to a very different conclusion. Researchers at the University of Minnesota found a troubling increase in hospitalizations among infected children and adolescents.
The study was based on data from 5,364 patients aged 19 and under who were hospitalized in 22 states from May 15 to Nov. 15 last year. The cumulative average rate rose to 17.2 hospitalizations per 100,000 children in November from 2 per 100,000 children in May.
The increase was not surprising in itself, simply because more children were becoming infected over time. But the percentage uptick was more than double the rise in adult hospitalization rates over the same period, said Pinar Karaca-Mandic, an expert in health economics at the University of Minnesota who was the research report’s senior author.
Taking a cue from the battered restaurant industry during the pandemic, the Girl Scouts of the U.S.A. said this week that they would offer contactless delivery and pickup of their cookies through Grubhub.
It’s the first time that the Girl Scouts, who have sold cookies for more than a century, have collaborated with a national delivery service, the organization said.
For decades, cookie stands stacked with boxes of Samoas, Thin Mints and Trefoils have been ubiquitous outside supermarkets and in other high-traffic areas. So have direct sales pitches from parents of Girl Scouts to their colleagues at work.
But then the pandemic hit, drastically limiting direct contact. So the Girl Scouts got creative.
“We’re proud of the resourceful ways Girl Scouts are running their cookie businesses safely and using their earnings to make the world a better place,” Judith Batty, the interim chief executive officer of the Girl Scouts, said in a statement. “This season, our girls will continue to exemplify what the cookie program taught them — how to think like entrepreneurs, use innovative sales tactics and pivot to new ways of doing business when things don’t go according to plan.”
Cookie sales were already underway last year when the pandemic was declared, which the organization said had prompted many Girl Scouts to adapt their strategies. Some created virtual cookie booths on social media, while others shipped orders or set up drive-through pickup sites.
The Girl Scouts said that online ordering would begin on Feb. 1, with Grubhub making deliveries in select markets. Additional markets will be introduced over the course of cookie-selling season, which typically runs from January through April.
The Girl Scouts said that Grubhub had agreed to waive the fees that it and competitors like Uber Eats and DoorDash typically charge to restaurants. The fees have become a source of complaints within the industry.