Covid-19 Live Updates: Volunteers to Be Infected in Vaccine Study

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Travelers from Pennsylvania to New York will be required to quarantine upon arrival, Gov. Andrew M. Cuomo’s office said, as the state joined New York’s growing list of areas with travel restrictions.

Despite a sharp uptick of cases in New Jersey and Connecticut, Mr. Cuomo said that travelers from there would not be required to quarantine, though the states meet the qualifications for the restriction.

“There is no practical way to quarantine New York from New Jersey and Connecticut,” Mr. Cuomo said. “There are just too many interchanges, there are too many interconnections, there are too many people that live in one place and work in the other.”

Still, Mr. Cuomo said that all nonessential travel between New York and the two states — regional partners with significant economic ties — should be avoided and promised he would issue more guidance on that point on Wednesday.

Mr. Cuomo also said that more than 40 places now qualified for New York’s travel advisory list, but the list of states was not immediately made available.

On Tuesday, more than 64,200 new cases and at least 517 new deaths were reported in the United States. Over the past week, there have been an average of 59,269 cases per day, an increase of 34 percent from the average two weeks earlier, and fears are growing in New York about a potential second wave. Two weeks ago, Mr. Cuomo closed nonessential businesses in parts of Queens and Brooklyn where positivity rates had spiked.

Since late June, New York, New Jersey and Connecticut have worked in concert to create a list of states from which travelers to the region are subject to a two-week quarantine.

Essential workers have been exempt from the quarantine since it began in June, and Mr. Cuomo did not announce changes to that policy. Other workers who cross state lines have technically been subject to the advisory, but officials have also said that the quarantine is only required by those who spend at least 24 hours in a state on the list — which would exclude most commuters.

The effort, which began when all three states had emerged from devastating outbreaks, was meant to blunt the spread of the virus from places outside the region that were then experiencing high rates of positive test results.

The quarantine was intended to apply to any person arriving from an area with a positivity rate higher than 10 per 100,000 residents over a 7-day rolling average or an area with a 10 percent or higher positivity rate over a 7-day rolling average.

As of Monday, both New Jersey and Connecticut exceeded the former metric, state officials said.

New Jersey has a population of about 8.88 million people, and so anything over an average of about 888 new cases puts the state above that threshold. According to a New York Times database, New Jersey has seen an average of 1,016 cases per day in the past week, an increase of 54 percent from the average two weeks earlier.

For Connecticut, the threshold is around 356, and its daily average in the past week was at 378 cases per day.

Though New York has seen a significant uptick in cases in parts of New York City and its suburbs, its overall positivity rate has remained lower than its neighbors.

“Frankly, most of New York has a positivity rate lower than Connecticut,” Gov. Ned Lamont of Connecticut said on Monday. “But you do have these red-hot pockets.”

Despite the data, governors in all three states had dismissed the possibility of excluding travelers from crossing the borders. The three states share public transit links and have long been economically interdependent, with a significant number of commuters crossing state borders.

“The state-by-state quarantine is complicated,” Mr. Lamont said.

Credit…Kirsty Wigglesworth/Associated Press

Researchers at Imperial College London are planning to deliberately infect healthy volunteers with the coronavirus early next year as part of the world’s first effort to study how people immunized with different vaccines respond to controlled exposure to the virus.

The study, known as a human challenge trial, is scheduled to begin in January at a quarantine facility in London with 34 million pounds, or $44 million, of British government funding, the government announced on Tuesday.

Such a study could save time in the race to winnow down a large number of vaccine candidates.

Rather than testing vaccines the usual way — by waiting for vaccinated people to encounter the virus in their homes and communities — researchers would expose them to the virus in a controlled setting.

In the first stage of the study, scientists will try to determine the smallest doses of the virus required to infect people. The scientists will test gradually increasing doses of virus on up to 90 healthy volunteers from 18 to 30 years old until they reach a level that reliably infects them.

Once they have decided on a dose — potentially by late spring, the government said — researchers will begin to compare a set of coronavirus vaccine candidates by immunizing people and then deliberately infecting them. The government will decide which vaccines to test, but it has not announced them yet.

It is possible that by early next year, some of the vaccine candidates now undergoing trials will have already received approval.

But experts in medical ethics are divided over whether such a study is acceptable, largely because there is no highly effective treatment for Covid-19. The Imperial College London researchers said they would use the antiviral medicine remdesivir, but that drug has been found to have only modest benefit. Most other challenge trials have involved diseases like cholera and typhoid, which can be quickly and reliably cured with drugs.

Another concern is that the illness caused by the coronavirus is unpredictable, and although young people in general do not become gravely ill, there have been unexpected and unexplained cases of severe illness in young patients.

The trial will need approval from Britain’s Medicines and Healthcare products Regulatory Agency before volunteers are enrolled, and it will be monitored by independent experts once it begins, the researchers said.

At least initially, the challenge trial will involve only young, healthy volunteers, meaning the findings may not fully apply to the people at greatest risk of severe illness from Covid-19 — older people and those with underlying health problems.

The researchers said volunteers would be compensated for their time taking part in the trial and their two to three weeks in quarantine following infection. About 2,000 people in Britain have expressed interest in taking part in challenge trials through an American group, 1Day Sooner, that advocates for such studies.

The trial will be run by Imperial College London together with hVivo, a company that specializes in human challenge trials. It will initially be held at a hospital in north London.


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Prime Minister Boris Johnson of Britain said the highest level of coronavirus restrictions would be imposed for Manchester, which includes forbidding indoor socializing by people from different households.CreditCredit…Jon Super/Associated Press

Prime Minister Boris Johnson of Britain announced on Tuesday that Greater Manchester, the country’s second-largest urban area, would be put under the highest level of virus restrictions, shutting many pubs and bars and forbidding indoor socializing by people from different households.

The announcement came despite opposition from the area’s mayor, Andy Burnham, who had pushed for greater financial aid for affected residents, and amid a spike in cases around Europe that has reinvigorated the debate over how to balance economic and health concerns.

“I know these restrictions are tough on businesses and on individuals,” Mr. Johnson said. “Not to act would put Manchester’s N.H.S. and the lives of many of Manchester’s residents at risk.”

Mr. Johnson pointed to the area’s growing outbreak — it has reported more cases over the last seven days than any other place in England, according to a Times database. He added that he hoped that local officials would work with the central government to implement the restrictions, which take effect Friday.

The government will provide some 22 million pounds in aid, which Mr. Burnham argued was woefully insufficient. Talks over relief funds collapsed shortly before the announcement was made, though Mr. Johnson indicated they could be restarted.

“At no point today were we offered enough to protect the poorest people in our communities through the punishing reality of the winter to come,” Mr. Burnham said.

Ireland on Monday became the first European country to reimpose a national lockdown, in a dramatic U-turn for the government, which two weeks ago fell short of imposing the highest level of restrictions despite advice from public health experts. The six-week period will begin on Wednesday.




Ireland Reimposes National Lockdown

Ireland will impose a six-week lockdown to curb the spread of coronavirus cases with the hope of reopening in time for Christmas.

In the effort to suppress the virus, we have already introduced what is probably Europe’s strictest regime. As a result of this, we can see some evidence that these restrictions have been effective in slowing the growth and spread of the virus. However, as the daily figures show, these restrictions on their own have not been enough to significantly reduce the levels of infection. The government has decided that the evidence of a potentially grave situation arising in the weeks ahead is now too strong. Therefore, for a period of six weeks, from midnight on Wednesday night, the entire country will move to Level 5 of the framework for living with Covid-19. Even as the winter comes in, there is hope and there is light. If we pull together over the next six weeks, we will have the opportunity to celebrate Christmas in a meaningful way. Every Christmas is important, but this year it is particularly so.

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Ireland will impose a six-week lockdown to curb the spread of coronavirus cases with the hope of reopening in time for Christmas.CreditCredit…Paul Faith/Agence France-Presse — Getty Images

And in Italy’s northern region of Lombardy, the original center of the country’s outbreak, officials announced that they intended to impose a curfew aimed at curbing nightlife, especially in Milan, starting Thursday.

“The curfew is the best solution to hit the contagion, and it shouldn’t have serious repercussions on the economic situation,” Lombardy’s president, Attilio Fontana, told the Italian newspaper La Repubblica on Tuesday, “It will allow us to avoid stricter measures.”

The president of Campania, in southern Italy, said on Tuesday that he would also request a curfew. He said previously that the move was aimed at preventing Halloween celebrations, which he labeled “immense, stupid Americanata.”

Italians are desperate to avoid new lockdowns after enduring Europe’s longest one. But Prime Minister Giuseppe Conte said on Sunday that while officials were preparing to avoid a generalized lockdown, more circumscribed ones could not be ruled out.

Credit…Arun Sankar/Agence France-Presse — Getty Images

In a televised address Tuesday night, Prime Minister Narendra Modi of India urged citizens to tighten up their vigilance against the coronavirus as the Hindu festival season approaches.

“Recently, we saw many photos and videos which clearly proved that people have lowered their guard,” he said. “This isn’t right.”

In the next few weeks, more than a billion Indians will celebrate several major Hindu holidays, including Dussehra and Diwali, and authorities are worried about people packing together.

India is rapidly catching up to the United States in terms of its reported infections, almost 7.6 million known cases there compared with 8.2 million in the United States. India had been outpacing the United States in new infections, reaching nearly 100,000 new daily infections in mid-September. But in recent days that number has come down. As of Monday, the seven-day average for new daily cases in India was approximately 61,000, according to a New York Times database, just slightly higher than the average over the same time in the United States.

Some experts say that the decline might reflect that the virus is reaching a plateau in India. Other scientists caution that the decrease could also be explained by a shift in testing methods. India is increasingly using cheaper, less reliable rapid antigen tests.

Mr. Modi said that the precautions taken by Indians since the pandemic started have left India in a “stable situation.” But he cautioned that “We must not let it deteriorate.”

He emphasized that India’s death rate remained much lower than those of the United States and other Western countries. And he promised that his government was making “all efforts” to ensure that every Indian has access to a coronavirus vaccine once it is available.

Credit…Stefani Reynolds for The New York Times

U.S. stocks rose on Tuesday, the day Speaker Nancy Pelosi of California set as a deadline for a compromise stimulus deal that could be considered before the election. The S&P 500 was up nearly half a percent in early trading, after falling 1.6 percent on Monday.

On Monday, Ms. Pelosi instructed key Democratic lawmakers to work with top Republicans to try to resolve critical differences holding up a broad agreement with the Trump administration.

The directive came after she and Steven Mnuchin, the Treasury secretary, held their latest talks, speaking for nearly an hour by phone. A spokesman for Ms. Pelosi said there would be more clarity on the details by the end of Tuesday.

The odds of a last-minute deal remain long, with Democrats and the Trump administration still haggling over funding levels and policy issues. Even if they could agree, Senate Republicans have all but ruled out embracing a plan anywhere near as large as the more than $2 trillion package under discussion.

If such a deal were struck, Senator Mitch McConnell, Republican of Kentucky and the majority leader, said the chamber would consider it, but he also made a point of scheduling two separate votes in the coming days on narrower bills of the kind senators in his party are more willing to accept. One would revive a lapsed federal loan program for small businesses and the other would provide $500 billion for schools, testing and expired unemployment benefits.

President Trump has insisted in recent days that he wants to spend more than the $2.4 trillion Ms. Pelosi has put forward in negotiations, and claimed he could easily cajole enough Senate Republicans into supporting an agreement of that size — a notion that many of them have told his top deputies would never happen.

Still, Ms. Pelosi insisted she was optimistic a bargain could be reached and said she was intent on reaching one before a new Democratic administration began in January.

“I don’t want to carry over the droppings of this grotesque elephant into the next presidency,” Ms. Pelosi told her members. “We’ve got to get something big, and we’ve got to get it done soon and we’ve got to get it done right.”

Credit…Carlo Allegri/Reuters

To reduce the number of students sent home to quarantine after exposure to the coronavirus, the Billings Public Schools, the largest school district in Montana, came up with an idea that has public health experts shaking their heads: Reshuffling students in the classroom four times an hour.

The strategy is based on the definition of a “close contact” requiring quarantine — being within 6 feet of an infected person for 15 minutes or more. If the students are moved around within that time, the thinking goes, no one will have had “close contact” and be required to stay home if a classmate tests positive.

Greg Upham, the superintendent of the 16,500-student school district, said in an interview that contact tracing had become a huge burden for the district, and administrators were looking for a way to ease the burden when they came up with the movement idea. It was not intended to “game the system,” he said, but rather to encourage the staff to be cognizant of the 15-minute window.

In an email to administrators last week, Mr. Upham encouraged staff to “whenever possible, disrupt the 15-minute timeline through movement, distancing, and masking.”

Infectious disease experts say that moving students around every few minutes is actually more likely to increase transmission of the virus, by exposing more people to an infected student. It will also complicate contact tracing efforts, they said.

“That is not an evidence-based practice or sound scientific policy,” said Dr. Jennifer Nuzzo, an epidemiologist at the John Hopkins Center for Health Security who has been supportive of reopening schools for in-person instruction.

The 15-minute, 6-foot definition is a guideline for identifying who might be at greater risk of infection, not a hard-and-fast rule about when it can or cannot happen, Dr. Nuzzo said, adding that a person can certainly become infected in less time or from farther away, especially indoors.

Dr. Sarah Fortune, chair of the department of immunology and infectious diseases at Harvard’s school of public health, said the 15-minute definition was meant to help contact tracers “effectively and efficiently identify people with the highest risk and target intervention to them.”

Kelly Hornby, principal of Billings West High School, wrote in an email to his staff last week that moving students around every few minutes and then returning them to their original desks would help dissipate airborne droplets containing coronavirus, to the point “where the risk of being contaminated is greatly reduced.”

Dr. Fortune disagreed with that idea. “The particles that transmit Covid, they hang out in the air, and they spread through the air, and the aerosols can hang out for a very long time,” she said. “So stirring that air up or moving around from your spot doesn’t really limit your exposure or risk.”

Credit…Doug Mills/The New York Times

President Trump attacked Dr. Anthony S. Fauci as “a disaster” on Monday and said, despite signs that the nation was headed toward another coronavirus peak, that people were “tired” of hearing about the virus from “these idiots” in the government.

The broadside, during a conference call with campaign staff just two weeks before Election Day, was hardly the closing message Trump advisers were looking for. It threatened to focus the electorate squarely on the president’s coronavirus response and pitted him against Dr. Fauci, who as the nation’s top infectious disease expert is a career government scientist the public likes and trusts far more than Mr. Trump.

In increasingly vocal terms, Dr. Fauci has been separating himself from the White House and warning Americans to “hunker down” and brace for a difficult winter — a message at odds with Mr. Trump’s repeated, if false, assurances that the nation is “rounding the corner” on a pandemic that has claimed about 220,000 American lives.

“People are tired of Covid,” Mr. Trump complained on the call, which several reporters were invited into. “I have the biggest rallies I’ve ever had. And we have Covid. People are saying: ‘Whatever. Just leave us alone.’ They’re tired of it.”

He added, “People are tired of hearing Fauci and these idiots, all these idiots who got it wrong.”

Later Monday, at a campaign rally in Prescott, Ariz., Mr. Trump invoked Dr. Fauci as a way of ridiculing the coronavirus plan of his Democratic opponent, Joseph R. Biden Jr.

“Biden wants to lock it down. He wants to listen to Dr. Fauci,” the president said, referring to coronavirus-related restrictions on the economy. (Dr. Fauci, addressing a group of pathologists last week, said no one wants to “shut down the country again.”)

The Biden campaign, which has been emphasizing a promise to listen to science over politics, responded with relish: “Mr. President, you’re right about one thing: The American people are tired. They’re tired of your lies about this virus.”

Credit…Gregory Bull/Associated Press

The the second-largest public school system in California is overhauling its grading system in an attempt to address what its board of trustees said were “discriminatory practices” that have worsened during the pandemic.

The San Diego Unified School District, with about 105,000 students, said it would de-emphasize behavioral factors like classroom conduct, allow students to retake tests, and base each student’s final grade more on the student’s grasp of material at the end of the grading period, rather than on homework, quizzes or mid-term exams.

“We’re not getting rid of grades; we’re not eliminating homework; we’re not eliminating attendance as a responsibility for students,” said Richard Barrera, the vice president of the board. “But if a student gets a few bad grades and then aces the final, we’re saying that shouldn’t just average to a C.”

Mr. Barrera said the new district-wide “standards-based grading” policy, approved last week, was already being used in the system’s elementary schools and is now being expanded into middle and high schools.

The idea was under discussion before the pandemic, stemming from disproportionate numbers of failing grades among Black and Latino students, and from the death of George Floyd at the hands of police in Minnesota. But it gained new urgency this fall, as the difficulties of remote learning deepened disparities in student performance.

Only 7.2 percent of white students in San Diego’s secondary schools received grades of D or F in the last school year, according to district data, compared with 20 percent of Black students, more than 22 percent of Latino students and more than 23 percent of Native American students.

Forty-six percent of the district’s students overall are Latino, 12 percent are Asian-Pacific Islander, 8 percent are Black and a small proportion are Native American, he said. Two-thirds of the teachers are white.

“We focused on becoming an anti-racist school district,” Mr. Barrera said.

The grading change has drawn criticism from some conservatives, who say it diminishes the idea of academic excellence. But Kevin Beiser, a trustee who teaches middle-school math in a nearby district, said standards-based grading is meant to mitigate inequities like teachers conflating behavior with academic achievement, or affluent students having greater access to tutors.

“It doesn’t matter when you learn how to solve for x in algebra, as long as you learn it before the end of the school year,” he said.

In today’s edition of the Morning newsletter, David Leonhardt writes:

Let’s check in on the state of the coronavirus this morning, with help from three charts. Here’s the first:

Credit…By The New York Times | Sources: The COVID Tracking Project, state and local health agencies and hospitals

As you can see, the number of new virus cases in the U.S. is surging — and not far from this summer’s peak. You’re probably familiar with versions of that blue line. It is the most common metric for tracking the virus.

The rising line mostly reflects reality: The virus is surging, especially in the Upper Midwest. Cooler weather is leading to more indoor activity, which often leads to new cases, and many Americans seem tired of pandemic restrictions.

But you’ll notice that the red line on the chart — the number of Americans currently hospitalized with virus complications — looks less bad. It has risen lately, but it is not close to its peak.

Why? Partly because the number of virus cases is not actually rising as much as the official case numbers suggest.

That brings us to chart No. 2:

Credit…By The New York Times | Sources: The COVID Tracking Project

The U.S. is conducting a lot more tests than in the summer or spring. More widespread testing means that the official numbers are capturing a larger share of new virus cases than earlier this year.

“We have probably gotten better at finding cases, as testing capacity has increased, and so we can’t directly compare the size of the waves based on case counts alone,” Caitlin Rivers of Johns Hopkins University told me. “That’s a good development.”

The third chart also suggests some encouraging news:

Credit…By The New York Times | Sources: state and local health agencies and hospitals

Even as case numbers have soared and hospitalizations have risen, deaths have held fairly steady.

That’s happened as many older people — who are most vulnerable — have been careful about avoiding exposure. A greater share of current new cases is among young Americans.

The quality of virus treatments is also improving. Remdesivir, dexamethasone and monoclonal antibodies all seem to help, as my colleague Donald G. McNeil Jr. points out. Just consider how quickly both President Trump and Chris Christie recovered, despite their age and underlying health risks.

The full picture: There are some silver linings. The statistics on new virus cases that get so much attention are somewhat exaggerating the severity of the current outbreak, because of the rise in testing. And treatments have improved, reducing the death count.

But the virus’s toll has still been horrific — and worse than in many other countries. More than 220,000 Americans have died, and hundreds of people are still dying every day.

The overall situation is also getting worse, as the hospitalization numbers make clear. In some states, hospitals are almost full, and the virus continues to spread. “I’m just waiting to see if our community can change our behavior,” Debra Konitzer, the top health officer in Oconto County, Wis., recently said. “Otherwise, I don’t see the end in sight.”

As Donald McNeil says, “The fall wave has just begun.”

Global Roundup

Credit…Kevin Frayer/Getty Images

Chinese vaccines have been administered to 60,000 people in clinical trials, many of them around the world, and none of them have experienced any serious adverse reactions, a senior Chinese official said on Tuesday.

The figures came from Tian Baoguo, a senior official at China’s Ministry of Science and Technology, who spoke at a news conference. “Initial results show that they are safe,” he said.

China has four vaccine candidates in Phase 3 trials, the last stage of testing before regulatory approval. Because the outbreak is largely under control in China, these trials are conducted in more than 10 countries.

Within China, the Chinese government has not waited for clinical trials to conclude before vaccinating tens of thousands of people. Officials have already laid out plans to give shots to even more people, citing emergency use. But scientists have warned that taking a vaccine that has not completed Phase 3 trials carries health risks. On Sunday, the eastern Chinese city of Yiwu stopped the sale of a coronavirus vaccine after dozens of people demanded to be inoculated over the weekend.

China is expected to produce up to 610 million doses of coronavirus vaccines by the end of this year, Zheng Zhongwei, head of China’s coronavirus vaccine development task force said at the news conference, adding output will grow next year.

In other developments around the world:

  • Starting Tuesday, Heathrow Airport in London will offer one-hour coronavirus tests to travelers to Hong Kong and Italy, which require arriving passengers to show a negative test result. Heathrow, one of the busiest airports in the world, typically sees more than 80 million passengers a year.

Credit…Paul Kane/Getty Images

New Zealanders, under a travel arrangement announced earlier this month with Australia, are allowed to visit the states of New South Wales and the Northern Territory, which have seen relatively low cases of the coronavirus.

But some appear eager to keep on traveling.

Gaps have emerged in the arrangement, meant to be the start a travel bubble that would later encompass Australia, after New Zealanders who entered the country via participating states have traveled on to other parts of Australia for vacations, or to visit friends and family.

But the rules for where they could travel after arriving are unclear, and many have caught connecting flights to other cities, including Melbourne — which has been under some of the strictest lockdown laws in the world after a second wave of the virus hit in July.

Initially, the state government of Victoria, the state that encompasses Melbourne, took the position that the dozens of passengers were unwelcome and sent police to track them down. It later backtracked, acknowledging that anyone from New Zealand, which has for the second time eliminated the virus, did not pose a risk to the state.

Michael Outram, the head of the Australian Border Force, said that the states had never raised objections to New Zealanders entering the country.

“Once a passenger leaves the international terminal, once they depart the customs controlled area, the back of the baggage hall, they cease to be an international traveler or passenger, they’ve entered Australia,” Mr. Outram told reporters on Monday.

The bubble, he added, “stops at the international terminal.”

Credit…Lido Vizzutti for The New York Times

This summer, Governor Steve Bullock of Montana mandated face coverings in public spaces to combat a spike in Covid-19 cases. But the sheriff in the town of Hamilton, backed up by the Ravalli County commissioners, elected not to enforce the order, saying individual rights took priority.

That decision left small businesses stuck in the middle of a monthslong national conflict over mask wearing as they try to keep staff safe and their doors open without alienating customers.

For the owner of River Rising Bakery, Nicki Ransier, the commissioners’ decision made her life easier: “It kind of took some pressure off of us, because we’re not having that confrontation with our customers when they walk in.”

Before the governor’s order, Ms. Ransier asked her staff to wear masks, but a few customers berated her employees — some of whom are in high school — over the decision. One customer told the teenagers that they were “bending the knee to tyranny” by following Mr. Bullock’s order.

Other patrons wanted Ms. Ransier to flatly require masks for all and install costly plexiglass barriers. She felt she couldn’t please anyone, so she decided her policy would focus on what she could control: employees. She would let customers choose, but ask her 14 workers to wear masks even though it can be hot and miserable.

But the commissioners’ move frustrated Randy Lint, the owner of Big Creek Coffee Roasters. He thought the governor’s order would put an end to mask conflicts. Instead, he said, the commissioners’ decision “puts us at odds with customers.”

“Dealing with fallout from stressed customers has been one of the hardest parts of the pandemic,” Mr. Lint said.