Covid-19 Live Updates: States Should Prepare for Possible Vaccine by Early November, C.D.C. Says

The C.D.C. tells health officials to be ready to distribute a vaccine by November, raising concerns over politicized timing.

The Centers for Disease Control and Prevention has notified public health officials in all 50 states and five large cities to prepare to distribute a coronavirus vaccine to health care workers and other high-risk groups as soon as late October or early November.

The new C.D.C. guidance is the latest sign of an accelerating race for a vaccine to greatly ease a pandemic that has killed more than 184,000 Americans. The documents were sent out last week, the same day that President Trump told the nation in his speech to the Republican convention that a vaccine may arrive before the end of the year.

Over the past week, both Dr. Anthony S. Fauci, the country’s top infectious disease expert, and Dr. Stephen Hahn, who heads the Food and Drug Administration, have said in interviews with news organizations that a vaccine could be available for certain groups before clinical trials have been completed, if the data were overwhelmingly positive.

Public health experts agree that agencies at all levels of government should urgently prepare for what will eventually be a vast, complex effort to vaccinate hundreds of millions of Americans. But the possibility of a rollout in late October or early November has also heightened concerns that the Trump administration is seeking to rush the distribution of a vaccine — or simply to suggest that one is possible — before Election Day on Nov. 3.

“This timeline of the initial deployment at the end of October is deeply worrisome for the politicization of public health and the potential safety ramifications,” said Saskia Popescu, an infection prevention epidemiologist in Arizona. “It’s hard not to see this as a push for a pre-election vaccine.”

Three documents were sent to public health officials in all states and territories as well as New York, Chicago, Philadelphia, Houston and San Antonio on Aug. 27. They outlined detailed scenarios for distributing two unnamed vaccine candidates — each requiring two doses a few weeks apart — at hospitals, mobile clinics and other facilities offering easy access to the first targeted recipients.

The guidance noted that health care professionals, including long-term-care employees, would be among the first to receive the product, along with other essential workers and national security employees.

People aged 65 or older, as well as those from “racial and ethnic minority populations,” Native Americans and incarcerated individuals — all communities known to be at greater risk of contracting the virus and experiencing severe disease — were also prioritized in the documents.

The National Academies of Sciences, Engineering and Medicine unveiled a 114-page plan on Wednesday, sponsored by the C.D.C. and the National Institutes of Health, that proposed a complicated four-phase system for priority.

The C.D.C. noted in its guidance that “limited Covid-19 vaccine doses may be available by early November 2020.” It also said its plans were still hypothetical, noting, “The Covid-19 vaccine landscape is evolving and uncertain, and these scenarios may evolve as more information is available.” A C.D.C. spokeswoman confirmed that the documents were sent but declined to comment further.

A Minnesota man is the first person known to have died of Covid-19 after attending the Sturgis Motorcycle Rally in South Dakota last month, a 10-day event where hundreds of thousands of people gathered, many showing little attention to social distancing or mask wearing, and health officials worried it could become a superspreader event.

State health officials in Minnesota confirmed the death, saying the man was in his 60s and had underlying health conditions; he had been hospitalized for several weeks, they said.

South Dakota has seen sharp increases in virus cases since the rally in Sturgis, a small town north of Rapid City in the western part of the state. And cases linked to the rally have been reported in a number of other states; Minnesota alone has confirmed more than 50 cases traced back to the Sturgis rally, officials said.

Before Aug. 1, Meade County, which includes Sturgis, had reported just 71 cases over the pandemic’s first six months. By Sept. 1, the figure had shot up to 305, according to the State Health Department. That includes 26 cases detected when the city of Sturgis held a testing event for residents after the rally; 650 people took part.

South Dakota as a whole has reported more than 2,000 new cases in the past week, setting single-day records several times, according to a New York Times database.

Despite the surge of cases in South Dakota, Gov. Kristi Noem has said she has no plans to tighten restrictions in the state or issue a mask order.

“I won’t be changing my recommendations that I can see in the near future,” Ms. Noem, a Republican, said at the Sioux Falls Rotary Club on Monday. “I think this is where we expected to be. None of this is a surprise, and we will continue to evaluate and see what the future looks like.”

Another mass event, the South Dakota State Fair, is scheduled to open in Huron, S.D., on Thursday and last through Labor Day. “Exposure to Covid-19 is an inherent risk in any public location where people are present,” the fair warns on its website, adding, “By visiting the South Dakota State Fairgrounds, you voluntarily assume all risks related to exposure to Covid-19.”

New studies show inexpensive steroid drugs can help critically sick people survive Covid-19.

International clinical trials published on Wednesday confirmed the hope that cheap, widely available steroid drugs can help seriously ill patients survive Covid-19.

Following release of the new data, the World Health Organization on Wednesday strongly recommended steroids for treatment of patients with severe or critical Covid-19 worldwide. But the agency recommended against giving the drugs to patients with mild disease.

The new studies include an analysis that pooled data from seven randomized clinical trials evaluating three steroids in over 1,700 patients. The study concluded that each of the three drugs reduced the risk of death.

That paper and three related studies were published in the journal JAMA, along with an editorial describing the research as an “important step forward in the treatment of patients with Covid-19.”

Corticosteroids should now be the first-line treatment for critically ill patients, the authors added. The only other drug shown to be effective in seriously ill patients, and only modestly at that, is remdesivir.

Steroids like dexamethasone, hydrocortisone and methylprednisolone are often used by doctors to tamp down the body’s immune system, alleviating inflammation, swelling and pain. Many Covid-19 patients die not of the virus, but of the body’s overreaction to the infection.

The analysis of pooled data found that steroids were linked with a one-third reduction in deaths among Covid-19 patients. Dexamethasone produced the strongest results: a 36 percent drop in deaths in 1,282 patients treated in three separate trials.

In June, researchers at Oxford University discovered that dexamethasone seemed to improve survival rates in severely ill patients. Researchers had hoped that other inexpensive steroids might help these patients.

Taken together, the new studies will bolster confidence in the use of steroids and address any lingering hesitancy on the part of some physicians, said Dr. Todd Rice, an associate professor of medicine and critical care physician at Vanderbilt University School of Medicine.

“This shows us steroids are clearly beneficial in this population and should clearly be given, unless you absolutely can’t for some reason, which needs to be a pretty rare occasion,” he said.

Silvio Berlusconi, Italy’s former prime minister, tested positive for the coronavirus following a “precautionary check,” his staff announced on Wednesday.

Mr. Berlusconi, 83, is working from his mansion near Milan, where he will spend the isolation period, according to a prepared statement. He will continue his political activities, including daily interviews on television and social media to support his party’s candidates at the upcoming regional elections.

His physician, Dr. Alberto Zangrillo, told the Italian news agency ANSA that Mr. Berlusconi was asymptomatic.

Mr. Berlusconi, also a media mogul, recently returned from a vacation at his villa in Sardinia, where he met political allies and friends, including Flavio Briatore, a businessman whose upscale nightclub gave rise one of the island’s largest clusters of coronavirus infections. Mr. Briatore also tested positive last week.

Some regions of the country set up tents for rapid testing at ports, airports and train stations, after it emerged that many recent cases stemmed had emerged among tourists returning from Sardinia. The island’s beaches and clubs were very busy this year, as Italians chose to spend their holidays nearer to home.

As the news spread that Mr. Berlusconi had the virus, politicians across the spectrum flooded social media with comments and good wishes.

“I want to send my best wishes to Silvio Berlusconi for a rapid recovery by all the democrats’ community,” Nicola Zingaretti, the leader of the Democratic Party and one of the first political leaders to have the virus last March, wrote on Twitter. “He will strongly fight this battle, too.”

Matteo Salvini, leader of the right-wing League party, sent a “hug” to his “friend” via social media, while Giorgia Meloni of the extremist party Fratelli d’Italia, Brothers of Italy, called Mr. Berlusconi a “lion” on Twitter and wrote that he will “Brilliantly overcome this, too.”

In March, when the pandemic hit Italy, Mr. Berlusconi was criticized for fleeing the country he once governed. He posted pictures of himself working from his daughter’s villa near Nice, France.

Judge orders the University of California to stop considering SAT or ACT scores because of the pandemic.

A state judge has barred the huge and influential University of California system from using SAT and ACT test scores in making decisions about which students to admit and whether to award scholarships, saying that students with disabilities would be unfairly hurt by having to take the tests under pandemic conditions.

“The barriers faced by students with disabilities have been greatly exacerbated by the Covid-19 pandemic, which has disrupted test-taking locations, closed schools and limited access to school counselors,” Judge Brad Seligman of Superior Court in Alameda County said in issuing a preliminary injunction on Tuesday.

The system’s governing board, the Board of Regents, voted in late May to phase out the use of standardized test scores in admissions for California students over the next four academic years. In the meantime, the system would look for a replacement test that would not be freighted with the accusations of bias against Black, Hispanic and poor students that have dogged the SAT and the ACT in recent years.

The judge’s decision comes two months before the application deadline for admission in the fall of 2021. The system had already decided to make submission of test scores optional because of the pandemic, and some U.C. campuses, like Berkeley, had decided not to consider them in admissions.

The judge’s injunction means that the test scores cannot be used anywhere in the U.C. system for admissions or scholarship decisions as long as the underlying lawsuit — a challenge to the tests’ legitimacy — is pending.

The University of California said in a statement that “an injunction may interfere with the university’s efforts to implement appropriate and comprehensive admissions policies and its ability to attract and enroll students of diverse backgrounds and experiences.” The statement said the university was considering whether to appeal.

Trump’s new coronavirus adviser has questioned masks and alarmed government scientists.

Dr. Scott W. Atlas has argued that the science of mask wearing is uncertain, that children cannot pass on the coronavirus and that the role of the government is not to stamp out the virus but to protect its most vulnerable citizens as Covid-19 takes its course.

Ideas like these, ideologically freighted and scientifically disputed, have propelled Dr. Atlas, a radiologist and senior fellow at Stanford University’s conservative Hoover Institution, into Mr. Trump’s White House. Dr. Atlas is neither an epidemiologist nor an infectious disease expert, but his frequent appearances on Fox News and his ideological surety caught the president’s eye.

Mr. Trump has embraced Dr. Atlas even as he upsets the balance of power within the White House coronavirus task force with ideas that top government doctors and scientists find misguided — even dangerous — according to people familiar with the task force’s deliberations.

That might be the point.

“I think Trump clearly does not like the advice he was receiving from the people who are the experts — Fauci, Birx, etc. — so he has slowly shifted from their advice to somebody who tells him what he wants to hear,” said Dr. Carlos del Rio, an infectious disease expert at Emory University. He was referring to Dr. Anthony S. Fauci, the country’s leading infectious disease scientist, and Dr. Deborah L. Birx, the White House coronavirus response coordinator.

Pompeo defends the U.S. decision to stay out of the W.H.O.’s global campaign to develop and distribute a vaccine.

Secretary of State Mike Pompeo accused the World Health Organization on Wednesday of being ineffective and politically influenced as he defended the Trump administration’s rejection of a coordinated global initiative to distribute a coronavirus vaccine.

At least 172 countries are negotiating to join the so-called Covax program, the only worldwide effort among governments and manufacturers to approve and distribute a vaccine. So far, nine potential vaccines have been evaluated, and nine more are still being tested, according to the W.H.O.

Earlier this year, the Trump administration blamed the W.H.O. for failing to do enough to stop the pandemic, including what officials described as allowing China to cover up the severity and spread of the coronavirus. In July, the United States started a one-year withdrawal process from the W.H.O. with a formal notification to the United Nations.

Since then, the United States has begun working independently with health organizations that are also part of the W.H.O. effort, including a $1.6 billion commitment to Gavi, the Vaccine Alliance. So far, the United States has committed to spend $20.5 billion on global coronavirus response efforts, including vaccines, according to the State Department.

“There is no nation that has been, or will be, as deeply committed to delivering vaccines all around the world as the United States of America,” Mr. Pompeo said on Wednesday, asked about the American refusal to join Covax, as first reported by The Washington Post.

At least 92 candidate vaccines are under active preclinical investigation in laboratories across the world, with 69 of them slated to begin clinical trials before the end of 2021, according to a database maintained by The Times.

In a statement, the W.H.O. called the United States a “vital partner” in global health efforts since the U.N. created the organization in 1948. “The response to this pandemic must be collective — no one is safe until everyone is safe,” the W.H.O. said.

Neymar, soccer’s costliest player, is among three players from the Paris St.-Germain team that played in last week’s Champions League final to test positive, becoming the latest high-profile soccer stars to do so ahead of the new season.

Neymar faces missing out on the start of his club’s latest campaign because of strict protocols that require players who have tested positive to isolate from the rest of the roster.

His team, which paid a record $263 million for the forward in 2017, confirmed that three of its players had tested positive, without providing names of the individual athletes. However, people familiar with the matter said Neymar was among the trio, speaking on condition of anonymity because the players were not identified publicly.

A spokeswoman for Neymar declined to comment. Media reports identified the other players as Ángel di María and Leo Parades, two teammates who accompanied Neymar on a vacation to the Spanish island Ibiza.

The cases put in doubt the availability of the three P.S.G. players for its first league game in defense of its French league title on Sept. 10. The virus has already disrupted the start of the French season, with the opening game between Marseille and Saint Etienne postponed after Marseille reported four positive tests.

P.S.G. said it will carry out more tests on players and staff over the next few days.

A German company has begun marketing a coronavirus antibody test that allows patients to prick their fingers at home and mail in a test strip for evaluation, forgoing the need to visit a doctor.

The test, called AProof and made by Adversis Pharma, is among the first at-home antibody tests, according to Dr. Alexander Edwards, who tracks antibody testing at the University of Reading in Britain. He called the new test a “significant development.”

The test kit contains two finger-pricking lancets, a paper card, and a return envelope addressed to a lab in Leipzig, Germany. The customer pricks a finger, places blood droplets on the paper, encloses it in a plastic bag and returns the sample to the lab.

Results are available online to people in Germany 24 to 48 hours after the lab receives the card, according to the company, and later to customers outside the country. The kit, developed with the University of Leipzig, costs $59 (or 49 euros).

Adversis Pharma said that the test is highly sensitive for coronavirus antibodies but acknowledged that false-positive results do occur.

Antibodies may develop days or weeks after infection with the coronavirus, and antibody testing is not recommended for diagnosis of the infection. Dr. Jörg Gabert, a director of the company, said he expected the test to be used by people who believe they might have been infected in the past but were not diagnosed.

It’s not clear what consumers should do about a positive antibody test. While researchers generally assume that antibodies confer some protection against the coronavirus, no one is yet certain how strong the immunity may be or how long it may last.

Antibodies to the virus decline within weeks or months of recovery from the infection, and scientists are struggling to understand what role another branch of the body’s disease-fighting machinery, so-called cellular immunity, plays in protecting people who have recovered.

Already scientists are finding cases of reinfection — patients who apparently recovered from the coronavirus but were infected again just weeks later. Until more is known, the World Health Organization has warned against using antibody tests to certify that people are immune.


Biden, in speech, faults Trump over reopening schools.

Joseph R. Biden Jr., pressing his argument that Mr. Trump is failing the country with his handling of the virus, said Wednesday that Mr. Trump is hurting the nation’s parents, teachers and schoolchildren with his push for schools to reopen.

“President Trump still doesn’t have any real plan for how to open our schools safely,” Mr. Biden said in a short speech in Wilmington, Del., after receiving a briefing from a group of experts. “No real plan for how to help parents feel secure for their children. He’s offering nothing but failure and delusions. From the start to finish, the American families and our children are paying the price for his failures.”

The Biden campaign said that Mr. Biden and his running mate, Senator Kamala Harris, were urging Mr. Trump to work with congressional leaders to provide emergency funding for schools of at least $200 billion. Mr. Biden and Ms. Harris also would direct the Federal Emergency Management Agency to make available federal aid to K-12 schools to support their reopening and operations amid the crisis, the campaign said.

Mr. Trump has demanded that schools reopen this fall and threatened to cut federal funding for school districts that defied his wishes. But his effort to pressure schools did not have the effect he desired, and many districts decided to begin the school year with remote instruction.

Prior to Mr. Biden’s speech, he and his wife, Jill Biden, a community college professor, were briefed by a group of experts, including Sylvia Mathews Burwell, who served as secretary of health and human services for President Barack Obama and is now the president of American University, and Linda Darling-Hammond, the president of the California State Board of Education.

Symone Sanders, a senior adviser for the Biden campaign, said Mr. Trump was “barreling forward trying to reopen schools because he thinks it will help his own re-election.”

“We believe this is a key contrast for voters,” Ms. Sanders said. “President Trump, who continues to ignore the science and has no plan to get the virus under control, and Joe Biden, who is working with the experts and putting together an effective plan to beat the virus and reopen schools safely.”

Elsewhere in the U.S.:

  • In New York City, where indoor dining remains prohibited, the mayor said on Wednesday that he felt like the industry was owed more clarity this month on a possible timeline and set of standards for reopening. “We need to decide that in the next few weeks,” the mayor said, “whether its good news or bad news.”

  • A day after New York City’s school system delayed the start of classes, Gov. Philip D. Murphy of New Jersey said that state’s schools were still on track to reopen next week. Mr. Murphy said that 434 of New Jersey’s school districts were expected to open with a hybrid model that combined in-person and remote learning, while 68 will start with all in-person instruction, 242 with only remote learning, and 22 with “some combination.”

  • As Iowa has faced the most new cases per capita of any state over the last seven days, Joni Ernst, the state’s junior senator and a Republican in a tight race for re-election, echoed a debunked conspiracy theory that coronavirus death tolls were being greatly inflated and suggested that health care providers had a financial motive to falsify cases.

  • A Trump administration order could allow millions of renters who have suffered financially because of the pandemic to avoid eviction through the end of the year. While the new policy, which goes into effect on Sept. 4, could bring relief to some American renters, there is a lot of fine print about who is eligible for the benefit (you must meet a five-pronged test), whether you will be expected to pay everything owed to the landlord in January (maybe) and what kind of penalties the landlord could face if the policy is ignored (depending on the situation, up to $250,000 or a year in jail or both).

Greece reported the first case of the coronavirus in the Moria camp for migrants on the Aegean island of Lesbos. The migration ministry said the facility would be locked down for two weeks as health inspectors tested other residents. Living conditions at the camp have been decried by human rights groups as it hosts nearly 12,000 people, four times its maximum capacity of 3,000. The patient is a 40-year-old man from Somalia who left after securing refugee status but “returned illegally to Moria and had been living in a tent outside the camp’s perimeter,” the ministry said.

In other news around the world:

  • Direct international flights to Beijing, the capital of China, will gradually resume, officials said Wednesday, with service from Thailand, Cambodia, Pakistan, Greece, Denmark, Austria, Sweden and Canada.

  • At the Vatican, Pope Francis welcomed his first general public audience since the pandemic struck more than six months ago. St. Peter’s Basilica had been closed to visitors since mid-March as the virus exacted a heavy toll on Italy. Francis said that it was “beautiful” to encounter people “face to face and not screen to screen,” referring to his virtual audiences.

  • Hungary reported a daily record on Wednesday, with 365 new cases. The country, which has had relatively few cases — 6,257, according to a New York Times database — has barred most foreign travelers and is making returning citizens isolate themselves.

  • After mass demonstrations in Berlin last weekend against the government of Germany’s coronavirus regulations, the city decided to require masks at large protests. Now, organizers say they’re planning a large event, timed for the 30th anniversary of German reunification on Oct. 3, at Lake Constance in the south.

  • Also in Germany, the state of Saxony will allow 8,500 fans — one-fifth of the stadium’s capacity — to attend a soccer match between RB Leipzig and Mainz 05 on Sept. 20. The country’s top league shut down in March, but restarted to finish its season without fans present; RB Leipzig persuaded local and state authorities that it could limit the risk of infection if it kept the crowd small, required masks and sold no alcohol.

  • After nearly three decades of economic growth, Australia officially fell into recession after its economy shrank 7 percent in the second quarter, the government said on Wednesday. The drop in quarterly G.D.P. is the largest since record-keeping began in 1959.

Reporting was contributed by Trip Gabriel, Michael Gold, Anemona Hartocollis, Sheila Kaplan, Thomas Kaplan, Juliana Kim, Niki Kitsantonis, Isabella Kwai, Ron Lieber, Benjamin Novak, Richard C. Paddock, Tariq Panja, Gaia Pianigiani, Roni Caryn Rabin, Campbell Robertson, Christopher F. Schuetze, Michael D. Shear, Dera Menra Sijabat, Daniel E. Slotnik, Sheryl Gay Stolberg, Eileen Sullivan, Jim Tankersley, Katie Thomas, Mark Walker, Katherine J. Wu, Noah Weiland and Elaine Yu.

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