Hospitals in New York State will now face fines and potentially lose the opportunity to distribute the coronavirus vaccine if they do not step up the pace of inoculations, Gov. Andrew M. Cuomo said on Monday.
The governor said hospitals could face fines of up to $100,000 if they did not use their current supplies of vaccine by the end of the week, and that facilities would be required to use future shipments within seven days of receipt, or face possible removal from distribution networks.
“We want those vaccines in peoples’ arms,” Mr. Cuomo said.
New York lags behind other large states in distributing the vaccine, and Mr. Cuomo is facing pressure to fast-track the vaccinations as deaths and hospitalizations continue to rise in the state.
Mr. Cuomo told reporters about the new penalties during a news conference at which he estimated that about 300,000 people in the state had been inoculated so far. In a call with reporters later on Monday, Mr. Cuomo announced that a case of a more contagious virus variant first identified in Britain had been found in New York State. Mr. Cuomo said the state had conducted about 5,000 tests for the British variant and that this was the first known case.
He also announced proposed legislation that would impose criminal charges on facilities and health care providers that ignore guidelines on who is eligible for the vaccine, and exhorted hospital administrators to dispense the vaccine faster, listing the 10 most and 10 least successful hospitals in the state side by side.
“This is a management issue of the hospitals,” Mr. Cuomo said, adding that “They have to move the vaccine faster.”
The announcements came after some health experts expressed concern about the slow pace of vaccinations in the city.
At an earlier news conference on Monday, Mayor Bill de Blasio said that New York City will double the number of coronavirus vaccination sites in the city and broaden the pool of people who are eligible to be inoculated in order to achieve his goal of administering one million doses in the city during January. He said that so far about 110,000 people in the city had received a first dose of the vaccine.
Mr. de Blasio said that New York State had added a number of categories of workers to the eligible list, including testing-site workers, contact tracers, dentists, physical therapists, police department medical staff, workers at specialized clinics, and outpatient and ambulatory care providers.
“We want to keep expanding those categories,” Mr. de Blasio said. “The more people that we can reach quickly, the better.”
There are currently about 125 vaccination sites in the city. Mr. de Blasio said he planned to open at least 125 more by the end of January. Dr. Dave A. Chokshi, the city health commissioner, said that the administration hoped to add at least 35 of the new sites by the end of this weekend.
“From this point on, seven days a week, 24/7, has to be the attitude and the approach,” Mr. de Blasio said.
Dr. Chokshi noted that some of the first health care workers to be vaccinated in the city would be receiving the required second dose this week.
The latest coronavirus statistics Mr. de Blasio offered were grim. New York City has been averaging 3,976 new cases a day over the past week, he said, with about 9 percent of tests coming back positive.
“We obviously want to get back below 5 percent,” Mr. de Blasio said. “We’re going to push hard to get this number back down in the days and weeks ahead. Nothing will be more important than the vaccination effort to help us get there.”
The case of the British variant found in the state was identified in a Saratoga Springs man in his 60s who had not traveled recently, suggesting community spread of the variant, Mr. Cuomo said.
Mr. Cuomo also appeared to effectively end the six-month battle over whether to reopen schools in New York City by announcing that the city and other regions of the state could keep schools open past the 9 percent positivity rate threshold he set over the summer. Schools can stay open as long as virus rates within school communities remain lower than the overall community average.
Mr. Cuomo said it would now be up to individual school districts, rather than his office, to decide whether to stay open.
In New York City, parents and educators had been nervously watching the local positivity rate climb for weeks, wondering if schools would close yet again. Mr. de Blasio said over the summer that schools would close if the citywide positivity rate reached 3 percent, according to the city’s metrics.
He closed schools when the city hit that threshold, but soon reopened them, saying there would no longer be a specific threshold for closure. On Monday, morning Mr. de Blasio said he expected to keep elementary schools open, along with classrooms for children with the most complex disabilities, and the governor has given him permission to do so.
But on Monday afternoon, the president of the city’s teachers’ union said it would push the mayor to close schools if the citywide positivity rate reaches 9 percent, according to the state’s metrics. The city could soon reach that number, setting up a potential battle between City Hall and the union. Middle and high schools have been closed since November, and appear likely to stay closed indefinitely.
As governments around the world rush to vaccinate their citizens, scientists and policymakers are debating whether to reserve the second doses everyone will need, or give as many people as possible just one shot now — potentially at the expense of giving second doses on schedule.
A number of countries in Europe are considering the options, or moving forward with the delay, despite a lack of evidence about how much protection a single dose of vaccine will provide and how long it will last.
Denmark on Monday approved a lag of up to six weeks between the first and second shots of the Pfizer-BioNTech vaccine, Reuters reported, although the vaccine is meant to to be given in doses three weeks apart. Germany and Ireland are considering similar moves.
Britain last week announced a plan to separate doses by up to 12 weeks. Britain has authorized Pfizer’s vaccine as well as the product developed by the University of Oxford and AstraZeneca, which is meant to be given in doses separated by four weeks.
So far, health officials in the United States have been adamantly opposed to the idea, saying it is not supported by the data gathered in clinical trials.
“The approach some countries are taking of delaying the booster shot could backfire and could decrease confidence in the vaccines,” Moncef Slaoui, scientific adviser of Operation Warp Speed, the federal effort to accelerate vaccines, said on Sunday night.
In the late-stage clinical trial that found the vaccine from Pfizer-BioNTech to be highly effective, participants generally received their seconds shots about three weeks after the first, although data were included from people who received the doses as far as seven weeks apart. In a statement on Monday, the European Union’s drug regulator, the European Medicines Agency, expressed support for sticking to the original plan for spacing the doses of the vaccine. “Any change to this would require a variation to the marketing authorization as well as more clinical data to support such a change,” said Monika Benstetter, an agency spokeswoman.
Since the United States began rolling out authorized vaccines from Pfizer-BioNTech and Moderna, second shots of the vaccines have been sequestered to guarantee that they will be available for people who have gotten their first injections.
Pfizer has also pushed back on the idea of additional lag time. “Two doses of the vaccine are required to provide the maximum protection against the disease,” said Steven Danehy, a spokesman for Pfizer. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”
The developers of authorized vaccines have reported that a degree of protection appears to kick in after the first shot of vaccine, although it’s unclear how quickly it may wane.
Still, despite a high-level repudiation of the U.K. strategy from Dr. Anthony S. Fauci, the nation’s top infectious disease expert, some scientists believe the United States should consider widening the gap between doses. Proponents of the idea argue that spreading vaccines more thinly across a population by concentrating on first doses may save lives.
On Sunday, Dr. Robert M. Wachter, the chair of the department of medicine at the University of California at San Francisco, and Dr. Ashish K. Jha, the dean of the Brown University School of Public Health, wrote in an opinion piece in The Washington Post that “it’s time to change the plan.”
“The biggest mistake you can make in medicine is anchoring bias,” Dr. Wachter told The New York Times. “You get stuck on what you thought, and you don’t shift with new information.”
The debate reflects frustration that so few Americans have gotten their first doses.
As of Monday morning, three weeks into the vaccination drive, 15.4 million doses of the Pfizer-BioNTech and Moderna vaccines had been shipped across the United States, but just 4.6 million people had gotten their first shots.
The rollout has been bumpy. In Houston, the Health Department phone system crashed on Saturday, the first day officials opened a free vaccination clinic. In Los Angeles, now a center of the pandemic, Mayor Eric Garcetti said that vaccine distribution was moving far too slowly. In New York, Gov. Andrew M. Cuomo said on Monday that hospitals in the state will now face fines and potentially lose the opportunity to distribute the vaccine if they do not step up the pace of inoculations.
But some experts are not convinced that increasing the gap between doses will solve the problems that have slowed the rollout of vaccines in the United States.
“We have an issue with distribution, not the number of doses,” said Saad Omer, a vaccine expert at Yale University. “Doubling the number of doses doesn’t double your capacity to give doses.”
Prime Minister Boris Johnson imposed a strict new national lockdown on Monday as Britain’s desperate race to vaccinate its population risked being overtaken by a fast-spreading variant of the coronavirus that was on track to overwhelm the nation’s beleaguered hospitals.
After several days of frighteningly high and escalating case numbers, Mr. Johnson ordered schools and colleges in England to shift to remote learning. He appealed to Britons to stay at home for all but a few necessary purposes, including essential work and buying food and medicine.
The decision was a fresh setback for Mr. Johnson, coming at a time when the arrival of two vaccines appeared to provide a route out of the crisis after nine fraught months and fierce criticism of his handling of the pandemic.
On the day that the first doses of a vaccine developed by AstraZeneca and the University of Oxford were administered, the good news was drowned out by the reintroduction of the type of sweeping restrictions used last spring when the pandemic first threatened to run out of control.
In recent weeks, a new, highly transmissible variant of the virus has taken hold in London and southeast England, prompting an alarming spike in case numbers and putting hospitals under acute pressure.
On Sunday, Mr. Johnson admitted that the current controls on daily life were insufficient. But the first announcement of a full-scale lockdown came not from him but from Scotland, where the first minister, Nicola Sturgeon, has consistently moved further and faster in efforts to tame the pandemic.
Britain is now involved in a high stakes race to roll out its mass vaccination program before its country’s health service is overwhelmed by the new variant. Non-Covid treatment is again being postponed and pictures of ambulances stacking up in the parking lots of some hospitals last week illustrated the challenge faced by the country’s weary health workers.
In a sign of the threat faced by hospitals, the government raised its Covid alert to its highest level for the first time, one that warned of a “material risk of health care services being overwhelmed.” On Monday, there were more than 26,000 Covid-19 patients in hospitals, an increase of 30 percent from the previous week, Mr. Johnson’s office said.
New infections have surged to a rate of almost 60,000 a day, double the rate of a few weeks ago.
With 75,024 deaths, Britain already has the highest death toll in Europe, and medical experts warn that the toll, after growing more modestly over the summer, will begin spiking again.
Thailand, which had been among the most successful countries in containing the coronavirus, imposed wide-ranging new measures on Monday as infections hit a new daily high of 745.
The prime minister, Prayuth Chan-ocha, urged people to stay home but stopped short of calling the new measures a lockdown, which would have prompted government compensation for people put out of work.
In Bangkok, the capital, the government closed schools, bars, entertainment venues and gyms. Employers were urged to allow working from home, but malls and cinemas were permitted to stay open and restaurants were allowed to serve food indoors until 9 p.m.
“This is up to everyone,” Mr. Prayuth told reporters. “If we don’t want to get infected, just stay home for 14 to 15 days.”
The announcement came as Japanese officials considered declaring a state of emergency in Tokyo for the first time since April. The authorities on Monday requested that restaurants and bars close by 8 p.m. to prevent further spread of the virus.
The capital had recorded a record high of 1,337 cases in one day last week, and the local government had already asked residents to refrain from all but essential outings at night. Companies have been encouraged to allow employees to work from home, and universities have been asked to move classes online.
Japan has not yet approved any coronavirus vaccines, but it has contracts to buy doses from Pfizer, Moderna and AstraZeneca.
The country has reported a total of more than 240,000 cases and more than 3,500 deaths, with several record-setting days in recent weeks. Last month, as Japan detected cases of the more transmissible variant of the coronavirus that first emerged in Britain, the government closed the borders to foreign travelers.
Thailand had seen greater success in avoiding outbreaks: Until mid-December, the country recorded about 6,000 cases and 60 deaths. Nearly all new cases were detected in quarantine, which is required for anyone arriving from abroad.
But an outbreak last month at a seafood market in Samut Sakhon Province near Bangkok quickly spread among migrant workers living in close quarters and, from there, to much of the rest of the country.
Of the 745 new cases reported on Monday, 577 were found among undocumented workers.
In China, where life is largely back to normal, “wartime mode” measures have been imposed in several regions in the north of the country, where officials are conducting mass tests, sealing off villages where there have been confirmed infections and limiting entry into certain districts. The health authorities reported 33 new cases and 40 asymptomatic cases, which the country does not designate as confirmed cases, in mainland China on Monday. Beijing has begun vaccinating adults under 60, using the state-backed Sinopharm vaccine.
And on Saturday in South Korea, the government said it would extend until Jan. 17 restrictions in and around Seoul that had shuttered schools, gyms, karaoke rooms, bars and other high-risk facilities. Those restrictions are at the second-highest level of a five-tier system, in a country whose pandemic response was once held up as a model.
The government in India has defended regulators’ decision to approve a homegrown coronavirus vaccine that is still under trial after opposition lawmakers and health care monitors said the authorization was a political move to burnish the image of Prime Minister Narendra Modi.
The approval for the shot, called Covaxin, which has been developed by the Indian company Bharat Biotech, came on Sunday, along with authorization for the Oxford-AstraZeneca vaccine.
With the approvals, India, which has a population of about 1.3 billion, became the first country in South Asia to authorize shots. Government figures have celebrated the Covaxin approval as a triumph for India and for a stimulus package introduced by Mr. Modi with the aim of making the country more “self-reliant.”
However, All India Drug Action Network, an independent network of nongovernmental organizations, expressed shock over the Covaxin authorization because the shot was still in Phase 3 trials.
“The only human data available on safety and immunogenicity is on 755 participants in Phase 1 and 2 trials,” the network said in a statement. “Other than this, there is data from animal studies.”
Other experts have also raised concerns, pointing out disparities in publicly available data about the vaccine’s effectiveness.
Dr. Gagandeep Kang, a medical researcher, said that although Bharat Biotech had published some information, the Phase 3 trial of Covaxin had started only in November.
“There is absolutely no efficacy data that has been published,” she said.
Shashi Tharoor, an opposition politician, posted a series of messages on Twitter on Monday, criticizing what he called “chest-thumping ‘vaccine nationalism’” and saying that the desire to bolster Mr. Modi’s stimulus campaign had “trumped common sense and a generation of established scientific protocols.”
But Dr. Harsh Vardhan, the Indian health minister, said such comments were “disgraceful.”
Dr. Vardhan said that all those receiving the Covaxin shots would be tracked and monitored as if they were in a trial and dismissed concerns about the vaccine’s success rate.
“We will not compromise on any protocol before approving a vaccine,” Dr. Vardhan said.
The N.C.A.A., in an attempt to limit the threat of coronavirus among teams, announced an agreement Monday to hold its signature men’s basketball tournament entirely in Indiana in March and early April.
The tournament includes 67 games and is usually held in numerous cities sprawled across the United States, culminating with the Final Four teams meeting in one city in April. This year’s Final Four — the tournament’s semifinals and final — was already scheduled for Indianapolis before the pandemic widely shut down American sports last year.
The N.C.A.A., which has its headquarters in Indianapolis, said the tournament would play out across six venues, detailing a plan it originally announced in November. The teams are scheduled to be selected on March 14, but the early rounds of the tournament have not been fully scheduled. With fewer courts, it will require some juggling to fit in all the games and practices.
The N.C.A.A. is working with local health officials in Marion County, where Indianapolis is, to determine safety protocols. Indiana has had a 17 percent decrease in new cases of the virus in the past two weeks, according to a New York Times database.
A limited number of family members for participating teams will be allowed at games, according to the announcement. However the organization said it would continue monitoring the pandemic before coming to a decision about allowing other spectators.
Teams will practice in the Indiana Convention Center and stay in hotels connected to the venue, with teams separated by hotel floors, unique dining and meeting rooms and “secure transportation to and from competition venues,” the N.C.A.A. said.
The 2021 women’s tournament is also set to play in one unique region, with the N.C.A.A. announcing in December that it was in preliminary discussions with officials in the San Antonio area to host. Both the 2020 men’s and women’s championships were among the first to be called off when the spread of the virus accelerated last March.
“The 2021 version of March Madness will be one to remember, if for no other reason than the uniqueness of the event,” Dan Gavitt, N.C.A.A.’s senior vice president of basketball, said in the announcement.
“This is going to be complicated and difficult; there’s no question about that,” he added.
Weeks before Christmas, Dan Eliasson, the head of the Swedish Civil Contingencies Agency, sent a text message to all Swedes advising them to follow recommendations to stay home for the holidays.
A short time later, he packed his bags and flew off on a two-week trip to the Canary Islands.
Now Mr. Eliasson is under fire in Sweden, where obeying rules and recommendations — especially during the pandemic — is seen as one of the highest virtues.
Mr. Eliasson was photographed looking rather surprised while waiting at the airport in Las Palmas, the Swedish newspaper Expressen reported. He told the paper the trip had been essential, saying he had “given up a lot of trips during this pandemic” but deemed this one necessary because he had a daughter living in the Canaries.
“I celebrated Christmas with her and my family,” he said, adding that he had worked remotely while on the islands.
Many Swedes who did not get to see their families over the holidays were upset. “What were you thinking?” one man wrote on Twitter.
Sweden has avoided going into lockdown, and many public places continue to be open despite recent case rates that are among the highest in Europe. Compared to its Nordic neighbors, the country has recorded a high number of virus deaths, but the figure is on par with other larger European countries.
Mr. Eliasson’s trip comes on the heels of criticism leveled at the country’s prime minister, Stefan Lofven, who was caught on camera shopping at a mall in central Stockholm on Dec. 23, days after he criticized Justice Minister Morgan Johansson for going shopping in Lund.
Earlier in December, Finance Minister Magdalena Andersson was spotted renting ski boots in Salen, a ski resort area.
The Swedish Public Health Agency has urged people to stay home as much as possible and avoid gatherings.
Florida hospitals may have future supplies of coronavirus vaccine reduced if they do not administer doses quickly enough, Gov. Ron DeSantis warned on Monday.
“Hospitals that do not do a good job of getting the vaccine out will have their allocations transferred to hospitals that are doing a good job of getting the vaccine out,” Mr. DeSantis said at a news conference in Longwood, Fla., near Orlando. “We do not want vaccine to just be idle in some hospital system.”
So far, about 80 percent of Florida’s vaccine doses have been distributed to hospitals across the state, Mr. DeSantis said, adding that hospitals have the equipment, expertise and community relationships needed to get the vaccine to the people that Florida has given top priority: people 65 and older and health care workers.
But the governor acknowledged that the state needs to do more. “We need to add additional layers to the vaccination strategy,” Mr. DeSantis said.
Long lines have formed when some county health offices in the state opened vaccination sites on a first-come, first-serve basis. Appointment hotlines and websites have been overwhelmed with demand. In Jacksonville, about 4,000 people who filled out online forms incorrectly received confirmation emails and thought they had appointments to be vaccinated, when they actually did not. The Florida Department of Health’s own website crashed on Monday.
Demand for the vaccines in Florida has far exceeded supply, in part because Mr. DeSantis’s administration decided not to limit eligibility for the early wave of immunizations to people 75 and older, as the Centers for Disease Control and Prevention suggested. “We’ve made the decision in Florida: Our seniors come first,” he said. “We’re going to stand by that.”
Vaccination efforts were off to a slow start in part because of unfortunate timing, the governor said, since the Moderna vaccine arrived just before Christmas when many people were on vacation or busy with families. He said vaccines have now been delivered to health department offices in each of the state’s 67 counties, and to nearly every hospital.
He said his administration would identify state-run coronavirus testing sites that could be converted into vaccination sites, and would hire 1,000 nurses to assist in giving the shots at state sites or at short-handed hospitals.
And while the CVS and Walgreens drugstore chains have been taking the lead in vaccinating residents and employees at the nearly 4,000 long-term care facilities in Florida, the governor said the state would get more involved in assisting that effort. “We want to accelerate that pace,” Mr. DeSantis said.
Wall Street began the year with a tumble on Monday, with the S&P 500 suffering its steepest decline in more than two months as it retreated from record territory.
Analysts traced the sell-off to a range of factors, from political jitters stemming from Tuesday’s runoff election in Georgia — which will determine control of the U.S. Senate — to concerns about a resurgent coronavirus, to the simple need for investors to take a breather after a stretch of sizzling gains.
The index fell 1.5 percent, its sharpest drop since late October. Stocks that have been most sensitive to investor sentiment about the coronavirus pandemic led the decline. Shares of Royal Caribbean Cruises, Wynn Resorts, Marriott International and Carnival were all down by 5 percent or more.
Major benchmarks in Europe also gave up most of their early gains on Monday, though they managed to stay in positive territory for the day. The Stoxx Europe 600 index rose 0.7 percent, and the FTSE 100 index in Britain gained 1.7 percent.
After Europe’s markets closed on Monday, Prime Minister Boris Johnson imposed a strict new national lockdown as a more contagious variant of the coronavirus threatened to overwhelm the nation’s beleaguered hospitals.
The variant is now present in the United States, where coronavirus cases and deaths have reached records in recent days.
Monday’s retreat also came after the S&P 500 rallied more than 16 percent in 2020, defying the economic crisis and the human catastrophe of the pandemic, as the Federal Reserve stepped in to support financial markets, Congress spent trillions on unemployment and business support programs, and vaccinations began, showing a sustainable way out of the pandemic.
But investors have always had to contend with the still-spreading coronavirus pandemic, the risk of new lockdowns and political turmoil in the United States.
On Tuesday, two runoff Senate elections in Georgia will settle control of the upper house of Congress, and finally determine how hard it will be for President-elect Joseph R. Biden Jr. to move forward on his agenda.
In the wake of the presidential election in November, investors had begun to anticipate that Republicans would retain control of the Senate, giving them the ability to limit the Biden administration’s ability to raise taxes or increase regulation.
That view had also helped lift stocks at the end of last year, but Monday’s trading showed investors had grown less confident in a Republican win on Tuesday.
“The market fears the Democrats taking both of those seats,” said Julian Emanuel, chief equity and derivatives strategist at the brokerage firm BTIG. He said that investors have been closely watching prediction markets price in greater chances of such an outcome in recent days. “It’s basically now a tossup as to what the outcome is going to be tomorrow, after the Republicans being heavily favored.”
Citing a steep increase in coronavirus cases and pressure on the National Health Service, Scotland’s first minister, Nicola Sturgeon, announced a new lockdown on Monday that will last until at least the end of January.
She said the new rules hew closely to the lockdown that was undertaken in March, and were necessary to contain the virus as vaccine distribution plans get underway.
People have been ordered to stay home beginning at midnight except for essential reasons, such as for caregiving responsibilities or exercise. Most students will move to remote learning until at least February. Beginning Friday, houses of worship will close, with exceptions for weddings, civil partnership ceremonies and funerals.
The new variant of the coronavirus accounts for almost half of new infections in Scotland, Ms. Sturgeon said in Parliament, adding that the country recorded 1,905 new cases on Monday. She said that Scotland was about four weeks behind the rapid acceleration that is being seen in London because of the variant.
“It is no exaggeration to say that I am more concerned about the situation we face now than I have been at any time since March last year,” Ms. Sturgeon said.
The new rules will apply to all areas of Scotland currently under Level 4 restrictions, which is all of mainland Scotland. The government said that island areas in Level 3 will remain in that lower designation.
At the same time, a mass vaccination campaign is making headway. More than 100,000 people in Scotland have gotten their first vaccine dose, Ms. Sturgeon said.
“There have been two significant game changers in our fight against this virus,” Ms. Sturgeon told lawmakers. “One, the approval of vaccines, is hugely positive and offers us the way out of this pandemic. But the other — the new, faster-spreading variant of the virus — is a massive blow.”