Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, said in an interview on Tuesday with the media outlet Newsy that she plans to retire after concluding her role helping the federal government transition to the Biden administration.
“I will be helpful in any role people think I can be helpful in. And then I will retire,” she said.
In recent weeks Dr. Birx, 64, indicated publicly and privately that she was open to serving in the Biden administration. It was unclear what prompted her to announce her plan to retire. In the interview with Newsy, she called her time at the White House “overwhelming” and difficult on her family. She suggested that recent coverage of a trip she made over the Thanksgiving holiday had unduly dragged her family into the spotlight.
The Associated Press on Sunday reported that after Dr. Birx recommended limiting holiday gatherings to the “immediate household,” she traveled to a vacation home in Delaware over Thanksgiving weekend with three generations of her family, which included several households. Dr. Birx told the A.P. that she did not travel to celebrate Thanksgiving, but rather to winterize the property before a potential sale. She said that those on the trip were part of her immediate household but lived in two homes.
“I think what was done in the last week to my family — you know, they didn’t choose this for me,” she said in her interview with Newsy on Tuesday. “They’ve tried to be supportive.”
Neither the White House nor Dr. Birx responded to requests for comment on Tuesday. Kayleigh McEnany, the White House press secretary, said in a tweet on Tuesday that Mr. Trump “has great respect for Dr. Birx and likes her very much.”
“We wish her well,” she wrote.
Dr. Birx arrived at the White House in late February as Vice President Mike Pence assumed control of the coronavirus task force, and quickly developed a niche as a numbers maven. She worked long hours overseeing a team of specialists in the White House complex gathering data on infections and hospitalizations, whose work she would organize into daily presentations for senior White House officials and the task force. She has also been the point of contact for state and local officials, and oversees the drafting of detailed reports offering guidance to the states.
In recent months, she has traveled around the country extensively, appealing to Americans to wear masks and limit their contact with others, a message that clashed with the White House’s relaxed approach to pandemic restrictions.
Her time in the West Wing, where she keeps an office, elicited broad criticism from public health experts. Senior administration officials said that she ingratiated herself with President Trump and Mark Meadows, the White House chief of staff, often presenting an optimistic picture of the pandemic. She also alienated officials at the C.D.C. with an aggressive campaign to overhaul the way the agency collects data on the spread of the coronavirus. And she clashed with officials on Operation Warp Speed, the administration’s vaccine development program, over the selection of vaccine candidates and the development of antibody treatments for Covid-19.
A colonel in the Army, she began her career in the early 1980s as an immunologist at the Walter Reed Army Medical Center. She spent time training as a fellow in Dr. Anthony Fauci’s lab. The two remain close.
Before she arrived at the White House this year, she spent six years at the State Department, where she oversaw the President’s Emergency Plan for AIDS Relief, or PEPFAR, created in 2003 by President George W. Bush when antiretroviral drugs saving lives in developed countries were not available in other nations.
As coronavirus cases, hospitalizations and deaths soar to new heights in the United States, Tennessee has become one of the worst-hit states, spurring the governor to warn residents against gathering and traveling for the holidays.
The state is identifying cases at the highest per capita rate in the nation by a wide margin. At least 9,265 new cases and 65 deaths were reported in Tennessee on Monday, according to a New York Times database. Over the last week, there has been an average of 8,953 cases per day, an increase of about 90 percent from the average two weeks earlier. Eight of the nation’s 20 metropolitan areas with the most recent cases per capita are in Tennessee.
“Tennessee is ground zero for a surge in sickness,” Gov. Bill Lee said in an address on Sunday from quarantine, the day after he announced that his wife has tested positive for the virus.
Arguing that Thanksgiving gatherings led quickly to a “record level of sickness,” Gov. Lee urged residents not to gather indoors with anyone outside their household over the upcoming holidays, despite the rollout of vaccines.
“We are in a war,” he said, stressing that the next few weeks would be critical for the state to avoid overwhelming hospitals already reeling from the Thanksgiving spike. “Tennessee cannot sustain a similar surge after Christmas or New Year’s.”
The stark warning comes as the virus explodes in the United States — parts of California are down to their last I.C.U. beds, and some hospitals in other states are at or over capacity — and the numbers are as alarming as they have ever been: At least 319,763 people have died, more than any other country in the world. On Monday, confirmed cases in the United States reached 18 million, just five days after surpassing 17 million.
This worrisome trajectory is evident in the South, where Georgia, Arkansas and South Carolina have all set weekly case records. Henry McMaster, the governor of South Carolina, tested positive for the coronavirus on Monday, several days after his wife also received a positive test, according to a statement from his office.
Both had tested negative on Dec. 14 before attending a White House Christmas event, but “there is no way to pinpoint precisely when or how Governor McMaster or the First Lady contracted the virus,” the statement said.
Gov. Lee became the latest governor to try to starkly limit indoor public gatherings, with new restrictions on dining and sporting events. Yet he declined to issue a statewide mask mandate, which he called “controversial.” Instead, he urged residents to wear masks and stressed the role of local officials in imposing such rules.
Governors on both coasts are also moving to counter the spread of a newly discovered virus variant circulating in Britain. Alarm about the variant has prompted dozens of countries to put in place some sort of travel regulation.
Gov. Andrew M. Cuomo of New York announced on Monday that British Airways, Virgin Atlantic and Delta Air Lines have agreed to require a negative coronavirus test result from passengers boarding flights from Britain to New York.
On Tuesday, Mr. Cuomo called for the United States to mandate testing for all international arrivals, a policy already enforced by at least 120 countries. The United States has yet to impose such a health measure.
“I think actually the United States should say we should test before anyone comes from any country, because the U.K. variant now has already migrated.” Mr. Cuomo said.
Gov. Jay Inslee of Washington State has stopped short of new testing requirements but ordered that travelers from Britain and South Africa, where a similar variant has also been seen, undergo a 14-day quarantine. He said more countries may be added to the travel proclamation.
The Trump administration and Pfizer are close to a deal under which the pharmaceutical company would bolster supply of its coronavirus vaccine for the United States by at least tens of millions of doses next year in exchange for a government directive giving it better access to manufacturing supplies, people familiar with the discussions said.
An agreement, which could be announced as early as Wednesday, would help the United States at least partly offset a looming vaccine shortage that could leave as many as 110 million adult Americans uncovered in the first half of 2021.
So far, only two pharmaceutical companies — Pfizer and Moderna — have won federal authorization for emergency distribution of Covid-19 vaccines, and most of what they are capable of producing for the next six months has already been allocated through contracts with the United States and other governments.
In the negotiations, the government is asking for 100 million additional doses from Pfizer from April through June. The company has signaled that it should be able to produce at least 70 million, and perhaps more, if it can get more access to supplies and raw materials.
To help Pfizer, the deal calls for the government to invoke the Defense Production Act to give the company better access to roughly nine specialized products it needs to make the vaccine.
Pfizer first started asking for the government’s help in obtaining supplies as early as September and has been unhappy about the lack of response, according to documents reviewed by The New York Times.
Pfizer and the administration have been negotiating for more doses from Pfizer for more than a month. But a host of other issues have stood in the way of a deal, including Pfizer’s commitments to other nations that moved faster than the United States to lock in a big supply, according to people familiar with the situation.
It is not clear how many more doses Pfizer can quickly produce even if the administration uses the Defense Production Act to clear away supply obstacles. One person familiar with the situation said the firm may only be able to deliver 70 million by the end of June, even with better access to supplies.
With infections, hospitalizations and deaths surging to record levels from a pandemic that has already killed more than 320,000 Americans, the pressure on Pfizer and the government to come to terms is growing.
The pharmaceutical firm has struggled to navigate the politics of the situation. Pfizer’s chief executive, Dr. Albert Bourla, repeatedly suggested that the firm would know if its vaccine worked by October. Mr. Trump, who saw a vaccine breakthrough as crucial to his re-election chances, initially praised Dr. Bourla as a “great guy” — then blamed the firm for his loss when the results were released after Election Day.
Christmas plans were canceled. Many flights off the island were stopped. And lawmakers called for cultivating new plots of land to shore up the nation’s food supply.
Britain, christened not long ago by a pro-Brexit lawmaker as “Treasure Island” for the riches it offers, earned another moniker on Monday as a new variant of the coronavirus ripped through the country and set off blockades at its borders: Plague Island.
As dozens of nations banned British travelers, choking off some of the most-traveled routes to and from Britain by road, air and sea, Britons raged at the seesawing plans of their own government, which suddenly reimposed a lockdown across much of the country’s southeast, including London, this weekend.
And they lamented having to grapple with a new and potentially more transmissible variant of the virus even as they steeled themselves for the looming chaos of the country’s split with the European Union in 10 days.
For Britons who were already girding for the country to finalize its messy divorce from the European Union on Dec. 31, the sudden sense of being cut adrift from the bloc — and from the world at large — felt like a bitter taste of what might be to come.
Supermarket giants were warning of fruit and vegetable shortages. Freight trucks were stranded near ports. People trying to leave Britain for their homes elsewhere in Europe before travel bans took effect were in some cases being held up for long stretches at airports.
And while Britain and France were taking steps on Monday to minimize threats to the food supply — about a quarter of all the food eaten in Britain is produced in the European Union — many people in Britain saw the travel ban and port closures as their worst fears about their country’s post-Brexit fate come true.
France will reopen its border with Britain, allowing truck drivers and their freight to cross the English Channel on Wednesday for the first time since Sunday night. But the deal announced late Tuesday won’t immediately alleviate the lines of trucks parked in the southeast of England and delays to the transport of perishable food on board.
All drivers will have to take a rapid coronavirus test and show evidence of a negative result before traveling into France, according to the announcement by the British Department for Transport of an agreement between the British and French governments. The British army will reportedly be used to oversee the thousands of tests that will be needed in the massive logistical effort. Testing the drivers currently waiting near the ports could take several days to complete, and Britain’s transport minister on Tuesday told drivers waiting elsewhere in the country to delay travel to the border.
On Sunday night, France closed its border for 48 hours to all travelers, including truck drivers, in response to a new strain of the coronavirus that has been spreading rapidly in England. The decision left more than 2,800 trucks stranded near the Port of Dover and the Eurotunnel in Folkestone, which were shut to outbound traffic.
France allowed trucks to bring goods into Britain, but those shipments also declined amid fears that the drivers would be marooned once they crossed onto the island.
“It’s a story of human misery,” Rod McKenzie, the director of policy at Road Haulage Association, which represents the British road transport industry, said of the drivers, some of whom have been stuck sleeping in their trucks for two nights. “The government planning has been shocking on this, and there are no adequate lavatory facilities on the motorway for the past couple of days with up to 1,000 trucks parked up.”
Drivers unable to stay in nearby towns had no easy access to food. On Monday, local officials handed out cereal bars, one for each driver on the road, Mr. McKenzie said. On Tuesday, local charities also provided meals as authorities brought in more food and portable toilets.
The British government implemented plans that had been prepared for Brexit-related travel disruption in the new year early. It shut off part of a motorway to allow trucks to park on the road, and it opened an old airport that has capacity for more than 4,000 trucks to be parked and has a few more facilities.
Many of the drivers were said to be Eastern European nationals making return journeys to the mainland. Mr. McKenzie said that while drivers pack their own food, they are often not in Britain for more than a few hours so they wouldn’t necessarily bring a lot.
On Tuesday, the European Commission issued a nonbinding recommendation saying its member states should lift any blanket bans on travelers from Britain to avoid disrupting supply chains. And it noted that until the end of the month, freedom of movement still applies to Britain as part of the Brexit transition period.
“Within the E.U., it is crucial that transport workers are exempted from any restrictive measures, as quarantine and testing,” Adina Valean, the transport commissioner, said in a statement. “We have to continue to maintain the supply chains intact.”
British shoppers have been told there is no need to panic buy over concerns that there could be shortages of some fresh food later in the week. Still, Tesco, a large supermarket chain, reintroduced limits on purchases such as eggs and toilet roll.
The French government had said it wanted to reopen the border “based on a system of mandatory testing upon departure” and encouraged any would-be travelers to get P.C.R. tests, which can take several days to return a result. On Tuesday, it announced that European Union citizens and Brits with a permanent residence across the Channel will be able to travel starting Wednesday if they have a negative coronavirus test within the past 72 hours, using a list of tests approved by the French government, and if their journey is deemed essential.
Members of the British royal family have been accused of flouting coronavirus restrictions on the same day parts of England imposed stricter measures to combat a virus variant. Photographs published by the Daily Mail appeared to show Prince William, Kate Middleton and their children breaking limits on social gatherings.
On Sunday evening, the family was photographed with Prince William’s uncle, Prince Edward, and his wife and two children at the Luminate, an annual winter light trail on the Sandringham Estate that is open to people who buy tickets. The photographs appear to show the group of nine mingling along the path.
Sandringham, located in the English county of Norfolk, is under tier two restrictions. Outdoor gatherings are limited to six people, including children.
The so-called rule of six was implemented by the British government in September. Violators could be fined up to £3,200.
The palace could not immediately be reached for comment.
The same day the photographs were taken, Tier 4 restrictions — imposed in an effort to battle a virus variant that could be more contagious than others — took effect in London and most of England’s southeast. People were advised to stay at home except for urgent travel, medical appointments and outdoor exercise. The new restrictions also effectively banned Christmas-season gatherings beyond individual households.
More than 50 countries have imposed restrictions on travel to and from the U.K. to tr to prevent the spread of the variant.
At a South Texas hospital, employees were enthusiastic about the coronavirus vaccine, according to many polls taken of its staff. An overwhelming number, in some cases as much as 75 percent of the staff, said they would get the shot.
But when the time came to take the dose, far fewer than expected at the Doctors Hospital at Renaissance in Edinburg, Texas, opted to take it. Not wanting to waste any of the doses it had received, the hospital system offered to vaccinate other medical workers in the area, according to a report in The Texas Tribune.
On Saturday, though, many others who were not in the state’s Tier 1 of vaccinations, which consists largely of frontline medical workers, also started showing up to get the shot, including a state senator, a police officer and a sheriff’s deputy.
It was not known on Monday how many of the 5,850 doses the hospital received had been administered to its staff members, and the hospital declined to comment. But Dr. Robert Martinez, the system’s chief medical officer, told The Tribune that the facility did not want to waste any doses after seeing how many were left. The hospital, he said, started to go “down the ladder a little bit.”
Renee Sánchez Leal, whose husband is a medical professional and works at an ophthalmologist’s office in the area, said that the physician he worked for received word on Saturday that the health system had opened up vaccinations to other medical professionals nearby.
On Sunday, Ms. Sánchez Leal stood in a line with her husband for 4.5 hours so that he could get a shot. She did not get the vaccine herself. “We were really lucky that it opened up the way that it did,” she said in an interview on Tuesday.
Dr. Denise De Los Santos, an assistant professor in the department of Obstetrics and Gynecology at the University of Texas Rio Grande Valley who is also a practitioner at the Edinburg hospital, got the vaccine last week. She said in an interview that there was some distrust of the vaccine among those she worked with, though in only a handful of her colleagues.
“I think for physicians ourselves, we’re super excited about the vaccine, and we’re really willing to get it,” she said. “In terms of hesitance for some people to not get vaccinated, I think it’s a misunderstanding of how the vaccine itself works.”
Dr. De Los Santos said many also weren’t sure what the side effects would be. “The main thing is just saying that they don’t understand how the vaccine really works,” she said, or “the long-term effects that we don’t know about yet because it’s so new.”
“At first, before I really understood how the vaccine worked, I also was kind of hesitant,” she said, noting that once she did more research, she was sure that the right choice was to take it.
global roundup
Antarctica is no longer the last continent free from the coronavirus after 36 people stationed at a Chilean research base tested positive, local media reported.
The virus was detected in 26 members of the Chilean military and 10 maintenance workers stationed at the Base General Bernardo O’Higgins Riquelme in the Antarctic Peninsula, the authorities said in a statement to 24 Horas, adding that they were tested after reports that some had developed symptoms.
They were among a group of 60 people who were evacuated from the base to the Chilean city of Punta Arenas over the weekend and have since been isolated, the program reported, and contact tracing was underway. Three cases have also been found in crew members of a Chilean Navy ship returning from the continent, La Prensa Austral reported.
The Chilean army and the Chilean Antarctic Institute did not immediately respond to requests for comment.
The U.S. National Science Foundation said it was aware of reports of virus cases among passengers who would have disembarked in the ports of Punta Arenas and Talcahuano from the Chilean Navy vessel Sargento Aldea, which had been traveling near the O’Higgins station.
“Personnel at U.S. Antarctic Program stations have had no interactions with the Chilean stations in question or the personnel who reside there,” a spokeswoman said, adding that the foundation “remains committed to not exchanging personnel or accepting tourists” at American stations.
Reports of the cases appear to end the continent’s nine-month escape from a virus that has been found in almost every other corner of the world. About 1,000 people have weathered a sunless winter on the continent, which contains about 40 bases, according to The Associated Press, and newcomers must quarantine and test frequently. Bases are small, with people living in close contact, and movement typically picks up in the austral summer, which began in November, when new supplies and people arrive to the continent as others leave.
Research and tourism on the continent have already been severely reduced, and experts say fallout from the pandemic is likely to have a longer impact on governance and travel there.
The Council of Managers of National Antarctic Programs has warned that the virus could have “catastrophic” consequences on the continent, given the extreme environment and limited medical and health resources there, according to The Associated Press.
In other news from around the world:
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The government of Spain approved new legislation designed to help owners of bars and restaurants shuttered or crippled by the Covid-19 pandemic. The legislation, which was passed by decree, will force landlords to reduce the rent by as much as half if they own more than 10 properties used by restaurants and bars in downtown areas, and offers owners of restaurants and bars a moratorium on rent until next May.
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Taiwan reported its first case of local coronavirus transmission in eight months, creating an unfamiliar sense of anxiety on the island, which has so far avoided mass lockdowns and had only a handful of Covid deaths. The government’s Central Epidemic Command Center said that the infected person, a woman in her 30s, had come in contact with an airplane worker who arrived in Taiwan from the United States last week and was confirmed to be infected on Sunday.
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About 700 foreigners in France who were exposed to the coronavirus through their work will be put on a fast track for naturalization as a reward for their commitment during the pandemic, the junior minister for citizenship said on Tuesday. The beneficiaries, whom the ministry called “frontline foreign workers in the face of the health crisis,” include health care workers, child care professionals, housekeepers and cashiers.
Henry Fountain Raphael Minder, Raymond Zhong, and Constant Méheut contributed reporting.
A panel of judges in the Cayman Islands on Tuesday cut the sentence of an American college student who violated the territory’s coronavirus laws to two months from four months after her lawyers argued that the sentence was too harsh.
A lawyer for the student, Skylar Mack, 18, and her boyfriend, Vanjae Ramgeet, 24, said they were sorry and asked for the forgiveness of the people of the Cayman Islands.
“Whilst it was our hope that Skylar would be able to return home to resume her studies in January, we accept the decision of the court and look forward to receiving its written reasons in due course,” the lawyer, Jonathon Hughes, said in a statement.
Ms. Mack and Mr. Ramgeet were sentenced last week to four months in prison after violating the Cayman Islands’ required 14-day quarantine period for visitors.
In late November, with her semester at Mercer University in Georgia complete, Ms. Mack flew to the Cayman Islands to watch Mr. Ramgeet compete in the islands’ Jet Ski racing national championship. But there was a problem: She arrived on a Friday, the championship was Sunday and she was required by law to remain in her hotel room for 14 days.
To elude the restrictions, Ms. Mack, after receiving a negative coronavirus test, slipped an electronic monitoring bracelet from her wrist and escaped to a beach on Grand Cayman’s South Sound, where she saw Mr. Ramgeet win first place.
But the event organizers were notified that Ms. Mack may have been in breach of the rules, and the police were called, her lawyer said. Ms. Mack was charged with leaving her home during the quarantine period; Mr. Ramgeet was charged with aiding and abetting her.
“This was as flagrant a breach as could be imagined,” Justice Roger Chapple said in court during the sentencing, according to The Cayman Compass, a news website in the Cayman Islands. “It was born of selfishness and arrogance.”
The islands, a British territory of nearly 65,000 residents, as of Monday have reported 316 coronavirus cases and two deaths, with no reported cases of local transmission since July. Only people who have been authorized to enter the Cayman Islands can travel there, and they must quarantine at home or in a government or private facility.
Dr. Anthony S. Fauci, the government’s top infectious disease expert, was vaccinated on Tuesday during a live broadcast of what the National Institutes of Health called a kickoff event showcasing Moderna’s vaccine, which was developed by scientists at the agency and received emergency authorization from the Food and Drug Administration on Friday.
Rolling up the sleeve of a blue dress shirt, Dr. Fauci called his public vaccination “a symbol to the rest of the country that I feel extreme confidence in the safety and the efficacy of this vaccine.”
“I want to encourage everyone who has the opportunity to get vaccinated so that we can have a veil of protection over this country that would end this pandemic,” he said.
Joining Dr. Fauci in an auditorium at N.I.H. to receive vaccinations were Dr. Francis S. Collins, the agency’s director, Alex M. Azar II, the health and human services secretary, and frontline workers at the N.I.H. Clinical Center. They will receive the second dose of the Moderna vaccine in 28 days.
The Moderna vaccine, which has received billions of dollars of support from the federal government, has become a triumphant symbol of the administration’s efforts to develop and distribute a vaccine. It was designed by scientists at N.I.H. and the company within two days of China’s releasing the genetic sequence of the coronavirus.
“What we’re seeing now is the culmination of years of research, which have led to a phenomenon that has truly been unprecedented,” Dr. Fauci said at the Tuesday event. “And that is to go from the realization that we’re dealing with a new pathogen, a virus that was described in January of this year, to less than one year later to have vaccines that are going into the arms of so many people, including myself.”
Dr. Fauci’s vaccination was long awaited by public figures and health experts. Former President Barack Obama recently said that if Dr. Fauci, who will also be the chief medical adviser to President-elect Joseph R. Biden Jr. once he takes office, endorses a coronavirus vaccine, that would be a signal to him that it is safe.
On Monday, Mr. Biden received a coronavirus vaccine on live television at the Christiana Hospital in Newark, Del., to send a message to Americans across the country that the vaccine was safe to take.
“Left’s good,” he told the nurse practitioner who administered the Pfizer-BioNTech Covid-19 vaccine, rolling up the sleeve of his black long-sleeve turtleneck and exposing his left arm. “You just go ahead anytime you’re ready.”
He credited the Trump administration for its work on Operation Warp Speed, which helped to deliver a quick vaccine.
“The administration deserves some credit getting this off the ground,” he said. “I’m doing this to demonstrate that people should be prepared when it’s available to take the vaccine.”
Mr. Biden, however, warned Americans that vigilance in the coming months was still necessary.
“It’s going to take time,” he said, encouraging people to continue to wear masks and socially distance. “If you don’t have to travel, don’t travel,” he said. “It’s really important.”
Since March, Mr. Biden’s team has been taking public health guidelines about social distancing and masks seriously, as President Trump and his aides have willfully disregarded them. But even Mr. Biden’s more careful circle has been infiltrated by the virus. Representative Cedric L. Richmond, Democrat of Louisiana and one of Mr. Biden’s closest advisers, tested positive for the coronavirus last week, the transition team announced.
Vice President-elect Kamala Harris is expected to receive her vaccine after Christmas, a spokeswoman said, following advice from doctors who recommended Mr. Biden and Ms. Harris stagger their first shots rather than receive them together.
Pulse oximeters are among the most commonly used tools in medicine. The small devices, which resemble a clothespin, measure blood oxygen when clipped onto a fingertip, and they can quickly indicate whether a patient needs urgent medical care.
Health providers use them when they take vital signs and when they evaluate patients for treatment. Ever since the pandemic started, doctors have encouraged Covid patients to use them at home.
But in people with dark skin, the devices can provide misleading results in more than one in 10 people, according to a new study.
The findings, published last week as a letter to the editor of a top medical journal, sent ripples of dismay through the medical community, which relies heavily on the devices to decide whether to admit patients or send them home.
The report also stirred concerns because the pandemic is taking a disproportionate toll on Black and Hispanic Americans, drawing attention to racial health disparities and prompting soul-searching among doctors about bias that permeates the practice of medicine. There have been several reports of acutely ill Black patients who sought medical care only to be turned away, and studies have found that African-Americans were hospitalized at higher rates, suggesting delays in access to medical care.
The researchers who conducted the oximeter study said they were surprised by the findings. Though scientific reports of the inaccuracies have been published in the past, they did not receive widespread attention or get incorporated into medical training.
“I think most of the medical community has been operating on the assumption that pulse oximetry is quite accurate,” said Dr. Michael W. Sjoding, an assistant professor of internal medicine at the University of Michigan Medical School and lead author of the new report, which appeared in The New England Journal of Medicine. “I’m a trained pulmonologist and critical-care physician, and I had no understanding that the pulse ox was potentially inaccurate — and that I was missing hypoxemia in a certain minority of patients.”
Key West, Fla., a small tourist town at the southernmost point of the continental United States, has watched its coronavirus numbers climb to more than 2,100 cases.
Last month a county commissioner, his wife and their 35-year-old daughter were infected and wound up in the intensive care unit at the same time. On Dec. 4, two days after the death of the commissioner’s wife, Cheryl Cates, the city enacted a strict three-night curfew for New Year’s weekend that forces all businesses to close and prohibits people from being on the sidewalk.
In an effort to keep throngs of holiday revelers off city streets, particularly for a popular public event featuring a drag queen that draws huge crowds, city leaders declared a 10 p.m. curfew beginning Thursday, Dec. 31, and continuing into Sunday morning. The penalty: 60 days in the county jail or a $500 fine.
A federal lawsuit filed late Monday in the U.S. District Court for the Southern District of Florida seeks a restraining order preventing the curfew, contending that it is a civil rights violation to disallow peaceful assembly.
On Tuesday, a federal judge in Fort Lauderdale ruled in favor of a similar lawsuit in Broward County, saying that the ban there on the sale of alcohol between midnight and 5 a.m. is “speculative and arbitrary,” and violates the governor’s orders to lift such restrictions.
The curfew was enacted despite more modest proposals, such as canceling large events, that were recommended by experts who had convened to review the issue, said William L. Athas, the lawyer who filed the suit. Mr. Athas said he hoped the court would consider a recent U.S. Supreme Court case that declared New York State’s church restrictions unconstitutional.
The curfew was unpopular among workers in the entertainment industry, which suffered huge losses during the lockdown earlier this year.
The suit was brought by Andrew T. Day, a veteran who works at a nearby military base and lives in Key West with his wife and two children, his lawyer said. Mr. Athas declined to say whether Mr. Day worked in an industry that was financially affected by the curfew.
Mr. Day’s Facebook profile shows he is a supporter of President Trump who has questioned the severity of the Covid-19 pandemic.
“His interest is he doesn’t want his constitutional rights taken away from him,” Mr. Athas said.
Alyson Crean, a spokeswoman for the city, declined to comment, citing pending litigation.
Hundreds of dollars in direct payments may start going to American households as soon as next week after Congress overwhelmingly passed a $900 billion stimulus package sending billions of dollars to individuals and businesses grappling with the economic and health toll of the coronavirus pandemic.
The long-sought relief package was part of a $2.3 trillion catchall package that included $1.4 trillion to fund the government through the end of the fiscal year on Sept. 30. It included the extension of routine tax provisions, a tax deduction for corporate meals, the establishment of two Smithsonian museums, a ban on surprise medical bills and a restoration of Pell grants for incarcerated students, among hundreds of other measures.
Though the $900 billion stimulus package is half the size of the $2.2 trillion stimulus law passed in March that provided the core of its legislative provisions, it remains one of the largest relief packages in modern American history. It will revive a supplemental unemployment benefit for millions of unemployed Americans at $300 a week for 11 weeks and provide for another round of $600 direct payments to adults and children.
“I expect we’ll get the money out by the beginning of next week — $2,400 for a family of four — so much needed relief just in time for the holidays,” Treasury Secretary Steven Mnuchin said on CNBC. “I think this will take us through the recovery.”
President-elect Joseph R. Biden Jr., who received a coronavirus vaccine on Monday with television cameras rolling, has insisted that this bill is only the beginning, and that more relief, especially to state and local governments, will be coming after his inauguration next month.
Lawmakers hustled on Monday to pass the bill, nearly 5,600 pages long, less than 24 hours after its completion and before virtually anyone had read it. At one point, aides struggled simply to put the measure online because of a corrupted computer file.
The legislative text is likely to be one of the longest ever, and it became available only a few hours before both chambers approved the bill. In the Senate, the bill passed 92 to 6. It will now go to President Trump for his signature.
Hospitalizations and deaths have continued to soar in California as the state has emerged as the new epicenter of the coronavirus pandemic — and they don’t appear to be slowing down.
With just 2.5 percent of the state’s overall intensive care capacity available, officials have been rushing to get more so-called field hospitals, or alternative care sites, up and running. And while Gov. Gavin Newsom didn’t officially extend what were supposed to be three-week stay-at-home orders affecting most of the state’s 40 million residents, he said on Monday it was “self-evident” that the orders would need to be in effect well into January, in light of projections that more than 90,000 people in California could be hospitalized with the virus in coming weeks.
The state added 295,000 cases over the past week, according to a New York Times database, and is likely to reach 300,000 new cases this week, given the virus’s trajectory.
Dr. Mark Ghaly, the state’s secretary of health and human services, said on Monday that health care providers and state and local leaders were working frantically to prevent health care systems from tipping into what he and the governor described as crisis mode.
“We continue to build up our capacity,” he said. “When we look forward to that forecast of quite a few patients toward the end of January — that’s not a story that’s already been written.”
But as has been the case in the last couple of months, making sure health care facilities are sufficiently staffed has been the biggest hurdle. Nurses, doctors, janitors and so many others are exhausted. Help from other states and the federal government is scarce as so much of the nation suffers from the rapid spread of Covid-19.
In the next week or so, more Californians could hear that many hospitals are simply full. Patients who are unable to avoid going to the hospital will encounter hourslong waits in hallways.
The mere possibility that California’s caseload could overwhelm even the state’s emergency surge capacity is likely to harm workers, said Joanne Spetz, a professor at the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco.
“The term psychologists use is ‘moral distress,’” she said. “And that is a huge, looming and developing issue among health professionals.”
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