An expert committee put people 75 and older and essential workers like firefighters, teachers and grocery store workers next in line for COVID-19 shots as a second vaccine began rolling out Sunday to hospitals, a desperately needed boost as the nation works to bring the coronavirus pandemic under control.The developments occurred as the nation seeks to ramp up a vaccination program that only began in the last week and so far has given initial shots to about 556,000 Americans, according to the Centers for Disease Control and Prevention.The vaccines from Pfizer Inc. and Germany’s BioNTech, as well as the one from Moderna Inc., which was approved by regulators last week go first to health care workers and residents of long-term care homes, based on the advice of the Advisory Committee on Immunization Practices.The committee voted 13-1 on Sunday to put people 75 and older as well as certain front-line workers next in line for the vaccines.Those essential workers include firefighters and police officers; teachers and school staff; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit and grocery store workers.The committee also voted that behind those groups should be other essential workers; people ages 65 to 74; and those aged 16 to 64 who have certain medical conditions — like obesity and cancer — that put them at higher risk for severe disease if they get infected with COVID-19.The expert panel’s recommendation next goes to the CDC director and to states as guidance to put together vaccination programs. CDC directors have almost always signed off on committee recommendations. No matter what the CDC says, there will be differences from state to state, because various health departments have different ideas about who should be closer to the front of the line.Pfizer’s shots were first shipped out a week ago and started being used the next day, kicking off the nation’s biggest vaccination drive.Earlier Sunday, trucks left the Olive Branch, Mississippi, factory, near Memphis, Tennessee, with the vaccine developed by Moderna and the National Institutes of Health. The much-needed shots are expected to be given starting Monday, just three days after the Food and Drug Administration authorized their emergency rollout.In Louisville, Kentucky, UPS driver Todd Elble said his vaccine shipment was the “most important load that I’ve hauled” in a 37-year career. His parents contracted COVID-19 in November, and his 78-year-old father died. He said the family speculates that his father got infected while traveling on a hunting trip with four other relatives to Wyoming, and some are still sick.“I’m going to take the vaccine myself. I’m going to be first in line for my father — I’ll tell you that much — and any others that should follow,” he said. “I feel in my heart that everybody should, to help get this stopped.”He added: “To bring this back, I feel Dad was in the truck with me today.”Dr. Moncef Slaoui, the chief science adviser to the federal government’s vaccine distribution effort, said on CNN’s “State of the Union” that nearly 8 million doses will be distributed Monday, about 5.9 million of the Moderna vaccine and 2 million of the vaccine from Pfizer Inc. He said the first Moderna shots should be given Monday morning.Public health experts say the shots — and others in the pipeline — are the only way to stop a virus that has been spreading wildly. Nationwide, more than 219,000 people per day on average test positive for the virus, which has killed over 316,000 in the U.S. and nearly 1.7 million worldwide.Slaoui also predicted the U.S. will experience “a continuing surge,” with larger numbers of coronavirus cases possible from gatherings for Christmas.“I think, unfortunately, it will get worse,” he said.There won’t be enough shots for the general population until spring, so doses will be rationed at least for the next several months. President-elect Joe Biden pledged earlier this month to have 100 million doses distributed in his first 100 days in office, and his surgeon general nominee said Sunday that it’s still a realistic goal.But Vivek Murthy, speaking on NBC’s “Meet the Press,” said it’s more realistic to think it may be midsummer or early fall before coronavirus vaccines are available to the general population, rather than late spring. Murthy said Biden’s team is working toward having the shots available to lower-risk individuals by late spring but doing so requires “everything to go exactly on schedule.”“I think it’s more realistic to assume that it may be closer to mid-summer or early fall when this vaccine makes its way to the general population,” Murthy said. “So, we want to be optimistic, but we want to be cautious as well.”Meanwhile, Trump’s surgeon general, Jerome Adams, defended the administration’s handling of the Pfizer vaccine Sunday, a day after the Army general charge of getting COVID-19 vaccines across the U.S. apologized Saturday for “miscommunication” with states over the number of doses to be delivered in the early stages of distribution. At least a dozen states reported they would receive a smaller second shipment of the Pfizer vaccine than they had been told previously.Gen. Gustave Perna told reporters in a telephone briefing that he made mistakes by citing numbers of doses that he believed would be ready. Slaoui said the mistake was assuming vaccines that had been produced were ready for shipment when there was a two-day delay.“And unless it’s perfectly right, we will not release vaccine doses for usage,” he said. “And, sometimes, there could be small hiccups. There have been none, actually, in manufacturing now. The hiccup was more into the planning.”But Adams, speaking on CBS’ “Face the Nation,” said that “the numbers are going to go up and down.”“It absolutely was not poor planning,” he said. “There’s what we plan. There’s what we actually allocate. There’s what’s delivered, and then there’s what’s actually put in people’s arms.”Adams, who is Black, said he understands that mistrust of the medical community and the vaccine among Blacks “comes from a real place,” the mistreatment of communities of color. He cited the decades-long Tuskegee experiment in Alabama, where Black men with syphilis were not treated so the disease could be studied.He also said immigrants in the U.S. illegally should not be denied the vaccine because of their legal status because “it’s not ethically right to deny those individuals.”“I want to reassure people that your information when collected to get your second shot, if you get the Pfizer or Moderna vaccine, will not be used in any way, shape or form to harm you legally,” Adams said. “That is something that I have been assured of.”Both the Moderna vaccine and the Pfizer-BioNTech shot require two doses several weeks apart. The second dose must be from the same company as the first. Both vaccines appeared safe and strongly protective in large, still unfinished studies.
 
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As COVID-19 cases skyrocketed before the Thanksgiving holiday weekend, Dr. Deborah Birx, coordinator of the White House coronavirus response, warned Americans to “be vigilant” and limit celebrations to “your immediate household.”For many Americans that guidance has been difficult to abide, including for Birx herself.The day after Thanksgiving, she traveled to one of her vacation properties on Fenwick Island in Delaware. She was accompanied by three generations of her family from two households. Birx, her husband Paige Reffe, a daughter, son-in-law and two young grandchildren were present.  The Centers for Disease Control and Prevention has asked Americans not to travel over the holidays and discourages indoor activity involving members of different households. “People who do not currently live in your housing unit, such as college students who are returning home from school for the holidays, should be considered part of different households,” the CDC said.  Even in Birx’s everyday life, there are challenges meeting that standard. She and her husband have a home in Washington. She also owns a home in nearby Potomac, Maryland, where her elderly parents, and her daughter and family live, and where Birx visits intermittently. In addition, the children’s other grandmother, who is 77, also regularly travels to the Potomac house and returns to her 92-year-old husband near Baltimore.Birx’s own experiences underline the complexity and difficulty of trying to navigate the perils of the pandemic while balancing a job, family and health, especially among essential workers like her.  Yet some of Birx’s peers in public health say she should be held to a higher standard given her prominent role in the government’s response to the pandemic and the current surge in COVID-19 deaths across the country.  Birx has expressed a desire to maintain a significant role on the White House coronavirus task force when President-elect Joe Biden is inaugurated next month, according to a person familiar with the Biden team’s personnel deliberations and a Trump administration coronavirus task force official. Neither was authorized to publicly discuss internal deliberations and both spoke on condition of anonymity.”To me this disqualifies her from any future government health position,” said Dr. Angela Rasmussen, a virologist at the Georgetown Center for Global Health Science and Security. “It’s a terrible message for someone in public health to be sending to the American people.”After The Associated Press raised questions about her Thanksgiving weekend travels, Birx acknowledged in a statement that she went to her Delaware property. She declined to be interviewed.She insisted the purpose of the roughly 50-hour visit was to deal with the winterization of the property before a potential sale — something she says she previously hadn’t had time to do because of her busy schedule.  “I did not go to Delaware for the purpose of celebrating Thanksgiving,” Birx said in her statement, adding that her family shared a meal together while in Delaware.  
Birx said that everyone on her Delaware trip belongs to her “immediate household,” even as she acknowledged they live in two different homes. She initially called the Potomac home a “3 generation household (formerly 4 generations).” White House officials later said it continues to be a four-generation household, a distinction that would include Birx as part of the home.  Birx’s job makes her an “essential worker” by federal guidelines, in a position that requires extensive travel to consult with state and local officials on the pandemic response. She has traveled to 43 states, driving 25,000 miles, (40,000 kilometers), she said, often to coronavirus hot spots. Birx also has an office in the White House, where numerous COVID-19 infections have been revealed.  Through it all, she said she has kept herself and her family safe through isolating, wearing a mask and regular testing.  Birx has not said how long she isolates for before visiting family. Medical experts say people who only recently became infected often do not test positive. They say wearing a mask has limited efficacy in an environment such as the White House, where few others use them.  Margaret Flynn, the children’s other grandmother, comes to the Potomac home to provide child care, then returns to her husband, who has health complications. Birx said that she hasn’t seen the other grandmother since the beginning of the pandemic and does not know how frequently she visits the Potomac house.  Flynn confirmed that she hasn’t spoken to Birx in months. Flynn declined to say how frequently she visits the home to look after the grandchildren.  From the podium at the White House, Birx has spoken about how she comes from a multigenerational family with her parents and her daughter’s family, including grandchildren, all living under one roof. Many saw that as a relatable family dilemma.FILE – President Donald Trump speaks during a meeting as White House coronavirus response coordinator Dr. Deborah Birx looks on, in the Oval Office of the White House in Washington, Aug. 5, 2020.In early April, she said she understood the sacrifices many were making and explained that she couldn’t visit her Potomac home when one of her grandchildren had a high fever.  “I did not go there,” she said, while standing next to President Donald Trump. “You can’t take that kind of risk.” 
She has resumed her visits to the house since then.Numerous elected officials, including prominent Democrats, have been forced to acknowledge that they have not heeded their own stern warnings to the public about the dangers of spreading the virus.But Birx occupies a position of far greater authority when it comes to the pandemic. Many Americans rely on the advice that she and the government’s top infectious disease expert, Dr. Anthony Fauci, have given.  Kathleen Flynn, whose brother is married to Birx’s daughter who lives in the Potomac house, said she brought forward information about Birx’s situation out of concern for her own parents, and acknowledged family friction over the matter.”She cavalierly violated her own guidance,” Flynn said of Birx.  Richard Flynn, her father, confirmed details of Birx’s Thanksgiving holiday gathering and visits to the Potomac house, but said he trusted the doctor and believes she’s doing what’s right. He said Birx’s visits to the house have occurred only every few weeks of late.  “Dr. Birx is very conscientious and a very good doctor and scientist from everything I can see,” Richard Flynn said during a recent interview.  Medical experts say public health officials such as Birx need to lead by example, including personal conduct that’s beyond reproach.”We need leadership to be setting an example, especially in terms of things they are asking average Americans to do who are far less privileged than they are,” said Dr. Abraar Karan, a global health specialist at Brigham and Women’s Hospital and Harvard Medical School, about the high-profile lapses in judgment.Birx came to the White House coronavirus task force with a sterling reputation. A public servant since the Reagan administration, Birx has served as a U.S. Army physician and a globally recognized AIDS researcher. She was pulled away from her ambassadorial post as the U.S. global AIDS coordinator to assist the task force in late February.Birx, however, has faced criticism from public health experts and Democratic lawmakers for not speaking out forcefully against Trump when he contradicted advice from medical advisers and scientists about how to fight the virus.  While she stayed in Trump’s good graces far longer than Fauci, who frequently contradicted Trump, the president by late summer had sidelined Birx, too.Kathleen Flynn said she urged her brother and sister-in-law not to allow her mother to babysit, arguing it put her mother at risk by spending so much time in a household other than her own, while also posing a danger to Birx’s elderly parents. Flynn, who said she has long had a strained relationship with her brother, is currently not on speaking terms with him and has never met Birx.Flynn said her mother waited about a week after Birx’s Thanksgiving trip before returning to the Potomac home to provide child care help.  Lawrence Gostin, a public health expert at Georgetown University’s law school who has known Birx professionally for years, said that he’s confident that Birx took all necessary precautions to minimize risks in her Thanksgiving travel. Still, he said it undercuts her larger goal to get Americans to cooperate with government officials’ efforts to minimize the death and suffering caused by the virus.”It’s extraordinarily important for the leaders of the coronavirus response to model the behavior that they recommend to the public,” Gostin said. “We lose faith in our public health officials if they are saying these are the rules but they don’t apply to me.”
 
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Johns Hopkins Coronavirus Resource Center said early Sunday there are 76.3 million global COVID-19 cases.The U.S. continues to lead the world in case numbers at 17.6 million, followed by India with 10 million and Brazil with 7.2 million.U.S. lawmakers are expected to vote Sunday on a nearly $1 trillion COVID-19 economic relief package. The package includes, among other things, $300 supplemental unemployment benefits and $600 direct stimulus payments to many Americans.“We can’t continue with Christmas as planned,” British Prime Minister Boris Johnson said Saturday as he announced new restrictions for London and southern England, where a mutant strain of the coronavirus is spreading and where there is now a virtual lockdown, with people urged to stay home.All nonessential stores in the region are set to close, and people should not enter or leave the British capital or large parts of southeastern England.South Korea recorded 1,097 new infections Sunday, the fifth consecutive day it recorded more than 1,000 new cases.A South Korean Justice Ministry official said an outbreak at a prison in Seoul has infected 184 prisoners and one worker.Starting Monday, the Australian states of Victoria and Queensland are banning people arriving from Sydney, where a 70-person coronavirus cluster has emerged in its northern beach suburbs which have now been placed under a strict lockdown until Christmas Eve.Thailand said Sunday it will test more than 10,000 people in the southwestern province of Samu Sakhon after a daily surge of more than 500.
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Johns Hopkins Coronavirus Resource Center said early Sunday there are 76.3 million global COVID-19 cases.The U.S. continues to lead the world in case numbers at 17.6 million, followed by India with 10 million and Brazil with 7.2 million.U.S. lawmakers are expected to vote Sunday on a nearly $1 trillion COVID-19 economic relief package. The package includes, among other things, $300 supplemental unemployment benefits and $600 direct stimulus payments to many Americans.“We can’t continue with Christmas as planned,” British Prime Minister Boris Johnson said Saturday as he announced new restrictions for London and southern England, where a mutant strain of the coronavirus is spreading and where there is now a virtual lockdown, with people urged to stay home.All nonessential stores in the region are set to close, and people should not enter or leave the British capital or large parts of southeastern England.South Korea recorded 1,097 new infections Sunday, the fifth consecutive day it recorded more than 1,000 new cases.A South Korean Justice Ministry official said an outbreak at a prison in Seoul has infected 184 prisoners and one worker.Starting Monday, the Australian states of Victoria and Queensland are banning people arriving from Sydney, where a 70-person coronavirus cluster has emerged in its northern beach suburbs which have now been placed under a strict lockdown until Christmas Eve.Thailand said Sunday it will test more than 10,000 people in the southwestern province of Samu Sakhon after a daily surge of more than 500.
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In China’s Wuhan, the original epicenter of the COVID-19 outbreak, the city’s residents are returning to normal life, even as they continue to grapple with memories of the early outbreak, which struck fear in the city.It’s been almost seven months since the city recorded a locally transmitted case of the disease due to a strict city-wide lockdown and a mass testing event of almost all the city’s 11 million residents.Today, restaurants, shopping streets and bars are crowded, but locals are still experiencing the lasting impact of the lockdown on mental health and work.Reuters asked people throughout Wuhan to share images and videos they took during their outbreak, as well as their hopes for 2021, as the city approaches the one-year anniversary of the outbreak. City health officials released the first public notice of the then-unknown virus on Dec. 31, 2019.Like the city itself, most people are enduringly optimistic, even as they reflect on the city’s toughest year in recent memory.An Junming, Wuhan volunteerAn worked as a volunteer during the city’s strict 76-day lockdown, delivering food to people trapped in their homes.“At that time, I could only eat one meal a day, because there was indeed a lot of work to do, but there were very few people doing this, so I was very anxious.“I hope that the entire city will prosper in 2021.“It can be said that in 2020 there were no people on the streets of the whole Wuhan – only animals were active outside.”An Junming poses for a picture on a street, almost a year after the global outbreak of the coronavirus disease (COVID-19) in Wuhan, Hubei province, China, Dec. 15, 2020.Zhang Xinghao, lead singer Of Wuhan band Mad Rat“At that time, I couldn’t do anything at home. It was very boring, so I thought I needed to write some music and sing some songs to find some fun in my life.“It made me reflect on a lot of things, and it is the first time in my life that I have experienced such a disaster.“The epidemic must not be ignored. I see that the news about foreign countries has a lot of infections, so this must not be ignored. We should not think that we are very powerful. In fact, I think we humans are quite fragile.”Duan Ling, 36, businesswomanDuan’s husband, Fang Yushun, caught COVID-19 in February while working as a surgeon.“I had my birthday on the day he was hospitalized during the epidemic, and he spent a day editing and sent a video to me. So I felt very moved.“We have experienced a lot of things in the year 2020, and I want to say goodbye to the 2020. But in the new year, I wish we could have a baby.”Lai Yun, 38, Japanese restaurant owner“At this time, every one of us in Wuhan feels like time flies very fast. Like closing the city only feels like yesterday.”Lai said he cherished memories of his children putting on performances in the family living room.“I think the inspiration that COVID-19 gives us is that a healthy body is more important than anything else.”Student Wu Mengjing, 22, right, poses with her friend on a street, almost a year after the global outbreak of the coronavirus disease (COVID-19) in Wuhan, Hubei province, China, Dec. 16, 2020.Wu Mengjing, 22, design student“I think the Wuhan epidemic has affected too many people. Many companies went bankrupt and residents were unemployed. This has a great impact on the entire development of Wuhan.“I am very worried that there will be a second wave in Wuhan, because there were some recurrences of the epidemic in various parts of the country, and the number of college students in Wuhan is particularly large.”Jiang Honghua, 34, street food vendor“During the epidemic, our whole family is together, and this time like this is very rare, and I felt very happy,” said Jiang, sharing photos of her son and daughter playing.“I thought my year in 2020 was actually OK – I felt lucky that I could maintain the livelihood of the whole family. I hope in year 2021 I can have good business.”Liu Runlian, 58, street dancer“2021 is coming, and I don’t expect much from myself. But I want to live a peaceful life, and then I hope everyone is safe.”
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U.S. distribution of Moderna Inc.’s COVID-19 vaccine began Saturday, with more than 3,700 sites scheduled to start receiving and administering shots as soon as Monday, vastly widening the rollout started last week by Pfizer Inc.Amid record coronavirus infections and deaths, Moderna has moved vaccine supplies from its manufacturing plants to warehouses operated by distributor McKesson Corp.Workers on Saturday were packing vaccines into containers and loading them onto trucks, U.S. Army Gen. Gustave Perna said during a news conference. Trucks will set out Sunday and shipments will start reaching health care providers as soon as Monday, he said.Doses of vaccine must travel with security guards, including U.S. Marshals, and will be stored in locked refrigerators. U.S. plans call for at-risk groups, such as elderly people in nursing homes and medical workers, to receive injections first.The Food and Drug Administration on Friday approved an emergency use authorization for Moderna’s vaccine, the second COVID-19 vaccine to receive approval.Moderna said a panel of outside advisers to the U.S. Centers for Disease Control and Prevention voted Saturday to recommend its vaccine for use in people age 18 and older. The Advisory Committee on Immunization Practices panel voted 11-0 in favor of the vaccine.The shot developed by Pfizer and its German partner BioNTech SE was authorized Dec. 11.Pharmaceutical services provider Catalent Inc.’s facility in Bloomington, Indiana, is filling and packaging vials with Moderna vaccine and handing them to McKesson. The company is shipping them from its facilities, including those in Louisville, Kentucky, and Memphis, Tennessee, which are close to air hubs for United Parcel Service Inc. and FedEx Corp.Pfizer organized its own distribution system. The U.S. government’s vaccine program, dubbed Operation Warp Speed, is in charge of logistics for Moderna’s distribution under Perna.Reduced number of dosesPerna apologized to U.S. governors for confusion on the vaccine’s availability after the U.S. government reduced the number of doses states would receive in the upcoming week.States including Oregon and Washington, which are ramping up to get front-line health care workers vaccinated as quickly as possible, said their allocation had dropped by as much as 40%.Perna said he made an error estimating the number of doses that would actually be cleared by regulators for shipment, which was fewer than the number of doses produced.A spokesperson for the U.S. Department of Health and Human Services said 7.9 million doses of Pfizer and Moderna vaccines would be delivered nationally this week.The Moderna delivery system will have some of the same players as Pfizer’s but will differ in ways.Transportation companies UPS and FedEx are giving priority to vaccines on planes and trucks that are moving holiday gifts and other cargo. Their drivers will handle the bulk of the last-mile Moderna vaccine deliveries. They are going directly to vaccination sites, unlike Pfizer’s, which was sent to large hubs and redistributed.“We added a lot of aircraft, a lot of temporary workers. (Vaccines) are a very small fraction of total volumes,” said Wes Wheeler, a UPS executive in charge of vaccine shipments.Moderna’s vaccine is available in quantities as small as 100 doses and can be stored for 30 days in standard-temperature refrigerators, while the inoculations from Pfizer come in boxes of 975 doses, must be shipped and stored at -70 Celsius, and can be held for only five days at standard refrigerator temperatures. Initial doses were given to health professionals.Programs by pharmacies Walgreens and CVS to distribute the Pfizer vaccine to long-term care facilities are expected to start Monday. A CDC advisory panel Sunday will consider which groups should get vaccinated next.Perna said the United States is on track to have enough doses of Pfizer and Moderna vaccines by the end of the year to inoculate 20 million people, as the government projected, but deliveries of those doses may continue into first week of January. Health care experts forecast it will take well into 2021 for a significant portion of Americans to be inoculated.Both vaccines were about 95% effective at preventing illness in clinical trials that found no serious safety issues.
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California hospitals are battling to find beds for patients amid fears the explosion of coronavirus cases will exhaust staffing resources.As of Saturday, nearly 17,400 people were hospitalized with confirmed or suspected COVID-19 infections — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach 75,000 by mid-January.More than 3,600 confirmed or suspected COVID-19 patients were in intensive care units. All of Southern California and the 12-county San Joaquin Valley to the north have exhausted their regular intensive care unit capacity, and some hospitals have begun using surge space, meaning space converted for intensive care. Overall, the state’s ICU capacity was just 2% Saturday.The enormous crush of cases in the last six weeks has California’s death toll spiraling ever higher. Another 272 fatalities were reported Saturday and in the last week nearly 1,600 people died.In hard-hit Los Angeles County, Director of Public Health Barbara Ferrer implored people to stay home as much as possible, not mingle with others outside their household and wear a mask and social distance when around others.”Places where people from different households gather and do not follow safety directives contributes to unnecessary COVID-19 spread that results in hospitalizations and deaths that could have been avoided,” she said. “Following the safety measures saves lives and is our only way to protect essential workers and our hospitals.”LA County health officials announced Saturday they had modified their health orders to comply with recent U.S. Supreme Court rulings calling for places of worship to be allowed to have outdoor and indoor services, with appropriate health safety precautions.On Saturday night, Apple Inc. announced that it is temporarily closing all 53 of its stores in California because of the coronavirus outbreak. Under the stay-at-home order in effect for nearly the entire state, retail stores are limited to 20% capacity.Clinicians evaluate a patient in a triage tent set up outside Providence St. Mary Medical Center amid a surge in COVID-19 patients in Southern California on Dec. 18, 2020, in Apple Valley, Calif.As businesses struggle during what should be a very busy holiday shopping season, many hospitals are preparing for the possibility of rationing care. A document recently circulated among doctors at the four hospitals run by Los Angeles County calls for them to shift strategy: Instead of trying everything to save a life, their goal during the crisis is to save as many patients as possible. That means those less likely to survive won’t get the same kind of care offered in normal times.”Some compromise of standard of care is unavoidable; it is not that an entity, system, or locale chooses to limit resources, it is that the resources are clearly not available to provide care in a regular manner,” the document obtained by the Los Angeles Times reads.The county’s Health Services director, Dr. Christina Ghaly, said the guidelines were not in place as of Friday night but that they were essential to develop given that the surge has arrived and “the worst is yet to come.”Many hospitals have implemented emergency procedures to stretch staff and space.Corona Regional Medical Center southeast of Los Angeles has converted an old emergency room to help handle nearly double the usual number of ICU patients. It’s using space in two disaster tents to triage ER patients because the emergency room is filled with patients who need to be hospitalized.In hard-hit Fresno County in central California, a new 50-bed alternate care site opened Friday near the community Regional Medical Center. The beds for COVID-19-negative patients will free up space in area hospitals, where just 13 of about 150 ICU beds were available Friday, said Dan Lynch, the county’s emergency medical services director.Lynch said he expects they will have to use the Fresno Convention Center, which can accommodate up to 250 patients, given current demand.Fresno and three neighboring counties also have taken the unprecedented step of sending paramedics on emergency calls to evaluate people. They won’t be taken to the emergency room if they could go to an urgent care facility or wait a few days to talk to their doctors, Lynch said.Some hospitals have canceled non-essential elective surgeries, such as hip replacements, that might require beds that may soon be needed for COVID-19 patients. Others are increasing staff hours or moving patients to free up space.
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Even as new infections slip to the lowest levels in three months, on Saturday, India crossed the 10 million mark of total infections since the pandemic began, second behind the U.S. mark of 17 million, according to Johns Hopkins Coronavirus Resource Center.India’s falling infections, down from its record of about 100,000 new cases daily to about 25,000 cases reported Saturday, give health experts some reason to hope. India has suffered more than 145,000 deaths, Johns Hopkins says.”If we can sustain our declining trend for the next two to three months, we should be able to start the vaccination program and start moving away from the pandemic,” Dr. Randeep Guleria, a government health expert, told The Associated Press.Some of the world’s biggest vaccine makers are located in India, and there are five vaccines in clinical trials. Two vaccines, by Oxford University-AstraZeneca and India’s Bharat Biotech, are nearing authorization for emergency use. The South Asian nation with a population of 1.3 billion people hopes to vaccinate 250 million people by July.As India’s cases are waning, Canada was approaching 500,000 cases Saturday, an increase of 25% since two weeks ago, when the North American country surpassed 400,000 cases.”COVID-19 is spreading among people of all ages, with high infection rates across all age groups,” Canada’s chief medical officer Theresa Tam said.Cases surging in CanadaCanada is to receive 500,000 doses of the Pfizer-BioNTech vaccine in January, Prime Minister Justin Trudeau said. And about 168,000 doses of the Moderna vaccine should arrive soon. It is expected to receive emergency-use approval by Canadian health officials soon.However, Minister of Public Services and Procurement Anita Anand said there will not be enough shots for every Canadian who wants one until September.Santa ‘good to go’One person who won’t have to wait for his shot is Santa Claus, thanks to Anthony Fauci, the top U.S. infectious disease expert.”I took care of that for you because I was worried that you’d all be upset,” he said Saturday during a CNN and “Sesame Street” coronavirus town hall for families, after worried youngsters asked whether Santa could safely enter homes on Dec. 25.”I took a trip up there to the North Pole; I went there, and I vaccinated Santa Claus myself. I measured his level of immunity, and he is good to go,” Fauci said.”He can come down the chimney, he can leave the presents … you have nothing to worry about,” he said.US general apologizesGen. Gustave Perna, the U.S. Army general in charge of distributing COVID-19 vaccine across the U.S., apologized Saturday to the governors of more than a dozen states that will be getting fewer doses of the Pfizer-BioNTech vaccine than they expected.”I want to take personal responsibility for the miscommunication,” he told reporters during a telephone briefing. “I know that’s not done much these days. But I am responsible. … This is a Herculean effort, and we are not perfect.”Perna said he mistakenly cited the number of doses he believed would be ready, not understanding the difference between manufactured doses and those ready to be released.Between the Pfizer vaccine and the Moderna Inc. vaccine, Perna said the government is expecting to deliver 20 million doses to the states by the first week of January.Moderna and its partners have started distributing its vaccine, the second approved for emergency use in the country. Trucks will begin shipping the vaccine to more than 3,700 U.S. locations on Sunday, Perna said Saturday during the virtual news conference.Perna said the Moderna vaccine will reach health care workers as early as Monday, but that the delivery of some of the first 20 million doses of vaccines from Moderna and Pfizer Inc. could be delayed until the first week of January.Nearly 76 million people around the world contracted the coronavirus as of midday Saturday, according to the Johns Hopkins Coronavirus Resource Center.The U.S. tops the list as the country with the most cases, with 17.6 million; India is second, with more than 10 million, followed by Brazil, with 7.1 million, according to Johns Hopkins.Zeng Yixin, vice minister of China’s National Health Commission, said Saturday the country would focus on vaccinating high-risk groups over the next several months before beginning to vaccinate the general public.”During the winter and spring seasons, carrying out novel coronavirus vaccination work among some key population groups is of great significance to epidemic prevention,” Zeng, who also is director of State Council’s vaccine R&D working group, said.The World Health Organization (WHO) said it has gained access to 2 billion doses of several coronavirus vaccines.WHO Director-General Tedros Adhanom Ghebreyesus said access to the vaccines ensures that some 190 countries will be able to inoculate their populations “during the first half of next year.”
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The Swiss government Friday ordered all bars, restaurants, cultural venues and sports facilities to close next week because of a surging number of coronavirus cases.At a news conference, Health Minister Alain Berset said the new restrictions, which take effect Tuesday, are necessary because the situation in health facilities ”is not tenable in the long term.”The government will also restrict the number of people who can be inside stores, which must close after 7 p.m. and on Sundays and public holidays.While the closures include restaurants and bars at ski resorts, the federal government is leaving it to Switzerland’s 26 cantons — or states — to decide whether to close skiing facilities.But Berset cautioned they should “think carefully” about their decision “because hospitals are full and putting a lot of people on snow slopes can lead to an increase in accidents and we need to be very careful.”The Swiss health minister’s cautionary stance is a reversal from earlier this month. As other European nations announced plans to close their ski facilities for at least the first several weeks of the season, he said Swiss resorts would be allowed to stay open if they put in place safety measures such as masks, proper hygiene, social distancing and limited capacity for bars and restaurants.At the time, he said he realized the stance could raise regional tensions, but said “We are a sovereign country and can decide ourselves what the facts are on our territory.”The seven-day rolling average of daily new cases in Switzerland has risen over the past two weeks from 43 cases per 100,000 people on December 3 to 50 cases per 100,000 people on Thursday.  
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Thailand says a local laboratory’s pact with Britain’s AstraZeneca will make the Southeast Asian country the regional hub for supplies of what’s likely to be one of the leading vaccines against COVID-19 as governments scramble to lock in supplies.Bangkok-based Siam Bioscience signed a letter of intent with AstraZeneca late last month to make 200 million doses of the British pharmaceutical firm’s COVID-19 vaccine, AZD1222, said Nakorn Premsri, director of Thailand’s National Vaccine Institute.Thailand’s Public Health Ministry and the local conglomerate SCG, with its packaging and chemicals divisions, also joined the deal.Nakorn said most of the doses would head abroad.”Thailand will secure only 26 million doses. We may ask for more, but it will not be a big part, so maybe more than half of that [200 million] can be exported,” he told VOA.”It’s in the letter of intent that we made together with Siam Bioscience, AstraZeneca, SCG and Ministry of Public Health that it will be distributed within the ASEAN region,” he added, referring to the 10-member Association of Southeast Asian Nations.In a brief statement to VOA, AstraZeneca’s Thailand office confirmed the broad outlines of its plans.”The Ministry of Public Health, SCG, Siam Bioscience and AstraZeneca share the focus on broad, equitable and timely access to an effective COVID-19 vaccine in Thailand and Southeast Asia region. AstraZeneca has been working with Siam Bioscience through technology transfer to expand AZD1222’s global manufacturing capacity,” it said.AstraZeneca’s vaccine, developed in collaboration with Britain’s Oxford University, is still pending approval in Britain. Officials there say regulators could reach a decision by early January.In the mixNakorn said AstraZeneca has already started sharing the technology Siam Bioscience will need to make its vaccine and that production could begin in the second quarter of next year. If all goes well, he said, inoculations could start by the middle of the year.Because those taking AstraZeneca’s vaccine will need two doses each, the 26 million jabs Thailand has reserved will be enough for 13 million people, about a fifth of the country’s population. How the rest of the doses are rolled out across Southeast Asia, a region of over 650 million people, will be up to the British firm, said Nakorn.A few other ASEAN countries besides Thailand have already announced plans to source vaccine from AstraZeneca, but it’s not clear how many of their doses will be arriving via Siam Bioscience.AstraZeneca’s Thailand office refused VOA’s request for an interview.COVID-19’s toll on the region has been mixed.Despite reporting the first case outside of China, in mid-January, Thailand has managed to keep a lid on the pandemic, thanks to tight border controls, with only 4,281 cases and 60 deaths recorded to date. Laos, Cambodia and tiny Brunei have all reported well under 1,000 cases each.Others have fared much worse.The Philippines and Indonesia have recorded over 450,000 and 640,000 cases, respectively, the most in Southeast Asia. Malaysia and Myanmar are in the midst of their worst waves of infection yet, with well over 1,000 new cases a day.Countries in the region are not waiting for the AstraZeneca-Siam Bioscience pact for deliverance, though.Some of them have announced plans or deals to source from a combination of suppliers including U.S. pharmaceutical leaders Moderna and Pfizer, whose COVID-19 vaccines have already been approved by Washington. A few say they plan to pad their stocks with vaccines from China and Russia as well.Six ASEAN members have also signed up to COVAX, a global plan co-led by the World Health Organization for rich countries to help buy doses of COVID-19 vaccine for the poorest.Pros and consStill, AstraZeneca’s plans to turn Thailand into a regional production hub is a boon for the country’s neighbors, said Khor Swee Kheng, a global health specialist and independent consultant to the WHO based in Malaysia.With this deal, “Southeast Asia has greater assurance of vaccine supplies in a global race that is currently dominated by rich countries.” he said.”Two, production facilities that are physically nearer to Southeast Asian countries will aid in logistics. Three, this arrangement can be leveraged for further Southeast Asian collaboration in regional vaccine manufacturing and stockpiling.”AstraZeneca’s COVID-19 vaccine also has the advantage of holding on to its potency for at least six months in a standard refrigerator. That compares with about one month for Moderna’s offering and only a few days for Pfizer’s. For most of its time, Pfizer’s vaccine must be stored at an ultra-cold minus 70 Celsius.As countries shop for vaccines, Khor said that gives AZD1222 an edge in tropical countries and those with limited cold storage facilities, though he added that governments will also be weighing safety, efficacy, availability and price.Farming out production also raises its own hurdles.”Regulatory approval for the vaccine produced by Siam Bioscience depends on a few variables,” said Khor.“One, how much of the production process is done in Thailand in Siam Bioscience facilities versus AstraZeneca facilities? Two, how much technology transfer and patent transfers have occurred between AstraZeneca and Siam Bioscience? This information is not yet available publicly.”If Siam Bioscience takes on much of the burden, regulatory bodies may insist on approval of not only AstraZeneca’s work but separately of its Thai partner’s contributions as well.
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U.S. Vice President Mike Pence is scheduled to get the coronavirus vaccine on live television Friday. His vaccination comes as surveys reveal some Americans are reluctant to receive the vaccine because of safety and efficacy concerns.The coronavirus surge in California’s Los Angeles County is so dire that the county’s public health department posted on Twitter: “Every hour, on average, 2 people are dying of COVID-19 in LA County.”The U.S. television network CBS reported there are so few hospital beds available in intensive care units in Los Angeles that some coronavirus victims are waiting up to seven hours in ambulances for beds.Sorry, but your browser cannot support embedded video of this type, you can
download this video to view it offline.Download File360p | 10 MB480p | 14 MB540p | 18 MB720p | 33 MB1080p | 70 MBOriginal | 85 MB Embed” />Copy Download AudioFrench President Emmanuel Macron has joined the list of world leaders who has tested positive for the coronavirus. Macron has left Elysée Palace and is temporarily working at an official residence in Versailles.Dr. Hans Kluge, the regional director of the World Health Organization’s European office, has urged people to stay home during the holidays. He said in a statement that it is “not worth the risk” of contracting the virus.Kluge also said the pandemic has created a “growing mental health crisis in Europe.” He added, “From anxieties around virus transmission, the psychological impact of lockdowns and self-isolation, to the effects of unemployment, financial worries and social exclusion – the mental health impact of the pandemic will be long term and far reaching.”There are more than 75 million global COVID-19 cases, according to John Hopkins University.The United States has 17.2 million cases, followed by India with almost 10 million and Brazil with 7.1 million cases.
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The head of the U.N. Migration Agency said the coronavirus pandemic has affected people worldwide, including migrants — many of whom have gotten ill, lost jobs or been stranded in destination countries.  “As usual in all crises, migrants are the first ones to lose jobs,” International Organization for Migration (IOM) Director General Antonio Vitorino told VOA ahead of International Migrants Day on Friday. “The World Bank forecasts, for instance, a drop in remittances to the countries of origin of around 20% this year, which will have a terrible impact in the living conditions of the countries of origin of those migrants.”  FILE – Antonio Vitorino, Director General of the International Organization for Migration, attends a news conference in Brussels, Belgium, Oct. 29, 2019.He said virus-related lockdowns, travel restrictions and border closures have also stranded about 3 million migrants all over the world.  The IOM estimates there are 272 million migrants globally. A little less than half are women. The United Nations considers a migrant to be anyone who changes their country, regardless of the reason. But most move to seek economic improvement.  According to IOM data, India has the largest number of migrants living abroad — 17.5 million — followed by Mexico (11.8 million) and China (10.7 million). The United States remains the top destination country, home to more than 50 million migrants. FILE – Migrant laborers returning to the city for work undergo COVID-19 tests in New Delhi, India, Aug. 18, 2020.Migrants are often thought of as being undocumented workers, but the vast majority legally reside in destination countries and work in all fields, from unskilled labor to highly specialized sectors.COVID-19 has particularly affected migrants working in the informal economy — many have lost jobs or work permits. They do not have the resources to manage financially through long lockdowns and quarantine periods. If they catch the virus, they often lack access to public health care or are afraid to use it if they are undocumented.  Others have found themselves on the front lines of the virus response, as factory or grocery store employees, truck drivers, or health care workers.  As some countries begin approving the first COVID-19 vaccines, Vitorino said the migrant community must not be excluded from receiving them.  “It is the responsibility of governments to guarantee that all that are present in their territory, whether nationals or non-nationals, migrants irrespective of their legal status, have access to vaccines,” he said. “Because in practical terms, the pandemic has shown us that nobody is safe till everyone is safe.”  Sadly, the pandemic has not stopped traffickers and other criminals seeking to exploit migrants.  FILE – Migrants wait on board the German charity Sea-Watch 4 rescue ship before being transferred to GNV Allegra, where they will be in quarantine as part of anti-coronavirus measures, at sea near the Sicilian city of Palermo, Italy, Sept. 2, 2020.“There are four times more arrivals in Italy this year through the Mediterranean, one of the most dangerous routes, than last year,” Vitorino said of those who try to cross on boats and rafts. “Or if you look to the Gulf of Aden, there are 130,000 people who are crossing the Gulf both ways to reach the (Arab) Gulf countries, and they did not stop because of the pandemic.”  More than 3,100 migrants have died trying to reach destination countries this year. Drowning is the most common cause.  Vitorino said that migration is a natural human phenomenon that must be done in safe, dignified and regular ways.  “It has always existed, and it will go on existing in our world,” he said.  
 
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The United States is expanding its rollout of the newly approved COVID-19 vaccine to hundreds of distribution centers where thousands of health care workers are expected to be vaccinated. More from VOA’s Mariama Diallo.
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A U.S. panel endorsed emergency use of a second COVID-19 vaccine Thursday.A committee of independent expert advisers to the U.S. Food and Drug Administration (FDA) voted, after seven hours of discussion, to recommend the use of a vaccine developed by U.S. drug manufacturer Moderna, one week after federal regulators authorized the first vaccine for emergency use. “The evidence that has been studied in great detail on this vaccine highly outweighs any of the issues we’ve seen,” Dr. Hayley Gans, Stanford University Medical Center, said Thursday. FILE – Biotechnology company Moderna protocol files for COVID-19 vaccinations are kept at the Research Centers of America in Hollywood, Florida, Aug. 13, 2020.The news comes as the United States has recorded nearly 310,000 deaths from the virus, according to the Johns Hopkins Coronavirus Resource Center. There are more than 17 million confirmed cases of COVID-19, the disease caused by the coronavirus, in the U.S. FDA authorization of emergency use of the vaccine could come as soon as Friday. Once approved, Moderna would then begin shipping nearly 6 million doses, with the first planned for health workers and nursing home residents. Last week, after the advisers endorsed the use of the first vaccine, the FDA authorized it for emergency use a day later. That vaccine, developed by U.S. drugmaker Pfizer and German partner BioNTech, is being distributed throughout the U.S.  The Pfizer/BioNTech vaccine’s distribution was threatened Wednesday and Thursday in Northeastern U.S. states by the region’s first major snowstorm, which forecasters said might leave more than 30 centimeters (12 inches) of snow on parts of New England before heading out to sea later Thursday. A massive inoculation program with an initial round of 2.9 million doses began Monday at U.S. hospitals and in long-term care facilities, as cases continued to surge across the U.S.  Staff members receive the COVID-19 vaccine at Holy Name Medical Center in Teaneck, N.J., Dec. 17, 2020.Thousands of people are dying daily, while intensive medical care units across the country are approaching capacity, threatening to overwhelm health care systems. Both vaccines were about 95% effective in clinical trials, but Moderna’s requires less onerous cold storage requirements than the Pfizer/BioNTech vaccine, making it a better choice for rural and remote areas. Moderna, however, reported more frequent side effects from its 30,000-person trial than those reported by Pfizer. These were mainly short-term reactions, such as hives, rashes and itching, officials said. FDA staffers did not mention any significant safety concerns about the Moderna vaccine in documents released Tuesday in preparation for the meeting.  General Gustave Perna, chief operating officer of the federal government’s Operation Warp Speed vaccine project, told reporters Monday the U.S. plans to transport 6 million doses of Moderna’s vaccine if it is approved. Operation Warp Speed scientific leader Moncef Slaoui said Monday that 20 million people in the U.S. would be vaccinated with either vaccine this month. Slaoui estimated that 100 million people, about one-third of the U.S. population, could be inoculated by the end of the first quarter of 2021. 
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Lawmakers in the lower house of Spain’s parliament approved a bill Thursday, amid ongoing protests, that would allow people to lawfully end their lives if they suffer from serious or incurable diseases.The bill, which is awaiting Senate approval, passed 198-138, in the face of staunch opposition from the conservative People’s Party, its supporters and religious groups.FILE – Santiago Abascal, leader of far-right party Vox, speaks at parliament in Madrid, Spain, Oct. 22, 2020.Many of the protesters who gathered outside parliament Thursday held banners that read “Government of death.”“The euthanasia law is a defeat for civilization and a victory for the culture of death, for those who believe that some lives are more worthy than others,” far-right Vox leader Santiago Abascal said in a video on social media.But Spanish Health Minister Salvador Illa told lawmakers the society “cannotFILE – Spain’s Health Minister Salvador Illa speaks at Hospital Clinic in Barcelona, Spain, Feb. 12, 2020.remain impassive when faced with the intolerable pain that many people suffer.”Euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.The practice is illegal in most countries but has received favorable consideration in the European Union. If passed by the Senate, Spain would become the fourth European country after Luxembourg, the Netherlands and Belgium to allow people to legally end their lives because of medical conditions.Without any amendments, the law could go into effect as early as next spring.After that point, patients who choose to die because of a medical condition are required to demand euthanasia or ask to be assisted to commit suicide four separate times.The first two requests must be in writing and submitted two weeks apart, while the fourth just before the procedure takes place. All these requests have to be approved by an oversight board with jurisdiction over the patient’s location.Only Spanish citizens or residents of adult age can request to end their lives. The law does, however, give doctors the chance to deny requests based on their personal beliefs. 
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