Countries are falling short of the inoculation targets set by leaders. There are more than twice as many Covid-19 patients in California hospitals now as there were a month ago.

Nearly 1,500 inmates in Mississippi have been infected, but officials won’t say how many have died.

As England enters a strict new national lockdown and other European nations extend restrictions to try to slow the spread of the coronavirus, political leaders have pointed to the promise of mass vaccination campaigns to bring an end to the suffering.

But in the race to beat the virus, the virus is still way out in front.

Around the world, inoculation efforts in many countries are rolling out slower than promised, even as the count of new infections soars and record numbers flood hospitals, placing a double burden on health care providers who have also been tasked with leading the vaccination push.

And a more contagious variant spreading widely in England and detected in dozens of other countries threatens to give the virus an even greater advantage.

Prime Minister Boris Johnson said that England would be locked down until inoculations reached the four most vulnerable groups: residents in nursing homes and those who care for them, everyone over the age of 70, all frontline health and social care workers, and everyone who is clinically extremely vulnerable.

“If we succeed in vaccinating all those groups, we will have removed huge numbers of people from the path of the virus,” he said.

The four groups that the prime minister cited include 13.9 million people in England, according to Nadhim Zahawi, the minister overseeing the vaccine effort.

Since the campaign started on Dec. 8, fewer than 800,000 people in England had been vaccinated as of Dec. 27, the last date when data was available.

But with the introduction on Monday of the first doses of a vaccine developed by the University of Oxford and AstraZeneca — shots that are easier to transport and do not need to be stored at very cold temperatures — British officials said that the campaign could now be ramped up.

According to Mr. Johnson, England is outpacing many countries in the European Union, where vaccination campaigns did not kick off until just before Christmas.

Data from 19 of the bloc’s 27 member states, including France, Germany and Italy, show that about 500,000 vaccinations have been carried out so far.

In Germany, where the government was poised to extend lockdown measures through January, nearly 265,000 people received a first shot as the nationwide drive entered its second week, according to health officials. At the moment, Germany and other European Union countries are relying on the BioNTech-Pfizer vaccine, which requires another booster shot weeks later to reach full efficacy. England has decided to delay that second shot and other countries are exploring doing the same.

The Italian government said that as of Monday, 151,606 people had been vaccinated. A majority, 134,255, were health care professionals.

The vaccination drives in Germany and Italy are moving much faster than in France, where only about 500 people received the vaccine during the previous week.

And the campaign in the United States, the world’s leader in new infections, is off to a much slower start than promised.

About 4.5 million people in the United States have received a dose of a Covid-19 vaccine, according to the Centers for Disease Control and Prevention, far short of the goal that federal officials set to give at least 20 million their first shots before the end of December.

The small number of vaccine recipients is particularly striking in New York City, where roughly 110,000 people — in a city of more than eight million — have received the first of two doses necessary to help prevent serious cases of the disease. That is about a quarter of the total number received by the city.

Cleveland Browns head coach Kevin Stefanski, two other coaches and two players tested positive for Covid-19, the team said on Tuesday, putting the team’s championship aspirations in doubt.

All five people will miss the Browns matchup against the Pittsburgh Steelers on Sunday night, Cleveland’s first postseason game in nearly two decades. Special teams coordinator Mike Priefer will take over as head coach in Stefanski’s absence.

The N.F.L. said there was no change to the status of the game, and the league and team continue “to conduct standard contact tracing to identify any possible high-risk close contacts.”

Stefanski and the other coaches and players must be isolated from the team for a minimum of 10 days. If any players or personnel are found to have had close contact with them, they would need to remain apart from the team for five days, after which they would be eligible to return to the team and play in the game.

During their 24-22 victory on Sunday over the Steelers, the Browns had six players on the Covid-19 reserve list who had either tested positive or had close contact with someone who had. The previous week, the Browns had played without any of their best wide receivers because of an outbreak on the team.

California’s daily coronavirus case tallies remain around four times what they were during the state’s summer surge, and officials predict that the aftereffects of a December surge linked to holiday gatherings will worsen as the winter drags on.

After new infections — driven by Thanksgiving travel and gatherings, then Christmas festivities — resulted in a surge unlike any the state had yet seen, the trajectory of its new cases has leveled off somewhat in the early days of 2021.

But there are more than twice as many Covid-19 patients in California hospitals now as there were a month ago, and many intensive care units in the state have been overflowing. At least six people in the state have also been found to be infected with the new, more transmissible variant of the virus first identified in Britain.

In the pandemic’s brutal logic, more cases inevitably translates to more suffering and deaths. As of Monday night, 4,258 people with Covid-19 had died in the preceding two weeks, compared with 3,043 in the two weeks before that.

“This is a deadly disease, this is a deadly pandemic,” Gov. Gavin Newsom told reporters on Monday. “It remains more deadly today than at any point in the history of the pandemic.”

There has been some progress. California’s daily average of 38,086 cases per day over the past week represents a decrease of 11 percent from the average two weeks earlier, for example. And although Covid-19 hospitalizations have increased by 18 percent over the past two weeks, to 20,618, Governor Newsom said that represents a slight flattening of the curve.

But the state’s last major Covid-19 surge, over the summer, only produced around 10,000 infections on its worst days. And in Los Angeles County, the latest crisis has stretched the health care system so thin that incoming patients at one hospital were recently being instructed to wait in an outdoor tent.

Mayor Eric Garcetti of Los Angeles said on Sunday that the county’s latest surge was infecting a new person every six seconds, and that many transmissions were occurring in private settings.

“It’s a message for all of America: We might not all have the same density as L.A., but what’s happening in L.A. can and will be coming in many communities in America,” he said.

The worst of the state’s outbreak is concentrated in Southern California and the San Joaquin Valley, where intensive care units are at zero percent capacity. Officials are now working to bring in extra nursing staff to care for the flood of patients; Governor Newsom said that 90 patients were being kept at “alternate care sites” outside hospitals to help ease the burden.

The state is also facing an oxygen shortage for patients, and it has deployed the U.S. Army Corps of Engineers and the California Emergency Medical Services Authority to help deliver and refill oxygen tanks.

In a sign of how dire that shortage is, Marianne Gausche-Hill, the medical director for Los Angeles County’s E.M.S. agency, issued guidelines to emergency workers on Sunday for administering the “minimum amount of oxygen necessary” to keep patients’ oxygen saturation level at or just above 90 percent. (A level in the low 90s or below is a concern for people with Covid-19.)

More inoculations would help ease California’s burden, but Governor Newsom said vaccinations were only just ramping up after facing some early challenges. So far, he said, the state has only administered about 35 percent of the coronavirus vaccine doses it has received.

In the meantime, said Dr. Mark Ghaly, the state’s secretary of health and human services, Californians should be extra cautious about gathering with people outside their household now that the virus is so prevalent.

“The same activities that you did a month ago, today are just so much more risky than they were from a Covid transmission perspective,” he said.

Chancellor Angela Merkel and state governors in Germany agreed on Tuesday to extend the nationwide lockdown by three weeks, until at least the end of January, and to tighten restrictions amid high rates of coronavirus cases and deaths and the fear that a more contagious variant of the virus could spread in Germany.

“The measures we have adopted today are drastic,” Ms. Merkel said in a news conference after the meeting. “They are not just a continuation of what we did before Christmas. Given the situation, they are tougher.”

Under the extended lockdown rules, members of a household cannot meet more than one person from another household; schools, child care centers, cultural sites and all but essential shops are closed. Ms. Merkel and the governors also agreed to limit movement to 15 kilometers from home for people living in areas in which there are more than 200 new infections a week per 100,000 people. It is the first such rule in effect across Germany since the pandemic began.

After the failure of lighter lockdown measures in November — under which both schools and most shops had remained open — the German authorities had set stricter rules in mid-December. Those restrictions, which were set to expire Jan. 10, cut short the pre-Christmas shopping period, discouraged family gatherings over the festive season and curtailed celebrations for New Year’s Eve.

In a recent YouGov poll, two thirds of German respondents said that they approved of an extension to the lockdown. About 24 percent also said that they thought the restrictions should be tightened, according to the poll, commissioned by the German news service DPA.

On Monday, the health authorities in Germany registered 11,897 new infections and 944 deaths. According to a New York Times database, there were 17,526 new infections per day on average during the last seven days, comparable to the number of daily infections registered at the beginning of November, when authorities started the lockdown.

While many countries are still reeling from Covid-19, China — where the pandemic originated — has become one of the safest places in the world. The country reported fewer than 100,000 infections for all of 2020. The United States has been reporting more than that every day since early November.

China resembles what “normal” was like in the pre-pandemic world. Restaurants are packed. Hotels are full. Long lines form outside luxury stores. Instead of Zoom calls, people are meeting face to face to talk business or celebrate the new year.

The country will be the only major economy to have grown this past year. While such forecasts are often more art than science, one outfit is predicting that the Chinese economy will surpass that of the United States in 2028 — five years earlier than previously expected.

Citizens of China don’t have freedom of speech, freedom of worship or freedom from fear — three of the four freedoms articulated by President Franklin D. Roosevelt — but they are able to move around and lead a normal day-to-day life. In a pandemic year, many of the world’s people would envy that.

But China’s freedom of movement comes at the expense of nearly every other kind. The country is roughly the most surveilled in the world. The government took extreme social-control measures at the beginning of the outbreak to keep people apart — approaches that are beyond the reach of democratic governments.

“There are actually a lot of parallels between how the Chinese government treats a virus and how they treat other problems,” said Howard Chao, a retired lawyer in California who invests in start-ups on both sides of the Pacific.

“It’s kind of a one-size-fits-all approach: Just completely take care of the problem,” he said. “So when it comes to a virus, maybe that’s not too bad a thing. When it comes to certain other problems, maybe not such a good thing.”

The Mississippi Department of Corrections has reported that 108 people died in its prisons in 2020, a toll that was significantly higher than a year earlier. But as of Monday, the department had not disclosed whether any of those deaths were caused by the coronavirus, though more than 1,400 inmates have been infected since the pandemic’s start, according to state data.

Grace Fisher, a spokeswoman for the prison system, did not respond to email and phone inquiries about how the state prison system determines, records and makes public the causes of inmate deaths. A spokeswoman for Gov. Tate Reeves did not respond to an email and phone call seeking comment.

Many states report Covid-19 cases and deaths in online dashboards. Others report them in news releases or when requested.

Mississippi’s prison system has touted its handling of the virus, saying in a news release in December that its prisons “remain among the safest in the nation from the Covid-19 virus.”

Burl Cain, the state’s prison commissioner, said in May that the prison system had successfully managed the virus by restricting inmate transfers, suspending family visits and using increased cleaning and disinfection practices.

Advocates of greater transparency from prison authorities say it is unclear whether Mississippi’s prisons are opting not to disclose coronavirus deaths or if officials are uncertain of a full count because deaths are not being fully investigated.

Cliff Johnson, the director of the University of Mississippi School of Law’s MacArthur Justice Center — which filed a Freedom of Information request to obtain the number of prison deaths — said the lack of information about the causes of prison deaths represented a public safety threat.

All but three states have reported Covid-19 deaths in their prison systems. Vermont has recorded no prisoner deaths from the virus, a representative for that system said. Wyoming has not disclosed any deaths. But Mississippi’s prison system is far larger, with about 16,350 inmates, compared with just 3,200 in Wyoming and Vermont combined.

In New Jersey, whose prisons house about 15,000 inmates, at least 53 have died from Covid-19, according to state data.

The rate of coronavirus testing in Mississippi’s prisons is among the lowest in the nation. Since the pandemic began, only one in five prisoners has been tested, according to state records.

Just over half of the teachers who were expected to report to school buildings in Chicago on Monday, as the first step in the district’s reopening plan, did not show up, the district said on Tuesday. The absences were part of a long-running clash between teachers and administrators that is complicating the district’s efforts to resume in-classroom instruction for the first time since March 2020.

Chicago Public Schools, the nation’s third largest district with some 340,000 students, is planning to welcome prekindergarten students and some special education students back to schools next week, followed by kindergarten through eighth-grade students on Feb. 1. The students’ families can choose to have them return or to continue with remote learning; about 37 percent have chosen to return.

The district’s plan has run into relentless opposition from the Chicago Teachers Union, which argues that virus transmission remains too high in many neighborhoods and that the district’s safety measures are inadequate. A majority of the City Council signed a letter opposing the plan and demanding that the district negotiate with the union over the conditions for reopening.

The district, which is under the control of Mayor Lori Lightfoot, indicated on Tuesday that it was determined to press forward with its reopening plans.

The district’s chief executive, Janice K. Jackson, said that overall, some 60 percent of school-based employees — including teachers and paraprofessionals — who were expected to return to schools on Monday did so, “which is significant,” she said, “considering the fact that they were pressured by the union not to return.”

For comparison, she said, about 83 percent of employees reported for work in the first two days following winter break last year, “which is what we typically expect around this time.”

“We are optimistic that more staff will report to work in the coming days,” Dr. Jackson said, adding that employees who continued to stay away would be subject to progressive disciplinary actions, up to dismissal.

The Food and Drug Administration late Monday criticized an idea floated by one of the administration’s top vaccine officials for stretching the limited number of Covid-19 vaccine doses, saying that a proposal for half-doses of the Moderna vaccine was “premature and not rooted solidly in the available science.”

The agency’s statement, posted on its website Monday night, exposed a fissure between Trump administration officials about whether they can somehow economize vaccine supplies in order to inoculate more people quicker. Moderna and the Pfizer-BioNTech are the only companies so far whose vaccines are authorized for emergency use in the United States, and together they can deliver only enough doses to vaccinate 185 million Americans by the end of June.

On Sunday, Moncef Slaoui, the scientific leader of Operation Warp Speed, the administration’s vaccine development program, said that federal officials and Moderna were discussing possibly halving each of Moderna’s two doses — effectively giving recipients the equivalent of one full dose.

He said data from Moderna’s clinical trials demonstrated that people between the ages of 18 and 55 who received two 50-microgram doses showed an “identical immune response” to the two 100-microgram doses.

But the F.D.A., which would have to approve such a change in protocol, suggested in its statement that the available data was insufficient to justify that shift — or other proposed regimen changes designed to stretch out doses.

“We have been following the discussions and news reports about reducing the number of doses, extending the length of time between doses, changing the dose (half-dose), or mixing and matching vaccines in order to immunize more people against COVID-19,” the statement said. Such changes should be researched in clinical trials before adopted, it said. Experts said such studies would take weeks, if not longer.

While some data already exists, clinical trial recipients of the Moderna or BioNTech vaccine who did not receive two doses at the proper time “were generally only followed for a short period of time,” the agency said. Therefore, “we cannot conclude anything definitive about the depth or duration of protection after a single dose of vaccine,” it said.

Changing the dosage could also complicate the vaccine effort just as the public is beginning to become more accepting of the program, according to Dr. Anthony S. Fauci, the government’s top infectious disease expert.

“One of the dangers of making a change in midstream is that it could confuse the public,” he said in an interview on Monday.

He also suggested that changing the vaccine dosage was “the right answer to the wrong question.” The current problem, he said, is not that there are not enough doses, but that state and local governments have been unable to vaccinate people with the doses they already have.

“At the present time we are not dealing with a shortage of doses — we are dealing with the need to increase our efficiency in getting people vaccinated,” he said. He suggested that changing the dosage “could become appropriate” if a shortage emerged.

The one-sentence letter didn’t say much. The coronavirus vaccine was “manufactured free of porcine materials,” Sinovac, the Chinese vaccine maker, wrote to Indonesia’s state-owned vaccine manufacturer in July.

While the letter was promising, Indonesian clerics needed more details. A vaccine laced with the smallest amount of pork DNA could dissuade some followers of Islam from inoculation in Indonesia, the country with the world’s largest Muslim population. Sinovac took months to provide more information, which came only this week.

The Chinese company’s delayed response has been yet another challenge in Indonesia’s already fragile vaccine rollout. With the highest number of coronavirus infections in Southeast Asia, the country is eager to drum up support for its goal of inoculating 181.5 million adults within 15 months. But looming questions about the safety of the Sinovac vaccine and whether it is halal, or allowed under Islam, are complicating the government’s efforts.

“There shouldn’t be any concern about whether this vaccine is halal or not halal,” President Joko Widodo has said. “We are in an emergency situation because of the Covid pandemic.”

Indonesia has recorded nearly 800,000 infections and more than 23,000 deaths, staggering numbers in a region where virus cases have remained relatively low. Inoculations are set to begin with health workers, soldiers and police officers in the coming weeks, once the health authorities are satisfied that the Sinovac vaccine is safe and effective.

Islamic authorities in other countries where Muslims make up a sizable share of the population, including Malaysia and the United Arab Emirates, have already ruled that coronavirus vaccines are permissible, even if they contain pork gelatin, which is used to stabilize many inoculations.

The Ulema Council, an influential group of Muslim clerics that decides which products are halal in Indonesia, is expected to issue a decree, or fatwa, authorizing the use of the Sinovac vaccine in the coming weeks. But the nature of its findings could affect how widely it is accepted in Indonesia, especially among the country’s many conservative Muslims.

A senior official in Singapore said on Monday that the country’s police force could legally use data from the government’s coronavirus contact-tracing program for criminal investigations. A privacy statement on the program’s website had said that the information would be used only for contact tracing, local news media reported. But Desmond Tan, the home affairs minister, said in Parliament on Monday that officers could use the data for criminal investigations “and for the purpose of the safety and security of our citizens.”

Japan’s top-ranked sumo wrestler, Hakuho, has tested positive for the virus after losing his sense of smell, the country’s national broadcaster reported on Tuesday. The Mongolian-born athlete had been scheduled to compete next week in the New Year Grand Tournament, a major sumo event.

As New York City braces for a pandemic winter, many parks, plazas and open spaces that are so vital to its public life in warmer months have been transformed into cold-weather playgrounds.

Outdoor space has become essential for a crowded city with the virus surging and new restrictions on indoor gatherings.

As a result, the outdoor offerings go beyond the usual ice rinks and winter festivities to make way for a far more robust outdoor culture.

There is a new iceless curling cafe in Bryant Park in Manhattan, where players slide stones across five slippery synthetic lanes. Outdoor movies play in a nearby plaza in Hudson Yards. An “outdoor living room” with timber benches beckons in the Prospect Heights neighborhood of Brooklyn. And an empty lot in the Astoria section of Queens has turned into a drive-in theater.

Heated igloos and cabins dot the city, and at the base of a skyscraper on Madison Avenue, a glass canopy being built over part of a public garden will shield visitors from rain and snow.

Just as the pandemic has transformed New York’s car-dominated streets with outdoor dining and shopping, the threat of the virus has spurred a broad reimagining of public spaces that normally sit empty during cold-weather months.

Even before the virus, there have been efforts to create more year-round outdoor public spaces. The design for a glass-and-steel canopy at 550 Madison Avenue — a city landmark that was once the home of AT&T and the Sony Corporation — was revealed in 2019.

But the pandemic has brought plenty of new and expanded outdoor options across the city, though many are in well-off neighborhoods and priced beyond the reach of many New Yorkers.

“They serve people who can afford it,” said Claudia Coger, 85, a retired city transit worker who has been treated to shows at the Astoria drive-in theater and would like to see more outdoor options around the city for everyone. “The rest of the people get left out. They need to go back to the drawing board at a time like this.”

Some groups have organized free and low-cost outdoor activities, like a new audio guide to Belvedere Castle, a fairy-tale lookout point in Central Park.

Genesis Community Church, outside of Boston, thought it was taking all the right safety precautions for its Christmas services: requiring an R.S.V.P. in case contact tracing was needed, limiting capacity and requiring masks.

But it was not enough. More than 40 people have tested positive for the coronavirus in cases that are believed to be connected to those gatherings.

The house of worship in Woburn, Mass., hosted a total of four Christmas celebrations on Dec. 23 and Dec. 24. Its lead pastor, Michael Davis, who declined to be interviewed, said in a series of emails that those who wanted to attend were required to essentially make reservations.

That allowed the church “to do accurate and complete contact tracing of everyone who was in the building,” Mr. Davis said. “The average attendance at each gathering was 105 per service, which is 35 percent of our building occupancy.”

But, he said, he knows of at least 44 people who were at those services who have tested positive. Tara Vocino, 32, a local photographer, is one of them. She said that she was tested on Dec. 29 and received her positive result two days later.

“It feels like there has been a knife in my mouth, and I’ve lost all sense of taste and smell,” Ms. Vocino said, adding that she feels so exhausted that she has been sleeping “about 16 hours a day.”

She said that she was at one of the services on Dec. 23, was in the front row at the church and was wearing a mask.

Ms. Vocino, who lives with her parents and suffers from asthma, said, “I’ve been in one room for the last couple of days, and I use a separate bathroom.”

Mr. Davis said that he has also tested positive for Covid-19 but is “almost back to full health.”

He added that the church is “working closely” with the Woburn Board of Health to help the agency with contact tracing. Mr. Davis said that within 24 hours of church officials learning of five of the Covid-19 cases, they contacted the health board.

Neither representatives from the health agency nor the mayor of Woburn responded to numerous calls and emails.

A pharmacist who was arrested on charges that he intentionally sabotaged more than 500 doses of the Covid-19 vaccine at a Wisconsin hospital was “an admitted conspiracy theorist” who believed the vaccine could harm people and “change their DNA,” according to the police in Grafton, Wis., where the man was employed.

The police said Steven Brandenburg, 46, who worked the night shift at the Aurora Medical Center in Grafton had twice removed a box of vials of the Moderna vaccine from the refrigerator for periods of 12 hours, rendering them “useless.”

“Brandenburg admitted to doing this intentionally, knowing that it would diminish the effects of the vaccine,” the police said.

The attempt to destroy precious doses of the vaccine came over the holidays as the state worked to administer vaccines quickly to frontline health care workers. As of Saturday, the state had received 159,800 doses of vaccines and had administered 64,657, according to the Centers for Disease Control and Prevention. Although the Moderna product is sometimes described as a “genetic” vaccine, it does not alter a person’s genes in any way.

The vials, which contained 570 doses of vaccine and which prosecutors said were worth $8,000 to $12,000, were discovered sitting out on Dec. 26. Five days later, Mr. Brandenburg was arrested on felony charges of reckless endangerment and property damage, though prosecutors on Monday said the charges could be dropped to a single misdemeanor if the vials, which have yet to be tested, are still usable.

The prosecutor, Adam Gerol, said that Mr. Brandenburg was “pretty cooperative and admitted to everything he’d done.” He said that according to co-workers, Mr. Brandenburg had brought a gun to work on two prior occasions.

In an order signed Monday, a family court granted temporary sole custody of Mr. Brandenburg’s two daughters to his wife, Gretchen Brandenburg, finding that the children were in “imminent danger of physical or emotional harm.”

Ms. Brandenburg filed for divorce last June. At a hearing in July, her lawyer testified that his client feared Mr. Brandenburg’s temper.


News – Covid-19 Live Updates: Global Vaccination Efforts Roll Out Slower Than Promised