The New York Times - USA (2020-12-07)

THE NEW YORK TIMES, MONDAY, DECEMBER 7, 2020 N A

Tracking an OutbreakWashington

normal, and we want people to

stop getting sick. This is just a re-

ally concrete reminder that things

are getting worse.”

California’s new measures are

its strictest since the beginning of

the pandemic, when it became the

first state to issue a stay-at-home

order, helping to control an early

outbreak. But many residents are

weary after nine months of shift-

ing rules about where they can go,

whether they can eat indoors or

outdoors and whether their chil-

dren can go to school. In some

cases, the restrictions run counter

to moves in other places; New

York City, for example, will reopen

some public schools on Monday,

reflecting changing public health

thinking about the importance of

children being in the classroom.

So this time, California’s restric-

tions have been met with more

skepticism and outright defiance

in some areas, even though state

and local health officials have de-

scribed the spread of the virus as

much more dangerous than in the

spring.

Over the weekend, Los Angeles

streets that had until recently

been alive with diners sitting on

sidewalks or in parking lots were

quieter, but shoppers still

streamed into grocery stores and

clustered outside restaurants

met with some skepticism as they
played out against an increasingly
desperate backdrop, with the vi-
rus surging across the country
and packing hospitals to near ca-
pacity with critically ill patients.
On Friday, more than 229,000 new
cases were reported in the United
States, a record, and several
states hit new daily highs over the
weekend. More than 101,
Covid-19 patients are in hospitals
now, double the number from just
a month ago.
Health experts said the timeline
sketched out by Dr. Slaoui and Mr.
Azar was uncompromising and
did not account for the possibility
of delay during the many steps
from vaccine manufacture to dis-
tribution at state and local levels,
not to mention the hesitancy that
many people might feel about tak-
ing a newly approved vaccine.
“To meet those kinds of ag-
gressive timelines, all the stars
would have to align,” said Dr. Pe-
ter J. Hotez, the dean of the Na-
tional School of Tropical Medicine
at Baylor College of Medicine.
Dr. Slaoui said his team charged
with distributing the vaccine was
scheduled on Monday to brief ad-
visers to Mr. Biden, who com-
plained last week that there was
“no detailed plan that we’ve seen,
anyway, as to how you get the vac-
cine out of a container, into an in-
jection syringe, into somebody’s
arm.”
Mr. Azar disputed Mr. Biden’s
remarks.
“With all respect, that’s just
nonsense,” he said. “We have com-
prehensive plans from the C.D.C.,
working with 64 public health ju-
risdictions across the country, as
our governors have laid out very
detailed plans that we’ve worked
with them on.”
At a rally in Georgia on Satur-
day night, President Trump once
again claimed that the country
was “rounding the corner” in deal-
ing with the pandemic, a state-
ment at odds with scenes in com-
munities across the country,
where doctors and nurses are
struggling to cope with more
cases of the virus than ever be-
fore.
On Sunday afternoon, Mr.
Trump announced on Twitter that
his personal lawyer Rudolph W.
Giuliani, who has led the presi-
dent’s efforts to overturn the re-
sults of the election, had tested
positive for the virus.
In California, under orders is-
sued on Thursday by Gov. Gavin
Newsom, residents across the
southern and central parts of the
state were directed not to leave
their homes for three weeks start-
ing at 11:59 p.m. Sunday, joining
parts of the San Francisco Bay
Area in shuttering outdoor dining
and bars, closing schools and rop-
ing off playgrounds.
Daily case reports have tripled
in the last month in California,
where more than 25,000 new in-
fections were reported on Satur-
day. Los Angeles County, with
more than 8,900 new cases, broke
its record for the third straight
day.
At the U.C. San Diego Medical
Center, just six of 112 intensive
care beds were unoccupied on
Sunday, and doctors expressed
concern that an extended crisis
would put extreme pressure on
nurses and doctors.
“It’s more about the duration,”
said Dr. Chris Longhurst, the hos-
pital’s associate chief medical offi-
cer. “If the surge were 48 hours, it
would be all hands on deck and
we’d all be there to take care of
them, and then we could get
through it. What you can’t manage
is a sustained surge.”
Before Sunday, much of Califor-
nia was already under a curfew
prohibiting residents from leaving
their homes to do nonessential
work or to gather from 10 p.m. to 5
a.m. The governor’s order re-
quired regions in the state to be
placed under new restrictions
once their intensive care unit
availability fell below 15 percent.
With capacity at 6.6 percent in
the San Joaquin Valley and 10.
percent in Southern California on
Sunday, shops there must operate
at limited capacity, and private
gatherings are prohibited. Any
open businesses must require ev-
eryone inside to wear masks and
distance themselves. Among the
facilities that must close: hair sa-
lons and barbershops; museums,
zoos and aquariums; indoor mov-
ie theaters; and wineries and
breweries.
“I haven’t heard of anybody
panicking,” said Rachel Heimann,
25, who lives in San Francisco.
“We all want things to go back to

waiting for takeout. Inside a dim

post office in the Echo Park neigh-

borhood, a queue of customers —

spaced as best they could —

snaked around the small, en-

closed room lined with mailboxes.

Mr. Newsom has emphasized

that California will withhold fund-

ing from counties that refuse to

enforce the stay-at-home order.

After some counties pushed back

on prevention measures during a

summer surge, an enforcement

task force levied more than $2 mil-

lion in fines against businesses, is-

sued 179 citations and revoked

three business licenses.

There is also resistance from

government leaders, parents and

public health experts to play-

ground closings.

Being outside at playgrounds

makes it harder for the virus to

spread, and the risk of transmis-

sion through contaminated serv-

ices is minimal — particularly

when using hand sanitizer and

masks and engaging in social dis-

tancing, said Joseph Allen, an as-

sociate professor of exposure as-

sessment science at the Harvard

T.H. Chan School of Public Health.

“When you step back and look

at this from a real exposure risk

standpoint, these are the exact

kind of activities we should be en-

couraging,” he said.

Ana Padilla, the executive di-

rector of the Community and La-

bor Center at the University of

California, Merced, said in an

email that the new order was

likely to be effective at controlling

the virus in communities where

many middle-class workers work

remotely and order takeout.

“It will do less for workers who

have no choice but to work in low-

wage, essential jobs, in which they

frequently come into contact with

others,” she said.

Delaware, Michigan, Oregon,

Washington State and cities such

as Philadelphia and Los Angeles

have also reimposed restrictions

aimed at slowing the spread of the

virus.

In Washington, a bipartisan

group of senators on Sunday

urged passage of a $908 billion

stimulus proposal to break the

stalemate in Congress over deliv-

ering additional economic relief to

Americans battered by shut-

downs and restrictions like those

in California and elsewhere.

Senator Mark Warner, Demo-

crat of Virginia and one of the law-

makers who drafted the plan, said

on “State of the Union” that “it

would be stupidity on steroids if

Congress doesn’t act.” But he pre-

dicted a few more “days of drama”

before the deal gained enough

support to pass both chambers.

Intended as a stopgap measure

to last until March, the plan would

restore federal unemployment

benefits that lapsed over the sum-

mer, but at half the rate, providing

$300 a week for 18 weeks. It would

give $160 billion to state, local and

tribal governments facing fiscal

ruin, a fraction of what Democrats

had sought. Also included is $

billion to help small businesses

and a short-term federal liability

shield from coronavirus-related

lawsuits.

In Britain, 800,000 doses of the

Pfizer vaccine were being trans-

ported to government ware-

houses on Sunday after the coun-

try’s regulators became the first

in the world to authorize a fully

tested vaccine last week. The

country’s National Health Service

was set to begin vaccinating doc-

tors, nurses, pharmacists, nursing

home workers and some people

over 80 on Tuesday.

American and European regu-

lators have questioned Britain’s

hasty authorization process, but

British lawmakers have largely

brushed off those concerns, forg-

ing ahead with an aggressive

strategy of fast-track reviews that

could result in a second vaccine,

developed by AstraZeneca and

the University of Oxford, also be-

ing authorized for emergency use

within weeks.

In the United States, an advi-

sory committee to the Food and

Drug Administration will meet on

Thursday to review safety and ef-

ficacy data on Pfizer’s vaccine. A

second vaccine, made by Mod-

erna, has also been submitted for

emergency authorization. And

two other candidates, made by As-

traZeneca and Johnson & John-

son, are not far behind, if their de-

velopment does not hit unexpect-

ed snags.

Operation Warp Speed’s time-

line has shifted more than once al-

ready. The project was initially ex-

pected to produce 300 million

doses by the end of the year. And

Pfizer said this summer that it

would have 100 million doses by

year’s end. But the companies

have hit manufacturing and sup-

ply chain problems.

Together, Pfizer and Moderna

now might produce 45 million

doses by January. The vaccines

were not likely to be available to

everyone until the end of the sum-

mer, experts said.

Dr. Slaoui acknowledged the

possibility of delays. “This is not

an engineering problem. These

are biological problems. They’re

extremely complex,” he said.

“There will be small glitches.”

Dr. Ashish K. Jha, the dean of

the School of Public Health at

Brown University, expressed con-

cern about a lack of clarity at the

state level on how vaccines would

be distributed to medical centers,

nursing homes or pharmacies.

And because fewer than half of

several high-risk groups — Black

people, firefighters, health care

workers — have said they would

take a vaccine, persuading them

to do so will require careful plan-

ning and communication to build

confidence.

“We have not been doing any of

that,” Dr. Jha said, “and that’s not

something you turn on overnight.”

Michael D. Shear reported from
Washington, Apoorva Mandavilli
from New York and Jill Cowan
from Los Angeles. Reporting was
contributed by Allyson Waller from
Conroe, Texas; Luke Broadwater
and Hailey Fuchs from Washing-
ton; Giulia McDonnell Nieto del
Rio, Ron DePasquale and Lucy
Tompkins from New York; Carly
Stern from San Francisco; and
Benjamin Mueller from London.

AMBITIOUS TIMETABLE

Vaccine May Ship in Days as Cases in U.S. Surpass Record

From Page A

Visiting Lake Hollywood Park the day before a three-week order to stay home took effect in parts of California late Sunday night.

PHOTOGRAPHS BY PHILIP CHEUNG FOR THE NEW YORK TIMES

Much of California, including Los Angeles, was already under a curfew before the new order began.

Hollywood remained listless as Los Angeles County reported over 8,900 new cases on Saturday.

Over 229,000 new

cases were reported

in the U.S. on Friday.

WASHINGTON — A doctor

who is skeptical of coronavirus

vaccines and promotes the anti-

malaria drug hydroxychloroquine

as a Covid-19 treatment will be the

lead witness at a Senate Home-

land Security and Governmental

Affairs Committee hearing on

Tuesday, prompting criticism

from Democrats who say Republi-

cans should not give a platform to

someone who spreads conspiracy

theories.

Dr. Jane M. Orient is the execu-

tive director of the Association of

American Physicians and Sur-

geons, a group that opposes gov-

ernment involvement in medicine

and views federal vaccine man-

dates as a violation of human

rights.

“A public health threat is the ra-

tionale for the policy on manda-

tory vaccines. But how much of a

threat is required to justify forcing

people to accept government-im-

posed risks?” Dr. Orient wrote in a

statement to the Senate last year,

calling vaccine mandates “a seri-

ous intrusion into individual lib-

erty, autonomy and parental deci-

sions.”

In a phone interview on Sunday,

Dr. Orient, an internist who re-

ceived her medical degree from

Columbia University in New York,

resisted being cast as an “anti-

vaxxer” and said she would not

get a coronavirus vaccine because

she had an autoimmune condition.

She added that she opposed the

government’s push for all Ameri-

cans to be vaccinated against the

coronavirus, noting that both vac-

cine candidates — one made by

the Pfizer and the other by Mod-

erna — use a new scientific

method.

“It seems to me reckless to be

pushing people to take risks when

you don’t know what the risks

are,” Dr. Orient said, adding:

“People’s rights should be re-

spected. Where is ‘my body, my

choice’ when it comes to this?”

Her selection as a witness as

federal health officials are trying

to promote a vaccine as a way to

end a pandemic that has killed

more than 281,000 Americans

prompted harsh criticism from

Senator Chuck Schumer, Demo-

crat of New York and the minority

leader.

“At such a crucial time, giving a

platform to conspiracy theorists

to spread myths and falsehoods

about Covid vaccines is downright

dangerous and one of the last

things Senate Republicans should

be doing right now,” Mr. Schumer

said in a statement on Sunday.

But at least two Republican

House members — Representa-

tive Andy Biggs of Arizona and

Representative Jeff Duncan of

South Carolina — appeared to em-

brace Dr. Orient’s warnings

against government mandates.

They took to Twitter to express

those views.

“Americans should have the

freedom to take the COVID vac-

cine,” Mr. Duncan wrote on Satur-

day. “Americans should also have

the freedom to decline the vac-

cine.”

A spokesman for the chairman

of the Senate committee, Senator

Ron Johnson, Republican of Wis-

consin, did not immediately re-

turn an email message asking

why Dr. Orient had been invited to

testify.

Dr. Orient, who lives in Tucson,

Ariz., said on Sunday that she

would appear remotely during the

hearing on early at-home treat-

ment for Covid-19. She said in the

interview that doctors were too of-

ten sending patients home with in-

structions to simply rest and ride

out the disease.

The association has also sued

the government in an effort to

force it to release hydroxychloro-

quine from the national stockpile

for use as a Covid-19 treatment, al-

though the scientific evidence in-

dicates that the drug is ineffective

against the coronavirus. The case

is currently before a federal ap-

peals court.

Dr. Orient said she intended to

use her testimony to call for gov-

ernment guidelines informing

doctors about hydroxychloro-

quine as a potential treatment for

Covid-19 patients, even though the

Food and Drug Administration re-

voked an emergency authoriza-

tion allowing the drug to be dis-

tributed from the national stock-

pile and has warned that it could

harm those patients.

VACCINES

In the Senate,

A Battle Flares

Over a Witness

On Treatment

By SHERYL GAY STOLBERG

Democrats say that a

doctor is spreading

conspiracy theories.