More than a year after a new coronavirus first emerged in China, a team of experts from the World Health Organization arrived on Thursday in the central city of Wuhan to begin hunting for its source.
But in a sign of Beijing’s continuing efforts to control the investigation, the team of scientists and W.H.O. employees almost immediately ran into obstacles. Two scientists were unable to enter China at the last minute and remained in Singapore because they had tested positive for coronavirus antibodies, the W.H.O. said on Twitter.
The Chinese authorities required the remaining 13 experts to undergo two weeks of quarantine in Wuhan, where the virus first emerged in late 2019.
The investigation, which aims to gain an understanding into how the virus jumped to humans from animals, is a critical step so that another pandemic can be avoided. But getting answers is likely to be difficult.
Here’s what to know about the investigation.
China set up hurdles and pushed for control.
Apparently worried about drawing renewed attention to the country’s early mistakes in handling the pandemic, Chinese officials have used a variety of tactics over the past year to hinder the W.H.O. investigation.
After resisting demands from other countries that it allow independent investigators onto its soil to study the origin of the pathogen, China let two W.H.O. experts visit in July to lay the groundwork. They were not allowed to visit Wuhan, where the virus first emerged.
For months, China delayed approving a visit by a full team of experts, frustrating the health agency’s leaders. When the visit seemed to be finalized this month, it fell apart when Beijing declined to provide visas for the visitors, according to the health agency.
Now that the investigators have arrived, critics say Beijing’s desire for control means the inquiry will probably be more political than scientific.
Tracing the virus will be a painstaking task.
The team that has come to Wuhan will face a city radically transformed from when the virus first emerged, in late 2019. The city, which went into lockdown on Jan. 23 last year and became a symbol of the virus’s devastation, has since been held up by Chinese officials as a success story in vanquishing the virus.
The W.H.O. experts have decades of experience plumbing the depths of viruses, animal health and disease control. But tracing the source of the virus that as of Thursday had killed almost two million people worldwide and infected more than 92 million will be painstaking. While experts believe the virus originated naturally in animals, possibly bats, little else is known.
How much access the team gets in China will be critical, public health experts say.
The team will have to sidestep attempts to politicize its inquiry.
The pandemic has hurt China’s reputation, with many foreign governments still angry that Beijing did not do more to contain the crisis in its earliest stages. So Chinese propagandists are trying to use the W.H.O. inquiry to help shore up China’s image and portray the country as a mature superpower.
Complicating that effort could be new virus flare-ups in recent weeks that have prompted fresh lockdowns in China. In all, more than 22 million people have been ordered to remain inside their homes — double the number affected a year ago in Wuhan. On Thursday, China’s National Health Commission reported a coronavirus death in the mainland for the first time since May.
“The major concern here is the origin of the outbreak has been so politicized,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “That has really narrowed the space for the W.H.O. to have an independent, objective and scientific investigation.”
In other developments around the world:
The Food and Drug Administration in the Philippines said on Thursday that it had given emergency use authorization to the Pfizer-BioNTech coronavirus vaccine, making Pfizer the first foreign company to be granted permission to distribute its Covid-19 vaccine in the country.
New Zealand, which has kept its borders tightly controlled while largely vanquishing the coronavirus, will let 1,000 international students back into the country starting in April, Chris Hipkins, the education minister, announced on Thursday. The move applies to students already enrolled in an undergraduate or postgraduate course who were locked out of New Zealand when border restrictions were imposed.
Andy Murray, the former top-ranked tennis player, has tested positive for the coronavirus, according to reports in British news outlets. He had been scheduled to travel to Melbourne for next month’s Australian Open, which was pushed back for three weeks because of the pandemic.
President-elect Joseph R. Biden Jr. is expected to outline proposals on Thursday for trillions of dollars in government spending to combat the pandemic and its effects on the economy, with an initial focus on large-scale expansions of vaccinations and virus testing capacity.
The efforts will cover the pandemic, the economy, health care, education, climate change and other domestic priorities, Brian Deese, the incoming director of the National Economic Council, said at the Reuters Next conference on Wednesday.
Mr. Biden will detail his plans, which he and his economic team have been honing for weeks, in an evening speech in Delaware. Top Democrats in Congress have said in recent days that they are preparing for the initiatives to span two bills.
“At this moment the president-elect feels that we need to move aggressively on both rescue and recovery,” Mr. Deese said.
Money to complete $2,000 direct payments to individuals and aid to small businesses and local and state governments, components that Mr. Biden has stressed in recent weeks, will be part of the initial package, Mr. Deese said. Others briefed on Mr. Biden’s thinking said he would also call for the first piece of legislation to include an extension of supplemental federal unemployment benefits, which are set to expire in March for many workers, and more help for renters.
Plans for the first package also include a significant increase in spending on vaccine deployment, testing and contact tracing, Mr. Deese said, and Mr. Biden will seek enough money to allow most schools to open.
“We need to get the schools open,” Mr. Deese said, “so that parents, and particularly women, who are being disproportionately hurt in this economy, can get back to work.”
Transition team officials would not say on Wednesday how expensive Mr. Biden’s proposals were likely to be or whether he would announce a cost estimate on Thursday. Last week, Mr. Biden said he expected that his full agenda would cost trillions of dollars.
Deaths from the coronavirus are skyrocketing in the United States, reaching levels never before seen, largely fueled by relentless surges in California and Arizona.
As the national death toll nears 400,000, weekly deaths in Maricopa County, Ariz., and in Los Angeles and Fresno Counties in California have reached new highs, according to data compiled by The New York Times.
The virus has been raging for weeks in California — especially in Los Angeles County, where Covid-19 has claimed one life about every eight minutes — although state officials said on Wednesday that they were seeing some encouraging signs.
In Arizona over the past week, state officials have recorded the highest number of new coronavirus cases per capita in the country.
Dr. Marjorie Bessel, chief clinical officer for the Banner Health hospitals in Arizona, warned on Wednesday that unless elected leaders and residents did more to stop the spread of the virus, five large health systems risked becoming overwhelmed with patients. More than two-thirds of the state’s intensive care units were full as of Monday, and the hospitals were preparing for a surge of 25 to 50 percent.
“We hope we do not get there,” Dr. Bessel said, adding, “We’re asking you — we’re imploring you — today to help us avoid that.”
She urged officials to adopt a statewide mask mandate and to ban indoor restaurant dining. Certain cities and counties, such as Maricopa and Pima, have full mask mandates, but Gov. Doug Ducey, a Republican, has resisted calls for a statewide order.
Nationwide, the numbers largely remained grim on Wednesday, though in the Northern Plains, cases this week were at about a quarter of their peak in mid-November, when the region was among the hardest hit in the country. There were at least 3,900 virus deaths in the United States on Wednesday, a day after the country hit a daily record of more than 4,400.
Earlier in the pandemic, cities bore the brunt of the virus. But now, although metropolitan areas are still suffering, rural communities are, too. Data compiled by The Times shows that deaths have spiked in less populous places, among them Butler County, Kan.; Sevier County, Tenn., and Etowah County, Ala.
“It’s taken a little while, but this highly contagious virus has now spread not only to the suburbs, but also to rural areas,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “In Tennessee, we have some very rural counties, and there’s no county that’s unaffected.”
The geographic diversity of the deaths makes clear that the virus has crushed the health care system in the state, Dr. Schaffner said. On Monday, nearly 90 percent of Tennessee’s intensive care units were full.
Yet it is still common in many rural areas to see people gather in large numbers, often not wearing masks. Some wind up in the hospital.
In regular circumstances, patients in rural areas who require a more sophisticated level of care — as gravely ill Covid-19 patients do — are sent to bigger hospitals in cities. But not all of those transfers are possible now.
“Now we can’t take referrals, because we’re full,” Dr. Schaffner said. “No wonder mortality is going up.”
The U.S. government, faced with an unrelenting surge in Covid-19 cases, issued recommendations this week regarding which people in the country should be vaccinated first. Here are answers to some common questions.
Who is now eligible to be vaccinated, according to federal guidance?
On Tuesday, Alex M. Azar II, the health secretary, urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19.
In all, that is more than 150 million people — almost half the population. They now join millions of health care workers and residents of long-term care facilities who previously qualified.
Mr. Azar did not specify which conditions would make someone eligible for vaccination now; presumably it will be up to governors to decide, as will the question of what documentation to require. But the federal Centers for Disease Control and Prevention has published a list of particularly high-risk conditions, including cancer, diabetes and obesity.
How does eligibility vary by state, and why?
Although the C.D.C. issued recommendations last month for which groups states should vaccinate initially while the vaccine supply is still relatively low, the priorities are not binding and each state has come up with its own groupings.
The federal government cannot require states to change the prioritization plans they have already announced, although the new pressure from Mr. Azar, along with growing public impatience as deaths from the virus continue to hit new peaks, may sway many to do so.
In coming up with priority groups, state officials considered criteria like who is most likely to die if they contract Covid-19 — including people of color, older people and people with underlying medical conditions — and which professions are critical to helping the economy fully reopen. Each state’s demographics also played a role.
I qualify now. How do I sign up?
This depends on what state or even what county you live in.
Some local public health departments have set up portals in which people can make appointments. Others are holding mass vaccination events and inoculating people on a first-come, first-served basis.
Generally, doctor’s offices and pharmacies have asked that patients and customers not call them seeking vaccine appointments just yet, and instead wait to be contacted.
Most pharmacies are not yet offering the vaccine, but CVS, Walgreens and a number of other chain pharmacies, including some in grocery and big-box stores, will soon start doing so through a partnership with the federal government.
With the federal government saying that older people and those with underlying medical conditions should be vaccinated next, what happens to essential workers whose jobs require them to come face to face with other people? Are they eligible now, too?
In some states, yes.
Health care workers in every state were the first to be offered the vaccine. And before Mr. Azar’s directive this week, several states had already opened vaccination to certain categories of “frontline” essential workers, such as police officers, firefighters, teachers, child-care workers and public transit employees.
But other states that had planned to start offering the vaccine to some essential workers in the coming weeks may reprioritize now based on Mr. Azar’s new guidance.
There is nothing stopping states from opening vaccination to a new priority group before they have reached everyone in an earlier group, but supply is an important consideration.
How many vaccine doses does the United States have access to?
Pfizer and Moderna, the two companies whose vaccines have been approved for emergency use in the United States, together have pledged to provide 400 million doses over the next seven months.
Both vaccines require two doses, so that will be enough for 200 million people, out of roughly 260 million who are currently eligible to be vaccinated. Children younger than 16 are not yet eligible for Pfizer’s vaccine, and those younger than 18 cannot yet take Moderna’s.
Johnson & Johnson, whose single-dose vaccine candidate is in late-stage clinical trials, has a contract with the U.S. government to provide 12 million doses by the end of February and a total of 100 million doses by the end of June. But the company has fallen behind on its production schedule.
How many people have been vaccinated so far?
The publicly available data lags by at least a few days, so it is hard to know for sure. But the C.D.C. reported on Wednesday that about 10.3 million people had received an initial dose, out of 29.4 million doses distributed around the country so far.
That includes nearly 1.1 million doses that have been given to residents and staff members in nursing homes and other long-term care facilities.
After falling over the summer, coronavirus infections among children, teens and young adults rose steadily from September through mid-December, paralleling the virus’s trajectory among older adults in the U.S. population, the Centers for Disease Control and Prevention reported on Wednesday.
Of 2.8 million coronavirus infections diagnosed in children and young adults under the age of 25 between March 1 and Dec. 12 last year, the incidence was lowest among children ages 10 and younger, who accounted for 18 percent of the cases. Most infections in those under 25 — nearly 60 percent — were among young adults aged 18 to 24, the study found.
The authors said the findings lent support to the argument that child care centers and elementary schools can operate safely when community transmission rates are low and mitigation measures are followed.
“We’re recommending that child care centers and schools, especially elementary schools, be the last settings to close after all other mitigation measures are deployed, and the first to reopen,” said Erin K. Sauber-Schatz, an epidemiologist at the C.D.C.
The study was one of two published this week that also looked at how often children have been hospitalized.
In the C.D.C. study, which drew data from 44 states, the District of Columbia, two territories and an associated state, 2.5 percent of infected children and adolescents under 25 were hospitalized, compared with 16.6 percent of sick adults, and just 0.8 percent were transferred to intensive care.
The largest percentage of hospitalizations in this group occurred among children under 5 years old. About 650 patients under the age of 25 died, about 0.1 percent.
But another study of children, adolescents and young adults, published in JAMA Pediatrics on Monday, has come to a very different conclusion. Researchers at the University of Minnesota found a troubling increase in hospitalizations among infected children and adolescents.
The study was based on data from 5,364 patients aged 19 and under who were hospitalized in 22 states from May 15 to Nov. 15 last year. The cumulative average rate rose to 17.2 hospitalizations per 100,000 children in November from 2 per 100,000 children in May.
The increase was not surprising in itself, simply because more children were becoming infected over time. But the percentage uptick was more than double the rise in adult hospitalization rates over the same period, said Pinar Karaca-Mandic, an expert in health economics at the University of Minnesota who was the research report’s senior author.