After a Skirmish Over U.K. Vaccine Approval, Fauci Offers an Olive Branch

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‘Pulling That Emergency Brake’: Newsom Announces New Virus Restrictions

Gov. Gavin Newsom of California announced on Thursday that stay-at-home orders would automatically go into effect in regions where intensive care units are close to filling up. Residents will be asked to stay home except for essential tasks. The most aggressive move the state has made since March.

The bottom line is if we don’t act now, our hospital system will be overwhelmed. If we don’t act now, we’ll continue to see a death rate climb — more lives lost. And that’s why today we are pursuant to the blueprint we put out some 14 or so weeks ago, pulling that emergency brake. Regions where the I.C.U. capacity is falling below 15 percent, we are now mandating that we are implementing a stay-at-home order for three weeks. We’ve defined these five regions: Northern California, greater Sacramento, Bay Area, San Joaquin Valley and the larger region in Southern California. As early, or rather as late as the next week or so, that the greater Sacramento, Northern California regions, as well as San Joaquin Valley and Southern California regions, will have reached that 15 percent or less I.C.U. capacity. The Bay Area may have a few extra days. Our current projections suggest mid-, maybe late, December. But all within just the next few weeks. When the region is placed in the stay-at-home category that bars, wineries, personal services, hair hair salons and the like will be temporary closed for that three-week period. There is light at the end of the tunnel. We are a few months away from truly seeing real progress with the vaccine, real distribution, real accessibility, real availability.

California announced its most aggressive steps since March to head off the coronavirus, saying it will impose sweeping stay-at-home orders region by region when hospitals become overburdened.

With cases and hospitalizations rising sharply in the state, Gov. Gavin Newsom portrayed the move as a push to get through a difficult winter before vaccines arrive.

“This is the final surge,” the governor said in a news conference. “This is the most challenging moment since the beginning of this pandemic.”

The new orders will take effect when the intensive care units in a region’s hospitals fill to more than 85 percent of capacity. None of the state’s five regions have reached that threshold yet, but some are expected to this week, officials said.

Residents would be required to stay home except for essential tasks and outdoor exercise. Most businesses would have to shut down, including in-person dining, salons and sports events. Hotels in affected areas would be allowed to operate only “in support of critical infrastructure services.”

Schools that have been allowed to reopen can continue to operate, and religious services could be held outdoors under the order. The state’s restrictions on religious services may not survive in the federal courts, after the Supreme Court on Thursday ordered a federal judge who had upheld them to reconsider the matter.

In a change from the strict stay-at-home orders the state imposed in the spring, Mr. Newsom said parks and beaches would remain open, and he encouraged residents to go outside and use them, and even to take outdoor fitness classes.

Some cities and counties in the state have already imposed new restrictions as cases have exploded. Los Angeles County issued a similar stay-at-home order last week. Though some municipalities within the county balked, like Pasadena and Beverly Hills, the City of Los Angeles followed up with its own strict stay-at-home order earlier on Thursday.

“My message couldn’t be simpler: It’s time to hunker down,” Mayor Eric Garcetti of Los Angeles said. “It’s time to cancel everything. And if it isn’t essential, don’t do it.”

Governor Newsom spoke on Thursday from his home, where he was still under quarantine after three of his children had contact with someone who later tested positive for the virus. His office said on Wednesday that a staff member had also tested positive, but had not been in recent contact with Mr. Newsom.

Californians have been on a kind of emotional roller coaster ride since the pandemic began, careening between relief that the state’s early stay-at-home orders helped rein in the virus and alarm that cases surged again despite a slow reopening tailored to each county’s conditions.

On Monday, leaders said that new restrictions were in the works, and the governor released dire projections showing that without them, the state’s intensive care units would be overloaded by the middle of this month. Hospitals in hard-hit regions like the San Joaquin Valley, where many low-paid essential workers live in crowded conditions, have been filling up rapidly for weeks.

“Everything is on the table, in terms of how we guide the state through this,” Dr. Mark Ghaly, California’s secretary of health and human services, said Monday.

But after months of hearing that businesses can safely operate outdoors and with proper precautions, many Californians are pushing back against new restrictions. And a growing list of elected leaders have been caught flouting the rules they’ve urged their constituents to follow.

As in March, the rollout of new restrictions, particularly in Los Angeles County, has been confusing, and enforcement has been spotty.

Mr. Newsom said on Thursday, as he did repeatedly in the spring, that the state would withhold money from counties that refuse to enforce stay-at-home orders.

“We didn’t want to be punitive, but we wanted to be firm,” he said.

That approach, however, has drawn criticism in the past for leading to piecemeal, inconsistent enforcement.

Advocates and experts have also criticized a lack of enforcement of protections for essential workers, which has added to the vulnerability of the low-paid Californians who were already more heavily affected by the virus than most others.

President-elect Joseph R. Biden Jr. said Thursday that on his first day as president, he would ask Americans to wear masks for 100 days.

“Just 100 days to mask,” Mr. Biden said in an interview on CNN. “Not forever. 100 days. And I think we’ll see a significant reduction.”

The president-elect spent considerable time addressing his planned response to the pandemic, saying that he had asked Dr. Anthony S. Fauci, the nation’s top infectious disease expert, to play a central role in his administration.

“I asked him to stay on in the exact same role he’s had for the past several presidents,” Mr. Biden said, “and I asked him to be a chief medical adviser for me as well, and be part of the Covid team.”

President Trump has been overtly critical of Dr. Fauci and frequently ignored the advice of health experts throughout the pandemic, despite testing positive for the coronavirus weeks before Election Day.

The day was still young when Dr. Robert Redfield, the head of the Centers for Disease Control and Prevention, took the virtual stage at a business group gathering and offered the starkest of warnings about the months of pandemic ahead.

“I actually believe they’re going to be the most difficult time in the public health history of this nation,” Dr. Redfield declared to the Chamber of Commerce Foundation on Wednesday morning.

As the day unfolded, the numbers did nothing to undercut him.

First, Americans learned in the afternoon that the number of people in the hospital for Covid-19 was more than 100,000. That was nearly double the high point in spring, when the pandemic hit its first peak, according to the Covid Tracking Project.

Then, not long after evening fell, the daily death toll in the U.S. surpassed the record set in April, when the pandemic hit its first peak in the country. By the time all the figures were in, 2,885 Covid-19 deaths had been reported Wednesday, with no sign of a letup. And with hospitals filling, the prospects for the days ahead seemed all too clear.

“If you tell me the hospitalizations are up this week, I’ll tell you that several weeks down the road, the deaths will be up,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston.

At least 2,857 additional deaths were announced across the United States on Thursday, the second-worst daily tally since the start of the pandemic.

Dr. Redfield told the Chamber of Commerce Foundation on Wednesday that the winter might prove devastating, and that perhaps by February, 450,000 Americans might be dead. (The number now is about 276,000.)

But the C.D.C. head seeded his caution with a grain of hope. Americans, he said, could reduce their losses through simple measures like wearing a mask.

“It’s not a fait accompli,” he said. “We’re not defenseless. The truth is that mitigation works. But it’s not going to work if half of us do what we need to do. Probably not even if three-quarters do.”

For all the similarities to the spring pandemic peak, there are some profound differences.

In April, the virus and the deaths were concentrated in New York and New England. Today, the pandemic’s toll is being felt across the country, with more than 14 million cases reported since the start of the pandemic.

Still more sobering: The April peak represented the worst moment of spring. It was followed by a decline in deaths as lockdowns were imposed and many Americans altered their behavior.

As staggering as it is, the death toll reported Wednesday appears likely only to worsen, experts say, as the delayed effects of Thanksgiving travel are felt. And many Americans are now weighing how to celebrate Christmas and New Year’s.

“This is a much worse situation,” said Dr. Ashish Jha, dean of Brown University’s School of Public Health. “Summer is not going to bail us out. Things are not shut down.”

There are other differences from the spring, some more hopeful.

Though coronavirus cases have exploded recently, with new infections topping one million a week, a far smaller proportion of people who get the virus these days are dying from it. National data from the Centers for Disease Control and Prevention shows that the share of cases resulting in death dropped from 6.7 percent in April to 1.9 percent in September.

But over all, deaths in the United States are still climbing.

“It’s terrible, because it was avoidable,” said Dr. Leora Horwitz, an associate professor of population health and medicine at the N.Y.U. Grossman School of Medicine. “We are a world outlier in this regard.”

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Second Wave ‘Is Right Upon Us,’ New York Mayor Warns

Mayor Bill de Blasio urged vigilance as New York faced a second wave of cases, but said the city was better equipped to handle them now than in the spring.

So let’s go over to indicators; No. 1, daily number of people admitted to New York City hospitals for suspected Covid-19, threshold is 200 patients. Today’s report, 174 patients. So we see a serious increase there, confirmed positivity level of 49.7 percent. I’m going to talk about all three indicators, and then I want to give a summary. The No. 2 is new reported cases; our seven-day average threshold, 550 cases, today, 1,962. And No. 3, percentage of people testing citywide positive for Covid-19; threshold 5 percent, today’s report, the daily 3.9 percent, but the seven-day rolling average has really increased to 5.19 percent. It’s quite clear at this point that this second wave, unfortunately, is right upon us. We are seeing a different reality in the hospitals for sure than in the spring. This is a very, very important point. Even though that number has gone up, it’s still a very different reality in our hospitals than what we experienced in the spring. The ability of our hospitals to deal with patients is greatly improved, the ability of patients to survive this disease is greatly improved. We are not seeing the kind of stress on our I.C.U.s anywhere near what we saw in the past. But we’re extremely concerned and vigilant to make sure that we protect our hospitals, and we can protect people’s lives. If you’re over 65, if you’re someone with one of those pre-existing conditions like diabetes or heart disease, you need to stay in to the maximum extent possible except for the most essential needs. And everyone has to do the hard work of continuing to distance and wear masks and take all precautions. This is a very serious situation. We all have to be part of the solution.

With New York City seeing sustained increases in coronavirus-related hospital admissions, case counts and the positive test rate, Mayor Bill de Blasio warned on Thursday that a second wave of the virus “unfortunately, is right upon us.”

The city’s seven-day average daily positive test rate rose above 5 percent, to 5.19, for the first time since May 28, when nonessential businesses remained shut down and the city was a center of the pandemic in the United States. (New York State, which compiles testing data and calculates statistics differently from the city, most recently reported the city’s seven-day average positive test result at 3.34 percent.)

Despite an increase in cases, Mr. de Blasio stressed his belief that the city was more prepared to address the virus than it was in the spring, when hospitals were crowded and resources were relatively scarce.

“The ability of our hospitals to deal with patients is greatly improved,” he said at a news conference. “The ability of patients to survive this disease is greatly improved. We are not seeing the kind of stress on our I.C.U.s anywhere near what we saw in the past.”

Still, the mayor repeated his pleas that people stay home when possible — particularly those at a high risk of severe illness from Covid-19 — and that city residents continue to adhere to social-distancing guidelines.

Mr. de Blasio discussed the city’s plan to distribute the first doses of vaccines, saying New York would prioritize health care workers and staff at nursing homes. He said that he also expected the city to focus on 27 city neighborhoods that have been most deeply affected by the virus and residents of the city’s cramped public housing projects.

A series of cyberattacks is underway aimed at the companies and government organizations that will be distributing coronavirus vaccines around the world, IBM’s cybersecurity division has found, though it is unclear whether the goal is to steal the technology for keeping the vaccines refrigerated in transit or to sabotage the movements.

The findings are alarming enough that the Department of Homeland Security plans to issue its own warning on Thursday to Operation Warp Speed, the Trump administration’s effort to develop and distribute coronavirus vaccines, federal officials said.

Both the IBM researchers and the department’s Cybersecurity and Infrastructure Security Agency said the attacks appear intended to steal the network credentials of corporate executives and officials at global organizations involved in the refrigeration process necessary to protect vaccine doses, or what the industry calls the cold chain.

Josh Corman, a coronavirus strategist at the cybersecurity agency, said in a statement that the IBM report was a reminder of the need for “cybersecurity diligence at each step in the vaccine supply chain.” He urged organizations “involved in vaccine storage and transport to harden attack surfaces, particularly in cold storage operation.”

The cyberattackers “were working to get access to how the vaccine is shipped, stored, kept cold and delivered,” said Nick Rossmann, who heads IBM’s global threat intelligence team. “We think whoever is behind this wanted to be able to understand the entire cold chain process.”

Many of the approaches came in the form of “spear phishing” emails that impersonated an executive at a major Chinese company, Haier Biomedical, which is a legitimate participant in the distribution chain.

Researchers for IBM Security X-Force, the company’s cybersecurity arm, said they believed that the attacks were sophisticated enough that they pointed to a government-sponsored initiative, not a rogue criminal operation aimed purely at monetary gain. But they could not identify which country might be behind them.

Outside experts said they doubted it was China, which left hackers in Russia and North Korea as the lead suspects.

As the United States tore past previous peaks in coronavirus deaths and hospitalizations this week, the virus, ever fluid, has been surging in some places even as it has begun to ebb in others.

For much of the fall, North Dakota has topped the hardest-hit states list, with more new cases relative to its population than anywhere else, hospitals filled to capacity and doctors growing increasingly overwhelmed. Its neighbor South Dakota was usually right behind.

But in the last few days, Minnesota has equaled them, and even briefly exceeded them, a sign of the constantly shifting geography of the pandemic and one of the reasons it has been so difficult to contain.

In the tiny town of Plato, Minn., population 300, an entire 20-person fire department went out of service last month when three-quarters of its members had either tested positive for the virus or been exposed to someone who had. Hundreds of health care workers at the Mayo Clinic, whose flagship hospital is in Rochester, Minn., have been sidelined by positive tests. Most caught the virus in the community, not at work.

Gov. Tim Walz of Minnesota, a Democrat, warned on Wednesday that Covid-19 was ravaging public safety services like fire and police departments in the state.

About 20 percent of fire departments in the state have had “major” Covid-19 outbreaks, said John Harrington, the state public safety commissioner, including the one in Plato.

“Just like we preach about fire safety, one little spark can cause a fire,” said Jay Wood, a Plato firefighter. “And that’s exactly what happened to us.”

Mr. Wood said the department, which serves about 500 households, was back up and running again, but he added, “Fire departments throughout Minnesota are facing this.”

Like much of the Upper Midwest, Minnesota made it through the spring and summer relatively unscathed. But the state has had a catastrophic autumn, with new coronavirus cases up as much as thirteenfold and deaths rising substantially.

As a result, by Wednesday Minnesota was averaging 96.7 new cases a day for every 100,000 people, second-worst in the nation behind South Dakota with 97.9, according to a New York Times database. Wyoming and Nebraska are up in the 90s, too. North Dakota, meanwhile, has improved substantially and is now averaging a lower, though still brutal, 87.3 new cases per 100,000.

St. Cloud, Minn., has the third-highest rate of new cases of any American metropolitan area. Mayor Dave Kleis said in an interview that the virus had swept in fairly suddenly in the fall after being almost nonexistent in the area over the summer.

“It hits home, I think, to a larger percentage of people when those cases rise,” he said. “It’s a complete difference than what you saw earlier.”

Public health officials have warned that the recent surge across the country is not expected to abate soon, because travel and gatherings over Thanksgiving and for the December holidays will spawn many new infections. Even in states like North Dakota, where daily case reports have started to trend downward, residents said they were bracing for the next few weeks.

In Minot, N.D., the Thompson-Larson Funeral Home went from handling one death a day to four or five, and had to convert a storage room into space to hold more bodies. Ben Slind, the funeral director, said he and his staff often worked late into the night, and added that he even pressed his teenage daughters into service to fold memorial pamphlets.

“Obviously, we’ve never seen anything like this,” said Mr. Slind, who has been a licensed funeral director for 20 years. He said on Thursday that he had four families to meet with.

Though the virus’s spread appears to have slowed slightly in North Dakota, Mr. Slind said things could still easily take a turn for the worse during the holidays.

“I sure hope not,” he said. “I’m praying not.”

The post-Thanksgiving rush for Covid-19 testing is on: Pharmacies in the Southern California suburbs are advising customers lucky enough to score appointments that it could be four days before they receive results. In Chelsea, Mass., a line of people who hoped for testing was pelted by rain and wind early this week. In Atlanta, people have idled in cars, sometimes for hours, to get swabbed at drive-throughs.

Testing has long been one of the keys to controlling the spread of the virus. Yet securing a test has become enough of an ordeal that many people have been dissuaded from even trying.

That has begun to change in recent weeks as a handful of communities across the country have rolled out the first do-it-yourself home saliva tests, which require users to simply dribble into a test tube, seal it and send it to a lab.

“This is the best thing for my parents’ safety,” said Sandra Reyes-Aceves, 48, who lives in Anaheim, Calif., with her two teenage children and aging parents. “I don’t have to make them leave the house to get tested.”

In Minnesota, once a testing kit is ordered, it is typically shipped within 24 hours. During sample collection, users are supervised via Zoom by a health worker at Vault Health, the company contracted by the state health department to manage the tests. Results are available in 24 to 48 hours.

Public health officials have long hoped that combining the ease of saliva sampling with at-home collection would open important new windows into the spread of the virus and help persuade those who did not know they were infected to stay home and limit further transmission.

A test people can do at home and mail in “really helps,” said Anne Rimoin, a professor of epidemiology at the U.C.L.A. Fielding School of Public Health. “It isn’t going to end the pandemic, but it is certainly a major step toward making testing more accessible and widespread.”

Encouraging news about Moderna’s coronavirus vaccine was published on Thursday, suggesting that it could protect people for at least three months.

The finding does not mean that immunity lasts only that long: Three months was just the length of time that people have been studied so far. Research on them will continue.

Moderna reported on Nov. 30 that its vaccine was 94.1 percent effective, and applied to the Food and Drug Administration and regulators in Europe for emergency approval to begin vaccinating the public. Expert advisers to the F.D.A. will review the application on Dec. 17.

How long immunity might persist is a major question that will eventually determine whether people need to be vaccinated more than once, and how often.

The new report was based on measurements of antibodies, the proteins made by the immune system to fight infections. The data came from 34 adults in the earliest phase of the Moderna study, who each received two shots, four weeks apart.

Levels of antibodies against the coronavirus were high after the second shot and then declined slightly. But they remained high enough three months later to provide continuing immunity, according to a letter in The New England Journal of Medicine from researchers at several medical centers and from Moderna and its collaborator in developing the vaccine, the National Institute of Allergy and Infectious Diseases.

The vaccine also led to increased levels of T cells, which are made by the immune system to fight viruses.

A Hawaii couple were arrested and charged with reckless endangerment after they took a flight back home from San Francisco, despite knowing they had tested positive for the coronavirus, the police said.

Wesley Moribe, 41, and Courtney Peterson, 46, of Wailua were tested for the virus in Seattle as part of Safe Travels Hawaii, a program that aims to limit the spread of Covid-19 through testing and tracing.

During a stopover in San Francisco on Sunday, they were told to isolate and not to fly home because their results had come back positive, the police said.

The couple, however, ignored the instructions and boarded a United Airlines flight home, “placing the passengers of the flight in danger of death,” the Kauai police said.

The Centers for Disease Control and Prevention notified the local authorities in Hawaii that the couple were on the flight, and they were arrested after the plane landed at Lihue Airport on Kauai, the police said.

Mr. Moribe and Ms. Peterson have posted bail, which was set at $1,000 each, the police said. They are scheduled to appear in court on Jan. 6, according to Justin Kollar, the Kauai County prosecuting attorney. If convicted, they could face up to a year in jail or a $2,000 fine, he said.

Mr. Kollar said the charges should send a simple message to the public.

“Now is not a good time to come to to Kauai, period,” he said. “We don’t have the resources in our health care system to be able to absorb a widespread outbreak of Covid-19. And definitely don’t get on a plane and go anywhere if you’ve tested positive for the coronavirus. That’s pretty basic.”

If you’re looking for the Grinch, look no farther than to our neighbors in the North.

“I’m the guy who’s stealing Christmas to keep you safe — because you need to do this now,” Brian Pallister, the premier of the Canadian province of Manitoba, said at a news conference Thursday at which he implored Manitobans not to gather this holiday season.

He also offered some choice words for any coronavirus skeptics out there: “If you don’t think that Covid is real right now, you’re an idiot.”

Manitoba, population 1.38 million, has averaged 354 daily new cases in the last week, according to a New York Times database. The provincial government reported a 13.1 percent positivity rate as of Thursday.

Mr. Pallister’s comments mirrored remarks two weeks ago by Canada’s prime minister, Justin Trudeau, who told his countrymen that “a normal Christmas is quite frankly out of the question.”

In the weeks following Canada’s Thanksgiving, held in October, outbreaks began to grow. Since then, new restrictions have been imposed in parts of the country, including Manitoba. But Thanksgiving is nowhere near as big for Canadians as Christmas, and they generally wait until then to travel for family get-togethers.

Mr. Pallister had one main piece of advice for citizens: Wait. If Manitobans get it right now, he said, there will be “lots to celebrate” next year.

The premier choked up as he urged people to forgo their usual family gatherings.

“You don’t need to like me,” he said. “I hope in years to come you might respect me for having the guts to tell you the right thing. And here’s the right thing: stay safe, protect each other, love each other, care for each other, you’ve got so many ways to show that, but don’t get together this Christmas.”

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‘Compromise Is Within Reach,’ McConnell Says of Stimulus Talks

Senator Mitch McConnell said negotiations on a new round of coronavirus relief were closer to agreement, but did not endorse a $908 billion compromise measure embraced by Democratic leaders.

“It has always been about policy differences. We have two sides with two different visions for the best way to support our nation through what we hope will be the last chapter of the pandemic. Now that isn’t new. We have disagreements all the time. Our system can handle disagreements. But both sides have to be willing to compile their commonalities and make law here. Our people are hurting. But they’re ready to finish this fight. Congress should not keep them waiting for reinforcements that should have arrived, literally, months ago. So compromise is within reach. We know where we agree, we can do this. Let me say it again, we can do this and we need to do this. So let’s be about actually making a law.” “Speaker Pelosi and I made a new offer to Leader McConnell and Leader McCarthy on Monday in hopes of jumpstarting serious negotiations, and Leader McConnell responded by circulating another version of a partisan Republican-only draft. So in the spirit of compromise, Speaker Pelosi and I believe the bipartisan framework introduced by a group of eight senators on Tuesday should be used as the basis, the framework, for immediate bipartisan, bicameral negotiations. The need to act is urgent, and we believe that with good faith negotiations we could very well come to an agreement. We are already much closer to an agreement because of the bipartisan talks these eight senators have done — have created. And we can build off their momentum.”

Nancy Pelosi, the House speaker, and Mitch McConnell, the Senate majority leader, talked Thursday about must-pass government funding legislation and a new coronavirus relief package amid pressure from rank-and-file members for a bipartisan compromise.

A spokesman for the Democratic speaker, Drew Hammill, said the conversation early Thursday afternoon focused on “their shared commitment to completing an omnibus and Covid relief as soon as possible.”

Mr. McConnell, a Republican, had been largely removed from discussions with Ms. Pelosi over a new stimulus bill since the two chambers enacted a sweeping $2.2 trillion package in March. Instead, as he worked to wrangle Republican support behind a series of targeted bills, Trump administration officials led discussions with Ms. Pelosi over a possible deal.

The phone call between the two congressional leaders came after Mr. McConnell left the door open to reaching a deal on a new round of stimulus to address the pandemic, but stopped short of endorsing a $908 billion compromise plan Democrats embraced on Wednesday, saying it did not represent a genuine concession.

Mr. McConnell said it had been “heartening to see a few hopeful signs” this week in stimulus relief negotiations.

“Compromise is within reach,” Mr. McConnell said in a speech on the Senate floor. “We know where we agree. We can do this. Let me say it again: We can do this, and we need to do this. So let’s be about actually making a law.”

Some Republican senators signaled openness to embracing the $908 billion framework that Democratic leaders had endorsed as a baseline for restarting negotiations.

“I’ve never been more hopeful that we’ll get a bill,” said Senator Lindsey Graham of South Carolina.

Global roundup

Vaccination for Covid-19 in France will be free, and focused first on those who are most at-risk, French authorities said on Thursday as they geared up for a three-phase rollout of a widespread vaccination campaign next year.

“The arrival of the vaccine is a real reason for hope,” Jean Castex, the French prime minister, said at a news conference on Thursday evening. But he warned that vaccination was a “new weapon that will add on to existing tools, not replace them.”

Mr. Castex said that once European and French health authorities greenlight the first vaccines — likely in late December or early January — retirement and nursing home residents would be vaccinated first, along with at-risk staffers in those establishments, for a total of roughly one million people. Vaccination will not be mandatory.

“Everyone will not be able to get vaccinated immediately,” Mr. Castex cautioned. Deploying the vaccine would be a logistical feat of “great complexity,” he said, and France will do a test-run of its distribution strategy in December.

A second wave of vaccinations starting in February will target 14 million more people, mainly health workers and at-risk populations like the elderly or those with chronic health conditions. A third and final vaccination campaign in the spring and summer will focus on the wider adult population, but not minors.

Olivier Véran, the health minister, said at the news conference that the main goal of the vaccination campaign is to decrease mortality rates and prevent patients from developing severe cases of Covid-19, as it is still unclear whether the vaccines will prevent transmitting the coronavirus.

He also said that regardless of vaccination plans, people should not become complacent anytime soon.

“Over the next few months, the vaccine will not fundamentally change the course of the epidemic,” Mr. Véran said, noting that vaccinating millions of people will take time and that restrictions on gatherings and rules like mask-wearing would continue for the foreseeable future.

Mr. Castex said the current outlook in France was positive, with fewer daily cases and less pressure on hospitals, and that the French needed to keep up their efforts to prevent another virus wave. Still, he encouraged people to limit holiday season family gatherings to six adults maximum.

Here’s what else is happening around the world.

• The Russian capital will open 70 vaccination centers on Saturday with teachers, doctors and social workers the first in line to receive the Russian-made Sputnik V vaccine, Moscow’s mayor said on Thursday. City residents will have to register online in advance for time slots to avoid overcrowding. On Wednesday, President Vladimir V. Putin ordered a voluntary vaccination program to begin by the end of next week across the country. But several hospitals near Moscow already began administering the vaccine last week. Russian authorities rushed to offer it, and drew criticism for not waiting for large-scale efficacy tests to conclude.

• Germany extended its lockdown, which includes the closure of bars and restaurants, to Jan. 10, three weeks after its restrictions were scheduled to expire on Dec. 20. Infection rates remain at over 50 cases per 100,000 people in a week, a goal that Chancellor Angela Merkel said allows health authority to trace individual infections. Health authorities registered 22,046 new cases on Wednesday, roughly the same as three weeks ago.

• Greece is also extending its national lockdown, which was set to end on Dec. 7, by one week, a decision the government said was unavoidable with new daily infections steadily rising and a sharp spike in deaths. The rising number of new cases has stretched hospitals to the limit, particularly in northern Greece where the majority of infections are being recorded. As of Wednesday, it had a total of 109,655 confirmed cases and 2,604 deaths, most of which have been recorded over the past month.

• Austria will loosen its lockdown beginning Monday, but bars and restaurants will remain closed until at least Jan. 7 and quarantines will extend to 10 days for arriving travelers. Those in quarantine will be allowed to take a free test after five days and can leave isolation early if it comes back negative. While announcing the changes, Chancellor Sebastian Kurz appeared to blame people with family abroad for reintroducing the virus to Austria when returning from visits at the end of the summer, prompting criticism in the country.

• The former president of France, Valéry Giscard d’Estaing, a modern-minded conservative who on his election in 1974 vowed to transform his tradition-bound, politically polarized country, only to lose his office seven years later after failing to accomplish his goals, died on Wednesday. His foundation said the cause was complications of Covid-19. He was 94.

• OPEC and other oil-producing nations headed by Russia reached a compromise on Thursday to modestly increase production, buoyed by the prospect of vaccines to ward off the virus, which caused oil prices to crash in April. The increase, representing less than 1 percent of the global oil market, comes at a time when demand is still under strain from the effects of the coronavirus pandemic.

The global economy could suffer significant damage if lower-income countries do not have enough access to coronavirus vaccines, according to a new report from the Eurasia Group, a political research and consulting firm.

That damage would hurt advanced and developing economies alike, putting decades of economic progress at risk, according to a statement from the World Health Organization on Thursday.

If vaccine access is equitable, the Eurasia Group’s analysis found, it would generate at least $466 billion in economic benefits by 2025 for 10 of the world’s largest donor countries.

The World Health Organization shared the report to spur investment in its Access to COVID-19 Tools Accelerator, an initiative promoting global collaboration to develop tests, treatments and vaccines. It includes a global vaccine allocation plan, known as Covax, to pool the resources needed for doses to be distributed equitably. Officials hope to deliver about two billion doses worldwide by the end of 2021.

The coronavirus pandemic has affected more than 64 million people globally, and at least 1.4 million people have died. Latin America has suffered a third of the world’s deaths. Africa has now surpassed two million cases. Shutdowns and quarantines have hit poor countries especially hard, where not working often means not eating.

“There is a clear humanitarian and ethical case for supporting the ACT Accelerator and the Covax facility, along with the obvious economic gains it would bring to developing countries,” said Alexander Kazan, a director with Eurasia Group and one of the authors of the report. “Doing nothing risks reversing years if not decades of economic progress. But our analysis shows that the program is likely to yield economic and other returns for major donor countries as well.”

U.S. roundup

As hospitals fill with virus patients, the biggest need has been finding enough staff to tend to the critically ill. Demand for travel nurses has increased by more than 40 percent in the last month, according to Aya Healthcare, an agency based in California that dispatches them to hospitals. At least 25,000 nurses work in travel nursing, taking up temporary contracts for higher fees and moving from city to city, and hospitals have depended on them for decades.

Laura Liffiton, 32, one of those travel nurses, found herself racing along behind the pandemic as the coronavirus cut a devastating path around the country.

She arrived in New York City in April, on one of the worst days of the pandemic, for a stint as a nurse in the overrun intensive-care unit of a crowded hospital. After her contract there ended, she flew in July to another hot spot with an urgent need for nurses: a hospital in Arizona where four of her patients died of the coronavirus on her first day. In October, Ms. Liffiton traveled on, to Green Bay, Wis., just as the virus was surging uncontrollably throughout the Midwest.

“When the pandemic began, I thought, ‘I’m going to go help, I can do some good, I can make some good money,’” she said. But on the first day of treating coronavirus patients, Ms. Liffiton remembered, “I was like Dorothy landing in Oz. I was totally unprepared for the reality.”

As the coronavirus has spiked across the country, leaving a record 100,226 Americans hospitalized on Wednesday, travel nurses, have become more urgently needed than ever.

Here is what else is happening across the U.S.

• In Puerto Rico, Gov. Wanda Vázquez ordered a new, partial lockdown on Thursday that will force most businesses to close on Sundays and ban weekend alcohol sales from Dec. 7 to Jan. 7. Only pharmacies, supermarkets, gas stations, hardware stores and food delivery and pickup will be allowed on Sundays. The rest of the week, businesses must close at 8:30 p.m. ahead of a 9 p.m. nightly curfew. (That would include Christmas Eve and New Year’s Eve.) Case numbers have been persistently high in Puerto Rico in recent weeks, with an average of more than 700 new infections announced each day. Ninety-two deaths were reported in the seven-day period ending Wednesday, the most in the territory in any weeklong stretch.

• Lubbock, Texas, is out of hospital beds. The West Texas city of 250,000 has had a daily average of 382 new coronavirus cases in the past seven days, according to a New York Times database. The Lubbock metro area has the fifth-highest cumulative per capita case rate the country has seen since the start of the pandemic.

• Jimmy Carter joined the chorus of former American presidents to support Covid-19 vaccine efforts, saying in a statement that he encouraged “everyone who is eligible to get immunized as soon as it becomes available in their communities.” Barack Obama, George W. Bush and Bill Clinton have all said they would be willing to get a vaccine for Covid-19 publicly to help ensure confidence in its safety, once a vaccine is approved for use in the United States.

• The Rose Bowl, the most famous postseason game in college football, will be played without spectators on New Year’s Day in the stadium near Los Angeles. Rose Bowl officials said they had asked the authorities in California to permit limited attendance — last season’s game drew more than 90,000 people — but that “the request was denied based on state and county guidelines.” The announcement came as little surprise to college football officials, particularly because of California’s swelling virus cases.