Covid-19: U.S. Air Travel Hits Pandemic High, Adding to Fears of Yet More Case Surges and the New Variant

The latest surge of the coronavirus in Los Angeles County is infecting a new person every six seconds, Mayor Eric Garcetti of Los Angeles said Sunday. And it is accelerating exactly where people are least likely to be on their guard: in private.

Mr. Garcetti said on the CBS program “Face the Nation” that despite what California has done to limit virus transmission in public, including high compliance with mask-wearing and tight restrictions reimposed on businesses, large numbers of new cases were still being detected, including a recent average of 14,000 a day in the county.

“This is something now that really is spreading in the home,” Mr. Garcetti said, adding: “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.”

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 four people in the state have been found to be infected with the new, more transmissible variant of the virus first identified in Britain.

And at the rate that immunization is going so far, the new vaccines offer little hope for quickly reining in the surge, the mayor said. “We are at a pace right now to deliver vaccines in L.A. over five years, instead of over half a year,” he said.

Mr. Garcetti criticized the Trump administration for failing to plan ahead by training more medical personnel to administer the vaccine, and for leaving it up to state and local governments to run a huge inoculation campaign without providing the resources needed to carry it out.

“The federal government can’t tell the local governments and state governments to do something and not give us aid,” he said.

A top official of Operation Warp Speed floated a new idea on Sunday for stretching the limited number of Covid-19 vaccine doses in the United States: Halving the dose of each shot of Moderna’s vaccine to potentially double the number of people who could receive it.

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 standard of two 100-microgram doses, said the official, Dr. Moncef Slaoui.

Dr. Slaoui said that Operation Warp Speed was in discussions with the Food and Drug Administration and the pharmaceutical company Moderna over implementing the half-dose regimen. Moderna did not respond immediately to a request for comment.

Each vaccine would still be delivered in two, on-schedule doses four weeks apart, Dr. Slaoui said in an interview with “CBS’s Face the Nation.” He said it would be up to the F.D.A. to decide whether to move forward with the plan.

Ray Jordan, a spokesman for Moderna, did not comment on Dr. Slaoui’s proposal, but noted that Moderna’s late-stage clinical trials focused on a regimen of two doses of 100 micrograms of vaccine apiece, spaced four weeks apart. This was the same schedule and dosing that earned the vaccine its emergency green light from the Food and Drug Administration last month.

Dr. Slaoui was asked whether the United States would follow Britain’s lead on another tactic for getting shots to more people: Delaying second doses of newly authorized vaccines to immunize a larger swath of the population. There is little or no data on dose delays, Dr. Slaoui said, but “injecting half the volume” might constitute “a more responsible approach that will be based on facts and data to immunize more people.”

Natalie Dean, a biostatisitician at the University of Florida, agreed that there might be more data to support a vaccine strategy that relied on half-doses rather than delayed doses.

“There is a path forward if you can show that two lower doses yield a similar immune response,” Dr. Dean said.

As caseloads continue to surge upward around the globe, and concerns mount over a new and potentially more transmissible variant of the coronavirus, “everyone is looking for solutions right now, because there is an urgent need for more doses,” Dr. Dean added. “But the dust has not settled on the best way to achieve this.”

John Moore, a vaccine expert at Cornell University, pointed out that the approach wouldn’t necessarily work for all vaccines. Injections are already doled out in very small volumes, and some might be harder to halve than others, he noted.

While Dr. Moore agreed that halving doses has more scientific backing than dose delays, he noted that “this is not something I would want to see done unless it were absolutely necessary.”

A crashed phone network in Houston. People waiting overnight in long lines in Florida. Older Tennesseans leaning on their walkers outside in the cold alongside a highway.

As distribution of Covid-19 vaccines begins to open up to wider segments of the United States population, there have been scenes of chaos across the country.

The initial vaccine deliveries were mostly for frontline medical workers and nursing home staff members and residents. But there was less of a clear consensus on how to distribute the second round of doses, and public health and elected officials had warned the process would become messier.

Those warnings appear to have been borne out, leaving the U.S. inoculation campaign behind schedule and raising fears about how quickly the country will be able to tame the epidemic.

In Puerto Rico, a shipment of vaccines did not arrive until the workers who would have administered them had left for the Christmas holiday. In California, where coronavirus cases are surging and hospitals are overstretched, doctors are worried about whether there will be enough staff members to both administer vaccines and tend to Covid-19 patients.

Many vaccination sites have operated smoothly since the first U.S. inoculation on Dec. 14, but as availability of vaccines broadened, logistical complications arose at some sites and yielded unnerving images.

In Tullahoma, Tenn., older people lined a sidewalk on Saturday as they waited to enter the Coffee County Health Department’s Tullahoma clinic, about 70 miles northwest of Chattanooga. Most of the people in line were wearing heavy coats or huddled under blankets.

A video of the scene posted to Facebook showed seniors leaning on walkers and canes and sitting on footstools and lawn chairs as they waited for the building to open. Vickie Rayfield Ham, who posted the video, wrote that she thought the distribution center would be a drive-through.

“Some of the elderly were having to walk down the road with their walkers to get to the end of the line, and people were flying by,” she told WTVC, a local television news station.

In a Facebook post that went up shortly before 10 a.m. local time, a couple of hours after Ms. Ham’s video, the city of Tullahoma said that all available doses had been administered for the day and that information about next week’s vaccination schedule would be released on Monday.

The opening day for Houston’s first free public Covid-19 vaccination clinic unleashed so much demand that the city health department’s phone system crashed, causing officials to scramble to move to on-site registration.

Vaccinations began in Houston soon after the first doses of the Pfizer vaccine started arriving at its hospitals on Dec. 14. On Saturday, the city opened a clinic at the Bayou City Event Center providing the Moderna vaccine to high-risk members of the public, saying it could accommodate 750 appointments a day.

Mayor Sylvester Turner said that the health department had received more than 250,000 calls.

“The system was literally overwhelmed,” he said during a news briefing on Saturday.

The clinic’s phone system was back up by the afternoon and as of 2 p.m. local time about 450 people had received a Covid-19 vaccine, Mr. Turner said.

Vaccine rollout sites in Florida continued to be overwhelmed in some places, with people waiting for hours overnight in hopes of getting the shot. The state had expanded its offering of vaccines to older members of the general public — in some cases, on a first-come, first-served basis.

Florida became one of the first states to open up vaccination to anyone older than 65, after Gov. Ron DeSantis issued an executive order on Dec. 23.

Mina Bobel, 74, and her husband, Dave Bobel, lined up at 2 a.m. outside the Lakes Regional Library in Fort Myers, Fla., on Wednesday in hopes of getting vaccinated. They came prepared with snacks and water, and even took turns sleeping in the back of their S.U.V. There were about 300 people ahead of them in line, Ms. Bobel said, and most of them had come well equipped, too — with coats and blankets to keep warm.

“For us, it was an adventure,” Ms. Bobel said, adding that she was “giddy” when finally, around 10 a.m., she stepped up to get her first dose. “We feel really lucky.”

When she left, Ms. Bobel said, the line was even longer than when she arrived.

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Cuomo Won’t Get Vaccine Until It’s Available for Those Hardest-Hit

Gov. Andrew M. Cuomo of New York said he would not be vaccinated for Covid-19 until vaccines were widely available for his age group in Black, Latino and poor New York communities.

Covid killed Black people in this country at two times the rate of white people and Hispanic people at one and a half times the rate of white people. Testing for Covid was more available in richer, whiter communities, and the infection rate was higher in Black, Hispanic and poor communities. This can’t happen again. And it can’t happen with this vaccine. I am committed to social and racial justice in the distribution of this vaccine. It will be available as fairly and as quickly as we can make it happen. Race or income will not determine who lives and who dies, and I mean it. And that’s why I say to you today, that I want to take the vaccine. I move around a lot and come into contact with many people, and I would feel much safer if I took the vaccine. But I will not take the vaccine until the vaccine is available for my group in Black, Hispanic and poor communities around the state.

Gov. Andrew M. Cuomo of New York said on Sunday that he would not get vaccinated until the coronavirus vaccines are available to Black, Latino and poor New Yorkers in his age group.

Mr. Cuomo is 63.

He made the announcement in a prerecorded message that aired during a service at the Abyssinian Baptist Church in the Harlem neighborhood of Manhattan.

In an interview, Mr. Cuomo said that many officials were opting to get vaccinated in public, to demonstrate to constituents that the vaccine is safe. He lauded that approach, but said he was opting to send a different message.

The same communities that were hit hardest by the virus — Black, Latino and poor neighborhoods — also have less access to some of the pharmacy chains that will be administering many of the vaccine doses. He said he wanted New Yorkers to understand that he is aware of the inequities and working to ensure such communities have good access to the vaccine.

“I want to make the statement that I will take it when I am eligible and it is available in Black, and Latino and poor communities in my age group,” Mr. Cuomo said. The state is currently prioritizing vaccines for health care workers, residents and employees of nursing homes, and others on the front lines. The next group eligible is likely to be people age 75 or older, a group numbering about one million, according to the governor.

New York City and New York State’s distribution of the vaccine has been halting so far, a situation the state blames on the federal government. Mayor Bill de Blasio of New York has suggested that the state bears some blame too, acting as a bottleneck by not yet authorizing the city to open up vaccinations to larger categories of people yet.

Mr. de Blasio, 59, has said he is deferring to the advice of his health commissioner on when he should receive the vaccine.

On Saturday, 138 people in the state died of the virus.

Pope Francis on Sunday criticized people who traveled abroad during the pandemic “to escape the lockdown,” saying they were ignoring those who were suffering.

In his weekly noontime Sunday address, Francis said, “I read in the papers something that quite saddened me: In a country — I don’t remember which — to escape the lockdown and have a good vacation more than 40 planes took off that afternoon.”

“Those people are good people, but didn’t they think of those who stayed at home, to the economic problems of many people who have been knocked down by the pandemic, to those who are ill?” Francis added. They thought “only to go on vacation, to have fun.”

“This really saddens me,” Francis said in a message streamed from the Vatican’s apostolic library. The pope normally blesses the faithful on Sundays from a window in a palace above St. Peter’s Square, but Italy has been on lockdown for the past 10 days, and the square is closed.

It is not clear what report the pope was referring to, or where the travelers were leaving from and heading to. On Saturday, The New York Times reported that more than half a million Americans went to Mexico in the month of November alone, but that article did not include anything about the number of planes on any given afternoon.

While Mexico has relatively few travel restrictions, stricter measures are in place in many countries — and many have been tightened since a more transmissible variant of the virus was first identified in Britain. And international travelers are often ordered or urged to quarantine for a week or more on arrival.

The United Nations World Tourism Organization reported that international arrivals had dropped by 72 percent for the first 10 months of 2020, and anticipates that, when tabulated, the drop for the full year will be between 70 and 75 percent.

On Sunday, the pope reiterated his plea that all peoples and nations should work together to fight the pandemic.

“We know that things will improve in the measure in which, with the help of God, we will work together for the common good, putting the focus on the weakest and the most disadvantaged,” Francis said.

“We don’t know what 2021 holds for us, but what each of us and all of us together can do, is to commit to taking care of each other and of creation, our common home,” rather than thinking of our own interests, Francis said.

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India Clears Two Coronavirus Vaccines for Emergency Use

India’s pharmaceutical regulator announced the approval for emergency use of two Covid-19 vaccines, the Oxford-AstraZeneca vaccine and another developed by Bharat Biotech in India.

After adequate examination, the C.D.S.C.O. has decided to accept the recommendations of the Expert Committee and, accordingly, vaccines of M/s Serum and Bharat Biotech are being approved for restricted use in emergency situations and permission is being granted to M/s Cadila Healthcare for conduct of Phase 3 clinical trials in India. The Phase 3 efficacy trial was initiated in India in 25,800 volunteers and, to date, approximately 22,500 participants have been vaccinated across the country and the vaccine has been found to be safe as per the data available to date.

NEW DELHI — India said on Sunday that it had approved two coronavirus vaccines, one made by AstraZeneca and Oxford University and the other developed in India, for emergency use, a major step toward halting the spread of the coronavirus in one of the world’s hardest-hit countries.

Dr. V.G. Somani, the drugs controller general of India, said at a news conference in New Delhi that the decision to approve the Oxford-AstraZeneca vaccine and a local vaccine developed by Bharat Biotech came after “careful examination” of both by the Central Drugs Standard Control Organization, India’s pharmaceutical regulator.

Indian regulators are still considering approvals for other vaccines. One, made by Pfizer and BioNTech, has already been approved in the United States, Canada and Europe. Another, Russia’s Sputnik V, appears to be less far along.

On Wednesday, Britain became the first country to grant emergency approval for the Oxford-AstraZeneca vaccine. Argentina soon followed suit.

Officials in India moved quickly for a number of reasons. The country is No. 2 in confirmed infections behind the United States, and the outbreak is widely believed to be worse than the official figures suggest. The pandemic has devastated the economy, and the unemployment rate is at a 45-year high.

India’s government will face steep challenges as it works to inoculate more than 1.3 billion people across the vast country. The government says it is ready. To get the vaccine across a country famous for its size and its sometimes unreliable roads, officials will tap into knowledge from nationwide polio vaccination and newborn immunization campaigns, and the skill and flexibility employed in India’s mammoth general elections, where ballot boxes are delivered to the furthest reaches of the country.

But the effort has already faced setbacks. The Serum Institute, an Indian drug maker that struck a deal to produce the Oxford vaccine even before its effectiveness had been proven, has managed to make only about one-tenth of the 400 million doses it had committed to manufacturing before the end of last year.

The Bharat Biotech vaccine, called Covaxin, is still in Phase 3 clinical trials in India and has not published efficacy data. Dr. Somani, the regulator, said the vaccine had so far been administered to 22,500 trial participants, “and the vaccine has been found to be safe.”

Both the AstraZeneca vaccine and the Bharat Biotech vaccine require two doses, Dr. Somani said. He did not specify whether the participants in Bharat Biotech’s continuing clinical trials had received both doses.

The lawmakers of the 117th Congress officially convened for the first time on Sunday to take the oath of office and elect leaders, a normally straightforward process tangled this year by the coronavirus pandemic.

The House of Representatives re-elected Nancy Pelosi, Democrat of California, as speaker, for what may be her final term. But the process, which began when the House convened at noon, took much of the day because of social distancing requirements, and was still not complete by late afternoon, though Ms. Pelosi had secured a majority by then.

The nearly party-line voting was conducted on an opening day marked more by precaution than pomp. Several House members who are sick with Covid-19 missed the session altogether, and others who are in quarantine cast their votes from a plexiglass enclosure set up in a gallery overlooking the chamber.

After two years as President Trump’s most outspoken Democratic antagonist, Ms. Pelosi will soon be responsible for trying to shepherd through Congress as much of President-elect Joseph R. Biden Jr.’s agenda as possible. It is no easy task. With her party holding 222 of 435 seats, Ms. Pelosi can afford to lose only a handful of Democrats on any given vote.

Ms. Pelosi will also have to contend with a health crisis that can sideline lawmakers of either party at any moment. More than 50 representatives and senators have tested positive for the virus or for antibodies to it since the pandemic began. One newly elected member — Luke Letlow, Republican of Louisiana — died of Covid-19 complications on Dec. 29.

The political frictions in the capital have added to the country’s broad partisan divide. On Saturday, the homes of both Ms. Pelosi and Senator Mitch McConnell, the leader of Congress’s Republicans, were reported to have been vandalized, with painted messages referring to the size of individual stimulus payments that have been criticized as inadequate by both the left and right — including President Trump.

On the other side of the Capitol from the House, the closely divided Senate convened an even more subdued opening day, awaiting runoff elections in Georgia on Tuesday that will determine which party will be in charge once Vice President Kamala Harris is sworn in on Jan. 20.

If the Democratic challengers defeat the Republican incumbents in both races, each party would have 50 seats, and the vice president, a Democrat, would vote to break ties; otherwise, the Republicans would retain control. Polls suggest that both races are close.

One of the Republican incumbents, David Perdue, went into quarantine on Dec. 31 after a member of his campaign staff tested positive.

An air-powered, inflatable costume worn by a staff member on Christmas to spread holiday cheer may be to blame for a coronavirus outbreak that infected dozens of workers in a hospital in San Jose, Calif., a hospital spokeswoman said.

An employee wore the costume “briefly” in the emergency department at Kaiser Permanente San Jose Medical Center, the spokeswoman, Irene Chavez, said in a statement. The hospital began an investigation after 44 staff members tested positive for the coronavirus between Dec. 27 and Friday, she said.

Inflatable costumes are usually powered by a battery-operated fan that sucks air into the suit, helping it keep its shape. T. rex and sumo wrestler models are among the more popular. Some costumes cover the wearer’s face, while others leave it open.

Ms. Chavez declined to say what kind of air-powered costume the hospital employee wore, but she described it as “holiday themed.” As part of its response to the outbreak, she said, the hospital was looking into “whether the costume, which did have a fan, was a contributing factor.” Air-powered costumes have been banned, she said.

It was unclear how long the employee wore the costume in the emergency department. It was also unclear if any of the infected staff members had received the first dose of a Covid-19 vaccine, but experts have said that it takes at least a couple of weeks for the vaccine’s protective effects to kick in.

“Any exposure, if it occurred, would have been completely innocent, and quite accidental, as the individual had no Covid symptoms and only sought to lift the spirits of those around them during what is a very stressful time,” Ms. Chavez said of the costumed worker.

The emergency department will be deep-cleaned, Ms. Chavez said, and employees will be offered free weekly testing in addition to protocols that were already in place.

GLOBAL ROUNDUP

LONDON — Parts of England may face harsher restrictions in the coming weeks, Prime Minister Boris Johnson said on Sunday, as Britain confronts a surge in coronavirus cases and hospitalizations linked to a new, more transmissible virus variant.

But with classes set to resume and his government’s plans for in-person teaching under increasing pressure, he also urged parents to send their children to school.

Mr. Johnson said in an interview with the BBC’s “Andrew Marr Show” that he was “fully reconciled” to implementing more restrictions and that the government had taken “every reasonable step” to prepare for the winter. He said that ministers could not have predicted the emergence of the new variant, which has led dozens of governments to restrict travelers from Britain, and that he hoped more vaccinations would lead the country out of lockdowns.

Britain was the first country to give emergency authorization to the vaccine developed by Pfizer and BioNTech and then, last week, one from AstraZeneca and the University of Oxford.

With classes set to return in many primary schools in England on Monday, Mr. Johnson added that parents should “absolutely” send their children to schools if possible. “We’ve really fought very hard in this pandemic across the country to keep schools open,” he said. “Schools are safe.”

The government had planned for primary schools across England to reopen on Monday, with secondary school students returning later in phases, but it moved last week to delay opening primary schools in parts of London and southeastern England, where the new variant first took off. The delay was extended to cover all of London late last week.

Teaching unions have opposed a return to in-person schooling, and on Saturday the largest, the National Education Union, advised primary-school teachers to stay home and offer to conduct lessons remotely. “The science now tells us that, although children largely do not become ill with Covid-19, they spread it to others,” the union said in a statement.

Britain reported 57,724 new cases on Saturday and 445 new deaths.

In other developments around the world:

• South Africa announced plans on Sunday to target 67 percent of the population with vaccines to achieve broad immunity against the coronavirus. But officials have come under criticism for only reserving enough vaccines for ten percent so far, set to arrive in the middle of the year. South Africa is experiencing a severe second surge of coronavirus infections and deaths, fueled by a new variant. The health minister said discussions with manufacturers were still underway.

• Kenya is extending a nightly curfew through March 12 in order to contain the spread of the coronavirus, President Uhuru Kenyatta’s office said on Sunday, according to Reuters. The curfew runs from 10 p.m. to 4 a.m.

• Prime Minister Erna Solberg of Norway announced new rules amid a growing wave of infections, Reuters reported, including a ban on serving alcohol in restaurants and bars and on inviting over visitors. University lectures were suspended a day earlier.

• The New Zealand Ministry of Health said Sunday that starting Jan. 15, travelers arriving from Britain and the United States will be required to show that they tested negative for the coronavirus before they departed. Under new rules already in effect, they are also required to be tested within 24 hours of arrival.

Coronavirus Then & Now

With 2020 having drawn to a close, we are revisiting subjects whose lives were affected by the pandemic. When Tim Arango first spoke with Alexis Frost Cazimero in the summer, she was helping her struggling neighbors find food to feed their families.

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By her own description, Alexis Frost Cazimero is a “natural born hustler.”

It was in that spirit that Ms. Cazimero, a mother of four who lives near San Diego, approached the pandemic when it struck last spring. Even as she lost work as an event planner and hair stylist and faced her family’s own financial difficulties, she gazed around her community and saw mounting struggles, especially among low-income families who suddenly found it hard just to put food on the table. There were friends and neighbors too ashamed to ask for help. Senior citizens locked down and unable to get to the grocery store. Families in trailer home communities who could no longer afford food.

All of them were people she wanted to help.

And so, day after day, as the pandemic stretched on, she spent hours driving around the county, her children piled into her minivan, from one food distribution center to another. She would return each day with a car filled with food — fresh vegetables, packaged meals, bread, frosted cakes — and keep just enough for her family and then take the rest to her needy neighbors.

I spent two days with Ms. Cazimero and her family over the summer, the first stop on a cross-country trip to chronicle the crisis of food insecurity unleashed by the pandemic.

By the time fall arrived, Ms. Cazimero decided even that wasn’t enough. So she and her mother and brother, with money from the sale of her mother’s house, leased a 5,000-square-foot space that she turned into a co-op for local business owners who had lost their stores, or individuals who had lost their jobs, to set up shop. Junktion 101 was born, with some 30 stalls selling everything from clothing to handicrafts to antiques to home goods. And she started her own food distribution operation, collecting donations and buying food with some of the proceeds from the co-op.

The venture soon attracted the attention of the local news media, and before she knew it people were lining up.

“Just like how you and I waited in line?” she reminded me. “Well, people wait in line now, and I get to hand them the box.”

For the holidays, she organized turkey dinners for families and a toy drive for children, even as there were fewer gifts under the tree in her own house.

And all these months later, Ms. Cazimero told me the same thing she did last summer: that the pandemic, for her, has been a call to serve others.

“It makes you think just really what you need and what you don’t need,” she said. “It’s been a wonderful blessing in disguise. I spend more time with my family. I spend more time with my community serving and giving and teaching my children what’s most important.”

For weeks, images of lawmakers from both parties getting their Covid-19 vaccinations have appeared on TV and across social media, in an effort to boost public confidence in the shots.

But there are now a few high-profile leaders who have chosen to forgo the early vaccines.

Gov. Andrew Cuomo of New York shared his stance on when he would get the vaccine sharply this week: “I’m not going to take the vaccine until the same people are eligible and it is available in the Black and Hispanic and poor communities in this state.”

Gov. Ron DeSantis of Florida said that he would wait until older Americans could get vaccinated. “It makes no sense for someone that’s 42 to jump ahead of someone that’s 70 years old,” he said.

President-elect Joseph R. Biden Jr., in his 70s, did not raise any eyebrows when he was inoculated. But other, younger politicians have chosen to be vaccinated, including Senator Marco Rubio in Florida, where the vaccine rollout is struggling.

The easy vaccine access for top elected officials, as regular Americans wait in long lines and distribution falls short of its goals, raises ethical questions: Should the nation’s leaders come before older Americans or those with severe health risks? On top of that, should their families and even congressional aides be at the front of the line? Republicans and Democrats alike have argued over the issue; Senator Rand Paul of Kentucky and Represenative Ilhan Omar of Minnesota both said it was not appropriate to jump the line.

“We have such a limited supply. There needs to be a decision made about priorities,” said Dr. Leana Wen, an emergency physician and Baltimore’s former health commissioner. “I understand at a certain level that elected officials need to be getting the vaccine for the purposes of continuity of government,” but, she added, “what is the most essential? Is it an I.C.U. physician or is it a congressional aide?”

She cited the guidelines from the Centers for Disease Control and Prevention, which prioritize high-risk and essential worker populations, and noted that many essential workers were less able to work remotely than politicians are.

“I think that really corrodes trust — when people don’t understand why the top-tier at-risk group isn’t the only group getting something,” said Arthur Caplan, the director of NYU Langone’s Division of Medical Ethics.

For other experts, though, the focus is on increasing public trust in the vaccine, and messiness in the priority groups is expected. “Trusted messengers” are key to vaccine confidence, said Lindsey Leininger, a Dartmouth professor who leads Dear Pandemic, a public education campaign about the pandemic.

There are also risks for the public perception in creating a “negative impression of people with influence and connections cutting in line, that undermines that whole notion of trust,” Dr. Caplan noted.

Those We’ve Lost

Anyone who had worked with Zelene Blancas in El Paso knew her as a teacher whose goal was to spread compassion above all else.

Ms. Blancas, who was born in Texas and lived in Mexico for much of her childhood, was a bilingual Spanish teacher at Dr. Sue A. Shook Elementary School, and she was hoping to become a bilingual special education teacher.

She gained popularity online after posting a video in 2018 of her students that gained more than 23 million views. It showed classmates hugging one another before a weekend break, smiles spread across their faces as they said goodbye — a reminder of the human capacity for love and connection.

Ms. Blancas tested positive for the virus on Oct. 20 and was hospitalized a few days later, her brother, Mario Blancas, said. After she had spent nearly two months in the I.C.U. and had exhausted all of her available sick days and paid time off, Mr. Blancas set up a GoFundMe page on Dec. 14 to help pay for his sister’s health care since she would soon be “without an income and will have to pay the full cost of her health insurance out of pocket,” according to the page.

But this week, at just 35 years old, Ms. Blancas died of complications from Covid-19. Her death has devastated the city.

During her teaching career, Ms. Blancas would often stay up late to speak on the phone with her students’ parents. She ran a literacy program for parents in the evenings, and when classes shifted to remote learning during the pandemic, she delivered care packages, complete with handwritten notes, to her students. Even from her hospital bed, Ms. Blancas was asking about her work at school, said her principal, Cristina Sanchez-Chavira.

“Her calling was just to spread kindness,” Ms. Sanchez-Chavira said. “I think education was the vehicle that she found, but that was her. She embodied kindness, and making others feel special. And she did that in and outside of the classroom.”

Ms. Blancas had been shocked to see the 2018 video clip of her students being shared so widely, Ms. Sanchez-Chavira said, adding that for Ms. Blancas, encouraging empathy among her students had always been a priority.

“She was so humble about it,” Ms. Sanchez-Chavira said of the video. “She was just doing everything for the kids, and I think that’s what made her such a phenomenal teacher — because she just did everything from her heart.”

Ms. Blancas spent her 35th birthday in her hospital room, without family by her side, Mr. Blancas said. The nurses all signed a birthday card for her, and her father sent her a picture of a cake and balloons.

The day before her death, Mr. Blancas said, he was able to visit his sister. It was painful, he said, to see his only sister in a hospital bed, breathing through a tube, her face swollen from the treatments. He brought a gift he knew would make her happy: a blanket emblazoned with pictures of her two beloved dogs, Chico and Rocky.

The United States reported at least 291,300 new coronavirus cases on Saturday, a single-day record but one that is inflated because of delays in reporting over the holidays.

Nineteen states reported no data on Friday, which was a public holiday for New Year’s Day. The remaining states reported a total of more than 147,000 new cases on Friday. The near doubling of cases on Saturday can mostly be explained by many states reporting cases for both Friday and Saturday, with one state, Michigan, reporting cases for Thursday as well. Other states will wait until Sunday or Monday to report cases from the past few days, which will continue to distort the totals.

Regular data reporting is expected to resume toward the end of next week.

The country’s previous single-day record, according to a New York Times database, was 280,514 new cases on Dec. 11, though that number was also inflated because of 43,000 cases that were added from a backlog in Texas. The highest number of new cases in a single day without any data anomalies was 251,191 on Dec. 18.

Regardless of holiday reporting delays, the United States has had the world’s worst outbreak for most of the pandemic and is experiencing a new surge in infections even as vaccine distribution begins. The deluge is particularly strong in Los Angeles County, the largest in the United States, where the seven-day average of new cases is at a peak of 16,193, about 12 times higher than the seven-day average from Nov. 1, which was 1,347.

And with fears that another wave of cases will crest after holiday travel and gatherings, the country reached yet another milestone on Saturday that was once unthinkable, surpassing 350,000 total deaths. At the same time, more than 123,000 Covid-19 patients were hospitalized, only a slight drop from the record level on Thursday.

Distribution of the vaccine in the United States is taking longer than expected, with holiday staffing shortages and other resource issues putting the campaign far behind schedule in its third week. More than 4.2 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 federal officials set to give at least 20 million people their first shots before the end of December.