AstraZeneca’s Vaccine Does Not Work Well Against Virus Variant in South Africa

Credit…Bram Janssen/Associated Press

South Africa has halted use of the AstraZeneca-Oxford coronavirus vaccine after evidence emerged that the vaccine did not protect clinical-trial participants from mild or moderate illness caused by the more contagious virus variant that was first seen in the country.

The findings were a devastating blow to the country’s efforts to combat the pandemic.

Scientists in South Africa said on Sunday that a similar problem held among people who had been infected by earlier versions of the coronavirus: The immunity they acquired naturally did not appear to protect them from mild or moderate cases when reinfected by the variant, known as B.1.351.

The developments, coming nearly a week after a million doses of the AstraZeneca-Oxford vaccine arrived in South Africa, were an enormous setback for the country, where more than 46,000 people are known to have died from the virus. And they were another sign of the dangers posed by new mutations. The B.1.351 variant has already spread to at least 32 countries, including the United States.

The low number of cases evaluated as part of the studies outlined by South African scientists on Sunday made it difficult to pinpoint the precise effect of the variant. And it was not clear whether the AstraZeneca-Oxford vaccine protected against severe disease from the B.1.351 variant.

The clinical trial participants who were evaluated were relatively young and unlikely to become severely ill, making it impossible for the scientists to determine whether the variant interfered with the AstraZeneca-Oxford vaccine’s ability to protect against severe Covid-19, hospitalizations or deaths.

However, based on the immune responses detected in blood samples from people who were given the vaccine, the scientists said they believed that the vaccine could yet protect against more severe cases.

If further studies show that it does, South African health officials said on Sunday that they would consider resuming use of the AstraZeneca-Oxford vaccine.

Even so, the fact that it showed minimal efficacy in preventing mild and moderate cases of the new variant added to the mounting evidence that B.1.351 makes current vaccines less effective. These research findings have not been published in a scientific journal.

Pfizer and Moderna have both said that preliminary laboratory studies indicate that their vaccines, while still protective, are less effective against B.1.351. Novavax and Johnson & Johnson have also sequenced test samples from their clinical trial participants in South Africa, where the variant caused the vast majority of cases — and both reported lower efficacy there than in the United States.

“These results are very much a reality check,” Shabir Madhi, a virologist at University of the Witwatersrand who ran the AstraZeneca-Oxford vaccine trial in South Africa, said of the findings released on Sunday.

The pause in the country’s rollout of the AstraZeneca-Oxford vaccine means that the first shipments will now be put in warehouses. Instead, South African health officials said they would inoculate health workers in the coming weeks with the Johnson & Johnson vaccine, which has strong efficacy in preventing severe cases and hospitalizations caused by the new variant.

Johnson & Johnson has applied for an emergency use authorization in South Africa. But health officials there indicated that even before it is authorized, some health workers could be given the vaccine as part of an ongoing trial.

In the AstraZeneca-Oxford trial in South Africa, roughly 2,000 participants were given either two doses of the vaccine or placebo shots.

There was virtually no difference in the numbers of people in the vaccine and placebo groups who were infected with B.1.351, suggesting that the vaccine did little to protect against the new variant. Nineteen of the 748 people in the group that was given the vaccine were infected with the new variant, compared with 20 of 714 people in the group that was given a placebo.

That equates to a vaccine efficacy of 10 percent, though the scientists did not have enough statistical confidence to know for sure whether that figure would hold among more people.

United States › United StatesOn May 23 14-day change
New cases 14,144 –38%
New deaths 189 –15%
World › WorldOn May 23 14-day change
New cases 266,505 –30%
New deaths 5,247 –12%

U.S. vaccinations ›

Where states are reporting vaccines given




Crowds Gather in Tampa, Fla., Ahead of Super Bowl

Fans gathered at Raymond James Stadium in Tampa, Fla., on Sunday, for the game between the Tampa Bay Buccaneers and the Kansas City Chiefs. Experts are concerned the event could spread coronavirus.

“It’s surreal, it didn’t really settle in until, you know, Friday or Saturday, you get off work, and over the last two weeks it’s kind of been like, OK, we’re really in the Super Bowl. We’re really in the Super Bowl at home. We’re in Tampa. We’re playing at our home field.” “People need hope, especially now, since 2020, and I think 2021 is going to be a better year, I feel deeply, it’s going to be a better year in every area. Yeah, and sports brings people together. I love it.”

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Fans gathered at Raymond James Stadium in Tampa, Fla., on Sunday, for the game between the Tampa Bay Buccaneers and the Kansas City Chiefs. Experts are concerned the event could spread coronavirus.CreditCredit…A.J. Mast for The New York Times

Just as the United States seems to have emerged from the worst of a surge in coronavirus cases that ravaged the country for months and peaked after Americans crowded indoors for the winter holidays, public health officials are concerned about another potential superspreader date: Super Bowl Sunday.

January was the country’s deadliest month so far in the pandemic, accounting for 20 percent, or 95,246, of the more than 460,000 coronavirus deaths the United States has recorded in the past 12 months. That’s more people than could fit into even the largest N.F.L. stadium. More than 27 million cases have been recorded, according to a New York Times database.

Experts worry that football fans gathering on Sunday in Tampa, Fla., for the championship game between the Kansas City Chiefs and the Tampa Bay Buccaneers, or at watch parties across the country, could set back the nascent progress of recent weeks.

The daily reports of new cases and deaths remain high but have fallen somewhat. The seven-day average of new case reports in the U.S. dropped to 125,804 on Friday, the lowest level since Nov. 10. Reports of deaths, a lagging indicator because patients who die from Covid-19 generally do so weeks after being infected, averaged 2,913 a day, the lowest rate since Jan. 7.

The United States is administering 1.3 million vaccine doses a day on average, as the Biden administration pushes to speed distribution before more contagious variants that might evade vaccines can become dominant. The N.F.L. has offered President Biden all 30 of its stadiums for use as mass vaccination sites.

Officials like Dr. Anthony S. Fauci, Mr. Biden’s chief medical adviser for Covid-19, have warned Americans against gathering for Super Bowl parties with people from other households, especially in places without ideal ventilation.

“You’re really putting yourself and your family in danger,” Dr. Fauci said Friday on MSNBC.

“It’s the perfect setup to have a mini superspreader event in your house,” he added. “Don’t do that for now.”

While health experts worry about a rise in cases after the game, some said they don’t anticipate anything as deadly as the post-holiday wave that peaked in January. That is because Thanksgiving and Christmas tend to spur more domestic travel than the Super Bowl does, said Dr. Catherine Oldenburg, an infectious disease epidemiologist at the University of California, San Francisco.

Still, even parties pose a threat, said Carl Bergstrom, a professor of biology at the University of Washington.

“My sense is that it’s a really great year to watch it at home with your family, and not go to Super Bowl parties that you usually would, because we’re just starting to get this under control in this country,” Dr. Bergstrom said.

Dr. Bergstrom said he was also concerned about the more than 20,000 people who are expected to attend the game in person at Raymond James Stadium in Tampa — about one-third of the stadium’s usual capacity.

“Any time you get 25,000 people together yelling and screaming during a pandemic, you’re going to have transmission,” Dr. Bergstrom said.

Public health experts worry that new, more contagious variants, like one first identified in Britain and known as B.1.1.7, will soon become dominant and drive a deadly surge this spring. At least 187 cases of the B.1.1.7 variant have been detected in Florida, more than in any other state, according to the Centers for Disease Control and Prevention.

Bars will be open in Florida during the game, and some are advertising Super Bowl parties. Before the game, Tampa’s mask order was extended to apply to outdoor areas where people could gather.

Super Bowl ticket holders have not been discouraged by the pandemic. Jeremiah Coleman, a Chiefs fan from Wichita, Kan., said, “On my deathbed, this will probably be one of the top five days I remember in my life, you know?”

The Super Bowl fan experience at the Tampa Riverwalk includes signage for coronavirus protocols.

Credit…Eve Edelheit for The New York Times

The N.F.L. didn’t just play football this season, it conducted an enormous coronavirus testing program: More than one million tests administered daily over a six-month period to more than 6,000 players, coaches and staff members. For good measure, the Buccaneers and Chiefs were tested twice a day for much of the past two weeks.

While few organizations have the tens of millions of dollars needed to test every employee every day, let alone track their movements to see where they contracted the virus, the league learned lessons that could help scientists and other sports leagues.

For instance, the league’s testing partner, BioReference, initially used five different testing systems. Over time, the company learned which ones were the most sensitive to picking up the virus, which helped teams isolate players more quickly.

“We were really able to see some of the nuances and sensitivities of those diagnostic tools, which were quite new,” said Christina Mack, an epidemiologist who advises the league.

Scientists who try to predict how viruses travel through communities are eager to see the N.F.L.’s testing data to fine-tune their models. Donald Burke, an epidemiologist the University of Pittsburgh, said the data could help him understand how long infected people have been in the community spreading the virus.

The N.F.L.’s data, including more than 700 positive cases over six months, “sound like an incredible way to figure out transmission patterns, which is still a dark art,” he said. “That’s plenty of cases to learn from and what went wrong and what didn’t work.”

A teacher in Chicago speaking with her students during a virtual class in January. Teachers have criticized the city’s plans for resuming in-person instruction.

Credit…Anthony Vazquez/Chicago Sun-Times, via Associated Press

The Chicago Teachers Union has reached a tentative agreement with Mayor Lori Lightfoot to reopen the city’s schools for in-person classes, the mayor announced on Sunday.

If it is finalized, the agreement would avert a strike that had threatened to disrupt instruction for students in the nation’s third-largest school district.

Under the agreement, prekindergarten and some special education students would return to classrooms on Thursday. Staff in kindergarten through fifth-grade classrooms would return on Feb. 22, and students in those grades would return on March 1. Staff members in sixth- through eighth-grade classrooms would return March 1, and students on March 8.

The deal must be approved by the union’s elected governing body, the House of Delegates, the mayor said. The union leadership is expected to meet with its rank and file Sunday afternoon, and then the House of Delegates will meet, according to a person with knowledge of the situation, who spoke on the condition of anonymity because the union did not want the agreement made public before members had a chance to see it.

The Chicago Tribune reported on the existence of the agreement Sunday morning. Shortly afterward, the union posted on Twitter: “We do not yet have an agreement with Chicago Public Schools. The mayor and her team made an offer to our members late last night, which merits further review. We will continue with our democratic process of rank-and-file review throughout the day before any agreement is reached.”

Mayor Lightfoot and the union have been locked in one of the most intense battles over reopening anywhere in the country. The mayor has argued that the city’s most vulnerable students need the opportunity to return to school in person, while the union condemned the city’s reopening plan as unsafe.

A similar fight is underway in Philadelphia, where prekindergarten through second-grade teachers are supposed to report to school buildings on Monday to prepare for students to return on Feb. 22. The teachers’ union there has told its members to continue working remotely, saying that it was not yet safe to return to school buildings.

Ms. Lightfoot said on Sunday that the battle with the union in Chicago had been a bitter one. She said she had heard from parents who felt that they were being held hostage and that their voices had been drowned out. She sought to put the vitriol in the past.

“My fellow Chicagoans, we need to move forward and we need to heal,” she said.

A woman waiting in line to receive the Covid-19 vaccine in New York last month. On Sunday, Dr. Anthony S. Fauci said doses of the vaccine would soon be more readily available.

Credit…James Estrin/The New York Times

Though more contagious variants are spreading in the United States, top health officials sounded notes of optimism on Sunday that both the supply of vaccines and the rate of vaccination will steadily increase.

“The demand clearly outstrips supply right now,” Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, said on the NBC program “Meet the Press.”

“I can tell you that things are going to get better, as we get from February into March, into April, because the number of vaccine doses that will be available will increase substantially.”

The number of shots administered daily in the United States has increased lately. The Centers for Disease Control and Prevention reported that more than 2.2 million doses were given on Saturday, and 1.6 million on Friday. That brought the latest seven-day average to 1.4 million a day, which approaches President Biden’s new goal of 1.5 million shots per day.

In addition, the supply of vaccines — though still well below demand — is growing. Federal officials recently increased shipments to the states to 10.5 million doses a week, as Moderna and Pfizer gradually increase production. The two companies have deals to supply the United States with a combined 400 million doses — enough to vaccinate 200 million people — by the summer.

Pfizer recently said that it would deliver its doses two months ahead of schedule, by May, in part because it is now counting an additional dose in each vial it is manufacturing. And Moderna is considering a production change that would allow it to increase the number of doses in its vials to 15 from 10.

Officials are also counting on the Food and Drug Administration authorizing a one-dose vaccine from Johnson & Johnson later this month. Although that company will initially provide the United States with only a few million doses, it is expected to step up output considerably by April. Other vaccines from Novavax and AstraZeneca could also be authorized for U.S. use in the spring, further increasing supply.

Officials are racing to vaccinate as many people as possible in order to outpace more contagious variants of the virus that were first identified in Britain and South Africa. The variant from Britain, known as B.1.1.7, is spreading rapidly in the United States, with its prevalence doubling roughly every 10 days, according to a new study. The C.D.C. said it could become the dominant form of the virus in the United States by March.

Although that variant is worrisome because it is more transmissible than earlier variants, vaccine developers are more concerned about a variant discovered in South Africa, known as B.1.351, because it appears to make current vaccines less effective. Several manufacturers have said they are addressing the problem by developing new versions of their vaccines, which could act as booster shots. The Food and Drug Administration has said it is working on a plan to allow those new vaccine versions to be authorized.

Developers of the AstraZeneca and University of Oxford vaccine said on Sunday that they expected to have a modified version of their vaccine available by the fall.

On the CBS program “Face the Nation,” Dr. Scott Gottlieb, a former F.D.A. commissioner and a member of Pfizer’s board, said on Sunday that he believed it would be possible to develop a booster that “bakes in a lot of the different variations that we’re seeing.”

“I think that there is a reasonable chance that we’re going to be able to stay ahead of this virus,” he said.

A nurse administering a coronavirus vaccine last Wednesday in Newark. States have each developed their own formulas to determine eligibility for the vaccine.

Credit…Justin Lane/EPA, via Shutterstock

Federal, state and local health authorities across the United States are using dozens of algorithms — some automated systems and others simple prioritization lists — to help determine where vaccines are sent and who can get them.

The formulas generally follow guidelines from the Centers for Disease Control and Prevention to prioritize frontline health care workers, nursing home residents, senior citizens and those with major health risks — and yet public health agencies and medical centers at every level have developed different allocation formulas, based on a variety of ethical and political considerations.

The result: Americans are experiencing wide disparities in vaccine access.

Oregon, for instance, has prioritized teachers over the elderly for Covid shots, an approach that could help schools and businesses reopen. New Jersey has put smokers ahead of educators, which could save lives.

Some prioritization formulas also conflict with one another or impose such prescriptive rules that they hinder immunizations, public health experts say.

Ellen P. Goodman, a professor at Rutgers Law School who studies how governments use automated decision-making systems, said algorithms were needed to efficiently allocate the vaccines. But public agencies and health centers should be transparent about the prioritization formulas, she added.

“We want to know who is using them, what they are trying to do, who owns the proprietary algorithms, whether they are audited,” she said.

A multiagency federal effort — originally called Operation Warp Speed and created by the Trump administration — has managed nationwide vaccine distribution through Tiberius, an online portal developed by Palantir, the data-mining giant. Now the Biden administration, which has retired the program’s name, has taken over and is continuing the effort.

To divvy up doses, federal administrators use a simple algorithm that divides the total amount of vaccine available each week among the 50 states — as well as U.S. territories and a few big cities like New York — based on the number of people over 18 in each place.

Even so, states began warning last fall about Tiberius’s potential drawbacks. In interim vaccine plans filed with the C.D.C., some state health administrators complained that the platform seemed overly cumbersome and that the algorithm’s week-by-week allotments would make it difficult to plan monthslong vaccination campaigns.

Indeed, some health officials and researchers have described the Tiberius algorithm as a black box.

“Why can’t they make public the methods that they use to make these estimations?” said Dr. Rebecca Weintraub, an assistant professor of medicine at Harvard Medical School who was a co-author of a recent study on state vaccination plans. “Why are the states receiving a different number of doses than they expected per week?”

A woman uses a kit to swab herself for coronavirus at the Levine Science Research Center at Duke University last Wednesday in Durham, N.C. The C.D.C. believes the more transmissible coronavirus variant first detected in Britain is likely to soon become the dominant strain in the United States.

Credit…Pete Kiehart for The New York Times

A more contagious variant of the coronavirus first found in Britain is spreading rapidly in the United States, doubling roughly every 10 days, according to a new study.

Analyzing half a million coronavirus tests and hundreds of genomes, a team of researchers predicted that in a month this variant could become predominant in the United States, potentially bringing a surge of new cases and increased risk of death.

The new research offers the first nationwide look at the history of the variant, known as B.1.1.7, since it arrived in the United States in late 2020. Last month, the Centers for Disease Control and Prevention warned that B.1.1.7 could become predominant by March if it behaved the way it did in Britain. The new study confirms that projected path.

“Nothing in this paper is surprising, but people need to see it,” said Kristian Andersen, a co-author of the study and a virologist at the Scripps Research Institute in La Jolla, Calif. “We should probably prepare for this being the predominant lineage in most places in the United States by March.”

Dr. Andersen’s team estimated that the transmission rate of B.1.1.7 in the United States is 30 percent to 40 percent higher than that of more common variants, although those figures may rise as more data comes in, he said. The variant has already been implicated in surges in other countries, including Ireland, Portugal and Jordan.

“There could indeed be a very serious situation developing in a matter of months or weeks,” said Nicholas Davies, an epidemiologist at the London School of Hygiene and Tropical Medicine who was not involved in the study. “These may be early signals warranting urgent investigation by public health authorities.”

Dr. Davies cautioned that U.S. data is patchier than data in Britain and other countries that have national variant monitoring systems. Still, he found results from some parts of the United States especially worrisome. In Florida, where the new study indicates the variant is spreading particularly quickly, Dr. Davies fears that a new surge may hit even sooner than the rest of the country.

“If these data are representative, there may be limited time to act,” he said.

Kyriakos Mitsotakis, the prime minister of Greece, in Athens last month.

Credit…Kostas Tsironis/EPA, via Shutterstock

Kyriakos Mitsotakis, the prime minister of Greece, came under fire by opposition parties and on social media over the weekend for apparently flouting his conservative government’s coronavirus restrictions — the second time he has been accused of disregarding such regulations in two months.

Footage posted on social media over the weekend showed Mr. Mitsotakis and dozens of officials at a gathering on the Aegean island of Ikaria, on the balcony of a local lawmaker’s home. He had been visiting Ikaria and Fournoi, both remote islands, to oversee the progress of his government’s vaccination program there.

The images prompted a barrage of angry comments by social media users, as well as criticism from rival political parties, because lockdown restrictions include a limit of nine people during gatherings, with fines of 3,000 euros for organizers and 300 euros for attendees. Between 30 and 40 people appear to have attended the lunch on Ikaria.

The gathering also came during the first weekend of tough new restrictions in much of the country as well as an earlier evening curfew on weekends. The measures were enacted after a recent spike in infections.

Local officials argued that all necessary precautions were taken: The gathering was outdoors, and guests wore masks before and after the meal.

But opposition parties called the footage “provocative” and “offensive.” Alexis Tsipras, leader of the leftist Syriza party, said the prime minister’s behavior showed “deep arrogance.”

Mr. Tsipras referred to another incident in December when Mr. Mitsotakis came under fire for a mountain bike excursion with his wife in a forest in northern Athens. He had posed for photos with several passers-by, none of them wearing masks.

Christos Tarantilis, a government spokesman, dismissed the opposition’s criticism as “lacking seriousness,” but added that “in any case, in the prime minister’s future tours, every possible effort will be made to avoid creating the wrong impression.”

In other developments around the world:

  • Hungary may start rolling out Russia’s Sputnik V Covid-19 vaccine this week, Prime Minister Viktor Orban said on Hungarian state radio on Friday, according to Reuters. It would be the first country in the European Union to distribute Russia’s shot. The country received 40,000 doses last week, and is expected to receive 600,000 by the end of the month.

  • France’s Labor Ministry said it would soon allow employees to eat lunch at their desks in order to contain the spread of coronavirus, a practice previously forbidden by the French labor code. French eating habits have already been sorely tested by pandemic curfews and closures.

  • Britain’s vaccine minister, Nadhim Zahawi, said on the BBC’s “Andrew Marr Show” on Sunday that a booster shot for the Covid-19 vaccine and then annual vaccinations were very likely. He compared it to annual flu vaccinations.

  • The Australian authorities have placed residents in Sydney and Melbourne on alert after two new cases of the coronavirus were recorded in cities that have largely quashed the disease. The first case was reported on Sunday in the state of New South Wales, where a traveler returning home tested positive 16 days after entering the country. In Victoria, an employee at a hotel quarantine facility returned a positive test on Monday, becoming the second such worker to contract the virus in less than a week.

Livia Albeck-Ripka contributed reporting.

Empty storefronts in Manhattan last month. Treasury Secretary Janet Yellen is urging lawmakers to pass a sizable coronavirus aid package for the sake of the economy.

Credit…Mohamed Sadek for The New York Times

The U.S. labor market is stalling and in a “deep hole” that could take years to escape if lawmakers do not quickly pass an aid package that gives workers a bridge to the end of the pandemic, Treasury Secretary Janet L. Yellen warned on Sunday.

By contrast, passing the $1.9 trillion package that President Biden has proposed could allow the economy to reach full employment by next year, Ms. Yellen said.

She rebutted concerns that big spending would lead to inflation, and said that the economy would be stuck in the kind of long, slow recovery that followed the 2008 financial crisis if lawmakers do too little now.

“The most important risk is that we leave workers and communities scarred by the pandemic and the economic toll that it’s taken,” Ms. Yellen said on the CNN program “State of the Union.” “We have to make sure this doesn’t take a permanent toll on their lives.”

Lawrence H. Summers, a former Treasury secretary under President Bill Clinton, argued in The Washington Post on Thursday that Mr. Biden’s proposal was so big that it might overheat the economy. But Ms. Yellen, a former Federal Reserve chair, said on CNN that she had spent years studying inflation and that she was confident that policymakers had the tools to deal with it if it were to materialize.

Democrats in Congress moved last week to fast-track Mr. Biden’s plan, but the details of the legislation are still being worked out. Ms. Yellen said it was important to ensure that not just low-income workers but also those in the middle class, like teachers and police officers, receive the additional support they need.

“Of course it shouldn’t go to very well-off families that don’t need the funds,” Ms. Yellen said on the CBS program “Face the Nation,” adding that Mr. Biden was discussing with Congress where to set the income ceiling for eligibility.

After a pandemic aid package passes, Ms. Yellen said, Mr. Biden wants to pass a jobs bill built around infrastructure investment, worker training and addressing climate change.

Giannis Antetokounmpo of the Milwaukee Bucks is among the players who have criticized the N.B.A.’s plans to hold an All-Star Game next month.

Credit…Jacob Kupferman/Associated Press

Multiple N.B.A. stars, including Giannis Antetokounmpo, Kawhi Leonard and Kevin Durant, have added their voices to the growing chorus of players criticizing the league’s handling of the coronavirus pandemic, particularly plans to hold the All-Star Game in Atlanta next month.

“We’ve got to all follow the big dog,” Antetokounmpo told reporters on Friday night, referring to LeBron James, who said this week that holding the game as planned on March 7 would be “a slap in the face” for players. Echoing James, Antetokounmpo, the reigning Most Valuable Player Award winner, said he had “zero excitement, zero energy” for the game.

Following Antetokounmpo’s comments, Leonard, the Los Angeles Clippers forward, said he was not surprised by the league’s plans, but that it was “just putting money over health right now, pretty much.”

“We all know why we’re playing it,” said Leonard, a four-time All-Star. “It’s money on the line. There’s the opportunity to make more money.”

The All-Star events are a chance to showcase the N.B.A.’s top talent. There is also a financial benefit, although how much is unclear. This year, the league, in conjunction with the players’ union, is planning to hold its 3-point contest and skills competition on the same day as the game to condense an affair that typically lasts days. The N.B.A.’s collective bargaining agreement requires those selected for the All-Star Game to play if they are healthy.

Nonetheless, a condensed schedule does not eliminate the added health risks of an event bringing together the game’s best players from across the country for an exhibition — and presents a sharp contrast to rules that bar players from sharing hugs and handshakes after games to help reduce the chances of spreading infection.

Those We’ve Lost

Albert Hale was elected the second president of the Navajo Nation in 1994, and later served in the Arizona State Senate and House of Representatives.

Credit…Ross D. Franklin/Associated Press

This obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.

Albert Hale was serving as president of the Navajo Nation when one of the most powerful political figures in the United States flared tempers by telling leaders in Indian Country that he had trouble understanding the concept of tribal sovereignty.

So in 1998, Mr. Hale, a trailblazing lawyer all too familiar with Washington’s methods of dealing with tribal nations, issued a retort to the official, Newt Gingrich, a Republican who was then speaker of the House of Representatives.

“When I come to Washington, you don’t send me to the Bureau of Indian Affairs,” said Mr. Hale, representing the largest Indian reservation in the United States, according to an article in The New York Times. “You have a state dinner for me.”

After a long political career, Mr. Hale died on Feb. 2 at a hospital in Mesa, Ariz. He was 70. The cause was Covid-19, his daughter April Hale said.

Mr. Hale was elected the second president of the Navajo Nation in 1994, not long after it created a three-branch system of government similar to many other democracies. He later served in the Arizona State Senate and House of Representatives.

Mr. Hale’s death was a reminder of how the virus is devastating the Navajo Nation, which has been one of the hardest-hit places in the United States during the pandemic. At least 1,038 people have died from the virus in the nation, which spreads over parts of Arizona, New Mexico and Utah, tribal officials said Wednesday.

A small but vocal band of demonstrators caused the Los Angeles Fire Department to shut down the vaccination site at Dodger Stadium for about an hour last weekend.

Credit…Irfan Khan/Los Angeles Times, via Shutterstock

An out-of-work stand-up comic originally from New Jersey. An actor and conservative podcast host dressed in a white lab coat. A gadfly who has run several unsuccessful campaigns for Congress in Los Angeles. And at least a few who had been in Washington the day of the Capitol riot.

They were among the motley crew of vaccine skeptics who recently converged on the entrance of the mass vaccination site at Dodger Stadium in Los Angeles to protest distribution of the coronavirus vaccine.

The loosely formed coalition represents a new faction in California’s long-established anti-vaccine movement. Their protest was the latest sign that Californians have become the unlikely standard-bearers for aggressive opposition to the vaccine at a time when virus cases continue to spread in the state.

California, which has averaged 500 daily deaths tied to the virus over the past week, will soon become the state with the largest number of coronavirus deaths, surpassing New York.

For months, far-right activists across the United States have been rallying against mask-wearing rules, business lockdowns, curfews and local public-health officials, casting the government’s response to the virus as an intrusion on individual liberties. But as masks and lockdowns have become an increasingly routine part of American life, some protesters have shifted the focus of their antigovernment anger to the vaccine.

Protesters appeared on Sunday at the Super Bowl, where health care workers who won tickets to the event had to pass anti-vaccine protesters to enter the stadium. The protesters, not wearing masks, held up signs with false or dubious claims.

Last week at Dodger Stadium, the same small but vocal band of demonstrators who previously staged anti-mask and anti-lockdown protests in the Los Angeles area disrupted a mass vaccination site that gives an average of 6,120 shots daily. About 50 protesters — some carrying signs reading “Don’t be a lab rat!” and “Covid = Scam” — marched to the entrance and caused the Los Angeles Fire Department to shut down the entrance to the city-run site for about an hour.

Then vaccinations continued as scheduled.

Angelica Gabriel, 47, and her husband, Felix Cesario, 50, at their apartment complex in Mountain View, Calif. The couple share their apartment with others to manage the rent.

Credit…Sarahbeth Maney for The New York Times

As the pandemic enters its second year, millions of renters are struggling with a loss of income and with the insecurity of not knowing how long they will have a home. Savings depleted, they are running up credit card debt to make the rent, or accruing months of overdue payments. Families are offsetting housing costs by moving in together.

Even before the pandemic, about 11 million households — one in four U.S. renters — were spending more than half their pretax income on housing, and overcrowding was on the rise.

Now, the pressure has grown worse. One study by the Federal Reserve Bank of Philadelphia showed that tenants who lost jobs in the pandemic had amassed $11 billion in rental arrears.

On Friday, as monthly jobs data provided new evidence of a stalling recovery, President Biden underscored the housing insecurity faced by millions. The rental assistance in his $1.9 trillion relief plan, he said, is essential “to keep people in their homes rather than being thrown out in the street.” And $25 billion in federal rental aid approved in December is set to be distributed. That, and Mr. Biden’s extension of an eviction moratorium, should help many people.

But for every million or so households who are evicted in the United States each year, there are many more millions who move out before they miss a payment, who cut back on food and medicine to make rent, or who take up informal housing arrangements that exist outside the traditional landlord-tenant relationship. The federal rental aid may not reach these people, who are the most vulnerable to slipping into homelessness.

While rents have fallen in many big cities, vacancy rates for the cheapest buildings are essentially flat from last year, according to CoStar Group, a commercial property group. Before the pandemic there was already a longstanding shortage of affordable housing, so anyone who loses an affordable home will still have a hard time finding a new one.

The coronavirus pandemic has been especially hard on single people.

Credit…Andrea Mantovani for The New York Times

The coronavirus pandemic has been rough on virtually everyone.

But those who have been single through the isolation, fear and upheaval say they’ve been confronted with a distinct set of challenges — not necessarily more or less severe than those who are coupled up, but different.

“The first few months I thought: ‘This is OK, I can work on myself,’” said Gagan Bhatnagar, 35, a clinical oncology consultant in London. “But then it just dragged on. One day I realized it had been three months since I had touched a human being.”

With a widely shared Twitter thread in December, Mr. Bhatnagar tapped into a wide range of single angst. The thousands of responses he received indicated single people often felt their needs were being overlooked or dismissed, and they frequently felt guilty about expressing them. What’s a bit of mopey loneliness when others are dying?

Being unable to date as usual has robbed people of the hope and excitement that can sustain them through typical rough patches, he said. (Many reported that socially distanced walks in the cold, one of the few Covid-safe ways to meet people after matching online, wasn’t conducive to forming connections.)

“The most physical contact I’ve had was with a cashier giving me change,” said Marc Fein, 35, an educator and mental health advocate in Jerusalem. “I don’t think I realized how much I needed it.”

Science supports the necessity of human touch: Tiffany Field, the director of the Touch Research Institute at the University of Miami, said research had shown touch to be crucial as a mood stabilizer.

“To have well-being, you need to have touch,” she said. “And if you don’t have that, you go into these states of anxiety and depression.”

In Elberton, Ga., the state Department of Health suspended a local medical center from its vaccination program for inoculating teachers before they were officially eligible. 

Credit…VIrginie Drujon-Kippelen for The New York Times

In the race to vaccinate Americans against Covid-19, most states and counties are struggling to move fast enough to meet the immense demand. In one rural county in northeast Georgia, though, a clinic has been punished for getting on with the job too fast.

Georgia health officials suspended the Medical Center of Elberton from the state’s vaccine program for six months for starting to vaccinate teachers before they officially became eligible under state guidelines.

The clinic says it thought it was doing the right thing. By the end of December, it had vaccinated everybody in the area who wanted a shot and who qualified in the first eligible group, known as 1A — frontline health care workers and the residents and staff of nursing homes. So it moved on to the next batch of eligible people, group 1B, which included essential workers like teachers.

On Dec. 30, though, the state switched things up, announcing that it was expanding eligibility to include everyone 65 and older and their caregivers, as well as law enforcement officers and firefighters. It called that huge new group 1A+, and made them eligible starting Jan. 11, pushing group 1B and the teachers farther back in line.

Too late. “We had already finished vaccinating teachers by the time 1A+ came out,” said Dr. Jonathan Poon, who works at the clinic, though the teachers had only received the first of the two required doses. “We got caught in this in-between zone between guidelines,” he said.

Dr. Poon said Elberton County’s small population of roughly 20,000 people allowed the clinic to get the first group done sooner than other parts of the state had done, and the clinic wanted to keep moving forward. But instead of drawing praise, that swift progress got the clinic into trouble.

The Georgia Department of Health called on Jan. 26 to ask whether the clinic had been vaccinating teachers. “Next thing we know, on Jan. 28, we had our vaccine privileges suspended,” Dr. Poon said.

The following week, he said, state workers came to the clinic and took away its vaccine supply, leaving the clinic with only enough to administer second shots to people who had already gotten their first doses there.

The health department said in a statement that the clinic was wrong to have vaccinated people beyond the current phase of eligibility, and that it would no longer receive shipments of vaccine from the state.

The clinic appealed the decision once and was turned down. It is awaiting a response to a second letter of appeal.

“We were trying to be part of the solution, to get our community vaccinated,” Dr. Poon said. “Obviously, it’s been completely stripped away. And it’s not because we were trying to be first — it’s just that we saw what was going to be the best opportunity to get this done efficiently, which I thought was the whole goal of the vaccine rollout.”