Here’s what you need to know:A volunteer in the Oxford-AstraZeneca vaccine trial getting a shot in Oxford, England, in November.Credit…Andrew Testa for The New York Times

A global push to accelerate vaccinations gathered steam on Wednesday, with new developments from Britain, China and Russia.

Britain became the first country to give emergency authorization to the coronavirus vaccine developed by AstraZeneca and the University of Oxford. The approval opens a path for a cheap and easy-to-store shot that much of the world will rely on to help end the pandemic. Indian officials met on Wednesday and were set to meet again on Friday to consider vaccine applications.

For Britain, where hospitals are overwhelmed by a new, more contagious variant of the virus, the regulator’s decision offered some hope of a reprieve. The health service is preparing to vaccinate a million people per week at makeshift sites in soccer stadiums and racetracks.

The Oxford-AstraZeneca shot is poised to become the world’s dominant form of inoculation. At $3 to $4 a dose, it is much less expensive than some other vaccines. And it can be shipped and stored at normal refrigeration temperatures for six months, rather than in the ultracold freezers required by the Pfizer-BioNTech and Moderna vaccines, making it easier to administer to people in poorer and hard-to-reach areas.

In a bold departure from prevailing strategies around the world, the British government also decided to begin giving as many people as possible a first vaccine dose, rather than holding back supplies for quick second shots, greatly expanding the number of people who will be inoculated. Clinicians in Britain will wait as long as 12 weeks to give people second doses, the government said.

The effects of delaying second doses as a way of giving more people the partial protection of a single dose are not fully known. Britain, which experts believe is the first country to undertake such a plan, will also delay second doses of the Pfizer-BioNTech vaccine, which has been in use in the country for several weeks and has been shown in clinical trials to have considerable efficacy after a single dose. Some participants in the clinical trial of the Oxford-AstraZeneca vaccine were given the two doses several months apart.

When given in two full-strength doses, AstraZeneca’s vaccine showed 62 percent efficacy in clinical trials — considerably lower than the roughly 95 percent efficacy achieved by Pfizer’s and Moderna’s shots. For reasons scientists don’t yet understand, AstraZeneca’s vaccine showed 90 percent efficacy in a smaller group of volunteers who were given a half-strength initial dose.

Here are other vaccine developments from around the world:

China announced that late-stage drug trials showed that one of its coronavirus vaccines was effective. The news could pave the way for the global rollout of hundreds of millions of vaccine doses in the coming months, but the announcement lacked crucial details. The state-controlled firm Sinopharm said that a vaccine candidate made by its Beijing Institute of Biological Products arm was shown to be 79 percent effective in interim Phase 3 trials.

Sinopharm said it had asked Chinese regulators to allow the vaccine to be used broadly. But Sinopharm’s announcement, only a few sentences long, provided no breakdown of results and left many questions unanswered, adding to a lack of clarity that has dogged China’s coronavirus vaccine development.

Russia secured an important outside vote of confidence in the safety of its vaccine, Sputnik V, with the start of mass inoculations in Belarus and Argentina. The vaccine had been dogged by criticism since President Vladimir V. Putin announced in August that it was ready for use even though clinical trials had not been completed.

Large-scale clinical trials carried out since then have shown the vaccine, developed by the Gamaleya National Research Institute of Epidemiology and Microbiology, to be more than 91 percent effective, according to its Russian backers. A voluntary vaccination program using Sputnik V began in Russia this month, but a recent survey found that only 38 percent of Russians intended to get the vaccine.

Hungary, whose leader, Viktor Orban, has pointed to Russia as a beacon of his model of so-called illiberal democracy, was the first member of the European Union to receive a delivery of the Russian vaccine, though the shipment it received on Monday was only 6,000 vials. Doses of the Russian vaccine also arrived in Serbia, which is outside the union, on Wednesday.

Prime Minister Giuseppe Conte of Italy said on Wednesday that the country was aiming to immunize 10 million to 15 million people by late spring but that it would not make the vaccine obligatory.

Open-air exercise is still allowed under the strict measures. But people are being asked to stay at home as much as possible.Credit…Tolga Akmen/Agence France-Presse — Getty Images

On the same day that Britain’s regulators gave emergency approval to the coronavirus vaccine developed by AstraZeneca and the University of Oxford, millions more people in England were told they will be placed under the country’s tightest regulations starting Thursday.

Three quarters of the country’s population will live under England’s toughest virus limits, Britain’s health secretary, Matt Hancock, announced in Parliament on Wednesday. The government stopped short of introducing a full national lockdown, but will effectively create one across almost all of the country, with northeastern England and large parts of northwestern, southwestern and central England set to join London and southern and eastern England under the tier four rules.

The return of high school and secondary school students after the winter break will be delayed until mid-January, the education secretary, Gavin Williamson, said on Wednesday. Universities will also be asked to reduce the number of students who return to campus next month.

Most primary schools for children 5 to 11 years old will return on Jan. 4 as previously planned, but some schools in areas with the highest infection rates will shift to remote learning for all students except those who are vulnerable or whose parents are essential workers. The government still hopes to introduce a mass testing program for all schools.

The measures were deemed necessary as Britain is fighting to contain the spread of an especially contagious strain of the coronavirus that has brought the country’s cases to record levels and pushed the National Health Service to its limits.

Britain reported 50,023 new lab-confirmed cases on Wednesday, and 981 deaths, the highest daily death toll since April. Frontline health care workers have been warning that hospitals are at a breaking point, with more patients admitted in England with Covid-19 than at the April peak. Some hospitals have already warned of shortages of bed space and oxygen supplies.

Shortly before Christmas, London and parts of southern England — where the new strain is most prevalent — were moved up to the strictest regulations. Those restrictions include: a ban on indoor socializing; people staying at home as much as possible; and gyms, nonessential shops and restaurants remaining closed, except for takeaway meals. Meeting one other person outdoors and open-air exercise are permitted.

The country’s approval of the homegrown AstraZeneca vaccine brought hope that the pandemic’s end could be near. “From the beginning, we’ve focused on the vaccine as a way out of this pandemic and now it is a reality,” Mr. Hancock said, adding that it was a day of “mixed emotions” as he acknowledged the new measures would place a significant burden on people and businesses. “We must all stick at it during the difficult weeks ahead,” he said.

A drive-through coronavirus testing site in Wheat Ridge, Colo., in March. Credit…David Zalubowski/Associated Press

The newly discovered, more contagious variant of the coronavirus — first seen in Britain — may have been found in a second person in Colorado, state officials said on Wednesday.

The first known case of the variant in the United States was reported there on Tuesday. The second case has not yet been confirmed but is “highly suspicious,” Dr. Emily Travanty, the interim director of the state public health laboratory, said on Wednesday in a conference call with reporters and Gov. Jared Polis.

Both cases involve members of the Colorado National Guard who were sent to Simla, Colo., to help staff the Good Samaritan nursing home, which has had a virus outbreak, Dr. Rachel Herlihy, the Colorado state epidemiologist, said on the call. Simla is a small town in Elbert County, about 80 miles southeast of Denver.

It was not clear whether the two National Guard members were infected at the nursing home or had picked up the virus before they went to Simla. They arrived on Dec. 23, long after most of the cases at the facility had occurred, Dr. Herlihy said. They were tested the next day as part of routine testing of National Guard members, and both tests came back positive, she said.

Luke Letlow in July. He said on Dec. 18 that he was isolating at home after testing positive for the coronavirus.Credit…Melinda Deslatte/Associated Press

Luke Letlow, a Republican who was elected to the House of Representatives this month to represent Louisiana’s Fifth Congressional District, died Tuesday evening of complications from Covid-19, a spokesman said. He was 41.

Mr. Letlow was set to take office on Sunday. His death was confirmed by several politicians, including Representative Garret Graves of Louisiana, who said in a Facebook post that the death of his friend and “former co-worker” was “a huge loss to Louisiana and America.” Mr. Letlow died at the Ochsner L.S.U. Health medical center in Shreveport, La., said the spokesman, Andrew Bautsch.

Mr. Letlow said on Dec. 18 that he was isolating at home after testing positive for the coronavirus. He was hospitalized a day later in Monroe, La., before being transferred to the hospital in Shreveport on Dec. 22. Mr. Bautsch said on Dec. 23. that Mr. Letlow had been receiving the antiviral drug remdesivir and steroids to treat his infection.

On Dec. 21, while he was hospitalized in Monroe, Mr. Letlow urged people who had recovered from Covid-19 to donate plasma. “Your plasma is ESPECIALLY needed by those who are suffering,” he wrote in a tweet. “I cannot stress this enough. Please consider saving lives by going out and donating at your local blood bank.”

He did not have any underlying conditions that would have increased his chances of dying from Covid-19, Dr. G.E. Ghali, a doctor at the Shreveport hospital, told The Advocate in Baton Rouge, La.

In a runoff this month against another Republican, Mr. Letlow was elected to succeed Representative Ralph Abraham, whom Mr. Letlow had served as chief of staff.

Mr. Letlow is survived by his wife, Julia, and their two children, Jeremiah and Jacqueline.

Speaker Nancy Pelosi said in a statement, “Tonight, the United States House of Representatives sadly mourns the passing of Congressman-elect Luke Letlow.

“Congressman-elect Letlow was a ninth-generation Louisianian who fought passionately for his point of view and dedicated his life to public service,” she said.

Kevin McCarthy, the House minority leader, said, “Our hearts break tonight as we process the news of Congressman-elect Luke Letlow’s passing.”

Gov. John Bel Edwards of Louisiana said Tuesday evening that Covid-19 had “taken Congressman-elect Letlow from us far too soon.” Mr. Edwards, a Democrat, said he had ordered flags to be flown at half-staff on the day of Mr. Letlow’s funeral.

Representative Mike Johnson, a Republican who represents the state’s Fourth Congressional District, issued a statement on behalf of the state’s six-member Congressional delegation: “We are devastated to hear of Luke Letlow’s passing. Luke had such a positive spirit, and he had a tremendously bright future ahead of him. He was looking forward to serving the people of Louisiana in Congress, and we were excited to welcome him to our delegation where he was ready to make an even greater impact on our state and our nation.”

Bobby Jindal, the former governor of Louisiana whom Mr. Letlow had previously worked for when Mr. Jindal was a congressional candidate, representative and governor, said the congressman-elect “had talked in recent days about his excitement about the opportunity to serve” his district.

“I first met Luke when he was still a college student, and spent countless hours with him in his truck driving the back roads of Louisiana,” Mr. Jindal said. “His passion for service has been a constant throughout his life.”

According to Ballotpedia, Mr. Letlow is the first elected federal official to die from the coronavirus; the first member of the federal government to die from it was a judge.

Other elected officials to die from Covid-19 include several state legislators: a Republican state senator from Minnesota, New Hampshire’s new Republican speaker of the House of Representatives, and in North Dakota, David Dean Andahl, a Republican known as Dakota Dave, who was elected posthumously to the State House of Representatives after dying from the virus.

Chris Long of Clarkston, Mich., has been in the hospital seven times since contracting the coronavirus.Credit…Emily Rose Bennett for The New York Times

Nearly a year into the pandemic, it is clear that recovering from Covid-19’s initial onslaught can be an arduous, uneven journey. Now, studies reveal that a significant subset of patients are having to return to hospitals, sometimes repeatedly, with complications triggered by the disease or the body’s battle against it.

The routine of Chris Long, 54, used to include biking 30 miles three times a week and taking courses toward a Ph.D in eight-week sessions. But since getting sick with the coronavirus in March, Mr. Long has fallen into a distressing new cycle — one that so far has landed him in the hospital seven times.

Every few weeks since his initial five-day hospitalization, his lungs begin filling, he starts coughing uncontrollably and runs a low fever. Roughly 18 days later, he spews up greenish-yellow fluid, signaling yet another bout of pneumonia.

Soon, his oxygen levels drop and his heart rate accelerates to compensate, sending him to a hospital near his home in Clarkston, Mich., for several days, sometimes in intensive care.

Data on rehospitalization of coronavirus patients is incomplete, but early studies suggest that in the United States alone, tens or even hundreds of thousands could ultimately return to the hospital.

“It’s an urgent medical and public health question,” said Dr. Girish Nadkarni, an assistant professor of medicine at Mount Sinai Hospital, who, with another assistant professor, is studying readmissions of Covid-19 patients.

A study by the Centers for Disease Control and Prevention of 106,543 coronavirus patients, initially hospitalized between March and July, found that one in 11 was readmitted within two months of being discharged, with 1.6 percent of patients readmitted more than once.

Readmissions strain hospital resources, and patients can be exposed to new infections and develop muscle atrophy from being bedridden.

Some research suggests implications for hospitals currently overwhelmed with cases. A Mount Sinai Hospital study of New York’s first wave found that patients with shorter initial stays and those not sick enough for intensive care were more likely to return within two weeks.

global roundup

A memorial in April for those who died of the coronavirus in Wuhan.Credit…Roman Pilipey/EPA, via Shutterstock

A new study released by the Chinese Center for Disease Control has suggested that the number of coronavirus infections in Wuhan, the Chinese city where the outbreak first discovered, may have been far higher than official data shows.

In Wuhan, a city of 11 million people, official tallies put the number of coronavirus infections at just above 50,000, with 3,869 deaths. But blood samples taken from residents after the pandemic’s first wave reveal that the number of infections could be as high as 500,000 — 10 times higher than the official count.

The study looked at samples from 34,000 people in Wuhan and other cities across China, including Beijing and Shanghai, as a way of estimating infection rates. More than 4 percent of the samples taken from Wuhan residents contained Covid-19 antibodies, a prevalence rate far higher than that found in other cities in the study. In other cities in Hubei Province, of which Wuhan is the capital, less than 1 percent of residents in the study had Covid-19 antibodies.

The results of the study were released on Monday by the Chinese Center for Disease Control. It concluded that the lower infection rates in other cities were evidence that China’s approach to controlling the coronavirus had been successful.

China has been criticized for its lack of transparency in its pandemic response and has been accused of hiding information that could cast the government in a negative light. But some experts said the discrepancy in case numbers suggested by the study released on Monday was evidence instead of the chaotic early days of the outbreak in Wuhan, when medical resources were scarce and little was known about the coronavirus.

“I don’t think this means that the authorities were hiding cases,” Tao Lina, a former immunologist at the Shanghai Center for Disease Control and Prevention, said in a phone interview. During the outbreak’s first weeks, Mr. Tao said, many people who were sick stayed home, treating their illness like a common cold. Others were turned away from hospitals because of a lack of space.

In other developments from around the world:

Saying a coronavirus variant in South Africa appears linked to a recent surge in infections, the World Health Organization urged all African countries on Wednesday to carry out “crucial investigations” to detect any new mutations and to help contain the virus’s spread. Infections are rising in 47 African countries, approaching the region’s July peak.

The authorities in France said that an overnight curfew in place since mid-December would begin two hours earlier in several regions hard hit by the pandemic. The new curfew will be enforced on Saturday if the rise of Covid-19 infections has not been curbed by then. The health minister, Olivier Véran, said that the existing curfew, which lasts from 8 p.m. to 6 a.m., would start at 6 p.m. France has reported an average of 13,000 new cases per day for the past two weeks — more than double the 5,000 set as a target for the easing of restrictions. For now, the government has ruled out a full lockdown.

China announced new measures in Beijing and the northern city of Shenyang as officials moved to control two local outbreaks. Officials in the Shunyi District of Beijing said on Wednesday that they were tightening controls as they worked to track down one outbreak, according to Xinhua, the state-run news agency. Officials said an infected person without symptoms had visited multiple locations. Officials in the northern city of Shenyang said on Wednesday they had declared “wartime status,” signaling new limits after eight cases were confirmed there, according to state-run China Central Television. The city will restrict large-scale gatherings including group meals, training sessions and parties.

The authorities in Germany recorded 1,129 coronavirus deaths on Tuesday, the highest daily number since the start of the pandemic. While experts say the number is elevated because of delays in reporting during Christmas, it has led to headlines in a country that prided itself on a relatively low fatality rate early in the pandemic. “The numbers show just how brutally this virus is still striking,” the German health minister, Jens Spahn, said at a news conference on Wednesday. Although registered infections had dropped from a week earlier, health officials warned that these were probably underreported. A national lockdown, scheduled to run to Jan. 10, is likely to be extended, Mr. Spahn said, though he did not give details.

Hackers from Turkey have been accused of defacing the website of the Chinese coronavirus vaccine manufacturer Sinovac. On Wednesday, the site included a large image with the words “Turkish defacer.” A separate page included the flag of East Turkestan, an emblem long-banned in China and generally used as a symbol of independence for the Uighurs, a Turkic Muslim minority group. The hack comes as Turkey began receiving the vaccine produced by Sinovac and as Turkey weighs ratifying an extradition treaty with China. A Sinovac spokesman did not immediately respond to questions about the hack.

People traveling to Sweden from Britain will need to show a negative test result for the virus before entering the country, the Swedish government said on Wednesday. The requirement will come into force on Jan. 1 and will not apply to Swedish citizens, the country’s home affairs minister, Mikael Damberg, said at a news conference, Reuters reported.

Prisoners affected by the coronavirus in facilities like the Eastern Oregon Correctional Institution in Pendleton have the right to sue Oregon state officials over their handling of the pandemic, a federal judge has ruled.Credit…Ricardo Nagaoka for The New York Times

Inmates in Oregon’s prisons, where coronavirus infections and deaths have been rising for months, have the legal right to sue state officials over their handling of the outbreaks, a federal court judge has ruled.

The ruling this month by Stacie Beckerman, a magistrate judge, is believed to be the first in the nation to allow state officials — including the governor and top prison officials — to be held accountable in court for failing to adequately protect prisoners from the virus.

If such lawsuits succeed, Oregon may ultimately be forced to pay damages, and prisoners in other states may follow the same legal road.

State prison officials around the nation have acknowledged that they have taken a trial-and-error approach to the pandemic, one that has failed to stop the virus from penetrating any state prison system in the nation, according to a New York Times database. As of Tuesday, there had been almost 265,000 confirmed infections and more than 1,600 Covid-19 deaths among inmates in state prisons, according to the database.

Indications that a prison took inadequate precautions might include anything from not requiring guards to wear masks to testing too few inmates, according to the court ruling.

In May, the Supreme Court denied a request from two inmates in a Texas geriatric prison to reinstate a trial judge’s order instructing officials to take steps to protect them from the coronavirus. But Juan Chavez, one of the lawyers representing prisoners in the Oregon lawsuit, said the Texas case was different.

The Texas prisoners were asking the court to order officials to act to prevent the spread of the virus, Mr. Chavez said. The Oregon lawsuit, however, includes a claim for money damages because the prisoners believe state leaders did too little to protect their health.

The Oregon Department of Corrections declined to comment on the lawsuit on Tuesday.

Advocacy groups and prisoners’ families have pressed the state to release many inmates to slow the spread of the virus, as some other states have done. But since March, only 247 people have had their sentences commuted, according to the department.

Bonnie Grady, whose son, Matthew Yurkovich, is incarcerated at the Snake River Correctional Institution in Ontario, Ore., said that prisoners slept within a few feet of one another and had limited access to cleaning supplies, and that guards did not always wear masks.

Ms. Grady said that in the spring, her son lost his sense of smell and taste, a symptom associated with the coronavirus, but that he was never tested. “If I did my job as poorly as the prison did their job with the virus, then I would have lost my job,” she said.

Nearly 2,200 prisoners and 500 correctional officers have been infected in Oregon state prisons, including more than 460 inmates at Snake River, according to state records. Twenty-one prisoners statewide have died. Coronavirus cases surged in the state prison system after wildfires in September forced the evacuation of several prisons.



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