Here’s what you need to know:Waiting in line for injections at a drive-through vaccination site in David, Fla., on Wednesday.Credit…Scott McIntyre for The New York Times

Dr. Anthony S. Fauci, the top infectious disease expert in the United States, predicted on Thursday that the daily death toll from the coronavirus would continue to rise for weeks to come, and counseled patience with the vaccination program gearing up across the nation.

Health officials in the United States reported nearly 4,000 virus-related deaths on Wednesday, a record, and the total for the pandemic surpassed 360,000. In an interview with NPR, Dr. Fauci said the continued high toll would probably be a reflection of increased travel and gatherings over the holidays.

“We believe things will get worse as we get into January,” he said.

He stressed that it was still possible to “blunt that acceleration” by strictly adhering to public health measures like social distancing and mask-wearing.

“Now’s not the time to pull back on this,” he warned.

The virus has exacted a punishing toll across the United States. In recent days, Wyoming and Arizona been among states that have recorded high per capita rates of virus deaths, according to a New York Times database. On Thursday, Florida reported more than 19,800 cases, the state’s highest single-day total.

Dr. Fauci advised Americans to be patient with the snags and delays that have slowed the vaccination effort and provoked widespread frustration.

So far, at least 5.9 million people in the United States have received a dose of one of the two Covid-19 vaccines that have been authorized for use, according to the Centers for Disease Control and Prevention. That figure is far short of the goal federal officials had set to give at least 20 million people their first shots by the end of December.

Dr. Francis S. Collins, the head of the National Institutes of Health, said Wednesday he was “not totally surprised” that vaccine distribution had gotten off to a “rocky” start.

“We had this remarkable plan that Warp Speed had put in place to have doses ready to go the very next day after the F.D.A. approval, but that’s a lot of logistics,” he told The Washington Post, referring to Operation Warp Speed, the administration’s vaccine development program. “So maybe we shouldn’t be too shocked that it didn’t go like clockwork.”

He also echoed Dr. Fauci’s warning, and said “the next couple of weeks are going to be really critical.”

But the rollout is beginning to accelerate. More people were reported as having received their initial shots in the third week of the vaccine drive than in the first two weeks combined. The C.D.C.’s count rose by 470,000 between Tuesday and Wednesday. and then by another 612,000 between Wednesday and Thursday.

In a letter on Thursday to Alex M. Azar II, the secretary of health and human services, the American Hospital Association called on the federal government to do more to coordinate what is being done in different states and municipalities.

“Hospitals are committed to be a central part of the vaccination effort, but hospitals alone cannot do it, especially as we care for burgeoning numbers of critically ill Covid-19 patients, and struggle to maintain sufficient staffing work to have enough personal protective equipment and other resources,” Richard J. Pollack, chief executive of the association, wrote in the letter.

Mr. Azar urged the states on Wednesday not to stick too rigidly to the C.D.C.’s guidelines on whom to vaccinate in what order.

“There is no reason that states need to complete, say, vaccinating all health care providers before opening up vaccinations to older Americans or other especially vulnerable populations,” Mr. Azar said at a news conference. He added that, “It would be much better to move quickly and end up vaccinating some lower-priority people than to let vaccines sit around.”

In the NPR interview, Dr. Fauci said that any program on so large a scale would have to overcome stumbling blocks, and that the timing of the rollout, which began around the December holidays, may have added to the delays.

“I think it would be fair to just observe what happens in the next couple of weeks,” he said. “If we don’t catch up on what the original goal was, then we really need to make some changes about what we’re doing.”

United States ›
United StatesOn Jan. 6
14-day change

New cases
255,728
+8%

New deaths
3,964
Flat

World ›
WorldOn Jan. 6
14-day change

New cases
785,681
+1%

New deaths
14,266
–5%

Where cases per capita are
highest

A worker in September at a factory producing Sinovac’s coronavirus vaccine in Beijing.Credit…Wang Zhao/Agence France-Presse — Getty Images

Brazilian officials said Thursday that a coronavirus vaccine made by a Chinese company was effective, bolstering the chances of approval for a second Chinese inoculation that could be rolled out in much of the developing world.

Officials in the state of São Paulo, where a prominent medical research institute carried out a large study of the vaccine made by the Beijing-based Sinovac, said the inoculation had an efficacy rate of 78 percent.

The vaccine prevented all participants from developing serious and mild complications from the virus, officials said, calling it a highly effective preventive tool.

In anticipation of approval, the vaccine, called CoronaVac, has already been shipped around the world as countries prepare for mass inoculation campaigns. Sinovac has sold more than 300 million doses, mostly to low- and middle-income countries, accounting for about half of the total doses that China says vaccine makers were capable of producing in 2020, based on an analysis of company statements and media reports.

China has set its sights on supplying the developing world with a Covid-19 vaccine, in a push to position itself as a leader in health diplomacy after its failures in the early days of the outbreak. It also wants to burnish its credentials in science by becoming a major player in the global vaccine business.

Even without the regulatory greenlight, China has embarked on an aggressive vaccination drive at home, with the goal of inoculating 50 million people by the middle of next month. Beijing has also developed an overseas distribution plan for exports, directing airlines to stock up on refrigerators and dry ice.

China is filling a void in poorer nations left by Western competitors. The United States is mainly focused on working through the chaos of distributing its vaccines at home. The European Union and other rich countries have bought many of the doses supplied by the American drugmakers Pfizer and Moderna.

The Chinese have been eager to get out in front, aware of the gap and the hoarding and pre-purchase of so many billions of doses by the Western governments that is leaving so many countries high and dry,” said J. Stephen Morrison, director of the global health policy center at the Center for Strategic and International Studies.

“It will become a tool in their diplomatic alliances, and it will give them some measure of prestige and standing with countries that choose to make use of them,” he added.

Credit…Eric Gay/Associated Press

State and federal officials are warning consumers about potential fraud involving the coronavirus stimulus payments that are now being distributed by check and direct deposit.

The Better Business Bureau said Wednesday that people receiving the payments should beware of calls or text messages seeking personal information that could leave their accounts vulnerable.

Callers might imply they are government employees, and text messages might direct consumers to click on a link leading to requests for personal information.

While many Americans have already received the second round of aid, many others are still waiting for their money.

The bureau said it had heard from numerous consumers complaining they had been contacted by potential fraudsters.

This is not the first time officials have warned of fraud linked to the pandemic. In April, the Federal Bureau of Investigation issued a warning about scammers looking to sell false coronavirus tests, cures, treatments and vaccines.

Similar alerts were issued in June, including the F.B.I.’s warning of scammers’ using advertisements for fraudulent Covid-19 antibody tests as a way to obtain information they could use for identity theft or medical insurance fraud. The Federal Trade Commission also alerted consumers about scammers pretending to be contact tracers, as did the Internal Revenue Service about frauds involving government stimulus payments.

Attorneys general in several states, including West Virginia and Florida, added their warnings to the chorus on Tuesday.

“As we have seen throughout the pandemic, bad actors are looking for ways to exploit the crisis to steal money, government benefits and people’s identities,” Ashley Moody, attorney general of Florida, said in a statement.

Here’s how authorities advise that consumers respond when they suspect fraud:

They should not trust calls claiming to be from government agencies and should use caution when receiving other unsolicited phone calls, text messages and emails.

They should avoid responding to text messages, emails or advertisements directing them to click on links, nor should they provide any personal or financial information in response to an unsolicited message.

Consumers should be wary of requests that they pay a fee to receive their checks.

VideoFacing a rapid rise in coronavirus cases, Prime Minister Yoshihide Suga of Japan declared a state of emergency for Tokyo and three surrounding prefectures.CreditCredit…Pool photo by Kiyoshi Ota

TOKYO — Japan declared a state of emergency in Tokyo and three surrounding prefectures on Thursday, after days of record coronavirus counts and a rapidly rising death toll. It was Japan’s first emergency declaration because of the pandemic since April.

The announcement came five days after governors from the affected prefectures had pleaded with the central government to act. Prime Minister Yoshihide Suga, reluctant to hurt the economy, had hesitated to invoke the emergency measure, but he eventually bowed to the pressure.

Deaths from the virus in Japan have doubled in less than two months, passing 3,700, and Tokyo’s governor has warned that the medical system is under stress. Polls have shown widespread dissatisfaction with Mr. Suga’s four-month-old administration and its handling of the pandemic.

The emergency declaration, which will last one month, relies mostly on voluntary compliance, and health experts warned that it might not be enough to turn the tide.

The government is asking restaurants to close by 8 p.m., employers to encourage staff members to work from home, and residents to refrain from going out for all but the most essential tasks — also after 8 p.m. Schools, museums, cinemas, gyms and shops will stay open.

Japan has reported a total of 258,393 cases, far fewer than many Western countries. After it emerged in May from its previous, brief state of emergency, it held up what it called the “Japan model”: an intense focus on contact tracing and cluster busting, widespread mask wearing and as few restrictions on the economy as possible.

But as Japan has experienced several record-setting days for new infections since late last month — Tokyo reported over 2,000 cases on Thursday, and the country a record 5,953 — its coronavirus-fighting model has come under strain. Japan is not expected to start inoculating the public until at least the end of February, a process that will take months.

“We are having too many cases to trace right now, and the state of emergency is coming too late,” said Fumie Sakamoto, an infection control manager at St. Luke’s International Hospital in Tokyo. She said the hospital’s intensive care beds and general wards were full.

A medical worker administered the Covid-19 vaccine to a doctor in Vannes, France, on Thursday.Credit…Stephane Mahe/Reuters

French officials vowed to speed up their vaccination campaign on Thursday, but warned that restrictions and curfews would remain in place in order to halt a rise in infections and hospitalizations.

“2021 will be the year of hope,” Jean Castex, the prime minister, said at a news conference, citing the vaccine, which has been administered to about 45,000 people in France so far.

But he added: “It is out of the question that we drop our guard in the coming weeks.”

Mr. Castex said that the number of new daily infections was still high — hovering around 20,000 — and pressure on hospitals was still acute, with nearly 25,000 Covid-19 patients hospitalized around the country.

Mr. Castex announced that cultural establishments that are currently closed, like museums, movie theaters and music halls, would remain shuttered until the end of January at least, and that bars and restaurants would not reopen before mid-February at the earliest — dashing the hopes of the service industry, which was still hoping to reopen on Jan. 20, as previously scheduled.

An 8 p.m. to 6 a.m. curfew will also remain in place for the time being, Mr. Castex said. In 15 areas of France, that curfew has already been tightened to 6 p.m., and could be similarly restricted in the coming days in 10 new areas. Mr. Castex said he could not rule out new nationwide restrictions, but he added that schools would only close again if the situation became particularly dire.

Mr. Castex also addressed a barrage of criticism over the government’s sluggish vaccination rollout, acknowledging that it had started slower than in other countries but attributing the delay to France’s initial focus on retirement and nursing homes.

Still, the government vowed to speed things up, promising that at least 1 million people would be vaccinated by the end of the month and announcing that all people older than 75 would be eligible for vaccinations starting Jan. 18.

“We are doing everything to enable you to get vaccinated in good conditions,” Olivier Véran, the health minister, said at the news conference, adding that vaccination centers would soon open around the country and that people would be able to go through a simplified sign-up procedure to get their shots.

Mr. Véran also announced that French health authorities had approved administering the second Pfizer vaccine shot up to six weeks after the first shot, instead of the recommended three-week interval.

France also announced on Thursday evening that health authorities had detected two clusters of the new, more transmissible variant of the virus that was first identified in Britain. The clusters were in the Ile-de-France region, where Paris is, and in Brittany. Overall, French health authorities have reported 19 cases of the variant in France, and three cases of a different one first detected in South Africa.

“We want to avoid the spread of this variant in France at all costs,” Mr. Véran said of the British variant, adding that health authorities were closely monitoring it.

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New York City Clashes With State on Vaccinating Police OfficersMayor Bill de Blasio said the state halted New York City’s plans to vaccinate large numbers of police department employees, and called on the state to give local governments more flexibility vaccinating residents.

Yesterday, I told you about new state rules that had come out that we interpreted, we think very clearly, very appropriately, very legally, to mean that we could vaccinate our correction officers, that we could vaccinate our police officers who respond to 911 calls, who have to administer CPR, who have to administer Narcan to stop someone from overdosing. The folks who at any moment could be in very close, intimate proximity with another person. And obviously another person who could have Covid. We were ready to go and do a huge vaccination effort at Department of Correction and the N.Y.P.D. We were told by the state that they would not allow that. They are allowing a smaller percentage, several thousand N.Y.P.D. medical corps members, and we’re going ahead with those vaccinations. But we really think the rules couldn’t be clearer. So I want to show you the city definition and the state definition on the screen to give you a clear sense of why we believed it was absolutely right to go ahead and vaccinate our patrol officers, so many of whom are ready, willing and able to be vaccinated. And we could vaccinate in a matter of days. Look at the definitions for yourself. I don’t think it’s at all gray. Why don’t we just resolve this and give the City of New York the freedom to vaccinate high-priority people as we see fit so we can speed up the vaccination process? By the way, I know this is true all over the state of New York. I know county executives, county public health officials are just asking for the freedom to vaccinate. We understand what we can do on the ground in our own communities. Give us that freedom because everyone agrees on one thing. We want the maximum number of high-priority people vaccinated. Sometimes the federal government, the state government need to stand back and let local government do what it knows how to do best.

Mayor Bill de Blasio said the state halted New York City’s plans to vaccinate large numbers of police department employees, and called on the state to give local governments more flexibility vaccinating residents.CreditCredit…James Estrin/The New York Times

Only a sliver of Police Department employees will be eligible for vaccination in New York City, Mayor Bill de Blasio said on Thursday, despite pledging earlier to vaccinate 10,000 members by the end of the week.

The change came after Mr. de Blasio said Wednesday that the state approved vaccines for some home care workers, Department of Corrections employees and other city staff members in emergency response or medical roles — including 25,000 police personnel.

“Yesterday I told you about the new state rules that have come out that we interpreted very clearly, very appropriately and very legally to mean we could vaccinate our corrections officers and that we could vaccinate our police officers,” Mr. de Blasio said Thursday. “We were told by the state they would not allow that.”

Under the state’s direction, the mayor said, only several thousand New York City medical corp. officers are currently eligible to be inoculated. Mr. de Blasio has urged Gov. Andrew M. Cuomo to expand the pool of people eligible for vaccines so that it could include seniors over the age of 75 as the city’s vaccine rollout remains sluggish.

The governor defended the state’s approach on Thursday, arguing that the state did not yet have enough supply to move to the next priority group and that police officers did not qualify as health care workers simply for being trained in C.P.R.

Mr. Cuomo said that the 900,000 or so doses the state had received so far were not enough to inoculate the estimated 2.1 million health care workers statewide who he said are part of the highest priority group, known as Phase 1A.

The governor said the state has administered 430,000 vaccines to date and had ramped up the pace of vaccinations this week, from 30,000 doses administered on Monday to about 50,000 doses expected to be administered on Thursday.

State officials said New York City had administered only 144,000 doses out of the 304,000 it has received since December — less than 50 percent — even though state officials said 917,000 city health care workers could receive the vaccine under Phase 1A.

On Thursday, Mitchell Katz, the head of the city’s public hospital system, NYC Health and Hospitals, said that workers in the hospital system who want to be vaccinated had been reached and that it was time to move on to other eligible groups.

“As the days moved on, we found that the demand, after all the people who most wanted it passed, the demand began to decrease,” Mr. Katz said. “We now have appointments available and we don’t have arms to give that injection to.”

Thousands of appointments to receive a vaccine were available, the city’s health commissioner, Dr. Dave A. Chokshi, said Thursday. On Saturday, eligible health care workers can begin booking appointments at the two massive vaccination sites opening on Sunday. These sites, one in Brooklyn and the other in the Bronx, will operate seven days a week, day and night.

“Everyone agrees on one thing, we want the maximum number of high priority people vaccinated,” Mr. de Blasio said. “Sometimes the federal government and the state government need to stand back and let the local government do what it knows how to do best.”

The governor and the mayor’s quarrel on vaccines was on full display on Thursday as each official blamed the other this week and aides to both leaders squabbling on Twitter over how to most efficiently distribute the vaccine.

The mayor’s plea has come as some federal officials have urged states not to stick rigidly to Centers for Disease Control and Prevention guidelines about whom to vaccinate first.

“There is no reason that states need to complete, say, vaccinating all health care providers before opening up vaccinations to older Americans or other especially vulnerable populations,” Mr. Azar said at a news conference on Wednesday. He added that, “it would be much better to move quickly and end up vaccinating some lower-priority people than to let vaccines sit around.”

Socially distanced seating for jurors in a Manhattan courtroom for a trial that was set to start in October.Credit…Jefferson Siegel for The New York Times

With coronavirus cases shattering records in much of the country, court officials in areas where jury trials had resumed are suspending them again. And experts say the suspensions could last months, swelling a backlog of untried cases.

In Florida, officials in Hillsborough and Pinellas Counties said Tuesday that they were halting jury trials. In California, Riverside County extended its suspension until the end of January. And in Arkansas, the U.S. District Court for the Eastern District has announced that it will not hold jury trials until March 23 at the soonest.

“Even with screening, distancing, masking, rearranged spaces, extra cleaning, and increased ventilation, the risk associated with extended gatherings this size remains substantial,” the chief judge of the court in Arkansas, D. Price Marshall Jr., wrote in an administrative order.

California, Florida and most other states have no statewide public health orders in place barring jury trials, leaving the issue to be determined locally based on local conditions, according to the National Center for State Courts.

Arkansas, New Mexico and Idaho have suspended state jury trials through January, according to the center; Tennessee and four other states have suspended them through February or March; and the District of Columbia and eight states have suspended them indefinitely, including Idaho, where the Supreme Court called them off in mid-December.

Paula Hannaford-Agor, the director of the Center for Jury Studies at the N.C.S.C., said there seemed little prospect of suspensions ending soon.

“The way things are looking right now, which are frankly awful,” Ms. Hannaford-Agor said, “my anticipation is that there will be few to no jury trials probably for another two months.”

Much depends on the speed and effectiveness of vaccination programs, she said.

The new chief justice of North Carolina, Paul Newby, said Wednesday that he had asked Gov. Roy Cooper to speed up vaccination of court personnel. “Access to justice through the courts is not a luxury — it’s a mandate,” Justice Newby said.

The inability to conduct jury trials has wreaked havoc with the dockets of many courts, including those of New York City, where only nine criminal jury trials were completed between March and the end of November.

“What is this going to look like when things start back up and there’s a huge backlog?” Ms. Hannaford-Agor said. “It’s going to be a mess.”

Paramedics in Los Angeles County loading a potential Covid-19 patient into an ambulance before transporting him to a hospital in Hawthorne, California last month.Credit…Apu Gomes/Agence France-Presse — Getty Images

With hospitals in Los Angeles County swamped with Covid-19 patients, a memo that went out to the county’s ambulance crews last week caused public alarm and prompted explanations from medics on social media about their care practices.

In the memo, a slightly updated version of which was released on Monday, the county Emergency Medical Services Agency instructed the crews not to transport most adult patients whose hearts had stopped beating to a hospital if resuscitation in the field was unsuccessful or if the patients met established criteria for declaring death.

The measure was needed “due to the severe impact of the Covid-19 pandemic on E.M.S. and 9-1-1 receiving hospitals,” Dr. Marianne Gausche-Hill, the agency’s medical director, wrote in the directive.

What the memo actually reflected, though, was an effort to spare overburdened emergency rooms from having to spend time and resources on patients who were already beyond their help. And rather than a dire last resort, it was actually a relatively small change from the county’s previous policy, which already discouraged emergency personnel from taking most patients whose heartbeats could not be restored where they were found to the hospital.

“Although this has been in place, paramedics have been transporting some of these patients to emergency departments,” Dr. Gausche-Hill wrote in an email in response to questions about the policies. “We suggest that they don’t,” she continued, because “the emergency department would not offer any additional therapeutic interventions.”

She added that the policy allowed exceptions for cases where the scene was unsafe or when emergency crews had particular concerns that need to be discussed with a physician.

Ambulances used to regularly rush patients without a heartbeat to a hospital, a practice known as “scoop and run,” but that changed about a decade ago, according to Dr. David K. Tan, president of the National Association of E.M.S. Physicians.

These days, he said, “the standard of care is to understand that cardiac arrest is an E.M.S. problem, it’s not a hospital problem, and that a patient’s chances of survival are better to work them where you find them.”

Several medics around the country, like Kari Dickerson, a paramedic in Kentucky who tweets as @MedicTrommasher, jumped into social media to try to quell anxieties about the directive they believed were unfounded.

“The people I saw most upset were Black and brown people,” said Ms. Dickerson, who said that she had to explain to her parents that “this is stuff we already do.” She said that she read posts by people expressing fears that “medics were just going to leave people on the floor” and that “E.M.S. was the one deciding who would live and who would die, who was worthy.”

In many places around the country, EMS hasn’t been transporting OOH-CAs for several years. EBM has proven time and time again that if EMS can’t get a pulse back, the likelihood of the ER getting pulses is very, very low…

— Shao Trommashere (@MedicTrommasher) January 1, 2021

Ms. Dickerson said she was concerned that these misunderstandings could lead to anger at personnel who had to break the news that someone had died, with families wondering, “Did they do this on purpose, did they not work as hard as they would have for somebody that looks like them?”

She added, “People are already worried that there’s some hierarchy of who gets care even prior to a pandemic, and now that we’re in it, it’s even worse.”

Research shows that once E.M.S. had attempted without success to resuscitate them, patients like those described in the Los Angeles directive rarely live, even if transported to a hospital, said Dr. Jeffrey M. Goodloe, a director of the American College of Emergency Physicians.

“None of us, ever, want to withhold the chance of survival from someone that is depending upon us,” said Dr. Goodloe, who is also chief medical officer for an E.M.S. system covering Oklahoma City and Tulsa.

So for areas where hospital wards are overflowing and empty beds are scarce, he said, “the best advice we can give somebody is work to keep yourself well so you don’t need E.M.S. care, or emergency department care, or hospital based care.” He added, “Prevention is more important than ever.”

A mob of Trump loyalists after forcing their way into the Capitol on.Credit…Reuters

The mob that stormed the Capitol yesterday did not just threaten the heart of American democracy. To scientists who watched dismayed as the scenes unfolded on television, the throngs of unmasked intruders who wandered through hallways and into private offices may also have transformed the riot into a super-spreader event.

The coronavirus thrives indoors, particularly in crowded spaces, lingering in the air in tiny particles called aerosols. If even a few of the pro-Trump extremists were infected — likely, given the current rates of spread and the crowd size — then the virus would have had the ideal opportunity to find new victims, experts said.

“It has all the elements of what we warn people about,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles. “People yelling and screaming, chanting, exerting themselves — all of those things provide opportunity for the virus to spread, and this virus takes those opportunities.”

President Trump has downplayed the pandemic almost since its beginning, and many of his supporters who entered the Capitol yesterday did not appear to be wearing masks or making any effort at social distancing. Under similar conditions, gatherings held in such close quarters have led to fast-spreading clusters of infection.

Similar concerns were raised by the Black Lives Matter protests in the summer. But most of those were held outdoors, and greater numbers of participants seemed to be masked. Research afterward suggested that they were not super-spreading events.

But hundreds of rioters shouting in crowded rooms and hallways for extended periods of time can infect dozens of people at once, Dr. Rimoin and other experts said.

The melee was most likely a super-spreader event, said Dr. Joshua Barocas, an infectious diseases physician at Boston University, “especially given the backdrop of the highly transmissible variants that are circulating,”

The prospect that members of Congress may have been exposed, amid an already difficult transfer of power, particularly disturbed some scientists.

“I am worried not only that it could it could lead to super-spreading, but also super-spreading to people who are elected officials,” said Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins University.

Representative Jake LaTurner, Republican of Kansas, announced on Twitter early Thursday morning that he had tested positive for the virus. Mr. LaTurner was cloistered in the chamber with other members of Congress for much of the day.

People walking on the University of Michigan campus in Ann Arbor in November.Credit…Erin Kirkland for The New York Times

The spread of the coronavirus accelerated sharply in U.S. counties where large universities held classes in person last fall, federal health researchers reported on Wednesday.

Incidence rates in those counties rose more than 50 percent in the first three weeks after classes started, compared with the previous three-week period, according to a new study by the Centers for Disease Control and Prevention. By contrast, infection rates declined in counties without large universities or where large universities held classes remotely last fall, the study said.

The findings come as many students who were home for the holidays prepare to return to campus. They will converge on college towns at a time when the virus is surging in many parts of the country, overwhelming hospitals and straining health care services.

At least 3,964 new coronavirus deaths and 255,728 new cases were reported in the United States on Wednesday, according to a New York Times database.

C.D.C. researchers focused on 101 counties with nonprofit universities that enroll 20,000 students or more and where classes started between July 27 and Aug. 28. The researchers defined remote learning as instruction that appeared to minimize in-person class work on campus; the definition allowed for some in-person instruction for lab and studio courses or for small groups with specific needs.

The incidence of new coronavirus cases was generally declining in early August, the researchers said, though rates among adults aged 18 to 22 were on the rise. Infection rates went on falling — by an average of 18 percent — where large universities chose to teach remotely, the researchers found, but the rates shot up where in-person instruction was underway.

The researchers did not take account of whether students were physically present on campus, even if classes were being held remotely, Dr. Lisa Barrios, a member of the C.D.C.’s Covid-19 response team, pointed out. As a result, she said, it was hard to know whether the large decreases in remote-learning counties happened because fewer students were physically present, or because the universities did other things as well, like impose rigorous mask mandates and bans on social gatherings.

The study also compared counties with large universities teaching in person against counties less than 500 miles away with about the same total population but no large university, and found similarly sharp differences in virus incidence: an 80 percent rise in the university counties, versus a drop of nearly 20 percent in the others.

Dr. Barrios urged universities to increase testing when students return to campus and make adequate provisions to isolate and quarantine infected and exposed students. Students and staff members who catch the virus may increase the risks to people off campus, particularly those who are older or have underlying health problems.

“Most universities don’t exist in a bubble,” Dr. Barrios said. “They are integral parts of their communities.”

Mark Peterson, a firefighter in Salt Lake City, receiving the Moderna Covid-19 vaccine on Tuesday.Credit…Rick Bowmer/Associated Press

Firefighters across the United States, especially those who also serve as emergency medical responders, have begun receiving the Covid-19 vaccine, as states continue to extend their vaccination efforts beyond hospital workers and nursing home residents.

In Philadelphia, where the fire department’s ambulance service is among the busiest in the country, about 100 emergency medical service workers have been vaccinated so far, the city’s fire commissioner, Adam Thiel, said on Wednesday.

Mr. Thiel said the department lost one firefighter to Covid-19 over the summer, and has faced constant staffing shortages as workers have fallen ill or had to quarantine. “We’ve been pretty severely affected,” he said. “It has real world impacts on all of our members and their families.”

Some members of the Philadelphia department are classified in Group 1A, the highest priority for vaccination, and some are in 1B, the next highest. The city does not have nearly enough doses yet to vaccinate everyone in the department, Mr. Thiel said, so for now, only the E.M.S. crews are receiving shots.

At the Des Moines, Iowa, Fire Department, Capt. Brian Davis received his first dose of the vaccine on Tuesday. He said he was eager to be vaccinated because some of his colleagues had been infected with the virus. Firefighters in Des Moines have worn masks and other protective equipment on the job for the past 10 months, he said, and the vaccine is one more step toward protecting their community.

“We see several people a day,” he said. “If we’re not able to keep those precautions, we could possibly infect other people. So it gives you a good feeling that you’re doing everything you can.”

The Des Moines firefighters are all classified as Group 1A. Fire Chief John TeKippe said that roughly 70 percent of the department’s employees have opted to receive the vaccine.

“We’re excited for the additional protection for our employees, but also for the peace of mind for them and their families,” Mr. TeKippe said. “It’s been a long road, and we have a ways to go.”

GLOBAL ROUNDUP

Bangkok on Thursday. Thailand, which had one of the best records in containing the virus, saw a daily spike of 745 new cases on Monday.Credit…Athit Perawongmetha/Reuters

The Thai police issued arrest warrants on Thursday for a husband and wife who helped smuggle and harbor 19 illegal immigrants from Myanmar, including seven who tested positive for the coronavirus.

The 19 immigrants, all Rohingya Muslims, were arrested on Monday at a crowded house near Don Mueang International Airport, which serves Bangkok, where they had been staying. All of them had traveled without work permits and some without passports, the authorities said. Three more illegal workers were arrested in the same area on Wednesday.

The police said that the wife, who is Thai, and the husband, who is Burmese, were wanted for smuggling the workers into the country in three groups. They face up to five years in prison.

Hostility toward people from Myanmar has been soaring in Thailand after a surge in coronavirus cases that apparently started with an outbreak among migrant workers from Myanmar at a seafood market in Samut Sakhon Province, near Bangkok.

Parts of the country, including the Thai capital, are now under severe restrictions. Schools, entertainment venues and sports centers are closed and residents have been advised to work from home, if possible. Officials have stopped short of calling it a lockdown, however, and malls, restaurants and cinemas remain open, with restrictions.

Thailand, which had one of the best records in containing the virus, saw a daily spike of 745 new cases on Monday, the most since the pandemic began. Daily case numbers have declined since then, with 305 new infections reported on Thursday.

Health officials have reported 9,636 cases in total and 67 deaths. More than 1,500 of Thailand’s cases have been detected in quarantine, which is mandatory for travelers arriving from abroad.

In other developments across the world:

South Africa said it had agreed to purchase 1.5 million doses of the Oxford-AstraZeneca vaccine produced by the Serum Institute of India to cover its health workers. A million of the doses are expected to arrive this month and the other half a million in February. The news comes as South Africa experiences a severe second surge of coronavirus infections and deaths, fueled by a new variant that appears to be more easily transmitted. The South African government, which had come under fierce criticism in recent days for failing to secure vaccine doses, had previously announced that it had reserved enough shots for 10 percent of its population of about 60 million through a global mechanism known as Covax. But those doses are not expected to begin arriving until the second quarter of the year.

China said it was imposing a strict lockdown on Shijiazhuang, a city of 11 million in the northern province of Hebei, part of a “wartime” campaign aimed at stamping out a recent rise in coronavirus cases. The decision was made after a small flare-up prompted city officials to begin a mass testing drive that uncovered nearly 130 new cases in two days. Officials said all 11 million residents in the city would be tested, while flights, trains and vehicles have been barred from leaving or entering the city.

The Chinese authorities are also continuing to take a draconian approach to the spread of information about the virus. On Wednesday, the police in Baoding, a city to the northeast of Shijiazhuang in Hebei Province, detained a man for posting a message in a social media chat group saying that more than 200 people had died from the virus in Shijiazhuang. According to a police statement, the man was given six days in detention and a fine of about $15 for spreading rumors.

Miguel Sola, 43, donated hyperimmune plasma at the Regional Transfusion Center in Madrid, Spain, in November 2020.Credit…J J Guillen/EPA, via Shutterstock

Blood plasma from recovered Covid-19 patients can help older adults avoid getting seriously sick with the coronavirus — if the therapy is administered within days of the onset of the illness, a small but rigorous clinical trial in Argentina found.

The results, published Wednesday in the New England Journal of Medicine, are some of the first to conclusively point toward the oft-discussed treatment’s beneficial effects. They arrive nearly five months after the Food and Drug Administration, under pressure from President Trump, gave the therapy an emergency green light for use in people hospitalized with Covid-19.

Thousands of patients have received infusions of plasma in the months since, while researchers waited for the data. The new study is one of the first well-designed clinical trials to show that the therapy has some benefit. “That’s kind of what we have been looking for, in terms of really having evidence,” said Dr. Boghuma Kabisen Titanji, an infectious disease physician at Emory University who was not involved in the research.

Convalescent plasma, the pale yellow liquid left over after blood is stripped of its red and white cells, teems with disease-fighting molecules called antibodies.

The new study, led by Dr. Fernando Polack, a pediatric infectious disease specialist and the scientific director of the INFANT Foundation in Argentina, appears to clarify the circumstances under which plasma performs best.

In 80 people, an infusion of plasma decreased the risk of developing a severe case of Covid by 48 percent, compared with another group of 80 who received a saline solution instead, the study found.

The study’s parameters were strict: Everyone enrolled in the trial was at least 65 years old — a group known to be at higher risk of falling seriously ill. About half of the participants also had health conditions that made them more vulnerable to the virus. And the plasma therapy, which was screened to ensure it contained high levels of antibodies, was always given within three days of the patients’ first symptoms.



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