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Trump Vaccine Chief Casts Doubt on Coronavirus Vaccine by Election Day - The New York Times

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Moncef Slaoui, the chief adviser for the White House vaccine program, said on Thursday that it was “extremely unlikely but not impossible” that a vaccine could be available by the end of October.

In an interview with National Public Radio, Dr. Slaoui, the chief scientific adviser of the Trump administration’s coronavirus vaccine and treatment initiative, called Operation Warp Speed, explained that the Centers for Disease Control and Prevention’s guidance to states to prepare for a vaccine as early as late October — a notification Dr. Slaoui said he had learned of through the news media — was “the right thing to do” in case a vaccine was ready by that time. “It would be irresponsible not to be ready if that was the case,” he said.

However, he described that as a “very, very low chance.”

That message ran counter to the optimistic assertions in recent days from the White House that a vaccine could be ready for distribution before Election Day in November. President Trump, during the Republican National Convention, said a vaccine could be ready “before the end of the year or maybe even sooner.” And he and others have tried to project confidence in a quick victory.

Dr. Slaoui confirmed that the two main candidates, referred to as Vaccine A and Vaccine B, were being developed by Pfizer and Moderna. He said that there was “no intent” to introduce a vaccine before clinical trials were completed, and that trials would only be completed when an independent safety monitoring board, separate from the government, affirmed the effectiveness of the vaccine.

The interviewer, Mary Louise Kelly, raised the timing of a possible vaccine given in the documents the C.D.C. recently sent to public health officials, and asked directly whether the delivery of the vaccine was being motivated by political concerns.

“For us there is absolutely nothing to do with politics,” Dr. Slaoui responded, saying that those involved were working as hard as they could because so many people were dying every day. “Many of us may or may not be supportive of this administration. It’s irrelevant, frankly.”

Though he continued to express doubt that a vaccine would be ready by the end of October, Dr. Slaoui said, “I firmly believe that we will have a vaccine available before the end of the year and it will be available in quantities that can immunize patients, subjects at the highest risk,” including the elderly and those who are working in jobs with high exposure to the virus.

He estimated that there would be enough vaccine by the end of the year to immunize “probably between 20 and 25 million people.” He said that manufacturing would be ramped up so that there would be enough vaccine doses to immunize the U.S. population “by the middle of 2021.”

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Prescriptions for hydroxychloroquine, the anti-malaria drug promoted by President Trump as a treatment for the virus, skyrocketed in March and April after the Food and Drug Administration issued an emergency waiver for its use against Covid-19, but tapered off to more normal levels in May and June, the Centers for Disease Control and Prevention reported on Thursday.

The F.D.A. withdrew its emergency use authorization for hydroxychloroquine (and its less-prescribed sister drug, chloroquine) in June after scientists concluded that its benefits did not outweigh its risks for Covid-19; the review that led to the revocation found more than 100 cases — including 25 deaths — of serious heart disorders in Covid-19 patients taking the drug. Clinical trials also showed it was of little benefit in treating the disease.

Even so, the C.D.C. reported that more than 1.3 million prescriptions — new and refills — were written in March and April, up from about 819,000 during the same period last year. The strong spike in usage suggests the influence that Mr. Trump and emergency waivers from the F.D.A. can have in driving medical decision-making — even in the absence of limited evidence of a drug’s effectiveness.

But perhaps the most striking finding was that “nonroutine prescribers” — specialists who would not typically have a reason to prescribe the drug — wrote more than 75,000 hydroxychloroquine or chloroquine prescriptions in the month of March alone. That is 80 times the number written during March 2019.

Hydroxychloroquine and chloroquine are approved to treat autoimmune diseases like lupus as well as malaria. Mr. Trump, who said he took hydroxychloroquine himself, called it a possible “game changer” and repeatedly promoted it during his daily briefings this spring.

The disease control centers analyzed prescriptions of the drug to gauge the effects of the F.D.A.’s emergency waiver, which was issued March 28 to allow the drugs to be distributed from the national stockpile. “During March and April 2020, nonroutine prescribers accounted for the largest percentage increase in new prescriptions compared with the same period in 2019,” the agency wrote, adding, “The nonroutine prescribing specialties with the highest prescribing volume and growth in March 2020 were ophthalmology, anesthesiology, and cardiology.”

But new prescriptions written by such prescribers have tapered off considerably. In June, roughly 1,900 were written.

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More than 51,000 cases of the coronavirus have been identified at American colleges and universities over the course of the pandemic, including thousands that have emerged in recent days as students returned to campus for the fall.

The New York Times surveyed more than 1,500 colleges, and found that over two-thirds have reported at least one case. More than 100 of the institutions have reported at least 100 cases, including several large public universities in the Midwest and South that have tested aggressively but struggled to contain the spread. Auburn, Illinois State and South Carolina are among at least six universities with more than 1,000 known cases.

Direct campus-to-campus comparisons are not meaningful because of differences in colleges’ size, mission and reporting practices. But it is clear that the pandemic has affected every segment of higher education. Small religious colleges, stand-alone medical schools, Ivy League universities, community colleges and public research institutions have all had significant outbreaks.

The reopening of campuses has led to case surges in several college towns, quarantines at fraternity and sorority houses, and pleas for students to avoid large gatherings. Iowa State scrapped plans to allow fans at its first football game. Virginia Commonwealth had to find more isolation space after a large cluster emerged. And California State University, Chico, sent its students home after dozens of cases emerged in the first days of the fall term.

“I, like you, wish the story of this semester had been much different,” Gayle Hutchinson, the university’s president, wrote in a letter announcing the decision.

Education Roundup

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Gettysburg College in Pennsylvania has ordered its entire student body to quarantine in their dorm rooms, becoming possibly the first American campus to lock down all its students because of coronavirus cases.

The small liberal arts school reported on Tuesday that 24 students had tested positive in the previous two days, a positivity rate of about 7 percent. (The World Health Organization recommends that the positivity rate be 5 percent or lower for 14 days before schools and businesses reopen.)

It then directed all its full-time students — its enrollment is generally about 2,500 — to remain in their rooms except to get takeout meals at campus dining facilities, use the bathroom, go for a coronavirus test or speak with a counselor. The lockdown could last through the end of the week, officials said.

In a letter to students, Julie Ramsey, the college’s dean of students, said that many of the infections “were connected to certain affinity groups or social gatherings.” Some students assert that Greek life organizations holding gatherings for rush week were responsible for the campus’s uptick in positive cases.

Many larger universities have created special isolation housing for students who test positive, or have ordered individual dormitories or fraternity houses to quarantine after outbreaks. But Jo Ellen Parker, a spokeswoman for the Council of Independent Colleges, said she knew of no other college that had asked an entire student body to quarantine in their rooms.

One Gettysburg student, Alexander Bove, a freshman, summed it up starkly: “It’s essentially a prison situation.”

“Our administration goes home to their families,” he said. “They can buy things. They can go to events. And they’re not being held to the same standard as we are.”

Thousands of coronavirus cases have been reported at American colleges and universities in recent day as more students return to campuses.

In other education news:

  • Temple University, which had planned to be online-only for just the first two weeks of classes, said Thursday that it would remain virtual for the rest of the fall term because of the continued spread of the virus. . As of Tuesday, the university had reported 212 active cases among students on and off campus, and none of them had more than moderate symptoms.

  • After testing found “uncontrolled spread” in its fraternity and sorority houses, the Indiana University has told the 2,600 students who live in them to move out and go home if possible. Thirty of the 42 Greek houses and communal living facilities connected with the campus in Bloomington, Ind., were already under quarantine orders, and five have had more than half their residents test positive. The houses were required to have safe living plans in place before opening for the fall, “but many of those plans are proving to be ineffective in adequately providing for the health and safety of the students living in the houses,” the college said in a statement Thursday.

  • The State University of New York at Oneonta closed its campus Thursday, canceling all in-person classes and ordering students to move out less than two weeks after the school opened. Nearly 400 students have tested positive for the coronavirus, according to the school’s Covid-19 dashboard. It is the first New York state school to close its campus after beginning classes.

  • And elsewhere in New York, officials at Syracuse University said they had detected traces of the virus in wastewater coming from one dorm. They ordered students in the dorm to return to their rooms and said all residents and employees who work there would be tested. The university recently placed 23 students under interim suspension for violating campus safety rules, including taking part in a large gathering on the quad, conduct that officials called reckless.

  • A 16-year-old student in Florida was arrested Thursday and accused of bringing the first day of virtual classes in his county to a virtual halt with a cyberattack. On Monday, students in Miami-Dade County, the fourth-largest school district in the United States, students logged on and immediately encountered glitches. “The student admitted to orchestrating eight distributed denial-of-service cyberattacks, designed to overwhelm district networks,” the district said in a statement. It said it believed others were involved.

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Just as Thailand reached 100 days without detecting a locally transmitted case of the coronavirus, health officials announced on Thursday that a man jailed for drug use was found to be infected.

The man, who worked as a D.J. in Bangkok nightclubs, tested positive for the virus on Wednesday, a week after being admitted to a jail in the city. The discovery prompted a lockdown of the detention facility and dozens of inmates and staff members were placed in isolation. So far, no one else has tested positive, officials said.

Thailand is one of the few major countries to reach the 100-day milestone. New Zealand celebrated reaching 100 days last month only to discover a new local outbreak two days later that prompted officials to lock down the city of Auckland.

Vietnam came close to 100 days before discovering an outbreak in coastal Danang that spread throughout the country and claimed 34 lives, Vietnam’s first deaths from the pandemic.

Taiwan, one of the most successful places in containing the virus, has gone more than 140 days without a case of local transmission, with the last case recorded on April 8.

Thai health officials said it was unclear how the 37-year-old man became infected adding that he had not traveled outside the country. He was living with his family in Bangkok and had worked at three locations in the Khao San Road area before reporting to jail on Aug. 26.

Thailand was the first country outside China to discover a case of the coronavirus. As of Friday morning, it had more than 3,400 cases and 58 deaths, according to a New York Times database.

Thailand has succeeded in containing the virus in part by halting the arrival of foreign tourists, which has dealt a major blow to the nation’s economy. Thailand is one of the world’s most popular destinations and tourism makes up about a fifth of the economy.

The discovery of the new case comes as the government is considering opening its borders to select foreign tourists. Under one plan, they would have to undergo 14 days of quarantine at a hotel before being allowed to travel within the country.

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Just days after filming resumed on “The Batman” at studios outside London, it shut down again after its lead actor, Robert Pattinson, tested positive for the virus.

In a statement Thursday, Warner Bros. confirmed that filming was “temporarily paused” and that “a member of ‘The Batman’ production has tested positive for Covid-19, and is isolating in accordance with established protocols.”

Work on the film first shut down in March because of the pandemic, which has staggered the entertainment industry. Filming began last September.

In the title role, Mr. Pattinson, 34, plays a young Bruce Wayne early in his career as the DC comic-book vigilante.

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Pfizer’s chief executive, Dr. Albert Bourla, said the drug-making company is in a “very advanced stage” and should know by the end of October whether the coronavirus vaccine they are developing is safe and effective.CreditCredit...Chandan Khanna/Agence France-Presse — Getty Images

Pfizer’s chief executive, Dr. Albert Bourla, said Thursday that the company expects to know whether its vaccine is effective by the end of October, and that it would apply immediately for approval if that was the case.

His remarks, made to the International Federation of Pharmaceutical Manufacturers and Associations, a global trade group, come as a handful of companies are racing to finish a vaccine that could help end the pandemic, and as scientists have increasingly worried that the Trump administration is pushing prematurely for a vaccine approval before the Nov. 3 presidential election.

Dr. Bourla said that about 23,000 people had enrolled in the company’s late-stage clinical trial, out of a goal of about 30,000, and that “a significant number” of them have received the second booster shot. Half of the participants receive the vaccine, half receive a placebo, and then researchers wait to see how many people in each group develop Covid-19.

If significantly more people get Covid-19 on the placebo than the vaccine, that is evidence that the vaccine is effective. The F.D.A. has indicated that vaccine makers should aim for 50 percent protection in order to be considered effective.

“If we have enough events, we may be able to say the product is safe and efficacious in the October time frame and submit it immediate for approval or authorization,” Dr. Bourla said.

Two other companies, Moderna and AstraZeneca, are in late-stage trials in the United States, but neither has laid out a similarly aggressive timeline, instead saying they expect to have a vaccine by the end of the year.

In planning documents sent last week to public health agencies around the country, the Centers for Disease Control and Prevention described preparations for two coronavirus vaccines they refer to simply as Vaccine A and Vaccine B. The technical details of the vaccines, including the time between doses and their storage temperatures, match well with the two vaccines furthest along in clinical tests in the United States, made by Moderna and Pfizer.

Here’s what you need to know about how the vaccines work, how they’re being tested and how they might be rolled out to the public — if, and it’s still a big if, they are proven to work.

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It was an unusual agricultural venture: a shipping container on the edge of a parking lot, packed with vertically stacked shelves where hydroponic lettuce, sprouts and other vegetables grew under LED lights. And the timing of its first sales — during the early days of Malaysia’s coronavirus outbreak — seemed less than ideal.

“We weren’t too sure if it would take off,” said Shawn Ng, 28, a co-founder of the vertical farm, the Vegetable Co., in Kuala Lumpur, Malaysia’s largest city. “But somehow the market kind of played in our favor.”

As in-person shopping wanes during the pandemic, Mr. Ng’s operation is one of many small farms around the world that are selling fresh produce directly to consumers in ways that bypass brick-and-mortar grocery stores. In Malaysia, many people have also been avoiding crowded “wet markets,” where fresh fruit and vegetables, as well as meat and fish, are sold from stalls.

“I was very ‘kan cheong’ during the lockdown period,” said one of Mr. Ng’s regular customers, Ayu Samsudin, using a Cantonese word for anxious. “Having fresh vegetables delivered to your doorstep was such a relief.”

Revenue at the Vegetable Co. grew 300 percent in its first few weeks, and the shipping container is now approaching production capacity because of high demand, said Mr. Ng’s business partner, Sha G.P.

The coronavirus took off in Malaysia in March, after an Islamic revivalist group’s gathering there became one of the pandemic’s biggest vectors in Southeast Asia. Since then, the country of about 32 million has weathered the outbreak relatively well. As of Thursday, it had reported fewer than 10,000 confirmed cases, according to a New York Times database.

But even though most businesses have reopened after an initial lockdown, many urban Malaysians have maintained their online shopping habits, said Audrey Goo, the founder of MyFishman, an e-commerce platform whose sales have roughly doubled.

“Not many end users are willing to go back to the wet market,” she said. “So I think the whole business model will continue to change.”

Global roundup

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Returning to school this fall has been fraught for parents everywhere. But in Spain, a message from the leader of the Madrid region that all schoolchildren would probably end up with the coronavirus was particularly alarming.

Speaking to a local radio station, Isabel Díaz Ayuso, who heads the Madrid region’s government, said Wednesday that it was “probable that all children would get infected, one way or another.”

But, she added, school was probably as safe as any place to be as a child was just as likely to catch Covid-19 at a family weekend gathering, or while out in the park.

“We don’t know, because the virus is everywhere,” she told esRadio. Ms. Díaz Ayuso did not say what scientific evidence she used to predict that the infection rate would be so high among children.

Madrid is once more the epicenter of Spain’s virus pandemic, accounting for almost one quarter of the 1,830 patients hospitalized in the country in the past week.

In response, Madrid is now requiring testing of all teachers returning to school, as is the case in other regions.

The result on Wednesday was chaotic: huge queues of school staff outside packed test centers forced the testing process to be suspended.

As the situation worsens in Madrid, some other regional leaders have been voicing their concerns about allowing residents from the capital region into their towns.

But Salvador Illa, Spain’s health minister, on Thursday ruled out the idea of imposing a lockdown around the Madrid area.

In other developments from around the world:

  • New Zealand on Friday reported its first death from the coronavirus in more than three months, after a man in his 50s who contracted the virus in Auckland died in a hospital. The country, which had previously come close to eliminating the virus, has recently seen a small spike in cases from an unknown source. “We have always recognized that further deaths linked to Covid-19 were possible,” said Dr. Ashley Bloomfield, the director-general of the Health Ministry.

  • Doctors in South Korea on Friday agreed to end a two-week strike after the government committed not to push through medical system overhauls until after the coronavirus subsided. Thousands of doctors, mostly interns and residents, have been on strike since Aug. 21, protesting the government’s plan to increase the number of medical school students and open public medical schools. In a deal signed Friday, the Health Ministry and the Korea Medical Association, a lobby for doctors, agreed to revisit and review the government’s proposals after the epidemic is over. Some doctors criticized the deal as insufficient and threatened to continue their walkout.

  • The Czech Republic reported 650 new cases on Thursday, its highest single-day increase.

  • Turkey will impose restrictions on weddings and other social events amid a surge in new cases. The daily number of cases has reached almost 1,600 in the last week.

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With the pandemic still raging as fall approaches, the government’s efforts to support development and deployment of a variety of testing methods are a rare if belated bright spot amid widespread failures to contain the coronavirus.

In the latest round of U.S. government backing, the National Institutes of Health said on Wednesday that it was providing nine more companies with $123.3 million from a $2.5 billion pot of money allocated last spring by the stimulus bill to support testing. That will bring the total amount disbursed so far by the N.I.H. to $372 million across 16 companies.

The goal is to support production of a broad spectrum of tests, making them more widely available and perhaps ultimately as easy to use as a home pregnancy test. Tests must show that they meet the Food and Drug Administration’s standards for safety and accuracy before they can be sold.

“It’s going to be a wonderful competition,” Dr. Francis S. Collins, the N.I.H. director, said in an interview on Tuesday evening.

Yet even as the government helps rush new tests to market, the administration continues to issue conflicting — and sometimes flatly contradictory — messages about how many and what types of tests are needed, when they should be administered and to whom.

President Trump has long derided testing, complaining that it drives up the number of confirmed cases. The lack of a clear national strategy has confused the public, deeply frustrated public health officials and befuddled pharmaceutical executives.

But as testing options have multiplied, easing some of the shortages and laboratory bottlenecks that hampered the early response to the pandemic, universities, employers, state and local governments and other institutions have been increasingly filling in some of the vacuum left by the administration with their own testing plans.

In a recent interview, Dr. Bruce J. Tromberg, who directs the N.I.H.’s test development program, estimated that the United States needed to test about six million people a day, citing reports by experts at the Rockefeller Foundation and other organizations. Without federal assistance, he said, companies would at best produce only half that number by the end of the year.

Trump administration officials like Adm. Brett P. Giroir, the testing czar and an assistant secretary of health, say they want states and localities to create their own testing plans that fit their specific needs rather than to be forced to follow federal dictates. But many experts complain that the lack of federal decision-making — including how many tests a day the United States should aim for — is an impediment in the nation’s battle against the virus, which so far has killed more than 184,000 people and infected more than six million.

“Let’s not just say we are ramping up and hope we get there. Let’s have a goal in mind,” said Dr. Mark McClellan, the director of the Duke-Margolis Center for Health Policy and the commissioner of the Food and Drug Administration under former President George W. Bush. “It’s not just a matter of getting the tests to market.”

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Tech stocks stumbled sharply on Thursday, causing the S&P 500 to close with its worst drop since June.

The S&P 500 dropped 3.5 percent, while the tech-heavy Nasdaq composite was down nearly 5 percent. The Dow Jones industrial average briefly lost 1,000 points and ended the day down more than 800 points. Apple was down 8 percent. Amazon was down more than 4.5 percent, and Microsoft was down more than 6 percent.

As investors bet that the coronavirus crisis would amplify the dominance of the tech companies’ business models, share prices of large-cap technology companies have surged, generating the lion’s share of the stock market’s gains.

The rip-roaring race for tech shares has increasingly pulled in armchair investors, who have taken up speculating on stocks amid the work-from-home environment. Many of those traders have opted not to buy actual shares but instead to speculate in options trades, which are essentially leveraged bets on where share prices will go.

Analysts say dealers have rushed to boost their bets on falling shares in recent days in an attempt to hedge their risks, amplifying the sell-off in technology shares.

“I think today for tech stocks, you’re seeing that dynamic play out,” said Yousef Abbasi, director of U.S. institutional equities at StoneX, a brokerage firm.

Amid a turbulent market, the number of U.S. workers filing new state jobless claims remained at a historically high level last week, though it is gradually falling.

The government reported on Thursday that 833,000 workers filed new claims for state unemployment benefits last week. An additional 759,000 claims were filed by unemployed freelancers, part-time workers and others who are receiving federal relief under a separate emergency relief program.

Neither figure is seasonally adjusted. On that basis, both totals represented an increase from the previous week. The seasonally adjusted number of new state claims was 881,000.

Credit...Jonah Markowitz for The New York Times

The Trump administration moved to eliminate millions in federal funding for states to disinfect schools, public transportation systems and government buildings this week, in an apparent escalation of President Trump’s efforts to cut support to cities controlled by Democrats. The move will most severely affect New York and California, which have each received around $1 billion of the funds, significantly more than any other state.

Since the pandemic’s onset, the Federal Emergency Management Agency has offered states billions in emergency aid for coronavirus-fighting efforts like disinfecting public buildings and purchasing personal protective equipment for public employees.

But this week, FEMA changed its rules for that funding to prevent the aid from being used to buy P.P.E. for nonmedical public employees or to disinfect public buildings. The shift will go into effect on Sept. 15 — a week before schools are set to reopen for in-person learning in New York.

“This is a downright dirty decision that nonsensically changes the rules in the middle of the game just when we need to keep sanitizing and PPE a federal priority,” said Senator Chuck Schumer, the minority leader and a New York Democrat.

Credit...Rebecca Blackwell/Associated Press

More than 7,000 health care workers have died from Covid-19 around the world, Amnesty International reported on Thursday, up from a July 3 tally of 3,000.

Mexico has had the highest toll, with 1,320 health worker deaths. After that comes the United States, with 1,077 dead. Britain, Brazil, Russia and India each have lost about 600 workers.

“For over 7,000 people to die while trying to save others is a crisis on a staggering scale,” said Steve Cockburn, head of economic and social justice at Amnesty International.

Mexico’s high death toll includes many hospital cleaners who were not given adequate protective equipment.

One cleaner at a state hospital, Don Alejandro, 70, told Amnesty in May that he had asked to be allowed to clean administrative areas instead of medical ones because he had a high risk of contracting the virus. His employer allowed him to move, but cut his income by 16 percent.

For its numbers, Amnesty used sources such as memorial pages, government figures, lists compiled by national medical associations, and lists and obituaries published in media globally. For the U.S. death count, researchers used a joint database from The Guardian and Kaiser Health News that specifically tracks deaths of the country’s health workers.

The Centers for Disease Control and Prevention, however, lists only 672 health worker deaths in the U.S. as of Thursday. The C.D.C. said that it was working with limited data.

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Malls in New York City and casinos across the state will be allowed to reopen on Sept. 9 with certain limits, Gov. Andrew M. Cuomo announced on Thursday.

Casinos will be allowed to operate at 25 percent capacity and malls at 50 percent capacity. Both will need to be equipped with specialized air conditioning systems capable of filtering out virus particles.

The announcement is the latest effort to return some semblance of normalcy to New York, which has for weeks managed to keep positivity rates and hospitalizations low after the virus ravaged the state, killing more than 30,000 people.

The governor said he was eager to restart indoor dining in New York City, where it remains prohibited since mid-March even as he has permitted indoor dining to resume in the rest of the state. Dining will still not be permitted inside the city’s malls and casinos. This week, New Jersey announced indoor dining would restart with limits on Friday.

Mr. Cuomo said he was concerned about New York City’s ability to enforce social distancing and capacity rules inside restaurants, and suggested the New York Police Department be involved in enforcement efforts. But involving the police could prove a delicate issue in the wake of protests against police brutality and after the police’s uneven enforcement of social distancing rules in the spring led predominantly to arrests of Black people.

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Michigan gyms, fitness centers, pools and other sports facilities that have been closed since March can reopen on Sept. 9.

Gov. Gretchen Whitmer signed an executive order opening the facilities on Thursday. The order also allows organized sports to resume, although the state recommends against contact sports like football, soccer and basketball.

Dr. Joneigh S. Khaldun, the state’s chief medical officer, said 30 Covid outbreaks in August were connected to athletic teams. “We are not out of the woods yet,” Dr. Khaldun said. “Covid-19 is still a very real threat to our families.”

Gyms and fitness centers will have to maintain social distancing of at least six feet, require all members to wear masks while working out and keep a database of when members use the facilities.

Sporting events will be limited to two guests for each of the players.

Shortly after the announcement, the Michigan High School Athletic Association, which had postponed the fall sports season last month, reinstated it for high schools across the state.

Left off the list of businesses that can reopen were movie theaters, which will remain closed except for theaters in northern Michigan and the Upper Peninsula, which have had a lower number of coronavirus cases and were able to reopen in July.

Ms. Whitmer shut down much the state on March 23 to prevent the spread of coronavirus. As of Wednesday, 104,395 cases of the virus- have been reported in Michigan, along with 6,519 deaths, according to the Michigan Department of Health and Human Services.

Several business organizations have filed lawsuits to try to reverse Ms. Whitmer’s executive order, but none have been successful. In May, heavily armed agitators — cheered on by President Trump on Twitter — stormed the Michigan statehouse demanding the state reopen.

A Republican-led petition drive to repeal a state law that gives the governor emergency powers during a public health crisis is underway and could be considered by the legislature later this year.

Credit...Kathryn Gamble for The New York Times

A former longtime spokeswoman for the Iowa Department of Public Health accused the state and Gov. Kim Reynolds of “a deliberate effort to thwart open communication” about the coronavirus pandemic. The spokeswoman, Polly Carver-Kimm, who was forced out in July, made the accusation in a wrongful termination lawsuit she filed Thursday in state court.

In the suit, Ms. Carver-Kimm says that she tried to comply with the state’s open records law and help reporters get answers to questions about the pandemic, but her efforts were met with resistance and criticism from superiors. She says she was then steadily stripped of her responsibilities, and no longer allowed to respond to open records requests or any media inquiries involving infectious disease.

“The only explanation I ever received was that I was not a team player and causing friction with the governor’s staff,” she said in a Zoom call with reporters on Thursday morning.

In the suit, she asserts that she was told in mid-July that she could either resign or be terminated because of “restructuring.”

The health department declined to comment on the lawsuit, and email and phone messages left with the governor’s spokesman were not returned. Ms. Reynolds is named in the suit.

Iowa had the second-highest rate of new coronavirus cases in the country over the last week, and two of its major college towns, Ames and Iowa City, are among the five metro areas with the greatest number of new cases per capita. The state also has the third highest rate of positive tests in the country, according to data collected by the Covid Tracking Project.

A report from the White House on Aug. 30 urged Iowa to adopt much more stringent safety measures than Ms. Reynolds, a Republican, has taken, including a statewide mask mandate, which the governor has rejected as unenforceable.

Ms. Carver-Kimm is not the only official in state government to complain of being ousted for not toeing the state’s line on the pandemic. Rebekah Jones, a data scientist who was fired by the Florida Department of Health in June, said she was forced out because she refused to manipulate data to make the coronavirus situation in the state look better than it was. She went on to make her own dashboard tracking the state’s Covid-19 cases.

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A shadow of hunger looms over the United States. In the pandemic economy, nearly one in eight households doesn’t have enough to eat. Long lines at food banks have revealed what was hidden in plain sight: that food insecurity has become a persistent problem for millions of Americans.

Brenda Ann Kenneally set out across the country, from New York to California, beginning in May, to capture the routines of Americans who are struggling to piece together various forms of food assistance, community support and ingenuity to make it from one month to the next.

Food insecurity is as much about the threat of deprivation as it is about deprivation itself and its psychological toll. Like many hardships, this burden falls disproportionately on Black and Hispanic families, who are almost twice as likely to experience food insecurity as white families are.

Credit...Amr Alfiky/The New York Times

A surge in government borrowing in the face of the pandemic recession has put the United States in a position it has not seen since World War II: In order to pay off its national debt this year, the country would need to spend an amount nearly as large as its entire annual economy.

And still, economists and many fiscal hawks are urging lawmakers to borrow even more to fuel the nation’s economic recovery.

The amount of U.S. government debt has grown to nearly outpace the size of the nation’s economy in the 2020 fiscal year and is set to exceed it next year, as the virus downturn saps tax revenues, spurs government spending and necessitates record amounts of federal borrowing, the Congressional Budget Office said on Wednesday. Federal debt, as a share of the economy, is now on track to smash America’s World War II-era record by 2023.

The budget office report underscored the scrambled politics of deficits in 2020: It showed debt held by the public climbing to 98 percent of the size of the economy for the fiscal year ending Sept. 30.

But the virus has upended deficit predictions, prompting even longtime champions of fiscal prudence to urge lawmakers on Wednesday to keep borrowing more for the time being, in order to help people and businesses survive the lingering pain of a sharp recession and now-slowing recovery.

“We should think and worry about the deficit an awful lot, and we should proceed to make it larger,” said Maya MacGuineas, the president of the Committee for a Responsible Federal Budget in Washington, which has for years pushed lawmakers to take steps to reduce deficits and debt.

Credit...Dmitry Kostyukov for The New York Times

Moving to combat its worst recession in decades, France unveiled a huge 100 billion euro ($118 billion) stimulus plan Thursday aimed at restoring the battered economy to pre-crisis levels by 2022, handing large tax cuts and hiring subsidies to companies in hopes of stimulating investment and creating jobs.

“We have to learn to live with the virus, and to survive it,” Prime Minister Jean Castex said at a news briefing.

The package, the biggest spending effort in Europe, comes on top of nearly €400 billion that President Emmanuel Macron made available to help keep thousands of businesses from going bankrupt and millions of people employed since a nationwide quarantine caused the economy to crater. Growth is expected to contract by 11 percent this year because of the Covid-19 epidemic.

But a new wave of infections is rolling across France, and with it the prospect of a protracted downturn.

The government effort focuses on supply-side stimulus and transitioning to so-called “green” technology across the economy. Industrial companies will get €35 billion in production tax breaks to stimulate investment and job creation, and the state will subsidize industrial development in hard-hit regions.

Around a third of the money will go toward making the nation’s infrastructure more environmentally sound. All told, the government said it hoped to create at least 160,000 jobs through the stimulus measures next year.

Credit...Henry Ford Health System/Agence France-Presse — Getty Images

In planning documents sent last week to public health agencies around the country, the U.S. Centers for Disease Control and Prevention described preparations for two coronavirus vaccines simply referred to as Vaccine A and Vaccine B.

But the technical details, including the time between doses and storage temperatures, match well with the two vaccines furthest along in U.S. clinical tests, made by Moderna and Pfizer.

Some experts are concerned about what they see as a rushed process. “It’s hard not to see this as a push for a pre-election vaccine,” said Saskia Popescu, an infection prevention epidemiologist in Arizona.

Still, public health experts agree that agencies at all levels of government should urgently prepare for what will eventually be a vast, complex effort to vaccinate hundreds of millions of Americans.

Here are some answers to some basic questions people may have.

How do these vaccines work?

Moderna and Pfizer are testing a new kind of vaccine that has never before been approved for use by people. It contains genetic molecules called messenger RNA that are injected into muscle cells, which treat them like instructions for building a protein.

How well do they work?

Both vaccines have gone through extensive early tests, but it is not known if they’re safe and effective.

If preclinical tests on animals yield promising results, then the vaccines go into three phases of clinical trials in people.

Moderna and Pfizer are currently testing their candidates in Phase 3 trials. In their earlier human studies, neither vaccine produced serious side effects. Both vaccines provoked people’s immune systems to make antibodies that can neutralize the coronavirus.

Could a vaccine be approved before clinical trials are completed?

Some federal health officials have said a vaccine could be made available to at least some groups before clinical trials are completed. An independent Data and Safety Monitoring Board is charged with checking in on clinical trials to ensure there are no serious safety issues.

What have companies said about when their vaccines may be ready?

Pfizer recently said it was “on track” for seeking government review “as early as October 2020.” Moderna has said it expects to complete enrollment in its Phase 3 trial in September, but has not provided an estimate about when the vaccine might be ready for the public.

Federal officials said in May that the first doses of a vaccine being developed by AstraZeneca, in partnership with the University of Oxford, could be delivered by October. But AstraZeneca, which recently began Phase 3 trials in the United States, is now saying it could supply the first doses by the end of 2020.

How would a vaccine reach the public?

Normally, vaccine makers would wait for clinical trials to yield definitive results before moving forward with manufacturing. This time, many manufacturers have begun preparing in advance for production, getting money from governments to buffer the risk.

When might the first vaccines be distributed?

The C.D.C. told public health agencies last week that limited doses may be available beginning in late October or November.

Who will get it first?

In its planning documents, the C.D.C. said certain groups would have priority, beginning with health care workers, essential workers (like police officers or those in critical industries like food production), “national security populations,” and employees and residents of long-term care facilities like nursing homes.

Credit...Jeon Heon-Kyun/EPA, via Shutterstock

South Korea was so proud of its handling of the coronavirus pandemic that it coined a term for it: K-quarantine, echoing the global musical phenomenon K-pop.

Its two-pronged strategy of fighting the virus while keeping the economy running appeared to work. The country all but halted a large outbreakwithout closing its borders, locking down towns or ​drawing an outcry over draconian restrictions on movement. ​The country was held up as a model for the rest of the world.

But now, South Korea is struggling with a second wave of infections spreading from the populous Seoul metropolitan area, and its strategy seems as precarious as ever. To complicate matters, some of the government’s strongest allies in the fight against​ Covid-19, young doctors, have gone on strike, unhappy with President Moon Jae-in’s medical reform program.

The government is also trying to sustain a fragile balance between controlling the virus and safeguarding the economy, and between ​using ​government power ​to protect public health and not infringing on civil liberties.

South Korea’s daily caseload of new infections​, once fewer than 10, has been in the triple digits​ since Aug. 14, taking the country of 50 million people to more than 20,000 cases and 329 deaths, according to a New York Times database. ​Officials reported 195 cases on Thursday, falling below 200 for the first time since Aug. 17.

The virus has spread quickly from churches and a large antigovernment protest rally. Mr. Moon’s government has threatened lawsuits​ and prosecution against ​churchgoers and protesters accused of impeding official efforts to control the epidemic. But they’ve pushed back, calling him a dictator who is running the country under “quarantine martial law.”

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Speaker Nancy Pelosi’s visit to a hair salon in San Francisco this week was captured on video and sparked backlash. At the time, Bay Area officials’ coronavirus guidelines prohibited indoor beauty services.CreditCredit...Justin Sullivan/Getty Images

At a news conference on Wednesday where she discussed coronavirus relief and reopening schools, House Speaker Nancy Pelosi was also asked to comment on another issue: her visit to a San Francisco hair salon.

Ms. Pelosi had broken the rules: Salons in the area were supposed to be closed to customers when she visited e Salon SF for a blowout on Monday. The episode drew criticism from President Trump and became a top story on Fox News, which shared video footage of Ms. Pelosi that appeared to show her walking through the salon with wet hair and a mask pulled down around her neck.

Ms. Pelosi called it a setup.

“I take responsibility for trusting the word of a neighborhood salon that I’ve been to over the years many times,” she said, adding that she had been told that the salon could accommodate one customer at a time.

“I trusted that,” she said. “As it turns out, it was a setup. So I take responsibility for falling for a setup.”

Many hair salons in the Bay Area have been shuttered for months in accordance with health officials’ guidelines, although some opened their doors in recent weeks to protest the shutdowns.

On Tuesday, the day after Ms. Pelosi’s visit, the San Francisco Department of Public Health issued new guidance, saying hair salons in the county were allowed to provide some services to customers, but only outdoors.

The owner of e Salon SF, Erica Kious, told Fox News that the appointment had been arranged by a stylist who rented a chair at her establishment. “It was a slap in the face that she went in, you know, that she feels that she can just go and get her stuff done while no one else can go in, and I can’t work,” Ms. Kious said, referring to Ms. Pelosi.

Drew Hammill, a spokesman for Ms. Pelosi, said that she “always wears a mask and complies with local Covid requirements.” In this case, he said, “This business offered for the speaker to come in on Monday and told her they were allowed by the city to have one customer at a time in the business.”

Mask requirements and reopening plans have both become flash points in the culture wars over the response to the coronavirus in the United States. Many people have resisted face coverings, including some Republican leaders who viewed mask requirements as a threat to personal liberty.

Calls to the salon’s two locations went unanswered on Wednesday, and Ms. Kious could not immediately be reached for comment. Amy Tarkanian, a conservative commentator and former chairwoman of the Nevada Republican Party, tweeted about a crowdsourcing fund-raiser for Ms. Kious on Wednesday and said the salon owner had told her she was receiving death threats and had been forced to relocate.

Reporting was contributed by Livia Albeck-Ripka, Liz Alderman, Ilise S. Carter, Choe Sang-Hun, Patricia Cohen, Ben Casselman, Luis Ferré-Sadurní, Jacey Fortin, Michael Gold, Christina Goldbaum, Kathleen Gray, Ethan Hauser, Mike Ives, Jennifer Jett, Juliana Kim, Isabella Kwai, Sharon LaFraniere, Raphael Minder, Richard C. Paddock, Matt Phillips, Campbell Robertson, Amanda Rosa, Eleanor Stanford, Jim Tankersley, Ian Teh, Katie Thomas, Lucy Tompkins, Neil Vigdor, Allyson Waller, Lauren Wolfe, Katherine J. Wu and Carl Zimmer.

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