The Food and Drug Administration has informed the drugmaker Moderna that it can put up to 40 percent more coronavirus vaccine into each of its vials, a simple and potentially rapid way to bolster strained supplies, according to people familiar with the company’s operations.
While federal officials want Moderna to submit more data showing the switch would not compromise vaccine quality, the continuing discussions are a hopeful sign that the nation’s vaccine stock could increase faster than expected, simply by allowing the company to load up to 14 doses in each vial instead of 10.
Moderna currently supplies about half of the nation’s vaccine stock. A 14-dose vial load could increase the nation’s vaccine supply by as much as 20 percent at a time when governors are clamoring for more vaccine and more contagious variants of the coronavirus are believed to be spreading quickly.
Two people familiar with Moderna’s manufacturing, who spoke on the condition of anonymity, said retooling the company’s production lines to accommodate the change could conceivably be done in fewer than 10 weeks, or before the end of April. That is because while the amount of liquid in each vial would change, the vials themselves would remain the same size, so the production process would not drastically change.
“It would be a great step forward,” said Dr. Moncef Slaoui, who served as the scientific leader of the Trump administration’s vaccine development program. “I think it will have an impact in the short term.”
In a recent email response to questions about the company’s discussions with regulators, Stéphane Bancel, the chief executive officer of Moderna, wrote, “No comment.” Ray Jordan, the company’s spokesman, said talks with federal officials were continuing.
Advocates for homeless people in New York City sued the Metropolitan Transportation Authority on Friday over a series of Covid-19 rules that the suit says unfairly target people who shelter in the city’s subways.
The rules prohibit people from staying in a subway station for more than an hour or after a train is taken out of service, and ban carts more than 30 inches long or wide. They were enacted on an emergency basis last April and made permanent in September.
Last spring, the pandemic and shutdowns emptied the subways of regular commuters, and dozens of transit workers died of the coronavirus. Images of trains half-filled with sleeping homeless people accompanied by the sprawl of their belongings became a symbol of a city in crisis and helped prompt Gov. Andrew M. Cuomo to shut down the system every night for cleaning.
The rules’ stated purposes were to “safeguard public health and safety,” help first responders get to work and “maintain social distancing.” But the rules exempt so many activities from the one-hour limit — including public speaking, campaigning, leafleting, artistic performances and collecting money for religious or political causes — as to make it “clearly apparent” that their real purpose is to exclude homeless people from the subways, the suit says.
The lawsuit was filed by the Urban Justice Center’s Safety Net Project on behalf of Picture the Homeless and a homeless man named Barry Simon.
Mr. Simon had been ordered out by the police “dozens of times” while resting in a station and threatened with arrest on several occasions, according to the lawsuit. Mr. Simon, 54, was ejected from stations at least 10 times because the cart he wheels his possessions in was too big, the suit says.
Because those experiencing homelessness in New York City are disproportionately Black and Latino and people living with disabilities, the rules violate state human and civil rights law, the suit says. It also says that the rules were enacted without proper review.
Abbey Collins, a spokeswoman for the M.T.A., said in a statement: “We are reviewing the lawsuit that we first learned of in the press. We will vigorously defend the regulations in court that were put in place to protect the health and safety of customers and employees in the midst of a global pandemic — period.”
Homeless people’s use of the subways as de facto shelters, long a fact of life in New York, has become a hot-button issue. Many homeless people now avoid the city’s barracks-style group shelters for fear of contracting the coronavirus. While the city is adding hundreds of private rooms in hotels to the shelter system, the contested rules and the nightly shutdown have left some people to choose between sleeping outdoors in winter and taking their chances in the group shelters.
Calls have grown in recent days to end the nightly shutdown.
Although vaccines for the coronavirus were developed and approved in record time, distribution efforts in the United States and elsewhere have been plagued with problems.
The rollout, which has largely prioritized older people and health care workers, has faced difficulties, delays and confusion as people try to figure out whether their state is now allowing them to get shots, how to sign up and where to go.
But American health officials say that while current vaccine supply levels still limit how many doses they can administer, states are becoming more efficient at immunizing people as shipments arrive.
On Jan. 1, just a quarter of Covid-19 vaccine doses delivered across the United States had been used. As of Thursday, that figure had risen to 68 percent. A handful of states have administered more than 80 percent of the doses they have received, and even states with slower vaccine uptake are making strides.
“We are in a much better place now,” said Claire Hannan, the executive director of the Association of Immunization Managers.
The Biden administration says it has secured enough vaccine to inoculate every American adult. On Thursday, officials said that they had arranged to get 200 million more doses of vaccine by the end of summer, which amounts to a 50 percent increase. That should be enough vaccine to cover 300 million people — enough for all adults in the country, with tens of millions of doses to spare. And Friday was the start of a new federal effort to deliver doses directly to grocery store pharmacies and drugstores.
But President Biden warned that logistical hurdles would most likely mean that many Americans will still not have been vaccinated by the end of the summer.
He also expressed open frustration with the former administration. “It was a big mess,” he said on Thursday. “It’s going to take time to fix, to be blunt with you.”
The average number of shots administered daily has been increasing steadily since late December. The Centers for Disease Control and Prevention reported that 1.62 million doses were given on Thursday, bringing the latest seven-day average to nearly 1.6 million a day. About 34.7 million people have received at least one dose of a Covid-19 vaccine, and about 11.2 million of them have also received the second dose, according to the C.D.C.
But many places are still plagued by shortages, as demand far outpaces supply and health care providers struggle to predict how many doses they might receive.
Some countries are faring far worse. While wealthier countries have been able to make deals with drug manufacturers to secure enough vaccine to ensure their citizens can be vaccinated, poorer countries have been not, leaving many unprotected — an imbalance that is expected to have global ripple effects.
The leaders of the World Health Organization and the United Nations agency for children, Unicef, warned in a joint statement this week that the vast chasm of inequality in the global vaccine rollout will “cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.”
Of the 128 million vaccine doses administered globally, more than three quarters were in just 10 countries, while nearly 130 other countries are yet to administer a single dose, the statement said.
SAN FRANCISCO — The fish and crab tanks at the back of the wood-paneled restaurant are empty, and chairs are stacked here and there. Bill Lee, the owner of the Far East Café in San Francisco’s Chinatown, surveyed the empty second-floor banquet hall that during any other Lunar New Year would be packed with hundreds of customers.
“I keep losing money,” Mr. Lee said of his century-old restaurant, a former Cantonese social club and speakeasy. “If it continues this way, I’d rather to close down.”
As the Year of the Ox began on Friday, there were only muted attempts to celebrate. The pandemic has hit San Francisco’s Chinatown, America’s oldest and largest, particularly hard. The lack of tourists, a spate of violent attacks and robberies in Chinese neighborhoods across the Bay Area, and pandemic-related racism against Asian-Americans have combined to exacerbate the economic pain felt in Chinatown.
From a strictly medical perspective, the neighborhood has fared better than many other parts of the country, heading off a mass outbreak early. And mask wearing was ubiquitous this week on the streets of the densely packed neighborhood, where shoppers strolled through the handful of shops selling Lunar New Year decorations.
But a few blocks away, in a park where older residents gathered to play board games, Will Lex Ham, a New York-based actor, was helping lead a neighborhood safety patrol, handing out whistles and a Chinese-language pamphlet titled “How to Report a Hate Crime.”
“During the Lunar New Year there is an assumption that the elderly have money on them,” Mr. Ham said.
He flew in from New York on Wednesday after seeing video on social media that has rocketed around the world of attacks on Asian-Americans in Oakland and San Francisco, including the killing of Vicha Ratanapakdee, an 84-year-old Thai man who was shoved to the ground last month and died of his injuries.
“So often, people in the community don’t speak out when violence happens to them for fear of repercussions and a sense that nothing ever comes of it,” Mr. Ham said. “This is our time to speak out.”
Across the Bay, Carl Chan, the president of the Oakland Chinatown Chamber of Commerce, has tallied more than 20 assaults in the area over the past two weeks. Many of them were not reported, Mr. Chan said, partly because it can take hours for police officers to arrive at the scene.
“Our seniors are afraid to walk their own streets,” Mr. Chan said.
David Lee, a political science lecturer at San Francisco State University who is an expert on the history of the Chinatowns in Oakland and San Francisco, said these neighborhoods were among the first in the nation to feel the effects of the pandemic last year.
Last February, before any lockdowns, tourists had deserted San Francisco’s Chinatown, prompting Nancy Pelosi, the House speaker, whose district includes Chinatown, to visit in a show of support.
Mr. Lee says that many of the shops that are boarded up and padlocked in San Francisco’s Chinatown may not return. But the neighborhood, he says, has survived fires, an emergence of the bubonic plague at the turn of the 20th century and decades of racism.
“We will not let Chinatown die,” Mr. Lee said. “It is too important to the cultural fabric of the people of San Francisco. But is Chinatown going to look the way it did before the pandemic? That is the question I have.”
More than six million people in Victoria, Australia, will enter into a snap lockdown for five days in response to a coronavirus outbreak at a quarantine hotel.
The order came as the Australian Open was being held in Melbourne, Victoria’s capital, but the tennis tournament will continue — without spectators — the authorities said on Friday.
Victorians will be allowed to leave home only for essential shopping, work, exercise and caregiving, and must wear masks whenever they leave home.
But while sports and entertainment venues will be shut down, professional athletes like tennis players will be classified as “essential workers” and allowed to continue their matches.
“There are no fans; there’s no crowds. These people are essentially at their workplace,” Daniel Andrews, the premier of Victoria, told reporters on Friday. “It’s not like the only people that are at work are supermarket workers.”
Tennis Australia said in a statement that it would notify all ticket holders of the changes and continue “to work with the government to ensure the health and safety of everyone.”
The lockdown, which goes into effect at 11:59 p.m. on Friday, comes after an outbreak at a Holiday Inn near the Melbourne Airport that was being used to house returned travelers.
By Friday, 13 people linked to the hotel had tested positive with the new virus variant that first emerged in Britain. In the past 24 hours, five new cases have been identified, bringing the state’s total number of cases to 19.
Describing the lockdown as a “circuit breaker,” the authorities said it was critical to stopping the spread of the variant, which is highly infectious and has outwitted contact tracers before they can contain outbreaks. Similar snap lockdowns in Perth and Brisbane in recent months were successful in quashing infections.
“The game has changed,” Mr. Andrews said. “This is not the 2020 virus.”
He said he hoped Victorians, who endured among the longest lockdowns in the world last year, would work together to prevent the state from entering a third wave of the coronavirus. “We will be able to smother this,” he said.
The order had ripple effects in Australia’s other states, which all announced travel restrictions with Victoria. International flights, excluding freight, into Melbourne were also canceled.
In other global developments:
Germany will close its border to the Czech Republic and the Austrian state of Tyrol starting Sunday as it tries to protect against new variants of the virus. As part of that effort, Germany this week extended its national lockdown for another month.
New Zealand will receive the first batch of its 1.5-million-dose order of the Pfizer-BioNTech vaccine next week and expects to begin vaccinating its border workers on Feb. 20, ahead of schedule, Prime Minister Jacinda Ardern said on Friday. The country, which has all but eliminated local transmission of the virus, has additional purchase agreements with Janssen Pharmaceutica, Novavax and AstraZeneca, and expects to start vaccinating its wider population in the second quarter of this year, Ms. Ardern said.
Gov. Andrew M. Cuomo and his top aides were facing new allegations on Friday that they covered up the scope of the coronavirus death toll in the state’s nursing homes, after admissions that they withheld data in an effort to forestall potential investigations into state misconduct.
The latest revelations came in the wake of private remarks by the governor’s top aide, Melissa DeRosa, and a cascading series of reports and court orders that have nearly doubled the state’s official toll of nursing home deaths in the last two weeks.
The disclosures have left Mr. Cuomo, a third-term Democrat, scrambling to contain the political fallout.
In a conversation reported on by the New York Post, Ms. DeRosa told a group of top lawmakers on Wednesday during a call to address the nursing home situation that “basically, we froze,” after being asked last summer for information by the Trump administration’s Department of Justice.
At the time, the governor’s office was simultaneously facing requests from the State Legislature for similar information.
“We were in a position where we weren’t sure if what we were going to give to the Department of Justice, or what we give to you guys, and what we start saying, was going to be used against us and we weren’t sure if there was going to be an investigation,” Ms. DeRosa told lawmakers, according to a partial transcript obtained by The New York Times.
The news of Ms. DeRosa’s remarks sparked a flurry of angry denunciations from both Democrats and Republicans. Early on Friday, Ms. DeRosa sought to clarify the context for her remarks, saying she was trying to explain that “we needed to temporarily set aside the Legislature’s request to deal with the federal request first.”
“We informed the houses of this at the time,” she said, referring to the upper and lower chambers of the Legislature.
This week, Massachusetts launched a first-in-the-nation experiment, offering vaccinations to younger people who accompany people who are 75 and older to mass vaccination sites.
The plan was intended to ease access problems for older people, who have struggled to book online appointments and travel to sports stadiums. Right away, it met with criticism from state legislators and some public health experts, who said it could result in scarce doses going to young, healthy people.
It also gave rise to an unusual online market, as entrepreneurial Massachusetts residents sought to forge caregiving relationships at top speed.
“I have a great driving record and a very clean Toyota Camry,” said one person in an advertisement on Craigslist. “I can pay $100 cash as well. I am a friendly conversationalist and will allow you to choose the music and show me all the pictures of your grandkids!”
Other inquiries were made more delicately.
At a Thursday news conference, Gov. Charlie Baker acknowledged that some were approaching the program opportunistically, and warned seniors to be cautious about offers of help from strangers.
“You should only reach out to somebody that you know or trust to bring you as your companion, whether that’s a child, a companion, a spouse, a neighbor or a caregiver,” he said. “Don’t take calls or offers from people you don’t know well or trust, and never share your personal information with anyone.”
Public health experts offered divergent opinions on the companion program, a concept that was not widely discussed before it was rolled out.
Andrew Lover, an assistant professor of epidemiology at the University of Massachusetts Amherst, said the plan would accelerate vaccinations by providing an “extra push” for older people who live alone.
“There’s definitely potential for people to game the system, but my assumption is it’s a reasonably small number,” he said. “The more people we can get vaccinated the better, in the grand scheme of public health, and we are more than happy to accept that small problematic fraction.”
Others worried that the policy allows young, healthy people doses that are in short supply.
Ohio health officials said they had overlooked about 4,000 deaths that occurred over the past several months and would begin reporting them to the public this week. The announcement came just as deaths nationwide had started to ebb after peaking in mid-January.
The first 650 or so of Ohio’s older deaths were reported Thursday, accounting for about 17 percent of all coronavirus deaths announced nationwide that day. The backlog in Ohio was expected to inflate the national death average in the coming days.
“You’ll see a jump today, tomorrow, maybe the next day,” Gov. Mike DeWine said at a news conference on Thursday. “We’re not sure exactly how many days it’s going to take, but you’re going to see a distorted number.”
During a routine employee training event, Ohio health officials discovered that thousands of deaths, some of which dated back to October, had not been properly merged between one reporting system and another, according to the state’s Department of Health. “This was a failure of reconciliation not taking place,” Mr. DeWine said, “so we’re getting that straightened out.”
The unreported deaths represent a significant portion of the state total. Through Thursday, about 12,500 deaths had been announced statewide over the course of the pandemic.
Ohio is not the first state to report a major backlog of cases or deaths. Earlier this month, Indiana added more than 1,500 deaths to its total after reviewing death certificates. In June, New York City reported hundreds of deaths from unspecified dates. And in September, Texas reported thousands of backlogged cases, causing a one-day spike.
President Biden initially pledged to reopen the nation’s schools by his 100th day in office, but the White House has in the past week sought to temper those expectations, setting a reopening benchmark of “the majority of schools” — or 51 percent.
That push will hinge on new guidance, expected to be released on Friday by the Centers for Disease Control and Prevention, about how schools can reopen safely.
A consensus of pediatric infectious disease experts said in a new survey that many of the common requirements — including vaccines for teachers or students, and low rates of infection in the community — were not necessary to safely teach children in person. Instead, the 175 experts — mostly pediatricians focused on public health — largely said it was now safe enough for schools to be open to elementary students for full-time and in-person instruction.
Some said that was true even in communities where Covid-19 infections is widespread, as long as basic safety measures are taken. Most important, they said, are universal masking, physical distancing, adequate ventilation and avoidance of large group activities.
The experts were surveyed by The New York Times in the past week. Depending on various metrics, 48 to 72 percent said the extent of virus spread in a community was not an important indicator of whether schools should be open, even though many districts rely on those metrics. Most respondents said that schools should close only when there are Covid-19 cases in the school itself.
“There is no situation in which schools can’t be open unless they have evidence of in-school transmission,” said Dr. David Rosen, an assistant professor of pediatric infectious diseases at Washington University in St. Louis.
The risks of being out of school are far greater, many of the experts said. “The mental health crisis caused by school closing will be a worse pandemic than Covid,” said Dr. Uzma Hasan, thee division chief of pediatric infectious diseases at RWJBarnabas Health in New Jersey.
For the most part, these responses match current federal guidance, which does not mention vaccines, and reflect significant scientific evidence that schools are not a major source of spread for children or adults.
But the consensus in the survey is at odds with the position of certain policymakers, school administrators, parent groups and teachers’ unions. Some in these groups have indicated that they do not want to return to school buildings even in the fall, when it is likely that teachers will be able to be vaccinated, though not most students.
Some districts have faced strong resistance to reopening, particularly in large cities, where teachers have threatened to strike if they are called back to school buildings.
Hungary has begun administering the Sputnik V coronavirus vaccine, sidestepping the European Medicines Agency to become the first European Union member state to use the vaccine developed by the Gamaleya Research Institute, part of Russia’s Ministry of Health.
On Friday, an official at Honved Hospital in Budapest confirmed in a telephone interview that it had begun administering the vaccine.
Cecilia Muller, Hungary’s chief medical officer and head of the government’s coronavirus task force, had called on 560 general practitioners in Budapest on Tuesday to find five people each to receive the Sputnik V vaccine. The initial 2,800 doses available are what remain from a 6,000-dose batch that arrived for testing in December.
The government said it would receive two million doses of Sputnik V from Russia over the next three months. Hungary had said in November that it was in talks with the Russian manufacturer about importing, and even manufacturing, the Sputnik V vaccine.
Prime Minister Viktor Orban has cited Serbia, which has a sizable ethnic Hungarian population, as an example of a country whose vaccination strategy includes the Russian Sputnik and Chinese Sinopharm vaccines.
In a report this month in the respected British medical journal The Lancet, late-stage trial results showed that the Sputnik V vaccine was safe and highly effective. The Sinopharm vaccine has been approved for use in China, Bahrain and the United Arab Emirates, but the company has yet to publish detailed results of its Phase 3 trial.
The Hungarian government’s approach to vaccine procurement and approval has raised alarm in the country’s medical community.
Last month, its Chamber of Physicians released a statement calling on the government and regulators to approve vaccines only after transparently following drug safety rules and testing in accordance with European Medicines Agency standards. They cited a need to strengthen the public’s confidence in vaccines and to ensure that doctors can administer the inoculations “in good conscience.”
Dr. Ferenc Falus, Hungary’s former chief medical officer, said Mr. Orban’s push to acquire vaccines from as many sources as possible raised serious concern.
“The responsibility of the National Center for Public Health in this respect is huge,” Dr. Falus said, “especially concerning how they are evaluating the batches that have arrived in Hungary. We simply do not know the origins of these batches.”
He noted that the emergence of new virus variants complicates matters further. The variant that was first detected in Britain has surfaced in Hungary, Hungarian officials said.
“Hungary is moving against the E.U.,” Dr. Falus said, urging regulators to wait for the vaccines to be approved by the European Medicines Agency and cooperate with the European Union on procuring and distributing tested vaccines.
More than 34 million Americans have received Covid vaccines, but the much-touted system that the government designed to monitor any dangerous reactions won’t be capable of analyzing safety data for weeks or months, according to numerous federal health officials.
For now, federal regulators are counting on a patchwork of existing programs that they acknowledge are inadequate because of small sample sizes, missing critical data or other problems.
Clinical trials have shown both of the vaccines authorized in the United States — Pfizer-BioNTech’s and Moderna’s — to be highly protective against the coronavirus and safe. But even the best trials have limited ability to detect adverse reactions that are rare, that occur only in certain population groups or that happen beyond the trials’ three-month period.
In interviews, F.D.A. officials acknowledged that a promised monitoring system, formally called the Biologics Evaluation Safety Initiative but more widely known as BEST, is still in development. They expect it to start analyzing vaccine safety data soon, but probably not for another month or two.
The government is now relying mostly on a 30-year-old monitoring system that relies on self-reporting from patients and health care providers, known as the Vaccine Adverse Event Reporting System, or VAERS, and a smartphone app that people who get vaccinated can download and use to report problems.
So far, few serious problems have been reported through these channels and no deaths have conclusively been linked to the vaccines. There have been a few severe allergic reactions, but they are treatable and considered rare. To date, the rate at which the potentially fatal reaction called anaphylaxis has occurred — 4.7 cases in every million doses of the Pfizer-BioNTech vaccine, and 2.5 cases per million for Moderna’s — are in line with the rates of other widely used vaccines.
Bruising and bleeding caused by lowered platelet counts have also been reported, though that could be coincidental. In total, 9,000 adverse events were reported, with 979 serious and the rest classified as nonserious, according to the most recent C.D.C. report available.
In interviews, public health experts, including current and former officials at the F.D.A. and the C.D.C., said that funding shortages, turf wars and bureaucratic hurdles had slowed BEST’s progress.
But even BEST will suffer from a data problem that hinders existing systems. Because the vaccines are free, there is a dearth of health insurance claims to show who got which vaccine and when — information crucial to tracking vaccine safety.
Indoor dining is restarting in New York City at 25 percent capacity on Friday, more than a month after Gov. Andrew M. Cuomo banned it and just in time for Valentine’s Day weekend. (Outside the five boroughs, indoor dining is available at 50 percent capacity.)
Mr. Cuomo originally said the city’s restaurants could open their dining rooms on Sunday, but later bumped up the date by two days.
Statewide, restaurants are still required to close by 10 p.m.
New York is one of several states that are loosening restrictions aimed at containing the coronavirus. On Thursday, Gov. Mike DeWine of Ohio lifted a statewide late-night curfew after the number of hospitalizations continued to decline.
The Ohio curfew, first declared in November, required people to stay home during late evening and overnight hours with exceptions for emergencies, grocery shopping and other essential activities.
Mr. DeWine cautioned that virus variants that are gaining a foothold across the United States could land Ohio “back in a situation of climbing cases” — and in that case the curfew could be reinstated.
Also on Thursday, Gov. Jay Inslee of Washington said that most areas in the state would be able to loosen virus-related restrictions starting next week, when limited indoor dining could resume.