Covid-19: Birx to Retire After Tumultuous White House Tenure

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Birx says she will retire after Biden transition.

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Dr. Deborah Birx said in recent weeks that she was open to serving in the Biden administration, but on Tuesday announced plans to retire.Credit...Stefani Reynolds for The New York Times

Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, said in an interview on Tuesday with the media outlet Newsy that she planned to retire after concluding her role helping the federal government transition to the Biden administration.

“I will be helpful in any role people think I can be helpful in,” she said. “And then I will retire.”

In recent weeks Dr. Birx, 64, indicated publicly and privately that she was open to serving in the Biden administration. It was unclear what prompted her to announce her plan to retire. In the interview with Newsy, she called her time at the White House “overwhelming” and difficult on her family. She suggested that recent coverage of a trip she made over the Thanksgiving holiday had unduly dragged her family into the spotlight.

The Associated Press reported on Sunday that after Dr. Birx recommended limiting gatherings to the “immediate household,” she traveled to a vacation home in Delaware over Thanksgiving weekend with three generations of her family, which included several households. Dr. Birx told The A.P. that she traveled not to celebrate Thanksgiving, but rather to winterize the property before a potential sale. She said that those on the trip were part of her immediate household but lived in two homes.

“I think what was done in the last week to my family — you know, they didn’t choose this for me,” she said in her interview with Newsy. “They’ve tried to be supportive.”

Neither the White House nor Dr. Birx responded to requests for comment on Tuesday. Kayleigh McEnany, the White House press secretary, said in a tweet on Tuesday that Mr. Trump “has great respect for Dr. Birx and likes her very much.”

“We wish her well,” she wrote.

Dr. Birx arrived at the White House in late February as Vice President Mike Pence assumed control of the coronavirus task force, and quickly developed a niche as a numbers maven. She worked long hours overseeing a team of specialists gathering data on infections and hospitalizations, whose work she would organize into daily presentations for senior White House officials and the task force. She has also been the point of contact for state and local officials, and oversees the drafting of detailed reports offering guidance to the states.

In recent months, she has traveled around the country, appealing to Americans to wear masks and limit their contact with others, a message that clashed with the White House’s relaxed approach to pandemic restrictions.

Her time in the West Wing, where she keeps an office, elicited broad criticism from public health experts. Senior administration officials said that she ingratiated herself with President Trump and Mark Meadows, the White House chief of staff, often presenting an optimistic picture of the pandemic. She also alienated officials at the C.D.C. with an aggressive campaign to overhaul the way the agency collects data on the spread of the coronavirus. And she clashed with officials on Operation Warp Speed, the administration’s vaccine development program, over the selection of vaccine candidates and the development of antibody treatments.

A colonel in the Army, she began her career in the early 1980s as an immunologist at the Walter Reed Army Medical Center. She spent time training as a fellow in Dr. Anthony Fauci’s lab. The two remain close.

Before she arrived at the White House this year, she spent six years at the State Department, where she oversaw the President’s Emergency Plan for AIDS Relief, created in 2003 by President George W. Bush when antiretroviral drugs saving lives in developed countries were not available in other nations.

Tennessee is ‘ground zero’ in the nation’s virus surge, and Christmas could make it worse, the governor warns.

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A testing site in Memphis this month.Credit...Whitten Sabbatini for The New York Times

As coronavirus cases, hospitalizations and deaths soar to new heights in the United States, Tennessee has become one of the worst-hit states, spurring the governor to warn residents against gathering and traveling for the holidays.

The state is identifying cases at the highest per capita rate in the nation by a wide margin. At least 9,265 new cases and 65 deaths were reported in Tennessee on Monday, according to a New York Times database. Over the last week, there has been an average of 8,953 cases per day, an increase of about 90 percent from the average two weeks earlier. Eight of the nation’s 20 metropolitan areas with the most recent cases per capita are in Tennessee.

“Tennessee is ground zero for a surge in sickness,” Gov. Bill Lee said in an address on Sunday from quarantine, the day after he announced that his wife has tested positive for the virus.

Arguing that Thanksgiving gatherings led quickly to a “record level of sickness,” Gov. Lee urged residents not to gather indoors with anyone outside their household over the upcoming holidays, despite the rollout of vaccines.

“We are in a war,” he said, stressing that the next few weeks would be critical for the state to avoid overwhelming hospitals already reeling from the Thanksgiving spike. “Tennessee cannot sustain a similar surge after Christmas or New Year’s.”

The stark warning comes as the virus explodes in the United States — parts of California are down to their last I.C.U. beds, and some hospitals in other states are at or over capacity — and the numbers are as alarming as they have ever been: At least 319,763 people have died, more than any other country in the world. On Monday, confirmed cases in the United States reached 18 million, just five days after surpassing 17 million.

This worrisome trajectory is evident in the South, where Georgia, Arkansas and South Carolina have all set weekly case records. Henry McMaster, the governor of South Carolina, tested positive for the coronavirus on Monday, several days after his wife also received a positive test, according to a statement from his office.

Both had tested negative on Dec. 14 before attending a White House Christmas event, but “there is no way to pinpoint precisely when or how Governor McMaster or the First Lady contracted the virus,” the statement said.

Gov. Lee became the latest governor to try to starkly limit indoor public gatherings, with new restrictions on dining and sporting events. Yet he declined to issue a statewide mask mandate, which he called “controversial.” Instead, he urged residents to wear masks and stressed the role of local officials in imposing such rules.

Governors on both coasts are also moving to counter the spread of a newly discovered virus variant circulating in Britain. Alarm about the variant has prompted dozens of countries to put in place some sort of travel regulation.

Gov. Andrew M. Cuomo of New York announced on Monday that British Airways, Virgin Atlantic and Delta Air Lines have agreed to require a negative coronavirus test result from passengers boarding flights from Britain to New York.

On Tuesday, Mr. Cuomo called for the United States to mandate testing for all international arrivals, arguing that at least 120 countries are requiring negative tests from people boarding flights from the United Kingdom. The United States has yet to impose such a health measure.

“I think actually the United States should say we should test before anyone comes from any country, because the U.K. variant now has already migrated.” Mr. Cuomo said.

Gov. Jay Inslee of Washington State has stopped short of new testing requirements but ordered that travelers from Britain and South Africa, where a similar variant has also been seen, undergo a 14-day quarantine. He said more countries may be added to the travel proclamation.

Tracking the Coronavirus ›

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Pfizer nears a deal with the Trump administration to provide more vaccine doses.

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A front line worker receiving the Pfizer vaccine at the Virginia Hospital Center in Arlington, Virginia, on December 16.Credit...Michael A. McCoy for The New York Times

The Trump administration and Pfizer are close to a deal under which the pharmaceutical company would bolster supply of its coronavirus vaccine for the United States by at least tens of millions of doses next year in exchange for a government directive giving it better access to manufacturing supplies, people familiar with the discussions said.

An agreement, which could be announced as early as Wednesday, would help the United States at least partly offset a looming vaccine shortage that could leave as many as 110 million adult Americans uncovered in the first half of 2021.

So far, only two pharmaceutical companies — Pfizer and Moderna — have won federal authorization for emergency distribution of Covid-19 vaccines, and most of what they are capable of producing for the next six months has already been allocated through contracts with the United States and other governments.

In the negotiations, the government is asking for 100 million additional doses from Pfizer from April through June. The company has signaled that it should be able to produce at least 70 million, and perhaps more, if it can get more access to supplies and raw materials.

To help Pfizer, the deal calls for the government to invoke the Defense Production Act to give the company better access to roughly nine specialized products it needs to make the vaccine.

Pfizer first started asking for the government’s help in obtaining supplies as early as September and has been unhappy about the lack of response, according to documents reviewed by The New York Times.

Pfizer and the administration have been negotiating for more doses from Pfizer for more than a month. But a host of other issues have stood in the way of a deal, including Pfizer’s commitments to other nations that moved faster than the United States to lock in a big supply, according to people familiar with the situation.

It is not clear how many more doses Pfizer can quickly produce even if the administration uses the Defense Production Act to clear away supply obstacles. One person familiar with the situation said the firm may only be able to deliver 70 million by the end of June, even with better access to supplies.

With infections, hospitalizations and deaths surging to record levels from a pandemic that has already killed more than 320,000 Americans, the pressure on Pfizer and the government to come to terms is growing.

The pharmaceutical firm has struggled to navigate the politics of the situation. Pfizer’s chief executive, Dr. Albert Bourla, repeatedly suggested that the firm would know if its vaccine worked by October. Mr. Trump, who saw a vaccine breakthrough as crucial to his re-election chances, initially praised Dr. Bourla as a “great guy” — then blamed the firm for his loss when the results were released after Election Day.

Trump demands changes to coronavirus relief bill, calling it a ‘disgrace.’

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President Trump said on Tuesday that the government should distribute $2,000 in direct payments to Americans.Credit...Stefani Reynolds for The New York Times

President Trump threatened on Tuesday to derail months of bipartisan work in Congress to deliver $900 billion in pandemic relief, demanding checks to Americans that are more than three times larger than those in the bill, which he called a “disgrace.”

The president, who has been preoccupied with the baseless claim that the election was stolen from him, seized on congressional leaders’ decision to pass the relief bill by combining it with a broader spending plan to fund government operations and the military. That plan includes routine provisions like foreign aid and support for Washington institutions like the Kennedy Center for the Performing Arts and the Smithsonian.

But Mr. Trump portrayed such spending items as “wasteful and unnecessary” additions.

“It’s called the Covid relief bill, but it has almost nothing to do with Covid,” Mr. Trump said in a video posted online. “Congress found plenty of money for foreign countries, lobbyists and special interests while sending the bare minimum to the American people.”

“I am asking Congress to amend this bill and increase the ridiculously low $600 to $2,000,” he added.

Speaker Nancy Pelosi of California, who had been pressing for similarly sized checks, welcomed Mr. Trump’s intervention, though it was not clear whether she was really open to changing the bill or simply trolling her Republican adversaries.

“Republicans repeatedly refused to say what amount the President wanted for direct checks. At last, the President has agreed to $2,000 — Democrats are ready to bring this to the Floor this week by unanimous consent. Let’s do it!” she wrote on Twitter.

In recent weeks, congressional leaders and a bipartisan group of moderates have worked around the clock to deliver a relief package aimed at saving businesses from closure, funding distribution of coronavirus vaccines and providing President-elect Joseph R. Biden Jr. with a stable economy when he takes office in January.

The $900 billion relief package revived supplemental unemployment benefits for millions of Americans at $300 a week for 11 weeks and provided for a round of $600 direct payments to adults and children. Republican and Democratic leaders hailed the bill as a badly needed stopgap measure until a new Congress can convene next year to consider providing more stimulus.

The bill passed with an overwhelming, veto-proof margin.

“Help is on the way,” said Senator Mitch McConnell, Republican of Kentucky and the majority leader.

But Mr. Trump, who sat out the negotiations, demanded on Tuesday that the government distribute much larger direct payments, despite opposition to such spending from Senate Republicans.

Senator Chuck Schumer of New York, the Democratic leader, enlisted the president in the Democrats’ push to get larger coronavirus relief checks to Americans next year.

“Trump needs to sign the bill to help people and keep the government open,” he wrote on Twitter, “and we’re glad to pass more aid Americans need. Maybe Trump can finally make himself useful and get Republicans not to block it again.”

The president’s move surprised even senior administration officials and represented an embarrassment for his top economic lieutenant, Treasury Secretary Steven Mnuchin, who helped negotiate the agreement.

“We are fully committed to ensuring that hardworking Americans get this vital support as quickly as possible and to further strengthening our economic recovery,” Mr. Mnuchin said in a statement on Tuesday in which he thanked Mr. Trump for his leadership.

He had said hundreds of dollars in direct payments authorized by the bill could begin reaching individual Americans as early as next week.

A spokeswoman for Mr. Mnuchin also cited his role in the negotiations earlier Tuesday, noting that he had participated in 190 calls about the legislation between Dec. 14 and Dec. 20 that included the president, Treasury staff members and congressional leaders. During the talks, Mr. Mnuchin pushed for bigger direct payments on behalf of the president in exchange for cutting supplemental unemployment benefits.

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France reopens border with Britain to trucks, requiring rapid Covid-19 tests for drivers.

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Trucks on Monday near the port of Dover, as France banned all travel and freight from Britain.Credit...Andrew Testa for The New York Times

France will reopen its border with Britain, allowing truck drivers and their freight to cross the English Channel on Wednesday for the first time since Sunday night. But the deal announced late Tuesday won’t immediately alleviate the lines of trucks parked in the southeast of England and delays to the transport of perishable food on board.

All drivers will have to take a rapid coronavirus test and show evidence of a negative result before traveling into France, according to the announcement by the British Department for Transport of an agreement between the British and French governments. The British army will reportedly be used to oversee the thousands of tests that will be needed in the massive logistical effort. Testing the drivers currently waiting near the ports could take several days to complete, and Britain’s transport minister on Tuesday told drivers waiting elsewhere in the country to delay travel to the border.

On Sunday night, France closed its border for 48 hours to all travelers, including truck drivers, in response to a new strain of the coronavirus that has been spreading rapidly in England. The decision left more than 2,800 trucks stranded near the Port of Dover and the Eurotunnel in Folkestone, which were shut to outbound traffic.

France allowed trucks to bring goods into Britain, but those shipments also declined amid fears that the drivers would be marooned once they crossed onto the island.

“It’s a story of human misery,” Rod McKenzie, the director of policy at Road Haulage Association, which represents the British road transport industry, said of the drivers, some of whom have been stuck sleeping in their trucks for two nights. “The government planning has been shocking on this, and there are no adequate lavatory facilities on the motorway for the past couple of days with up to 1,000 trucks parked up.”

Drivers unable to stay in nearby towns had no easy access to food. On Monday, local officials handed out cereal bars, one for each driver on the road, Mr. McKenzie said. On Tuesday, local charities also provided meals as authorities brought in more food and portable toilets.

The British government implemented plans that had been prepared for Brexit-related travel disruption in the new year early. It shut off part of a motorway to allow trucks to park on the road, and it opened an old airport that has capacity for more than 4,000 trucks to be parked and has a few more facilities.

Many of the drivers were said to be Eastern European nationals making return journeys to the mainland. Mr. McKenzie said that while drivers pack their own food, they are often not in Britain for more than a few hours so they wouldn’t necessarily bring a lot.

On Tuesday, the European Commission issued a nonbinding recommendation saying its member states should lift any blanket bans on travelers from Britain to avoid disrupting supply chains. And it noted that until the end of the month, freedom of movement still applies to Britain as part of the Brexit transition period.

“Within the E.U., it is crucial that transport workers are exempted from any restrictive measures, as quarantine and testing,” Adina Valean, the transport commissioner, said in a statement. “We have to continue to maintain the supply chains intact.”

British shoppers have been told there is no need to panic buy over concerns that there could be shortages of some fresh food later in the week. Still, Tesco, a large supermarket chain, reintroduced limits on purchases such as eggs and toilet roll.

The French government had said it wanted to reopen the border “based on a system of mandatory testing upon departure” and encouraged any would-be travelers to get P.C.R. tests, which can take several days to return a result. On Tuesday, it announced that European Union citizens and Brits with a permanent residence across the Channel will be able to travel starting Wednesday if they have a negative coronavirus test within the past 72 hours, using a list of tests approved by the French government, and if their journey is deemed essential.

More nations close their doors to Britain as alarm grows over virus variant.

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The closed port at Dover, England, on Monday evening.Credit...Andrew Testa for The New York Times

More than 40 governments have barred travelers from Britain, suspending flights and cutting off trade routes in scenes reminiscent of the frenzied early days of the pandemic.

The disruptions caused by the closing of borders stoked fears of panic buying in British supermarkets, as Britons, already rattled by a surge in infections and a hastily imposed lockdown in much of England, worried about running out of fresh food in the days before Christmas.

The current upheaval over the virus mutation grew after Prime Minister Boris Johnson of Britain said that it had been shown to be 70 percent more contagious than other variants. The 70 percent estimate of greater transmissibility is based only on modeling and has not been confirmed by lab experiments, said Muge Cevik, an infectious disease expert at the University of St. Andrews in Scotland and a scientific adviser to the British government. British officials said there was no reason to believe that the new variant caused more serious illness.

But the statistic raised alarm around the world. France imposed a 48-hour suspension of freight transit across the English Channel, leaving thousands of truck drivers stranded in their vehicles on Monday as the roads leading to England’s ports were turned into parking lots. Officials were working on Tuesday to end the impasse.

Austria, Belgium, Bulgaria, France, Germany, Ireland, Italy, the Netherlands and Poland are among the European nations that have announced restrictions on travel.

On Monday, the German authorities formalized a ban on planes, trains, buses and ships entering from Britain and South Africa, where a similar variant has emerged, until Jan 6. It will stay in place until more emerges about the virus mutations, said Jens Spahn, the German health minister. Some exceptions would be made for returning crews and freight shipments.

Spain announced that only citizens and residents would be allowed to fly into the country from Britain, and it implemented tighter border checks with Gibraltar, the British territory located at the southern tip of Spain. Greece has extended to 10 days the quarantine period for travelers flying in from Britain, a day after raising it to seven days, but has not suspended flights.

Israel is essentially closing its skies to most foreign nationals starting Wednesday afternoon. Saudi Arabia announced a one-week ban on all international travel, according to the Saudi Press Agency. Kuwait on Monday evening suspended all commercial international flights and closed its land and sea borders until Jan. 1.

In the Asia-Pacific region, South Korea announced it was suspending flights with Britain through the end of the year and Japan said travelers from the U.K. would barred starting Thursday. Hong Kong on Monday closed its borders to all travelers from Britain, including Hong Kong residents. India has suspended all flights between India and Britain until Dec. 31.

On Tuesday, Singapore said it would tighten its border restrictions starting Thursday, while the government of Fiji said all inbound passenger flights would be suspended starting Thursday until at least Dec. 28, citing the British variant.

In South America, Argentina and Colombia canceled flights to and from Britain and imposed a quarantine for travelers who had been there. Peru suspended all flights originating in Europe for two weeks and suspended indefinitely all flights from Britain, including those with layovers in the country. El Salvador enacted restrictions on entry for people who in the last 30 days had been to Britain or South Africa, where a different variant is also driving a new wave of infections.

Starting on Tuesday, Chile banned nonresident foreign nationals who have been in Britain in the last 14 days and suspended flights to and from the country.

Canada, Iran and Russia also issued new restrictions.

In the United States, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, told CNN that he would advise against suspending flights from Britain, but that officials should watch the variant closely.

“Follow it carefully, but don’t overreact to it,” he said.

The new variant, first detected several months ago, spread through southeastern England and has also been identified in small numbers in Denmark, the Netherlands and Australia, according to World Health Organization officials.

Reporting was contributed by Dan Levin, Marc Santora, Aurelien Breeden, Tiffany May, Juliana Kim, Raphael Minder, Marie Fazio, Christopher F. Schuetze, and Isabella Kwai.

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British royals photographed breaking rules as England endures virus variant.

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Prince William and his wife Catherine, with Prince Edward, and his wife Sophie, at an event at Windsor Castle earlier this month. Credit...Pool photo by Richard Pohle

Members of the British royal family have been accused of flouting coronavirus restrictions on the same day parts of England imposed stricter measures to combat a virus variant. Photographs published by the Daily Mail appeared to show Prince William, Kate Middleton and their children breaking limits on social gatherings.

On Sunday evening, the family was photographed with Prince William’s uncle, Prince Edward, and his wife and two children at the Luminate, an annual winter light trail on the Sandringham Estate that is open to people who buy tickets. The photographs appear to show the group of nine mingling along the path.

Sandringham, located in the English county of Norfolk, is under tier two restrictions. Outdoor gatherings are limited to six people, including children.

The so-called rule of six was implemented by the British government in September. Violators could be fined up to £3,200.

The palace could not immediately be reached for comment.

The same day the photographs were taken, Tier 4 restrictions — imposed in an effort to battle a virus variant that could be more contagious than others — took effect in London and most of England’s southeast. People were advised to stay at home except for urgent travel, medical appointments and outdoor exercise. The new restrictions also effectively banned Christmas-season gatherings beyond individual households.

More than 50 countries have imposed restrictions on travel to and from the U.K. to tr to prevent the spread of the variant.

Some staff members at a Texas hospital were hesitant to be vaccinated, so others got a chance.

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Staff members at Doctors Hospital at Renaissance preparing Covid-19 vaccines for health care workers — and, unexpectedly, for others — in Edinburg, Texas, on Dec. 17.Credit...Delcia Lopez/The Monitor, via Associated Press

At a South Texas hospital, employees were enthusiastic about the coronavirus vaccine, according to many polls taken of its staff. An overwhelming number, in some cases as much as 75 percent of the staff, said they would get the shot.

But when the time came to take the dose, far fewer than expected at the Doctors Hospital at Renaissance in Edinburg, Texas, opted to take it. Not wanting to waste any of the doses it had received, the hospital system offered to vaccinate other medical workers in the area, according to a report in The Texas Tribune.

On Saturday, though, many others who were not in the state’s Tier 1 of vaccinations, which consists largely of frontline medical workers, also started showing up to get the shot, including a state senator, a police officer and a sheriff’s deputy.

It was not known on Monday how many of the 5,850 doses the hospital received had been administered to its staff members, and the hospital declined to comment. But Dr. Robert Martinez, the system’s chief medical officer, told The Tribune that the facility did not want to waste any doses after seeing how many were left. The hospital, he said, started to go “down the ladder a little bit.”

Renee Sánchez Leal, whose husband is a medical professional and works at an ophthalmologist’s office in the area, said that the physician he worked for received word on Saturday that the health system had opened up vaccinations to other medical professionals nearby.

On Sunday, Ms. Sánchez Leal stood in a line with her husband for 4.5 hours so that he could get a shot. She did not get the vaccine herself. “We were really lucky that it opened up the way that it did,” she said in an interview on Tuesday.

Dr. Denise De Los Santos, an assistant professor in the department of Obstetrics and Gynecology at the University of Texas Rio Grande Valley who is also a practitioner at the Edinburg hospital, got the vaccine last week. She said in an interview that there was some distrust of the vaccine among those she worked with, though in only a handful of her colleagues.

“I think for physicians ourselves, we’re super excited about the vaccine, and we’re really willing to get it,” she said. “In terms of hesitance for some people to not get vaccinated, I think it’s a misunderstanding of how the vaccine itself works.”

Dr. De Los Santos said many also weren’t sure what the side effects would be. “The main thing is just saying that they don’t understand how the vaccine really works,” she said, or “the long-term effects that we don’t know about yet because it’s so new.”

“At first, before I really understood how the vaccine worked, I also was kind of hesitant,” she said, noting that once she did more research, she was sure that the right choice was to take it.

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global roundup

With first positive tests in Antarctica, no continent is untouched by the virus.

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The Presidente Eduardo Frei Montalva base on Fildes Bay, King George Island. A coronavirus outbreak has been detected at a Chilean army research base in Antarctica.Credit...Chilean Antarctic Institute, via Agence France-Presse — Getty Images

Antarctica is no longer the last continent free from the coronavirus after 36 people stationed at a Chilean research base tested positive, local media reported.

The virus was detected in 26 members of the Chilean military and 10 maintenance workers stationed at the Base General Bernardo O’Higgins Riquelme in the Antarctic Peninsula, the authorities said in a statement to 24 Horas, adding that they were tested after reports that some had developed symptoms.

They were among a group of 60 people who were evacuated from the base to the Chilean city of Punta Arenas over the weekend and have since been isolated, the program reported, and contact tracing was underway. Three cases have also been found in crew members of a Chilean Navy ship returning from the continent, La Prensa Austral reported.

The Chilean army and the Chilean Antarctic Institute did not immediately respond to requests for comment.

The U.S. National Science Foundation said it was aware of reports of virus cases among passengers who would have disembarked in the ports of Punta Arenas and Talcahuano from the Chilean Navy vessel Sargento Aldea, which had been traveling near the O’Higgins station.

“Personnel at U.S. Antarctic Program stations have had no interactions with the Chilean stations in question or the personnel who reside there,” a spokeswoman said, adding that the foundation “remains committed to not exchanging personnel or accepting tourists” at American stations.

Reports of the cases appear to end the continent’s nine-month escape from a virus that has been found in almost every other corner of the world. About 1,000 people have weathered a sunless winter on the continent, which contains about 40 bases, according to The Associated Press, and newcomers must quarantine and test frequently. Bases are small, with people living in close contact, and movement typically picks up in the austral summer, which began in November, when new supplies and people arrive to the continent as others leave.

Research and tourism on the continent have already been severely reduced, and experts say fallout from the pandemic is likely to have a longer impact on governance and travel there.

The Council of Managers of National Antarctic Programs has warned that the virus could have “catastrophic” consequences on the continent, given the extreme environment and limited medical and health resources there, according to The Associated Press.

In other news from around the world:

  • The government of Spain approved new legislation designed to help owners of bars and restaurants shuttered or crippled by the Covid-19 pandemic. The legislation, which was passed by decree, will force landlords to reduce the rent by as much as half if they own more than 10 properties used by restaurants and bars in downtown areas, and offers owners of restaurants and bars a moratorium on rent until next May.

  • Taiwan reported its first case of local coronavirus transmission in eight months, creating an unfamiliar sense of anxiety on the island, which has so far avoided mass lockdowns and had only a handful of Covid deaths. The government’s Central Epidemic Command Center said that the infected person, a woman in her 30s, had come in contact with an airplane worker who arrived in Taiwan from the United States last week and was confirmed to be infected on Sunday.

  • About 700 foreigners in France who were exposed to the coronavirus through their work will be put on a fast track for naturalization as a reward for their commitment during the pandemic, the junior minister for citizenship said on Tuesday. The beneficiaries, whom the ministry called “frontline foreign workers in the face of the health crisis,” include health care workers, child care professionals, housekeepers and cashiers.

Henry Fountain Raphael Minder, Raymond Zhong, and Constant Méheut contributed reporting.

The U.K. gets a Brexit preview as borders are shut to slow the coronavirus variant.

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Kings Cross station in London on Monday, after a suddenly imposed lockdown, in an attempt to deal with a mutated coronavirus, restricted many activities.Credit...Andrew Testa for The New York Times

Christmas plans were canceled. Many flights off the island were stopped. And lawmakers called for cultivating new plots of land to shore up the nation’s food supply.

Britain, christened not long ago by a pro-Brexit lawmaker as “Treasure Island” for the riches it offers, earned another moniker on Monday as a new variant of the coronavirus ripped through the country and set off blockades at its borders: Plague Island.

As dozens of nations banned British travelers, choking off some of the most-traveled routes to and from Britain by road, air and sea, Britons raged at the seesawing plans of their own government, which suddenly reimposed a lockdown across much of the country’s southeast, including London, this weekend.

And they lamented having to grapple with a new and potentially more transmissible variant of the virus even as they steeled themselves for the looming chaos of the country’s split with the European Union in 10 days.

For Britons who were already girding for the country to finalize its messy divorce from the European Union on Dec. 31, the sudden sense of being cut adrift from the bloc — and from the world at large — felt like a bitter taste of what might be to come.

Supermarket giants were warning of fruit and vegetable shortages. Freight trucks were stranded near ports. People trying to leave Britain for their homes elsewhere in Europe before travel bans took effect were in some cases being held up for long stretches at airports.

And while Britain and France were taking steps on Monday to minimize threats to the food supply — about a quarter of all the food eaten in Britain is produced in the European Union — many people in Britain saw the travel ban and port closures as their worst fears about their country’s post-Brexit fate come true.

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The Cayman Islands reduces the sentence of a U.S. college student who broke quarantine.

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A beach in the Cayman Islands.Credit...Carter Johnston for The New York Times

A panel of judges in the Cayman Islands on Tuesday cut the sentence of an American college student who violated the territory’s coronavirus laws to two months from four months after her lawyers argued that the sentence was too harsh.

A lawyer for the student, Skylar Mack, 18, and her boyfriend, Vanjae Ramgeet, 24, said they were sorry and asked for the forgiveness of the people of the Cayman Islands.

“Whilst it was our hope that Skylar would be able to return home to resume her studies in January, we accept the decision of the court and look forward to receiving its written reasons in due course,” the lawyer, Jonathon Hughes, said in a statement.

Ms. Mack and Mr. Ramgeet were sentenced last week to four months in prison after violating the Cayman Islands’ required 14-day quarantine period for visitors.

In late November, with her semester at Mercer University in Georgia complete, Ms. Mack flew to the Cayman Islands to watch Mr. Ramgeet compete in the islands’ Jet Ski racing national championship. But there was a problem: She arrived on a Friday, the championship was Sunday and she was required by law to remain in her hotel room for 14 days.

To elude the restrictions, Ms. Mack, after receiving a negative coronavirus test, slipped an electronic monitoring bracelet from her wrist and escaped to a beach on Grand Cayman’s South Sound, where she saw Mr. Ramgeet win first place.

But the event organizers were notified that Ms. Mack may have been in breach of the rules, and the police were called, her lawyer said. Ms. Mack was charged with leaving her home during the quarantine period; Mr. Ramgeet was charged with aiding and abetting her.

“This was as flagrant a breach as could be imagined,” Justice Roger Chapple said in court during the sentencing, according to The Cayman Compass, a news website in the Cayman Islands. “It was born of selfishness and arrogance.”

The islands, a British territory of nearly 65,000 residents, as of Monday have reported 316 coronavirus cases and two deaths, with no reported cases of local transmission since July. Only people who have been authorized to enter the Cayman Islands can travel there, and they must quarantine at home or in a government or private facility.

Dr. Anthony Fauci receives the Moderna Covid-19 vaccine.

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Top U.S. Health Officials Receive Coronavirus Vaccine on Camera

On Tuesday, Dr. Anthony S. Fauci, Dr. Francis S. Collins and Alex M. Azar II received the Moderna vaccine. They will receive the second dose in 28 days.

“For me, it’s important for two reasons: One is that I’m an attending physician here on the staff at the National Institutes of Health Clinical Center, and so I do see patients. But as important, or more important, is as a symbol to the rest of the country that I feel extreme confidence in the safety and the efficacy of this vaccine. And I want to encourage everyone who has the opportunity to get vaccinated. So that we could have a veil of protection over this country that would end this pandemic.” “I get to talk a lot about these vaccines and their promise for ending this terrible global pandemic. But it’s one thing to hear me talk about it. It’s another to have me roll up my sleeve and say, ‘I believe that this is the way we’re going to get through this.’ This is something that the evidence has shown in rigorous scientific analysis to be safe and effective. So I’m rolling up my sleeve and I’m saying, ‘Dr. — bring it on.’ Are you done yet?” “Oh, you just got lucky.” “That was no problem, people.” “I have complete confidence in the safety and efficacy of these vaccines. And I am just so grateful to N.I.H. and Moderna, and all the participants in Operation Warp Speed for bringing us to this point where now we can see the light at the end of the tunnel from this dark period. So thank you.” “Just a second — little Band-Aid just in case it bleeds. Thank you so much, sir.”

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On Tuesday, Dr. Anthony S. Fauci, Dr. Francis S. Collins and Alex M. Azar II received the Moderna vaccine. They will receive the second dose in 28 days.CreditCredit...Pool photo by Patrick Semansky

Dr. Anthony S. Fauci, the government’s top infectious disease expert, was vaccinated on Tuesday during a live broadcast of what the National Institutes of Health called a kickoff event showcasing Moderna’s vaccine, which was developed by scientists at the agency and received emergency authorization from the Food and Drug Administration on Friday.

Rolling up the sleeve of a blue dress shirt, Dr. Fauci called his public vaccination “a symbol to the rest of the country that I feel extreme confidence in the safety and the efficacy of this vaccine.”

“I want to encourage everyone who has the opportunity to get vaccinated so that we can have a veil of protection over this country that would end this pandemic,” he said.

Joining Dr. Fauci in an auditorium at N.I.H. to receive vaccinations were Dr. Francis S. Collins, the agency’s director, Alex M. Azar II, the health and human services secretary, and frontline workers at the N.I.H. Clinical Center. They will receive the second dose of the Moderna vaccine in 28 days.

The Moderna vaccine, which has received billions of dollars of support from the federal government, has become a triumphant symbol of the administration’s efforts to develop and distribute a vaccine. It was designed by scientists at N.I.H. and the company within two days of China’s releasing the genetic sequence of the coronavirus.

“What we’re seeing now is the culmination of years of research, which have led to a phenomenon that has truly been unprecedented,” Dr. Fauci said at the Tuesday event. “And that is to go from the realization that we’re dealing with a new pathogen, a virus that was described in January of this year, to less than one year later to have vaccines that are going into the arms of so many people, including myself.”

Dr. Fauci’s vaccination was long awaited by public figures and health experts. Former President Barack Obama recently said that if Dr. Fauci, who will also be the chief medical adviser to President-elect Joseph R. Biden Jr. once he takes office, endorses a coronavirus vaccine, that would be a signal to him that it is safe.

On Monday, Mr. Biden received a coronavirus vaccine on live television at the Christiana Hospital in Newark, Del., to send a message to Americans across the country that the vaccine was safe to take.

“Left’s good,” he told the nurse practitioner who administered the Pfizer-BioNTech Covid-19 vaccine, rolling up the sleeve of his black long-sleeve turtleneck and exposing his left arm. “You just go ahead anytime you’re ready.”

He credited the Trump administration for its work on Operation Warp Speed, which helped to deliver a quick vaccine.

“The administration deserves some credit getting this off the ground,” he said. “I’m doing this to demonstrate that people should be prepared when it’s available to take the vaccine.”

Mr. Biden, however, warned Americans that vigilance in the coming months was still necessary.

“It’s going to take time,” he said, encouraging people to continue to wear masks and socially distance. “If you don’t have to travel, don’t travel,” he said. “It’s really important.”

Since March, Mr. Biden’s team has been taking public health guidelines about social distancing and masks seriously, as President Trump and his aides have willfully disregarded them. But even Mr. Biden’s more careful circle has been infiltrated by the virus. Representative Cedric L. Richmond, Democrat of Louisiana and one of Mr. Biden’s closest advisers, tested positive for the coronavirus last week, the transition team announced.

Vice President-elect Kamala Harris is expected to receive her vaccine after Christmas, a spokeswoman said, following advice from doctors who recommended Mr. Biden and Ms. Harris stagger their first shots rather than receive them together.

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A study finds that pulse oximeters are less reliable when used on Black patients.

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Pulse oximeters detect the amount of oxygen in the blood by shining light through the finger.Credit...BSIP SA/Alamy

Pulse oximeters are among the most commonly used tools in medicine. The small devices, which resemble a clothespin, measure blood oxygen when clipped onto a fingertip, and they can quickly indicate whether a patient needs urgent medical care.

Health providers use them when they take vital signs and when they evaluate patients for treatment. Ever since the pandemic started, doctors have encouraged Covid patients to use them at home.

But in people with dark skin, the devices can provide misleading results in more than one in 10 people, according to a new study.

The findings, published last week as a letter to the editor of a top medical journal, sent ripples of dismay through the medical community, which relies heavily on the devices to decide whether to admit patients or send them home.

The report also stirred concerns because the pandemic is taking a disproportionate toll on Black and Hispanic Americans, drawing attention to racial health disparities and prompting soul-searching among doctors about bias that permeates the practice of medicine. There have been several reports of acutely ill Black patients who sought medical care only to be turned away, and studies have found that African-Americans were hospitalized at higher rates, suggesting delays in access to medical care.

The researchers who conducted the oximeter study said they were surprised by the findings. Though scientific reports of the inaccuracies have been published in the past, they did not receive widespread attention or get incorporated into medical training.

“I think most of the medical community has been operating on the assumption that pulse oximetry is quite accurate,” said Dr. Michael W. Sjoding, an assistant professor of internal medicine at the University of Michigan Medical School and lead author of the new report, which appeared in The New England Journal of Medicine. “I’m a trained pulmonologist and critical-care physician, and I had no understanding that the pulse ox was potentially inaccurate — and that I was missing hypoxemia in a certain minority of patients.”

Key West is facing a legal challenge to its 10 p.m. New Year’s weekend curfew.

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Revelers outside the Bourbon St. Pub in Key West, Fla., watched as the drag queen Sushi was dramatically lowered last New Year’s Eve.Credit...Rob O’Neal/Florida Keys News Bur, via Reuters

Key West, Fla., a small tourist town at the southernmost point of the continental United States, has watched its coronavirus numbers climb to more than 2,100 cases.

Last month a county commissioner, his wife and their 35-year-old daughter were infected and wound up in the intensive care unit at the same time. On Dec. 4, two days after the death of the commissioner’s wife, Cheryl Cates, the city enacted a strict three-night curfew for New Year’s weekend that forces all businesses to close and prohibits people from being on the sidewalk.

In an effort to keep throngs of holiday revelers off city streets, particularly for a popular public event featuring a drag queen that draws huge crowds, city leaders declared a 10 p.m. curfew beginning Thursday, Dec. 31, and continuing into Sunday morning. The penalty: 60 days in the county jail or a $500 fine.

A federal lawsuit filed late Monday in the U.S. District Court for the Southern District of Florida seeks a restraining order preventing the curfew, contending that it is a civil rights violation to disallow peaceful assembly.

On Tuesday, a federal judge in Fort Lauderdale ruled in favor of a similar lawsuit in Broward County, saying that the ban there on the sale of alcohol between midnight and 5 a.m. is “speculative and arbitrary,” and violates the governor’s orders to lift such restrictions.

The curfew was enacted despite more modest proposals, such as canceling large events, that were recommended by experts who had convened to review the issue, said William L. Athas, the lawyer who filed the suit. Mr. Athas said he hoped the court would consider a recent U.S. Supreme Court case that declared New York State’s church restrictions unconstitutional.

The curfew was unpopular among workers in the entertainment industry, which suffered huge losses during the lockdown earlier this year.

The suit was brought by Andrew T. Day, a veteran who works at a nearby military base and lives in Key West with his wife and two children, his lawyer said. Mr. Athas declined to say whether Mr. Day worked in an industry that was financially affected by the curfew.

Mr. Day’s Facebook profile shows he is a supporter of President Trump who has questioned the severity of the Covid-19 pandemic.

“His interest is he doesn’t want his constitutional rights taken away from him,” Mr. Athas said.

Alyson Crean, a spokeswoman for the city, declined to comment, citing pending litigation.

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Congress passes the long-awaited stimulus deal.

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Hundreds of dollars in direct payments may start going to American households as soon as next week after Congress overwhelmingly passed a $900 billion stimulus package.CreditCredit...Stefani Reynolds for The New York Times

Hundreds of dollars in direct payments may start going to American households as soon as next week after Congress overwhelmingly passed a $900 billion stimulus package sending billions of dollars to individuals and businesses grappling with the economic and health toll of the coronavirus pandemic.

The long-sought relief package was part of a $2.3 trillion catchall package that included $1.4 trillion to fund the government through the end of the fiscal year on Sept. 30. It included the extension of routine tax provisions, a tax deduction for corporate meals, the establishment of two Smithsonian museums, a ban on surprise medical bills and a restoration of Pell grants for incarcerated students, among hundreds of other measures.

Though the $900 billion stimulus package is half the size of the $2.2 trillion stimulus law passed in March that provided the core of its legislative provisions, it remains one of the largest relief packages in modern American history. It will revive a supplemental unemployment benefit for millions of unemployed Americans at $300 a week for 11 weeks and provide for another round of $600 direct payments to adults and children.

“I expect we’ll get the money out by the beginning of next week — $2,400 for a family of four — so much needed relief just in time for the holidays,” Treasury Secretary Steven Mnuchin said on CNBC. “I think this will take us through the recovery.”

President-elect Joseph R. Biden Jr., who received a coronavirus vaccine on Monday with television cameras rolling, has insisted that this bill is only the beginning, and that more relief, especially to state and local governments, will be coming after his inauguration next month.

Lawmakers hustled on Monday to pass the bill, nearly 5,600 pages long, less than 24 hours after its completion and before virtually anyone had read it. At one point, aides struggled simply to put the measure online because of a corrupted computer file.

The legislative text is likely to be one of the longest ever, and it became available only a few hours before both chambers approved the bill. In the Senate, the bill passed 92 to 6. It will now go to President Trump for his signature.

Spain approves legislation bringing some rent relief to stricken bars and restaurants.

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The terrace of a bar in Barcelona earlier this month, after bars and restaurants there were allowed to reopen under strict constraints. The government declared a state of emergency in October.Credit...Samuel Aranda for The New York Times

Spain’s government on Tuesday approved new legislation designed to help owners of bars and restaurants shuttered or crippled by the Covid-19 pandemic.

The legislation, which was passed by decree, will force landlords to reduce the rent by as much as half if they own more than 10 properties used by restaurants and bars in downtown areas.

If needed, owners of restaurants and bars will also be granted a moratorium on the payment of their rent until next May, when Spain’s current state of pandemic emergency is set to expire. The government estimated that as many as 19,000 owners could apply for the rent relief, paying any outstanding rent over the following two years.

But for now, Spain is not offering direct financial aid to its hospitality sector, as many restaurant owners had demanded.

The Socialist-led coalition government also agreed to give further protection to residents facing a possible eviction, by making it illegal for landlords to cut off their electricity or water.

Spain’s state of emergency was imposed in October as a second wave of infections took hold. Restaurants and bars are operating under strict constraints, and a nightly curfew is in effect, as well as travel restrictions in many regions. There have been at least 1.8 million confirmed cases of coronavirus in Spain, according to the Spanish Ministry of Health.

As of Tuesday morning, 49,260 people had died, and the seven-day average of new reported infections was 9,624 cases a day.

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South Korea is struggling under the strain of a severe outbreak.

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A coronavirus patient was loaded into an ambulance at a nursing home in Gwangju, South Korea, on Tuesday for transport to a hospital.Credit...Yonhap/EPA, via Shutterstock

SEOUL, South Korea — In several provinces across South Korea, there are no I.C.U. beds available to treat the rapidly rising number of Covid-19 patients. As of Monday, only 42 beds were available nationwide, the government said. In the Seoul metropolitan area, home to half of the country’s population and the majority of its recent infections, there were just six. ​

The latest explosion of coronavirus cases in South Korea has put the country on edge in a way that it has not been since the beginning of the pandemic. If cases cannot be brought under control and the strain on hospitals alleviated, the government could for the first time impose Level 3 restrictions, the set of social-distancing rules ​just short of a lockdown in South Korea.

A quiet fear has taken hold in a country that for much of the year was held up as a model for the rest of the world. The streets of Seoul are growing emptier by the day. Supermarkets have reported brisk sales of instant noodles and meal kits. Restaurant owners are anxious they will be forced to close their doors except for takeout orders.

And now, the virus is even harder to contain.

“Unlike in the past, this time the virus seems to pop up everywhere and no place is safe,” said Myeong Hae-kyung, a chief nurse at the Yeungnam University Medical Center in Daegu who served on the front line when the city was the epicenter of the country’s first coronavirus outbreak early this year.

“In recent days, my life has been alternating just between the hospital and home,” she said. “I am afraid to go anywhere else.”

In this wave, hospitals are a critical focus in South Korea. The country has aimed to provide patients with hospital beds within a day of receiving a diagnosis.

But as of Sunday, 368 patients in the Seoul metropolitan area were waiting at home for beds to be assigned to them. Last week, a patient in Seoul died at home while waiting for a hospital bed. Another died at home in Seoul on Sunday.

Taiwan records its first locally transmitted case since April.

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Commuters in Taipei last week. Taiwan has so far avoided mass lockdowns and had only a handful of Covid deaths.Credit...An Rong Xu for The New York Times

Taiwan on Tuesday reported its first case of local coronavirus transmission in eight months, creating an unfamiliar sense of anxiety on the island, which has so far avoided mass lockdowns and had only a handful of Covid deaths.

The government’s Central Epidemic Command Center said that the infected person, a woman in her 30s, had come in contact with an airplane worker who arrived in Taiwan from the United States last week and was confirmed to be infected on Sunday.

The airplane worker, whom the government described as a man in his 60s from New Zealand, had worked on the same Dec. 12 flight, from Taiwan to the United States, as two other people who have since tested positive for the virus. The three had spent time drinking and dining together without protective equipment, the Taiwan authorities said. The man from New Zealand had also been coughing on the flight, the authorities said.

Taiwan’s epidemic command center said on Tuesday that the man had traveled with the woman who tested positive to two department stores in Taipei and a Costco in the nearby city of Taoyuan between Dec. 8 and Dec. 11.

The command center said it had identified 167 people who may have come into contact with the woman and was arranging testing for them.

Taiwan has enjoyed remarkable success at dodging the worst of the pandemic by enforcing quarantines on people who enter from abroad. The island has recorded seven deaths related to the coronavirus and 770 confirmed infections, nearly all of them overseas arrivals.

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