An empty classroom at Govalle Elementary School in Austin, Texas, in December.
Credit…Sergio Flores for The New York Times

The Centers for Disease Control and Prevention on Friday urged that K-12 schools be reopened and offered a comprehensive science-based plan for doing so speedily, an effort to resolve an urgent debate roiling in communities across the nation.

The new guidelines highlight the growing body of evidence that schools can openly safely if they put in effect layered mitigation measures. The agency said that even when students lived in communities with high transmission rates, elementary students could receive at least some in-person instruction safely — a finding echoed by an independent survey of 175 pediatric disease experts conducted by The Times.

Middle and high school students, the agency said, could attend school safely at most lower levels of community transmission — or even at higher levels, if schools put into effect weekly testing of staff and students to identify asymptomatic infections.

Among the pediatric experts surveyed by The Times, the point of most agreement was requiring masks for everyone: students, teachers, administrators and other staff. All respondents said universal masking was important, and many said it was a simple solution that made the need for other preconditions to opening less essential.

“C.D.C.’s operational strategy is grounded in science and the best available evidence,” Dr. Rochelle Walensky, director of the C.D.C., said on Friday in a call with reporters.

The guidelines arrive in the middle of a debate that is already highly fraught. Some parents whose schools remain closed are becoming increasingly frustrated, and public school enrollment has declined in many districts across the country.

Education and civil rights leaders are despairing about the harms being done to children who have not been in classrooms for nearly a year. And many of the pediatric health experts also expressed deep concern about other risks to students of staying home, including depression, hunger, anxiety, isolation and learning loss.

“Children’s learning and emotional and, in some cases, physical health is being severely impacted by being out of school,” said Dr. Lisa Abuogi, a pediatric emergency medicine physician at the University of Colorado, expressing her personal view. “I spend part of my clinical time in the E.R., and the amount of mental distress we are seeing in children related to schools is off the charts.”

The Biden administration has made a high priority of returning children to classrooms, and the new recommendations try to carve a middle ground between school officials as well as some parents who are eager to see a resumption of in-person learning and powerful teachers’ unions resisting a return to school settings that they regard as unsafe amid the coronavirus pandemic.

Whether the guidelines will persuade powerful teachers’ unions — allies of Mr. Biden — to support teachers returning to classrooms remains to be seen. In advice that may be disappointing to some unions, the document states that, while teachers should be vaccinated as quickly as possible, teachers do not need to be vaccinated before schools can reopen.

“I completely understand teachers’ and other school employees’ fear about returning to school, but there are now many well-conducted scientific studies showing that it is safe for schools to reopen with appropriate precautions, even without vaccination,” said Dr. Rebecca Same, an assistant professor in pediatric infectious disease at Washington University in St. Louis. “They are much more likely to get infected from the outside community and from family members than from school contacts.”

The C.D.C. document embraces the often-repeated mantra that schools should be the last settings to close in a community and the first to reopen. But that has been followed nowhere in the country, and these guidelines have no power to force communities where transmission remains high to take steps, such as closing nonessential businesses, to decrease it.

As a result, some teachers’ unions will continue to argue that the overall environment remains unsafe to return to in-person classrooms.

A majority of districts in the country are offering at least some in-person learning, and about half of the nation’s students are learning in classrooms. But there are stark disparities in who has access to in-person instruction, with urban districts, which serve mostly poor, nonwhite children, more likely to be closed than nonurban ones.

Moderna currently supplies about half of the nation’s vaccine stock. 
Credit…Jim Wilson/The New York Times

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.

Outreach workers try to sign up homeless people to go to shelters at the Woodlawn subway station in The Bronx.
Credit…Victor J. Blue for The New York Times

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.

Rosario Sabio, 77, receiving a coronavirus vaccine in San Diego last month.
Credit…Ariana Drehsler for The New York Times

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 on Friday reported more than two million new vaccinations, bringing the latest seven-day average to about 1.66 million a day. About 35.8 million people have received at least one dose of a Covid-19 vaccine, and about 12.1 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.

The French National Authority for Health has recommended a single dose of the vaccine for people who have already been infected with Covid and have had the results confirmed by a P.C.R. or antigen test.
Credit…Andrea Mantovani for The New York Times

France’s top health authority said Friday that one dose of the coronavirus vaccine, rather than two, would be sufficient for most people who have recovered from Covid-19.

The Pfizer-BioNTech, AstraZeneca and Moderna vaccines — all of which are approved for use in the European Union — are meant to be injected in two doses spaced a few weeks apart.

But most people who have been infected with the coronavirus have already developed a strong immune response. In those cases, the French National Authority for Health said in a news release, a single shot could suffice, essentially serving as a booster.

It said the shot should be administered at least three months — and ideally closer to six months — after a Covid-19 infection.

While Britain and a number of other countries are delaying second doses to prioritize getting first doses to more people, the French announcement appeared to be the first to recommend only a single dose for those who have had the virus.

The independent body’s recommendation came with exceptions for people with compromised immune systems. It added that people who contract Covid-19 shortly after getting a single dose of the vaccine should wait three to six months before getting a second dose.

By contrast, the U.S. Centers for Disease Control and Prevention says that people who become infected in the days after their first dose can get their second dose after they recover, but that they can also choose to delay receiving the second dose.

According to a study posted online this month, which was not peer reviewed, researchers at Icahn School of Medicine at Mount Sinai in New York found that Covid survivors had far higher antibody levels after both the first and second doses of the vaccine and might need only one shot. But some scientists have urged caution, warning that more data was needed to prove that those antibodies could effectively stop the virus from replicating.

The pandemic has devastated businesses in San Francisco’s Chinatown, where banquet halls are closed and few shoppers are in the mood to buy Lunar New Year decorations.
Credit…Jim Wilson/The New York Times

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.”

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‘We Need a Circuit Breaker’: Victoria Enters Lockdown

After multiple new cases of coronavirus were identified in Victoria, Australia, officials placed the region under lockdown, despite the tennis tournament currently taking place there.

I am sad to have to report it is the advice to me that we must assume that there are further cases in the community than we have positive results for, and that it is moving at a velocity that has not been seen anywhere in our country over the course of these last 12 months. Because this is so infectious and is moving so fast, we need a circuit breaker. Therefore, I’m announcing on advice from the chief health officer and after a meeting of relevant cabinet committees and the full cabinet, that from 11:59 p.m. tonight, Victoria, all of Victoria, will go to Stage 4. These restrictions are all about making sure that we respond appropriately to the fastest-moving, most infectious strain of coronavirus that we have seen. I know this is not the news that Victorians want to hear today. I know it’s not the place that we want it to be in. However, we’ve all given so much. We’ve all done so much.

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After multiple new cases of coronavirus were identified in Victoria, Australia, officials placed the region under lockdown, despite the tennis tournament currently taking place there.CreditCredit…Darrian Traynor/Getty Images

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.

  • Canadian Prime Minister Justin Trudeau announced new travel restrictions on Friday. Beginning Feb. 22, all travelers by both land and air must show proof of a negative virus test taken within 72 hours before arrival in the country and they will be given another test when they arrive at the border. Air travelers will also be required to book a three-night stay in a government-authorized hotel at their own expense to quarantine while they await test results. All travelers must complete a full 14-day quarantine or risk heavy fines and possible jail time.

    “These are some of the strongest restrictions in the world. But with new variants emerging, we’re stepping them up even further,” Trudeau said during a news conference Friday.

  • 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.

Funeral proceedings in Cape Town, South Africa, in June of last year. The World Health Organization said that deaths across the African continent had risen by 40 percent in the last month. 
Credit…Marco Longari/Agence France-Presse — Getty Images

NAIROBI — The number of people dying from the coronavirus has swelled in more than half of the countries in Africa in the past month, the World Health Organization has warned, linking the rise to overwhelmed hospitals and health workers.

“The increasing deaths from Covid-19 we are seeing are tragic, but are also disturbing warning signs that health workers and health systems in Africa are dangerously overstretched,” said Dr. Matshidiso Moeti, the W.H.O.’s regional director for Africa. “This grim milestone must refocus everyone on stamping out the virus.”

The global health body said on Thursday said that deaths had increased in 32 of the continent’s 55 countries in the last month, pushing the overall African death toll near 100,000. Mortalities rose overall by 40 percent, the W.H.O. said, with more than 22,300 deaths recorded in the last 28 days compared with 16,000 deaths in the 28 days preceding that.

The rise in deaths comes as the continent faces a second deadlier wave of the virus, the emergence of new variants that vaccines may not fight effectively — particularly in hard-hit South Africa — and growing concerns around inequalities in distributing vaccines.

To forestall more deaths, the W.H.O. directed governments to ramp up investments in health care systems and to enforce measures including mask wearing, washing hands and social distancing.

Dr. Moeti also encouraged Africans to “go out and get vaccinated when a vaccine becomes available in your country.”

Her statement came just a week after she urged Tanzania’s government to start sharing data on its Covid-19 situation and begin preparations for a vaccination campaign. The East African nation has not submitted information about coronavirus cases to the W.H.O. since last April. The country’s president, John Magufuli, insists that Tanzania is coronavirus free and argues that “vaccines don’t work.”

In a leaked phone call, Melissa DeRosa, Gov. Andrew M. Cuomo’s top aide, told lawmakers that “basically, we froze.”
Credit…Justin Lane/EPA, via Shutterstock

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.

Inoculations at Gillette Stadium in Foxborough, Mass.
Credit…Joseph Prezioso/Agence France-Presse — Getty Images

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.

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Ohio officials said on Thursday they discovered about 4,000 overlooked Covid-19 deaths that occurred over the past several months after the state’s Health Department said the deaths had not been properly merged between the internal death certificate database and the federal database.CreditCredit…Doral Chenoweth/The Columbus Dispatch, via Associated Press

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.

A laboratory assistant with a tube of Russia’s Sputnik V vaccine in Budapest.
Credit…Matyas Borsos/via Reuters

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.

A livery cab driver waiting in a recovery area after getting his first vaccine dose in the Bronx last month.
Credit…James Estrin/The New York Times

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.

Dining in plastic igloos outside an East Village restaurant in Manhattan in November. Indoor dining has been banned in New York City since mid-December.
Credit…Hiroko Masuike/The New York Times

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.

Christian Smalls speaks to a group of protestors and media as he leads a workers strike at JFK8 Amazon Fulfillment Center on May Day last year.
Credit…Gabriela Bhaskar for The New York Times

Amazon on Friday sued New York’s attorney general, Letitia James, in an attempt to stop her from bringing charges against the company over safety concerns at two of its warehouses in New York City.

The company also asked the court to force Ms. James to declare that she does not have authority to regulate workplace safety during the Covid-19 pandemic or to investigate allegations of retaliation against employees who protest their working conditions.

In the case, filed with the U.S. District Court for the Eastern District of New York, Amazon said Ms. James’s office had been investigating pandemic safety concerns raised by employees at its large fulfillment center on Staten Island and at a delivery depot in Queens. It said Ms. James “threatened to sue” Amazon if it did not agree to her demands, including subsidizing bus service, reducing worker productivity requirements, disgorging profits and reinstating Christian Smalls, an worker Amazon fired in the spring.

Mr. Smalls has said he was retaliated against for leading a protest at the Staten Island warehouse. Amazon has said he was fired for coming to the work site for the protest even though he was on paid quarantine leave after he had been exposed to a colleague who tested positive for Covid-19.

Mr. Smalls became the most visible case in the clashes between workers and Amazon, which faced a surge of orders from consumers hunkering down. As the pandemic spread across the country, many Amazon workers said the company missed early opportunities to provide better protection against Covid-19.

Amazon has strongly defended its safety measures and has gone on the offensive against its critics. In its 64-page complaint, Amazon said its safety measures “far exceed what is required under the law,” and it argued that federal law, not the state law enforced by the New York attorney general, has primary oversight for workplace safety concerns.

Amazon declined to comment beyond the filing.

Ms. James, in a statement, said the suit was “nothing more than a sad attempt to distract from the facts and shirk accountability for its failures to protect hardworking employees from a deadly virus.”

She said her office was reviewing their legal options. “Let me be clear: We will not be intimidated by anyone, especially corporate bullies that put profits over the health and safety of working people,” she said.

Orignially published in NYT.

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