Restaurants, gyms, cafes and other crowded indoor venues accounted for some 8 in 10 new coronavirus infections in the early months of the U.S. epidemic, according to a new analysis that could help officials around the world now considering curfews, partial lockdowns and other measures in response to renewed outbreaks.
The study, which used cellphone mobility data from 10 U.S. metro areas from March to May, also offers provides an explanation for why many low-income neighborhoods were hardest hit. The public venues in those communities were more crowded than in more affluent ones, and residents were more mobile on average, likely because of work demands, the authors said in the research published in the journal Nature on Tuesday. The metro areas were Atlanta, Chicago, Dallas, Houston, Los Angeles, Miami, New York, Philadelphia, San Francisco and Washington D.C.
Infectious disease models had provided similar estimates of the risk posed by crowded indoor spaces, going back to February; all such models are subject to uncertainties, due largely to unforeseen changes in community behavior. The new analysis provides more precise estimates for how much each kind of venue contributed to urban outbreaks, by tracking hourly movements and taking into account the reductions in mobility from lockdown restrictions or other changes that occurred during those first crucial months. It did not model infection in schools or office workplaces.
“Restaurants were by far the riskiest places, about four times riskier than gyms and coffee shops, followed by hotels” in terms of new infections, said Jure Leskovec, a computer scientist at Stanford University and senior author of the new report, in a conference call with reporters. The study was a collaboration between scientists at Stanford, Northwestern University, Microsoft Research and the Chan Zuckerberg Biohub.
Public officials across Europe and in parts of the United States, including Gov. Philip D. Murphy of New Jersey, have begun to institute partial closures of restaurants and bars, or limited indoor hours, as new infections have surged in recent weeks. In New York City, a spike in virus cases threatens the city’s recovery and could mean “a lot more restrictions,” Mayor Bill de Blasio said Monday.
These measures are especially important in lower income areas, the new study suggests. Infections exploded in many such communities last spring, and the new model provides one likely explanation: Local venues tend to be more crowded than elsewhere. Grocery stores, for example, typically have some 60 percent more people per square foot, on average, than in more affluent areas, and shoppers stay inside longer. And residents are less able to shelter at home.
“We think a big reason for that is that essential workers had to be on the job, they weren’t working from home,” said Serina Chang, a co-author also at Stanford.
By focusing on indoor public venues, the researchers could also model the impact of partial restrictions. Limiting restaurant occupancy to one-fifth of capacity, for example, would reduce new infections there by 80 percent, while preserving some 60 percent of customers.
“These are important tradeoffs,” Dr. Leskovec said. “Our work highlights that it does not have to be all or nothing,” when implementing restrictions.
The Food and Drug Administration has granted emergency authorization of a Covid-19 treatment made by the American pharmaceutical company Eli Lilly that was given to Chris Christie, the former New Jersey governor, when he was infected with the coronavirus.
The authorization, announced on Monday, applies only to people newly infected with the virus, and the agency said it should not be used in hospitalized patients. The treatment is approved for people 12 and older who have tested positive and are at risk of developing a severe form of Covid-19 or being hospitalized for the condition. That includes people who are over 65 and obese, the agency said — a key group that early studies have shown can benefit the most from the treatment.
Eli Lilly said that its treatment, called bamlanivimab, should be administered as soon as possible after a positive test, and within 10 days of developing symptoms.
The company and its collaborators, including the National Institutes of Health, were able “to create a new drug, manufacture it, test it in clinical trials, and get it authorized for use in just seven months,” said Dr. Daniel M. Skovronsky, the chief scientific officer of Eli Lilly.
In October, the company announced that it had reached a $375 million deal to sell 300,000 doses of the treatment to the U.S. government. Eli Lilly said Monday that it would begin shipping the treatment immediately to AmerisourceBergen, a national distributor, which will then distribute it on behalf of the federal government.
The treatment consists of a single powerful antibody that is believed to keep the infection in check, and has been shown in early studies to reduce emergency room visits and hospitalizations in patients who get the drug early in the course of their disease.
Eli Lilly’s authorization raised immediate questions about who would get access to the treatments, which must be infused in a clinic or hospital. The company has said it expects to have enough to treat one million people by the end of the year. That means, even in the best-case scenario, there won’t be nearly enough to curb a virus that is now infecting an average of over 116,000 people a day in the United States.
As the virus surges throughout the United States, President-elect Joseph R. Biden Jr. has begun preparing for how he will manage the pandemic by naming several high-profile advisers — including a former surgeon general and a former Food and Drug Administration commissioner — and imploring Americans to wear masks.
“A mask is not a political statement, but it’s a good way to start pulling the country together,” Mr. Biden said in Wilmington, Del. on Monday.
Mr. Biden has said he will ask governors to institute a mask mandate in their states; if they refuse, he will work with local officials to get mandates in place.
More than 130,500 new cases were announced in the United States on Monday, the second-highest total of the pandemic, and the sixth day in a row the country exceeded 100,000 cases in a single day. Twelve states and the territory of Guam set single-day records for new cases.
Across the country, governors and local leaders have put new restrictions in place in an attempt to slow the spread of the virus.
Gov. Philip D. Murphy of New Jersey laid out new restrictions for the state on Monday, calling for restaurants and nightclubs to shut down indoor service at 10 p.m. starting Thursday, and saying that no one may be seated directly at the bar.
Mr. Murphy said he was considering additional targeted restrictions on nonessential businesses.
In New York City, where the number of new cases is swiftly rising, health officials and Mayor Bill de Blasio’s aides have been discussing whether new citywide restrictions should be imposed.
New measures could include a broader shutdown of nonessential businesses if the citywide seven-day average rate of positive virus test results climbs, and stays, above 3 percent. The figure as of Monday was 2.26 percent over the last week, according to the city’s health department.
In Utah, Governor Gary Herbert, a Republican, has announced a state of emergency, including a mask mandate that would apply statewide.
Social gatherings will be limited to “household only” for the next two weeks, Mr. Herbert said in a tweet, and all extracurricular activities at schools will be put on hold.
Utah had the 10th-highest daily average of cases per person on Monday evening, according to a New York Times database.
Denver installed a “Home by 10” order on Sunday evening, instructing people to remain in their homes between 10 p.m. and 5 a.m., except for essential activities. The order also prohibits “all public and private gatherings” between people from different households at all times.
Mayor Bill de Blasio on Tuesday expressed growing fears about virus’s resurgence in New York City, saying that the seven-day average rate of positive test results had increased to 2.31 percent in what he called a “warning sign” of a potential second wave of infections.
At the beginning of September, that figure had dropped below 1 percent. But over the last month, it has been steadily creeping upward, reflecting what city officials said was an increase in transmission within the community, as well as travel-related infections.
Health officials are watching cases rise in specific neighborhoods, including Tottenville in Staten Island where the positivity rate exceeded 6 percent the past seven days, according to city data. But the rising numbers could have major implications for all New Yorkers and threaten to bring back the devastation the city experienced in the spring.
Mr. de Blasio said on Tuesday that if the seven-day average rate crosses 3 percent public schools would be forced stop in-person instruction and move to remote learning. A continued increase could force the city to shut down some or all businesses again, he added. While hospitals in the city have so far been able to handle new patients, the rise in cases could put a strain on health care, he said, mirroring the difficulties that cities are experiencing nationwide.
“And of course the most horrible dilemma, the most horrible consequence: starting to lose lives on a large scale, particularly our elders,” Mr. de Blasio said. “This is our last chance to stop a second wave. If we aren’t able to stop it, there will clearly be lots of consequences that will remind us to much of where we were before.”
Despite the city’s contact tracing efforts, it was not immediately clear where the new infections were coming from. Dr. Jay Varma, a senior adviser for public health to Mr. de Blasio, said on Tuesday that about 5 percent of cases have been associated with gatherings and another 5 percent with “congregate settings” like nursing homes. He said about 10 percent of cases or more are associated with travel, he said.
But Dr. Varma said that for about 50 percent of new cases, the city cannot determine the source of infection and that number has been growing over time.
“That is one of the major warning signs that we have been tracking and been concerned about,” he said.
JERUSALEM — Saeb Erekat, a senior Palestinian leader and negotiator who passionately advocated the establishment of an independent Palestinian state as a resolution to the Israeli-Palestinian conflict, has died. He was 65.
His death was confirmed by the hospital, Hadassah Medical Center in Jerusalem; his daughter and his Fatah party. The hospital said Mr. Erekat, who had previously had a lung transplant, was admitted in critical condition on Oct. 18 with Covid-19, the disease caused by the coronavirus. He required immediate ventilation and resuscitation. “His condition did not improve and remained critical, and he passed away following multi-organ failure.
For three decades, as a close confidant of the Palestinian leader Yasir Arafat and his successor, President Mahmoud Abbas of the Palestinian Authority, Mr. Erekat was one of the most prominent voices of the Palestinian cause.
As the chief negotiator for the Palestinians, he was one of the main authors of key parts of the landmark Oslo peace accords of the 1990s, the first agreements between the Israelis and the Palestinians, which established Palestinian self-government in parts of the occupied West Bank and Gaza Strip.
Although his public statements sometimes gave him the image of a firebrand, he was liked and respected by many of his American and Israeli counterparts, who found the Western-educated diplomat frank and knowledgeable.
Mr. Erekat was initially treated at home when he became ill with the virus, but on Oct. 18, he was taken to Hadassah Medical Center in Jerusalem in an ambulance.
His life’s ambition of helping to bring about Palestinian statehood and an end to Israeli occupation eluded him, a source of frustration.
“I’m not finished with what I was going to do,” he recently messaged Tzipi Livni, the former Israeli foreign minister and one of his main negotiating partners. “I overcame a lung transplant, and I’ll defeat this Covid.”
Brazil said on Monday that it had halted a late-stage trial of a Chinese vaccine, which had been considered a global front-runner in the race to develop a protective shot for the coronavirus, after a “serious adverse” reaction in a participant.
The Brazilian health regulator provided little information on its decision, and did not say whether the reaction was related to the vaccine, called CoronaVac and produced by the Chinese company Sinovac, or coincidental.
The participant who had the reaction became ill on Oct. 29, according to the authorities. They did not divulge where in Brazil the vaccine had been administered or what had happened to the volunteer, citing patient confidentiality. In a statement, they said that such a “serious adverse incident” might include death, disability, hospitalization, birth defects or other “clinically significant events.”
CoronaVac is one of 11 experimental vaccines, produced by some of the world’s foremost pharmaceutical companies, currently in Phase 3 trials.
On the same day that Brazil suspended the Sinovac trial, the American company Pfizer announced that an early analysis of its coronavirus vaccine trials suggested that its drug was more than 90 percent effective in preventing the virus that causes Covid-19.
Sinovac’s drug was seen in China as a leading candidate. But in Beijing’s push to get a Chinese vaccine to be the first on the global market, officials stretched the definition of “emergency use.” They have permitted tens of thousands of people to receive the Sinovac vaccine and two other locally made vaccines, despite having not yet concluded Phase 3 trials.
Adverse effects are not unusual in Phase 3 trials. AstraZeneca and Johnson & Johnson both paused their trials after a few volunteers fell seriously ill, resuming them six weeks later, in October, after concluding that the illnesses were not related to the vaccines
The details of why the Brazilian health regulator had paused the trials were uncertain.
In a statement issued on Tuesday, Sinovac said Instituto Butantan, the medical center coordinating the Brazilian trials, had deemed the “serious event” not related to the vaccine. The company said it was “confident in the safety” of its vaccine.
According to news reports, the institute confirmed that a volunteer had died, but officials there said they were “surprised” by the government’s decision to halt the trials.
Dimas Covas, head of the institute, told a Brazilian television network that he found the government regulator’s decision strange “because it’s a death unrelated to the vaccine.”
Prof. Kim Mulholland, a pediatrician at the Murdoch Children’s Research Institute in Melbourne, Australia, called it “alarming” that Instituto Butantan appeared to have no idea why the trial had been stopped. “It leaves me wondering who had done that and why,” Professor Mulholland added. “That’s the question that really needs to be answered because this is a violation of the normal process.”
At least three people who attended an election party at the White House last week, including the housing secretary and President Trump’s chief of staff, have tested positive for the coronavirus. Several hundred people gathered at the event in the East Room for several hours, many of them not wearing masks as they mingled and watched election returns.
Ben Carson, the secretary of housing and urban development, tested positive for the coronavirus on Monday, according to a spokesman for the agency. He is the latest in a long list of administration officials, including Mr. Trump, to contract the virus.
“He is in good spirits and feels fortunate to have access to effective therapeutics, which aid and markedly speed his recovery,” Coalter Baker, the agency’s deputy chief of staff, said in an email. Mr. Baker did not specify which treatments Mr. Carson had received or would receive.
Another is David Bossie, an adviser Mr. Trump recently appointed to be the face of his efforts to contest vote tabulations in states like Nevada and Georgia, two people familiar with the diagnosis said on Monday. Mr. Bossie tested positive on Sunday.
The third person from the election party is Mr. Trump’s chief of staff, Mark Meadows, who tested positive for the virus the day after the election, aides said.
Mr. Carson, a neurosurgeon who ran unsuccessfully for the Republican presidential nomination in 2016, has defended Mr. Trump’s response to the virus and is a member of the White House virus task force.
At 69, Mr. Carson is at an elevated risk for complications. He is also a cancer survivor, having undergone surgery in 2002 for an aggressive form of prostate cancer.
According to Armstrong Williams, a friend and personal adviser to Mr. Carson, the secretary felt ill over the weekend and was examined and tested early Monday at Walter Reed National Military Medical Center.
Mr. Carson’s wife, Candy, accompanied him to Walter Reed and was tested, but the results were not back yet, Mr. Williams said. It was not clear which kind of test each had taken.
The secretary was one of several hundred people at the White House party, according to people with knowledge of the situation. But Mr. Williams said that Mr. Carson thinks he caught the virus before then, while campaigning for Mr. Trump by bus before Election Day.
Five other White House aides and a Trump campaign adviser also tested positive in the days before and after Election Day, people familiar with the diagnoses told The Times on Friday.
Peter Szijjarto, the Hungarian foreign minister, came to Southeast Asia to promote trade and investment. He would leave possibly having infected at least five people in two countries with the coronavirus.
Last Tuesday, Mr. Szijjarto tested positive for the virus upon arrival in Thailand, which has kept its caseload low by defending its borders. The day before, he had met with Prime Minister Hun Sen of Cambodia and other senior leaders in a country that has limited its coronavirus cases to a few hundred people.
Mr. Szijjarto was asymptomatic, Thai health officials said, and he left Thailand by private jet soon after his positive test.
Fast-forward a week, and a Hungarian diplomat in Bangkok who met with Mr. Szijjarto was confirmed to have tested positive for the virus, according to Thai health authorities.
On Monday, three people in Cambodia who had contact with Mr. Szijjarto — a Cambodian lawmaker and agriculture ministry official, and the Hungarian ambassador to Vietnam and Cambodia — were found to have the virus, according to Cambodian health officials. Two days before, a Cambodian bodyguard who had protected the Hungarian foreign minister during his trip also tested positive.
Mr. Hun Sen, who met with Mr. Szijjarto without social distancing protocols, is now in home quarantine. Schools in Phnom Penh, the Cambodian capital, have shut again, after having opened last week after a long coronavirus closure, as a precaution following the Hungarian foreign minister’s visit.
In other developments around the world:
Australia’s prime minister, Scott Morrison, said on Tuesday that the country was considering opening its borders to several Asian countries, including Japan, South Korea, Singapore and Taiwan. Australia already has a one-way travel bubble with New Zealand, which allows visitors from that country to enter Australia, but not the other way around. “I think we proceed cautiously,” Mr. Morrison told reporters in Canberra.
Returning citizens of the Solomon Islands will be prosecuted if they lie on predeparture forms about their exposure to the coronavirus, Prime Minister Manasseh Sogavare said Monday. “My government will hold these people responsible for endangering our people and our country,” he said in his weekly address to the nation, the local news media reported. The Solomon Islands, which recorded its first coronavirus case last month, now has a total of 16, all of them detected among people in quarantine after arriving from overseas.
Restaurants and nightclubs in Moscow will be forbidden from serving customers between 11 p.m. and 6 a.m. for two months to reduce the spread of the virus, Reuters reported. Moscow’s mayor, Sergei Sobyanin, wrote on Tuesday on his website that these measures would be in place from Nov. 13 until Jan. 15. During that period, schoolchildren would also have to stick to online remote learning.
Nepal has resumed free tests and treatment after a court order and as new infections and deaths have increased across the Himalayan country. The government in Kathmandu had been providing free tests and treatment to all virus patients up until a month ago. Because of the deepening economic crisis, with tourism and remittances severely curtailed, the government instructed state-run hospitals and labs to begin collecting fees. A group of lawyers appealed to the Supreme Court, which last week ruled that the government must bear all expenses related to coronavirus tests and treatment.
President Rodrigo Duterte of the Philippines has named as his national police chief an officer who drew public ire this year for violating pandemic restrictions.
The appointment of Maj. Gen. Debold Sinas, who was previously the police chief of metropolitan Manila, was announced on Monday by Mr. Duterte’s spokesman, Harry Roque. General Sinas was among 19 police officers charged in May with violating social-distancing rules after his birthday party was held at the police headquarters in Manila during a lockdown. At the time, the government said the charges proved its commitment to stamping out misbehavior by officials.
Mr. Roque defended General Sinas’s appointment, saying he had been a “big help” in Mr. Duterte’s war on drugs, which has left thousands dead since the president took office in 2016. General Sinas is required to retire when he turns 56 next May.
“Let’s give him a chance,” Mr. Roque said. “He has six months to prove his worth and let’s see if he will inspire people.”
Rights groups say that extrajudicial killings tied to the drug war have continued despite the lockdowns this year, and in fact have gone unchecked as the country grapples with the health crisis. Cristina Palabay, head of the Philippine rights group Karapatan, said that under General Sinas there had been more drug-related killings as well as illegal arrests.
The Philippines, a country of more than 100 million people where virus cases peaked in August, has had close to 400,000 infections, one of the highest totals in Southeast Asia. There have been 7,647 deaths, according to a New York Times database.
Children across Britain have lost basic skills and regressed in learning because of school closures resulting from the coronavirus pandemic, according to a report released on Tuesday by the government’s school inspection body.
While many schools in England reopened in September — and remain open through England’s lockdown this month — the impact of a national lockdown that began in March before being lifted in the summer is now being felt deeply by many students, according to research from Ofsted, the inspection body.
Younger children have lost early progress in numbers and words, some who were potty-trained have gone back into diapers, and others have even forgotten how to eat with a knife and fork, school inspectors say. For some children, prolonged isolation means they are having to relearn how to maintain friendships.
Older children are struggling with their reading and writing, the research found, and their physical fitness is lacking. There has also been a notable increase in eating disorders and self-harm.
Children who coped well with the restrictions were those who had “good support structures around them,” the chief schools inspector, Amanda Spielman, said in a statement. The children hardest hit by the slip in learning were those whose parents couldn’t work flexibly, for whom lockdown meant spending less time with their parents and less time with other children, Ms. Spielman said.
The report came as the education minister for Wales announced that older students would not take exams next year to “ensure fairness” as they will have spent different amounts of time in schools during the pandemic. Grades will instead be given based on assessments from teachers.
Jay Foreman, the chief executive of the toymaker Basic Fun in Boca Raton, Fla., has a simple message for his employees: It’s time to come back to the office.
It may seem that Mr. Foreman is swimming against the tide. Corporate giants like Microsoft, Target and Ford Motor have extended remote working arrangements until next summer. But a recent survey by LinkedIn and Censuswide found that more than two-thirds of offices had reopened or never closed.
Mr. Foreman is among the employers who don’t believe the coronavirus pandemic has fundamentally reordered the way millions of Americans should work. And those employers are recalling their employees even as the coronavirus surges in parts of the country, arguing that a balance can be struck between safety and the need to reunite under one roof.
At Basic Fun, masks are mandatory, desks are spread out, and there are stations with hand sanitizer throughout the 20,000-square-foot office.
Last week, the last of the Basic Fun workers who had been at home returned to the office full time.
Some employees have come back eagerly, while others have done so reluctantly after asking for more time. At least one has found another job rather than face returning to the office.
The divergent feelings echo larger patterns in the American workplace. At some companies, a new dynamic is unfolding between those who are staying home and those who are venturing in every day.
A June survey by the accounting and consulting firm PwC found that 72 percent of workers would like to be able to work from home at least two days a week. And a majority expected to be able to work from home one day a week even after the pandemic.
But at Basic Fun, there is no longer any choice.
Mr. Foreman is not a mask doubter or a coronavirus skeptic. Nor is he a fan of President Trump, who has questioned the efficacy of masks and criticized the lockdowns that have forced many employees to work from home. Mr. Foreman backed Senator Kamala Harris in the Democratic presidential primary and supported President-elect Joseph R. Biden Jr. in the general election.
But he believes the necessary steps have been taken to assure his workers’ safety.
For those who must travel, or those who are itching to do so, airlines and airports are increasingly offering ways to get tested for the coronavirus ahead of a trip. Taking a test can assure you and others that you aren’t spreading the virus geographically.
In recent weeks, some destinations, like Hawaii, New York, Washington and some Caribbean countries began allowing people who have tested negative for the virus and can show test results to skip mandatory 14-day quarantines, a process that some view as risky because it is possible that people can take a test, receive a negative result and then contract the virus later.
People who have a trip coming up should get a coronavirus test before they travel, experts say. Figuring out the exact time can be tricky, but you can’t wait too long to take the test because you may not get the results back in time to go on your trip.
For those reasons, many destinations, including France, Aruba, Bonaire, Puerto Rico and Hawaii, require that the test be taken within 72 hours of departure. Abu Dhabi and Croatia require test results within 48 hours of departure. Some airlines, like Egypt Air, allow travelers to use results from a test taken up to 96 hours before traveling, depending on where they are traveling from and to.
There are two categories of tests: virus tests, which help determine if a person has the coronavirus, and antibody tests, which detect if a person has an immune response because of past exposure to the virus.
Those who want to find out if they currently have the virus should plan on taking a polymerase chain reaction, or P.C.R., test. P.C.R. tests are considered the gold standard because of their accuracy and reliability.
Another type of diagnostic test is an antigen test, which detects the presence of a specific viral antigen or bits of coronavirus proteins, implying current viral infection. For antigen tests, a sample is collected by nasal swabbing, with hopes that there are some virus proteins in the sample.
There are antibody tests, too, but those are not what people need in order to travel. The presence of antibodies indicates only whether people were previously infected with the coronavirus, not their current infection status, though reinfections are exceedingly rare.
Lockdown, something experienced, dreaded and needed by much of the world in 2020, is Collins English Dictionary’s word of the year.
The dictionary defines the word as “the imposition of stringent restrictions on travel, social interaction, and access to public spaces.”
But most of us are pretty familiar with it.
“Our lexicographers chose ‘lockdown’ as Word of the Year because it is a unifying experience for billions of people across the world, who have had, collectively, to play their part in combating the spread of Covid-19,” Collins said on its website.
The dictionary counted over a quarter of a million uses of the word this year, up from 4,000 last year.
Other words that made the short list were “coronavirus” — “any of a group of viruses that cause infectious illnesses of the respiratory tract, including Covid-19” — “self-isolate” and “furlough.”
Denmark’s plan to kill its farmed mink is on hold because of a question about the government’s legal authority to order the cull, the Danish environment and food minister, Mogens Jensen, said in an interview on Denmark’s TV2 on Tuesday.
Last week, Denmark announced that it would kill all its farmed mink because of coronavirus infections and virus mutations.
In Tuesday’s interview, Mr. Jensen said he was not aware that the government did not have legal authority to require all healthy mink to be culled.
Mink farmers are still encouraged to cull their mink and the government is seeking legal approval, Mr. Jensen said.
Farms with coronavirus infections and other farms within a radius of about five miles are required to cull their animals under a pre-existing order.
Denmark’s concern is that a mutated variant of the coronavirus that came from mink and that has infected some people could diminish the effectiveness of potential vaccines.
The World Health Organization has said there is no evidence yet that vaccines would be affected. And there is no evidence that the mutated virus, one among many existing mutations in both people and mink, is more transmissible or causes more serious illness than any other variant.