The White House on Wednesday announced a billion-dollar investment in at-home rapid coronavirus tests that it said would help quadruple their availability by later this year.
By December, 200 million rapid tests will be available to Americans each month, with tens of millions more arriving on the market in the coming weeks, Jeffrey D. Zients, the White House’s Covid-19 coordinator, said at a news conference. Mr. Zients also said the administration would double the number of sites in the federal government’s free pharmacy testing program, to 20,000.
The changes reflect the administration’s growing emphasis on at-home testing as a tool for slowing the spread of Covid-19. President Biden in September said that he would use the Defense Production Act to increase the production of rapid testing kits and would work with retailers, including Amazon and Walmart, to expand their availability. He pledged $2 billion to the effort, or roughly 280 million tests.
The Biden administration’s commitment “allows the manufacturers to have the confidence in the demand to scale up their production,” Mr. Zients said. “It’s an expansion of the industrial base, so that more manufacturing occurs, based on the U.S.’s commitment to the testing sector.”
By December, the U.S. will produce about a half billion tests a month, roughly half of which will be the at-home units, he added.
The Biden administration’s efforts to expand testing access received a significant boost on Monday, when the Food and Drug Administration authorized Acon Laboratories’ at-home test. Dr. Jeffrey E. Shuren, the director of the agency’s medical devices center, said the move could double at-home testing capacity in the coming weeks.
“By year’s end, the manufacturer plans to produce more than 100 million tests per month, and this number will rise to 200 million per month by February 2022,” he said. Like tests already available from Abbott, Quidel, Becton Dickinson and other makers, Acon’s test is made to detect proteins from the virus on a nasal swab, and produces results in 15 minutes.
Mr. Zients did not say which tests the administration’s investment would go to purchase.
Asked why the White House had not moved sooner to spend more on tests, Mr. Zients said the administration had increased access to at-home tests “as the innovation allowed for” more tests to come to the market.
Rapid tests can cost as little as $10, which public health experts say can still be prohibitively expensive for some people. Mr. Zients said on Wednesday that the Acon test would likely cost less than $10. “As we get more and more tests approved, and manufacturing ramps up, pricing should come down,” he said.
Rapid tests are not as sensitive as P.C.R. tests, but experts say they are still accurate in detecting the virus in someone who is in the first week of displaying symptoms, when the viral load is likely to be highest.
Some pharmacies and retailers have recently struggled to keep tests in stock, or have had to place limits on how many customers can purchase. Demand has increased with the school year underway and employees returning to many workplaces.
Last week, Ellume, an Australian company that makes a widely available at-home coronavirus test, recalled nearly 200,000 test kits because of concerns about a higher-than-expected rate of false positives. The recall did not affect most of the 3.5 million test kits Ellume has shipped to the United States.
President Biden is traveling to Chicago on Thursday to talk about vaccine mandates.
Chicago was picked in part because it is the home of United Airlines, which became one of the first major carriers to require shots for its 67,000 U.S. employees. Other airlines have followed with similar requirements, including American Airlines, Southwest, JetBlue and Alaska Airlines.
Jeff Zients, the White House coronavirus response coordinator, announced the trip on Wednesday, and said Mr. Biden would focus on the success of vaccine mandates.
Last month, Mr. Biden said he would use his presidential powers to require two-thirds of American workers be vaccinated against the coronavirus. That included a private sector to mandate that all companies with more than 100 workers require vaccination or weekly testing.
Mr. Biden also moved to mandate shots for health care workers, federal contractors and the vast majority of federal workers, who could face disciplinary measures if they refuse.
Mr. Biden will talk about the impact that those requirements are having, Mr. Zients said.
“We believe that vaccination requirements at workplaces are very effective and an efficient way to ensure people are vaccinated or tested,” Mr. Zients said.
United Airlines has previously said that it would terminate about 600 employees for refusing to comply with its vaccination requirement. About 99 percent of its U.S. work force has been vaccinated, according to the airline.
Lt. Gov. Janice McGeachin of Idaho took advantage of an out-of-state trip by Gov. Brad Little on Tuesday to issue an executive order forbidding educational institutions from requiring proof of vaccination from employees. She said on Twitter that in her pursuit of “individual liberty,” she had “fixed” an order the governor had issued earlier.
Governor Little’s order, made in the spring, prohibits state agencies from requiring or issuing proof of Covid vaccinations, but does not specifically name universities and public K-12 schools. When he returned Wednesday from a trip to Texas, he promptly repealed Ms. McGeachin’s order, writing that he had notified her that “no official business would require her services in an acting governor capacity” during his absence.
The lieutenant governor, who is elected independently of the governor, is challenging Mr. Little for the position, and the two have feuded throughout their tenure. Ms. McGeachin has consistently criticized Mr. Little’s measures to contain the virus, casting his restrictions as government overreach. And this week was not their first round of political one-upping.
In May, when Mr. Little was away at the Republican Governors Association conference, Ms. McGeachin issued a ban on mask mandates, which he then repealed. Idaho did not have a statewide mask mandate, but an executive order required masks at long-term care facilities and said they were “strongly recommended” elsewhere. Nor did Mr. Little prevent municipalities from issuing their own directives on masks.
On Tuesday, Ms. McGeachin also asked about mobilizing the Idaho National Guard and sending troops to the Mexican border, where Mr. Little and other Republican governors had traveled that day.
Mr. Little replied on Facebook that “attempting to deploy our National Guard for political grandstanding is an affront to the Idaho constitution.” In the past he has described Ms. McGeachin’s activity in his absence as “irresponsible” and “self-serving.”
Asked about the battles, Jaclyn J. Kettler, a political scientist at Boise State University, noted that although both Mr. Little and Ms. McGeachin are Republicans, the lieutenant governor is further to the right politically and that there is tension between the two, particularly regarding coronavirus rules and restrictions.
While Ms. McGeachin’s base might be cheering her on for defying Mr. Little, Prof. Kettler said, “there are many Idahoans that are perhaps baffled or frustrated with these type of developments.”
“The Covid situation here is not great,” she said.
About 42 percent of eligible people in Idaho are vaccinated, according to a New York Times database. The state’s recent weekly average has been about 1,300 new cases a day.
Michael Levenson contributed reporting.
Even as parents in the United States wrestle with difficult questions over vaccinating their children against the coronavirus, families in other countries have been offered a novel option: giving children just one dose of the vaccine.
Officials in Britain, Hong Kong, Norway and other countries have recommended a single dose of the Pfizer-BioNTech vaccine for children ages 12 and older — providing partial protection from the virus, but without the potential harms occasionally observed after two doses. On Wednesday, Sweden and Denmark joined the ranks, announcing that adolescents should get only one jab of the Moderna vaccine.
Health officials in those countries are particularly worried about increasing data suggesting that myocarditis, an inflammation of the heart, may be more common among adolescents and young adults after vaccination than had been thought.
The risk remains very small, and significant only after the second dose of an mRNA vaccine. But the numbers have changed the risk-benefit calculus in countries where new infections are mostly lower than in the United States.
Advisers to the Centers for Disease Control and Prevention reviewed data on myocarditis in June, and unanimously voted to recommend the vaccine for children ages 12 and older, saying the benefits far outweighed the risk.
Agency research has estimated that for every million vaccinated boys ages 12 to 17 in the United States, the shots might cause a maximum of 70 myocarditis cases, but they would prevent 5,700 infections, 215 hospitalizations and two deaths. Studies have also shown that the risk of heart problems after Covid-19 is much higher than after vaccination.
Myocarditis was among the concerns that led the Food and Drug Administration to ask vaccine makers this summer to increase the number of children in clinical trials. The issue is likely to be the focus of intense discussion when agency advisers meet next week to review the evidence for vaccinations of children ages 5 to 11 years.
The latest analysis, which was published on Wednesday in The New England Journal of Medicine, found that the incidence of myocarditis after vaccination in Israel was highest among males aged 16 to 29 years. About 11 of every 100,000 males in that age group developed the condition a few days after being vaccinated, a rate higher than most earlier estimates. (The risk was negligible in females of any age.)
Of the 54 cases identified in the study, one was severe enough to require ventilation. Another patient with a history of heart disease died of an unknown cause soon after discharge from the hospital.
The U.N.-backed vaccine program will fail to meet its target for delivering doses to Latin America and the Caribbean this year, in part because wealthy countries that pay more for the shots are buying up most of the supply, a World Health Organization official said Wednesday.
The global Covax program, the primary source of Covid vaccines for most of the world, aimed to provide enough doses this year for Latin American and Caribbean countries to inoculate 20 percent of their people. But most countries have only received around 30 percent of the supply they contracted through Covax, said Dr. Jarbas Barbosa, assistant director of the Pan American Health Organization, a division of the W.H.O.
“Producers are not prioritizing delivery to the Covax mechanism,” Dr. Barbosa said at a news conference. “They continue to prioritize the bilateral agreements they have because in these bilateral agreements the vaccines are more expensive.”
Wealthy countries have raced far ahead of the rest of the world in vaccination rates, and continue to buy doses as demand for booster shots rises. The W.H.O. said last week that only nine of Africa’s 54 countries had met the goal of vaccinating 10 percent of their people by the end of September.
India’s prohibition on exporting vaccines has contributed to delays in delivering shots to other parts of the world. India, the world’s largest drug producer, imposed the ban in May as it fell behind on domestic vaccination, but it said recently that with production expanding and its own inoculation program gaining speed, it would lift the embargo this month.
Covax is focusing on delivery of vaccines to countries that have so far vaccinated less than 10 percent of their population. In the Americas, that includes Jamaica, Nicaragua and Haiti.
With the Covax program faltering, the Pan American Health Organization has struck separate deals to buy millions of vaccine doses from China’s Sinopharm and Sinovac, as well as AstraZeneca. But those agreements still fall far short of meeting the need.
Around 37 percent of the population in Latin America and the Caribbean has been fully vaccinated, but access in the region has been very uneven; Cuba, Chile and Uruguay are among the most highly vaccinated countries in the world.
“We continue to urge countries with surplus doses to share these with countries in our region, where they can have life-saving impact,” said Dr. Carissa F. Etienne, director of the P.A.H.O.
In April 2020, Christopher Charles Perez posted a message on Facebook saying that he had paid someone infected with Covid-19 to lick groceries at a San Antonio grocery store.
“My homeboys cousin has covid19 and has licked everything for past two days cause we paid him too,” Mr. Perez wrote in a post about an H-E-B supermarket. “YOU’VE BEEN WARNED.”
The claim was not true, and the post came down after 16 minutes, according to court documents.
But someone anonymously submitted a screenshot of the post to the Southwest Texas Fusion Center, a group of law enforcement agencies that investigates possible criminal and terrorist activity. When the F.B.I. confronted Mr. Perez, he said he had been trying to scare people from going to public places “to stop them from spreading the virus,” according to a federal affidavit.
Mr. Perez, 40, of San Antonio, was found guilty in June of disseminating false information and hoaxes related to biological weapons. On Monday, a federal judge sentenced him to 15 months in federal prison.
In a statement, federal prosecutors said that Mr. Perez had been trying to frighten people with threats of “spreading dangerous diseases.” His arrest in April 2020 came early in the pandemic, when there was still uncertainty over how the coronavirus spread, and as people were wiping down their groceries and emptying stores of disinfectant.
“Perez’s actions were knowingly designed to spread fear and panic,” Christopher Combs, the special agent in charge of the F.B.I.’s San Antonio field office, said in the statement. The sentence, he said, “illustrates the seriousness of this crime.”
Mr. Perez’s sentence, which included three years of supervised release, requires him to seek mental health treatment and take mental health medication.
The financial windfall at Moderna, the biotech company behind one of the three federally cleared Covid-19 vaccines, has propelled three new names onto Forbes magazine’s list of the 400 richest people in the United States.
Using stock prices and exchange rates from early September, the magazine’s list added Noubar Afeyan, Moderna’s chairman and co-founder; Robert Langer, a Massachusetts Institute of Technology professor and Moderna co-founder; and Timothy Springer, a Harvard Medical School professor and early investor in the company. The stated net worth of each was more than $3.5 billion.
A representative for Moderna did not immediately respond to a request for comment.
The coronavirus pandemic has been an economic catastrophe for much of the country, but the richest have done well, Forbes noted when it published the list on Tuesday: The 400 people included saw their collective wealth increase 40 percent during the last year.
Moderna makes one of the three vaccines authorized for use in the United States. Headquartered in Cambridge, Mass., the company was founded in 2010 with the goal of bringing RNA-related products to market. Its only commercial product is the Covid vaccine, for which the U.S. government provided $1 billion to support design and testing. With countries around the world buying as much vaccine as possible, Moderna’s valuation topped $100 billion this summer.
The company’s stock price Wednesday was more than four times its value at this time last year, even though its share prices have been slipping, with a major drop of about 18 percent in the past week alone. Most of that drop came on Friday, after the pharmaceutical giant Merck said that its new pill to treat Covid-19 reduced the risk of hospitalization and death by about 50 percent. Merck plans to seek federal emergency use authorization for the antiviral pills.
That drop significantly reduced the worth of the three Moderna billionaires. Dr. Springer was No. 176 on the list and worth $5.9 billion when the Forbes calculations were made on Sept. 3, a figure that had dropped to $4.6 billion by Wednesday. The reported worth of Mr. Afeyan, No. 212, fell from $5 billion to $3.8 billion. And the wealth of Dr. Langer, No. 222, slipped from $4.9 billion to $3.7 billion, Forbes said.
Moderna’s vaccine, which is built around messenger RNA, as is the one developed by Pfizer-BioNTech, was authorized for emergency use for people 18 and older by the Food and Drug Administration last December. Moderna submitted its vaccine for an emergency use authorization in 12- to 17-year-olds in June and for full federal approval in August; regulators’ decisions are pending.
More than 283 million doses of Moderna’s vaccine have been administered in almost 40 countries that reported their vaccine distribution data to the Our World in Data Project at Oxford University, and Moderna’s revenues have ballooned since the vaccine saw widespread use.
In its most recent financial statement Moderna said that its total revenues were $4.4 billion for the three months ending June 30, 2021, compared to $67 million for the same period in 2020. Net income for the six months ending on June 30, 2021, was $4 billion, compared to a net loss of $241 million during the same period in 2020.
Tracking community transmission is at the heart of efforts to stop the spread of the coronavirus, scientists say, and in most states the daily dashboards showing new cases have been a critical tool for public health officials trying to track the trajectory of the virus, which has killed 700,000 Americans.
Yet for three crucial months this summer, Nebraska did not report any county-level information to the public. State officials stopped sharing counts of new coronavirus cases by county with the public on June 30, just as the Delta variant began surging in the United States.
That was by design. Gov. Pete Ricketts, a Republican who opposes both mask and vaccine mandates, allowed his emergency order to expire in June, and the state’s unusually strict privacy laws were reinstated, which he said prohibited the continued release of the data.
At the time, the number of new cases in Nebraska had reached a low in the state, and Test Nebraska, which gave free virus tests to hundreds of thousands of residents, ended its operations shortly after the emergency ended.
The virus continued to spread in the state, however, driven by the highly contagious Delta variant. Hospitalizations increased tenfold from the end of June through mid-September. New cases rose sharply in August. Deaths increased as well.
On Sept. 20, after coronavirus hospitalizations surpassed 10 percent of the state’s capacity of staffed hospital beds, Mr. Ricketts announced that county-level case data would once again be made public on a new “hospital capacity” state dashboard.
But he said the data will disappear again if the number drops below 10 percent on a 7-day rolling average. And the state is still not reporting county-level deaths.
Public health experts in Nebraska were dismayed all summer about the decision to delete the dashboard, and state legislators wrote a letter requesting that it be restored.
A handful of the state’s 93 counties continued to provide daily data on their websites throughout the pandemic because they have more than 20,000 residents.
That meant that the only real-time data on the virus across the state that doctors like Dr. David Brett-Major, an infectious disease specialist, had during July and August was watching sick people stream into the emergency department of the University of Nebraska Medical Center in Omaha.
“If the tests are only happening when the cases are more severe, then you’re not getting a broad look,” he said in a recent interview.
Susan Bockrath, the executive director of the Nebraska Association of Local Health Directors, said her group brought up the missing dashboard repeatedly with state officials, pointing out it was also a necessary tool in the campaign against pandemic misinformation.
The dashboard was removed just as Stephanie Summers, board of education president in David City, was trying to determine the best policy for students and families in her rural community one hour west of Omaha. Mr. Ricketts has told Nebraskans to get vaccinated, but declined to require masks, despite pleas from some public health officials.
“The state cannot insist on an individual’s freedom to choose to wear, or not wear, a mask, or whether or not to get vaccinated, and then also withhold the data needed for citizens to make informed decisions,” she said, adding that she fully agreed with state leaders in emphasizing those individual freedoms.
While the dashboard has mostly been restored, some doctors doubt the current testing system is capturing the reality on the ground. Two dozen doctors sent a letter in early September to Mr. Ricketts asking for the return of Test Nebraska.
“Our access to testing is so bad right now, and the turnaround so bad, that these numbers are probably vast underestimates, and not accurate just because there is not enough testing,” said Dr. Bob Rauner, chief medical officer of OneHealth Nebraska, a group of 65 locally owned medical clinics across the state.
The governor and his aides have defended their decision to stop the flow of data on privacy grounds, saying publishing county-level data could violate the state’s version of HIPAA, which prevents the release of patients’ personal health information without their consent.
Experts say privacy becomes a concern in releasing data from counties with only a handful of cases, and for that reason, states generally suppress information in jurisdictions with fewer than five cases or deaths.
Shortly after the pandemic erupted last year, doctors were baffled by a surge of patients, mostly teenagers and young adults, who came in complaining of chilblains — painful lesions on their toes, and sometimes also on their fingers.
The condition came to be called Covid toes. They were seen, like the loss of smell and taste, as yet another strange telltale sign of the disease, even though most of the patients tested negative for coronavirus. Physicians were hard-pressed to explain the association.
The lesions are red or purple in white people, and often purplish or brownish in people of color. They cause painful burning or itching sensations, and sometimes make it difficult for people to wear shoes or walk.
Now a study from France, published in the British Journal of Dermatology, sheds some light on the causes of Covid toes. The research indicates that the lesions may be a side effect of the immune system’s shift into high gear in response to exposure to the virus, which can damage cells and tissues in the process.
The French researchers analyzed blood samples and skin biopsies from 50 patients who had chilblainlike lesions for the first time in April 2020, and who were referred to St.-Louis Hospital in Paris. Slightly more than half of the patients had other symptoms suggestive of Covid-19, like coughing, shortness of breath and loss of smell, but all of them tested negative for the virus on PCR tests.
The samples showed high levels of Type 1 interferon, a protein that activates the body’s immune system to fight viruses, but which may also cause damage. The researchers also found high levels of an antibody that can inadvertently attack the body’s own cells.
Abnormal changes in the linings of the blood vessels may also play a role in the lesions, the study suggests.
Although the relationship between coronavirus infection and chilblainlike lesions “is still controversial,” the authors wrote, the “peaks of chilblainlike lesions concomitant with peaks of Covid-19 deaths in 2020 strongly suggest that this disorder is closely related to SARS-CoV-2 infection.”
The explanation for Covid toes is not entirely surprising; one of the hallmark features of the disease is an immune system overreaction called a cytokine storm, which may ultimately cause more illness than the virus itself.
German scientists published a paper last year saying they had found a strong localized interferon-driven response in three young men who came in with chilblains. That paper suggested that the men, who tested negative for the coronavirus, may have developed chilblains several weeks after an initial infection caused mild or asymptomatic disease, and that the interferon-driven immune response may have led to early control of the virus and prevented respiratory disease.
Dermatologists say that people with Covid toes generally do well and are unlikely to develop severe Covid, and that the symptoms reflect a healthy immune response to the virus.
The new study suggested treating Covid toes with local or systemic anti-inflammatory agents may be effective.