Coronavirus Updates The latest developments in the COVID-19 pandemic.
The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

Coronavirus Updates

Latest developments in the COVID-19 pandemic

A health care worker withdrew a dose of the Johnson & Johnson COVID-19 vaccine from a vial at the Klerksdorp Hospital in Klerksdorp, South Africa, on Feb. 18. Phill Magakoe/AFP via Getty Images hide caption

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Phill Magakoe/AFP via Getty Images

A health care worker withdrew a dose of the Johnson & Johnson COVID-19 vaccine from a vial at the Klerksdorp Hospital in Klerksdorp, South Africa, on Feb. 18.

Phill Magakoe/AFP via Getty Images

In a unanimous 22-0, a panel of advisers to the Food and Drug Administration recommended that the COVID-19 vaccine developed by Johnson & Johnson be authorized for emergency use in adults during the pandemic.

The vote in favor of the vaccine, which requires only one shot for protection, was taken to answer this question: Do the benefits of the Johnson & Johnson vaccine outweigh its risks for use in people 18 years of age and older.

The FDA typically follows the advice of its expert advisers. If the agency agrees, the Johnson & Johnson vaccine would be the third one cleared for use in the U.S.

A quick decision is expected given the state of the pandemic. The FDA authorized the Pfizer-BioNTech and Moderna COVID-19 vaccines one day after the same panel recommended them for clearance during separate meetings last December.

The Johnson & Johnson vaccine was tested in an international study of about 40,000 people, half of whom got the vaccine and half of whom got a placebo. The study found the company's vaccine to be 66% effective overall in preventing moderate to severe COVID-19 disease. For disease judged severe or critical, the effectiveness was 85%. The study was conducted in the U.S., South America and South Africa.

The main study included in the company's application found that 28 days or more after immunization, the Johnson & Johnson vaccine prevented hospitalizations and death related to COVID-19.

The overall efficacy figures are lower than Pfizer's 95% for preventing COVID-19 disease and 94% for Moderna.

As the pandemic has drawn on, the coronavirus has mutated. Variants first seen in South Africa and Brazil, where the Johnson & Johnson vaccine was tested, mutated in ways that help them evade the immune response prompted by vaccines developed against the original form of the virus.

Among more than 6,000 study participants who were queried within a week of vaccination, the most common side effects were pain at the site of injection (49%), headache (39%), fatigue (38%) and muscle pain (33%). These side effects were mostly mild or moderate.

The authorization of Johnson & Johnson's vaccine would help expand the supply of COVID-19 shots. The company said 4 million doses of vaccine would be available in the U.S. as soon as the FDA gives its OK. A total of 20 million doses would be ready by the end of March, and Johnson & Johnson has committed to deliver 100 million doses under its contract with the federal government by the end of June.

Centers for Disease Control and Prevention Director Rochelle Walensky said on Friday that the says that the 7-day average of confirmed cases in the U.S. has ticked up for the past three days, warning that "now is not the time to relax restrictions." Jim Watson/AFP via Getty Images hide caption

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Jim Watson/AFP via Getty Images

Centers for Disease Control and Prevention Director Rochelle Walensky said on Friday that the says that the 7-day average of confirmed cases in the U.S. has ticked up for the past three days, warning that "now is not the time to relax restrictions."

Jim Watson/AFP via Getty Images

The head of the Centers for Disease Control and Prevention warned Friday of an uptick in the country's confirmed COVID-19 cases, saying recent progress may be "stalling" as highly infectious new variants become more predominant.

Dr. Rochelle Walensky said at a White House briefing that after weeks of declining cases and hospitalizations, the 7-day average in confirmed cases has ticked up in the past three days in what the CDC considers a "very concerning shift in trajectory." The most recent 7-day average of deaths is at about 2,000 per day, she said, which is slightly higher than that of the week before.

"Things are tenuous. Now is not the time to relax restrictions," Walensky said. "Although we have been experiencing large declines in cases and hospital admissions over the past six weeks, these declines follow the highest peak we have experienced in the pandemic."

In other words, she said, the decline in cases could taper off at a level that is still dangerously high.

Walensky warned of the threat posed by the continued spread of coronavirus variants. These variants now account for roughly 10% of U.S. cases, she said, up from between 1% and 4% in recent weeks. The prevalence of the B.1.1.7 variant — first seen in the U.K. — is even higher in certain parts of the country.

Scientists predict that the B.1.1.7 variant — which is 50% more transmissible than the strain that has been circulating in the U.S. — will become the country's dominant strain by mid-March. Walensky said that the spike in case numbers may be the first sign that it is starting to take over.

Other variants emerging in New York City and California also appear to spread more easily and account for a large portion of cases in those areas, she added.

"We may be done with the virus, but clearly the virus is not done with us," Walensky said. "We cannot get comfortable or give into a false sense of security that the worst of the pandemic is behind us."

Nearly a year into the pandemic, Walensky acknowledged that Americans are tired and longing for a return to normalcy. She implored them to be vigilant and continue taking protective measures to prevent another surge.

This is especially important, she said, with mass vaccination "so very close." Some 46 million people, or 14% of the population, have received at least one dose of a COVID-19 vaccine, according to Walensky. And with Food and Drug Administration experts meeting to evaluate the Johnson & Johnson vaccine today, she said the country may soon have a third vaccine in its toolbox.

Also on Friday, White House COVID-19 Senior Advisor Andy Slavitt said the Biden administration has been in discussions with ride-sharing companies Uber and Lyft to arrange transportation to vaccine sites for vulnerable populations. Lyft and CVS are partnering to provide 60 million free rides, he said.

The administration is also working with a coalition of business groups to promote pandemic control measures aimed at making workplaces safer for customers, employees and communities, Slavitt said. Those measures include educating individuals about masking and social distancing on site, and providing employees with incentives to get vaccinated.

A British Airways plane comes in to land behind a tail fin at Heathrow Airport in London. On Friday, the head of the group that owns BA called for instituting an electronic health pass for passengers as the company announced steep losses due to COVID-19. Kirsty Wigglesworth/AP hide caption

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Kirsty Wigglesworth/AP

A British Airways plane comes in to land behind a tail fin at Heathrow Airport in London. On Friday, the head of the group that owns BA called for instituting an electronic health pass for passengers as the company announced steep losses due to COVID-19.

Kirsty Wigglesworth/AP

The owner of British Airways is calling for digital health passes for passengers as a step toward getting airlines back in the sky after devastating losses due to the COVID-19 pandemic.

International Airlines Group, which also owns carriers such as Iberia and Aer Lingus, announced Friday a total annual loss of £6.4 billion ($9.8 billion) for the group after passenger traffic plunged by one third in 2020 compared to the previous year. The group's CEO, Luis Gallego, said the company was looking for "a clear roadmap" for scaling back restrictions on travel "when the time is right."

"We're calling for international common testing standards and the introduction of digital health passes to reopen our skies safely," Gallego said.

The International Air Transport Association recently said its "IATA Travel Pass" — a smartphone app that verifies that a passenger has had a negative coronavirus test or has been vaccinated — should be ready "within weeks."

"The key issue is one of confidence," said Vinoop Goel, IATA's regional director of airports and external relations, according to the BBC. "Passengers need to be confident that the testing they've taken is accurate and will allow them to enter the country ... And then governments need to have the confidence that the tests is one which is accurate," he added.

However, it's not yet clear if such a pass would be utilized by airlines or governments.

In January, the U.S. Centers for Disease Control and Prevention began requiring passengers entering the country from abroad to provide a negative coronavirus test before boarding a U.S.- bound flight.

IAG said despite its steep losses, its cargo business had helped prop up the passenger side of the operation. The company made more than 4,000 cargo-only flights last year, with revenue for the sector up strongly.

"Our results reflect the serious impact that COVID-19 has had on our business," Gallego said.

The losses at IAG have been felt worldwide throughout the airline industry, with U.S.-based carriers hit particularly hard.

In January, American Airlines posted its largest annual loss on record — $8.9 billion for 2020, with United Airlines reporting a $7.1 billion loss. Southwest Airlines posted an annual loss of $3.1 billion – its first since 1972.

IATA expects U.S. airlines to see a rebound in demand in 2021, but that it will still be down 45% from 2019, according to an analysis published in November.

In December, the U.S. Treasury began distributing $15 billion in aid approved by Congress to help airlines meet payroll through March 2021, after a similar $25 billion infusion earlier in the pandemic. As part of the COVID-19 relief package working its way through Congress, another $15 billion could go to support airline industry workers.

President of the Tokyo 2020 Olympics Organizing Committee Seiko Hashimoto (right) talks to Tokyo 2020 Vice Director General Yukihiko Nunomura before a press briefing on the operation and media coverage of Tokyo 2020 Olympic Torch Relay in Tokyo on Thursday. Behrouz Mehri/AP hide caption

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Behrouz Mehri/AP

President of the Tokyo 2020 Olympics Organizing Committee Seiko Hashimoto (right) talks to Tokyo 2020 Vice Director General Yukihiko Nunomura before a press briefing on the operation and media coverage of Tokyo 2020 Olympic Torch Relay in Tokyo on Thursday.

Behrouz Mehri/AP

The traditional prelude to the Olympics, the torch relay, will look – and sound – a bit different this year, as spectators are asked to avoid crowds and dampen their cheers when the torch passes by them.

Members of the Tokyo Organizing Committee announced a series of pandemic measures on Thursday, including leaving the option open for suspending portions of the relay should health officials deem it necessary.

"No shouting, no cheering. Please cheer by clapping your hands and maintain appropriate distance in case there is crowding," Yukihiko Nunomura, the vice director general of the committee, said at a press conference Thursday, according to The Associated Press.

The subdued torch relay is set to begin March 25 in Fukushima and travel through Japan until July 23, the day of the Games' Opening Ceremony. The Olympics were delayed by a year because of the coronavirus pandemic.

The Olympic rings displayed outside the National Stadium, a venue for the 2020 Olympic Games, in Tokyo last year. The Games have been delayed until 2021 because of the coronavirus. Behrouz Mehri/AFP via Getty Images hide caption

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Behrouz Mehri/AFP via Getty Images

The Olympic rings displayed outside the National Stadium, a venue for the 2020 Olympic Games, in Tokyo last year. The Games have been delayed until 2021 because of the coronavirus.

Behrouz Mehri/AFP via Getty Images

About 10,000 torchbearers and others expected to take part in the torch relay, the AP added.

The organizing committee also released detailed safety protocols including what it calls avoidance of the "3C's:" closed spaces, crowded places, and close-contact settings.

It also asked that spectators not watch from the roadside if they feel sick, and encouraged them to wear facial coverings.

Officials are also allowing task forces from local governments to enforce "suspension of the Torch Relay on public roads and/or the hosting of only a Torch lighting ceremony with no spectators," if such safety protocols are required.

Additionally, torchbearers are asked to follow safety protocols in the lead up to their portion of the relay.

In the two weeks prior to their leg, according to official guidelines, "torchbearers will be asked to refrain from activities that may involve a risk of COVID-19 infection, such as eating out or going to crowded places."

In the 14 days prior to their portion of the relay, torchbearers must also submit a daily health checklist. On the day of their leg of the relay, if the torchbearers feel sick or suspect they are infected, they must immediately report it to the organizing committee staff.

If they have a temperature above 37.5 degrees Celsius (99.5 degrees Fahrenheit) they may be asked to refrain from running, according to the guidelines.

The embattled Tokyo Olympic Games have faced a number of headwinds besides the coronavirus.

Earlier this month, Japan chose Seiko Hashimoto, one of the nation's most prominent female politicians, to step in as its new organizing executive.

Her predecessor Yoshiro Mori resigned on Feb. 12 after making sexist remarks saying that women talk to much in meetings.

Following his resignation, International Olympic Committee President Thomas Bach issued a statement saying he respects Mori's decision to step down, and looks forward to working with his successor.

Despite the ongoing pandemic, organizers are pushing forward with planning the event, a daunting task that is scheduled to bring thousands of athletes, media and volunteers from around the world.

Few people in Japan are likely to be vaccinated by the time the Games open, The Guardian reported, increasing fears the event could trigger a new round of outbreaks there.

President Joe Biden, pictured on the campaign trail in Nov. 2020, has long encouraged Americans to mask up in the fight against COVID-19. On Wednesday, his administration announced it will provide 25 million masks to community health centers and food banks across the country. Carolyn Kaster/AP hide caption

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Carolyn Kaster/AP

President Joe Biden, pictured on the campaign trail in Nov. 2020, has long encouraged Americans to mask up in the fight against COVID-19. On Wednesday, his administration announced it will provide 25 million masks to community health centers and food banks across the country.

Carolyn Kaster/AP

The Biden administration will distribute millions of face coverings to thousands of community health centers and food banks in an effort to help vulnerable Americans more easily mask up, officials said on Wednesday.

The federal government will distribute some 25 million masks to more than 1,300 community health centers and 60,000 food pantries and soup kitchens across the country, White House COVID-19 Response Coordinator Jeff Zients said at a briefing. The White House said in a press release that the masks will be available between March and May, and are expected to benefit some 12 to 15 million Americans.

"Not all Americans are wearing masks regularly, not all Americans have access, and not all masks are equal," Zients said. "With this action, we are helping to level the playing field, giving vulnerable populations quality, well-fitting masks."

Anyone who needs a mask will be able to pick one up at participating locations, Zients said, adding that the "high-quality, American-made" masks will be free, washable and available in both adult and children sizes.

The Centers for Disease Control and Prevention recommends mask-wearing as a simple, effective step in preventing the spread of COVID-19. Earlier this month, it said layering a cloth mask over a surgical mask and tying knots on the ear loops of surgical masks can offer even better protection in the face of transmissible new variants.

Biden has consistently emphasized the importance of wearing masks, and issued executive orders requiring face coverings on federal property and during interstate travel shortly after taking office.

The initiative will not impact the availability of masks for healthcare workers, according to the White House.

The Department of Health and Human Services will partner with the Department of Defense to deliver the masks to federally qualified community health centers, where staff will distribute them to recipients. Two-thirds of the people served by these health centers are living in poverty, 60% are racial and/or ethnic minorities, and nearly 1.4 million are unhoused, the White House said. Meanwhile, the DOD will also work with the Department of Agriculture to deliver masks through the nation's vast food bank and food pantry system.

At the same time, Zients said, the federal government will continue ramping up its efforts to get Americans vaccinated quickly and equitably.

He said the weather-related backlogs in vaccine distribution have been resolved, with some 14.5 million doses allocated to states, tribes and territories this week, and 2.1 million more going to select pharmacies.

While last week's extreme winter weather created a backlog of millions of doses, closed down clinics and lowered the 7-day average for daily vaccinations — it stands at 1.4 million doses, down from 1.7 million — Zients said that number is expected to start rising again shortly.

A medical worker gives a coronavirus vaccine shot to a patient at a vaccination facility in Beijing, in January. Two pharmaceutical companies in China announced Wednesday they are seeking market approval for new vaccines. Mark Schiefelbein/AP hide caption

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Mark Schiefelbein/AP

A medical worker gives a coronavirus vaccine shot to a patient at a vaccination facility in Beijing, in January. Two pharmaceutical companies in China announced Wednesday they are seeking market approval for new vaccines.

Mark Schiefelbein/AP

Chinese pharmaceutical makers are seeking market approval from Beijing for two new coronavirus vaccines – one that has shown 72% efficacy and another 69% efficacy in human Phase III trials.

The separate announcements on Wednesday come from Sinopharm for its second vaccine after the state-run company's first was approved for distribution in December, and from CanSino Biologics, Inc. (CanSinoBIO), for its first vaccine.

Another vaccine, produced by Beijing-based Sinovac, received market approval earlier this month, although it – like Sinopharm's first vaccine — had been in use since July on an emergency basis.

Unlike the revolutionary mRNA vaccines developed in the West by Moderna and Pfizer/BioNTech, which use a piece of the virus' genetic code to trigger an immune response, three of the four Chinese vaccines are based on a more conventional approach that uses an inactivated form of the coronavirus.

The fourth – the one made by CanSinoBIO – is a single-dose vaccine that is based around a technique called viral vector, which uses a modified version of a different virus as a vector to deliver instructions to a cell. China is also reportedly working on its own mRNA vaccine.

One advantage for the Chinese vaccines already approved or seeking market approval is that they can be stored at room temperature, while the Moderna vaccine must be stored at -20 degrees Celsius (-4 degrees Fahrenheit) and the Pfizer vaccine at -70 C (-94 F), nearly as cold as dry ice.

China has yet to approve any Western vaccines, preferring to rely on its own. However, Hong Kong's government has agreed to buy 7.5 million doses each from Sinovac; the British-Swedish firm AstraZeneca; and Fosun Pharma, which is delivering the Pfizer/BioNTech vaccine.

After delays, the first 1 million doses of the Sinovac vaccine arrived in Hong Kong last week. As of Wednesday, the first shipment of the Pfizer vaccine had yet to arrive, but was expected within days, according to the South China Morning Post.

Despite moving ahead on new vaccines, China, where the virus that causes COVID-19 was first identified more than a year ago, has been slow in getting the country's 1.4 billion people inoculated against the disease. It vaccinated tens of thousands of people on the first day of its official drive in early January. Since then it has inoculated large numbers of people, but still a relatively small portion of its vast population.

Health authorities say that about 40 million doses of the two-dose vaccines have been administered so far, covering a first shot for only about 3% of the population, NPR's Beijing correspondent Emily Feng reported Wednesday. That's well short of the minimum 700 million people that the chairman of the China National Biotec Group (CNBG), Yang Xiaoming, told state-run media in December would be required to adequately protect the country from COVID-19.

China is prioritizing workers in the health care, transportation and shipping sectors for the first round of vaccinations. But unlike most other countries, it isn't immediately focusing on seniors. Instead, people aged 18-59 who are considered at high risk and highly likely to spread the virus are being targeted, Wang Bin, an official of National Health Commission, told reporters in January.

As the vaccine supply increases, people 60 years and older will gradually be phased in, Wang said.

That has reportedly caused concern among some older Chinese.

Instead, China seems to be banking on its current low positivity rate, which has been bolstered by extensive testing, quarantines and travel restrictions, to keep SARS-CoV-2 at bay within its own borders.

Meanwhile, despite its lagging vaccine drive, Beijing has been sending millions of doses abroad. Many developing countries are counting on Chinese-developed vaccines as affordable and available options, and China's foreign ministry on Feb. 8 said it will provide them to 53 countries.

Serbia and Hungary are among the recipients, as are several countries in Latin America. Thailand on Wednesday received its first 200,000 of 2 million doses it expects to receive of the Sinovac vaccine.

A shipment of COVID-19 vaccines from the COVAX global program arrived at the Kotoka International Airport in Accra on Wednesday, as Ghana received the group's first vaccine shipment. Nipah Dennis/AFP via Getty Images hide caption

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Nipah Dennis/AFP via Getty Images

A shipment of COVID-19 vaccines from the COVAX global program arrived at the Kotoka International Airport in Accra on Wednesday, as Ghana received the group's first vaccine shipment.

Nipah Dennis/AFP via Getty Images

Updated at 2:10 p.m. ET

The first wave of coronavirus vaccines from the COVAX initiative are now reaching their destinations. Ghana became the first country to receive the vaccine on Wednesday, marking an important step for the international effort to help low- and middle-income countries cope with the COVID-19 pandemic.

As the first round of allocations continues to roll out, more countries will receive their own doses in coming days, according to the World Health Organization, a leader of the initiative. In all, the COVAX alliance hopes to deliver nearly 2 billion doses of the vaccines this year.

The 600,000 doses of the AstraZeneca-Oxford vaccine that arrived in Ghana were produced by the Serum Institute of India. Along with the initial shipment to Accra, more deliveries are expected to arrive in Abidjan, Cote d'Ivoire, this week, according to the WHO. The vital supplies will also include the Pfizer-BioNTech vaccine.

The shipments are the start of "what should be the largest vaccine procurement and supply operation in history," according to a joint statement by WHO Representative to Ghana Dr. Francis Kasolo and UNICEF's representative in Ghana, Anne-Claire Dufay.

"After a year of disruptions due to the COVID-19 pandemic, with more than 80,700 Ghanaians getting infected with the virus and over 580 lost lives, the path to recovery for the people of Ghana can finally begin," Kasolo and Dufay said.

As for why Ghana, in West Africa, was chosen to receive the vaccine before other countries, a UNICEF representative told NPR that the country met conditions for receiving the vaccine. After Ghana's national deployment and vaccination plan was approved, they said, the country was added to the allocation process.

Other factors affecting when countries receive the vaccine include the speed with which they get national approval and provide an import license for the COVID-19 vaccines.

The COVAX initiative was created to boost equitable access to COVID-19 vaccines, particularly for lower-income countries. Through donations, licensing and build purchases, COVAX helps those countries acquire vaccines — something they've struggled to do, as wealthy countries compete with each other to buy the limited number of vaccines worldwide.

"We will not end the pandemic anywhere unless we end it everywhere," said WHO Director-General Tedros Adhanom Ghebreyesus. "Today is a major first step towards realizing our shared vision of vaccine equity, but it's just the beginning."

As the WHO's Dr. Katherine O'Brien, who directs the WHO's Department of Immunization, Vaccines and Biologicals, told NPR earlier this month, "We're in a situation where we have 108 million doses of vaccine that have been distributed worldwide, but 75% of those doses have gone to just 10 countries."

For nearly all of the COVAX initiative's existence, the U.S. did not join the coalition. But President Biden has reversed that course, and the U.S. recently announced it would send some $4 billion in contributions to COVAX.

A health care worker looks away as she's immunized with Johnson & Johnson's COVID-19 vaccine at Klerksdorp Hospital in Klerksdorp, South Africa, on Feb. 18. Phill Magakoe/AFP via Getty Images hide caption

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Phill Magakoe/AFP via Getty Images

A health care worker looks away as she's immunized with Johnson & Johnson's COVID-19 vaccine at Klerksdorp Hospital in Klerksdorp, South Africa, on Feb. 18.

Phill Magakoe/AFP via Getty Images

The Food and Drug Administration released an analysis of Johnson & Johnson's COVID-19 vaccine Wednesday morning that supports its authorization for emergency use.

On Friday, a panel of advisers to the agency will meet to evaluate the vaccine and make a recommendation about whether it should be given the OK. If the agency goes on to authorize the Johnson & Johnson vaccine, it would be the third, after those made by Pfizer-BioNTech and Moderna, to become available in the U.S.

The Johnson & Johnson vaccine has some advantages. Immunization with the Johnson & Johnson vaccine requires only one shot, unlike the two-shot dosing for the vaccines from Pfizer and Moderna. The Johnson & Johnson vaccine also doesn't require special refrigeration for shipment and storage.

The FDA review noted that an international study of about 40,000 people, half of whom got the vaccine and half of whom got a placebo, found the company's vaccine to be 66% effective overall in preventing moderate to severe COVID-19 disease. The study was conducted in the U.S., Latin America and South Africa.

The agency also said the vaccine has a "favorable safety profile" and that there were "no specific safety concerns identified that would preclude issuance of an EUA." This language mirrors the assessments for vaccines by Moderna and Pfizer-BioNTech, which were authorized in December for emergency use.

The efficacy figures are lower than Pfizer's 95% for preventing COVID-19 disease and 94% for Moderna. Over the course of the pandemic, the coronavirus has begun to change. Variants first seen in South Africa and Brazil, where the Johnson & Johnson vaccine was tested, mutated in ways that help them evade the immune response prompted by vaccines developed against the original form of the virus.

But there are more important measures, Dr. Ashish Jha, dean of the Brown University School of Health told All Things Considered on Monday. "What you care about is hospitalizations and deaths," he said. In the large clinical trial that is the centerpiece of the company's application to the FDA, nobody who received the vaccine required hospitalization or died once the vaccine took full effect (28 days after immunization). "Johnson & Johnson appears to be just as good as Moderna and Pfizer at preventing those," Jha said.

The most common adverse reactions among more than 6,000 study participants who were queried about their experience were injection site pain (49%), headache (39%), fatigue (38%) and muscle pain (33%). These side effects were mostly mild or moderate.

The authorization of Johnson & Johnson's vaccine could eventually help expand the supply of COVID-19 shots for Americans. But its availability won't make a huge difference right away.

In congressional testimony Tuesday, a Johnson & Johnson executive said 4 million doses of vaccine would be available in the U.S. when the FDA grants an emergency use authorization. A total of 20 million doses would be ready by the end of March, he said, and the company would be able to deliver a total of 100 million doses by the end of June.

People wait in front of the hospital of the Military Medical Academy in Sofia, Bulgaria, on Feb. 21 for a COVID-19 vaccination. NurPhoto/Getty Images hide caption

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People wait in front of the hospital of the Military Medical Academy in Sofia, Bulgaria, on Feb. 21 for a COVID-19 vaccination.

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SOFIA, Bulgaria - In an effort to boost vaccination rates among a skeptical public, Bulgaria has opened up COVID-19 inoculations to all who want them.

On Friday, Bulgarian Prime Minister Boiko Borissov told the nation he was creating "green corridors" where any Bulgarian resident could line up for the vaccine.

Bulgaria first began administering the shots on Dec. 27. But before the mass vaccination campaign began Saturday, Bulgaria had one of the lowest vaccination rates in Europe, with fewer than 1% of Bulgarians having taken the first dose and fewer than half of those fully vaccinated as of Feb. 14, according to the European Centre for Disease Prevention and Control.

In a poll of 1,000 Bulgarians conducted by Alpha Research and cited by The Sofia Globe, some 52 percent said they did not intend to be immediately vaccinated.

Since the mass vaccination campaign began, more than 30,000 people have received a first shot, according to local media reports.

Thousands stood in line for hours over the weekend at vaccination points set up at hospitals in Sofia, with temperatures hovering around freezing. Many are receiving the AstraZeneca-Oxford vaccine, which has been approved for use in some EU countries but not in the U.S. The Moderna and Pfizer -BioNTech vaccines are also part of the campaign. Some have received appointments to return for their second shot — up to 10 weeks from the first vaccination date — and others have been told they'll be contacted for follow-up.

As of Feb. 18, 229,679 cases of COVID-19 had been reported in Bulgaria with 9,624 deaths. As of Feb. 14, about 200,000 vaccine doses had been delivered to Bulgaria – with more expected to arrive in coming days.

The number of COVID-19 cases is up week-over-week in Bulgaria though the country is under partial closure – with restaurants and bars shuttered until at least March 1. Proof of a negative COVID-19 test is required to enter the country until at least April 30.

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Bubble sheet test with pencil.
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The U.S. Education Department says states must resume the annual testing of students that was suspended a year ago amid the pandemic.

For the past two decades, federal law has required schools to test students once each year in math and reading, in grades three through eight and once in high school. And they are required to publicly report these standardized test results, broken out by racial and ethnic group and disability status, and in some cases, hold schools accountable with various sanctions if their students score too low.

In March of 2020, with nearly every school in the nation suddenly pivoting to remote learning, the department waived these requirements.

But in a Feb. 22 letter to state schools chiefs and governors, the department wrote that states must again give these tests and report the results. It remains "vitally important that parents, educators, and the public have access to data on student learning and success," the letter says.

States must also publicly report other indicators, like chronic absenteeism, as well as, where possible, information on students' access to computers and the Internet for remote learning. This information is intended "to address the educational inequities that have been exacerbated by the pandemic, including by using student learning data to enable states, school districts, and schools to target resources and supports to the students with the greatest needs."

The department is granting states lots of flexibility, but critics of the current accountability system are still unhappy with this move to reinstate mandatory testing.

The department invites states to request waivers of the requirement that they use this data to identify "failing" schools. These waivers would also exempt schools from the current requirement that at least 95% of students participate in testing. And the letter invites states to be flexible in how schools give the tests, such as by shortening the tests, administering them remotely and offering multiple testing windows into the summer and even the fall.

The move toward collecting data while reducing accountability measures effectively lowers the "stakes" on high-stakes testing. This has been a major issue of contention in education circles, with a national parent-led "opt-out" movement peaking around 2015.

Still, this news will be unwelcome for the states where leaders have already begun talking about canceling tests altogether this spring — California, New Jersey, New York, Illinois, Michigan and Georgia, to name a few.

Some education leaders say it is logistically impossible to test most students safely and accurately, and an unwise use of limited resources in an ongoing emergency.

"While the vast majority of Georgia schools are offering in-person instruction, students are dealing with the ongoing effects of a global crisis and the trauma of necessary, but unprecedented, isolation," Georgia's Department of Education wrote in a letter requesting a waiver.

More than half of the nation's students are learning remotely or in hybrid classrooms with reduced in-person class time. Comparing this spring's results with those of any other year will be difficult. When the NWEA, a nonprofit test organization, released fall 2020 test results in December, about a quarter of students were "missing" from the data — and these were more likely to be Black and Hispanic students, from high-poverty areas, or lower-performing in the first place. So even though the students who did take the test showed progress on reading and only a little less progress than a normal year on math, there are concerns that the data do not reflect the true learning loss of the most vulnerable students.

Conversely, if tests are given remotely, students might get help from family members or look up the answers, artificially inflating the results.

"Standardized tests have never been valid or reliable measures of what students know and are able to do, and they are especially unreliable now," said Becky Pringle, president of the National Education Association, in a statement urging states to seek maximum flexibility on waivers. "High-stakes standardized tests administered during the global health crisis should not determine a student's future, evaluate educators, or punish schools; nor should they come at the expense of precious learning time that students could be spending with their educators."

The Met Considers Selling Its Art To Stave Off Financial Shortfall

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Visitors wear masks at the Metropolitan Museum of Art in October. The museum's director says the Met is considering selling art to pay for operating expenses. John Minchillo/AP hide caption

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Visitors wear masks at the Metropolitan Museum of Art in October. The museum's director says the Met is considering selling art to pay for operating expenses.

John Minchillo/AP

The pandemic is causing The Metropolitan Museum of Art in New York to consider selling its artwork to cover operational costs as it falls short of $150 million in revenue.

The country's flagship art museum has still not made a final decision on selling its work.

Museum Director Max Hollein says the Met isn't quite facing an "existential crisis." But he tells Rachel Martin on Morning Edition that the museum's "attendance is of course, way, way below from where we were before the pandemic. And it's going to continue to be that way, even when restrictions are going to be lifted."

Back in April 2020, the museum had to lay off 81 employees in its customer service and retail departments and sizably cut the salaries of top executives.

The process of selling artwork, also known as deaccessioning, is regulated by the Association of Art Museum Directors, a professional organization that sets policies and guidelines for art museums across America.

However, last spring the AAMD announced it would relax its guidelines on deaccessioning until April 2022 to allow for museums to keep themselves afloat against the existential threat posed by the pandemic. Previously, money collected from deaccessioning was only allowed to be used to purchase new art. Now, it can go toward other expenses, including salaries for those who work in collection care.

Already, at least nine museums around the country have sold off art to stay afloat.

A spokesperson from the Met said the museum has still not looked into which pieces would be up for auction if it decides to take advantage of the new deaccessioning rules.

The Met has always practiced deaccessioning, Hollein wrote in a blog post — resulting in revenue that's varied from $45,000 to $25 million. The pieces must meet specific criteria set by the museum to be eligible for resale, such as if the work is redundant or of lesser quality than other pieces in its collection.

The move has met with some criticism, including from former Met director Thomas Campbell, who warned that selling art to cover operating costs could "become the norm."

And as Artnet reported, the Met has an endowment of $3.3 billion and multiple billionaires sit on its board.

Hollein counters that the actual slippery slope would be museums dipping into endowments to cover operating costs, which would "have enormous effects in the long run."

Hollein tells Morning Edition that despite the conditions, the Met will still be able to acquire new art through its endowment.

"We will get this year another $50 million of endowment proceeds through restricted endowments that are just for acquisitions, we get another $50 million just to buy art," Hollein said. "So it doesn't mean that the museum is no longer acquiring new works, or that we are not growing as a collection. We continue to grow, we just for this two-year period might not grow as vigorously or as rapidly as before."

Ziad Buchh and Scott Saloway produced and edited the audio interview.

The University of Texas Rio Grande Valley School of Medicine in Edinburg, Texas, last year. The Rio Grande Valley, a four-county region that stretches across Texas's southernmost tip, remains one of America's most afflicted areas, with the highest hospitalization rates, deaths at more than twice the state average, overwhelmed hospitals and refrigerated trucks serving as back-up morgues. Callaghan O'Hare/Bloomberg via Getty Images hide caption

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Callaghan O'Hare/Bloomberg via Getty Images

The University of Texas Rio Grande Valley School of Medicine in Edinburg, Texas, last year. The Rio Grande Valley, a four-county region that stretches across Texas's southernmost tip, remains one of America's most afflicted areas, with the highest hospitalization rates, deaths at more than twice the state average, overwhelmed hospitals and refrigerated trucks serving as back-up morgues.

Callaghan O'Hare/Bloomberg via Getty Images

The University of Texas Rio Grande Valley is apologizing for turning away two people eligible for COVID-19 vaccinations on Saturday because they could not prove they live in the United States.

On Feb. 21, it posted a statement on Twitter. UT Health Rio Valley, the clinical practice of the university, stated it "apologizes to those patients who were affected" and "did not follow the most current State of Texas guidelines."

Proof of residency and citizenship are not required to get the vaccine, according to the Texas Department of State Health Services — as stated in guidance on the agency's website. UT-RGV spokesperson Patrick Gonzalez confirmed the university did not follow state protocol.

Abraham Diaz, who lives in San Juan, says his father was one of the people turned away. He tweeted about the experience on Feb. 20.

Diaz said his dad called him upset and embarrassed after waiting in line for four hours at the UT-RGV vaccine clinic, only to be wrongly told by a person working there he was not eligible for the shot.

"[Dad] said that [the health worker] told him in front of everybody, 'you don't have a social, so we can't help you at all. And it's only for U.S. citizens,' " said Diaz.

The Rio Grande Valley is located near the U.S.-Mexico border and is a majority Hispanic region with a large number of undocumented and mixed-status families.

The university said it is working to reschedule individuals wrongly turned away.

NPR's Malak Gharib contributed to this story.

Why The Johnson & Johnson Vaccine Has Gotten A Bad Rap — And Why That's Not Fair

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Kurtis Smith gives the Moderna coronavirus vaccine to a resident at Red Hook Neighborhood Senior Center in Brooklyn, N.Y., on Monday. Michael M. Santiago/Getty Images hide caption

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Kurtis Smith gives the Moderna coronavirus vaccine to a resident at Red Hook Neighborhood Senior Center in Brooklyn, N.Y., on Monday.

Michael M. Santiago/Getty Images

Two COVID-19 vaccines are being distributed in the U.S. right now, and this week an FDA advisory committee will vote on whether a third should join them.

If granted emergency use authorization, Johnson & Johnson's one-dose vaccine would become available in the U.S., along with those from Pfizer and Moderna.

In clinical trials, the Johnson & Johnson vaccine appears to be 66% effective at preventing moderate to severe cases of COVID-19 — compared to about 95% for Moderna and Pfizer. That has some people wondering if they should avoid the Johnson & Johnson vaccine.

Absolutely not, says Dr. Ashish Jha, dean of the Brown University School of Public Health.

"What I've been saying to my family is, as soon as the J&J vaccine is authorized, if that's what you can get, you should get it as soon as it's your turn in line," says Jha.

He points out that the 66% vs. 95% effectiveness isn't the right comparison for several reasons. He notes that the Johnson & Johnson vaccine was tested in different settings — the U.S., several Latin American countries and South Africa, where some worrisome variants of the virus were first seen.

"So that 66% number really represents an amalgamation of a variety of different clinical trials. Moderna and Pfizer were not tested in those circumstances," Jha tells All Things Considered. "And even if you just look at the U.S. data, the Johnson & Johnson number then starts getting much closer to the Moderna and Pfizer numbers."

But all of that misses what Jha says is the most important point.

"What you care about is hospitalizations and deaths," he says. "And Johnson & Johnson appears to be just as good as Moderna and Pfizer at preventing those."

Jha notes that among the vaccines that have reported results, almost all of them — including the Johnson & Johnson vaccine — have shown to be close to 100% effective at preventing hospitalizations and deaths.

In excerpts from his interview, Jha discusses the advantages of the Johnson & Johnson vaccine and how that might affect distribution.

Are there other significant differences among the vaccines?

Johnson & Johnson has the huge advantage of being one shot. So that's, of course, really helpful. There are a lot of differences in storage. The Johnson & Johnson vaccine can be stored basically in any refrigerator. [The Pfizer vaccine is shipped and stored at ultracold temperatures.] So transportation, widespread availability, much easier. But I certainly think for most people, the idea of a single-shot vaccine should be attractive for a lot of folks. And that also makes it easier for people to get.

As people organizing this vaccination effort look at which vaccine should go where, does the ease of administering a one-shot vaccine that can be kept in a refrigerator determine where the Johnson & Johnson vaccine is going to go?

I think you're going to see that play out. The two-shot Pfizer vaccine is particularly hard to manage in, let's say, rural settings, hard-to-reach places. Doable, but harder. J&J vaccine — much, much easier on that front. There are also certain people who may just decide they'd rather get a single shot than two shots. And, you know, and that may also influence who ends up getting what.

Some people are expressing concern that the vaccines that appear to be more effective — Moderna, Pfizer — are going to go to constituencies that have more political power, more clout, a louder voice, and that the so-called less effective vaccine, Johnson and Johnson, is going to go to more disenfranchised groups. What's your response to that?

First of all, I want to make the case that the J&J vaccine is not a lesser vaccine. And second is we absolutely should not be distributing these things based on socioeconomic status or any of those things. We should really be getting all these vaccines out everywhere, we should be focused on disenfranchised groups, actually, for priority because they've been hit so hard.

Mia Venkat and Sarah Handel produced and edited the audio interview.

Columns along the sides of the Lincoln Memorial Reflecting Pool pay tribute to victims of COVID-19 at a Jan. 19 memorial. Just over a month later, a Monday evening ceremony will pay tribute to 500,000 Americans lives lost. Michael M. Santiago/Getty Images hide caption

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Columns along the sides of the Lincoln Memorial Reflecting Pool pay tribute to victims of COVID-19 at a Jan. 19 memorial. Just over a month later, a Monday evening ceremony will pay tribute to 500,000 Americans lives lost.

Michael M. Santiago/Getty Images

Updated at 4:45 p.m. ET

As the U.S. passes the grievous marker of 500,000 lives lost to COVID-19, President Joe Biden will order flags on federal property to be lowered at half staff for five days to mark the solemn milestone, White House press secretary Jen Psaki said at a Monday briefing.

Biden will commemorate the people who died at a Monday evening ceremony, joined by First Lady Jill Biden, Vice President Harris and second gentleman Doug Emhoff. The event will include remarks, a candle lighting ceremony and a moment of silence, according to Psaki.

"Tonight's events, including the president's remarks, will highlight the magnitude of loss that this milestone marks for the American people and so many families across the country," she said. "He will also speak to the power of the American people to turn the tide on this pandemic by working together, following public health guidelines and getting in line to be vaccinated as soon as they are eligible."

Monday's event comes nearly a year into the coronavirus pandemic, and just over a month after the U.S. crossed the threshold of 400,000 confirmed deaths. It has the highest recorded number of cases and deaths in the world, according to data from Johns Hopkins University, with communities of color hit disproportionately hard.

The milestone of half a million confirmed deaths exceeds the worst-case projections from the start of the pandemic, NPR's Allison Aubrey said on Morning Edition. And new research shows that average U.S. life expectancy dropped by a year in the first half of 2020, with the pandemic mostly to blame.

Dr. Anthony Fauci, Biden's chief medical adviser, described the pandemic's toll as historic in a Sunday interview with CNN's State of the Union.

"It's nothing like we've ever been through in the last 102 years, since the 1918 influenza pandemic," Fauci said. "To have these many people to have died from a respiratory-borne infection, it really is a terrible situation that we've been through, and that we're still going through."

As of this month, the U.S. is starting to see a decline in average new daily infections, which dropped below 100,000 for the first time since November. But, as new and highly transmissible variants continue to circulate, the race to get vaccines into Americans' arms remains as urgent as ever.

West Virginia's Vaccination Rate Ranks Among Highest In World

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West Virginia Gov. Jim Justice announced in late December that residents older than 80 would be able to receive doses of the vaccine from their county health departments. Chris Jackson/AP hide caption

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West Virginia Gov. Jim Justice announced in late December that residents older than 80 would be able to receive doses of the vaccine from their county health departments.

Chris Jackson/AP

West Virginia isn't known for its good health outcomes. It leads the nation in deaths from diabetes, accidents and drug overdoses. But when it comes to distributing the COVID-19 vaccine, the state has been a shining star.

It didn't start out that way. In late December, on what was the day that Gov. Jim Justice announced West Virginians older than 80 would be able to receive doses of the vaccine from their county health departments, seniors began lining up right away — even before doses of the vaccine were available. Chris Dorst, a Charleston Gazette-Mail photographer for 30 years, was sent out by his editor to photograph the serpentine line of senior citizens she'd seen waiting outside the Kanawha-Charleston Health Department, under the gray December sky.

"Some people had wheelchairs or walkers — elderly people, and maybe some family members with them in line, just waiting. It seemed to move really slow," Dorst says.

Behind the scenes at Kanawha-Charleston Health Department, things were chaotic. The staff received a call from the governor's office at 11 a.m. letting them know they would receive vaccines to distribute to seniors, just one hour before Justice's public announcement. As soon as the governor made the announcement, octogenarians came down to stand outside the health department. By the time Dr. Sherri Young, the county health director, returned to the building with the doses of the Moderna vaccine, it was nearly 2 p.m. But the vaccine she'd just picked up still needed to thaw, the line of elderly constituents was only getting longer and rain was in the forecast. Young's office was able to repurpose thawed doses of the vaccine meant for first responders and deliver 210 shots to the people in line that day.

In other parts of the country, some beleaguered county health departments have reported that beyond making vaccine doses available to them, state governments did nothing to help them get shots into arms.

But West Virginia has been successful in part because the opposite is true.

Maj. Gen. James Hoyer is the head of the state's COVID-19 Joint Interagency Task Force for Vaccines. Hoyer, who retired as head of the West Virginia National Guard before assuming his role at the head of the vaccine task force, saw Dorst's striking photograph in the Charleston Gazette-Mail in his morning paper the following day.

"I remember seeing the picture," Hoyer says.

People didn't have any information yet about where and when to go, so they just showed up. Hoyer says it was a communications problem he needed to solve as quickly as possible. He got on the phone with Young to discuss "how we're going to help her get folks in."

Many states have relied on electronic registration systems — including the online ticket sales website Eventbrite after their own websites crashed — to help the public schedule vaccine appointments. But Hoyer says in West Virginia, that's not a great option. As much as 30% of the state's population lacks access to broadband Internet. Plus, as Hoyer puts it, "If you're talking about people over the age of 70 and in their 80s, how many of them are Internet savvy?"

Hoyer's team decided on a simple solution: a telephone hotline. Call it and residents can ask questions about how and where to get the vaccine, as well as schedule appointments.

Elsewhere, state COVID-19 hotlines have crashed, impacting cell service generally as networks strain under too many calls. West Virginia's population of 1.8 million reduced the chances of that happening. The state decided not to outsource the hotline to a private company as some states have done, housing it instead under the Department of Health and Human Resources' Office of Constituent Services. Justice gets a report every night on call volume, wait times and appointments scheduled.

"The last time I looked, it was 6 minutes," Hoyer says disapprovingly, of the hotline's average wait time. "What that tells us is we probably need more people manning the hotline."

West Virginia has administered almost 450,000 doses of COVID-19 vaccine. More than 9% of its population has gotten both doses. Alaska and West Virginia trade off for first place among states for the percentage of the population that have received both doses of the COVID-19 vaccine. If broadened out to look at the whole world, the percentage of the population of West Virginia already fully vaccinated would rank third.

"Not bad for a bunch of hillbillies," Hoyer says.

White House national security adviser Jake Sullivan, seen here during a press briefing on Feb. 4, told CBS the World Health Organization has more work to do to get to the bottom of where the coronavirus emerged. Chip Somodevilla/Getty Images hide caption

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White House national security adviser Jake Sullivan, seen here during a press briefing on Feb. 4, told CBS the World Health Organization has more work to do to get to the bottom of where the coronavirus emerged.

Chip Somodevilla/Getty Images

President Biden's national security adviser said Sunday that the administration has concerns over the data China has provided to the World Health Organization regarding the origins of the coronavirus pandemic.

"We need a credible, open, transparent international investigation led by the World Health Organization," Jake Sullivan said in an interview with CBS' Face the Nation.

Sullivan said the Biden administration has questions about an upcoming report from the WHO about the pandemic's origins.

"We do not believe that China has made available sufficient original data into how this pandemic began to spread, both in China and then eventually around the world," he said. "And we believe that both the WHO and China should step up on this matter."

He said Biden did "raise the issue of COVID-19 and the need for all countries to shoulder responsibility" during his recent call with Chinese President Xi Jinping.

Earlier this month a WHO team presented its initial findings after wrapping up a visit to Wuhan, where the coronavirus was first detected in late 2019. The researchers said the outbreak almost certainly did not start in a Chinese lab, but that its path from animals to humans needs further investigation.

And one of those team members, Dutch virologist Marion Koopmans, told NPR's Steve Inskeep that said she and her team believe the pandemic did not originate at the Huanan Seafood Market in Wuhan.

"The market is not the whole story," she said. "The market has been one of those spreading events but there also was circulation outside of, aside from the market."

Hostages in Iran

Sullivan also told CBS that the Biden administration has started communication with Iran about the at least five Americans currently being held hostage in the country.

"Our strong message to the Iranians will be that we will not accept a long-term proposition where they continue to hold Americans in an unjust and unlawful manner," he said. "It will be a significant priority of this administration to get those Americans safely back home."

On Thursday, the Biden administration announced it would restart diplomacy talks with Tehran centered on the Iran nuclear deal that the Trump administration withdrew from in 2018.

Sullivan said Biden is "prepared to go to the table" to talk with Iranians about getting constraints back on their nuclear program, and noted that Iran has not yet responded.

"That offer still stands because we believe diplomacy is the best way to do it," he said. "Iran has not yet responded. But what's happened as a result is that the script has been flipped. It is Iran that is isolated now diplomatically, not the United States. And the ball is in their court."

Britain's Prime Minister Boris Johnson holds a vial of the AstraZeneca vaccine during a visit to a coronavirus vaccination center in London on Feb. 15, 2021. The British government hopes to vaccinate all adults by the end of July. Jeremy Selwyn/AP hide caption

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Jeremy Selwyn/AP

Britain's Prime Minister Boris Johnson holds a vial of the AstraZeneca vaccine during a visit to a coronavirus vaccination center in London on Feb. 15, 2021. The British government hopes to vaccinate all adults by the end of July.

Jeremy Selwyn/AP

The British government has announced that every adult in the U.K. will be offered a first dose of COVID-19 vaccine by the end of July, one month earlier than initially planned. Prime Minister Boris Johnson says the accelerated target will allow vulnerable people to be protected "sooner," which should help relax the lifting of lockdown restrictions across the country.

Senior ministers met to discuss the plan Sunday. Johnson will unveil the plan to ease restrictions to the House of Commons on Monday.

Health Secretary Matt Hancock told the BBC that about one-third of U.K. adults — about 17 million people — have already been vaccinated. The new target also calls for everyone over 50 or with an underlying health condition to get a vaccine shot by April 15, rather than the previous target of May 1.

The U.K. uses both Pfizer and AstraZeneca vaccines.

Britain is delaying giving second vaccine doses until 12 weeks after the first in an effort to give as many people as possible partial protection quickly, according to the Associated Press. While the move is backed by scientific advisors in the U.K., Pfizer says it does not have data to support the delay.

The U.K. was the first country in the world to grant emergency authorization of a COVID-19 vaccine. Still, the government has faced widespread criticism for its handling of the pandemic, which has left more than 120,000 people dead, the highest toll in Europe.

The country is more than a month into its third national lockdown, leaving businesses and schools closed. The prime minister is under increasing pressure to ease the lockdown to help get the nation's struggling economy moving.

The latest lockdown was spurred by fast-spreading variants of the coronavirus — including one from South Africa — which overwhelmed British hospitals. Hancock said the number of cases of variants from South Africa was falling from a month ago.

"The latest data shows that there's around a dozen new ones, so a much, much smaller number, and each time we find a new one we absolutely clamp down on it," he said.

Controls On Vaccine Exports 'Hold Back' Pandemic Recovery, Warns Incoming WTO Head

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Ngozi Okonjo-Iweala, pictured in July 2020 in Geneva, will head the WTO beginning in March. She wants countries to drop restrictions on the export of vaccines and other medical supplies. Fabrice Coffrini/AFP via Getty Images hide caption

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Ngozi Okonjo-Iweala, pictured in July 2020 in Geneva, will head the WTO beginning in March. She wants countries to drop restrictions on the export of vaccines and other medical supplies.

Fabrice Coffrini/AFP via Getty Images

The incoming head of the World Trade Organization says getting countries to drop export restrictions on vaccines and medical supplies needed to fight the coronavirus pandemic will be one of her top priorities.

Nigerian economist Ngozi Okonjo-Iweala is set to become the WTO's director-general on March 1. She's the first woman and first African to lead the group that governs trade rules between countries.

The pandemic has had a profound impact on global trade, which "dropped precipitously in 2020," Okonjo-Iweala tells NPR's Michel Martin on All Things Considered.

Overall, the global economy contracted by 4.3% in 2020, according to the World Bank. The International Monetary Fund predicts the global economy will grow by 5.5% in 2021. But variants of the coronavirus and vaccine rollout complications make those forecasts uncertain.

"Until we solve the public health issues of the pandemic, we can't really get the economic issues settled," Okonjo-Iweala says.

Okonjo-Iweala talked with NPR about the WTO's role in improving access to vaccines, areas where she feels the WTO needs reform and being the first woman to head the organization. Here are excerpts of the interview, edited for clarity and length.


Interview Highlights

Do you feel that the WTO can influence this issue in the short term?

How can the WTO help? Well, when people think of vaccines, when they think of therapeutics and diagnostics, these are also traded goods. And to the extent that countries, WTO members, have export restrictions or even prohibitions on the exports of these goods, this helps hold back the recovery.

So trying to use the rules to monitor strongly and encourage members to drop these restrictions is very important. Up to a hundred members still have them. So I believe the WTO can contribute strongly by trying to get these rules dropped, encouraging a freer flow of goods, helping to exercise the needed flexibilities to encourage more manufacture of vaccines all over the world. I think these are ways to help.

The WTO's effectiveness as a trade regulating body, I think many analysts would say, has been weakened in the face of rising nationalism and protectionism. ... Do you agree with the critique? And secondly, what are your priorities in reforming the organization?

I agree with the critique that the WTO needs reforms, there's absolutely no doubt about that. And I had said in my campaign that it cannot be business as usual. The reason is that the WTO is about people. It even says so in the preamble to the agreement that was made in Marrakesh [to establish the WTO]. It's to improve living standards, to help create employment, support sustainable development. And so it must be reformed to ensure it contributes to those.

And first and foremost, I've talked about the top priority for me, seeing how the rules can be looked at so that we can help contribute to a solution of this pandemic, both on the health and economic side.

The second area we need to look at is the dispute settlement system. You alluded to it. The WTO has the only place in the entire world where countries can bring disputes, trade disputes they have with each other, and have them looked at and settled. So we need to reform this. It's been paralyzed. There have been criticisms of the way it functions, that it goes beyond its mandate. And there are genuine criticisms that we need to look at from all members. And we need to reform that quickly.

... There's no point making new rules if the place where disputes can be settled is not working.

I think the third aspect is that the WTO has fallen behind in its rule-making. We need to update rules to 21st century realities. I'll just give you an example. This pandemic has heightened the issue of the digital economy and e-commerce is booming. And there are no rules right now that underpin e-commerce. There is a set of negotiations going on among members on e-commerce. So the sooner we expand those negotiations and finalize them and come to rules that can really help underpin trade so it is fair, there's a level playing field, it's balanced, both poor and rich countries can have access. I think these are some of the areas where I think our top priority is to take action.

There are so many firsts in your resume. You are the first woman to serve as finance minister and foreign minister in Nigeria. You will be the first woman and the first African to lead the WTO. ... That feels like a lot to carry.

My sincere hope is that we open the door so that in future women will just go into these jobs and it will not create as much noise always as it has. Second, it does carry a sense of responsibility when people are looking to you and you are in such a public place to do better. But I've been there before.

I'm focused on delivering results. Because I felt that, look, this is what I have to do to make clear that we shouldn't think twice about bringing women into these jobs. And my pride and joy is that since I was finance minister, three more women have been made finance minister in Nigeria. So actually it's now become the thing, not only in Nigeria but on the continent, to have women running finance. ...

If you wake up in the morning thinking, oh my God, I have these huge responsibilities, then you become paralyzed. I'm just going to focus on: How can I get results? How can I get people together to produce for the global economy? And above all, how can I also see that the WTO serves poor countries so that they can also benefit from the multilateral trading system?

Jeff Pierre and William Troop produced and edited the audio interview. James Doubek produced for the Web.

California Governor Gavin Newsom speaks at a press conference following the opening of a new large scale COVID-19 vaccination site in Los Angeles on Tuesday. Newsom says the state will start setting aside 10% of its vaccine allotment for teachers, day care workers and other school employees. Mario Tama/Getty Images hide caption

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California Governor Gavin Newsom speaks at a press conference following the opening of a new large scale COVID-19 vaccination site in Los Angeles on Tuesday. Newsom says the state will start setting aside 10% of its vaccine allotment for teachers, day care workers and other school employees.

Mario Tama/Getty Images

California is planning to start setting aside 10% of the COVID-19 vaccine the state receives each week to vaccinate teachers, day care workers and other school employees in the hopes of getting more students back in the classroom.

"It must be done, and it must be done much sooner than the current path we are on. And we believe this will advance that cause," Gov. Gavin Newsom said Friday as he announced the plan at an Oakland vaccination site.

The plan will begin March 1 by setting aside about 75,000 vaccine doses from the state's current weekly allotment, Newsom said.

The vaccine will be used to inoculate "the ecosystem that is required to reopen our schools for in-person instruction," including teachers, day care workers and other public school employees, such as bus drivers and cafeteria workers, Newsom said.

Most of the state's large school districts have been teaching students remotely for most of the school year.

But 35 of California's counties are already prioritizing vaccinating teachers and other educators.

"We want to operationalize that as a standard for all 58 counties in the state," Newsom said

The announcement came a day after Newsom said a plan by Democrats in the state legislature aimed at opening schools by April 15 was not aggressive enough.

"While the Legislature's proposal represents a step in the right direction, it doesn't go far enough or fast enough," Newsom said in a statement. "I look forward to building on the growing momentum to get our schools open and continuing discussions with the legislature to get our kids back in school as safely and quickly as possible."

The issue of vaccinating teachers has become one of the most contentious issues as the nation grapples with the pandemic.

The Centers for Disease Control and Prevention's new guidelines for how schools can safely offer in-person learning recommends vaccinating school staff, but does not require it. That has drawn criticism from powerful teachers' unions.

A representative of the California Teachers Association described the 10% allotment as "an important step to ensuring teachers and school staff have access to the vaccine before opening schools and worksites for in-person instruction," according to the Los Angeles Times.

Newsom has come under fire for how he has handled the pandemic, especially for imposing strict lockdowns.

Newsom says the state can begin setting aside vaccine doses because the Biden administration has begun providing more reliable projections for how much vaccine the state receives each week.

California has been hit particularly hard by the pandemic. But the move comes as the number of people getting infected by the coronavirus has finally started falling in the state, along with the number of people hospitalized with COVID-19 and dying from the disease.

A Bicycle. A Trip. Or Just Pants: The Things We Buy When Pining For Normal Times

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Ordinary items such as bicycles or hair extensions are gaining symbolic significance as we use them to project to a time when we can finally use them with others or show them off. Kaz Fantone for NPR hide caption

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Kaz Fantone for NPR

Ordinary items such as bicycles or hair extensions are gaining symbolic significance as we use them to project to a time when we can finally use them with others or show them off.

Kaz Fantone for NPR

When Chase Hensel in Alaska daydreams about life returning to some type of normal, he thinks of his two granddaughters living in London.

Both are learning to ride bikes, and he envisions himself flying there to pedal with them along a local park.

So Hensel bought himself a foldable bike, one that would be easy to travel with once it feels safe again.

"I think buying the bike was sort of putting a marker towards the future and saying this will happen, even if it's still not really clear when," Hensel says. "But at least it's throwing a marker out there, even if it's in wobbly sand."

Experts have long touted the mental value in anticipation, in daydreaming about purchases before we use them. These benefits usually apply best to experiences, like buying tickets to a concert or booking a flight for a vacation.

But now, after nearly a year of lockdowns, even the most common purchases are having a similar effect as we crave the routines and experiences of daily life in this period of isolation.

"We get pleasure from things before they even happen," says Amit Kumar, a professor of psychology and marketing at the University of Texas. "It extends the satisfaction that we derive from those purchases."

For Kelly Jenkins, 33, that sense of anticipation comes from hair extensions.

They were an impulse buy a few weeks ago. Today, they hang on the wall of her apartment in Brooklyn.

And when she looks at them, she daydreams about wearing them on a big night out when she can finally clip them in and show off that long, voluminous hair to her friends.

She can even picture the venue and hear the music playing as she dances.

"I want it to be crowded, with fun lighting and fun music, probably funk or disco. And somehow, there's someone taking great photographs," Jenkins says as she bursts out laughing. "I don't know, it sounds ridiculous describing it out loud."

That object of anticipation can even be more mundane.

Take Mitch Schaller, a 23-year-old who graduated from college during the pandemic.

"I bought dress shoes and a couple suit jackets. Nice pants, some ties. The whole outfit," he says.

Schaller daydreams of one day walking into a real office in his slick new outfit, sitting at a desk and interacting with real life co-workers, not just video headshots on a screen.

"This is going to sound ridiculous, but I definitely want to wear like the best possible outfit on the first day back," he says. "Maybe this is vain to say, but I hope I turn a few heads when I walk in."

Tom Gilovich, a professor of psychology at Cornell University, is another expert who understands the feeling.

The social starvation impacting us all, he notes, is what gives these everyday purchases the anticipation usually reserved for bigger experiences.

"We've been in lockdown for so long that this unexceptional thing can nonetheless have that effect," Gilovich says.

Like Hensel in Alaska, who clings to that new bike as he runs through a day with his granddaughters that has yet to happen.

"Hopefully we'll get home before there's a meltdown, but maybe not — and that's okay," he says. "Maybe that's just the end of a good day."

So go ahead — buy the high heels. Get a dinner party set. Plan a trip.

Let yourself dream. It's worth more than you might think.

A sign at a vaccination site in Los Angeles reflects the holdup in vaccine distribution as a result of this week's storms. White House officials said Friday that the extreme weather delayed the shipment of some 6 million doses across the country. Frederic J. Brown/AFP via Getty Images hide caption

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Frederic J. Brown/AFP via Getty Images

A sign at a vaccination site in Los Angeles reflects the holdup in vaccine distribution as a result of this week's storms. White House officials said Friday that the extreme weather delayed the shipment of some 6 million doses across the country.

Frederic J. Brown/AFP via Getty Images

White House officials on Friday confirmed the extent of the weather's chilling effect on COVID-19 vaccine distribution, saying this week's storms created a backlog of some 6 million doses affecting all 50 states.

That number represents three days' worth of delayed shipments, said Andy Slavitt, senior adviser on the White House COVID-19 Response Team. He added that many states have been able to cover some of the delay with their existing inventory, and that the Biden administration expects to make up the backlog shortly.

"If we all work together, from the factory, all the way to the vaccinators, we will make up for it in the coming week," Slavitt said during the briefing.

He said 1.4 million doses are in transit on Friday, and that most of the backlogged doses are expected to be delivered within the next several days.

The impact of the historic storms on vaccine distribution became clear throughout the week, as dangerous driving conditions and widespread power outages forced numerous states and localities to cancel vaccine appointments and close down clinics. Many, from Nevada to Florida, reported getting word of delayed shipments.

Extreme weather snarled the process at three main places along the distribution chain, according to Slavitt. Many UPS, FedEx and McKesson workers were snowed in and unable to package the vaccines and supplies, and road closures further held up deliveries between hubs.

And more than 2,000 vaccination sites were located in areas without power, Slavitt said, meaning they would have been unable to store doses at the proper temperatures. Doses for those sites were held back rather than risk expiration, he said, and will be shipped as soon as weather permits.

"With everybody's hard work and collective effort we will be able to catch up, but we understand this will mean asking more of people," Slavitt said.

States, sites and vaccinators should take extra steps to prepare for additional vaccine volume and get doses into more peoples' arms, Slavitt said. The administration is asking vaccine sites to extend their hours, offer additional appointments and try to reschedule canceled appointments in the coming days and weeks.

He also announced plans to stand up five additional mass vaccination sites in Florida and Pennsylvania, which the federal government will work with state and local jurisdictions to get up and running in the next two weeks.

A sign directs drivers to a COVID-19 vaccination site at the Orange County Convention Center in Orlando, Fla. Health officials in Orange County said on Thursday that two women were caught dressing up as "grannies" in an effort to cut the vaccine line. Paul Hennessy/NurPhoto via Getty Images hide caption

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Paul Hennessy/NurPhoto via Getty Images

A sign directs drivers to a COVID-19 vaccination site at the Orange County Convention Center in Orlando, Fla. Health officials in Orange County said on Thursday that two women were caught dressing up as "grannies" in an effort to cut the vaccine line.

Paul Hennessy/NurPhoto via Getty Images

Two Florida women disguised themselves as elderly grandmothers in an unsuccessful attempt to get their second doses of the COVID-19 vaccine, officials said Thursday.

Dr. Raul Pino, the director of the Florida Department of Health in Orange County, told reporters that the women were caught dressing up as "grannies" — "the bonnets, the gloves, the glasses, the whole thing" — at the vaccination site on Wednesday. He said he was not sure how they had managed to get their first doses but noted the community's high demand for vaccines.

"We haven't had any lack of willing arms to get vaccinated," Pino said. "We also have people faking to be old to be vaccinated."

The Orange County Sheriff's Office told NPR over email that the women's ages are 34 and 44. Florida is currently prioritizing vaccinations for adults 65 and older, health care personnel and long-term care facility residents and staff.

The dates of birth on their driver's licenses did not match those they had used to register for the vaccines, though their names did, according to the Sheriff's Office. Health department personnel asked the deputies to issue trespass warnings, and no other law enforcement action was taken.

The Sheriff's Office said it does not have further information about the incident.

When asked whether there have been other cases of people misrepresenting themselves to try to get vaccinated, Pino said there had been a few, including one man who shared the same name as his elderly father.

"As we are engaged in this process of trying to move people quickly, some people could squeeze in, so it's probably higher than we suspect," he said of the exact number.

And, noting that vaccines are "the hottest commodity," he said officials have increased security around the site to prevent similar incidents from happening in the future.

Other states have also issued warnings against such plots. New York Gov. Andrew Cuomo has proposed legislation that would make it a crime to provide vaccines to people who are trying to skip the line, and officials in an Indiana county said earlier this month that as many as 30 people had lied about their vaccine eligibility in just one weekend, which they called a "substantial lack of morality."

The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

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