After a summer of uncertainty and fear about how schools across the globe would operate in a pandemic, a consensus has emerged in recent months that is becoming policy in more and more districts: In-person teaching with young children is safer than with older ones, and particularly crucial for their development.
On Sunday, New York City, home to the country’s largest school system, became the most high-profile example of that trend, when Mayor Bill de Blasio announced that only elementary schools and some schools for children with complex disabilities would reopen after all city classrooms were briefly shuttered in November. There is no plan yet to bring middle and high school students back into city school buildings.
It was an abrupt about-face for the mayor, who had for months promised to welcome all of the city’s 1.1 million children — from 3-year-olds to high school seniors — back into classrooms this fall.
But the decision put New York in line with other cities around America and across the world, which have reopened classrooms first, and often exclusively, for young children, and in some cases kept them open even as they have confronted second waves of the virus.
In-person learning is particularly crucial for young children, who often need intensive parental supervision to even log on for the day, education experts say. And mounting evidence has shown that elementary school students in particular can be safe as long as districts adopt strict safety measures, though it’s an unsettled question for older students.
“With younger kids, we see this pleasant confluence of two facts: science tells us that younger children are less likely to contract, and seemingly less likely to transmit, the virus,” said Elliot Haspel, the author of Crawling Behind: America’s Child Care Crisis and How to Fix It. “And younger children are the ones that most need in-person schooling, and in-person interactions.”
Districts including Chicago, Washington D.C. and Philadelphia have either begun to bring back only young children or have plans to do so whenever they eventually reopen classrooms.
In Rhode Island, Gov. Gina Raimondo, a strong proponent of keeping schools open, recently asked colleges to shift to all-remote learning after Thanksgiving, and gave districts the option of reducing the number of high school students attending in person. But she asserted that middle and elementary schools were not sources of community spread.
That model of giving priority to younger students has been pioneered in Europe, where many countries have kept primary schools open even as most other parts of public life have shuttered during the continent’s second wave.
Italy has kept its primary schools open but kept teaching remote for middle and high schools. All schools in Germany are open, and discussions about possible closures have focused mainly on high schools.
And in America, more and more districts have begun to prioritize elementary school students for in-person learning.
In urban districts that have been slow to reopen, that has meant making plans to bring back the youngest students. In parts of the Midwest where school districts were more aggressive about reopening, and where there has been a huge rise in cases in recent weeks, public health officials have prioritized keeping elementary schools open even as they have closed high schools and in some cases middle schools.
“The data is becoming more compelling that there is very limited transmission in day care and grade schools,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of President-elect Joseph R. Biden Jr.’s coronavirus task force, in a recent interview.
“I keep telling people, ‘Stop talking about kids — talk about those younger than 10,’” he added. “We’re seeing a very different epidemiology in that group than we’re seeing, for example, in high school students.”
Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, headed into the White House on Tuesday morning to meet with Mark Meadows, the chief of staff, who summoned Dr. Hahn to explain why regulators have not yet approved the emergency use of the coronavirus vaccine developed by Pfizer, according to people familiar with the situation.
Dr. Hahn prepared for the meeting by pulling data from the past few weeks showing how productive the F.D.A. has been, an administration official said.
One official said Mr. Meadows is concerned that the British government may approve emergency use of a coronavirus vaccine before American regulators act, potentially embarrassing the Trump administration. The meeting was reported earlier by Axios.
On Friday, the British government asked its drug regulator to consider AstraZeneca’s vaccine for emergency approval. The regulator, the Medicines and Healthcare products Regulatory Agency, had previously been conducting a rolling review of the vaccine. It is also reviewing Pfizer’s vaccine.
President Trump and Mr. Meadows have pressured the F.D.A. for months to speed up the development and approval of a vaccine, and allies of Dr. Hahn are worried that he could be fired if he fails to satisfy the White House demands.
Pfizer and its German partner, BioNTech, announced on Nov. 18 that clinical trial results showed its vaccine was 95 percent effective and had no serious side effects. It submitted an application for emergency use authorization to the F.D.A. two days later.
An F.D.A. spokesman said that government experts must now review “thousands of pages of technical information.” Among other matters, he said, they must analyze the effects of the vaccine on various groups of patients and Pfizer’s controls on the manufacturing process.
The agency’s outside advisory panel of experts is scheduled to meet on the Pfizer vaccine on Dec. 10. Unless the reviews uncover unexpected problems, the F.D.A. is expected to approve the Pfizer vaccine within days.
The coronavirus pandemic has created a record need for global humanitarian aid, the United Nations said on Tuesday, forecasting that 235 million people will require aid in 2021, an increase of 40 percent over the same period last year.
The proportion of people needing aid rose to one in 33 people worldwide from one in 45 last year. Fighting off famine, poverty and disease, while keeping children vaccinated and in school, will require $35.1 billion in funding, or more than double the record $17 billion raised in 2020, the United Nations said.
Even as much of the world looks with hope to promising coronavirus vaccines, which could begin to be rolled out as early as next month, the lingering impact of the pandemic — including rising food prices, falling incomes and halted education — will disproportionately hit more vulnerable people, said Mark Lowcock, organization’s humanitarian and emergency relief efforts.
Extreme poverty will increase for the first time since the ’90s, life expectancy will fall, deaths from diseases like malaria and tuberculosis will double, twice as many people will face starvation, and many children will be unable to go back to school, he said.
“The rich world can now see the light at the end of the tunnel,” Mr. Lowcock said. “The same is not true in the poorest countries. The Covid-19 crisis has plunged millions of people into poverty and sent humanitarian needs skyrocketing.”
The United Nations presented its forecast in Geneva on Tuesday as it introduced its Global Humanitarian Overview, an annual assessment of projected needs. At the same event last December, before the coronavirus outbreak had grown to a global pandemic, the United Nations predicted 168 million people would need aid in 2020, requiring $28.8 billion in funding.
Its plan for 2021 would target aid to 160 million people in 56 countries, with the largest populations in Yemen, Ethiopia, the Democratic Republic of Congo, Afghanistan, Sudan, Syria and Nigeria.
The coronavirus may have infected people in the United States as early as Dec. 13, more than a month earlier than researchers had thought, according to scientists who analyzed blood samples taken from American Red Cross donations. Outside scientists cautioned, however, that the virus was probably not spreading that early.
The researchers noted that they cannot say whether the apparent infections were in travelers who had been infected in other countries, or whether the infections themselves were dead ends, and did not lead to community transmission.
Before this new report, the earliest documented infection in the country was on Jan. 19 in someone who had traveled to China. Although other genetic studies have suggested the possible presence of the virus earlier than Jan. 19, the new study found that blood donations from nine states sent to the Centers for Disease Control and Prevention carried coronavirus antibodies — protein markers of past exposure to the virus.
But at least one prominent virus researcher cautioned that these results could be interpreted differently. Trevor Bedford, an epidemiologist at the University of Washington who has been deeply involved in genetic studies of how, when and where the virus has spread, said in a series of tweets that he thought the study could be identifying people who had antibodies to other human coronaviruses, which cause common colds, although he did not rule out that it may have picked up some cases of travelers who had been infected in other countries.
In the new report, which was released online Monday and has been accepted for publication in the journal Clinical Infectious Diseases, Dr. Sridhar V. Basavaraju of the C.D.C. and others reported that they had looked for antibodies that reacted to the specific virus that has caused the pandemic, SARS-CoV-2.
In more than 7,000 samples, 106 showed antibodies, they found. The researchers did not find these tests definitive, however, because they can sometimes reveal antibodies to other coronaviruses.
After further tests, they found one blood sample to be most convincing because it showed antibodies to a specific part of the SARS-CoV-2 protein. It was collected on Jan. 10 in Connecticut was “likely from an individual with a past or active SARS-CoV-2 infection.” That person could have been infected while traveling.
A Centers for Disease Control and Prevention advisory committee will meet on Tuesday afternoon to decide what its advice will be about who should get access to coronavirus vaccines first. But much like its recommendations about masks and travel restrictions, the C.D.C.’s guidance about vaccine distribution will only inform states, which will ultimately need to devise their own plans.
Alex M. Azar II, the health and human services secretary, said on Monday that vaccine doses will be distributed through normal processes for vaccines, with governors acting as “air traffic controllers” to determine which hospitals or pharmacies receive shipments.
There is wide agreement that frontline health care workers should be prioritized, and the C.D.C. has said in documents sent to public health agencies that essential workers like police offers or workers in food production, as well as employees and residents of long-term care facilities, should be close behind. But it is unclear where other vulnerable populations, like transit workers, inmates and teachers, stand.
States don’t have to follow the C.D.C.’s recommendations, but most probably will, said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which represents state health agencies.
Moncef Slaoui, the head of the Trump administration’s Operation Warp Speed virus program, told Politico that he expects some states “may prefer long-term care facilities or the elderly, while others may prioritize their health care workers.”
The C.D.C. panel hinted last week that it would recommend the country’s 87 million essential workers be next in line. These workers are disproportionately Black and Hispanic, populations that have been hit especially hard by the virus, and at increased risk because they are more likely to work at jobs that preclude working from home.
After essential workers, next are likely adults with medical conditions that put them at high risk of coronavirus infection, and people over 65.
As of Monday, two major vaccine makers, Moderna and Pfizer, have applied to the Food and Drug Administration to authorize its vaccine for emergency use.
With the limited quantities of the Moderna and Pfizer vaccines set to be distributed as early as later this month, states are scrambling to plan their distribution.
Federal officials have said they plan to ship the first 6.4 million doses within 24 hours after the F.D.A. authorizes a vaccine, and the number each state receives will be based on a formula that considers its adult population.
In Kentucky, Gov. Andy Beshear said on Monday that 26,000 residents and employees of nursing homes and other long-term-care facilities would be the first in the state to get vaccinated, along with 12,000 of the state’s more than 200,000 health care workers. The federal government has allocated an initial 38,025 doses of Pfizer’s vaccine for Kentucky, based on its population, he said.
That is a much smaller amount than what the state had planned for, he said, adding that Kentucky is also projected to receive an initial 76,700 doses of a vaccine made by Moderna by the end of December if the regulatory process goes quickly.
The initial allocation would reach about half of the 50,000 patients and staff members in “the highest, most intensive tier of long-term care” in Kentucky, Mr. Beshear said. A staggering 66 percent of deaths from Covid-19 in Kentucky have been among their residents, and protecting them could help prevent hospitals from becoming overwhelmed, he said.
Teachers and emergency medical workers will likely be next in line, he said.
Pfizer and BioNTech have submitted their final application to the European health authorities for approval of their Covid-19 vaccine, the companies announced Tuesday.
Initial approval could come as early as Dec. 29 when the European Union’s medicine agency plans to meet in an extraordinary session to decide if the data submitted is “sufficiently robust” to show the safety and efficacy of the vaccine.
“Today’s announcement marks another key milestone in our efforts to fulfill our promise to do everything we can to address this dire crisis given the critical public health need,” Dr. Albert Bourla, chief executive of Pfizer, said in a statement.
Last month, Pfizer announced that the vaccine was more than 90 percent effective based on a Phase 3 study involving 43,538 participants, and that it had already submitted an application to the Food and Drug Administration in the United States to authorize it for emergency use.
“We will continue to work with regulatory agencies around the world to enable the rapid distribution, should the vaccine receive the approval, contributing to the joint efforts to let the world heal and regain its normal pace of life,” said Ugur Sahin, co-Founder of BioNTech, the German start-up that created the vaccine.
The news comes a day after Moderna, the makers of another promising vaccine, announced that it had applied for approval from the European market.
If the applications are approved by the European Medicines Agency, the first doses could be available before the end of the month. The agency is “assessing all the applications for COVID-19 medicines under the minimum time frame necessary to allow for a thorough evaluation of the medicine’s benefits and risks,” it said.
If the agency concludes that the benefits of the vaccine outweigh its risks, it will recommend a conditional marketing authorization, which the European Commission will then fast-track to approve in all European member states within days.
On Tuesday, BioNTech officials, speaking at a news conference, said vaccine doses were waiting for approval to be shipped.
“We have produced a stockpile; everything that we have can really be distributed within a few hours,” said Sierk Poetting, the company’s chief financial officer and chief operating officer.
Dr. Scott W. Atlas, the former Stanford University radiologist who espoused disputed theories and rankled government scientists while advising President Trump on the pandemic, has resigned his White House position, according to a senior government official.
The move was not entirely unexpected. Dr. Atlas caught Mr. Trump’s eye with his frequent appearances on the Fox News Channel over the summer, and joined the White House in August as a special government employee for a limited term that was set to expire this week. Fox News first reported his resignation, which Dr. Atlas later announced on Twitter.
“I worked hard with a singular focus — to save lives and help Americans through this pandemic,” Dr. Atlas wrote in a letter obtained by Fox, adding that he “always relied on the latest science and evidence, without any political consideration or influence.”
But some of Dr. Atlas’s administration colleagues would likely differ with that assessment, citing views that differ starkly from those put forth by officials at the Centers for Disease Control and Prevention and other government scientists. Dr. Atlas has argued, for example, that the science of mask wearing is uncertain and that children cannot pass on the coronavirus.
Even more controversial was his libertarian vision of the role of the government in the pandemic. In Dr. Atlas’s view, the government’s job was not to stamp out the virus but simply to protect its most vulnerable citizens as Covid-19 takes its course.
His argument was that most people infected with the virus would not get seriously ill, and at some point, enough people will have antibodies from Covid-19 to deprive the virus of carriers — “herd immunity.” Public health experts were appalled, and Dr. Atlas clashed in particular with Dr. Anthony S. Fauci, the government’s top infectious disease specialist, and Dr. Deborah L. Birx, the coronavirus response coordinator.
“I don’t want to say anything against Dr. Atlas as a person, but I totally disagree with the stand he takes. I just do, period,” Dr. Fauci said earlier this month on the NBC program “Today.”
But Dr. Atlas had the ear of one person who mattered: Mr. Trump.
France’s coronavirus test positivity rate, at 11.1 percent, is nearly four times that of New York City.
And yet schools across France have remained open during the latest lockdown, in sharp contrast to New York City, which closed schools after its average test positivity rate climbed to 3 percent before abruptly deciding to reopen elementary schools over the weekend.
Even as the virus has surged again in Europe, classrooms across the continent have largely remained open despite increasing restrictions, in a significant departure from the first lockdowns last spring. Based in part on scientific evidence that young children are low transmitters of the virus, the decisions have helped soften the pandemic’s academic and economic blows.
“Obviously, the decline has been slower because schools are open, but we had to find a middle ground,” said Yazdan Yazdanpanah, an infectious disease specialist and a member of France’s Scientific Council, which advises the government on the pandemic. But, he added, the slower drop in infections has been offset by positive effects on education, mental health and the economy.
Three months into France’s school year, schools have not become a major driver of infections. Only 7,776 schoolchildren tested positive for the coronavirus last week, or just 0.06 percent of the country’s 12 million schoolchildren, according to figures released by the Education Ministry.
On Nov. 27, out of 61,500 schools, only 19 primary schools, three middle schools and three high schools were closed because of outbreaks.
France’s experience, at least so far, suggests that it is possible to flatten the curve, or bend it down, even when schools are open. A week ago, France’s 14-day rate of infection was nearly 800 per 100,000 people; as of Wednesday, it had dropped to 483.
With schools open, parents have been able to focus on their work at home or commuting to their workplaces, which has helped blunt the second lockdown’s depression on the economy. The country has shuttered cafes and restaurants through at least mid-January, but allowed essential sectors to keep operating. The Eiffel Tower, it was announced on Tuesday, will reopen on Dec. 16; the monument, one of the biggest tourist attractions in Paris, has been closed since late October.
In other global developments:
Also in France, President Emmanuel Macron said on Tuesday that he was considering implementing a widespread vaccination campaign next spring after a more targeted one for health workers and vulnerable populations. Mr. Macron, speaking at a news conference in Paris alongside Alexander De Croo, the Belgian prime minister, said there would probably be a first wave of priority vaccinations in early 2021 with first-generation vaccines, which might prove logistically complex to deploy. But Mr. Macron repeated that getting a vaccine would not be mandatory, and he insisted instead on a “strategy of conviction and transparency.”
Hamas, the militant group that rules the Gaza Strip, said on Tuesday that Yehya Sinwar, its chief in the territory, had tested positive for the coronavirus. Hamas said that Mr. Sinwar was doing “well” and was working while in quarantine.
Vietnam suspended commercial flights on Tuesday, two days after its first case was confirmed in 89 days. Two additional cases were reported in Ho Chi Minh City on Tuesday, both linked to a flight attendant who officials said violated quarantine regulations. Officials were working to trace the contacts of the three infected people, and Prime Minister Nguyen Xuan Phuc urged vigilance in prevention measures.
Ireland exited a six-week lockdown on Tuesday, reopening nonessential businesses, gyms and religious services. Health officials still discouraged socializing, but groups of six people will be permitted inside bars and restaurants serving substantial meals starting on Friday.
The Netherlands began requiring masks in public buildings on Tuesday, making it one of Europe’s last countries to introduce the mandate. The government had long discouraged the use of masks, saying they promoted a false sense of security, before an abrupt shift in October when they advised people to use them. Violations under the new law will carry a fine of 95 euros, or $114.
In Spain, the regional leader of Madrid, Isabel Díaz Ayuso, inaugurated her flagship infrastructure project: a new hospital on Tuesday focused on patients affected by epidemics like Covid-19. The hospital has no patients yet, as only a quarter of its infrastructure has been installed and its medical staff is incomplete. Ms. Díaz Ayuso told reporters on Tuesday that “a new hospital can never be bad news,” but the project, which she announced in May, has come under intense criticism, with medical professionals and opposition politicians calling on her government to instead strengthen staffing and resources at existing hospitals.
Seven families sued the state of California on Monday over the quality of education that their children are receiving at home this year, saying they have been left behind by the shift to remote learning during the pandemic.
The suit argues that a lack of attention to the realities of remote learning has exacerbated inequality in schools and deprived minority students from poor families of their right to an education.
“The change in the delivery of education left many already underserved students functionally unable to attend school,” the lawsuit, which was filed Monday in the Alameda County Superior Court, asserts. “The state continues to refuse to step up and meet its constitutional obligation to ensure basic educational equality or indeed any education at all.”
The plaintiffs include 15 Black and Latino students in Oakland and Los Angeles, who range from kindergartners to high school seniors. The suit details their individual struggles as they try to continue their education despite a lack of sufficient computers, internet access and instruction.
For two twins in Oakland, who were in second grade when distance learning began, the experience “barely resembled learning,” the suit said. Their teacher held remote classes only twice between March 17 and the end of the school year. When the twins’ mother asked why, the teacher responded that because some students could not connect to the internet, classes were canceled for everyone, it said. The mother “felt like her children had been written off.”
Representatives of the state of California could not immediately be reached for comment.
California schools, with more than six million students, have relied on mostly remote learning since March. Early progress reports this fall showed a sharp drop in performance as students struggled to learn from home.
With a new administration and coronavirus vaccines on the way, there is hope for the United States, even as it grapples with the appalling milestone of more than one million new coronavirus cases every week.
But for now, the nation has little alternative but to confront the dark winter ahead. “The next three months are going to be just horrible,” warned Dr. Ashish Jha, the dean of Brown University’s School of Public Health.
Some epidemiologists predict that the death toll by March could be close to twice the 250,000 figure surpassed only last week. Hospitals in some states are beyond capacity, while the number of deaths seem on track to easily surpass the 2,200-a-day average in the spring.
President Trump could help to save the lives of millions of his supporters by urging them to wear masks, in accordance with new C.D.C. guidelines, or avoid gathering indoors. But that seems unlikely to occur, many health experts said.
Had Mr. Trump heeded his medical advisers and adopted measures to curb new infections in late spring, he could have been the hero of this pandemic. Operation Warp Speed appears on track to deliver vaccines and therapies in record-breaking time, with the first doses of vaccine available to Americans as soon as later this month. Vaccinations are expected to go first to health care workers, nursing home residents and others at highest risk.
President-elect Joseph R. Biden Jr. will inherit the fruits of Operation Warp Speed and oversee their distribution. Speaking anonymously, members of his transition team said they were already discussing whether to create a secure way for vaccinated individuals to prove they have received both shots, and whether Covid vaccines should ultimately be made mandatory, as some experts recommend.
To do so may be a political struggle, but it is within American religious tradition and within the scope of American law.
It was the day before Thanksgiving when Brian Stone, of Tilghman, Md., heard the alarm ring from his phone: the jarring buzz that tells people to look out for missing children or evacuate their homes to escape an advancing wildfire.
But this alert was different: It told him to wear a face mask and to expect stricter enforcement of coronavirus health orders.
Mr. Stone then turned off the notification system.
“You get this beep, this electronic sound, and you think it’s something important, and it’s just ‘Wear a mask and be safe,’” said Mr. Stone, whose wife, Ellen, wrote a letter to The Baltimore Sun about the emergency alert. “It wasn’t an emergency.”
Ed McDonough, a spokesman for the Maryland Emergency Management Agency, said: “We’ve been trying to be very judicious in how we use it.” Mr. McDonough said officials felt that with families gathering for Thanksgiving, it was important to remind them to be as safe as possible.
State and local officials are turning to the Wireless Emergency Alert system to warn residents of rising case counts and of other public health issues related to the virus. The model allows police departments and other public agencies to warn residents with geographically targeted messages, usually when there is severe weather or a child has been abducted.
In Los Angeles, officials used the system to tell residents that virus testing sites were expanding their hours ahead of the holidays.
On Monday, Rhode Island issued an alert to warn residents that hospitals were at capacity. And in Pennsylvania, Gov. Tom Wolf said in a news release last week that the state would use the alerts to target specific regions of the state with high case counts.
While emergency alerts provide an easy way to get important information to residents, the system also potentially oversaturates people with messages, creating a “boy who cried wolf” effect that could lead people, like Mr. Stone, to become disillusioned with the system.
Mr. Wolf said the alerts are “one more way to reach as many Pennsylvanians as we can to provide timely information on Covid-19.”
For pedestrians who cannot see or have limited vision, navigating the chaotic sidewalks and crosswalks of New York City was dicey enough before the pandemic. But the outbreak, blind people say, has made crossing the city’s streets even riskier and more harrowing.
It has reduced the flow of cars and trucks at times, leaving streets in some neighborhoods as placid as suburban lanes.
That may sound like a blessing for blind New Yorkers like Terence Page. But, in fact, the opposite is true. The normal roar of traffic provides clues — often the only ones — about when it is time to venture into a crosswalk.
“Quiet is not good for blind people,” Mr. Page said as he swept his long green cane across the sidewalk along Sixth Avenue in Manhattan, trying to locate the curb at West 23rd Street.
Mr. Page traversed that avenue with confidence, because the crossing is equipped with an audible signal that tells pedestrians when they have the go-ahead to stride across the pavement. The vast majority of the city’s 13,200 crossings are not.
As a result, a federal judge has found that the city has failed to fully protect some of its most vulnerable residents.
The judge ruled in October that the “near-total absence” of those devices — known as Accessible Pedestrian Signals — violated the civil rights of blind people by denying them equal access to the city’s crosswalks.
The pandemic has also hampered another source of help. When in doubt, blind people often can rely on other pedestrians to offer guidance or an elbow to clasp. The coronavirus has made fellow travelers less inclined to get so close, Mr. Page said.
“There are less people who want to help you or even touch you,” he said.
To make matters more challenging, the sidewalks and streets are filled with new obstacles: dining tables surrounded by makeshift fences and tents.