NEW YORK -- Coronavirus deaths are rising in nearly two-thirds of American states as a winter surge pushes the overall toll toward 400,000 amid warnings that a new, highly contagious variant is taking hold.
As Americans observed a national holiday Monday, New York Gov. Andrew Cuomo pleaded with federal authorities to curtail travel from countries where new variants are spreading.
Referring to new versions detected in Britain, South Africa and Brazil, Cuomo said: "Stop those people from coming here. ... Why are you allowing people to fly into this country and then it's too late?"
The U.S. government has already curbed travel from some of the places where the new variants are spreading -- such as Britain and Brazil -- and recently it announced that it would require proof of a negative covid-19 test for anyone flying into the country.
But the new variant seen in Britain is already spreading in the U.S., and the Centers for Disease Control and Prevention has warned that it will probably become the dominant version in the country by March. The CDC said the variant is about 50% more contagious than the virus that is causing the bulk of cases in the U.S.
While the variant does not cause more severe illness, it can cause more hospitalizations and deaths simply because it spreads more easily. In Britain, it has aggravated a severe outbreak that has swamped hospitals, and it has been blamed for sharp leaps in cases in some other European countries.
As things stand, many U.S. states are already under tremendous strain. The seven-day rolling average of daily deaths is rising in 30 states and the District of Columbia, and on Monday the U.S. death toll neared 399,000, according to data collected by Johns Hopkins University -- by far the highest recorded death toll of any country in the world.
Ellie Murray, an assistant professor of epidemiology at the Boston University School of Public Health, said cases have proliferated in part because of gatherings for Christmas and New Year's -- and compounded surges from Thanksgiving and the return of students to schools and universities in the fall.
The pace of any further spread will depend on whether those who did gather with family and friends quarantined afterward or went back to school or work in person, she said.
One of the states hit hardest during the recent surge is Arizona, where the rolling average has risen over the past two weeks from about 90 deaths per day to about 160 on Sunday.
Rural Yuma County -- known as the winter lettuce capital of the U.S. -- is now one of the state's hot spots. Exhausted nurses there are now regularly sending covid-19 patients on a long helicopter ride to hospitals in Phoenix when they don't have enough staff. The county has lagged on coronavirus testing in heavily Hispanic neighborhoods and just ran out of vaccines.
But some support is coming from military nurses and a new wave of free tests for farmworkers and the elderly.
ACCELERATE TO VACCINATE
Amid the rise in cases, a vast effort is underway to get Americans vaccinated -- what Cuomo called "a footrace" between the vaccination rate and the infection rate. But the campaign is off to an uneven start. According to the latest federal data, about 31.2 million doses of vaccine have been distributed, but only about 10.6 million people have received at least one dose.
In some cases, vaccine supplies thus far do not meet demand. More than 172,000 people in Missouri's St. Louis County have registered for the vaccine, but the the local health department has received only 975 doses, said County Executive Sam Page.
In California, counties are pleading for more vaccine as the state tries to reduce a high rate of infection that has led to record numbers of hospitalizations and deaths.
Although the state last week said anyone 65 or older can receive the vaccine, Los Angeles County and some others have said they don't have enough to immunize so many people. They are concentrating on protecting health care workers and the most vulnerable elderly in care homes first.
On Monday, the superintendent of the Los Angeles Unified School District sent a letter asking for state and county authorization to provide vaccinations at schools for staff, local community members -- and for students once a vaccine for children has been approved.
The death rate in Los Angeles County -- an epicenter of the U.S. pandemic -- works out to about one person every six minutes. On Sunday, the South Coast Air Quality Management District suspended some pollution-control limits on the number of cremations for at least 10 days in order to deal with a backlog of bodies at hospitals and funeral homes.
In other areas of the country, officials are working to ensure that people take the vaccine once they're offered it amid concerns that many people are hesitant. Maryland Gov. Larry Hogan, in a livestreamed event on Martin Luther King Jr. Day, received a shot, and urged other Marylanders to do likewise.
"We're all looking forward to the day we can take off and throw away our masks," Hogan said. "The only way we are going to return to a sense of normalcy is by these covid-19 vaccines."
But challenges to the campaign are surfacing worldwide.
The head of the World Health Organization warned Monday that the world is on the brink of a "catastrophic moral failure" if wealthier nations don't ensure the equitable distribution of vaccines to combat the pandemic. He also lambasted drugmakers' profits.
WHO Director General Tedros Adhanonom Ghebreysus, who repeatedly has warned richer countries against excluding poorer ones by cutting bilateral deals with vaccine suppliers, took his rhetoric up a notch in his opening remarks at an executive board session.
"I need to be blunt: The world is on the brink of a catastrophic moral failure -- and the price of this failure will be paid with lives and livelihoods in the world's poorest countries," he said, noting that while 39 million doses have been administered in more than 40 higher-income countries, one poor country has administered just 25 doses.
He did not specify the country, but a WHO spokeswoman identified it as Guinea.
While Tedros hailed the vaccine rollout as a great scientific achievement, he noted that there were lessons to be learned from past global pandemics when vaccines took a long time to reach developing countries. The current crisis was a chance to "rewrite history" by ensuring that vaccines are distributed fairly between countries and to those who need them the most, he said.
The WHO has partnered with several vaccine makers to provide 2 billion doses to a consortium of low-income countries in an initiative called Covax, but Tedros said there are concerns the vaccines won't be delivered.
"Even as they speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around Covax, driving up prices and attempting to jump to the front of the queue," he said.
He called on wealthier countries to hold off on vaccinating their young and healthier adults so that older people and front-line health workers in developing countries could be immunized.
The British government has vowed to vaccinate its four priority groups -- which include National Health Service workers and care home residents -- by Feb. 15.
England's Department of Health and Social Care said Sunday that an estimated 45 percent of people older than 80 have been vaccinated and that more than 1 million within the age group had been invited to book appointments.
Several countries including Sweden and Finland have expressed concern and anger that shipments of the Pfizer vaccine have been delayed, calling the setback -- which the U.S. firm called a temporary delay -- "unacceptable."
The president of the European Commission, Ursula von der Leyen, said last week that Pfizer had agreed to supply the EU with 600 million doses this year.
Those in Africa face a much longer wait for help, with the Africa Centers for Disease Control and Prevention estimating that a distribution program may not begin until April.
Ahmed Ogwell Ouma, deputy director of the Africa CDC, said last month that people in African nations were "often holding the short end of the stick."
India, which has the second-highest caseload in the world, is also beginning mass vaccination efforts and hopes to immunize around 300 million people by summer -- despite concerns that one of its vaccines may not work.
California's top epidemiologist told health care providers Sunday to stop using a batch of Moderna's vaccine after a "higher than usual" number of people had apparent allergic reactions at a San Diego clinic.
Dr. Erica Pan, the state epidemiologist, said that "out of an extreme abundance of caution," providers should stop using the doses until federal, state and company officials finish an investigation.
California has received about 330,000 doses from the Moderna lot in question -- about 10% of all the vaccine, both Moderna's and Pfizer's, that has been distributed across the state, officials said.
The apparent allergic reactions occurred at San Diego County's drive-thru mass vaccination site at Petco Park, said California Department of Public Health spokesman Darrel Ng.
A number of patients who received the vaccine appeared to be suffering from allergic reactions. Their symptoms were severe and required medical attention, Pan said.
Dr. Eric McDonald, San Diego County's director of epidemiology, said in a livestreamed news briefing Wednesday that operations at Petco Park slowed down after six health care workers who had just been vaccinated had apparent allergic reactions.
"That number, clustered together, was slightly higher than expected for the time period," McDonald said. He said the health providers swapped out the batch of vaccines they were administering, "in the possible event" that reactions were connected.
"Any vaccination, whether it's the covid vaccination or the flu vaccination at your doctor's office, should be given under medical supervision," McDonald said. "In this case, with a new vaccine, there are very specific guidelines that all sites giving this vaccine must follow."
That includes monitoring patients for at least 15 minutes after the shot is administered, and longer in cases where patients have a medical condition that could lead to a reaction.
No other cluster of issues, or individual issues, have been reported with the Moderna batch, which was distributed to 287 medical providers across the state, officials said. The batch arrived in California between Jan. 5 and Jan. 12.
Moderna did not immediately return a request seeking comment.
Information for this article was contributed by David Crary and Colleen Slevin of The Associated Press; by Paul Schemm and Jennifer Hassan of The Washington Post; and by Laura J. Nelson of the Los Angeles Times (TNS).