Ever since the race to develop a coronavirus vaccine began last spring, upbeat announcements were stalked by ominous polls: No matter how encouraging the news, growing numbers of people said they would refuse to get the shot.
The time frame was dangerously accelerated, many people warned. The vaccine was a scam from Big Pharma, others said. A political ploy by the Trump administration, many Democrats charged. The internet pulsed with apocalyptic predictions from longtime vaccine opponents, who decried the new shot as the epitome of every concern they’d ever put forth.
But over the past few weeks, as the vaccine went from a hypothetical to a reality, something happened. Fresh surveys show attitudes shifting and a clear majority of Americans now eager to get vaccinated.
In polls by Gallup, the Kaiser Family Foundation and the Pew Research Center, the portion of people saying they are now likely or certain to take the vaccine has grown from about 50 percent this summer to more than 60 percent, and in one poll 73 percent — a figure that approaches what some public health experts say would be sufficient for herd immunity.
Resistance to the vaccine is certainly not vanishing. Misinformation and dire warnings are gathering force across social media. At a meeting on December 20, members of an advisory panel to the Centers for Disease Control and Prevention cited strong indications that vaccine denouncements as well as acceptance are growing, so they could not predict whether the public would gobble up limited supplies or take a pass.
But the attitude improvement is striking. A similar shift on another heated pandemic issue was reflected in a different Kaiser poll this month. It found that nearly 75 percent of Americans are now wearing masks when they leave their homes.
The change reflects a constellation of recent events: the uncoupling of the vaccine from Election Day; clinical trial results showing about 95 percent efficacy and relatively modest side effects for the vaccines made by Pfizer-BioNTech and Moderna; and the alarming surge in new coronavirus infections and deaths.
A huge truck jam at the Port of Dover in England eased further on Saturday, days after France lifted a border blockade imposed over fears of a fast-spreading variant of the coronavirus.
As many as 6,000 trucks had lined up at the height of the days-long jam, and many drivers spent a bleak Christmas sleeping in their vehicles as France demanded that all those crossing the border show proof of a negative coronavirus test.
“It was shocking to see that in a G7 country like the U.K., that such things would happen,” said Benjamin Richtzenhain, a traveler who crossed the English Channel on Thursday. He said that the authorities had communicated poorly to those in the logjam and that access to water, bathrooms and blankets had been limited.
The misery at the port added to a general sense of gloom permeating the holiday season in the country. Christmas came scarcely a week after the government announced the presence of a fast-spreading coronavirus variant sweeping the country and imposed widespread lockdowns and other tight restrictions.
By Saturday morning, officials from the transportation department said that about 1,600 vehicles remained in the traffic jam while at least 8,000 had crossed the English Channel via the Eurotunnel since Wednesday, when the authorities ramped up coronavirus testing.
At the port, officials worked intensively on Saturday to test the remaining drivers in hopes of clearing the backup. More than 15,526 have been tested, with 36 coming up positive, the department said.
Hundreds more military personnel were deployed on Friday to reinforce testing efforts and to distribute food and water provided by an array of organizations.
But almost a week after the blockages of sea, rail and air routes, the magnitude of the task made it impossible to predict when the delays would clear and whether drivers would spend yet another day in limbo and another night sleeping in their trucks.
The end of the pandemic is finally in view. So is rescue from the most traumatic global economic catastrophe since the Great Depression. As coronavirus vaccines enter the bloodstream, recovery has become reality.
But the benefits will be far from equally apportioned.
Wealthy nations in Europe and North America have secured the bulk of limited stocks of vaccines, positioning themselves for starkly improved economic fortunes. Developing countries — home to most of humanity — are left to secure their own doses.
The lopsided distribution of vaccines appears certain to worsen a defining economic reality: The world that emerges from this terrifying chapter in history will be more unequal than ever. Poor countries will continue to be ravaged by the pandemic, forcing them to expend meager resources that are already stretched by growing debts to lenders in the United States, Europe and China.
The global economy has long been cleaved by profound disparities in wealth, education and access to vital elements like clean water, electricity and the internet. The pandemic has trained its death and destruction of livelihood on ethnic minorities, women and lower-income households. The ending is likely to add another division that could shape economic life for years, separating countries with access to vaccines from those without.
“It’s clear that developing countries, and especially poorer developing countries, are going to be excluded for some time,” said Richard Kozul-Wright, director of the division of globalization and development strategies at the United Nations Conference on Trade and Development in Geneva. “Despite the understanding that vaccines need to be seen as a global good, the provision remains largely under control of large pharmaceutical companies in the advanced economies.”
International aid organizations, philanthropists and wealthy nations have coalesced around a promise to ensure that all countries gain the tools needed to fight the pandemic, like protective gear for medical teams as well as tests, therapeutics and vaccines. But they have failed to back their assurances with enough money.
The leading initiative, the Act-Accelerator Partnership — an undertaking of the World Health Organization and the Bill and Melinda Gates Foundation among others — has secured less than $5 billion of a targeted $38 billion.
The United States has secured claims on as many as 1.5 billion doses of vaccine, while the European Union has locked up nearly two billion doses — enough to vaccinate all of their citizens and then some. Many poor countries could be left waiting until 2024 to fully vaccinate their populations.
India is home to pharmaceutical manufacturers that are producing vaccines for multinational companies including AstraZeneca, but its population is unlikely to be fully vaccinated before 2024, according to TS Lombard, an investment research firm in London. Its economy is likely to remain vulnerable.
“You need to vaccinate health care workers globally so you can reopen global markets,” said Clare Wenham, a health policy expert at the London School of Economics. “If every country in the world can say, ‘We know all our vulnerable people are vaccinated,’ then we can return to the global capitalist trading system much quicker.”
PORT ELIZABETH, South Africa — When the pandemic began, global public health officials raised grave concerns about the vulnerabilities of Africa. But its countries over all appeared to fare far better than those in Europe or the Americas, upending scientists’ expectations.
Now, the coronavirus is on the rise again in swaths of the continent, posing a new, possibly deadlier threat.
In South Africa, a crush of new cases that spread from Port Elizabeth is growing exponentially across the nation. Eight countries, including Nigeria, Uganda and Mali, recently recorded their highest daily case counts all year.
“The second wave is here,” John N. Nkengasong, the head of the Africa Centers for Disease Control and Prevention, has declared.
When the virus was first detected, many African countries were considered particularly at risk because they had weak medical, laboratory and disease-surveillance systems and were already battling other contagions. Some were riven by armed conflict, limiting health workers’ access. In March, Tedros Adhanom Ghebreyesus, the first African director-general of the World Health Organization, cautioned, “We have to prepare for the worst.”
But many African governments pursued swift, severe lockdowns that — while financially ruinous, especially for their poorest citizens — slowed the rate of infection. Some deployed networks of community health workers. The Africa C.D.C., the W.H.O. and other agencies helped expand testing and moved in protective gear, medical equipment and pharmaceuticals.
The reported toll of the pandemic on the continent — 2.6 million cases and 61,000 deaths, according to the Africa C.D.C. — is lower than what the United States alone currently experiences in three weeks.
But that accounting is almost certainly incomplete. Evidence is growing that many cases were missed, according to an analysis of new studies, visits to nearly a dozen medical institutions and interviews with more than 100 public health officials, scientists, government leaders and medical providers on the continent.
Now, as they battle new outbreaks, doctors are convinced that deaths have also gone uncounted. Dr. John Black, the only infectious-disease specialist for adults in Port Elizabeth, said he and other physicians feared that many people were dying at home. Indeed, a government analysis showed that there had been more than twice as many excess deaths as could be explained by confirmed cases in South Africa. “We don’t know what the real number is,” he said.
Scientists are also considering other explanations for the continent’s outcome. These range from the asymptomatic or mild infections more common in youth — the median age in Africa is just 19.7, about half that of the United States — to unproven factors including pre-existing immunity, patterns of mobility and climate. If those conditions helped protect against the virus earlier, officials ask, will they do so now?
In South Africa, the continent’s leader by far in coronavirus cases and deaths, the growing devastation in its medical system has led to the rationing of care for older adults. Last week, officials announced that a new variant of the virus that may be associated with faster transmission has become dominant. With stricter control measures lifted and many people no longer seeing the virus as a threat, public health officials fear that Africa’s second wave could be far worse than its first.
Resilience
Much as the pandemic has been a story of devastation and loss, it has also been one of resilience — of individual people, families and entire communities not only surviving a deadly threat but seeing in the moment a chance to serve others. We asked our correspondents around the world to share stories from this year that speak to the strength of the human spirit, and to how disruption can bring out the best in us.
The teacher had inherited $300,000 and was planning to buy a new car.
But when the virus came, and with it remote learning, he made a U-turn, instead deciding to buy 343 tablets for elementary school students shut out of class because their families could not afford the equipment.
For good measure, the teacher, Hoseein Asadi, also bought the children 30,000 masks to protect them from infection.
Some of his friends and family members thought he had lost his mind.
But Mr. Asadi, 50, has dedicated 28 years to educating elementary school children from villages and nomadic tribes around Khuzestan Province. A father of five who lives in Andimeshk, he said his conscience would not allow him to buy a car when hundreds of students were at the risk of losing an academic year.
“They told me, ‘You will never be able to buy a new car or house on a teacher’s salary,’” Mr. Asadi said in a telephone interview. “But for me seeing the sweet smile on the children’s faces and knowing I had given them the gift of education is enough.”
Overnight, Mr. Asadi became a national hero, appearing on state television and written about in local media outlets. The minister of education telephoned him to personally express his gratitude.
He has also inspired others to act.
State-owned industries, the private sector and ordinary Iranians have mobilized to raise money for tablets. Iranians in the diaspora as far away as Australia have also offered to help. So far, Mr. Asadi said, the education department has received and distributed 12,000 tablets to low-income school districts in several provinces.
“Creating happiness for kids who have nothing is the most rewarding feeling,” Mr. Asadi said.
A trickle of skiers recently zigzagged down the slopes at the Squaw Valley Ski Resort. Couples and families wandered through the resort’s village, which was decorated with golden Christmas lights and frosted with snow.
It looked like the beginning of a merry season. But a closer inspection revealed it was anything but.
Restaurant patios were nearly empty as masked workers swept through with lime green disinfectant sprayers strapped to their backs, part of the $1 million that Squaw Valley has spent on sanitizing equipment and other safety measures. At ski lifts, sparse groups waited in socially distant lines. The resort felt “so dead,” said a skier, Sabrina Nottingham, partly because it was limiting ticket sales to fewer than 50 percent of the norm.
Squaw Valley, a marquee destination for winter sports enthusiasts, is one of many ski resorts across the country bracing for a highly unpredictable season. Forced to rethink how to operate in the coronavirus pandemic and with vaccines still rolling out, resorts have made a plethora of changes in places such as Aspen, Colo.; Park City, Utah; Taos Ski Valley, N.M.; and Killington, Vt. Many are setting visitor restrictions and requiring ticket reservations; New Mexico has limited resorts to 25 percent of capacity.
Resorts are also minimizing in-person interactions by installing kiosks for ticket pickups, adding space between people in line for ski lifts and gondolas, requiring masks, limiting the number of people on a lift at once and, in some places, shutting down indoor dining.
While the pandemic has dealt a heavy blow to the entire travel industry, ski resorts may feel a disproportionate impact this winter because of their short window of business. The ski industry already took a hit in the spring when the pandemic struck and many resorts had to close early, leading to $2 billion in losses and causing layoffs or furloughs of thousands of employees, according to the National Ski Areas Association, a trade group. The industry saw its lowest number of visits, 51 million, since the 2011-12 season, the association said.
Now resorts such as Squaw Valley are setting their expectations low for the new ski season.
“I don’t think that anybody in the business is looking to have this be their best year ever,” said Ron Cohen, the president of Squaw Valley and neighboring Alpine Meadows, which laid off 2,000 seasonal workers in the spring.
Others echoed that sentiment. Mike Pierce, a spokesman for Mount Rose Ski Tahoe, a resort in western Nevada, said the mind-set was “to just maintain status quo and survive.”
In one video, during the lockdown in Wuhan, she filmed a hospital hallway lined with rolling beds, the patients hooked up to blue oxygen tanks. In another, she panned over a community health center, noting that a man said he was charged for a coronavirus test, even though residents believed the tests would be free.
At the time, Zhang Zhan, a 37-year-old former lawyer turned citizen journalist, embodied the Chinese people’s hunger for unfiltered information about the epidemic. She was one of several journalists, professionals and amateurs, who had flocked to Wuhan after the lockdown was imposed in late January.
The authorities were preoccupied with trying to manage the chaos of the outbreak, and for a brief period, China’s strict censorship regime loosened. Reporters seized that window to share residents’ raw accounts of terror and fury.
Now, Ms. Zhang has become a symbol of the government’s efforts to deny its early failings in the crisis and promote a victorious narrative instead.
Ms. Zhang abruptly stopped posting videos in May, after several months of dispatches. The police later revealed that she had been arrested, accused of spreading lies. On Monday, she will go to court, in the first known trial of a chronicler of China’s coronavirus crisis.
The prosecution is part of the Chinese Communist Party’s continuing campaign to recast China’s handling of the outbreak as a succession of wise, triumphant moves by the government. Critics who have pointed to officials’ early missteps have been arrested, censored or threatened by police; three other citizen journalists disappeared from Wuhan before Ms. Zhang did, though none of the rest has been publicly charged.
Prosecutors have accused Ms. Zhang of “picking quarrels and provoking trouble” — a frequent charge for government critics in China — and recommended between four and five years in prison.
Ms. Zhang appeared to know the risks of her actions. In one of her first videos, on Feb. 7, she mentioned that another citizen journalist, Chen Qiushi, had just disappeared, and another, Fang Bin, was under surveillance. Whistleblower doctors had been silenced, she added.
“But as someone who cares about the truth in this country, we have to say that if we just wallow in our sadness and don’t do something to change this reality, then our emotions are cheap,” she said.
Soon after her arrest, she began a hunger strike, according to her lawyers. She has become gaunt and drained but has refused to eat, the lawyers said, maintaining that her strike is her form of protest against her unjust detention.
Then & Now
As 2020 comes to a close, we are revisiting subjects whose lives were affected by the pandemic. When Campbell Robertson first spoke with Yanti Turang in March, she was working in a makeshift Covid-19 tent and treating patients with a novel coronavirus.
In the harrowing days of late March, Yanti Turang was a New Orleans emergency nurse with an ominously relevant résumé: Five years earlier, she had been working on the front lines of the Ebola epidemic in Sierra Leone. What had been a curious background just a few weeks earlier was now expertise in demand.
A few days later, she was working in a Covid-19 tent when she got a call from a physician colleague. “She was like, ‘Can you help me build this hospital?” Ms. Turang recalled. “I said, ‘I don’t really know what you’re talking about.’”
This is how Ms. Turang became the deputy medical operations manager for the enormous field hospital set up by the National Guard in the New Orleans convention center. She would work there for the next eight months.
Though the census of patients at the convention center waxed and waned, it was a huge undertaking. Within her first week, Ms. Turang and her small team discovered that the field hospital was in many ways set up in preparation for a different kind of patient population than it would likely be getting. With the pandemic still new, she said, it was only just becoming clear how destructive it would be for people in nursing homes.
The convention center was set up to take in a typical mix of patients in hospital intensive care units — people who could feed themselves, could walk when they felt better and could turn over in bed on their own — so Ms. Turang and her team began hurriedly transforming it into a hospital designed to care for patients who are elderly, with all the chronic complications that go along with that.
“That’s the huge pivot that we made,” she said. “That’s how we took care of Louisiana.”
All of this work (she also took on a job as a medical consultant to a group of schools in the city) devoured her year. But this month, Ms. Turang was vaccinated, the first concrete signal that an end to the pandemic could be coming.
And after her shot, she did something that she had not allowed herself to do much over the last 10 exhausting, demanding, grief-filled months: She cried.