BOSTON — Boston is joining several other cities including Arlington, Brockton, Lynn, Newton, Somerville and Winthrop in again tightening restrictions in an effort to reduce the spread of the coronavirus, which has again surged in Massachusetts.

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Lenora Kahn, her dog Bella, and Judith Albert dine outside of Marjoram Roux on Railroad Street in Great Barrington, Mass., on Friday. Even as the weather gets chilly, outdoor dining is safer than dining indoors at a restaurant. Ben Garver/The Berkshire Eagle via Associated Press

Starting Wednesday, Boston will return to what Mayor Marty Walsh described as a modified version of phase two of the state’s reopening plan.

Walsh said the steps were needed following a steady climb in COVID-19 cases in the weeks following Thanksgiving.

“Unfortunately, we are at the point where we need to take stronger action to control COVID-19 in Boston,” Walsh said.

Under the tighter restrictions, several kinds of businesses will have to close their doors for at least three weeks beginning Wednesday including: movie theaters; museums; aquariums; indoor recreational and athletic facilities (exempting college and professional sports); sightseeing and tour buses including duck boats, harbor cruises and whale watching cruises; indoor historical sites; indoor and outdoor gaming arcades; bowling alleys; driving ranges; batting cages; and rock-climbing facilities.

Other industries may remain open in Boston with additional restrictions.

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Offices can remain open at 40 percent capacity. Indoor dining in restaurants can stay open with restricted bar seating and with a 90-minute limit on meals strictly enforced. Activities such as pool tables, darts, trivia, etc. will be prohibited.

Outdoor event spaces used for gatherings and celebrations and outdoor theaters and outdoor performance venues may continue to operate with a 25-person capacity limit.

U.S. tops 300,000 dead of virus, as vaccinations roll out

When Brittany Palomo was hired as a nurse in March, her parents tried to talk her out of it, fearful of the fast-spreading coronavirus. All the more reason, she told them, to start the career that had been her long-held dream.

The pandemic, though, is a nightmare — one that has now claimed 300,000 lives in the U.S. and counting.

“Wake up, my little girl, wake up!” Palomo’s mother, Maria Palomo Salinas, screamed, her grief echoing through a Harlingen, Texas, hospital, when her daughter died of COVID-19 complications around 2 a.m. on a Saturday in late November.

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Palomo was 27 and, as a health care worker, was probably weeks away from getting the new vaccine that could have protected her from the virus. Instead, she became yet another victim of the relentless outbreak whose U.S. toll is accelerating as it eclipses another round-number mark.

“The numbers are staggering — the most impactful respiratory pandemic that we have experienced in over 102 years, since the iconic 1918 Spanish flu,” Dr. Anthony Fauci, the government’s top infectious-disease expert, said days before the U.S. reached the milestone.

The U.S. crossed the 300,000 threshold on the same it day it launched the biggest vaccination campaign in American history, with health care workers rolling up their sleeves for COVID-19 shots Monday.

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Physician assistant Nicole Thomas conducts a COVID-19 examination in the parking lot at Primary Health Medical Group’s clinic in Boise, Idaho in November. AP Photo/Otto Kitsinger, File

The death toll was reported by Johns Hopkins University from data supplied by health authorities across the U.S. The real number of lives lost is believed to be much higher, in part because of deaths that were not accurately recorded as coronavirus-related during the early stages of the crisis.

It took four months for the virus to claim its first 100,000 American lives. But with cold weather driving people inside, where the virus spreads more easily, months of reluctance in many states to require masks, and an increase in gatherings over the holidays, some public health experts project 100,000 more could die before the end of January.

“It can certainly feel like you’re standing on the beach and sandbagging a tsunami,” said Dr. Leon Kelly, who attends to both the dead and the living as coroner for El Paso County, Colorado, and deputy medical director of its public health department.

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Already, the number of dead in the U.S. rivals the population of St. Louis or Pittsburgh. The toll is equivalent to repeating a tragedy on the scale of Hurricane Katrina every day for 5 1/2 months.

Read the full story here.

White House official recovering from COVID after 3 months in hospital, foot and lower leg amputation

A White House official who fell ill with COVID-19 in September is recovering after three months in the hospital, though he lost his right foot and lower leg in his battle against the virus, according to a friend.

Crede Bailey, the director of the White House security office, was the most severely ill among dozens of COVID-19 cases known to be connected to the White House. Bailey’s family has asked the White House not to publicize his condition, and President Donald Trump has never publicly acknowledged his illness.

Bailey’s friends have raised more than $30,000 for his rehabilitation through a GoFundMe account. The White House declined to say whether Trump has contributed to the effort.

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“Crede beat COVID-19 but it came at a significant cost: his big toe on his left foot as well as his right foot and lower leg had to be amputated,” Dawn McCrobie, who organized the GoFundMe effort for Bailey, wrote Dec. 7.

Bailey is now at a rehabilitation center and will be fitted for a prosthetic leg in the coming months, she wrote.

“His family has staggering medical bills from a hospital stay of 2+ months and still counting in the ICU and a long road ahead in rehab before he can go home,” McCrobie wrote Nov. 13, when she created the account. “When he does make it home there will be major changes necessary to deal with his new, and permanent, disability.”

McCrobie did not respond to messages and White House spokespeople declined to comment. Efforts to reach Bailey and multiple members of his family by phone, email and social media have been unsuccessful.

Bailey’s office handles credentialing for access to the White House complex and works closely with the U.S. Secret Service on security measures. Bailey was known on the compound as a strong Trump supporter.

The president has repeatedly minimized the risk from COVID-19 since the beginning of the pandemic, both before and after he was hospitalized with the disease Oct. 2-5.

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Doctors are still learning about the extent to which the coronavirus can damage the body, but loss of blood flow is one possible consequence. The virus is known to attack the vascular system and can cause deadly blood clots.

Crunch time for COVID-19 relief as bipartisan bills unveiled

WASHINGTON — A bipartisan group of lawmakers was unveiling a detailed COVID-19 aid proposal Monday as Congress labored toward a final agreement on a new round of virus relief.

Progress was being reported on other fronts, too, as lawmakers cobbled together a year-end catchall funding package that will be the basis for the last significant legislation of the Trump presidency.

The dozen or so lawmakers sealed agreement on their COVID relief plan over the weekend and decided to offer two bills. One is a $748 billion aid package containing money for struggling businesses, the unemployed, schools, and for vaccine distribution. The other bill proposes a $160 billion aid package for state and local governments and provisions shielding businesses from COVID-related lawsuits, a dynamic favored by Senate Republicans.

The path forward for their proposals — and for COVID-19 aid more generally — remains unclear. Parallel negotiations over virus relief and government funding are proceeding on the leadership level involving House Speaker Nancy Pelosi, D-Calif., and Treasury Secretary Steven Mnuchin. Senate Majority Leader Mitch McConnell, R-Ky., remains central to any agreement. Outstanding issues include a potential second round of direct payments to individuals, a plan for $300 bonus unemployment benefits, state and local aid, and the GOP-sought liability shield against lawsuits.

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There’s a hoped-for deadline of midnight Friday to deliver the completed package to President Donald Trump, which is when a partial government shutdown would arrive with the expiration of last week’s temporary funding bill. But there’s no guarantee that the massive year-end measure will be completed in time. If the talks drag, further temporary bills could be needed.

Meanwhile, negotiations on a $1.4 trillion catchall spending bill are “essentially finished,” said a congressional aide participating in the talks. While details are closely held, “the status quo is prevailing.” That means Trump would get another $1.4 billion or so for a final installment to continue construction of his long-sought U.S.-Mexico border wall.

Read the full story here.

Experts recommend pregnant women consider getting vaccine

PHILADELPHIA — As health-care workers begin receiving Pfizer’s COVID-19 vaccine starting this week, a Centers for Disease Control and Prevention committee has recommended that pregnant workers — a group typically excluded from vaccine trials — still be allowed to decide with their doctors whether to receive the vaccine.

The majority of health-care workers are women, and Johns Hopkins University researchers noted in STAT News last week that an estimated 330,000 in this workforce “will be pregnant or breastfeeding as initial doses of vaccine are being distributed.” Even more could become pregnant in the weeks between administration of the two doses of vaccine required for full protection from the virus.

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The New York Times reported this weekend that the CDC committee’s discussion on pregnancy and the vaccine focused on the large number of pregnant health-care workers at risk of getting the virus.

Pregnant women were not included in Pfizer’s vaccine trials earlier this year, but about two dozen people who got the vaccine became pregnant while participating in the studies. None reported complications.

Larger-scale vaccination distribution will inevitably include women who don’t yet know they’re pregnant, or who become pregnant while in between the two-shot vaccine regimen, so the CDC should monitor such women for adverse side effects, said Paul Offit, a member of the advisory panel that recommended emergency approval of the vaccine to the Food and Drug Administration last week.

Offit, a pediatrician who directs the Vaccine Education Center at Children’s Hospital of Philadelphia, said that although there were not sufficient data on the vaccine in pregnancy, there is no “real or even theoretical risk for pregnancy or the unborn child,” because of how the Pfizer vaccine is made. Still, for pregnant women unwilling to be inoculated, careful precautions can protect them while the virus continues to rage. “The best thing you can do is mask and social-distance,” he said.

Some obstetricians say that they would advise that their pregnant patients should be allowed to receive the vaccine because they’re at a higher risk of serious complications from the virus.

Read the full story here.

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‘Relieved’: U.S. health workers start getting COVID-19 vaccine

The biggest vaccination campaign in U.S. history kicked off Monday as health workers rolled up their sleeves for shots to protect them from COVID-19 and start beating back the pandemic — a day of optimism even as the nation’s death toll closed in on 300,000.

“I feel hopeful today. Relieved,” critical care nurse Sandra Lindsay said after getting a shot in the arm at Long Island Jewish Medical Center in New York.

With a countdown of “three, two, one,” workers at Ohio State University’s Wexner Medical Center gave the first injections to applause.

And in New Orleans, Steven Lee, an intensive care unit pharmacist at Ochsner Medical Center, summed up the moment as he got his own vaccination: “We can finally prevent the disease as opposed to treating it.”

Other hospitals around the country, from Rhode Island to Texas, unloaded precious frozen vials of vaccine made by Pfizer Inc. and its German partner BioNTech, with staggered deliveries set throughout Monday and Tuesday. Several other countries also have authorized the vaccine, including Britain, which started vaccinating people last week.

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Nurse Sandra Lindsay, center, gives an interview after she was inoculated with the Pfizer- BioNTech COVID-19 vaccine, Monday, Dec. 14, at the Jewish Medical Center, in the Queens borough of New York. AP Photo/Mark Lennihan, Pool

For health care workers, who along with nursing home residents will be first in line for vaccination, hope is tempered by grief and the sheer exhaustion of months spent battling a coronavirus that still is surging in the U.S. and around the world.

“This is mile 24 of a marathon. People are fatigued. But we also recognize that this end is in sight,” said Dr. Chris Dale of Swedish Health Services in Seattle.

Read the full story here.

U.S. set for first COVID-19 shots as shipments begin arriving

Hospital workers begin unloading precious frozen vials of COVID-19 vaccine Monday, with the first vaccinations against a scourge that has killed nearly 300,000 Americans expected later in the day.

“It feels like the cavalry is arriving,” Robert C. Garrett, CEO of Hackensack Meridian Health, said as New Jersey’s largest health network awaited delivery.

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Shots made by Pfizer Inc. and its German partner BioNTech are the first authorized for emergency use by the Food and Drug Administration — beginning what will become the largest vaccination campaign in U.S. history. Several other countries also have OK’d the vaccine, including the U.K., which started vaccinating last week.

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Boxes containing the Pfizer-BioNTech COVID-19 vaccine are prepared to be shipped at the Pfizer Global Supply Kalamazoo manufacturing plant in Portage, Mich., Sunday, Dec. 13. AP Photo/Morry Gash, Pool

For health workers who, along with nursing home residents, will be first in line for vaccination, hope is tempered by grief and the sheer exhaustion of months spent battling a coronavirus that still is surging in the U.S. and around the world.

“This is mile 24 of a marathon. People are fatigued. But we also recognize that this end is in sight,” said Dr. Chris Dale of Swedish Health Services in Seattle.

Packed in dry ice to stay at ultra-frozen temperatures, the first of nearly 3 million doses being shipped in staggered batches this week made their way by truck and by plane around the country Sunday from Pfizer’s Kalamazoo, Michigan, factory. Once they arrive at distribution centers, each state directs where the doses go next.

Some hospitals across the country spent the weekend tracking their packages, refreshing FedEx and UPS websites for clues.

More of the Pfizer-BioNTech vaccine will arrive each week. And later this week, the FDA will decide whether to green light the world’s second rigorously studied COVID-19 vaccine, made by Moderna Inc.

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Now the hurdle is to rapidly get vaccine into the arms of millions, not just doctors and nurses but other at-risk health workers such as janitors and food handlers — and then deliver a second dose three weeks later.

“We’re also in the middle of a surge, and it’s the holidays, and our health care workers have been working at an extraordinary pace,” said Sue Mashni, chief pharmacy officer at Mount Sinai Health System in New York City.

Plus, the shots can cause temporary fever, fatigue and aches as they rev up people’s immune systems, forcing hospitals to stagger employee vaccinations.

A wary public will be watching closely to see whether health workers embrace vaccination. Just half of Americans say they want to get vaccinated, while about a quarter don’t and the rest are unsure, according to a recent poll by The Associated Press-NORC Center for Public Health Research.

Read the full story here.

Trump says he’s reversing plan to let White House officials be among first for vaccine

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WASHINGTON — President Donald Trump said Sunday that he was reversing an administration directive to vaccinate top government officials against COVID-19, while public distribution of the shot is limited to front-line health workers and people in nursing homes and long-term care facilities.

Trump made the announcement hours after his administration confirmed that senior U.S. officials, including some White House aides who work in close proximity to Trump and Vice President Mike Pence, would be offered coronavirus vaccines as soon as this week under federal continuity of government plans.

“People working in the White House should receive the vaccine somewhat later in the program, unless specifically necessary,” Trump said in a tweet. “I have asked that this adjustment be made. I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time.”

It was not immediately clear what the scale of the vaccination program was supposed to be, according to two people briefed on the matter, or what effect Trump’s tweet would have on the government’s efforts to protect top leadership.

News that White House staff would receive the vaccine early drew criticism on social media. Trump and his aides have consistently flouted the COVID-19 guidelines issued by his own administration, including hosting large holiday parties with maskless attendees this December.

Officials said earlier Sunday that doses of the newly approved vaccine from Pfizer would be made available to those who work in close quarters with the nation’s top leaders. They said the move was meant to prevent more COVID-19 spread in the White House and other critical facilities. Trump was hospitalized with the virus for three days in October.

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“Senior officials across all three branches of government will receive vaccinations pursuant to continuity of government protocols established in executive policy,” National Security Council spokesperson John Ulyot had said. “The American people should have confidence that they are receiving the same safe and effective vaccine as senior officials of the United States government on the advice of public health professionals and national security leadership.”

The two people briefed on the matter spoke on condition of anonymity because they were not authorized to discuss the matter publicly. The New York Times first reported that top U.S. officials would get early access to the vaccine.

Read the full story here.

Family doctors start offering vaccine in England

LONDON — Family doctors in England are set to start COVID-19 inoculations this week, in the latest stage of the U.K.’s mass vaccination program.

The National Health Service said hundreds of general medical clinics across England are taking delivery of the Pfizer-BioNtech vaccine on Monday, and some will start offering the shots by the afternoon. The majority, though, will begin on Tuesday, it said.

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Priority will go to people who are 80 and older, as well as staff and residents of care homes.

Britain launched its vaccination program this month after becoming the first country to give emergency approval to the Pfizer-BioNtech vaccine, and authorities plan to dispense 800,000 doses in the first phase.

Thousands of health service workers and vaccinators have already received the shot. In Scotland, elderly residents of nursing homes are also due to start getting the vaccine on Monday, officials said on the weekend.

Germany angered over EU delay in vaccine appoval

BERLIN — Germany’s health minister has expressed impatience Monday that the European Union is still waiting for its regulatory agency to approve a coronavirus vaccine, while other officials urged Germans to forgo Christmas shopping two days before a new hard lockdown will close schools and shut most stories.

Chancellor Angela Merkel and the governors of Germany’s 16 states agreed Sunday to step up the country’s lockdown measures beginning Wednesday and running to Jan. 10 to stop the exponential rise of COVID-19 cases. Merkel said existing restrictions imposed in November failed to significantly reduce the number of new infections. Germany has been hitting records of new daily infections and virus deaths in recent weeks.

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Health Minister Jens Spahn said in a series of tweets that Germany, which has built up more than 400 vaccination centers and has activated about 10,000 doctors and medical staff to start mass vaccinations as early as Tuesday, was hamstrung by the lack of regulatory approval.

The vaccine developed by Germany’s BioNTech and American drugmaker Pfizer has been authorized for use in Britain, the United States, Canada and other countries, but it’s still waiting for approval by the European Medicines Agency, or EMA, and can therefore not be used in Germany yet.

Vaccinations in Spain to begin in January

MADRID — Health Minister Salvador Illa says that vaccination against the coronavirus in Spain could begin on Jan. 4 or 5 following the approval of the first vaccine by European drug regulators.

The European Medicines Agency has set Dec. 29 as the deadline for ruling on the approval of the vaccine developed by Germany’s BioNTech and its U.S. partner Pfizer.

Speaking at an economy forum on Monday in Madrid, Illa said that the country has logistics ready for an incremental distribution of the vaccines nationwide.

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The Spanish government has pledged to purchase 80 million vaccines in 140 million doses, enough to more than cover its 47 million population. Herd immunity could be achieved by the end of the summer, Illa said Sunday in an interview published by the Público news website.

New cases rose again in several of Spain’s 19 regions and autonomous cities over the weekend, offsetting some of the gains of the past few weeks, when the rate of contagion slowed down. Spain has officially confirmed 1.73 million cases of COVID-19 and at least 47,624 deaths.

Eswatini prime minister dies of coronavirus

JOHANNESBURG — The government of Eswatini has announced on Twitter that Prime Minister Ambrose Dlamini has died after testing positive for COVID-19.

The 52-year-old Dlamini, who had been prime minister since 2018, announced in November that he had tested positive for the virus and was being treated at a hospital in neighboring South Africa. The Eswatini government said he died on Sunday afternoon.

Eswatini, formerly known as Swaziland, is a small mountain kingdom northeast of South Africa. It has recorded almost 7,000 confirmed COVID-19 cases and 127 deaths.

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South Africa is experiencing a resurgence of COVID-19 and President Cyril Ramaphosa is scheduled to address the nation Monday evening on the country’s response.

New Zealand to open COVID bubble with Australia

WELLINGTON, New Zealand — New Zealand Prime Minister Jacinda Ardern says the country plans to open a travel bubble with Australia in the first quarter of next year.

That would mean people traveling from Australia to New Zealand would no longer need to go into quarantine for two weeks upon arrival. Australia is already letting New Zealanders skip quarantine.

The announcement Monday comes two days after New Zealand said it planned a similar bubble with the Cook Islands. The two arrangements would represent the first travel bubbles that New Zealand has agreed to since closing its borders when the coronavirus first hit earlier this year.

New Zealand has moved cautiously on restarting international travel after stamping out community spread of the virus. Ardern says there are some remaining logistical issues to overcome, including how it would deal with a large influx of returning travelers in the case of another significant outbreak in Australia.

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The announcement comes as some relief to families separated by the virus and to tourism operators, many of whom rely on visitors from Australia.

First vaccine doses arrive in Canada

TORONTO — Prime Minister Justin Trudeau says the first of many freezer-packed COVID-19 vaccine vials have arrived in Canada.

Trudeau tweeted a picture of them being taken off a plane. Canada’s health regulator approved the vaccine made by U.S. drugmaker Pfizer and Germany’s BioNTech last Wednesday.

The Canadian government recently amended its contract with Pfizer so that it would deliver up to 249,000 doses this month. Trudeau says it is good news but he is urging Canadians to continue to wear masks, avoid gatherings and to download a government app that lets users know if they’ve come in contact with those who have tested positive.

Los Angeles breaks record again for virus hospitalizations

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LOS ANGELES — Los Angeles County has again broken a record for coronavirus hospitalizations, fulfilling the county public health director’s dire predictions in just days.

Figures released Sunday afternoon show that more than 4,000 people were hospitalized for COVID-19 in the nation’s most populous county.

That breaks the previous record set only the day before, with 3,850 patients in a hospital, and follows the trend of hospitalizations increasing nearly every day since Nov. 1.

The LA County health director warned on Monday, when hospitalizations were near 3,000, that the county could see the statistic to climb to 4,000 within two weeks.

Statewide coronavirus figures were not immediately available Sunday.

More than 325,000 doses of a COVID-19 vaccine are on their way to California.

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