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White House Plans to Bolster Vaccine ManufacturingJeffrey D. Zients, President Biden’s coronavirus response coordinator, said the administration would partner with companies to increase U.S. manufacturing capacity in order to expand global access and prepare for potential future pandemics.

From the start, President Biden has been clear that the only way to defeat Covid is to defeat the virus here at home and around the world. That’s why we’ve committed to donating 1.2 billion doses to the world. For every one shot we’ve administered here in the United States, we’re donating about three doses to people around the world. Today, we will hit a major milestone in our effort to deliver on this commitment: 250 million doses delivered to 110 countries. Today, we’re taking another major step to bolster vaccine manufacturing, both for this pandemic and to prepare for any future threats. H.H.S. is soliciting interest from companies that have experienced manufacturing mRNA vaccines to identify opportunities to scale up their production capacity. Importantly, initial production could provide more mRNA Covid vaccines for the world. The goal of this program is to expand existing capacity by an additional billion doses per year, with production starting by the second half of 2022. This program would also help us produce doses within six to nine months of identification of a future pathogen, and ensure enough vaccines for all Americans. It would combine the expertise of the U.S. government in basic scientific research with the robust ability of pharmaceutical companies to manufacture mRNA vaccines. We hope companies step up and act quickly to take us up on this opportunity to expand production of mRNA vaccines for the current pandemic, and set us up to react quickly to any future pandemic threats.

Jeffrey D. Zients, President Biden’s coronavirus response coordinator, said the administration would partner with companies to increase U.S. manufacturing capacity in order to expand global access and prepare for potential future pandemics.CreditCredit…Stefani Reynolds for The New York Times

The White House, under pressure to increase the supply of coronavirus vaccines to poor nations, plans to invest billions of dollars to expand U.S. manufacturing capacity, with the goal of producing at least one billion doses a year beginning in the second half of 2022, two top advisers to President Biden said in an interview on Tuesday.

The investment is the first step in a new plan, announced on Wednesday, for the government to partner with industry to address immediate vaccine needs overseas and domestically and to prepare for future pandemics, said Dr. David Kessler, who oversees vaccine distribution for the administration, and Jeff Zients, Mr. Biden’s coronavirus response coordinator.

“This is about assuring expanded capacity against Covid variants and also preparing for the next pandemic,” Dr. Kessler said. “The goal, in the case of a future pandemic, a future virus, is to have vaccine capability within six to nine months of identification of that pandemic pathogen, and to have enough vaccines for all Americans.”

The move comes as the Biden administration also plans to buy enough of Pfizer’s new Covid-19 pill for about 10 million courses of treatment to be delivered in the next 10 months, paying over $5 billion, according to people familiar with the agreement. The government has also pledged $3 billion for rapid over-the-counter tests, which are needed to detect the virus early for the Pfizer drug to work.

Taken together, the investments amount to an aggressive effort to vanquish a pandemic that is heading into its third year. When given promptly to trial groups of high-risk unvaccinated people who developed symptoms of the disease, the Pfizer drug sharply reduced the risk of hospitalization and death. Pfizer applied on Tuesday for federal authorization of the drug on an emergency basis.

The antiviral drugs have helped inspire hope among senior administration officials that the United States will be able to curb the devastating toll from the virus. Their promise depends in part on access to testing, because the pills have proved to work in five days or less after symptoms develop.

But the tests are pricey. While federal regulators have cleared a dozen of them, a test typically costs about $12 and not everyone can easily obtain one. One of the newest rapid tests costs $7, though, and by the end of the year the overall supply is projected to be nearly 10 times what it was in August, federal officials said.

The idea for the new public-private vaccine partnership is still in its early stages, and the price tag is uncertain. Dr. Kessler, who has been working on the proposal for months, estimated it at “several billion.” The money has been set aside as part of the American Rescue Plan, the $1.9 trillion pandemic relief package that Mr. Biden signed into law in March.

The Biomedical Advanced Research and Development Agency intends to issue a “request for information” to solicit ideas from companies that have experience manufacturing vaccines using mRNA technology. Mr. Zients said that officials wanted responses “in a very short period of time, 30 days, to understand how most efficiently, effectively and reliably we can increase manufacturing.”

Activists, many of them veterans of the AIDS epidemic, have been demanding for months that Mr. Biden do more to scale up global vaccine manufacturing capacity. Some, furious with what they regard as the administration’s slow progress, turned up at the home of Ron Klain, Mr. Biden’s chief of staff, in September and deposited a fake mountain of bones on the sidewalk in protest.

At the same time, the administration is offering booster shots to millions of vaccinated Americans, despite criticism from World Health Organization officials and other experts who say the doses should go to low- and lower-middle-income countries first. The Food and Drug Administration is aiming to authorize booster doses of Pfizer-BioNTech’s Covid vaccine for all adults as early as Thursday, according to people familiar with the agency’s plans.

Whether the new Biden plan will satisfy the administration’s critics is unclear. Many activists have demanded that the administration build up manufacturing capacity overseas, particularly in Africa, but the Biden plan is focused on building capacity among domestic vaccine makers. “This effort is specifically aimed at building U.S. domestic capacity,” Dr. Kessler said. “But that capacity is important not only for the U.S. supply, but for global supply.”

James Krellenstein, a founder of Prep4All, an AIDS advocacy group, called the Biden plan “a step in the right direction,” but suggested the government build its own vaccine production facility, so as not to depend on the private sector, and hire a contract manufacturer to run it.

“It’s the only way you can leverage the unique skills of the private sector while protecting the taxpayer investment,” he said.

James Duke Butterfoss, 6, received his first dose of the Pfizer-BioNTech coronavirus vaccine in San Francisco on Sunday.Credit…Mike Kai Chen for The New York Times

The pace of vaccination against the coronavirus among newly eligible younger children is accelerating, and nearly 10 percent of the nation’s 5- to 11-year olds have already had their first shot, the White House estimated on Wednesday.

Last week alone, 1.7 million young children were vaccinated, about double the previous week, Jeff Zients, President Biden’s coronavirus response coordinator, said at a White House Covid-19 briefing. The administration estimates that by the end of Wednesday, 2.6 million of the 28 million children in that age group will have had their first of two doses of the Pfizer-BioNTech vaccine, the only one currently authorized for them.

“Just 10 days into our program being in full strength, we’re at 10 percent of kids,” Mr. Zients said. “For perspective, it took about 50 days for us to reach 10 percent of adults with one shot. And when the polio vaccine was first rolled out for kids in the 1950s it took about three months to cross two and a half million shots in arms.”

The pediatric figures come as the nation is about to cross another vaccination threshold: Nearly 80 percent of Americans aged 12 and older have had their first shot, according to the Centers for Disease Control and Prevention.

The figure suggests slow but steady acceptance of the vaccine. This past summer, President Biden failed to meet his goal of having 70 percent of U.S. adults receive at least one dose by the July 4 holiday.

Studies and real-world evidence show that coronavirus vaccines are extremely effective at preventing hospitalization and death from Covid-19. During Wednesday’s briefing, Dr. Anthony S. Fauci, Mr. Biden’s top medical adviser for the pandemic, shared a slide deck showing data from states including Texas and Indiana to make that point.

In Texas, Dr. Fauci said, unvaccinated people were 13 times more likely than fully vaccinated people to become infected with the coronavirus during the month of September, and 20 times more likely to die of Covid-19. In Indiana, during the week that began on Sept. 30, 1,447 people were hospitalized with Covid-19; about 10 were fully vaccinated. Of 219 who died, fewer than 15 were fully vaccinated.

A drive-in screening center in Pijnacker, the Netherlands, on Wednesday. Appointments have become very hard to find.Credit…Ramon Van Flymen/EPA, via Shutterstock

Soaring demand for Covid testing in the Netherlands, combined with a shortage of workers to book them, is pushing the limits of the country’s health services, officials have said.

In a statement on Tuesday, the association of regional health services in the Netherlands called the increase in demand for new testing appointments “explosive,” adding that it was taking the approach of “all hands on deck.”

Officials said that they aimed to reach up to 120,000 tests a day, depending on workers’ availability. On Monday, at least 116,000 new appointments were scheduled and 91,000 people were tested — new daily records — according to Jaap Eikelboom, a Covid program director for the health service association.

“We are reaching the maximum of our capacity on all sides,” he said.

Virus cases have been rising in the Netherlands, with more than 110,000 people testing positive over the past week, an increase of almost 44 percent compared with the week before, according to official figures. Last week, the government announced a national partial lockdown for three weeks, including limited operating hours for restaurants, bars and shops.

It is also now largely impossible to book most Covid testing appointments online because of the high demand, the Dutch newspaper De Volkskrant reported, saying that there was only one place in the Netherlands — in the southern province of Zeeland — where people were able to do so.

Speaking at a news conference this month, Prime Minister Mark Rutte hailed the importance of testing to stop the spread of the virus, even for people who are vaccinated.

“Stay home if you have symptoms, and get tested,” he said.

Although coronavirus case levels remain far lower than at the peak of the summer surge, we’re seeing a rise in cases in the Northeast and parts of the Midwest.

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirus

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirus

As the holidays approach, Covid-19 cases are starting to rise again. Conditions are deteriorating in the Upper Midwest and parts of the West.

Here’s what to know →

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirusThe New York Times

Minnesota and Michigan lead the country in recent cases per capita. Reports of new infections there increased more than 60 percent in a two-week period.

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirusThe New York Times

Across the country, infection levels remain far lower than at the peak of the summer surge. Hospitalizations and death reports have been relatively steady.

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirusThe New York Times

Parts of the Northeast are seeing steep increases. Case levels have soared in Vermont, one of the most vaccinated states, but there has not been a corresponding spike in hospitalizations.

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirusThe New York Times

The South, which suffered the worst outbreaks this summer, continues to average fewer cases than any other region. But after months of progress, infection rates there have started to tick upward again.

U.S. Covid Cases are Increasing Again

Mitch SmithReporting on the coronavirusMike Kai Chen for The New York Times

Nearly three out of five Americans are fully vaccinated. The country is administering about 1.5 million new doses a day, a number that has grown since booster shots and vaccines for younger children were authorized.

Read more on the coronavirus:

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The Disney Dream, docked in Port Canaveral, Fla., last year.Credit…Joe Burbank/Orlando Sentinel, via Associated Press

Disney Cruise Line updated its immunization policy for guests on Wednesday, requiring all children over the age of 5 to be fully vaccinated against the coronavirus.

The vaccine mandate will go into effect on Jan. 13 and will apply to sailings both in the United States and abroad. Until then, unvaccinated guests between the ages of 5 and 11 must take a pre-departure coronavirus test. Currently, guests age 12 and up and all crew members on Disney ships must be fully vaccinated.

The new requirement comes after federal regulators recently cleared Pfizer-BioNTech’s pediatric vaccine for children ages 5 through 11 earlier.

Like Disney, most other major cruise lines have required passengers 12 and older to be fully vaccinated. While some companies like Carnival Cruise Line, Royal Caribbean Group and MSC Cruises have allowed unvaccinated children on board ships with testing requirements, some sailings have had to limit numbers on board because of policies that require at least 95 percent of passengers to be fully vaccinated.

Last week, the chief executive officer of Royal Caribbean, Richard Fain, said he expects an update on vaccine protocols for children soon, but no changes have been announced yet.

“I think we’re moving in the direction where every cruise will have 100 percent of the crew vaccinated and 95 or more percent of the guests,” he said at a media event on board Odyssey of the Seas, a cruise ship owned by Royal Caribbean.

Norwegian Cruise Line has one of the most stringent immunization policies, requiring all passengers and crew to be fully vaccinated — including eligible children — and recently announced that the rules would be extended “indefinitely” in the near future. It bars ineligible children from sailings.

To encourage family cruise vacations, Holland American Line recently announced a new offer allowing fully vaccinated children ages 5 to 17 to sail for free as third and fourth guests in the same stateroom.

“Now that kids ages 5 and older can receive the Covid-19 vaccine, getting out and seeing the world is on everyone’s mind,” said Gus Antorcha, president of Holland America Line.

Last month in Dublin.Credit…Clodagh Kilcoyne/Reuters

Ireland’s bars and nightclubs will be required to close at midnight starting on Friday as part of measures that the government is imposing to curb the spread of the coronavirus as a surge of cases has left hospitals overwhelmed and officials scrambling for solutions.

The measures, which the country’s leader, Micheal Martin, announced on Tuesday night, also include a request that people work from home when possible and a requirement that they show a vaccine pass before entering theaters.

“The surge that we are now experiencing is a dramatic reminder of what this virus can do and the threat that it continues to represent,” Mr. Martin said. “We need to act now to deal with this surge.”

In the last week, Ireland has experienced its second highest rate of hospital admissions in 2021, Mr. Martin said, a situation that is putting hospitals nationwide under significant pressure.

But even as the measures were announced, Mr. Martin acknowledged that “continued progress in the journey to normal conditions is not inevitable.”

He said that he could not rule out further measures to curb the spread of the virus, but that the country’s successful vaccination program meant that a large-scale lockdown could be avoided at least for now.

Stephen Donnelly, the health minister, said that “stark new modeling” on the number of predicted cases was behind the rationale for the new measures.

Speaking to RTE Radio, the public broadcaster, he said on Tuesday that the models showed that without mitigation measures, Ireland’s intensive care units would see an influx of 200 to 450 patients by Christmas. The country has just over 300 permanent intensive-care beds.

“That would be something we have to avoid, so we are making some changes,” Mr. Donnelly said.

Mateusz Sochowicz competing in Sochi, Russia, last year.Credit…Vasily Fedosenko/Reuters

A Polish luge athlete who was injured during a Winter Olympics training event near Beijing was flown out of China on a cargo plane this week after coronavirus restrictions prevented him from taking a commercial flight, according to the head of Poland’s luge association.

The incident speaks to the kinds of complications that could arise at next year’s Winter Games, which are scheduled to begin on Feb. 4 in accordance with strict health protocols. For training and other events in the prelude to the Games, athletes and team officials are not allowed to move about freely until they have spent 21 days inside a bubblelike training and competition zone.

The luger, Mateusz Sochowicz, 25, hit a barrier and fractured his leg on Nov. 8 while training on the track that will be used during the Winter Games. He was hospitalized near Beijing, and the International Luge Federation said that it and the local track operator were introducing additional safety measures for the Games after the accident.

But when organizers tried to arrange for Mr. Sochowicz to travel back to Poland on a commercial flight, they were told that Covid regulations prevented him from doing so for another two weeks, according to Janusz Tatera, the head of Poland’s luge federation.

Instead, Mr. Sochowicz traveled on an Air China cargo plane from Beijing to Milan on Monday, before taking another flight to Warsaw, Mr. Tatera said in a telephone interview.

The cargo plane’s interior was just like that of a passenger jet, Mr. Tatera said, adding that Mr. Sochowicz had described his journey from Beijing as “very comfortable.”

Mr. Sochowicz remains optimistic, Mr. Tatera said, that he will compete in Beijing 2022 after recovering from the injury.

Oklahoma’s newly appointed adjutant general for the National Guard, Brig. Gen. Thomas H. Mancino, announced on behalf of the governor that no guardsmen in the state would be required to be vaccinated.Credit…Brendan Smialowski/Agence France-Presse — Getty Images

A standoff between the governor of Oklahoma and the Pentagon over a coronavirus vaccine mandate for troops has turned into a stormy test of federal power, as President Biden moves to require vaccinations for a broad swath of the American work force.

Last week, Oklahoma’s newly appointed adjutant general for the National Guard, Brig. Gen. Thomas H. Mancino, announced on behalf of the governor, Kevin Stitt, that guardsmen in the state would not be required to get the Covid-19 vaccine, defying a Pentagon directive issued in August that makes vaccinations mandatory for all troops, including the National Guard, by deadlines set by each service branch.

“The order I issued came directly from the governor. That is the lawful order to the men and women of the Oklahoma National Guard,” General Mancino said in an interview, adding that he had been vaccinated.

Pentagon officials said Wednesday that a failure to follow “valid medical readiness requirements” could “jeopardize” the status of troops.

The officials insist that Mr. Stitt has no legal standing to obviate the mandate, though experts on the obscure laws governing the Guard disagree. They note that unless federally deployed, National Guard members are under the jurisdiction of the governor of their state and therefore not subject to federal mandates. “Guard members can only serve one boss at a time,” said John Goheen, a spokesman for the National Guard Association of the United States.

The Pentagon is not without redress. It could deny funding to state units or impede the promotions of Guard members who refuse to get vaccinated. Officials said Wednesday that Guard members who refused to be vaccinated also could face dismissal, just as with active duty troops.

“Oklahoma may be able to take this step as a legal matter, but there are definitely things the federal government can do in response that might make it a painful Pyrrhic victory,” said Eugene Fidell, an adjunct professor of law at the New York University Law School. “The governor and state adjutant general thus might find themselves commanding some very unhappy personnel.”

The Pentagon is bracing for other states to follow Oklahoma’s lead. So far none have, but many are believed to be closely watching the situation, which could become the subject of lawsuits. “This could be contagious,” Mr. Fidell said.

National Guard troops have been caught in the political cross hairs over the years, including in 2018, when several governors said they would withhold or recall their troops from the border with Mexico as the Trump administration separated adults who illegally crossed into the United States from their children. In 1986, several governors balked at sending Guard troops for maneuvers in Honduras ordered by President Ronald Reagan.

But these rare conflicts in the military have never centered on vaccine mandates, which have existed for decades. Many countries now require full vaccination for those crossing into their borders, and Defense Secretary Lloyd J. Austin III has insisted the vaccine against the coronavirus is vital for troop readiness. “In 2021, many things are political,” Mr. Goheen said

FedEx said it would continue delivery services as usual in Hong Kong.Credit…Budrul Chukrut/SOPA Images, via Getty Images

FedEx said on Wednesday that it would close its Hong Kong crew base and relocate its pilots, citing an evolving global business environment and the strict pandemic requirements in the Asian financial hub.

FedEx said that it would continue delivery services as usual in Hong Kong, and did not specify where its crew would move. The South China Morning Post, citing a FedEx memo, reported that the routes would be flown by workers based in Oakland, Calif., where 180 Hong Kong-based pilots had relocated early this year.

Hong Kong has been successful at controlling the spread of the coronavirus, with just 213 deaths in a city of 7.5 million. But the tough restrictions on travel have grated on many and spurred criticism from some businesses that rely on the swift movement of goods and people.

This week Hong Kong ordered 130 Cathay Pacific cargo pilots to undergo three weeks of quarantine because they had stayed at a hotel near Frankfurt where three crew members who tested positive for the coronavirus had also resided.

Carrie Lam, Hong Kong’s chief executive, acknowledged on Tuesday that the quarantine orders put strains on freight companies and highlighted the city’s dependence on goods brought in from overseas and mainland China.

“If there are one or two more such incidents, our freight planes will have no pilots,” she said.

Also on Wednesday, Tara Joseph, the president of the American Chamber of Commerce in Hong Kong, said that she was stepping down, a decision that she partly attributed to the difficulties created by the city’s coronavirus control measures.

“I think the quarantine rules are a huge red line for many people, including myself,” said Ms. Joseph, who is currently in the United States. She said she planned to stay in her role until the chamber found a replacement.

Earlier this year, Alan Beebe and Ker Gibbs, the presidents of the American chambers of commerce in Beijing and Shanghai, said they were resigning from their roles.

Hong Kong’s quarantine rules have weighed on global companies with a presence in the city. The restrictions were making it hard to retain talent, Jamie Dimon, the chief executive of JPMorgan Chase, said this week during a short visit to the city. He was one of a small number of executives who have been granted a quarantine exemption.

— Austin Ramzy and Alexandra Stevenson

Booster shots of Pfizer-BioNTech’s coronavirus vaccine on offer in Chelsea, Mass., last week.Credit…Brian Snyder/Reuters

WASHINGTON — The Food and Drug Administration is aiming to authorize booster doses of Pfizer-BioNTech’s coronavirus vaccine for all adults as early as Thursday, a move that would expand the number of Americans eligible for additional shots by tens of millions, according to people familiar with the agency’s plans.

The Centers for Disease Control and Prevention’s independent committee of vaccine experts has scheduled a meeting for Friday to discuss data on the booster dose’s efficacy and safety. If both the F.D.A. and the C.D.C. sign off this week, they will have acted strikingly quickly — a little more than a week after Pfizer asked for authorization of boosters for everyone 18 and older.

Under that scenario, any adult who received a second dose of the vaccine at least six months earlier would be officially eligible to get a booster as soon as this weekend. The F.D.A. is expected to rule without consulting its own expert panel, which has met frequently during the pandemic to review vaccine data and make a recommendation ahead of a regulatory decision.

Moderna is expected to soon submit its own request for the F.D.A. to broaden eligibility for its booster. But for now, every adult could get the Pfizer booster, according to people familiar with the planning.

The broad booster authorization has been viewed as something of a fait accompli for weeks. Some state and local officials have begun rolling out similar policies ahead of F.D.A. action — responding to persistent virus case counts and the eagerness of many Americans to seek additional protection ahead of holiday gatherings.

New York City health officials on Monday encouraged all adults who want boosters to seek them out. Arkansas, California, Colorado and New Mexico have already moved to expand access.

Many Americans have taken the matter into their own hands and sought out extra doses even if they do not officially qualify yet.

The F.D.A. in September downsized Pfizer-BioNTech’s request to fully approve booster doses for all adults, instead signing off on a more limited population, including those 65 and older, as well as adults with underlying medical conditions or those at risk because of their jobs.

At least 30 to 40 percent of vaccinated adults are still excluded from booster eligibility, according to some estimates.

More than 30 million people have gotten additional shots, with the number often outpacing the number of first shots given each day around the country. Booster doses were also authorized in October for everyone who received the single-dose Johnson & Johnson vaccine, and for vulnerable groups who received Moderna’s two-dose shot.

The C.D.C.’s gathering on Friday is scheduled to be briefer than recent meetings about Covid vaccines, just three hours, and is expected to be straightforward, one federal official familiar with the planning said, in part because of how far the nation’s booster campaign has come. That would suggest a significant softening of opposition among public health experts since President Biden announced in August that he hoped to offer booster doses to all adults.

— Noah Weiland and Sharon LaFraniere

Dozens of lawsuits have been filed challenging a vaccine mandate for employees at larger companies.Credit…Saul Martinez for The New York Times

A federal judicial panel has assigned the appeals court in Cincinnati to handle at least 34 lawsuits filed around the United States that challenge the Biden administration’s attempt to mandate that large employers require their workers to get vaccinated against the coronavirus or submit to weekly testing.

A court clerk for the U.S. Judicial Panel on Multidistrict Litigation selected the Court of Appeals for the Sixth Circuit on Tuesday by drawing from a drum containing entries for the 12 regional courts of appeal, each of which has at least one related case pending. The procedure can be used to consolidate cases that raise the same issue.

The step also removed the matter from the Court of Appeals for the Fifth Circuit in New Orleans. This month, a three-judge panel there blocked the government from moving forward with the rule, declaring that it “grossly exceeds” the authority of the occupational safety agency that issued it.

The Occupational Safety and Health Administration, a part of the Labor Department, issued the “emergency” standard this month. Under that rule, companies with at least 100 employees must require unvaccinated workers to wear masks indoors starting on Dec. 5. Starting on Jan. 4, any who remain unvaccinated must undergo weekly testing at work.

The rule makes an exception for employees who do not come into close contact with other people at their jobs.

Plaintiffs including several large employers and several Republican-controlled states have filed lawsuits against the employer mandate, arguing that it is an unlawful overreach.

Tammy Adams at her home in Horsham, Pa., last April. Adams’ son, David, died in November 2020 from an overdose.Credit…Hannah Yoon for The New York Times

Americans died of drug overdoses in record numbers as the pandemic spread across the country, federal researchers reported on Wednesday, the result of lost access to treatment, rising mental health problems and wider availability of dangerously potent new street drugs.

In the 12-month period that ended in April, more than 100,000 Americans died of overdoses, up almost 30 percent from the 78,000 deaths in the prior year, according to provisional figures from the National Center for Health Statistics. The figure marks the first time the number of overdose deaths in the United States has exceeded 100,000 a year, more than the toll of car accidents and guns combined. Overdose deaths have more than doubled since 2015.

Though recent figures through September suggest the rise in deaths may have slowed, the grim threshold nonetheless signals a public health crisis whose magnitude was both obscured by the Covid pandemic and accelerated by it, experts said.

“These are numbers we have never seen before,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, said of the tally. The fatalities have wide repercussions, since most of them occur among people aged 25 to 55, in the prime of life, she added.

“They leave behind friends, family and children, if they have children, so there are a lot of downstream consequences,” Dr. Volkow said. “This is a major challenge to our society.”

The rise in deaths — the vast majority caused by synthetic opioids — was fueled by widespread use of fentanyl, a fast-acting drug that is 100 times more powerful than morphine. Increasingly fentanyl is added surreptitiously to other illegally manufactured drugs to enhance their potency.

Overdose deaths related to use of stimulants like methamphetamine, cocaine, and natural and semi-synthetic opioids, such as prescription pain medication, also increased during the 12-month period.

Fentanyl’s ubiquity, combined with the unique social conditions caused by the pandemic, have combined to create a perfect storm, experts said. While some drug users seek out fentanyl, Dr. Volkow said, others “may not have wanted to take it. But that is what is being sold, and the risk of overdose is very high.”

The vast majority of these deaths, about 70 percent, were among men between the ages of 25 and 54. And while the opioid crisis has been characterized as one primarily impacting white Americans, a growing number of Black Americans have been affected as well.

After years of going to a gym to work out, Cindy Cicchinelli uses her Peloton exercise machine in her Pittsburgh townhouse.Credit…Keith Srakocic/Associated Press

Shares of companies like Peloton, the home fitness equipment maker, and Zoom Video, the online conference software that replaced face-to-face communications for countless schools and businesses, were darlings of the stock market for the better part of last year.

But as the economic reopening gains speed — aided by rising vaccination numbers and promising new treatments for those who get sick — some of the stocks at the center of the so-called stay-at-home trade collapsed.

“The markets clearly sense the pandemic is over,” said Ben Emons, managing director of global macro strategy for Medley Global Advisors. “We’re in a full reopening and we’re moving toward a normalized situation.”

That has been bad news for the share prices of some of last year’s hottest stocks.

Peleton stock, which rose about 470 percent last year, is down nearly 64 percent for the year. Other once-hot stocks have also skidded. Shares of the online education company Chegg plunged almost 50 percent in a single trading session on Nov. 2 and are off 67 percent in 2021. Zoom Video plummeted 17 percent on a single day in late August after it noted that strong demand for its products showed signs of easing as the pandemic abated.

Instead, many investors are shifting their attention to corners of the market they considered no-go zones last year, with businesses including airlines, live events companies and commercial real estate firms posting large gains.



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