Dr. Francis Collins, the director of the National Institutes of Health, took issue on Wednesday with President Trump’s suggestion that a coronavirus vaccine would be available by Election Day, as he repeatedly sought to reassure senators and the public that a vaccine would not be made available to the public unless it was safe and effective.
“Certainly, to try to predict whether it happens on a particular week before or after a particular date in early November is well beyond anything that any scientist right now could tell you and be confident they know what they are saying,” Dr. Collins told a Senate panel at a hearing on the effort to find a vaccine.
Wednesday’s hearing, before the Senate Health, Education, Labor and Pensions Committee, came amid growing concern over whether people would be reluctant to take a coronavirus vaccine, and whether Mr. Trump would apply political pressure on his administration to quickly approve one to give him a boost in his re-election bid against former Vice President Joseph R. Biden Jr.
On Tuesday, a group of drug companies all in the race to develop vaccines pledged that they would not release any vaccines that did not follow rigorous efficacy and safety standards. Hours later, a leading vaccine developer, AstraZeneca, announced that it had suspended a large-scale clinical trial of a vaccine candidate after a patient experienced what may be a severe adverse reaction. Dr. Collins pointed to that development as “a concrete example of how even a single case of unexpected illness is sufficient to hold a clinical trial in multiple countries” — and evidence that “we cannot compromise” on safety.
In an interview on “CBS This Morning,” Dr. Anthony S. Fauci, the government’s top infectious disease expert, echoed that sentiment.
“That’s the reason why you have various phases of trials, to determine if in fact these candidates are safe,” Dr. Fauci said, adding that such a halt was “not uncommon at all.”
At the hearing, Democrats on the panel grilled both Dr. Collins and Surgeon General Jerome Adams on the effect of Mr. Trump’s false statements about the vaccine, and whether they would erode trust in the development process. Dr. Collins demurred, however, as Senator Elizabeth Warren, Democrat of Massachusetts, asked him point blank whether Mr. Trump’s misinformation would discourage people from taking the vaccine and hurt the effort to distribute it.
“I’m not sure I know the answer to that question,” Dr. Collins said. When Ms. Warren pressed him again, he added, “I just hope Americans will choose to take the information they need from scientists and not from politicians.”
Three companies are in late-stage, Phase 3 clinical trials that seek to enroll 30,000 Americans, half of whom will be injected with the vaccine candidate and half of whom will get a placebo.
Dr. Collins said he had “cautious optimism” that a safe and effective vaccine would emerge by the end of the year, though he added, “but even that is a guess.”
Even as the trials proceed, there are huge questions about who will get a vaccine first and how it will be distributed. Dr. Adams told the panel that the administration intended to release guidelines later Wednesday that would allow state-licensed pharmacists to vaccinate anyone older than age 3.
AstraZeneca, a front-runner company in the race to develop a coronavirus vaccine, announced on Tuesday a global pause in late-stage trials for its product because of a suspected adverse event.
Several individuals familiar with the event, who spoke on the condition of anonymity, said that an individual in the United Kingdom who was enrolled in a Phase 2/3 trial had experienced symptoms consistent with a condition called transverse myelitis, or inflammation of the spinal cord.
The trial’s suspension will allow an independent board of experts to determine whether the participant’s condition was linked to the vaccine or merely coincidental, said Saad Omer, a vaccine expert at Yale University.
Part of this process will include generating a timeline of the participant’s symptoms to see if they match up roughly with when the vaccine was administered. The committee will also investigate other potential causes of the symptoms, in a process of elimination. After determining whether AstraZeneca’s vaccine is a probable culprit, experts will advise the company on whether to resume their trials.
In the interim, no further doses of the vaccine will be administered. It remains unclear how long the evaluation process will take. AstraZeneca representatives did not respond to repeated requests for comment and clarification.
The suspension marks the second time that AstraZeneca has halted coronavirus vaccine administration in the United Kingdom because of severe neurological symptoms, according to information sheets uploaded to a clinical trial registry that was first reported by Nature News. Another participant developed symptoms of transverse myelitis, researchers reported in July, and was later diagnosed with an “unrelated neurological illness.” After a safety review, trials resumed.
Transverse myelitis is relatively rare, sparking symptoms in roughly 1,400 people each year in the United States, according to the National Institutes of Health. Its root cause is often mysterious, although doctors believe that the syndrome generally results when inflammatory responses in the body go awry, sometimes in response to an ongoing or past infection, said Dr. Felicia Chow, a neurologist at the University of California, San Francisco. “It’s not uncommon that we never figure out the cause,” Dr. Chow said.
There has been some past speculation that vaccines might be able to cause transverse myelitis, she added, but “there’s never been really any clear-cut, definitive proof.”
Should other participants in the AstraZeneca trials develop symptoms consistent with transverse myelitis, “that would raise these questions again,” Dr. Chow said.
Gov. Andrew M. Cuomo announced on Wednesday that the ban on indoor dining in New York City would be lifted on Sept. 30, a boost to the city’s recovery from the pandemic that would end its status as one of the few places in the nation with a complete ban.
The governor’s announcement, which would allow restaurants to open indoor tables at 25 percent capacity, could be a major milestone in the coronavirus crisis in New York City, where restaurants form a critical part of the city’s economy and its currently moribund tourist trade, and are a vital part of its usually vibrant social fabric.
The announcement came more than two months after the governor and Mayor Bill de Blasio halted a plan to reopen indoor dining at restaurants, citing ongoing concerns about the coronavirus, which has killed more than 30,000 people in New York. But the infection rate in the state has been kept below 1 percent for weeks, allowing for the easing of some restrictions. Indoor dining resumed in neighboring New Jersey at 25 percent capacity last week.
“Because compliance is better, we can now take the next step,” the governor said.
The timing coincided with a date, still three weeks away, that is around when fall weather is likely to put a chill on outdoor tables. Additional restrictions would also be placed on restaurants and their patrons, including temperature checks and a requirement to wear face coverings when not seated. Bars will be used to make drinks to serve tableside and restaurants must close at midnight.
Even with the reopening plan, the restrictions in New York City will still be more stringent than other parts of the state, where restaurants are operating with half their indoor tables in use.
“This may not look like the indoor dining that we all know and love,” Mr. de Blasio said in a statement after the governor’s announcement, “but it is progress for restaurant workers and all New Yorkers.”
Britain, seeing a spike in new coronavirus cases, will ban most gatherings of more than six people beginning next week, Prime Minister Boris Johnson said Wednesday.
“I wish we did not have to take this step,” Mr. Johnson said. “As your prime minister, I must do what is necessary to stop the spread of the virus.”
He stressed hand washing and wearing face coverings, and said the new rule would be in place only “as long as necessary.”
He said the order, which he referred to as the “Rule of Six,” superseded old guidelines and would apply to public and private gatherings.
The government’s chief medical officer, Professor Chris Whitty, said the uptick the country is seeing is not just a matter of testing more people and compared the situation Britain is facing to the one in France, where cases are surging.
Restaurants and other hospitality venues will also now be required by law to take customers’ personal details for contact-tracing purposes. And Mr. Johnson said there will be stronger enforcement of quarantine rules for those entering the country.
The new rules will take effect Monday and people who break them can be fined and possibly arrested.
“You must not meet socially in groups of more than 6,” Mr. Johnson said. “If you do you will be breaking the law.”
About 3,000 new cases were reported on both Sunday and Monday of this week, the highest daily figures in Britain since May. And about 2,500 more new cases and 32 deaths were reported on Tuesday.
In other developments around the world:
A fast-moving fire destroyed most of Europe’s largest refugee camp on the Greek island of Lesbos, leaving its 12,000 residents homeless just days after they were collectively quarantined because of a coronavirus outbreak there.
France’s prime minister, Jean Castex, is self-isolating after he came into contact with the director of the Tour de France, who has tested positive. Mr. Castex tested negative on Tuesday, but he will isolate until being retested seven days after the contact took place. France is facing a resurgence, with a daily average of 7,000 cases for the last seven days and an increase in the number of patients in intensive care after months of decline.
India’s Health Ministry said Tuesday that it planned to open classrooms for high school students on a voluntary basis, and only with their parents’ approval, starting Sept. 21. The vast majority of schoolchildren will continue to study online. The Taj Mahal will also open for tourism on Sept. 21, with access restricted to 5,000 people per day. India has recorded more than 4.3 million cases, second only to the United States, with nearly 90,000 new infections reported on Tuesday.
China’s biggest air show will go ahead in November, the organizer said on Wednesday, backtracking on an earlier announcement that the event had been canceled because of the pandemic. The biennial International Aviation and Aerospace Exhibition comes amid a steep downturn in the industry.
Germany extended a travel advisory to include all countries outside Europe through Sept. 30. But the foreign ministry said that starting in October, it would evaluate individual non-European destinations case by case, rather than issue another blanket warning.
A photo of an older man having a meal in a pub in Galway, Ireland, started a national conversation about virus regulations and life’s simple pleasures.
Schools in Iowa’s big cities are fighting orders from the governor to open their classrooms.
Like millions of schoolchildren across the country, students in Des Moines’s public schools started classes remotely on Tuesday, despite orders from the governor and a ruling by a state judge requiring the district to hold at least half of its classes in person.
The litigation in Iowa is one of numerous legal battles that have emerged across the country as school districts, elected officials, educators and parents wrangle over balancing educational needs with public health concerns. In North Carolina, a group of parents filed a lawsuit earlier this month against the Charlotte-Mecklenburg school board demanding in-person classes.
In Des Moines, District Judge Jeffrey Farrell on Tuesday denied the school district’s request for an injunction that would allow it to continue holding all of its classes remotely amid rising coronavirus caseloads, which school officials said make their classrooms unsafe.
Despite the ruling, the district again held remote classes on Wednesday, although the school board was meeting with lawyers to discuss options. Another judge made a similar ruling Tuesday against schools in Iowa City, which also started remotely under a two-week waiver from the state that Des Moines did not receive.
Des Moines schools sued the Iowa Department of Education and Gov. Kim Reynolds, a Republican, in August after the governor issued an order requiring schools in the state to offer in-person instruction for at least 50 percent of their classes if the coronavirus positivity rate in their communities is less than 15 percent — triple the rate recommended by the Centers for Disease Control and Prevention. Polk and Warren Counties, home to Des Moines’s public schools, both exceed that federal threshold. Tuesday’s ruling denied the district a temporary injunction while the lawsuit proceeds.
Despite the denial, Des Moines schools will remain closed “until further notice” in order to protect public health, even if that puts the district at risk of losing state funding, the Des Moines superintendent, Thomas Ahart, said in a statement.
Mr. Arhart later said by telephone: “There’s not a way for us to tell our community that we are genuinely protecting their students, or for us to tell our staff that we’re not putting them in harm’s way and to meet the return-to-learn requirements of the state. Those two are incompatible actions.”
Trump admitted to the journalist Bob Woodward that he played down the threat of the virus.
President Trump acknowledged to the journalist Bob Woodward that he had knowingly played down the coronavirus earlier this year even though he was aware it was “deadly” and vastly more serious than the seasonal flu.
“This is deadly stuff,” Mr. Trump told Mr. Woodward on Feb. 7 in one of a series of interviews he conducted with the president for his upcoming book, “Rage.” The Washington Post and CNN were given advance copies of the book and published details on Wednesday.
“You just breathe the air and that’s how it’s passed,” Trump said. “And so that’s a very tricky one. That’s a very delicate one. It’s also more deadly than even your strenuous flu.”
That was a vastly different story than Mr. Trump was telling the public.
“I wanted to always play it down,” Mr. Trump told Mr. Woodward on March 19. “I still like playing it down, because I don’t want to create a panic.”
In public, Mr. Trump claimed early on that the virus would disappear, predicting in February that by April, “when it gets a little warmer, it miraculously goes away.”
The national security adviser, Robert O’Brien, warned the president on Jan. 28 that the coronavirus represented the “biggest national security threat” of his presidency, according to CNN’s account of the book, but Mr. Trump later said he did not remember the warning.
Former Vice President Joseph R. Biden Jr. took aim at Mr. Trump over the revelations during an appearance in Michigan on Wednesday
“He had the information,” Mr. Biden said, accusing Mr. Trump of lying to the public. “He knew how dangerous it was. And while this deadly disease ripped through our nation, he failed to do his job on purpose. It was a life-and-death betrayal of the American people.”
At the White House press briefing on Wednesday, shortly after the book’s contents were made public in press reports, the press secretary, Kayleigh McEnany, claimed that the president had not lied.
“This president does what leaders do, good leaders,” she said, saying “The President has never lied to the American public on Covid.”
Arizona reported its lowest number of new Covid-19 cases since late March, reflecting the progress made in curbing the spread of the disease following harrowing outbreaks over parts of the summer.
Arizona had only 81 new cases of the virus on Tuesday, a remarkably sharp decline from July, when new cases were reaching 3,800 a day. There have been at least 206,048 cases and 5,221 deaths in Arizona since the start of the pandemic, including two new deaths on Tuesday.
The state led the nation in coronavirus infections per capita after Gov. Doug Ducey reopened the economy quickly in late spring. Mr. Ducey then reversed himself by allowing cities and counties to issue mask mandates and ordering some businesses to close once again.
The Navajo Nation, which spreads over parts of Arizona, New Mexico and Utah, is also making strides against Covid-19. For the first time in nearly six months, Navajo authorities reported on Tuesday no new cases of the disease.
Still, epidemiologists warn that cases in Arizona could spike again, citing the potential for outbreaks from school reopenings and Labor Day gatherings. While new cases fell markedly on Tuesday, they still averaged 525 a day over the last week.
Mnuchin expressed little optimism about another stimulus bill.
Treasury Secretary Steven Mnuchin raised doubts on Wednesday about the likelihood of another economic stimulus package being passed this year and said his current focus is on a measure to extend government funding later this month.
The comments come as Republicans and Democrats in Congress remain far apart in their views about the scope and cost of another relief bill and as Mr. Trump has been largely disengaged from the negotiations.
Asked about the prospects of another bill, Mr. Mnuchin showed little optimism.
“I don’t know,” Mr. Mnuchin said outside the White House. “We’ll see. I hope there is. It’s important to a lot of people out there.”
The Treasury secretary said that he has been having discussions with Speaker Nancy Pelosi about a “clean” bill to keep the government funded until after the election, avoiding a government shutdown. He has also had talks with Senator Richard Shelby of Alabama, the top Republican on the Senate Appropriations Committee, about such a bill.
“It doesn’t seem promising at the moment on stimulus,” Mr. Shelby said on Tuesday after speaking with Mr. Mnuchin about a stopgap bill, known formally as a continuing resolution. “So if we don’t get a stimulus then the only game in town would be a few nominations and the CR, funding the government.”
Mr. Mnuchin has also been in touch with Senate Republicans about the scaled-back stimulus bill that they unveiled on Tuesday that would provide federal aid to unemployed workers, schools, farmers, the Postal Service and small businesses. The legislation, which slashes billions of dollars from the original $1 trillion Republican proposal unveiled in July, does not include another round of $1,200 stimulus checks or additional funding for state and local governments.
A vote on that bill that is scheduled for Thursday in the Senate is expected to fail to meet the necessary 60 vote threshold, as Democrats continue to push for a more robust and costly package.
Asked if he was frustrated by Trump’s unmasked rallies, Fauci says ‘we want to set an example.’
On Wednesday morning, a day after Mr. Trump held a large rally in North Carolina without wearing a mask, Anthony S. Fauci, the nation’s leading official on infectious diseases, expressed concerns about the example this set.
“Well, yes it is, and I’ve said that often,” he said. “We want to set an example.”
Dr. Fauci, whose differences with the president have been noted throughout the course of the pandemic, said that public health measures such as wearing masks, keeping physical distance, avoiding crowds and moving activities outdoors rather than indoors “are the kind of things that turn around surges and also prevent us from getting surges.”
“So I certainly would like to see a universal wearing of masks,” he said.
While Mr. Trump’s recent rallies have been outdoors or in airport hangars, they are certainly crowded, with little evidence of physical distancing. And even in places where there is an official mask requirement, like North Carolina, masks at the rallies are few and far between. The Republican chairman of the county commission where the rally on Wednesday took place said beforehand that the president should wear a mask, given the statewide order on face coverings. Mr. Trump did not.
Report shows how Postal Service delivery of prescription drugs slowed under DeJoy.
Senate Democrats on Wednesday released a report showing that the delivery of prescription drugs by mail slowed over the summer as Louis DeJoy, the postmaster general, implemented cost-cutting changes at the United States Postal Service. That corroborates reports of delayed packages from across the country.
Delivery times lengthened by as much as 32 percent, and patients had to wait, on average, an extra day or two to receive their prescriptions, the report said.
Some delays were longer. According to the report, one company said, “The number of orders taking over five days to deliver has risen dramatically since the onset of the pandemic.”
Two Democratic senators, Elizabeth Warren of Massachusetts and Bob Casey of Pennsylvania, collected information from five of the country’s largest pharmacies and administrators of prescription drug programs.
Some deliveries began to slow before Mr. DeJoy, a Republican megadonor and ally of President Trump, took office in June, probably because of the coronavirus pandemic and disruptions in supply chain. But the delays were exacerbated in July after Mr. DeJoy started his cost-cutting measures, the report said.
“He needs to resign,” Senator Warren wrote on Twitter and said that if Mr. DeJoy did not resign, the Postal Service’s board of governors should remove him.
The Postal Service did not immediately respond to the report, but said last week that mail performance had begun to improve.
Quarantine breakdowns at colleges in the U.S. are leaving some at risk.
Across the United States, colleges that have reopened for in-person instruction are struggling to contain the spread of the virus among tens of thousands of students, with perhaps their most complex problem being what to do with students who test positive or come into contact with someone who has.
Many have set aside special dormitories, or are renting off-campus apartments or hotel rooms to provide isolation beds for infected students and separate quarantine units for the possibly sick.
But some undergraduates and epidemiologists say the policies have broken down, often in ways that may put students and college staff members at risk.
At the University of Alabama in Tuscaloosa and the University of Notre Dame, students have reported their classmates for violating quarantine and wandering outside. At Iowa State University, a student who was waiting for his virus test results said he was sent back to his regular dorm room where he could have infected his roommate.
And at many campuses, students with confirmed or possible infections have flooded social media platforms to describe filthy rooms, meager food rations, lack of furniture, chaotic procedures and minimal monitoring from their universities.
The policy breakdown reflects the chaotic nature of this extraordinary semester, when schools are struggling to deliver both in-person and remote classes; to identify, isolate and treat coronavirus outbreaks; and to maintain safe behavior among sometimes unruly undergraduates.
At the University of North Carolina in Chapel Hill, Brianna Hayes developed a fever after a week at school, went to campus health services and was immediately assigned to a quarantine dorm for students with virus risks. Two days later, the university informed Ms. Hayes, a first-year student, that she had tested positive and would need to move again, this time to a Covid-19 isolation dorm.
But there was no university staff in the dorm to help sick students, Ms. Hayes said, and during her week in isolation, she said, no one from the university came to check on her.
“I felt like everyone was only interested in how I was affecting others, like who I came in contact with, and then I was just left to be sick,” she said.
Amy Johnson, U.N.C.’s vice chancellor for student affairs, said the school worked hard “to facilitate an easy and comfortable transition for students,” and to keep “lines of communication open.” With more than 900 student virus cases over the last month, the university switched to online instruction in mid-August, but it has permitted some students with demonstrated needs to remain on campus.
The former Italian prime minister Silvio Berlusconi was on Sardinia in August, as was his friend, the club owner Flavio Briatore. Now both are among hundreds of cases linked to the island, a favorite of rich partygoers.
It is unclear when or how Mr. Berlusconi and Mr. Briatore got the virus. What is known, though, is that the number of cases on the island shot up from a few dozen before the summer to more than 1,000 in a month.
Mr. Berlusconi, 83, lies in a Milan hospital with pneumonia. Mr. Briatore, who dropped in to pay him a visit at his Sardinian estate and who had publicly complained about what he said was an overreaction by the government to the pandemic, is quarantined.
In March, as cases and deaths exploded in the Italy’s north, the southern island’s governor, Christian Solinas, pleaded with the authorities in Rome to ban travel to Sardinia. The government obliged. For months, the island staved off the worst.
But August has been Sardinia’s hot season since the 1960s, and not even the pandemic could stop it.
Roberto Ragnedda, the mayor of the Sardinian town of Arzachena, said “10 days of madness” in August had caused “enormous damage to our image and to economy.”
Some offenders caught without a mask were required to lie down in a coffin. Others were ordered to sit in the back of a hearse.
As Indonesia’s coronavirus caseload surges past 200,000, some officials are finding creative ways to drive home the message that wearing a mask is necessary to prevent new infections.
In East Jakarta, the authorities punished several people with time in a coffin.
“The coffin is a symbol to remind people not to underestimate the coronavirus,” said Budhy Novian, head of East Jakarta’s public order agency. “It’s our effort to convey the message to the people: The Covid-19 number is high and it causes death.”
But officials halted the practice after critics pointed out that onlookers were violating social distancing rules by crowding around to gawk and take photos.
Indonesia, the world’s fourth most populous country, passed 200,000 reported cases on Tuesday. New cases have been averaging more than 3,000 a day for two weeks, according to a New York Times database, and the death toll of 8,230 is the highest in East Asia.
Indonesia has one of the lowest rates of testing in the world, and its positivity rate is nearly 14 percent, slightly higher than Sweden’s and well above the 5 percent that the World Health Organization has given as a rough benchmark for relaxing social distancing measures. (A rising positivity rate can point to an uncontrolled outbreak; it can also indicate that not enough testing is occurring.)
Some independent experts suspect that Indonesia’s actual number of cases is many times higher than 200,000.
In Jakarta, the capital, officials erected a coffin-themed monument last week to highlight the rising death toll and remind people to follow coronavirus protocols.
Flouting the requirement to wear a mask in public in Jakarta is punishable by a fine of up to $67 for repeat offenders, a substantial sum for many residents.
Reporting was contributed by Aurora Almendral, Troy Closson, Emily Cochrane, Katie Glueck, Michael Gold, Maggie Haberman, Jason Horowitz, Mike Ives, Thomas Kaplan, Patrick Kingsley, Dan Levin, Jesse McKinley, Constant Méheut, Claire Moses, Richard C. Paddock, Alan Rappeport, Simon Romero, Christopher F. Schuetze, Natasha Singer, Karan Deep Singh, Kaly Soto, Megan Specia, Sheryl Gay Stolberg, Muktita Suhartono, Katie Thomas, Katherine J. Wu and Elaine Yu.