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A significant delay in coronavirus vaccinations is putting pressure on public health leaders to explain the slow progress, all while the number of infected people hospitalized soars to record levels heading into the new year.

Here are some significant developments:
  • Colorado officials reported the first known U.S. case of a coronavirus variant that has been spreading rapidly in Britain. The variant appears to be more transmissible, but it does not make people sicker or more likely to die, scientists have said.
  • In an address to the nation, President-elect Joe Biden condemned the Trump administration’s pandemic response as a “travesty” and pledged to use his executive authority to speed up the distribution of vaccines and personal protective equipment.
  • California extended its stay-at-home orders in two of the hardest-hit parts of the country: the San Joaquin Valley and Southern California, where soaring infections have nearly overwhelmed hospitals.
  • Senate Majority Leader Mitch McConnell (R-Ky.) blocked consideration of a House bill that would increase stimulus checks for most Americans to $2,000. The move spurned President Trump’s demands and marked the beginning of what is likely to be a week-long saga.
  • More than 1 million people passed through airport security checkpoints Monday, marking the seventh time in 11 days that milestone has been reached, the Transportation Security Administration announced. It has been the busiest period for U.S. air travel during the pandemic.
  • World Health Organization emergencies chief Mike Ryan warned Monday that the coronavirus pandemic may not be the “big one” and that worse pandemics may be on the horizon.
  • China is experiencing a new outbreak of cases. In a rollback of months of loosened restrictions, the country is enacting strict rules ahead of the Lunar New Year holiday season in February.
  • A Russian official said the country’s covid-19 death toll is about three times the number previously reported. The updated count, which includes “excess deaths” that have been linked to the virus, would give Russia the third-most fatalities in the world, with 186,000, after the United States and Brazil.

Although officials projected that the United States would be able to vaccinate 20 million people by the end of December, the Centers for Disease Control and Prevention reported that 11.4 million doses had been sent to states and only about 2.1 million people had received the vaccine’s first dose.

While officials have cautioned that a delay in reporting vaccinations means that the tally is almost certainly an undercount, the number of inoculations stands at only a fraction of predicted levels.

Gustave Perna, who oversees vaccine distribution for the Trump administration’s Operation Warp Speed, apologized earlier this month for a “miscommunication” that caused states to receive far fewer doses of the Pfizer-BioNTech vaccine than they had expected.

In a live-streamed address, Biden said the Trump team’s plan to distribute and administer the vaccines “is falling behind, far behind.”

“If it continues to move as it is now, it’s going to take years — not months — to vaccinate the American people,” Biden said.

He pledged to ramp up the pace of vaccinations to 1 million per day, aiming for 100 million shots in the first 100 days of his presidency. He said he would “move heaven and earth” to get it done.

“This will take more time than anyone would like and more time than the promises from the Trump administration have suggested,” Biden said. “This is going to be the greatest operational challenge we have ever faced as a nation, but we’re going to get it done.”

Questioned Tuesday about the pace of vaccinations, Anthony S. Fauci, the nation’s top infectious-diseases expert, acknowledged the lag and said he was cautiously optimistic that vaccinations would pick up momentum to reach previously projected levels.

“The people who are responsible for it are really on it,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on CNN. “The question is: Are they going to be able to get back to the pace that we set early on?”

Also on Tuesday, Vice President-elect Kamala D. Harris became the latest high-profile politician to receive a first vaccine dose, following Biden and Vice President Pence earlier this month. Scores of government leaders have been among the first to be inoculated in what they frame as an effort to build trust in the vaccines, though many health-care workers waiting for their own doses have expressed frustration.

Leaders in some Republican states, notably Texas and Florida, have bucked federal recommendations and prioritized vaccinations for the elderly over front-line health-care workers. The divergent approaches carry political undertones similar to debates over mask mandates and stay-at-home orders, and they could pose problems at a time when Biden is calling for increased coordination.

While health officials face criticism over the pace of vaccinations, coronavirus-related hospitalizations set a record on Tuesday, with nearly 125,000 people under care in facilities across the country, according to data gathered by The Washington Post.

Approximately 180,000 new infections have been reported per day over the past week, while the nation’s death toll continues to climb. More than 3,200 new virus deaths were reported on Tuesday, the eighth time daily fatalities exceeded 3,000. All eight days have been in December.

Officials have expressed concern that holiday travel could fuel an even greater surge of infections, straining the capacities of already struggling health-care systems. In his CNN interview, Fauci urged people who have recently traveled to avoid gathering with people outside their households.

“That’s what we’re concerned about — that in addition to the surge, we’re going to have an increase superimposed on that surge, which could make January even worse than December,” he said.

The nation’s “out of control” level of infections, he added, makes it difficult for local health officials to effectively trace the contacts of infected people and isolate those who have the virus. The CDC has implored Americans to stay home on New Year’s Eve.

The ambiguity around the pace of vaccinations leaves open the question of when cases, deaths and hospitalizations will begin to noticeably decline. Gabor Kelen, an emergency-medicine professor at Johns Hopkins University, told Bloomberg News on Monday that he expected “serious relief” would come at the end of March, while former Food and Drug Administration commissioner Scott Gottlieb predicted in a CNBC interview that cases would sharply decrease in the spring, leading to a “quiet” spring and summer.

But the prospect of a vaccinated future is cold comfort for those in California who are living through the worst surge of recorded virus cases at any point in the pandemic.

Even as officials have reported a leveling off of infections and patients needing hospitalization in the more northern parts of the state, Southern California and the San Joaquin Valley are still struggling. Intensive care unit capacity in both regions remained at 0 percent, with hospitals treating patients in hallways and conference rooms.

The state extended its stay-at-home orders for the regions indefinitely on Tuesday.

Los Angeles County — the nation’s most populous — went further, implementing a new self-quarantine requirement Monday. Anyone who leaves the county is now expected to remain at home for 10 days after their return.

Los Angeles has averaged more than 13,000 new cases per day over the past week, and over 7,700 coronavirus patients were in county hospitals on Tuesday, according to Post data. If it were a state, Los Angeles County would be reporting more new cases than anywhere but the rest of California and Texas. It would have more people hospitalized than all but three states.

“Suffering followed by more suffering continues as too many residents and businesses behave as if we are not living in the most dangerous time of the most devastating pandemic," Barbara Ferrer, director of the county health department, said in a statement. “Our healthcare workers are overwhelmed with covid-19 patients and this current path of surging covid-19 hospitalizations is not sustainable.”

In New York, the country’s first major epicenter, officials have observed an uptick in people testing positive for the virus and have seen a steady increase in patients in need of hospitalization. On Tuesday, more than 7,800 people were in hospitals across the state — just under half the hospitalization levels the state saw during the worst days of April.

Across the Atlantic Ocean, the first person in the world to receive the Pfizer-BioNTech vaccine outside of a clinical trial received the inoculation’s second dose Tuesday — a symbolic victory amid a worsening crush of infections in the United Kingdom. Cases per capita there have increased by 15 percent in the past week, placing the nation among the virus’s global hot spots.

The new variant, first discovered in Britain and South Africa, continues to be detected around the world. Nations in Asia, Europe and South America reported cases recently, according to the BBC and Reuters.

On Tuesday, officials in Colorado reported the first known case of the variant in the United States. The case involves a man in his 20s who was in isolation southeast of Denver and had no travel history, according to a tweet from the office of Gov. Jared Polis (D).

Infectious-disease experts have said they are confident that the vaccines will be effective against mutation-laden variants such as the one causing alarm worldwide.