National

China has recorded the highest number of COVID-19 cases since the pandemic began, as Beijing authorities lock down more areas this week — including parts of the central city Zhengzhou, where Apple's main iPhone factory is located.

The latest: China hit a new daily record for a second straight day on Friday as authorities moved to enforce restrictions in an attempt to control outbreaks across the country, per Reuters.

State of play: Beijing eased some pandemic measures earlier this month, including reducing quarantine periods, in an attempt to cause less disruption to the world's second-largest economy.

However, authorities are now moving to cordon off major cities "block by block" and introducing other curbs while conducting mass testing in an attempt to curb surging COVID cases, Bloomberg reports.

It's triggered panic-buying in parts of Beijing, and grocery stores the capital's largest district, Chaoyang, have stopped accepting orders due to delivery apps being inundated with requests, according to Bloomberg.

Meanwhile, some 6.6 million Zhengzhou residents were affected by five-day stay-at-home orders that began Thursday — including the area where Apple manufacturer Foxconn's factory is located and where police in hazmat suits clashed with workers following a pay dispute Tuesday and Wednesday, AP reports. 

Of note: Chinese President Xi Jinping's zero-COVID policy has already increased wait times for Apple's newest iPhone 14 Pro models as fresh restrictions in China hamper production during the tech giant's most crucial time of the year, the holiday quarter, Axios' Hope King writes.

Foxconn issued a statement earlier this month that it was "operating at significantly reduced capacity."

By the numbers: China's National Health Commission said Thursday 31,454 local COVID cases were recorded within the past 24 hours.

That broke the previous record set in April when financial hub Shanghai was on lockdown when 29,390 COVID cases were recorded, AFP notes.

On Friday, Reuters reports that the NHC recorded 32,695 domestic infections.

The big picture: Nearly three years into the pandemic, China is the last major economy to have retained the strategy of trying to keep out the virus by imposing strict measures such as lockdowns and quarantines.

Outbreaks of defiance from citizens against the sustained strict measures first emerged earlier this year, with spasmodic protests erupting in the face of food shortages, family separations and lost wages from lockdowns.

It's also impacted the country's economy, along with global business, though China's gross domestic product grew 3.9% from a year earlier in the third quarter of the year.

Yes, but: Activity is slumping and growth is set to fall far short of the ruling Chinese Communist Party's 5.5% target, AP notes.

Go deeper: China's shifting economic storyline

Editor's note: This article has been updated with new details throughout.

China locks down key iPhone city as daily COVID cases hit record high

Chinese President Xi Jinping's zero-COVID policy is hampering iPhone production.

A cashier in PPE works in a supermarket in Zhengzhou in central China's Henan province Friday, Nov. 11.

A cashier in PPE works in a supermarket in Zhengzhou in central China's Henan province Friday, Nov. 11. Photo: Yu Hongen/Feature China/Future Publishing via Getty Images

China

Coronavirus

China is becoming the most formidable rival America has faced, and the risk of confrontation with Russia, North Korea or Iran still looms. Authoritarians are rising, the chaotic Afghanistan exit revealed the limits of U.S. power, and the pandemic, climate change and other critical challenges continue to pose grave threats.

World

After a record economic expansion, the coronavirus pandemic sent the U.S. economy into a recession as unemployment soared to staggering heights. The country now faces urgent questions about how much stimulus is needed for reeling consumers and businesses, and what a recovery might look like.

Economy & Business

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

Outgoing NIAID director Anthony Fauci appeared at his last White House press briefing Tuesday, urging Americans to get their updated COVID-19 booster shots.

Driving the news: Fauci, who served as President Biden's chief medical adviser since January 2021, announced in August that he would be retiring from government service in December in order to "pursue the next chapter" of his career.

 The nation's top infectious disease expert, Fauci has led the National Institute of Allergy and Infectious Diseases since 1984 and emerged as the face of the nation's coronavirus response in the early days of the pandemic in 2020.

State of play: Fauci urged Americans to get their updated COVID-19 vaccines during the press briefing, calling the shots safe and effective.

"My final message — may be the final message I give you from this podium — is that, please for your own safety, for that of your family, get your updated COVID-19 shot as soon as you're eligible, to protect yourself, your family and your community," Fauci said.

Asked about his most difficult moments during the pandemic, Fauci highlighted seeing people "not getting vaccinated for reasons that have nothing to do with public health, but have to do because of divisiveness and ideological differences."

"As a physician, it pains me because I don't want to see anybody get infected, I don't want to see anybody hospitalized, and I don't want to see anybody die from COVID," he said.

What they're saying: Fauci "has been a source of information and facts" during the pandemic, White House press secretary Karine Jean-Pierre said Tuesday, also highlighting his work combating HIV/AIDS and Ebola.

White House COVID-19 response coordinator Ashish Jha said he would argue that Fauci “has been the most important, consequential public servant in the United States in the last half century and a leader and a role model for so many of us.”

The big picture: Fauci warned in October that a new COVID-19 variant could emerge this winter.

Fears of a "tripledemic" have abounded in recent weeks as physicians across the country have reported seeing cases of the respiratory syncytial virus (RSV) rise, coinciding with the flu season and covid-19 pandemic.

“I feel very confident that if people continue to get vaccinated at good numbers, if people get boosted, we can absolutely have a very safe and healthy holiday season," Jha said.

Editor's note: This story has been updated with additional reporting.

Fauci appears at last White House COVID briefing before retirement

"Get your updated COVID-19 shot as soon as you're eligible, to protect yourself, your family and your community."

Anthony Fauci gives an update on the Omicron COVID-19 variant during the daily press briefing 

Anthony Fauci at a daily press briefing at the White House in Dec. 2021. Photo: Chen Mengtong/China News Service via Getty Images

Anthony Fauci

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

Cambodian Prime Minister Hun Sen has canceled his meetings at the G20 summit in Bali, Indonesia, and was returning home after testing positive for COVID-19, he said in a Facebook post on Tuesday.

The big picture: The positive test comes just days after Hun Sen hosted several Asian leaders, as well as President Biden and others for the Association of Southeast Asian Nations (ASEAN) summit in the Cambodian capital Phnom Penh.

The White House said Biden tested negative for the coronavirus on Tuesday morning and was not considered a close contact per the U.S. Centers for Disease Control and Prevention guidelines.

The pair shook hands at the ASEAN gathering, held a meeting together and sat next to each other at a gala on Saturday evening, per AP.

Hun Sen said he tested daily before leaving Cambodia for Indonesia, including right before boarding the plane. He tested positive Monday night and the diagnosis was confirmed on Tuesday.

The Cambodian prime minister also canceled his trip to Bangkok for the APEC economic forum.

Cambodia PM cuts G20 trip short after testing positive for COVID

Hun Sen hosted several world leaders, including President Biden for the ASEAN gathering over the weekend.

Biden shakes hands with Cambodia's Prime Minister Hun Sen as they meet on the sidelines of the Association of Southeast Asian Nations (ASEAN) Summit in Phnom Penh on November 12, 2022

President Biden shakes hands with Cambodia's Prime Minister Hun Sen as they meet on the sidelines of ASNEA Summit in Phnom Penh on Nov. 12. Photo: Saul Loeb/AFP via Getty Images

A cruise ship carrying roughly 800 passengers who had tested positive for COVID-19 docked in Sydney on Saturday morning, the Guardian reported.

Driving the news: The Majestic Princess cruise ship had been halfway through a 12-day trip from New Zealand to Australia when an outbreak of COVID cases was detected, Carnival Australia president Marguerite Fitzgerald said at a press briefing Saturday, CNN reported.

About 4,600 passengers and crew were aboard the ship when it arrived in Sydney, meaning that nearly one in five persons on board tested positive, per the BBC.

All of the cases were asymptomatic or mildly symptomatic, Fitzgerald said, per the BBC.

State of play: "All COVID-positive people are isolating and being cared for by the onboard medical team," New South Wales Health said in a statement Saturday.

"NSW Health’s assessment is that the COVID-19 risk level for the Majestic Princess is now Tier 3, which indicates a high level of transmission," the statement added.

Passengers who tested negative on a rapid antigen test within 24 hours of the ship's arrival have been allowed to disembark. Meanwhile, Carnival Australia is working with officials to "make safe onward travel arrangements" for passengers who tested positive, NSW Health added.

Princess Cruises said in a statement that passengers who were positive for COVID-19 would disembark separately and not take public transport, per the Washington Post.

Company staff would help passengers positive for COVID-19 "with accessing private transport and accommodation to complete their isolation period," Fitzgerald said, the BBC reported.

The Majestic Princess set sail for Melbourne on Saturday afternoon, per the Guardian.

The big picture: Australia has been recently experiencing a surge in COVID-19 cases.

"I can confirm we are entering the fourth wave of COVID," NSW's Chief Health Officer Kerry Chant told the Australian Broadcasting Corp (ABC) on Friday.

The Majestic Princess' case drew comparisons to the Ruby Princess cruise ship, which arrived in New South Wales in the early days of the pandemic with more than 600 COVID-19 infections aboard.

Cruise ship with 800 positive COVID cases docks in Australia

Australia has been recently experiencing a surge in COVID-19 cases.

The Majestic Princess cruise ship is seen docked at the International Terminal on Circular Quay in Sydney on November 12

The Majestic Princess cruise ship docked at the International Terminal in Sydney on Nov. 12. Photo: Muhammad Farooq/AFP via Getty Images

COVID-19

China's government eased some pandemic measures Friday — including reducing quarantine periods for travelers and close contacts of people infected with COVID-19 and ending penalties on airlines for bringing virus cases into the country.

Why it matters: The new rules are a notable adjustment to President Xi Jinping's zero-COVID policy. China is the last major economy to have retained the strategy of trying to keep out the virus with measures such as lockdowns and quarantines. 

It's impacted China's economy, along with global business, and seen outbreaks of defiance from citizens against the strict measures as recently as this week when authorities enforcing quarantine restrictions clashed with residents in the country's northeast.

The big picture: Among the adjustments, quarantine periods for travelers into China and close contacts are being cut by two days.

Travelers would be required to isolate for five days in a hotel or specialist government facility and a further three days at their place of residence, with similar measures for close contacts, per a statement from Beijing's National Health Commission Friday.

By the numbers: Chinese authorities confirmed 10,500 new COVID cases on Thursday — the highest in one day since April when Beijing locked down tech hub Shanghai.

What they're saying: "Optimizing and adjusting prevention and control measures is not relaxing prevention and control, let alone opening up and 'laying flat,' but to adapt to the new situation of epidemic prevention and control and the new characteristics of Covid-19 mutation," China's National Health Commission, per Reuters. 

Go deeper... WHO chief: China's zero-COVID strategy not "sustainable"

China eases COVID curbs

It's a notable adjustment to President Xi Jinping's zero-COVID strategy.

A video screen shows Chinese President Xi Jinping as security check visitorson October 15, 2022 in Beijing, China. 

A video screen shows Chinese President Xi Jinping as security check visitors at the 20th National Congress of the Communist Party of China in a closed loop hotel to prevent the spread of COVID in October in Beijing, China. Photo: Kevin Frayer/Getty Images

Pfizer and its partner BioNTech said Thursday they have started evaluating a combination COVID 19-flu vaccine using the companies' Omicron booster.

Why it matters: A combined vaccine could simplify immunizations and simultaneously fight two respiratory diseases that require repeated vaccinations. 

Moderna and Novavax are also developing combination COVID and flu shots. 

Details: Pfizer and BioNTech aim to enroll 180 U.S. volunteers between the ages of 18 and 64 for an early-stage trial to assess the safety, efficacy and optimal dosage. The first participant received a dose of the combination shot this week.

The candidate vaccine combines an mRNA influenza vaccine with the companies' COVID-19 shot based on the BA.4 BA.5 variants.

Between the lines: While COVID case counts remain low in the U.S., public health efforts are increasingly focused on new ways to address multiple threats, like a "tripledemic" of more transmissible variants, a major uptick in RSV cases and worse-than-usual flu season.

Go deeper ... Flu season arrives early with highest severity in over a decade

Pfizer and BioNTech study COVID-flu combo vaccine

A combined shot could fight two respiratory diseases that require repeated vaccinations.

Illustration of two different syringes twisting together

COVID-19 vaccines

Public health

President Biden will receive an updated COVID-19 booster shot this week, White House spokesperson Kevin Munoz said Sunday evening.

The big picture: "Around 20 million people have gotten an updated COVID vaccine so far," White House press secretary Karine Jean-Pierre said at a briefing Thursday. "This is really an important progress, but it's not enough."

Biden will emphasize this point when he gets boosted on Tuesday, a White House official told NBC News.

Of note: It's been over three months since Biden contracted the coronavirus, so he's getting boosted in line with CDC wait time recommendations.

Go deeper: Omicron boosters are now available for American kids. Many won't get them

Biden to get updated COVID vaccine booster shot Tuesday

Only about 20 million Americans have had an updated COVID vaccine, White House says.

President Joe Biden speaks at a Democratic National Committee event at the Howard Theatre on October 18, 2022 in Washington, DC. 

President Biden during a Democratic National Committee event in Washington, D.C., this month. Photo: Anna Moneymaker/Getty Images

COVID vaccine boosters

Joe Biden

Pfizer plans to charge $110 to $130 per dose for its COVID-19 vaccine once government purchases end next year, the drugmaker's U.S. president said on an investor call Thursday.

The big picture: Weak demand for the shots and private market pressures were expected to cost manufacturers billions once government purchases end. Price increases, while expected, could lead to higher insurance premiums.

The government now pays about $30 a dose to Pfizer and its partner BioNTech. 

Driving the news: Angela Lukin, Pfizer's global primary care and U.S. president, said on the investor call that the new private market pricing "reflects the value this vaccine has brought to society" and was "well below the thresholds for what would be considered a highly cost effective vaccine."

The price reflects the cost of developing a single-dose shot and distributing it, she said.

But the announcement brought swift criticism from some advocacy groups. Julia Kosgei, policy advisor to the People's Vaccine Alliance, called it "truly a mask-off moment for one of the great profiteers of this pandemic." 

Catch up quick: Next year, Americans will lose free access to government-funded COVID tests, treatments and vaccines. The cost will begin to be transferred to patients through premiums and out-of-pocket costs.

Pfizer and BioNTech this summer signed a $3.2 billion deal with the U.S. government for 105 million more doses of vaccine in anticipation of a fall surge of new cases. 

Centers for Disease Control advisers on Thursday unanimously voted to add COVID-19 vaccines to the 2023 schedule of childhood and adult immunizations. Health plans are required to cover vaccines listed on the schedule.

What we're watching: While vaccines will continue to be available to virtually anyone with public and private insurance in a private market, it's not clear how much access the uninsured will have. 

Pfizer to charge $110-$130 a dose for COVID vaccines

Price increases, while expected, could lead to higher insurance premiums.

Photo Illustration: Nikos Pekiaridis/SOPA Images/LightRocket via Getty Images

Coronavirus vaccines

Health care costs

Respiratory illnesses in children are overwhelming hospitals across the United States right now.

The big picture: The unseasonably high numbers of respiratory illness in kids has put a strain on hospitals that are already preparing for the typical wintertime surge of patients ill from viruses.

Hospitals are also battling incoming cases of COVID, rhinoviruses and the flu year-round. It doesn't help that there's been a nationwide shortage of health care workers.

Physicians across the country have reported seeing more cases of the respiratory syncytial virus, or RSV, in recent weeks.

RSV is a common respiratory virus among children that produces common cold symptoms.

For most, a mild case of RSV lasts about two weeks. But some infants, young children and older adults, especially those with pre-existing health conditions, may suffer from more severe cases, leading to hospitalization, according to the Centers for Disease Control and Prevention.

By the numbers: Data from the CDC show that cases of RSV detected by PCR tests have tripled in the last two months.

Case numbers have already reached peak levels from 2021, according to CDC data.

Zoom in: Children's National Hospital in Washington, D.C., neared capacity this week as respiratory illness cases spiked, Axios D.C. reports.

Children's Hospital Colorado has been filling up with sick kids, too, per Axios Denver.

Connecticut Children's Medical Center in Hartford is considering building a field hospital outside the main facility if case numbers continue to grow, Juan Salazar, the physician-in-chief, told the Wall Street Journal.

How we got here: In pre-pandemic years, RSV would make its rounds in the fall and winter before going away in the summer, according to the Wall Street Journal. COVID shifted the pattern, causing a dip in RSV as the coronavirus bullied its way through the population.

But this year, RSV and other respiratory illnesses lingered throughout the summer and now into early fall.

What they're saying: "RSV admissions have skyrocketed at Connecticut Children's. October has been like never before for this virus," Monica Buchanan, senior director at Connecticut Children's Hospital, told CNN.

"I've been doing this for a long time, I’ve been at Connecticut Children’s for 25 years, and I have never seen this level of surge — specifically of RSV — coming into our hospital," Salazar told CNN.

"I think for the next four to eight weeks, we just have to be careful."

What to do: Officials recommend caregivers vaccinate their children for influenza to protect against a rise in those cases later this winter.

Go deeper: Here's what caregivers should consider when assessing their children's health this winter

Respiratory virus cases in children surging "like never before"

RSV case numbers have reached peak levels from 2021.

Registered nurse Jean Boone watches from Children's National Hospital.

Registered nurse Jean Boone watches from Children's National Hospital. Photo: Sarah Silbiger/Getty Images

Children's health

Advisers to the Centers for Disease Control and Prevention on Thursday unanimously voted to add COVID-19 vaccines to the 2023 schedule of childhood and adult immunizations.

Why it matters: The 15-0 vote by the Advisory Committee on Immunization Practices creates streamlined guidance for what shots people are able to receive and at what age. 

Yes, but: States and localities still have the power to decide whether to require vaccinations for school-age children. 

Worth noting: More than 20 states have already prohibited COVID vaccine from being required for students, per the National Academy of State Health Policy.

Washington D.C. is the only jurisdiction so far to mandate COVID vaccinations for students who are eligible for FDA-approved shots, but the city council could delay the Jan. 3, 2023 deadline.

California won't mandate shots this school year, health officials have said. The earliest COVID-19 vaccines would be required for school attendance is July 1, 2023.

While the flu vaccine has long been on the annual immunization schedule, only seven states require it, according to a tracker of vaccine mandates for child care and pre-K.

What they’re saying: Thursday’s vote drew swift pushback from conservatives like Florida Gov. Ron DeSantis, who said parents should have the final say.

In a tweet Wednesday about the updating of the vaccine schedule, FDA Commissioner Robert Califf noted, “We need to be clear that the benefits outweigh the risk of vaccination, but mandates are not the remit of either CDC or FDA.”

What’s next: The CDC is widely expected to accept the recommendation. 

The endorsement could expand vaccine access, since the Affordable Care Act requires health plans to cover vaccines listed on the CDC schedule, said Emmanuel Drabo, a health economist at Johns Hopkins University. 

But the decision “is not enough to get our vaccine coverage levels to the levels we want them to be,” said Julie Morita, executive vice president of the Robert Wood Johnson Foundation and Chicago’s former health commissioner.

“The challenge we have ahead of us really is more resources,” Morita said.

Flashback: The CDC panel separately added COVID vaccines to the federal Vaccines for Children Program, to ensure uninsured kids will continue to have access to shots when funding runs out.

The FDA has approved only the Pfizer primary series vaccine for people 12 and up and the Moderna primary series for those 18 and older. 

COVID vaccines for children 6 months and up and all booster doses are authorized for emergency use.

This includes Novavax, which the agency authorized as a booster shot for adults on Wednesday.

CDC panel votes to add COVID shots to immunization schedule

CDC panel votes to add COVID vaccines to immunization schedule

Illustration of a syringe checking off boxes on a list

A market in Wuhan, China, was the epicenter of the COVID-19 pandemic, and the virus emerged from activities connected with the live animal trade, according to research published in Science on Tuesday.

Why it matters: The case-mapping and genetic studies offer some of the strongest evidence yet that the coronavirus jumped from an animal host to humans — a type of zoonotic spillover seen in other outbreaks like SARS, from 2002 to 2004.

What they found: There were two lineages of the virus introduced in humans as early as November 2019.

The variants over time spread into the neighborhoods surrounding the market and beyond, challenging the idea the market was the source of a single superspreader event.

Early cases linked to the part of the market where wildlife sales took place resemble cross-species transmissions later observed on mink farms and from infected hamsters to humans in the pet trade.

What they’re saying: University of Glasgow virologist David Robertson told BBC News he hoped the studies would "correct the false record that the virus came from a lab."

"In a city covering more than 3,000 square miles, the area with the highest probability of containing the home of someone who had one of the earliest COVID-19 cases in the world was an area of a few city blocks, with the Huanan market smack dab inside it," per University of Arizona biologist Michael Worobey.

The intrigue: While early patient data showed few of those hospitalized had a direct link to the market, Robertson said, “it's exactly what we would expect, because many people only get very mildly ill, so they would be out in the community transmitting the virus to others and the severe cases would be hard to link to each other.”

A map of samples collected from market stalls showed most that tested positive for the virus were on the southwestern side, where animals like Raccoon dogs and hedgehogs were sold.

Flashback: An unclassified intelligence report into COVID’s origin released last year was inconclusive, stating the two dominant theories — that it came from a lab leak or was naturally transmitted from an animal — remain plausible.

A World Health Organization-backed team of scientists said in June that available data suggests SARS-CoV-2 had a zoonotic origin and that the theory that the virus escaped from a laboratory needs “further investigations,” per the Washington Post.

The bottom line: Accurately determining the causes of COVID-19 will go a long way toward informing what can and should be done to prevent the next pandemic.

Wuhan market pinpointed as pandemic's Ground Zero

The case-mapping and genetic studies offer some of the strongest evidence yet that the coronavirus jumped from an animal host to humans.

Axios Vitals

Data: CDC; Chart: Erin Davis/Axios Visuals 

The COVID-19 vaccine strategy for the fall remains beset with unanswered questions after an FDA expert panel on Tuesday spent hours debating how and whether to update the shots.

Why it matters: Time is running short to develop a game plan with existing vaccines losing effectiveness against new variants and more than half of Americans still without a booster dose. 

Driving the news: The Vaccines and Related Biological Products Advisory Committee voted 19-2 to recommend an Omicron-specific update to COVID-19 booster vaccines expected to be rolled out within the next few months.

The panel didn’t formally decide whether to update shots with the prevalent Omicron strain in circulation, currently the fast-spreading BA.4 and BA.5 subvariants, or the BA.1 lineage that emerged late last year, as the World Health Organization recommended. 

The consensus appeared to be for a bivalent, or combination, booster combining the original COVID-19 strain that emerged in late 2019 with BA.4 and BA.5.

The FDA will continue to evaluate what to do about the primary series of vaccines for the fall. 

Experts were split on whether there was enough data to recommend the updated shots for kids, or whether more studies are needed on dosage and possible side effects.

There also were concerns about what effect an updated vaccine would have on developing nations’ willingness to use older COVID shots to inoculate their populations. 

And above all, it's unclear whether all the questions about who gets which shot when will add to public confusion and apathy that’s dogged the vaccination effort in recent months.

What they're saying: "None of us has a crystal ball and we’re trying to use every last ounce of what we can from predictive modeling and data that’s emerging to try to get ahead of a virus that's very crafty," said top FDA vaccine regulator Peter Marks.

"Unfortunately, looking in the past doesn’t help us a great deal to look in the future for [a] virus that has baffled a lot of us and made predictions almost irrelevant," said acting panel chairman Arnold Monto, a University of Michigan epidemiologist.

The timetable: Pfizer-BioNTech said an updated mRNA vaccine could be ready in October if regulatory uncertainties are ironed out. Moderna said it could have large amounts ready in late October or early November. Novavax is still awaiting emergency use authorization for its protein-based shot, but said it could have an updated vaccine by the fourth quarter.

The latest CDC data released Tuesday shows the Omicron subvariants BA.4 and BA.5 now make up more than 50% of the virus circulating in the U.S.

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Coronavirus

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