U.S. reports another record number of cases, and hard-hit states retreat from reopening.
As the United States reached its third consecutive day with a record number of new reported coronavirus infections, officials were urgently rethinking their strategies to head off new infections.
The U.S., which leads the world in total confirmed cases and deaths, reported more than 45,000 new infections on Friday, according to a Times database. Before this week, the country’s largest daily total had been 36,738 on April 24.
Globally, countries reported more than 191,000 new infections — a single-day record as the total number of cases neared 10 million. India’s caseload surged past 500,000 on Saturday.
At least six U.S. states — Florida, Idaho, Kansas, Oregon, South Carolina and Utah — reported their highest one-day case totals, and Dr. Anthony S. Fauci, the country’s top infectious diseases expert, warned that outbreaks in the South and West could engulf the country.
Dr. Fauci said in a brief interview that officials were having “intense discussions” about a possible shift to “pool testing,” in which samples from many people are tested at once in an effort to quickly find and isolate those who are infected.
European Union officials said the bloc was ready to bar most travelers from the U.S. and other countries considered too risky because they have not controlled the outbreaks. And for the first time, some U.S. governors were backtracking on reopening their states, issuing new restrictions on some elements of public life.
In Texas and Florida, leaders abruptly set new restrictions on bars, a reversal that appeared unthinkable just days ago.
Mayor Carlos Giménez of Miami-Dade County in Florida said he would sign an emergency order on Saturday closing beaches from July 3 to July 7, citing a surge in new cases and fears about mass gatherings during the July Fourth holiday weekend. The order would ban groups of more than 50 people, including parades, and would also close parks to public fireworks displays — which the mayor said “must be viewed from one’s home or parked vehicle.”
In California, which had one of the earliest stay-at-home orders in the United States, Gov. Gavin Newsom announced new restrictions on Imperial County, which has the state’s highest rate of infection.
“This disease does not take a summer vacation,” he said.
The decisions represented the strongest acknowledgment yet that reopening had not gone as planned. Only days ago, the two states’ governors were resisting calls to close back down.
“If I could go back and redo anything, it probably would have been to slow down the opening of bars,” Gov. Greg Abbott of Texas said in an interview with KVIA-TV in El Paso on Friday evening.
Leaders outside the new hot zones in the South and West also expressed mounting anxiety.
“This is a very dangerous time,” Gov. Mike DeWine of Ohio said in an interview on Friday, as cases trended steadily upward in his state after appearing to be under control.
“I think what is happening in Texas and Florida and several other states should be a warning to everyone,” he said.
With new cases of the coronavirus suddenly surging across multiple states that had had low and manageable caseloads just months ago, confusion and anger is swirling among those who obeyed lockdowns and drastic social measures out of a sense of civic duty to help bring the epidemic in the United States under control.
Many business owners and workers who lost their jobs say they feel their leaders failed to prepare for the economic devastation that followed shutdowns that states adopted, to differing degrees, since March. And they say that recent reopenings undercut their sacrifices.
In recent weeks, some conservatives said they had an additional concern: After weeks of being told that going to church, attending funerals, and participating in protests was a willful, careless spurning of science, political leaders and some public health officials condoned — and even joined — the crowds protesting the killing of George Floyd.
“It’s just a real social whiplash,” said Philip Campbell, vice president of a pest control company in Central Michigan, who took part in the first protests against the lockdown in Lansing in April from the cab of his truck. “Two weeks ago you can’t go out because you are going to kill grandma. Now it’s ‘you have an obligation to go out.’ It leaves me feeling that the science and the public health authorities have been politicized.”
In Florida and Texas, governors closed bars on Friday, as they scrambled to control what appeared to be a brewing public health catastrophe. All this is leaving people with a strange sense of déjà vu and a bitterness at public officials for what felt like a fumbling of people’s sacrifices.
“Are we doing a full circle? Yes,” said Judy Ray, 57, a cosmetologist and hairdresser in Florida who was laid off from her job at a barbershop at Walt Disney World Resort in March.
Some fault the state and city leaders who rushed to reopen while the virus surged in other corners of the country and now face daunting outbreaks in their own backyards. Others fault a lack of federal leadership, and a White House that defies expert guidance.
At a news conference on Friday, Vice President Mike Pence deflected a question about whether the Trump administration was sending mixed messages by reiterating public health officials’ advice while resuming crowded campaign rallies and refusing to wear masks.
“Even in a health crisis the American people don’t forfeit our constitutional rights,” he said. “We were creating settings where people can choose to participate in the political process, and we will continue to do that.”
Fears of a second wave of coronavirus infections in China receded somewhat after the government responded to an outbreak in Beijing this month with a partial lockdown and a push to test millions of people.
But while the number of new reported cases has mostly tapered off, the city’s recent surge has confirmed fears of sporadic flare-ups even after countries tame their outbreaks.
The new infections came to light as officials discovered a cluster in people who had worked or shopped at the sprawling Xinfadi wholesale market, which supplies most of the city’s fruits and vegetables.
Within days, officials had locked down dozens of residential complexes, prohibited taxis from leaving Beijing and postponed school reopenings. As of June 22, the authorities had taken samples from more than 2.9 million people over the previous 10 days, the state news media reported.
Wu Zunyou, the head of the Chinese Center for Disease Control, said last week that the outbreak was “under control.” In an interview this week with the state news media, he predicted that the number of cases would not exceed 400. As of Saturday morning, the authorities had reported 297 cases in Beijing, and cases tied to the city had been found in at least four provinces.
Even state news outlets acknowledged that it might be too early to claim victory, taking into account long lines for testing and a potential delay in results.
“We’ve had two outbreaks in half a year,” Zeng Guang, an expert at the National Health Commission, told Global Times, a state-controlled tabloid. “So it is highly possible that the outbreak will make a comeback in the near future.”
In other international news:
The European Union finished its list of countries whose travelers will be allowed in when the bloc reopens starting on July 1: Algeria, Australia, Canada, Georgia, Japan, Montenegro, Morocco, New Zealand, Rwanda, Serbia, South Korea, Thailand, Tunisia, Uruguay, Andorra, San Marino and Monaco. Travelers from the Vatican will be allowed, and also from China — so long as China allows in European Union travelers. Left out: the United States, Russia, and dozens of other countries suffering what is seen as uncontrolled outbreaks.
The Hong Kong police on Saturday banned an annual pro-democracy march planned for Wednesday, the anniversary of the Chinese territory’s handover from British rule, citing concerns about the virus and potential street violence. Mainland China’s top legislative committee could pass a sweeping security law for Hong Kong on Tuesday.
As lockdowns loosen around the world and workers head back to their jobs, city leaders from Taipei to London to Bogotá are scrambling to address a new problem: gridlock as commuters retreat from mass transit into the safer space of their cars.
Nursing home deaths make up 43 percent of those in the U.S.
A stunning proportion of coronavirus deaths in the United States — 43 percent — are linked to nursing homes and other long-term care facilities for older adults, according to a New York Times database, which found at least 54,000 residents and workers in such facilities had died. As of June 26, the virus had infected more than 282,000 people at some 12,000 facilities.
The share of deaths linked to these facilities is even starker at the state level. In 24 states, the number of residents and workers who have died accounts for either half or more than half of all deaths from the virus. In New Hampshire, for example, the share of such deaths is 80 percent, and in Minnesota it is 77 percent.
Nursing home populations are at a high risk of being infected by — and dying from — the coronavirus, according to the Centers for Disease Control and Prevention. Covid-19, the disease caused by the coronavirus, is known to be particularly lethal to adults in their 60s and older who have underlying health conditions. And it can spread more easily through congregate facilities, where many people live in a confined environment and workers move from room to room.
Infected people linked to nursing homes also die at a higher rate than the general population. The median case fatality rate — the number of cases divided by the number of deaths — at facilities with reliable data is 17 percent, significantly higher than the 5 percent case fatality rate nationwide.
The number of coronavirus infections in many parts of the United States is more than 10 times higher than the reported rate, according to data released Thursday by the Centers for Disease Control and Prevention.
The analysis is part of a wide-ranging set of surveys initiated by the C.D.C. to estimate how far the virus has spread. It found, for instance, that in South Florida as of April 10, under 2 percent of people had been exposed to the virus. (The proportion is likely to be much higher now, given the surge of infections in the state.) The C.D.C. estimated 117,400 people in that region had been infected — about 11 times the reported number of 10,500 cases.
The results confirm what some scientists have warned about for months: that without wider testing, scores of infected people go undetected, and continue to circulate the virus.
“Our politicians can say our testing is awesome, but the fact is our testing is inadequate,” said Scott Hensley, a viral immunologist at the University of Pennsylvania who was not involved in the research.
The numbers indicate that even in areas hit hard by the virus, the overwhelming majority of people have not yet been infected, Dr. Hensley said.
“Many of us are sitting ducks who are still susceptible to second waves,” he said.
The difference between recorded infections and those that were missed was even more significant in Missouri, where about 2.65 percent of the population was infected with the virus as of April 26, although many people might not have felt sick. This number is about 24 times the reported rate: nearly 162,000 compared with the 6,800 believed to have been infected by then.
Dr. Robert R. Redfield, the director of the C.D.C., noted this trend on Thursday during a call with reporters.
“Our best estimate right now is for every case reported there were actually 10 other infections,” Dr. Redfield said.
The C.D.C. researchers tested samples from 11,933 people across six regions in the United States during discrete periods from March 23 through May 3: The Puget Sound region of Washington, where the first case in the country was diagnosed, as well as New York City, South Florida, Missouri, Utah and Connecticut.
The samples were collected at commercial laboratories from people who came in for routine screening such as cholesterol tests, and were evaluated for the presence of antibodies to the virus — which would indicate previous infection even in the absence of symptoms.
Facing numerous lockdown violations, the British police vow to crack down.
The police in Britain vowed to crack down on unauthorized gatherings this weekend after tens of thousands of people flocked to beaches, gathered outside for unauthorized parties and violated coronavirus restrictions in recent days.
In the country’s south, the police in several seaside cities issued dispersal orders after large numbers of beachgoers caused huge traffic jams and engaged in antisocial behavior this week — including brawls, excessive drinking and even defecating in public.
The police in London and other cities like Derby, in central England, vowed to robustly disperse any unauthorized gathering. Over 140 officers in London have been injured while patrolling protests and breaking up unsanctioned parties in recent weeks.
And in Liverpool, the police have been given the power to disperse any gathering of more than two people in the center of the city, after thousands of supporters flouted social distancing rules on Friday when celebrating their soccer club’s English Premier League championship title.
When fans turned out in large numbers for the second night in a row to celebrate Liverpool’s title — its first in 30 years — Mayor Joe Anderson denounced the presence of “too many people intoxicated and causing antisocial behavior.”
A building in the city briefly caught fire on Friday night after a firework was set off. And on Saturday, Liverpool FC condemned the gatherings in a joint statement with the City Council and the local police.
“Our city is still in a public health crisis, and this behavior is wholly unacceptable,” the statement read.
In a parallel to H.I.V., studies find the coronavirus can deplete vital immune cells.
The coronavirus initially seemed to be another respiratory illness. But it has turned out to affect not just the lungs, but also the kidneys, heart and circulatory system — even, somehow, the senses of smell and taste.
Now, researchers have discovered yet another unpleasant surprise. In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V.
One of the more detailed studies, published as a preprint and under review at Nature Medicine, was conducted by Dr. Adrian Hayday, an immunologist at King’s College London.
He and his colleagues compared 63 Covid-19 patients with 55 healthy people, some of whom had recovered from coronavirus infections.
One of the most striking aberrations in Covid-19 patients, the researchers found, was a marked increase in levels of a molecule that sends T cells to areas of the body where they are needed.
The result: a confused response from the immune system.
Some experts have wondered whether antiviral treatment makes sense for severely ill Covid-19 patients, if their main affliction is an immune system overreaction. But if the virus directly causes the immune system to malfunction, Dr. Hayday said, then an antiviral makes sense.
This week, in response to those findings, Norway reopened all of its gyms with the same safeguards in place that were used in the study.
The trial, begun on May 22, included five gyms in Oslo with 3,764 members, ages 18 to 64, who had no underlying medical conditions. Half were invited to go back to their gyms and work out, while the others were not allowed to.
The researchers found just one coronavirus infection, in a person who had not used the gym before he was tested; it was traced to his workplace. Some participants visited hospitals, but for conditions other than Covid-19.
Is there hope for gymgoers elsewhere?
“I personally think this is generalizable, with one caveat,” said Dr. Michael Bretthauer, a cancer screening expert at the University of Oslo who helped lead the study.
It is unlikely to be applicable, he said, in “places where there is a lot of Covid, or where people are less inclined to follow restrictions.”
Citing the severity of the pandemic, a federal judge in Los Angeles on Friday ordered the release of migrant children held in the country’s three family detention centers.
The order, which mandates their release by July 17, came after plaintiffs in a long-running case reported that some of the children had tested positive for the coronavirus. It applies to children who have been held for more than 20 days in detention centers run by Immigration and Customs Enforcement, including two in Texas and one in Pennsylvania.
There were 124 children living in those facilities on June 8, according to the ruling.
“The family residential centers are on fire, and there is no more time for half measures,” Judge Dolly M. Gee of the U.S. District Court for the Central District of California wrote in the order.
She also criticized the Trump administration for its spotty compliance with recommendations from the Centers for Disease Control and Prevention in the centers.
It was the first time a court had set a firm deadline for the release of minors in family detention if their parents designated a relative in the United States to take custody. Recent orders had required their “prompt” release.
Over all, about 2,500 immigrants in ICE detention have tested positive for the virus. The agency has said that it has released at least 900 people with underlying conditions and that it has shrunk the population in each facility to mitigate the spread of the virus.
The Affordable Care Act, the landmark health law that has been a subject of caustic debate for more than a decade, is being tested as never before as millions of Americans lose their jobs and medical coverage in the midst of the pandemic.
The law offers most newly unemployed people a path to stopgap health coverage, providing a cushion that did not exist during the last crushing recession, or ever before. But the crisis also highlights fundamental weaknesses in its patchwork system.
This week, as the United States reported several daily records in new coronavirus cases, the Trump administration continued the Republican Party’s push to abolish the law, with the Justice Department asking the Supreme Court to overturn the legislation.
Joseph R. Biden Jr., the presumptive Democratic nominee, supports improving and expanding the A.C.A., rather than replacing it with a “Medicare for all” system preferred by many in his party.
And as these political and legal battles play out, how the law functions in the coming months could sway both its durability and future.
“It’s not just a test — it’s a national study of what happens in states that implemented the A.C.A. as opposed to those that didn’t,” said Peter V. Lee, the executive director of Covered California, the state’s insurance marketplace created under the law.
Four out of every five people who have lost employer-provided health insurance during the pandemic are eligible for free coverage through expanded Medicaid programs or government-subsidized private insurance, according to the Kaiser Family Foundation, a nonpartisan research group. And many jobless 20-somethings have been able to join their parents’ plans. All three options were made possible by the law.
Yet nearly three million low-income people are ineligible for assistance in the 14 states that have declined to expand Medicaid under the law, including several where coronavirus cases are now spiking.
The Times’s Claudio E. Cabrera was among the New Yorkers who rejoiced when the city’s salons and barbershops reopened this week. Here, he writes about the experience.
For the last three months, I’ve spent my Google Hangout work meetings wearing a Yankees cap.
Despite being a born-and-bred New Yorker, I am not a Yankees fan at all. But it was the only cap I had in my house to cover my lack of a shape-up, my lack of a haircut, with barbershops in the city closed because of the pandemic.
When people talk about the relationship between people of color and their barbers, they tend to forget that it’s not just that they raise your self-esteem and help you look good — they are people you can also share your life with, and who can share their life with you.
And they aren’t your typical friend. They don’t come out with you to the bar. You may never go on a guys’ trip with them. You have those friends.
But your barber is your part-time therapist, and sometimes you are his.
In late January, a doctor in Munich discovered Germany’s first coronavirus case, but the diagnosis made no sense. The patient reported only one possible contact with the infection: a business colleague visiting from China who had seemed healthy during her stay.
The visitor later told colleagues that she had not started feeling ill until after the flight back to China. Days later, she tested positive for the coronavirus.
Although it is now widely accepted that seemingly healthy people can spread the virus, scientists at the time believed that only people with symptoms could infect others.
“People who know much more about coronaviruses than I do were absolutely sure,” recalled Dr. Camilla Rothe, an infectious disease specialist at Munich University Hospital who diagnosed the businessman’s case.
The possibility of transmission from seemingly healthy people could strongly limit the ability of public awareness campaigns, airport screenings and stay-home-if-you’re sick policies to stop the virus.
Dr. Rothe and her colleagues were among the first to warn the world. But interviews with doctors and public health officials in more than a dozen countries showed that for two crucial months, Western health officials and political leaders played down or denied the risk of symptomless spreading. Leading health agencies provided contradictory and sometimes misleading advice.
It is impossible to calculate the human toll of that two-month delay, but models suggest that earlier action might have saved tens of thousands of lives. Though estimates vary, models using data from Hong Kong, Singapore and China suggest that 30 to 60 percent of spreading occurs when people have no symptoms.
“This was, I think, a very simple truth,” Dr. Rothe said. “I was surprised that it would cause such a storm. I can’t explain it.”
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Reporting was contributed by Reed Abelson, Matt Apuzzo, Nicholas Bogel-Burroughs, Julie Bosman, Claudio E. Cabrera, Tess Felder, Selam Gebrekidan, Manny Fernandez, Abby Goodnough, Shawn Hubler, Miriam Jordan, David D. Kirkpatrick, Gina Kolata, Patricia Mazzei, Giulia McDonnell Nieto del Rio, Sarah Mervosh, and Giulia McDonnell Nieto del Rio, Dave Montgomery, Elian Peltier, Frances Robles, Michael D. Shear, Jeanna Smialek, Sheryl Gay Stolberg, Jim Tankersley and Vivian Wang.