In the 10 months since a mysterious pneumonia began striking residents of Wuhan, China, Covid-19 has killed more than one million people worldwide as of Monday — an agonizing toll compiled from official counts, yet one that far understates how many have really died.
The coronavirus may already have overtaken tuberculosis and hepatitis as the world’s deadliest infectious disease. And unlike all the other contenders, it is still growing fast.
Like nothing seen in more than century, the virus has infiltrated every populated patch of the globe, sowing terror and poverty, infecting millions of people in some nations and paralyzing entire economies.
But as attention focuses on the devastation caused by halting a large part of the world’s commercial, educational and social life, it is all too easy to lose sight of the most direct human cost.
More than a million people — parents, children, siblings, friends, neighbors, colleagues, teachers, classmates — all gone, suddenly, prematurely. More than 200,000 in the United States, which has the largest total number of coronavirus deaths in the world, followed by Brazil, with over 140,000.
Those who survive Covid-19, the disease caused by the virus, are laid low for weeks or even months before recovering, and many have lingering ill effects of varying severity and duration.
Yet much of the suffering could have been avoided.
“This is a very serious global event, and a lot of people were going to get sick and many of them were going to die, but it did not need to be nearly this bad,” said Tom Inglesby, the director of the Johns Hopkins Center for Health Security.
At the height of the first wave, places like China, Germany, South Korea and New Zealand showed that it was possible to slow the pandemic enough to limit infections and deaths while still reopening businesses and schools.
But that requires a combination of elements that may be beyond the reach of poorer countries — and that even ones like the United States have not been able to muster: wide-scale testing, contact tracing, quarantining, social distancing, mask wearing, providing protective gear, developing a clear and consistent strategy, and being willing to shut things down in a hurry when trouble arises.
Time and again, experts say, governments reacted too slowly, waiting until their own countries or regions were under siege, either dismissing the threat or seeing it as China’s problem, or Italy’s, or New York’s.
Thomas R. Frieden, a former head of the U.S. Centers for Disease Control and Prevention, said that a major failing had been in governments’ communication with the public, nowhere more so than in the United States.
“You have standard principles of risk communication: Be first, be right, be credible, be empathetic,” he said. “If you tried to violate those principles more than the Trump administration has, I don’t think you could.”
The world now knows how to bend the curve of the pandemic — not to eliminate risk, but to keep it to a manageable level — and there have been surprises along the way.
Masks turned out to be more helpful than experts initially predicted. Social distancing on an unheard-of scale has been more feasible and effective than anticipated. The difference in danger between an outdoor gathering and an indoor one is greater than expected.
And, crucially, people are most contagious when they first show symptoms or even earlier, not days or weeks later, when they are sickest — a reversal of the usual pattern with infectious diseases. That makes preventive measures like wearing masks and swift responses like isolating and testing people for possible exposure much more important. If you wait until the problem is evident, you’ve waited too long.
After months of promising signs in its fight against the coronavirus, New York State on Monday reported a spike in its rate of new cases, including a rise in New York City and in its northern suburbs.
The rate of positive test results in the city reached 1.93 percent, Mayor Bill de Blasio said on Monday, an increase from the 1.5 percent rate reported by the city a week before, as officials continued to warn about dangerous behavior in several communities.
The increase in the city, the one-time center of the pandemic, and some suburbs contributed to the statewide rate of approximately 1.58 percent — a jump from results reported on Sunday and in prior weeks.
Gov. Andrew M. Cuomo, a third-term Democrat, said on Monday that the increase was primarily because of clusters in Brooklyn, as well as in Rockland and Orange Counties, in the Hudson Valley, saying there was “significant action” in those areas.
Officials are particularly concerned about eight neighborhoods in Brooklyn and Queens, some with large Orthodox Jewish communities, that have accounted for about one-fourth of New York City’s new cases in the past two weeks, despite representing about 7 percent of the city’s population.
On Friday, city health officials began carrying out emergency inspections at private religious schools in some of those neighborhoods, and threatened to limit gatherings or force closings of businesses or schools if there was not better compliance to social distancing requirements. The communities are celebrating Jewish high holidays through mid-October, which are marked by religious and family gatherings.
A continued rise could affect a closely watched plan to reopen the city’s schools: The mayor has said that he will automatically shut down classrooms — which are all slated to be open by Thursday — if the positivity rate exceeds 3 percent over a seven-day rolling average. The mayor has also has twice delayed the start of in-person classes for most students, and on Sunday, the union representing the city’s principals called on the state to take over the reopening effort from Mr. de Blasio.
Mr. Cuomo has previously said that reaching a 2 percent positivity rate would make him “nervous,” and that surpassing a 3 percent rate would cause “the alarm bells to go off.”
On Monday, Mr. Cuomo said that he would make 200 rapid testing machines available to schools and local governments in areas where rates were rising, saying “the key with these clusters is to jump on them quickly.”
All told, the state on Monday reported 834 new cases, out of nearly 53,000 tests, the governor said, adding the spike in the positivity rate was largely confined to 20 ZIP codes, where the rate went as high as 30 percent, in contrast with the rest of the state, where the rate remained around 1 percent.
The statewide positivity rate began to creep up over the weekend, when officials reported rates just slightly above 1 percent; hospitalizations have also risen over the last several days, according to state statistics.
Mr. Cuomo stressed that “mask compliance is important,” and urged local governments to enforce mask rules and prohibitions on large gatherings, even if residents were feeling “compliance fatigue.” On Wednesday, New York City will allow indoor dining to resume at 25 percent.
Over the summer, the state began requiring travelers from states with increasing cases to quarantine for 14 days upon their arrival in New York, though the enforcement has been lax. On Monday, Mr. Cuomo said he would sign a new executive order subjecting most travelers from other countries to the 14-day quarantine.
U.S. Roundup
The number of homicides in 27 cities across the United States was 53 percent higher this summer than in the pre-pandemic summer of 2019, according to an updated analysis by the Council on Criminal Justice, a nonpartisan research group.
The update, covering the months of June, July and August, found that aggravated assaults also increased from last year, by 14 percent, but that many other types of crime plummeted, including residential burglaries, larcenies and drug offenses. Across the country, overall crime rates remain at or near generational lows, despite striking increases in violence in some cities.
Fluctuations in crime rates are notoriously hard to explain, but 2020 has seen two factors with potentially seismic influence: the coronavirus pandemic, which has caused mass unemployment and made the most proven types of anti-violence measures far more difficult to implement, and the killing of George Floyd in police custody in late May, which sparked nationwide protests.
The new report’s authors, Richard Rosenfeld and Ernesto Lopez, wrote that “subduing the pandemic, pursuing crime control strategies of proven effectiveness, and enacting needed police reforms will be necessary to achieve durable reductions in violent crime in our cities.”
The F.B.I reported on Monday that violent crime continued its downward trend in 2019, but that preliminary figures for 2020 show a 15 percent increase in homicides, the largest single-year increase on record.
A New York Times analysis finds that despite President Trump’s attempts to blame “Democrat cities” for failing to curb violence, homicides have increased regardless of the political party of the mayor. In three cities recently called “anarchist” by the Department of Justice — Portland, Ore., New York and Seattle — the murder rate remains quite low. Those cities were not among the top 40 American cities ranked by their projected 2020 murder rate.
And murder is not the only violent crime on the rise. The Chicago Police Department said that domestic-violence-related calls increased 12 percent during a period from the start of the year through mid-April, compared with the same time period in 2019. In other cities, including Los Angeles and New York, the police have seen a drop in calls, but the authorities have said they believed that victims were in such close quarters with their abusers that they were unable to call the police.
In other U.S. news:
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After a six-month closure, the Washington Monument will reopen to the public on Thursday. The monument will be open seven days a week from 9 a.m. to 5 p.m., with a new set of safety and cleaning procedures. Tickets, which must be reserved at recreation.gov, will be available starting on Wednesday.
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Officials in Montana reported 412 new cases on Monday, a single-day record for the state. Daily reports of new cases have more than doubled in the last two weeks to an average of 250 a day, according to a New York Times database — shattering records and raising concerns that Montana’s hospitals could become overwhelmed. Almost half the state’s total 174 deaths from Covid-19 have come in the past month, and hospitalizations are up sharply. Some of the surge can be attributed to outbreaks in prisons and nursing homes, but state experts also point tothe recent reopening of schools and universities.
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Officials in Idaho reported more than 880 new cases on Monday, a single-day record, with the possibility of more cases as counties continue to report through the evening. The previous record (681 new cases) was set on Friday.
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A Maryland man has been sentenced to one year in jail and fined $5,000 for throwing two large parties in violation of the state’s ban on gatherings of more than 10 people.
Inovio Pharmaceuticals, a Pennsylvania firm whose chief executive boasted to President Trump in March that it was the world’s leader in coronavirus vaccines, said on Monday that it will delay the next stage of testing for its vaccine until addressing questions from the Food and Drug Administration.
The company said the pause is not related to any serious side effects from the first phase of testing of its vaccine, which uses a DNA technology that stimulates a person’s immune system with some of the coronavirus’s genes. No DNA-based vaccine has ever made it to market for any human disease. The company is not able to start Phase ⅔ testing but its Phase 1 trial will continue, it said.
Inovio’s pitch has long been that this genetic approach would allow for faster design and manufacturing than its competitors. But it’s now far behind the pack. More than two dozen coronavirus vaccines have made it to later testing phases than Inovio’s has.
The F.D.A. had questions about the vaccine’s “Cellectra 2000 delivery device,” which uses an electrical pulse to open skin pores in order to more consistently deliver the vaccine dose. Regulatory questions about a similar device held up clinical trials for an Inovio cancer vaccine in 2016.
The company said it plans to respond to the F.D.A.’s questions in October. After that, the agency will have 30 days to decide whether to allow the trials to proceed.
Most of the coronavirus vaccine trials have not run into safety issues. The exception is AstraZeneca’s, which was recently halted when two volunteers became seriously ill after getting its experimental vaccine. That trial is still on pause in the United States.
Negotiators resumed talks on Monday over a coronavirus relief package in a final bid to revive stalled negotiations as House Democrats unveiled a $2.2 trillion coronavirus relief bill that would provide aid to American families, businesses, schools, restaurants and airline workers.
The release of the legislation came minutes before Speaker Nancy Pelosi of California and Steven Mnuchin, the Treasury secretary, spoke on the phone Monday evening, as the pair seeks to end the impasse over another round of coronavirus. The two agreed to speak again Tuesday morning, said Drew Hammill, a spokesman for Ms. Pelosi.
The moves appeared to be the most concrete action toward another stimulus bill since negotiations stalled nearly two months ago. But the sides remain far apart on an overall price tag, and with just over a month before Election Day, lawmakers and aides in both chambers warned that the time frame for striking a deal was slim.
Absent an agreement with the administration, the House could vote as early as this week to approve the legislation, responding to growing pressure for Congress to provide additional relief and quelling the concerns of moderate lawmakers unwilling to leave Washington for a final stretch of campaigning without voting on another round of aid. But at roughly $1 trillion more than what Mr. Mnuchin has signaled the White House is willing to consider, the package is likely just a starting point, all but guaranteed to be rejected by the Republican majority in the Senate should the House pass it in its current form.
Democrats maintained a provision that would revive a lapsed $600 enhanced federal unemployment and another provision that would send a second round of $1,200 stimulus checks to Americans. And some measures were either added or expanded: $225 billion for schools and $57 billion for child care, an extension of an expiring program intended to prevent the layoffs of airline workers through March 31 and the creation of a $120 billion program to bolster ailing restaurants.
The rate of infections with the coronavirus in adolescents aged 12 to 17 years is about twice that in children aged 5 to 11 years, according to an analysis released Monday by the Centers for Disease Control and Prevention.
The finding is based on a review of 277,285 confirmed cases in children from March to September, when most schools in the nation offered only remote learning or were closed.
Children often have mild symptoms, if any at all, so some researchers have suggested that the low numbers of confirmed cases in children result from a lack of testing.
The number of children tested increased to over 320,000 in mid-July from 100,000 on May 31. By July, the incidence of infected children had risen to 37.9 per 100,000 from 13.8.
Along with other evidence about the incidence of coronavirus infections in those under age 19, the new figures suggest “that young persons might be playing an increasingly important role in community transmission,” the authors wrote.
The number of tests and the incidence of infections decreased after July, but may again be rising, the researchers added.
The number of children infected during the study period varied by age. The weekly incidence among adolescents was 37.4 per 100,000, compared with 19 per 100,000 among younger children.
Children who had underlying conditions were more likely to become severely ill, the analysis also found. Among school-aged children who were hospitalized, admitted to an intensive care unit, or who died, 16 percent, 27 percent and 28 percent, respectively, had at least one underlying medical condition, the researchers reported.
Deaths among children were rare, but Black and Hispanic children were more likely to be hospitalized or admitted to an I.C.U., the C.D.C. reported.
They caught the coronavirus months ago and survived it, but they are still stuck at home, gasping for breath. They are no longer contagious, but some still feel so ill that they can barely walk around the block, and others grow dizzy trying to cook dinner. Month after month, they rush to the hospital with new symptoms, pleading with doctors for answers.
As the coronavirus has spread through the United States over the past seven months, infecting at least seven million people, a subset of them are suffering from serious, debilitating and mysterious effects of Covid-19 that last far longer than a few days or weeks.
“Before this, I was a weight lifter, kayaker, hiker, white-water rafter,” said Karla Monterroso, 39, who was living and working in the San Francisco Bay Area when she caught the coronavirus in March. She has been sick for going on 200 days.
“I can’t do anything right now, physically, without harming myself,” she said.
Patients wrestling with alarming symptoms many months after first becoming ill — they have come to call themselves “long-haulers” — are believed to number in the thousands in the United States, including many young people who were healthy before being infected. Their symptoms can span a wide range, including piercing chest pain, deep exhaustion or a racing heart.
The New York Times asked four long-haulers to describe their experiences in their own words.
In many parts of the developing world, school closures have put children on the streets. Families are desperate for money. Children are an easy source of cheap labor. While the United States and other developed countries debate the effectiveness of online schooling, hundreds of millions of children in poorer countries lack computers or the internet and have no schooling at all.
United Nations officials estimate that at least 24 million children will drop out and that millions could be sucked into work. Ten-year-olds are now mining sand in Kenya. Children the same age are chopping weeds on cocoa plantations in West Africa. In Indonesia, boys and girls as young as 8 are painted silver and pressed into service as living statues who beg for money.
In southern India, an 11-year-old boy, Rahul, would be a fine addition to any classroom. But with his school closed because of the virus, he currently finds himself part of the swarm of children who pour into the street from his housing project, bound for another day rummaging garbage dumps in search of recyclable plastic. It pays pennies an hour.
“I hate it,” said Rahul.
The surge in child labor could erode the progress achieved in recent years in school enrollment, literacy, social mobility and children’s health.
“All the gains that have been made, all this work we have been doing, will be rolled back, especially in places like India,” said Cornelius Williams, a high-ranking UNICEF official.
The longstanding antagonism that pits Paris, the occasionally overbearing French capital, against Marseille, its sunnier, more rambunctious rival on the Mediterranean coast, has found a new battleground: the coronavirus.
Politicians and businesses in Marseille and its neighbor, Aix-en-Provence, are furious since the government ordered all bars, cafes and restaurants in those two cities — and nowhere else in mainland France — closed for 15 days starting on Sunday evening, to counter rising Covid-19 hospitalizations in the region.
“It’s a catastrophe, we are all anticipating permanent closures,” said Laurent Ceccarini, the owner of two restaurants, both a short walk from the Old Port in Marseille.
In the center of Marseille, a city of over 800,000 residents, French television on Monday showed some shuttered cafes and others that had briefly flouted the restrictions — until patrolling police officers calmly but sternly asked coffee-sipping customers to leave the sun-drenched terraces.
National authorities and some local health officials say the closures are a painful but necessary brake to prevent hospitals in both cities from being overwhelmed.
But some opponents of the targeted shutdown say it was imposed, with little warning, by vindictive government officials who want to punish Marseille’s rebel streak, which in recent months has coalesced around the figure of Didier Raoult, an eminent microbiologist from the city. His contrarian stance — including a claim, rejected by other scientists, that common drugs can cure Covid-19 — has endeared him to Marseille and its political class.
Officials are mounting protests and legal challenges against the new measures. One even said that the municipal police, ignoring government instructions, would not issue fines for establishments that broke the rules.
Growing numbers of Europeans are dismissing the threat of the coronavirus as media hype and sometimes embracing conspiracy theories, as the virus takes a second spin around the continent.
The sentiment echoed that of thousands of unmasked protesters who packed Trafalgar Square in the center of the city on Saturday, and a week earlier, rallying against Britain’s coronavirus restrictions. Many called the pandemic a hoax — even as the global death toll neared a million.
“Take off your mask” was freshly scrawled across an already-graffitied door alongside a strip of houses on London’s Portobello Road.
In Berlin, Brussels, Dublin and Paris, similar gatherings have gone ahead in recent weeks as coronavirus cases are again rising across much of Europe. But with health experts warning that a second wave has already arrived in some places and with many governments moving to reintroduce restrictions, the ranks of those dismissing the dangers of the virus and others calling it a government-led hoax have swelled.
Science has long shown that wearing a mask can prevent a person from spreading airborne illness, and new research suggests that it also protects the person wearing it. But protesters remain unconvinced.
In France, where infections have skyrocketed with a daily average of 12,000 new cases reported over the past week, critics have questioned the effectiveness of masks and new measures to control the spread, while others have urged people to ignore the government’s guidance entirely.
In Germany, there has been a growing and vocal number of German QAnon supporters, who contend that powerful players behind the scenes are using the virus to control the masses.
And in Slovakia, which on Friday recorded its highest number of new daily cases for a third day in a row, the country’s Ministry of Health this summer appointed a specialist to fight disinformation about the pandemic.
People who do not self-isolate in England will now face fines of up to 10,000 pounds, or almost $13,000, as the nation battles a second coronavirus wave.
As of Monday, it is illegal for those who test positive for the virus or have come into contact with a positive case to not quarantine for 14 days. The fines begin at £1,000 but could increase to £10,000 for especially egregious or repeated offenses. The government said it would begin offering a payment of £500 to lower-income residents who cannot work while isolating.
In addition, about two-thirds of the population in Wales will be under lockdown restrictions as of Monday evening. The rules largely ban nonessential movement outside of local areas.
The new rules come as Britain faces a surge in cases and what Prime Minister Boris Johnson called a “perilous turning point.” Earlier this month, Mr. Johnson announced a raft of new restrictions, including bans on most gatherings over six people and closing times of 10 p.m. for pubs and restaurants.
Britain recorded 5,692 new cases on Sunday, and the seven-day daily average is above 5,800, the highest since the pandemic began. There have been at least 434,900 confirmed cases of coronavirus in Britain, and as of Monday morning, nearly 42,000 people had died.
The government has not ruled out the possibility of a second national lockdown or one for the city of London. Britain has been using local lockdowns to try to control the spread of the virus.
“We must do all we can to avoid going down that road again,” Mr. Johnson said last week of a second national lockdown. “But if people don’t follow the rules we have set out, then we must reserve the right to go further.”
An uproar over precisely who faces restrictions has flared after The Times of London reported Monday morning that Parliament’s bars were exempt from the 10 p.m. curfew because they provide food and drink for a workplace. By late morning, that position seemed to have changed: “Alcohol will not be sold after 10 p.m. anywhere on the parliamentary estate,” a government spokesman said.
A new cloud of uncertainty hangs over the November election in Texas, as legal battles mount over how and when voters will cast their ballots because of the pandemic.
The Texas Supreme Court is weighing whether to delay the start of early voting, which had been scheduled to begin in two weeks, while it deals with questions raised by Republican lawmakers about whether voting could legally start that soon.
And a federal judge has temporarily blocked Texas from getting rid of straight-ticket voting, saying that doing so would lengthen wait times and worsen congestion at the polls. “Forcing Texas voters to stand in longer lines and increasing their exposure to a deadly virus burdens the right to vote,” wrote U.S. District Judge Marina Garcia Marmolejo of Laredo.
The Texas attorney general, Ken Paxton, said the state would appeal the decision.
In a state known for unusually long ballots, the century-old practice of straight-ticket or one-punch voting has been popular. It allows a voter to select a party’s entire slate with one ballot mark, instead of having to make separate marks for each race. About two-thirds of Texas voters used the straight-ticket option in the 2018 general election.
The Republican-dominated Legislature passed a law eliminating the option for this year, with proponents arguing that doing so would cause voters to become better informed and would bring Texas in line with most other states. Critics of the step, including the Democratic Party’s congressional campaign committees, sued the state, saying that eliminating the practice would have a discriminatory impact on Black and Hispanic Texans, who use it more than other voters do.
India’s coronavirus caseload has surpassed six million, the country’s health ministry announced Monday, as infections continued to grow across the South Asian country of 1.3 billion people.
India has the world’s second-highest caseload after the United States and has recorded at least 95,540 deaths, including 1,039 deaths in the past 24 hours. The country has recorded an average of 83,000 new cases a day for the past week, down from more than 90,000 cases earlier in the month.
At least 76,000 police and paramilitary forces personnel in India have been infected by the virus, with at least 400 deaths, the local media reported on Monday.
During his monthly radio address over the weekend, Prime Minister Narendra Modi renewed his appeal for people to wear face masks when outside their homes.
Despite years of progress, Black people continue to be underrepresented in science and engineering.
Whereas more than 13 percent of the United States’ population identifies as Black or African-American, Black people make up less than 7 percent of students who earn bachelor’s degrees in science or engineering fields and less than 5 percent of people granted doctorates in microbiology each year, according to the National Science Foundation.
The number of Black scientists has “been largely stagnant over the past decade,” said Johnna Frierson, the assistant dean of graduate and postdoctoral diversity and inclusion at the Duke University School of Medicine. In some fields, representation has even begun to decline — a trend that has worried experts. “There’s something in the system that is not optimized in order for us to continue diversifying in the way we hope to,” Dr. Frierson said.
A former virologist, she will participate in a panel on Monday as part of Black in Microbiology Week, the latest in a series of virtual events highlighting Black scientists in a variety of disciplines.
The event will feature seven days of talks, panels and online discussions under the microbiology umbrella, including the coronavirus, and address disparities in medicine, education and career advancement.
LaNell Williams, a member of Black in Microbiology’s programming team and a Ph.D. student at Harvard University, studies physics and virology, straddling two fields in which Black women are extraordinarily scarce.
During her time at Harvard, she has dealt with colleagues who have touched her hair without permission, dismissed her admission to her graduate program as affirmative action and used racial slurs in her presence. Over the years, she said, “I’ve gotten used to people not expecting much of me when I walk into a room.”
President Trump announced at the White House on Monday a plan to distribute 150 million coronavirus tests — rapid antigen tests that will expand the ability to detect infection, but that also tend to be less accurate — purchased by the federal government to states, tribes and other jurisdictions in the coming months.
The tests, a product called BinaxNOW manufactured by Abbott Laboratories, do not require specialized laboratory equipment and can yield results within 15 minutes, based on a quick and relatively painless swab that shallowly samples the nostrils. Adm. Brett P. Giroir, a member of Mr. Trump’s coronavirus task force, demonstrated the administration of one of the tests from a lectern in the Rose Garden.
Governors of some states, including New Jersey and Connecticut, announced on Twitter just before Mr. Trump’s news conference that they expected to receive thousands of the tests within coming weeks, and millions by year’s end. Some 6.5 million of those tests would ship this week, Admiral Giroir said.
The tests, which were given an emergency greenlight from the Food and Drug Administration in August, are cleared only for use in people with symptoms of Covid-19, and must be administered by, or in the presence of, a trained health care professional. Such tests are intended for use, according to Abbott, within the first seven days of when a person starts to feel ill. Testing in people who don’t have symptoms is thus considered off-label use — something the company was not required to submit data for to get their test approved.
The test is designed to look for antigens, or pieces of coronavirus proteins. Such tests tend to be less accurate than laboratory tests, most of which rely on a time-intensive but very reliable technique called P.C.R. Abbott has said that its test has been able to achieve results that mirror P.C.R. testing more than 97 percent of the time in the lab. But the longer a person waits, the worse the Abbott test performs. And experts have said those numbers will likely fall if the test is used outside of its target population.
“This is, it was said by Republicans and Democrats alike earlier, this is a game changer,” said Gov. Tate Reeves of Mississippi, a Republican, at the White House news conference, adding that the kits would allow teachers in his state to be tested more frequently.
Some have argued that frequent testing — perhaps on a weekly or even near-daily basis — could help compensate for the higher false negative rates of antigen tests. Such a feat, however, would require an even higher volume of tests than announced by the White House on Monday.
“I’m happy that they are trying to invest in technologies that would expand the number of tests that could be done in the U.S., and in particular, trying to signal demand for these rapid tests is useful,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “That said, 150 million tests is really a very small drop in the bucket considering how these tests are envisioned to be used.”
She added that “these tests haven’t been evaluated in people without symptoms. Certainly some clinicians may be inclined to use things off label. That doesn’t mean we understand how they will perform in people without symptoms.”
A number of experts have criticized the fast and frequent testing approach as logistically impractical, and worry that in certain populations where the virus is scarce, false positives could end up outnumbering true positives, compromising public trust in tests.
More than 100 million coronavirus tests of various approaches have been conducted across the United States, with nearly 850,000 conducted each day. But these numbers still fall short of the millions per day some experts say are needed to adequately assess the virus’s true prevalence in the population, and help keep outbreaks in check.
New cases have been trending steadily upward across the country, to around 43,000 daily over the last week as of Sunday, though they remain far below their peak levels from mid-summer. The Upper Midwest and Mountain West regions have struggled in recent days, with North Dakota, South Dakota, Wisconsin and Utah reporting the most recent cases per capita.
About 750 deaths were being reported each day over the last week as of Sunday, more than in early summer but far fewer than in the spring. The problems in the Midwest and West have been offset somewhat by relatively few cases in the Northeast, as well as sustained progress in populous states like Florida and California that were hit hard in June and July.
Mr. Trump said the tests will be distributed first to vulnerable populations. Among these groups will be those living in nursing homes and assisted living facilities, as well as those at historically Black colleges and universities and tribal nation colleges.
Authorities in North Dakota are trying to ease concerns over hospital capacity as the state grapples with the country’s steepest current surge in coronavirus cases.
Relative to the size of its population, North Dakota has reported more new cases in the last week — 363 per 100,000 — than any other state, according to tracking by The New York Times. (Neighboring South Dakota is second, at 322 per 100,000.) So far, the state has reported 234 coronavirus-related deaths, including four on Sunday.
North Dakota state health officials met in Bismarck with the leaders of two large hospital systems over the weekend, following news reports that hospitals in the state were so crowded with Covid-19 patients that they were deferring some elective procedures and putting Covid-19 patients in emergency-room areas for lack of beds.
Following the meeting, Dr. Michael LeBeau of Sanford Health, which operates hospitals in several states including North Dakota, said in a statement that the hospital system intended to announce plans later this week to increase bed capacity in Bismarck.
The number of active coronavirus hospitalizations in the state has nearly doubled, with 105 as of Sunday, compared with 57 two weeks ago. While North Dakota’s official figures suggest that there is still ample capacity in the state as a whole, some say that the stress on hospitals is growing acute in some areas. The leaders of Essentia Health warned last week in a statement that its hospital in Fargo was “at or near capacity.”
Gov. Doug Burgum, a Republican, is also dealing with criticism of his reluctance to issue a statewide mask mandate and his move to rescind a quarantine order for close contacts of people who test positive for the coronavirus.
The state’s interim health officer, Dr. Paul Mariani, resigned on Friday after Governor Burgum rescinded the quarantine order. Dr. Mariani was the third person to hold the position since the start of the pandemic.
Not only are businesses shedding workers, with America’s unemployed numbering roughly 13.6 million, but employers are also cutting expenses like health coverage, and projections of rising numbers of uninsured have grown bleak.
Tens of millions of people could lose their job-based insurance by the end of the year, said Stan Dorn, the director of the National Center for Coverage Innovation at Families USA, a consumer group in Washington, D.C. “The odds are we are on track to have the largest coverage losses in our history,” he said.
While estimates vary, a recent Urban Institute analysis of census data says at least three million Americans have already lost job-based coverage, and a separate analysis from Avalere Health predicts some 12 million will lose it by the end of this year. Both studies highlight the disproportionate effect on Black and Hispanic workers.
Many businesses have tried to keep their workers insured during the pandemic. Employers relied on government aid, including the Paycheck Protection Program authorized by Congress to ease the economic fallout, to pay for premiums through the spring and summer.
Government funding appears to have “prevented the economic crisis from becoming a coverage crisis right away,” said Leemore S. Dafny, a professor at Harvard Business School and one of the authors of a report last month looking at the pandemic’s effect on small business.
Describing those employers as “the proverbial canary in the coal mine,” the researchers say there could be significant coverage losses if insurers and lawmakers fail to act in the coming months. Nearly a third of small businesses surveyed in late June said they were not sure they could keep paying premiums beyond August, according to the report.
The strict stay-at-home order issued by Myanmar last week for its largest city, Yangon, barred residents from traveling from any of its 44 townships to another. There are some exceptions, such as for police officers, emergency workers and doctors.
But one group not given special status to cross township boundaries is the news media. That includes reporters, photojournalists and the drivers of newspaper delivery trucks. The exclusion prompted protests Monday from journalists and news vendors alike.
“How can we stay at home while we need to cover the news as videojournalists?” said U Wai Yan, a correspondent with Xinhua News. “If the people do not get the true news, then there might be lots of rumors, and these are toxic for people.”
With cases of the coronavirus soaring, the government has issued stay-at-home orders for Yangon, a city of seven million people. It issued similar restrictions in Rakhine State, where the first major outbreak occurred, and most recently for three townships in Mandalay, a city of one million.
Myanmar, which was ruled for decades by the military, is one of the poorest nations in Southeast Asia, and doctors say that its underfunded medical system would be quickly overwhelmed if the virus is not contained.
The number of reported cases has skyrocketed over the past month to nearly 11,000, with 226 deaths. But the rate of testing in Myanmar is among the lowest in the world and the number of cases is likely much higher.
On Sunday, the government issued a requirement that anyone seeking an exception to the travel restrictions must register online. But it included no category for members of the media.
“I would say the government does not understand the importance of independent private media,” said U Myint Kyaw, secretary of the Myanmar Press Council.
The council, which seeks to protect the media’s interests, has appealed to the government to provide an exemption so that reporters can cover the news and newspapers can be delivered.
Critics said the restrictions on movement would make it more difficult for news organizations to cover Myanmar’s national election, which is scheduled for Nov. 8.
The main opposition party argues that holding the election in the middle of a pandemic favors the ruling party of Daw Aung San Suu Kyi, the country’s civilian leader, and has called for it to be postponed. Election officials have rejected a delay.
Sonny Swe, the founder and chief executive of the influential magazine Frontier Myanmar, said journalists must have sufficient freedom of movement so they can cover the election, the health crisis and other significant events.
“I can understand the restrictions and necessary measures for the sake of public health,” he said. “But the media should be considered an essential business.”
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A 61-year-old Afghan man died on Sunday in Greece, becoming the first resident of a Greek migrant reception facility to die of the virus. The man, a father of two, died in an Athens hospital. He had been living in the Malakasa camp near the city, a Greek Migration Ministry official said, adding that his two children have been tested and are isolated within the camp. Malakasa is one of nine migrant reception facilities on the mainland that are locked down because of virus outbreaks.
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A cruise ship carrying more than 1,500 people was turned back from the Greek island of Milos in the Aegean Sea after 12 crew members tested positive for the virus, a Greek Shipping Ministry official said. The Mein Schiff 6, which sails under the flag of Malta, left Crete on Sunday and was off the coast of Milos early on Monday when the test results were released, the official said.
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The municipal government in Beijing announced new procedures to allow medical personnel to bypass their bosses in reporting health emergencies directly to hotlines and government agencies. The rules are supposed to protect whistle-blowers’ identities and shield them from any retaliation. The goal, although not mentioned by the Beijing authorities, appears to be to prevent any repeat of the slow response last winter to the emergence of the coronavirus in Wuhan, China. The ophthalmologist who sounded the alarm there on social media, Dr. Li Wenliang, was called in by medical officials and the police and forced to sign a statement denouncing his warning; he later died of the disease.
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The next Group of 20 summit meeting, which was scheduled to be held in Riyadh, Saudi Arabia, will take place virtually on Nov. 21 and 22, the kingdom said in a statement on Monday. Saudi Arabia, which holds the group’s rotating presidency, also hosted an emergency virtual summit meeting in March in response to the pandemic.
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