Coronavirus Live Updates: Crisis Builds From Coast to Coast in U.S. as Death Toll Nears China’s

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Credit…Sarah Blesener for The New York Times

The American public on Tuesday is expected to get its first look at the statistical models guiding the policy decisions that have led governors and mayors across the country to order more than 250 million people to stay at home.

It is expected to be unsettling.

Dr. Deborah Birx, the White House coordinator for the virus response team, tried to brace both President Trump and the country for some tough weeks ahead.

Even if all of the social distancing guidelines are followed “perfectly,” Dr. Birx said, the death toll in the nation could reach 100,000 to 200,000.

The United States already has the highest number of reported infections in the world, with 160,000, and has yet to fully ramp up testing, meaning that many cases are going undetected.

As the death toll ticked past 3,000 on Tuesday, the nation was set to overtake that of China, where 3,305 people have reportedly succumbed to the virus, although the Chinese figures are coming under increasing scrutiny.

Nations across Europe also continue to see a steady rise in new infections and deaths. France has surged past 3,000 fatalities. And the virus has ravaged Italy and Spain — where the countries’ combined death toll approached 20,000, roughly half the global total — demonstrating the high price nations can pay if the virus outstrips the capacity of a nation’s health care system.

In the United States, the outbreak in New York remains the largest in the nation, with more than 1,200 deaths, and is weeks away from its apex, Gov. Andrew M. Cuomo warned. More than 250 coronavirus patients died between Sunday and Monday, and the governor said that number could ultimately reach 800 a day.

“I want to prepare for that apex, because this virus has been ahead of us every step of the way,” he told reporters.

In Michigan, state officials reported 50 additional deaths on Monday, even as they cautioned that the outbreak was still in the early stages.

Gov. John Bel Edwards of Louisiana said his state was a few weeks behind New York, as he reported a surge in deaths to 185 from 34 in just 24 hours.

Virginia, Maryland and the District of Columbia became the latest places to order residents to stay at home.

The models used by the White House team are standard epidemiological tools but are not precise, as the results can vary widely depending on how closely people follow the guidelines. In other words, the assumptions built into the models can shape the results.

Across Asia, countries that thought they had the coronavirus pandemic under control are now worried that people from outside their borders will import cases and cause a new wave of outbreaks.

In a flurry of recent moves, China, Hong Kong and Singapore barred foreigners from entering. Japan has barred visitors from most of Europe and is considering further bans of travelers from countries including the United States. South Korea is requiring travelers from all other countries to quarantine for 14 days upon arrival. Taiwan has also barred foreigners.

In China, international flights to the country have been cut back so severely that students abroad wonder when they will be able to get home. In Singapore, people who have returned from overseas receive daily text messages from public health authorities, signaling them to check in and prove that they are sticking to quarantines.

“It seems like leaders will sometimes lurch from complacency to an almost panicked lockdown approach,” said Karen Eggleston, the director of the Asia health policy program at the Shorenstein Asia-Pacific Research Center at Stanford University.

“It’s not entirely clear which one in the end is going to lead to the greater costs, but at this point in the pandemic, when we have exponential growth,” closing borders, she said, “can be the prudent approach.”

As countries grapple with measuring the scale of the coronavirus pandemic, concerns are growing that some are being less forthcoming about the true scope of their outbreaks, including China, North Korea and Indonesia.

China on Tuesday announced more than 1,500 coronavirus cases that had not previously been made public, giving in to pressure for greater transparency nearly two weeks after officials there first announced zero new local infections.

Questions about the accuracy of China’s numbers have circulated since the start of the pandemic there, even as the country has touted its apparent success in bringing the outbreak under control. The 1,541 newly announced cases were people who had tested positive but were asymptomatic, according to an official at China’s National Health Commission.

China had not previously included asymptomatic patients in its public tallies of confirmed cases, even though the World Health Organization recommends doing so, and many within China and abroad had expressed fear about the true scale of the epidemic.

It was not immediately clear whether the 1,541 figure represented the total number of asymptomatic infections detected in China, or merely a fraction. The South China Morning Post, a Hong Kong-based newspaper, recently reported that asymptomatic cases could number as many as 43,000, or one-third of China’s total case count, citing classified government data.

In the case of North Korea, many observers doubt its claims to not have a single coronavirus case, though some attribute it to a lack of testing equipment. Others accuse the government of hiding an outbreak​ to preserve order.

In Indonesia, the government has for weeks reported zero cases. Yet in a sign that the coronavirus is there faster than the government acknowledges, Jakarta’s governor says deaths in the capital may be around 283, nearly four times the official count.

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Listen to the Call: Bullock and Trump Discuss Testing

Gov. Steve Bullock of Montana discussed the difficulty of getting access to coronavirus tests on a conference call with President Trump and other governors.

“Literally, we are one day away if we don’t get test kits from the C.D.C. Then we wouldn’t be able to be tested in Montana. We have gone, time and time again, to the private side of this. The private market, in where the private market is telling us that it’s a national resource that are then taking our orders apart. Basically, we’re getting our orders canceled. And that’s for PPE. That’s for testing supplies. That’s for testing equipment. So, while we’re trying to do all the contact tracing, we don’t have adequate tests to necessarily do it. We don’t have the [inaudible] along the way, and we’re not finding markets to be able to do that. Along the way are private suppliers. So we do have to rely on a national chain of distribution or we’re not going to get it. But we are doing our best to try to do exactly that. Like, Gallatin County would be an example where we have almost half of our overall state’s — those are the positives. We’re trying to shift the supply to really isolate that and do the contact tracing, but we just don’t have enough supplies to even do the testing.” “Right. Tony, uh, you can answer it if you want, but I haven’t heard about testing in weeks. We’ve tested more now than any nation in the world. We’ve got these great tests, and we come out with another one tomorrow where, you know, it’s almost instantaneous testing. But I haven’t heard about testing being a problem.”

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Gov. Steve Bullock of Montana discussed the difficulty of getting access to coronavirus tests on a conference call with President Trump and other governors.

President Trump on Monday expressed optimism about the federal government’s ability to provide adequate testing for the coronavirus and suggested that it would soon be producing so many ventilators, masks and other personal protective equipment that it would be able to send stocks of supplies to other countries.

America’s governors painted a different picture on the ground.

In a conference call with governors on Monday, Mr. Trump said that he “hasn’t heard about testing in weeks,” suggesting that a chronic lack of kits to test people for the coronavirus is no longer a problem. Yet one governor said his state was “one day away” from not being able to test anyone at all.

Hours later, Mr. Trump’s comments at a news conference suggested that he thought the scarcity of ventilators and other supplies, which has become an emergency in some states, will soon end.

But in New York, where deaths from the coronavirus jumped above 1,200 and a hospital ship arrived to ease the pressure on overwhelmed hospitals, Gov. Andrew M. Cuomo said the worst of the outbreak was yet to come.

“You have to prepare before the storm hits, and in this case the storm is when you hit that high point, when you hit that apex,” the governor said. “How do you know when you’re going to get there? You don’t.”

In Virginia, Maryland and Arizona, governors from both parties issued new stay-home orders.

In Washington, the Food and Drug Administration granted emergency approval permitting the use of two malaria drugs to treat coronavirus patients, and Speaker Nancy Pelosi, Democrat of California, said it was only a matter of time before Congress would act on a fourth relief measure to try to contain the economic fallout of the pandemic.

“This isn’t about how fast we can do it,” she said. “It’s how fast we must do it.”

In the nation’s jails, prisoners are worried about their health as they wipe down communal phones with prized alcohol wipes and washed down cell bars and table tops with diluted shampoo.

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Over 12,000 health care workers have contracted Covid-19 in Spain amid grave shortages in personal protective equipment. Nurses and doctors showed us how they make their own gowns, masks and shields.CreditCredit…Courtesy of Alfonso Vidal

Health care workers have been hailed as heroes, the front-line soldiers taking grave risks to save lives in the fight against the coronavirus. But Eugenia Cuesta, an emergency room nurse at a Madrid hospital, thought there was a more apt metaphor.

“They’re turning us into health care kamikazes,” Ms. Cuesta, said in a video interview.

Like the pilots sent to their deaths during World War II, she said, health care workers were being asked to sacrifice their health without proper protection.

Hospital beds do not offer sufficient space for workers to safely care for patients. Weeks into the crisis, there is still a shortage of protective equipment for doctors and nurses. And health professionals in Madrid have denounced the “chaos” and “disaster” inside an exhibition center converted into a field hospital.

Over 13,000 health care workers have been infected in Spain, the highest reported rate in the world. On Monday, officials said that Fernando Simón, a calming figure who has led the country’s response to the epidemic, had also tested positive for the virus.

Spain reported over 9,000 new cases on Tuesday and set a new daily record overnight of 849 deaths, totaling over 8,000 casualties.

In Madrid, the authorities have presented the field hospital at the exhibition center as the “largest hospital in Spain.” But health care associations are suing the authorities over the level of basic protection gear provided to workers.

“We cannot expose our professionals and let them enter without protection” into the exhibition center, said Alicia Martín, a union representative for primary care professionals.

The central government is considering moving patients out of Madrid and other saturated areas to other regions that have been less affected by the coronavirus.

Exactly 32 years after a group of young activists gathered to form Fidesz — which is now Hungary’s governing party — its leader, Prime Minister Viktor Orban, has been granted the authority to rule the country unchallenged indefinitely.

The party, which controls Parliament, on Monday adopted a sweeping act extending a state of emergency in response to the coronavirus. The measure allows Mr. Orban to suspend elections and existing legislation and to rule by decree until he declares the emergency over.

The situation is an example of how the crisis has accelerated democratic backsliding in the West, as countries across the world face increasing political and economic uncertainty.

Since Mr. Orban was propelled back into power in 2010, his party has adopted a new Constitution, altered election laws and stacked the justice system with loyalists. His allies also control the state news media and most of the country’s private media outlets.

“The new state we are building,” Mr. Orban said in 2014, “is an illiberal state.”

Some monitoring groups say that Hungary has an authoritarian regime, and others rank the country as one of the most corrupt in Europe. Now, the reshaping of its democratic framework has cemented Mr. Orban’s control over the small Eastern European nation.

Tracking the movements of infected people is critical for stemming the spread of disease. And at a time when cellphones are a powerful personal tracking tool, it is not surprising that governments want to harness that potential to aid in the fight against the coronavirus.

But in the European Union, which has strict laws to protect people’s digital privacy, using such technology is a complicated and thorny issue.

That friction is coming to the fore in Germany, where the government is considering introducing an app that would allow the authorities to quickly alert anyone who may have come into contact with someone who is found to have been infected.

As researchers across Europe scramble to develop an app that would respect personal privacy while still helping track the virus, Germany’s justice minister, Christine Lambrecht, said on Tuesday that the government could not require people to use such technology.

“Voluntary use is a very important aspect here,” she told the public broadcaster Deutschlandfunk. “We will not and we do not want to get around that.”

Digital tracking measures have been credited with keeping public life going in Singapore and South Korea, while still limiting the spread of the virus.

In Europe, Poland is using an app to track the movements of an estimated 10,000 people who are under home quarantine because they either tested positive for coronavirus or recently returned from abroad. Users are required to upload selfies several times a day to prove that they are following the rules of self-isolation, and any lapse in compliance results in an alert being sent to the police.

In Croatia, rights groups are pushing back against proposed legislation to monitor cellphones, saying that it would be “an unnecessary violation of human rights.”

Germany’s health minister has called for a nationwide debate about the ethics of using such technology. Polls have shown an increasing willingness among Germans to rely on digital technology to combat the spread of the virus, in exchange for a return to more personal freedom.

The World Health Organization said it was hopeful that coronavirus outbreaks in some of the hardest-hit nations in Europe are beginning to stabilize, after Italy reported the smallest number of new cases in almost two weeks on Monday.

The comments outlined how European lockdowns are beginning to have an impact.

Mike Ryan, the W.H.O.’s head of health emergencies, said at a news conference that it was the agency’s “fervent hope” that Italy and Spain are approaching a peak in the number of new cases even as the combined death toll in the two countries has approached 20,000.

Still, elsewhere across the continent, countries are still grappling with an influx of new cases and deaths. France reported a total of 44,550 confirmed cases on Monday and 3,024 deaths — including the biggest increase in its death toll — as the authorities continued to evacuate patients away from the most affected areas, sometimes to hospitals abroad.

Jérôme Salomon, a top official at France’s health ministry, said that over 5,000 people were in intensive care. Until recently, that was France’s maximum capacity, but Mr. Salomon said that hospitals had pushed that ceiling up to 8,000 beds nationally and that the government was aiming for 10,000 soon.

France has also started importing over a billion face masks from China, in what the government has called a huge “airlift” that will take place over several weeks.

As new infections surge around the globe, crowded cities are increasingly turning to the police to enforce restrictions on movement. And in Britain, some are accusing the police of overreach.

There is “a strong temptation for the police to lose sight of their real functions and turn themselves from citizens in uniform into glorified school prefects,” Jonathan Sumption, a former Supreme Court judge, told the BBC on Monday.

The police in Britain have been given an extended set of powers, including the authority to instruct people to leave a place or return home, and issue fines to anyone who is out in public for anything other than necessary shopping, exercising once a day, or traveling to and from essential work. Officers have issued summons for people for taking drives “out of boredom” and reprimanded others for sitting in the park.

Nor is Britain alone. In New York, Mayor Bill de Blasio said on Sunday that he had given police officers the power to issue fines when necessary. In France, more than a quarter of a million people have been fined since restrictions on movement were announced, according to Interior Ministry figures. And in Italy, the country hardest hit by the outbreak in Europe, anyone violating quarantine rules can be fined up to 3,000 euros, about $3,300.

But some have expressed discomfort with the new measures.

Mr. Sumption, the former judge, condemned the conduct of the Derbyshire Police as “disgraceful” after they posted a video criticizing people walking dogs and taking photos in a national park.

“This is what a police state is like,” he said on Monday. “It’s a state in which the government can issue orders and express preferences with no legal authority and the police will enforce ministers’ wishes.”

Experts keep saying to plan for this to last for a long time. And with many communities a week or more into being homebound, the novelty is wearing off. Here are some tips to help fight burnout, manage antsy teenagers, and even freshen up a home to make it better suit current needs.

It has returned to “a wartime factory,” Mayor Bill de Blasio said as he toured a former shipbuilding hangar there on Thursday.

That hangar had become an events space called the Duggal Greenhouse, part of Duggal Visual Solutions, a graphic display and printing company that typically makes printed glossy graphics for such brands as Estée Lauder and Coach.

But with the greenhouse’s scheduled events canceled because of the coronavirus outbreak, the space has been repurposed as a factory for making disposable face shields. The operation includes more than 300 workers, many recently laid off from restaurant jobs or nonessential businesses that the state ordered to temporarily close.

Kings County Distillery, a small-batch whiskey and bourbon company, has begun distilling alcohol for hand sanitizer in partnership with EcoLogic Solutions, which makes green cleaning products.

Reporting and research were contributed by Aurelien Breeden, Constant Méheut, Selam Gebrekidan, Marc Santora, Megan Specia, Joanna Berendt, Benjamin Novak, Raphael Minder, Elian Peltier, Steven Erlanger, Iliana Magra, Donald G. McNeil Jr., Anna Schaverien, Maria Abi-Habib, Sameer Yasir, Raymond Zhong, Knvul Sheikh, Melissa Eddy, Choe Sang-Hun and Richard C. Paddock.

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