Coronavirus Live Updates: Global Alarm as the Toll Continues to Rise

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Credit…Gabriela Bhaskar for The New York Times

The White House has signaled that American companies are increasing efforts to restock hospitals with crucial supplies during the pandemic, but it has stopped short of more assertive steps that some state and local leaders have been demanding.

Vice President Mike Pence said at a news conference at the White House on Saturday that the federal government had ordered hundreds of millions of N-95 masks for health care facilities, but he did not say when they would be delivered.

The White House’s moves appeared unlikely to satisfy calls for more aggressive action as the nation grappled with a reorientation of American life. More than 21,000 cases have been confirmed in the United States, a number expected to soar in the coming weeks.

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‘We’re Working Quickly,’ Trump Says About Coronavirus Relief Efforts

President Trump discussed his approval of a major disaster declaration for the State of New York, attempts to address medical supply shortages and other developments in the pandemic.

We’re working quickly to pass additional legislation that will provide massive relief to small businesses and affected industries, and give direct payments to our great workers and hardworking American families. Last night, I approved a major disaster declaration for the State of New York. I worked very closely with Governor Cuomo. And this is the first time in our nation’s history that a president has used the Stafford Act to declare a major disaster in response to a public health crisis. Never happened before. I’m considering other areas where we may or may not be doing that. And I’m working very closely with Gavin Newsom, governor of California, and others. We may be doing the same thing depending on their needs, depending on what they’re asking for. There’s been a clear call to action to the private sector and the call is made right here. It’s been really pretty amazing what’s happened with the private sector — they are really in sixth gear, I think — which has responded in full force, helping to produce and supply much needed masks, swabs, sanitizers, ventilators, and everything else. This is a move on that’s incredible right now. And by way of example Hanes — everybody knows Hanes, great company, great consumer cotton products company— is retrofitting its manufacturing capabilities in large sections of their plants to produce masks. And they’re in that process right now. As you can see over 195,000 people in America have completed their testing. That means tests plus results. This does not count the people whose tests are in process. And as you see this curve is going, it will continue to rise dramatically over the next period of time. Now on a personal note many of you may have been made aware that a member of my staff has tested positive for the coronavirus. We learned of that late yesterday. I am pleased to report that he is doing well. He had mild coldlike symptoms for about a day and a half, has not been to the White House since Monday. Neither the president nor I had direct contact with that staff person. We worked immediately with a White House physician and the C.D.C. We’ve done all contact tracing And, although the White House doctor has indicated that he has no reason to believe that I was exposed and no need to be tested, given the unique position that I have as vice president and as leader of the White House coronavirus task force, both I and my wife will be tested for the coronavirus later this afternoon.

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President Trump discussed his approval of a major disaster declaration for the State of New York, attempts to address medical supply shortages and other developments in the pandemic.CreditCredit…Al Drago for The New York Times

Officials in a number of states, including New York and California, have warned of dwindling supplies of crucial gear, like protective equipment, and what they believe will be a vast demand for ventilators.

Mr. Trump has sent conflicting signals on how the federal government might address the supply issues. On Saturday, he said that he had not used the Defense Production Act — which empowers the government to mobilize the private sector to increase the production of scarce goods — because companies were stepping up voluntarily. He cited Hanes and General Motors, which he said would make masks and ventilators.

“We want them on the open market from the standpoint of pricing,” Mr. Trump said.

A Hanes spokesman said the company had agreed to make up to six million masks a week along with a group of other yarn and clothing companies after Trump administration officials reached out about a week ago. The masks will not be the highly sought-after N-95 masks. Hanes is negotiating a contract with the U.S. government to supply the masks at market rates, the spokesman said.

Other companies the administration announced coordination with include Honeywell and 3M. Mr. Trump also said Pernod Ricard USA had repurposed production facilities in four states to manufacture hand sanitizer, with the first delivery expected on Tuesday. Tim Cook, Apple’s chief executive, said on Saturday that the company would donate millions of masks to health professionals in the U.S. and Europe.

Also on Saturday, a spokesman for Mr. Pence said he and his wife had tested negative for the coronavirus. They were tested after an official in Mr. Pence’s office was confirmed to be infected.

Gov. David Ige of Hawaii has ordered a mandatory 14-day quarantine for everyone arriving in Hawaii, including tourists and returning residents.

Starting on Thursday, returning residents are to quarantine in their homes, and visitors are to stay in their hotel rooms or rented lodgings. They are to leave only to seek medical care.

“The threat of Covid-19 is extremely serious, and it requires extreme actions,” Mr. Ige said in a news conference on Saturday.

Mr. Ige said in a Facebook post that failure to follow the order would be punishable by a fine of up to $5,000, up to a year’s imprisonment or both. The Hawaii Department of Health on Saturday reported 48 cases of coronavirus in the state, an increase of 11 from the day before.

The governor said the delay in putting the order in place was to give tourists time to cancel or postpone their trips, which he said he hoped they would do.

“We know that our economy will suffer from this action,” he said, adding that the move was necessary so that the state’s health care system is not overwhelmed.

As the number of global coronavirus cases surpassed 300,000 and the death toll rose to more than 13,000, the World Health Organization’s top emergency expert said on Sunday that countries could not simply lock down their societies to defeat coronavirus without public health measures to avoid a resurgence of the virus down the road.

“What we really need to focus on is finding those who are sick, those who have the virus, and isolate them, find their contacts and isolate them,” the expert, Mike Ryan, said in an interview on the BBC’s “Andrew Marr Show.”

“If we don’t put in place the strong public health measures now,” he said, “when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up.”

  • The Spanish government, meanwhile, is extending for another 15 days the country’s state of emergency, local reports said, as the death toll rose to 1,720 on Sunday amid over 28,000 confirmed cases in the country. And an earthquake hit the Croatian capital, Zagreb, Sunday morning, complicating quarantine measures to slow the spread of the outbreak. Spain’s nationwide state of emergency bars people from all but essential outings.

Lorenzo Sanz, the former president of the soccer powerhouse Real Madrid, died on Saturday, becoming the most prominent person to succumb to the virus in the country to date. Mr. Sanz, 76, led the soccer club from 1995 to 2000. He was taken to hospital with fever this past week and had kidney failure, according to local news reports. The Madrid region has been the epicenter of the Spanish coronavirus crisis, with more than 800 deaths.

  • The quake in Croatia struck during a partial lockdown. People have been warned to avoid public areas such as parks and public squares, but the tremors sent residents pouring into the streets. A 15-year-old was reported to be in critical condition and others were injured, news outlets reported.

The earthquake, measuring magnitude 5.3, hit around 6:30 a.m., and was followed by two aftershocks. Photos shared on social media showed extensive damage to the city’s center, with facades crumbling, cars crushed and the spire atop the city’s cathedral snapped off. There were also reports of power cuts and sporadic fires. It was the strongest earthquake to hit the city since 1880.

The police ordered residents to leave their homes and buildings, while the government asked residents to keep their distance from one another. The defense minister said the army would aid the rescue efforts. Croatia has experienced a spike in Covid-19 infections, with 78 new cases reported Saturday, bringing the total to 235, but no reported deaths.

  • Uzbekistan, which has reported 42 cases, said it would close its borders from Monday and require residents to wear masks if they leave their homes. The country’s commission to prevent the spread of the coronavirus said the country’s borders with Kazakhstan, Turkmenistan, Kyrgyzstan, Afghanistan and Tajikistan would be closed to everyone except foreign citizens leaving the country and international cargo haulers. From Wednesday, anyone not wearing a mask in a public place will be fined, the commission said.

  • In Iran, the supreme leader, Ayatollah Ali Khamenei, rejected a reported offer of assistance from the United States to fight the coronavirus, citing an unfounded conspiracy theory that the virus is man-made. Ayatollah Khamenei on Sunday called the offer strange.

“Several times Americans have offered to help Iran to contain the virus. Aside from the fact that there are suspicions about this virus being created by America,” he said in a televised speech. “Their offer is strange since they face shortages in their fight against the virus. Iran has the capability to overcome any kind of crisis, including the coronavirus outbreak.”

On Sunday, a spokesman for Iran’s health ministry announced 29 new virus deaths, raising the total to 1,685. The spokesman, Kianush Jahanpur, said on state television that there had been 1,028 new confirmed cases in the past 24 hours, raising the total to 21,638, with 7,913 people recovered.

The French medical charity M.S.F., or Doctors Without Borders, said on Sunday that it was setting up a 50-bed emergency center to treat severe Covid-19 cases in Iran. A team of nine intensive-care medics will work at the facility on the grounds of Amin Hospital in the central province of Isfahan, the charity said, as Iran grapples with the worst outbreak of coronavirus in the region.

  • The number of coronavirus cases in the Czech Republic rose to 1,047 as of Sunday morning, Health Ministry data showed. Six people have recovered, and there have been no reported deaths. Health workers had tested 15,584 people as of Saturday.

  • Belgium is heading into “the peak of the epidemic, after which the curve will go down,” the country’s health minister, Maggie de Bock, said on Twitter on Sunday. “I think that this situation will last at least eight weeks, that would be the normal curve.”

The nation of 10 million, which hosts the European Union institutions, has seen confirmed coronavirus cases and deaths jump in the past few days despite adopting stringent measures to curb economic and social activities. There were 3,400 confirmed cases and 75 deaths as of Sunday. Over the weekend, police vans were deployed in Brussels neighborhoods asking people to stay indoors and to observe strict social-distancing measures.

  • Poland has reported fewer than 500 cases, but one of the country’s hospitals was shut down and evacuated on Saturday after 30 patients and staff members were found to have the virus. France, one of the countries in Europe hit the hardest, raised its totals to 14,459 confirmed cases and 562 deaths, and said it had ordered over 250 million face masks from French and foreign suppliers.

  • The Palestinian government on Sunday ordered residents of the Israeli-occupied West Bank to be confined to their homes for two weeks as a precaution against the spread of coronavirus. Prime Minister Mohammed Shtayyeh said the quarantine would go into force at 10 p.m. local time, with medical personnel, pharmacists, grocers and bakers exempt.

  • Italy has imposed a lockdown, deployed the army and risked its economy to try to stop the spread of the coronavirus. Yet the virus’s toll is growing more staggering by the day: On Saturday, officials reported 793 additional deaths, by far the largest single-day increase. Italy has surpassed China as the country with the highest death toll, becoming the epicenter of a shifting global pandemic.

Italy increasingly being seen as a tragic warning for other countries to heed, in part because it is paying the price of early mixed messages by scientists and politicians. The people who have died in staggering numbers recently — more than 2,300 in the last four days — were mostly infected during the confusion of a week or two ago.

  • In Pakistan, where Prime Minister Imran Khan has resisted implementing a total lockdown, provincial governments are calling for one that comes with strict measures for those who violate it. Several provinces have sought help from the military, which is setting up temporary medical facilities and deploying doctors to help provide civilian medical services.

On Sunday, Prime Minister Boris Johnson of Britain had stern advice for the nation as it celebrated Mother’s Day: Don’t visit your mother.

“If your mother is elderly or vulnerable, then I am afraid all the statistics show that she is much more likely to die from the coronavirus,” Mr. Johnson wrote in an opinion article published by The Times of London. “We cannot disguise or sugarcoat the threat.”

The message came as local news outlets reported that the National Health Service planned to send personally addressed letters to 1.5 million people judged most likely to die from the disease, saying they should isolate themselves for the next 12 weeks.

People with any of more than a dozen serious conditions — including cancer and respiratory diseases — and transplant patients will receive the letter from their general practitioners in the next 24 hours. Of those affected, 40 percent are over the 75, The Sunday Times reported. All people over 70 in the country had already been advised to observe stringent social distancing.

The move came after the N.H.S. said it had struck a deal with independent hospitals on Saturday for about 20,000 extra staff members; 8,000 more hospital beds across England, of which at least 2,000 will be in London; about 1,200 extra ventilators; and more than 10,000 nurses and 700 doctors joining the system to help tackle the pandemic.

It is the first time such a deal has been agreed to, the N.H.S. said.

“We’re dealing with an unprecedented global health threat and are taking immediate and exceptional action to gear up,” Simon Stevens, the services’s chief executive, said in a statement.

The measures came after the government had for days refused more stringent measures. But Mr. Johnson then announced the shutdown of pubs, cafes, restaurants, clubs, gyms and theaters from Friday night.

The government is also working to repatriate hundreds of Britons who have been stranded in Peru since that country announced a lockdown last week. Britain’s Foreign Office said in an email on Sunday that a flight would leave Peru for Britain early this week and that it was working to arrange further flights in the coming days.

To fight the economic effects of the outbreak, Germany is effectively suspending a long-held tradition — some would say obsession — with balanced budgets. Officials are preparing to make available another 150 billion euros, more than $160 billion, to help the country weather the fallout.

The budget plan, which includes measures to help companies survive the looming recession and secure millions of jobs, is expected to be passed Monday.

“We have a big challenge ahead of us,” said Olaf Scholz, the finance minister. Justifying the decision to borrow more than 10 times what Germany’s normally strict budget rules would allow for, he said that “150 billion is a very big sum, but it gives us the opportunities that we need now.”

Not all Germans have been following the social-distancing guidance to stem the outbreak, with several cities and states reporting groups of people socializing. As a result, Chancellor Angela Merkel will discuss the prospect of harder curfews with the premiers of Germany’s 16 states on Sunday afternoon.

Ms. Merkel, meanwhile, was spotted at her local supermarket in Berlin this weekend, demonstrating what responsible shopping looks like in times of the coronavirus. Keeping her distance from other shoppers, a smiling Ms. Merkel had cherries, soap, several bottles of wine and toilet paper — one pack — in her shopping cart, photos on social media showed.

She paid by card, effectively discarding another German tradition: paying cash. Many stores have become averse to exchanging coins and notes during the outbreak.

Officials on Sunday reported the first two coronavirus cases in the densely populated Gaza Strip, where aid workers say the virus’s spread could quickly lead to a public health disaster.

Two Palestinian men who had been in Pakistan and then entered Gaza via Egypt have tested positive for the virus, said Yousef Abu Al-Reesh, the deputy health minister in Gaza. The men, age 53 and 78, are being treated in a field hospital in Rafah.

Health officials said they had quarantined a number of people who interacted with the men.

International aid groups have been bracing for the arrival of the coronavirus in Gaza, an impoverished coastal enclave where medical facilities have eroded under a 13-year blockade maintained by Israel and Egypt.

The United Nations has been leading an effort to obtain testing kits and protective gear for medical workers for Gaza, and a team was headed there on Sunday to assess whether its quarantine and intensive care facilities were up to the task, said Jamie McGoldrick, the U.N.’s humanitarian coordinator for Palestine.

He said that about 1,000 people had returned to Gaza from abroad during the coronavirus pandemic; 2,000 more are still expected and will need to be screened and quarantined as they arrive.

Officials of Hamas, the militant group that controls Gaza, said this weekend that they would close all restaurants, wedding halls and weekly markets.

Just days ago, funerals in Gaza were still drawing large crowds, Mr. McGoldrick said. “Hopefully, this will ring an alarm bell and people will become much more worried and disciplined in how they move around,” he said.

Doctors need to wear gloves, gowns, eye gear and masks when treating coronavirus patients. But hospitals have been running dangerously low on essential supplies for weeks, and many medical professionals on the front lines do not have adequate protection.

Why is this happening?

A widespread buying of masks by anxious consumers and the prolonged outbreak in China diminished the supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold but continues to hold onto its supply.

The outbreak also came after a particularly mask-intensive few months. Wildfires in California and in Australia had diminished some humanitarian organizations’ supplies.

Ideally, clinicians would be using a new, tightly sealed respirator like the N95 with each patient. These are thicker than standard surgical masks and are designed to fit more tightly around the mouth and nose to block out much smaller particles.

The Food and Drug Administration said that neither surgical masks nor N95s should be shared or reused, but the C.D.C. updated its recommendations to optimize the limited supply of protective gear.

“As a last resort,” the C.D.C. said “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.

Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.

Australia’s prime minister, Scott Morrison, announced a nationwide shutdown of pubs, clubs, casinos, churches and other gathering places on Sunday night, seeking to force young people in particular to practice social distancing, after a weekend in which the country’s confirmed coronavirus cases spiked.

“I would seek and implore Australia to follow this advice,” Mr. Morrison said. “You’ll be saving lives and you’ll be saving livelihoods.”

Mr. Morrison said that many small businesses would be allowed to stay open, but restaurants would be limited to takeout and delivery service. Schools will remain open in most of the country, except in the state of Victoria, where Easter break will start two weeks ahead of schedule.

Earlier Sunday, New South Wales, Australia’s largest state, began a major lockdown of nonessential services, fencing off beaches all over Sydney and calling for people to stay home.

As in some other countries, Australia’s strict new measures represent a shift away from a moderate approach to the virus — in part because the public had not been complying with social distancing recommendations. On Friday, thousands flooded Bondi Beach in Sydney despite warnings against large gatherings, leading to an outright ban on beachgoing up and down the coast.

Mr. Morrison did not say how the new restrictions would be enforced, but the New South Wales police have said they would rely on powers under the Public Health Act, under which people can be fined and sentenced to up to six months in jail.

Australia announced 281 new coronavirus cases on Sunday, bringing its total to 1,354 — up from 876 on Friday. The country, which has had seven deaths from the virus, has ramped up testing for the virus in recent days, with more than 132,000 people having been screened.

Schools and businesses have closed, local economies have unraveled and medical facilities are facing a shortage of crucial supplies — but there are ways to lend a helping hand.

For those seeking to give money, GlobalGiving connects nonprofits, donors and companies. Money received will help send emergency medical workers to communities in need.

Relief International focuses on supporting medical professionals with supplies. It operates in 16 countries and recently focused its efforts on helping Iran, where more than 20,000 infections have been reported. Similarly, Heart to Heart International is distributing equipment and medication to its global partners.

The outbreak has caused a severe blood shortage, according to the American Red Cross. It’s asking healthy donors to give blood, platelets or plasma.

Keeping families and children fed while schools are closed is a concern for many communities. World Central Kitchen works to distribute meals to children in New York City, Washington, D.C. and Little Rock, Ark. The program will expand to Los Angeles on Monday. The Covid-19 Response fund from Feeding America will support thousands of food pantries and hundreds of food banks across the country.

There are also organizations dedicated to supporting children, including UNICEF, Save the Children and First Book, which aims to deliver seven million books to children in the United States while schools are closed.

The chief executives of major airlines, UPS and FedEx said in a letter to congressional leaders on Saturday that they would postpone mass layoffs and stock buybacks and dividends if Congress secured a large enough bailout for their industry.

“We are united as an industry and speaking with one voice,” wrote the group, which included the heads of Southwest Airlines, Delta Air Lines, United Airlines and American Airlines. “We urge you to swiftly pass a bipartisan bill with worker payroll protections to ensure that we can save the jobs of our 750,000 airline professionals.”

If Congress approves at least $29 billion in grants for the industry, the executives said they would commit to no furloughs or layoffs through August. If an equal amount in loans is passed, they would commit to limiting executive compensation and freezing stock buybacks and dividends for the life of the loan.

In a separate letter to senators on Saturday, Sara Nelson, the president of the Association of Flight Attendants union, echoed the call for grants tied to employment, criticizing Senate Majority Leader Mitch McConnell’s plan to provide the industry with loans.

“Federal aid designed for payroll is the only way to prevent massive layoffs,” she said. “Loans won’t cut it.”

Ms. Nelson said that such aid should be tied to limits on buybacks, executive pay and dividends, as well as protecting union contracts.

President Trump sent a letter to North Korea’s leader, Kim Jong-un, expressing willingness to help the North battle the coronavirus, according to North Korea, which responded by expressing gratitude.

“I would like to extend sincere gratitude to the U.S. president for sending his invariable faith to the Chairman,” said Kim Yo-jong, the North Korean leader’s sister and policy aide, in a statement carried by the North’s state-run Korean​ Central​ News Agency. Ms. Kim lauded Mr. Trump’s decision to write the letter as “a good judgment and proper action.”

In the letter, Mr. Trump “wished the family of the Chairman and our people well-being,” Ms. Kim said, referring to his brother by one of his official titles. She said Mr. Trump had also expressed a desire to move relations between the two countries forward.

The White House confirmed that Mr. Trump had sent Mr. Kim a letter but did not comment on its specifics.

Mr. Trump and Mr. Kim have repeatedly touted their unusual relationship. But relations between Pyongyang and Washington ​have cooled since the leaders’ second summit meeting, held in Vietnam in February of last year, collapsed over differences regarding how quickly North Korea should dismantle its nuclear weapons program and when Washington should ease sanctions.

The chief medical officer at Virginia Mason Memorial in Yakima, Wash., warned on Saturday that the hospital could run out of life-preserving ventilators by April 8 if the case projections do not improve and the hospital cannot acquire other machines.

The official, Dr. Marty Brueggemann, said he had witnessed a jarring juxtaposition of what is going on inside the hospital — which is controlling visitors and preparing for an onslaught of patients — and out in the community, where people have still been gathering in large groups. He said the general population wasn’t grasping the gravity of the situation.

“We will have to decide who gets a ventilator and who doesn’t,” Dr. Brueggemann said. “That’s only 19 days away.”

Washington’s Department of Health has told local leaders that only the highest-priority areas will have access to the government’s reserves of protective equipment, including N95 masks.

Long-term care facilities with confirmed infections and hospitals with the largest number of confirmed cases are at the top of the list, while sites lower down include homeless shelters or medical facilities that don’t have confirmed cases. The agency cautioned that not all requests will be fulfilled, and leaders at places like neighborhood health clinics have already seen weeks pass without requests being approved.

Federal grant programs have helped hospitals, states and the Veterans Health Administration develop what are essentially rationing plans for a severe pandemic. Now those plans, some of which may be outdated, are being revisited for the coronavirus outbreak.

In California, even as officials have pushed for widespread testing, health authorities have issued guidance to hospitals to restrict testing, reflecting a lack of testing kits and crucial medical supplies like masks and gowns.

The shift suggests that the state may never get a handle on exactly how many people are infected, because many who have only mild symptoms or believe they were in contact with an infected person but are not themselves sick are being told they do not qualify for testing.

The United States was late to identify the severity of the crisis, and officials say it is too late to pursue the strategy of South Korea, which instituted widespread testing to contain the pandemic. Instead, in California and other states, the focus is on identifying those who are the most sick and trying to save lives.

Many Americans seem to be following the recommendations of public health officials to clean and sterilize countertops, doorknobs, faucets and other frequently touched surfaces in their homes. But many are then tossing disinfectant wipes, paper towels and other paper products into the toilet.

The result has been a coast-to-coast surge in backed-up sewer lines and overflowing toilets, according to plumbers and public officials, who have pleaded with Americans to spare the nation’s pipes from further strain.

Most urban sewage systems depend on gravity and water flow to move toilet paper and waste. They were not designed to accommodate disinfectant wipes and paper towels, which do not break down as easily and clog the system, officials say.

Many say the problem has been compounded by the dearth of toilet paper on store shelves, which is leading some to use paper towels, napkins or baby wipes instead.

Reporting was contributed by Austin Ramzy, David M. Halbfinger, Katrin Bennhold, Iyad Abuheweila, Matina Stevis-Gridneff, Choe Sang-Hun, Damien Cave, Joe Orovic, Iliana Magra, Yonette Joseph, Maggie Haberman, Motoko Rich, Katie Rogers, Mariel Padilla, Vanessa Friedman, Jessica Testa, Kate Taylor, Andrew Keh, Matt Futterman, Tariq Panja, Amelia Nierenberg, Mike Baker, Sheri Fink, Derrick Bryson Taylor, Niraj Chokshi, Aurelien Breeden, Melissa Eddy, Raphael Minder, Joanna Berendt, Jason Horowitz, Elisabetta Povoledo, Maria Abi-Habib, Tim Arango, Michael Levenson, Emily Badger and Kevin Quealy.

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