Coronavirus Live Updates: Global Toll Rises; W.H.O. Expert Says Lockdowns Aren’t Enough

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Credit…Alessandro Penso for The New York Times

Italy has imposed a lockdown, deployed the army and risked its economy to try to stop the spread of the coronavirus. Yet its toll is growing more staggering by the day: By Sunday the country had more than 53,500 cases and over 4,800 deaths, surpassing China as the country with the highest death toll.

Italy’s struggle is 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 were mostly infected during the confusion of a week or two ago.

The government has sent in the army to enforce the lockdown in Lombardy, the northern region at the center of the outbreak, where bodies have piled up in churches. On Friday night, the authorities tightened the nationwide lockdown, closing parks, banning outdoor activities including walking or jogging far from home.

On Saturday night, Prime Minister Giuseppe Conte announced another drastic step in response to what he called the country’s most difficult crisis since World War II: Italy will close its factories and all production that is not absolutely essential, an enormous economic sacrifice intended to contain the virus and protect lives.

“The state is here,” he said in an effort to reassure the public.

If Italy’s experience shows anything, it is that measures to isolate affected areas and limit the movement of the broader population need to be taken early, put in place with absolute clarity and then strictly enforced.

As California officials told hospitals to restrict coronavirus testing and a hospital in Washington State warned that it could run out of life-preserving ventilators by early next month, the U.S. airline industry said this weekend that it would postpone mass layoffs and major stock moves if Congress provided a sufficient bailout.

In California, even as officials have pushed for widespread testing, health authorities have told hospitals to restrict testing, amid a dearth of testing kits and crucial medical supplies.

The shift in the state, which has over 1,500 confirmed cases, suggests that the state may never get a handle on exactly how many people are infected. 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.

U.S. officials say it is too late to pursue the strategy of South Korea, which instituted widespread testing to contain the pandemic. Instead, the focus is on identifying those who are the most sick and trying to save lives.

In Washington State, which has over 1,600 confirmed coronavirus cases, the chief medical officer at Virginia Mason Memorial in Yakima said on Saturday that the hospital could run out of 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 hav​e​ been gathering in large groups.

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

​The state’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. 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.

Airlines, which are struggling to save their companies and the jobs they provide, have meanwhile told congressional leaders 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,” the chief executives of major airlines, UPS and FedEx said in a letter to congressional leaders on Saturday. “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,” wrote the group, which included the heads of Southwest Airlines, Delta Air Lines, United Airlines and American Airlines.

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.

The pandemic is also leading to a strain on the country’s sewer lines.

As Americans clean and sterilize countertops, doorknobs, faucets and other frequently touched surfaces in their homes, many people are then tossing disinfectant wipes, paper towels and other paper products into the toilet.

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

Most urban sewage systems were not designed to accommodate disinfectant wipes and paper towels, which do not break down easily, 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.

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 move came as 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.

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 311,000 and the death toll rose to more than 13,400, 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. The country’s death toll rose to 1,720 on Sunday amid over 28,500 confirmed cases in the country. Among the toll was Lorenzo Sanz, the former president of the soccer powerhouse Real Madrid, who died on Saturday, becoming the most prominent person to succumb to the virus in Spain 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.

  • A quake struck on Sunday near the Croatian capital, Zagreb, complicating quarantine measures to slow the spread of the outbreak and sending residents pouring into the streets during a partial lockdown. 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. Croatia reported 78 new coronavirus cases on 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 the total stood at 21,638, with 7,913 people recovered. The French medical charity M.S.F., or Doctors Without Borders, also 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.

  • 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.” There were 3,400 confirmed cases and 75 deaths as of Sunday in the nation of 10 million, which hosts the European Union institutions. 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. Staff members in three other hospitals in the area were infected with the coronavirus, as well.

  • France, one of the countries in Europe hit the hardest, raised its totals to 14,459 confirmed cases and 562 deaths by Sunday, and said it had ordered more than 250 million face masks from French and foreign suppliers.

  • 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. As of Sunday, the country had more than 5,000 cases and 233 deaths.

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.

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.

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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