Coronavirus Live Updates: Hospitals on Both Sides of the Atlantic Struggle as Cases Climb

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Credit…Nadia Shira Cohen for The New York Times

The peril posed by the twin scourges of pestilence and material ruin brought on by the swift advance of the coronavirus deepened on Friday as the global death toll hit 10,000 and jobless numbers soared.

On both sides of the Atlantic, policymakers struggled to find an effective response for both a public health disaster and a growing economic crisis.

California extended its “shelter in place” orders to all 40 million residents of the state, saying people should leave their homes only for essential business. Gov. Andrew Cuomo of New York has expressed his dislike of the term, but with more than 5,200 confirmed cases — the highest in the nation — the state has asked for much the same thing.

The State Department warned Americans not to leave the country, and said that citizens who are already abroad should either return home or stay where they are.

A Senate debate over a $1 trillion relief package was hamstrung by the kind of partisan division that had largely paralyzed Congress before the pandemic.

Economists warned that the suspension of ordinary commerce was already savaging businesses and producing record levels of job losses.

The Labor Department reported a 30 percent increase in unemployment claims last week, one of the largest spikes on record. The department also asked state officials not to release precise figures, according to an email reviewed by The New York Times.

And as countries around the world try to confront a crisis within their own borders, there has been a creeping sense that nationalistic interests are also at work.

Vaccine trials are underway in the United States, Europe and China. While there is cooperation, governments will try to ensure that their own people are the first in line. And an effective vaccine is likely to be 12 to 18 months away, public health experts say.

The immediate challenge remained trying to slow the spread of the virus, and limit the corresponding surge of patients that could overwhelm health systems, as happened in China and Italy.

The death toll in Italy, which has 64 million people, surpassed China’s, with a population of 1.4 billion, raising profound questions about the effectiveness of restricting movement in Western democracies unable to enforce those measures with the efficiency of an authoritarian regime.

With other European countries seeing exponential increases in confirmed cases, officials said it was only a matter of days before hospitals throughout the continent would begin to be overwhelmed.

Spain on Friday became the second European nation to register more than 1,000 deaths, and officials warned that the country’s health care system could soon be overwhelmed even as doctors were already being forced to choose which patients to save.

“Admitting someone may mean denying the entry to someone else who may benefit more,” a Spanish organization that represents intensive care providers wrote in a report released on Thursday. It recommended prioritizing patients with more than two years of life expectancy, and taking “social value” into account.

“The health situation in Madrid is critical,” said Ángela Hernández, the deputy secretary general of Amyts, an association of doctors in Madrid, which has so far has accounted for most of the 1,000 deaths nationwide. She listed several problems, including shortages of protective gear for health care workers and a lack of ambulances.

“There’s a saturation of emergency services,” she said. “We’re no longer in a phase of health alert, but instead of alarm.”

In the Catalonia region, hospital patients are being housed in hotels. Some hospitals in the Basque region have now dedicated most floors to coronavirus cases.

Italy registered 1,000 deaths a week ago, and this week it surpassed China in nationwide fatalities, with more than 3,400 deaths so far. Across Europe, hospitals are racing to prepare for an influx of coronavirus patients that experts say will swell in the next week.

Health officials in Germany are attempting to increase the country’s capacity of 28,000 intensive care beds by setting up temporary hospitals in empty rehabilitation clinics, hotels and trade fair halls.

Lothar Wieler, president of the Robert Koch Institute for public health, warned that Germany was facing “exponential growth” and a similar situation to the one seen in Italy.

France has called in the military to build temporary hospitals even as health care workers have warned that they do not have enough protective gear, including face masks.

In Britain, letters are being sent to thousands of former doctors and nurses asking them to rejoin the National Health Service.

Doctors in Spain said they were increasingly unable to treat older patients in intensive care units.

“We have to choose whom we intubate,” said one doctor working in an emergency room in Madrid, who requested anonymity because he wasn’t allowed to comment publicly. “We can’t use it on everyone any more.”

America’s most populous state is ordering its residents to remain indoors.

Gov. Gavin Newsom of California on Thursday ordered all 40 million Californians to stay at home as much as possible in the coming weeks as the state confronts an escalating coronavirus outbreak. Mr. Newsom made the announcement from the state’s emergency operations center in Sacramento, which normally coordinates responses to wildfires and earthquakes, and spoke in stark terms of the risk the virus poses to the population.

Mr. Newsom cited a model used by state planners suggesting that more than 25 million Californians could be infected over eight weeks. “This is not a permanent state, this is a moment in time,” he said. “We will look back at these decisions as pivotal.”

Several counties in the Bay Area, plus Sacramento, had already issued similar orders, although there are several exceptions such as buying groceries or picking up prescriptions. Those exceptions also apply to the state order.

The restrictions came as cases in the United States surged past 10,000 on Thursday, prompting sweeping action from other state leaders who had previously been reluctant to order imposing changes to daily life.

In Texas, Gov. Greg Abbott declared a public health disaster for the first time since 1901 and issued an executive order stopping dine-in service at restaurants and bars. The order also called for closing schools, and a ban on gatherings of more than 10 people statewide.

Florida’s southernmost county, which includes the Florida Keys, ordered all of its hotels to close. The move, at the height of the state’s tourism season, is expected to deal a severe blow to the local economy.

U.S. stock futures rallied on Friday, signaling a higher open on Wall Street as global financial markets looked set to finish a tumultuous week on a more positive note.

Investors, who have been rattled by the effects of the coronavirus pandemic, were encouraged by fresh measures to shore up economies worldwide. In the United States, Senate Republicans presented a $1 trillion economic stimulus bill. The Federal Reserve continued its swift action with a plan to support money market funds and extend currency swap lines to nine countries in an attempt to keep dollars around the world.

News of European Central Bank’s massive bond-buying program also appeared to cheer investors, who piled money into exchanges in Europe, sending stocks in Paris and Frankfurt up more than 3 percent. In London, the FTSE 100 was up nearly 2 percent.

“The pledged policy response has been swift — and we expect total fiscal stimulus to be similar in size to that of the financial crisis but in a shorter time frame,” wrote analysts at BlackRock Investment Institute, a research arm of the world’s biggest money manager.

Stocks across the Asia-Pacific region also rose on Friday.

As businesses across the country scale back, close their doors and let workers go, we spoke to New Yorkers about how changes have affected their lives.

The state government has told nonessential businesses in New York City to keep 75 percent of their workers home, bringing one of the busiest cities in the world to a grinding halt.

Luca di Pietro, who owns five restaurants in Manhattan, described the pain of telling his staff that his restaurants would be closing.

“There is no money, there is no money to pay salaries,” he said, becoming emotional. “It pains me greatly to let people down.”

Chinese health experts visiting Italy warned that the country may not be taking the stringent lockdown measures seriously enough, even as outside aid groups begin to set up systems to lend support.

The number of coronavirus deaths in Italy passed the total for China on Thursday. And as new infections in China continued to drop, numbers across Europe have exploded.

On a visit to Milan, the vice president of the Chinese Red Cross, Sun Shuopeng, chided Italians for not taking restrictive measures more seriously. The situation in the northern region of Lombardy region, which has been hit hardest by the outbreak, echoed that in Wuhan, China, during the peak of its epidemic, he said.

Italy was the first Western country to introduce lockdown measures, following the model established by the Chinese government. But Mr. Sun said the Italian authorities had not gone far enough.

In Milan, public transportation was still moving, and people were still on the streets.

“We need to close the town,” Mr. Sun added, prompting Attilio Fontana, the president of Lombardy, to nod vigorously. Mr. Fontana has been pushing the national government to adopt stricter lockdown measures.

With hospitals overwhelmed, aid groups have also begun setting up in Italy. Samaritan’s Purse, the international Christian relief agency, opened a field hospital on Friday in Cremona to deal with the overflow patients.

Ken Isaacs, vice president of programs and government relations for the aid group, described the situation at Cremona’s hospital as “horrific” and “a raging fire.”

The agency had already sent equipment and disaster relief personnel, including doctors and nurses to work with the Italian medical staff.

“They’re so exhausted,” Mr. Isaacs said of the medical workers. “We’ve brought some hope.”

Reaching out to provide assistance or charity in this trying time can ease your own anxiety too. Consider supporting local businesses, safely donating blood or reaching out in more creative ways.

A global arms race for a coronavirus vaccine is underway.

In the three months since the virus began its deadly spread, China, Europe and the United States have all set off at a sprint to become the first to produce a vaccine. But while there is cooperation on many levels — including among companies that are ordinarily fierce competitors — hanging over the effort is the shadow of a nationalistic opportunity for the winner to potentially gain the upper hand in dealing with the economic and geostrategic fallout from the crisis.

What began as a question of scientific accolades, the patents and ultimately the revenue from a successful vaccine have become a broader issue of urgent national security. And behind the scramble is a harsh reality: Any vaccine that proves potent against the coronavirus is sure to be in short supply as governments try to ensure that their own people are first in line.

In China, 1,000 scientists are at work on a vaccine, and the issue has already been militarized: Researchers affiliated with the Academy of Military Medical Sciences have developed what is considered the nation’s front-runner candidate for success and is recruiting volunteers for clinical trials.

President Trump has talked with pharmaceutical executives about making sure a vaccine is produced on American soil, to assure the United States controls its supplies. German government officials said they believed he tried to lure a German company, CureVac, to do its research and production in the United States.

The company has denied it received a takeover offer, but its lead investor made clear that some kind of approach had been made.

Hong Kong saw its biggest daily jump in confirmed coronavirus infections on Friday, as the city grappled with a second wave of cases in travelers returning from abroad as well as some local transmissions.

The city reported 48 new infections on Friday, bringing its total to 256. Most new patients had recently traveled to Europe, North America or Southeast Asia, a spokeswoman for the department of health said at a news conference Friday.

The sudden spike in Hong Kong came as Taiwan confirmed 27 new cases and its second death from the coronavirus on Friday. Singapore also saw a record high of 47 new infections on Wednesday, driven by imported cases as residents returned from overseas.

Taiwan, Singapore and Hong Kong have been lauded for their strategies in keeping the epidemics at bay, but health officials and residents are gearing up for a longer fight.

The Hong Kong health authorities are also looking into a string of cases potentially linked to the nightlife district of Lan Kwai Fong, which includes many bars and gyms and is popular with expatriates. Several restaurants in the city have begun to refuse entry to anyone who has traveled abroad in the past 14 days.

Cathay Pacific, the main Hong Kong airline, said on Friday it would scrap 96 percent of its passenger flights in April and May as the pandemic brought travel to a virtual shutdown. HK Express, a low-cost carrier owned by Cathay, plans to suspend all flight operations from March 23 to April 30.

The health authorities in Australia are trying to track down thousands of passengers who left a Princess Cruise ship in Sydney on Thursday after four people tested positive for the new coronavirus.

Three passengers, one of whom is in serious condition, and one crew member from the Ruby Princess were confirmed to have the virus.

The ship tested 13 people who displayed symptoms but allowed 2,700 passengers to disembark before the results were known. Of the known cases, one person was a passenger who was not tested onboard but later visited a hospital after feeling sick.

The ship, which was traveling from New Zealand to Australia, has been quarantined off the eastern coast of Australian with about 1,100 crew members on board.

In a signal that Japan believes it may be over the worst of the coronavirus outbreak, Prime Minister Shinzo Abe indicated that the nation’s schools, closed since the beginning of March, could reopen in April.

Mr. Abe shocked Japan’s teachers and parents late last month when he abruptly asked all schools in the country to close, disregarding the advice of experts and circumventing the Education Ministry. On Friday, he said he was requesting that the ministry draw up plans to reopen the schools for the start of the school year, which begins in April in Japan.

A panel of epidemiological experts released a report on Thursday saying they could not determine if the school closures had been effective in helping to slow the spread of infections.

“We don’t have a scientific conclusion,” said Hiroshi Nishiura, a professor at the Hokkaido University medical school who specializes in modeling infectious diseases. “We don’t know the effectiveness of school closure.”

The peace agreement in Afghanistan, already stalled by delays in the release of Taliban prisoners and by a political stalemate in Kabul, is increasingly being defined and constricted by the coronavirus crisis.

The U.S. peace envoy, Zalmay Khalilzad, fired off a series of Twitter posts this week that cited the coronavirus as both an impediment to negotiations and a reason to urgently resolve political differences.

“It’s time for Afghans to compromise,” one of Mr. Khalilzad’s posts read. In another, he wrote, “coronavirus makes prisoner releases urgent.”

Mr. Khalilzad also acknowledged that disruptions triggered by coronavirus measures have made face-to-face negotiations increasingly difficult.

“Coronavirus and the resulting travel restrictions likely requires virtual engagement now,” he wrote.

Already, President Ashraf Ghani, 70, is spending time in self-imposed isolation in his private residence at the palace complex in Kabul. The palace Facebook site posted photos of Mr. Ghani alone at home, conferring with cabinet ministers and aides by video link.

Reporting and research were contributed by Raphael Minder, Megan Specia, Marc Santora, Elisabetta Povoledo, Aurelien Breeden, Melissa Eddy, Edward Wong, David E. Sanger, David D. Kirkpatrick, Sui-Lee Wee, Katrin Bennhold, Richard Pérez-Peña, Tim Arango, Jill Cowan, Emily Cochrane, Jim Tankersley, Alan Rappeport, Maya Salam, David Zucchino, Isabella Kwai and Dan Barry.

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