Coronavirus Live Updates: Hospitals Struggle to Prepare for Surge in Patients, Job Losses Mount

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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 approached 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.

That question may be answered in coming weeks in Italy, where the government is considering tightening restrictions that already ban mass gatherings and require people to stay home except for essential matters.

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.

In Spain, public health experts said that time was running out.

“The health situation in Madrid is critical,” said Ángela Hernández, the deputy secretary general of Amyts, an association of doctors in Madrid, which 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.”

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.

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.

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.”

The Trump administration is asking state labor officials to delay releasing the precise number of unemployment claims they are fielding, an indication of how uneasy policymakers are about further roiling a stock market already plunging in response to the coronavirus outbreak.

In an email sent Wednesday, the Labor Department instructed state officials to only “provide information using generalities to describe claims levels (very high, large increase)” until the department releases the total number of national claims next Thursday.

The email, which was shared with The New York Times, noted that the reports were monitored closely by financial markets and should therefore remain embargoed. “States should not provide numeric values to the public,” wrote Gay Gilbert, the administrator of the department’s Office of Employment Insurance.

Ms. Gilbert has worked at the Labor Department under presidents of both parties, and there has been no indication that she was urged by political appointees to make the request. But President Trump has privately expressed irritation at the dire predictions of some of his advisers, most notably when Treasury Secretary Steven Mnuchin told lawmakers that unemployment could reach 20 percent this year.

Some states that received the guidance from Ms. Gilbert found it disturbing. It prompted at least one governor’s office, which shared the message on the condition of anonymity, to seek an opinion from the state attorney general about whether the state had to temporarily withhold the information.

In another state, lawmakers got a preview of the staggering numbers that are being withheld for the moment. In a private conference call Thursday with elected officials and union leaders, a top Pennsylvania labor official was blunt about the depth of the economic crisis, according to someone on the call.

Robert O’Brien, the state’s deputy secretary of labor and industry, said the government had been overwhelmed by a flood of unemployment insurance claims — 180,000 in the last few days. He said that was far more than the state usually gets in a whole month.

The situation may be even more dire in Washington State, the first center of the contagion in the United States. State officials there would only say they are seeing an “even more dramatic increase this week” after unemployment claims soared 150 percent last week.

The federal numbers released Thursday morning were already alarming: 281,000 people nationwide applied for unemployment insurance last week, up from 211,000 the previous week. They were apparently only a grim preview of what is to come.

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.

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.

The State Department announced on Thursday that Americans should not travel outside the country, and that citizens abroad should either return home or stay in place as the coronavirus pandemic grows.

Some Americans overseas have urged the Trump administration to evacuate them.

The department raised its global health advisory to Level 4, or “do not travel,” which is the highest warning, usually reserved for nations that are war zones or facing serious disruptions such as political unrest or natural disasters.

The announcement is a recommendation, not a requirement. Millions of Americans are still overseas, and many are likely to opt to remain in place.

Some tourists or American citizens without long-term living arrangements or support networks abroad have been trying to get back to the United States, but have found that difficult because of border closings or flight cancellations and other transportation shutdowns. For example, American students trapped in Peru because of new travel restrictions imposed by the government there have been pleading with American officials to get them back to the United States.

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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