Coronavirus Live Updates: Overuse of Antibiotics In the Pandemic Could Undermine Lifesaving Drugs

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The overuse of antibiotics early in the pandemic could spur resistance to lifesaving drugs.

The patients who deluged the emergency room at Detroit Medical Center in March and April exhibited telltale symptoms of the coronavirus: high fevers and infection-riddled lungs that left them gasping for air.

With few treatment options, doctors turned to a familiar intervention: broad-spectrum antibiotics, the shot-in-the dark medications often used against bacterial infections that cannot be immediately identified. They knew antibiotics were not effective against viruses, but they feared the patients could be vulnerable to life-threatening secondary bacterial infections.

“During the peak surge, our antibiotic use was off the charts,” said Dr. Teena Chopra, the hospital’s director of epidemiology and antibiotic stewardship. She and other doctors across the United States who liberally dispensed antibiotics in the early weeks of the pandemic said they soon realized their mistake.

Now, doctors nationwide are seeking to draw lessons from their overuse of antibiotics, a practice that can spur resistance to lifesaving drugs as bacteria mutate and outsmart the drugs. Antimicrobial resistance is a mounting threat that claims 700,000 lives annually — a global health crisis that has been playing out in slow motion behind the scenes while the coronavirus took center stage.

In recent weeks, public health experts have been warning that the same government inaction that helped foster the rapid spread of the coronavirus could spur an even deadlier epidemic of drug-resistant infections. The United Nations warns such an epidemic could kill 10 million by 2050 if serious action is not taken.

The pipeline for new antimicrobial drugs has become perilously dry. Over the past year, three American antibiotic developers with promising drugs have gone out of business, and most of the world’s pharmaceutical giants have abandoned the field.

Legislation in Congress to address the broken antibiotics marketplace has failed to gain traction in recent years, but public health experts are hoping the coronavirus pandemic can help break the political logjam in Washington.

U.S. orders states to report demographic data, after disproportionate effects of the virus.

Credit…Erin Schaff/The New York Times

The Trump administration on Thursday released new requirements for states to report coronavirus data based on race, ethnicity, age and sex of individuals tested for the virus, in an effort to respond to demands from lawmakers for a better picture of the pandemic.

All laboratories — as well as nonlaboratory facilities offering on-site testing and in-home testing — will be required to send demographic data to state or local public health departments based on the individual’s residence, according to details released by the Department of Health and Human Services.

Adm. Brett P. Giroir, the assistant secretary of Health and Human Services and the federal government’s lead on coronavirus testing efforts, said that the deadline for states to start sending the data was Aug. 1, but that he expected many states to begin earlier. “We definitely recognize the importance of doing this quickly,” he said.

The new guidelines came as Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, faced a barrage of questions from House lawmakers at a health subcommittee hearing about his agency’s often halting response to the pandemic, and what some members of Congress said was its failure to anticipate the pandemic’s effect on black and Hispanic communities.

“We didn’t have the data we needed to be able to answer that in a responsive way,” Dr. Redfield conceded.

Public health experts have criticized the Trump administration for failing to address the disproportionate effects of the virus on communities of color. The questioning came as large protests continued across the United States over the killing of George Floyd, a black man who died last week in police custody after a white officer knelt on his neck for nearly nine minutes.

Fine-grained data on race and ethnicity of Covid-19 patients may help the government begin to address the inequities by marshaling resources to particularly hard-hit regions of the country. In its announcement, the Health and Human Services Department said the data would help with “epidemiologic case investigations, assisting with contact tracing, assessing availability and use of testing resources, and anticipating potential supply chain issues.”

The data, which Health and Human Services said would help standardize the way states reported new cases, will be stripped of identifying information for privacy reasons but will be publicly available, said Admiral Giroir.

As part of the Paycheck Protection Program and the Health Care Enhancement Act, which was signed into law in April, the Trump administration was required to include demographic data in its Covid-19 analysis. Yet the results thus far have been slim. In May, Health and Human Services sent a brief report signed by Dr. Redfield that mostly included hyperlinks to the C.D.C. website’s testing statistics.

Senator Elizabeth Warren of Massachusetts wrote on Twitter that Health and Human Services should “be embarrassed by the lazy, incomplete, 2.5-page copy-and-paste job it calls a ‘report’ on the racial disparities of Covid-19 cases.”

A study in The Lancet on the risks of hydroxychloroquine is retracted by its authors.

Credit…George Frey/Reuters

The authors of a sensational paper that last month reported dismal findings about the use of chloroquine and hydroxychloroquine to treat Covid-19 patients have retracted their report after the data that it was based on was called into question.

The paper, published in The Lancet in May, led to the suspension of some clinical trials of the medications, including by the World Health Organization. (Some have since resumed.)

The drug has been repeatedly promoted by President Trump, despite the lack of evidence that it is effective against the virus. He has said that he had taken it himself to try to ward off infection, even though the Food and Drug Administration had issued a safety warning that it could cause dangerous abnormalities in heart rhythm in coronavirus patients. His endorsement had the effect of politicizing scientific questions that normally would have been left to dispassionate researchers.

The retracted Lancet paper was not the only study that called the drug’s effectiveness into question. A more rigorous study — the first large controlled clinical trial of hydroxychloroquine — found that hydroxychloroquine did not prevent Covid-19 in a randomized test of 821 people who had been exposed to patients infected with the virus.

After Mr. Trump promoted the use of hydroxychloroquine and another malaria drug, chloroquine, at a White House briefing on March 19, many people flocked to try them; the rate of first-time prescriptions surged to more than 46 times the weekday average by that evening. His announcement in May that he had started taking hydroxychloroquine himself did not inspire many Americans to follow his lead: By the next day, the rate was only about 2.8 times the average, the equivalent of an increase of about 400 prescriptions.

The Lancet paper, which was purportedly based on data from a huge, privately held registry of patient records from hundreds of hospitals around the world, had concluded that the anti-malaria drugs were associated with dramatically higher rates of heart arrhythmias and deaths in Covid-19 patients.

The database belonged to a company called Surgisphere, which is owned by Dr. Sapan Desai, one of the four co-authors.

The other three co-authors, including Dr. Mandeep R. Mehra, a professor at Harvard Medical School, retracted the article on Thursday after their attempts to verify the database’s veracity and authenticity were stymied by Dr. Desai.

“We launched an independent third-party peer review of Surgisphere with the consent of Sapan Desai to evaluate the origination of the database elements, to confirm the completeness of the database, and to replicate the analyses presented in the paper,” their statement said.

“Our independent peer reviewers informed us that Surgisphere would not transfer the full data set, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements.”

Controversy over the provenance of the database and inconsistencies in the patient records has been rising in scientific circles since publication of the study.

Later on Thursday, The New England Journal of Medicine retracted a heart study that was published by the same authors with data from the same registry. That study, published in May, was said to analyze 8,910 Covid-19 patients hospitalized through mid-March at 169 medical centers in Asia, Europe and North America. The authors concluded that cardiovascular disease increased their risk of dying.

“Because all the authors were not granted access to the raw data and the raw data could not be made available to a third-party auditor, we are unable to validate the primary data sources underlying our article,” the authors wrote in the retraction of the study.

Justice Sotomayor temporarily blocks an order shielding prisoners from the virus.

Justice Sonia Sotomayor on Thursday temporarily suspended a trial judge’s rulings requiring the Trump administration to move more than 800 older or medically vulnerable inmates out of the Elkton Federal Correctional Institution in Ohio, where nine prisoners have died from the coronavirus.

Justice Sotomayor’s order, which gave no reasons, will remain in effect at least until the United States Court of Appeals for the Sixth Circuit, in Cincinnati, rules on the administration’s appeal. The appeals court is scheduled to hear arguments in the case on Friday.

Last week, in the same case, the Supreme Court refused to block the first of two rulings from the judge instructing prison officials to take step to protect the inmates. The justices’ earlier order was tentative, and the majority said it might revisit the matter “if circumstances warrant.” Justices Clarence Thomas, Samuel A. Alito Jr. and Neil M. Gorsuch said they would have granted the administration’s first request for a stay.

In April, four prisoners filed a class-action lawsuit saying that conditions at the prison violated the Eighth Amendment’s prohibition of cruel and unusual punishment. In a pair of rulings, Judge James S. Gwin of the Federal District Court in Cleveland ordered officials to make plans to remove the most vulnerable inmates from the prison through compassionate release, home confinement, parole or transfer to another facility.

For the deaf, social distancing can mean social isolation.

Credit…Francois Lenoir/Reuters

The pandemic has flipped life upside down for many, but for the deaf, social distancing guidelines like staying six feet from others and wearing a mask present particular challenges.

Some 466 million people worldwide have disabling hearing loss. In the United States, over 37 million adults, about 15 percent of the population, report some trouble hearing, according to the National Institutes of Health.

Grace Cogan, who is deaf and lives in Jamesville, N.Y., experiences feelings of anxiety when shopping because masks prevent her from effectively communicating, leaving her to rely on eyes and the slant of eyebrows to understand others. So her boyfriend now does most of the shopping.

“This pandemic has really further divided the inclusion of deaf and hard of hearing community from the hearing world, or in other words, isolated us even more,” she said.

Sign language interpreters are among a growing group of essential workers, often called on to stand beside officials communicating vital information on television and in internet livestreams. But they are not everywhere.

Roberta J. Cordano, president of Gallaudet University, a liberal arts university for the deaf in Washington, said, “The ‘two adults, six feet apart’ standard carries its own inherent bias, assuming all those social distancing are the same: that they are hearing, seeing and without any need of support.”

Ashlea Hayes, who is deaf and blind and who works as the secretary of National Black Deaf Advocates, lives in Compton, Calif., where she usually does most of her food shopping herself. But lately she has become more reliant on delivery services, and, unable to visit with and touch friends and colleagues, she said her anxiety has been spiking.

“The sense of panic everywhere is overwhelming.” Ms. Hayes said.

The head of the C.D.C. told lawmakers that the country needs up to 100,000 contact tracers.

Credit…Jim Wilson/The New York Times

Dr. Redfield told House lawmakers on Thursday that the federal government and state health departments needed to dramatically increase the number of tracers working to identify who those infected by the coronavirus had come in contact with, saying that up to 100,000 would be needed by September.

At a health subcommittee hearing, Dr. Redfield said that the number of tracers would need to grow well beyond the 600 C.D.C. employees he said were “embedded” nationally working on contact tracing, and beyond the number of people hired by states, some of which have over 1,000 already committed to the work.

“It is fundamental that we have a fully operational contact tracing work force that can — every single case, every single cluster — can do comprehensive contact tracing within 24 to 36 hours, 48 hours at the latest, get it completed, get it isolated, so that we can stay in containment mode as we get into the fall and winter,” he said.

Dr. Redfield said that the numbers needed would vary.

“In some states it may be 500. In other states, it may be 5,000,” he said. “We’re in the process of doing that state by state by state to help them understand what is that work force they need.”

At the hearing, Dr. Redfield faced testy questions from Representative Rosa DeLauro, the subcommittee chairwoman, who displayed photos of recent large gatherings across the country, including one at the Lake of the Ozarks over the Memorial Day weekend and another in Florida, where crowds watched the SpaceX launch at Cape Canaveral.

Dr. Redfield repeatedly urged Americans to continue their efforts to socially distance and wear masks. But he admitted that the C.D.C. was struggling in its campaign to convince Americans to wear masks. In some parts of the country masks become a political signifier, and Mr. Trump has almost never worn one in public, saying once that he did not want to allow the media to see him in a mask.

“We’re very concerned that our public health message isn’t resonating,” he said. “We continue to try to figure out how to penetrate the message with different groups.

A federal appeals court gives Texas Republicans a victory in their efforts to restrict voting by mail.

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A federal appeals court on Thursday sided with Texas Republicans in their legal battle to restrict voting by mail during the pandemic, striking down a lower-court ruling that would have allowed voters who fear contracting the virus to cast ballots by mail instead of in person.

The decision by a three-judge panel of the appellate court, the United States Court of Appeals for the Fifth Circuit in New Orleans, was only a temporary victory for the state and its Republican attorney general, Ken Paxton. The Fifth Circuit only nullified the lower court’s ruling while the case proceeds, and the Texas Democratic Party, which brought the lawsuit against the state, suggested it would appeal to the U.S. Supreme Court.

“We find ourselves in the midst of a once-in-a-century pandemic,” the chairman of the Texas Democratic Party, Gilberto Hinojosa, said in a statement. “Voters who are rightfully worried about the safety of in-person voting should have the option to vote by mail.”

A legal back-and-forth has played out for weeks between the state’s Republican leaders, Democrats and judges in both state and federal courts. At issue are Texas’ rules limiting those who can cast mail-in ballots and whether healthy voters who fear contracting Covid-19 meet the legal definition of a disabled voter.

In Texas, voters can cast mail-in ballots only if they are going to be absent from the county, have a disability that prevents them going to the polling place, are aged 65 or older or are confined in jail. Thursday’s appellate decision keeps those rules in place, for now, for the two elections this year in Texas — a primary runoff election in July and the November general election.

The Texas Democratic Party, voting rights groups and individual voters who sued Texas said the state’s strict interpretation of disability in its election code, and the age restrictions that make mail-in ballots available only to those 65 and older, will decrease the turnout of minority voters, in violation of the Voting Rights Act, and will force Texans to choose between their health and their right to vote.

But Mr. Paxton’s office said in court documents that the election code “does not permit an otherwise healthy person to vote by mail merely because going to the polls carries some risk to public health.”

The Fifth Circuit, regarded as one of the most conservative federal appellate courts in the country, ruled on Thursday that the spread of the coronavirus has not given judges “a roving commission” to rewrite state election codes and that even with the age restrictions, there was no evidence Texas had denied or abridged the right to vote.


The number of confirmed cases is growing faster than ever as new hot spots emerge around the world.

Credit…Victor Moriyama for The New York Times

The pandemic is ebbing in some of the countries that were hit hard early on, but the number of new cases is growing faster than ever worldwide, with more than 100,000 reported each day.

Twice as many countries have reported a rise in new cases over the past two weeks as have reported declines, according to a New York Times database. On May 30, more new cases were reported in a single day worldwide than ever before: 134,064. The increase has been driven by emerging hot spots in Latin America, Africa, Asia and the Middle East.

Over all, there have been more than 6.3 million reported cases worldwide and more than 380,000 known deaths. More than a quarter of all known deaths have been in the United States. But the geography of the pandemic is changing quickly.

The increases in some countries can be attributed to improved testing programs. But in many places, it appears that the virus has only now arrived with a wide scope and fatal force. Here is a look at some of the countries where the number of new cases has been doubling every two to three weeks.

  • The death toll in Brazil, Latin America’s largest country, passed 30,000 on Tuesday, when officials reported 1,262 deaths, which was the nation’s highest one-day total. President Jair Bolsonaro, who has repeatedly minimized the threat, said, “We are sorry for all the dead, but that’s everyone’s destiny.” Brazil now has more than half a million known cases, second only to the United States.

    But it has no health minister: Two were forced out in less than a month after they balked at expanding the use of hydroxychloroquine, a malaria drug promoted by President Trump and subsequently Mr. Bolsonaro that has not been proved effective against the virus. And despite the growing number of cases and hospitals that are close to capacity, businesses have started reopening in major cities, including Rio de Janeiro, Manaus and Vitória.

  • Peru has more than 170,000 confirmed cases, despite taking the virus seriously early on. The president, Martín Vizcarra, ordered one of the first national lockdowns in South America. Though the official virus death toll stands at around 5,000, Peru had 14,000 more deaths than usual in May, suggesting that a growing number of people are dying at home as hospitals struggle to handle a flood of cases.

    The pandemic provoked an exodus from Lima, the capital, as people unable to work fled by bus, and even by foot, to family farms. It is widely expected that the number of new cases and of deaths will continue to rise in coming weeks as winter nears and the economy slowly reopens.

  • For months, Egypt, the Arab world’s most populous country, seemed to avoid the worst of the pandemic. In early March, Egypt confirmed 45 cases on a Nile tour boat in the area, among both crew and passengers. But recently the number of cases there has been rising significantly, reaching 27,536 on Tuesday.

    The recent death of a young doctor, who was denied treatment for Covid-19 at an overwhelmed hospital, ignited a revolt by members of the medical staff. They said the government had failed to provide adequate protective equipment and training to front-line workers.

  • With more than 35,000 confirmed infections, the most in Africa, South Africa still has a growing number of new cases, despite enacting a strict lockdown in March that included a ban on the sale of tobacco and alcohol. The prohibition was lifted this month even though the total number of cases continued to rise.

  • Bangladesh now has 55,000 known cases, and its troubles were compounded last month by Cyclone Amphan, a deadly storm that tore through communities under lockdown.

    This week, the country reported its first death from Covid-19 in a refugee camp: A 71-year-old Rohingya man died May 31 while receiving treatment in an isolation center. His death raised fears about the hundreds of thousands of Rohingya refugees who, after fleeing Myanmar, live in camps with tightly packed tents and shacks.

If AstraZeneca’s vaccine is approved, an Indian manufacturer has agreed to make at least a billion doses.

Credit…Jeff Chiu/Associated Press

The Britain-based pharmaceutical company AstraZeneca said Thursday that it had struck a deal with a vaccine manufacturing giant, Serum Institute of India, to produce a billion doses of a potential virus vaccine for distribution to low and middle income countries.

The potential vaccine, devised in a laboratory at Oxford, is one of several candidates now in clinical trials and has not been proven effective. But governments and nonprofit foundations are risking hundreds of millions of dollars to arrange for the production of large volumes of several potential vaccines, including AstraZeneca’s, so that any that are approved can be rapidly distributed.

Should its vaccine be proven effective, AstraZeneca has now secured the capacity to manufacture as many as two billion doses by next year, the company said. If the current trials succeed, the vaccine might be approved for emergency use in the United States and elsewhere as soon as this fall.

AstraZeneca said that two nonprofit organizations had agreed to pay $750 million for the manufacturing and procurement of 300 million doses by the end of this year. They are the Coalition for Epidemic Preparedness Innovation, a relatively new Norway-based public-private partnership, and the older Geneva-based Gavi vaccine alliance. Both receive funding from several Western governments as well as from the Bill & Melinda Gates Foundation.

The U.S. government has agreed to pay for the production of as many as 300 million doses, and Britain has agreed to pay for as many as 100 million.

AstraZeneca’s chief executive, Pascal Soriot, said in a video conference that during the pandemic, the company would distribute the vaccine “at no profit” and allow governments and donors to audit its finances to ensure that it was not profiting off the vaccine.

“We don’t usually do this,” he added. “It is quite a unique process.”

U.S. Roundup

N.Y.C. could enter the second reopening phase in early July, the mayor says.

Credit…Sarah Blesener for The New York Times

Mayor Bill de Blasio of New York City said on Thursday that the city could begin a second phase of reopening “as early as the beginning of July,” in which offices, stores and personal-service businesses like barber shops could reopen with restrictions, and restaurants could offer outdoor dining.

The city has yet to start reopening at all, but the mayor has reiterated that the city was on track to begin the first phase on Monday. Under state guidelines, regions in Phase 1 that continue to meet health-related benchmarks can enter Phase 2 after two weeks.

After seven days of crowded, mostly peaceful protests against racism and police brutality in New York City, the governor said that the state’s testing criteria were being expanded to include anyone who had participated in the protests and encouraged people to tested. The city announced universal testing earlier this week.

Gov. Andrew M. Cuomo also said that demonstrators should inform others that they had been to a protest and to behave as if they had been exposed. Statewide, there were an additional 52 virus-related deaths, he said. Nine counties ringing the city are expected to enter Phase 2 next week, he said, and the state is allowing drive-in and drive-through graduations.

As more Americans return to offices and stores after months stuck indoors, new coronavirus clusters continue to emerge. Here’s a look around the rest of the country.

  • In northeastern Mississippi, a recent funeral spread the virus to at least nine people, some of whom were from other states. In Arkansas, at least 35 people at a factory that makes boots became ill. And in Kansas City, Mo., health officials announced a cluster this week of more than 200 employees at a facility that makes paper plates and cups.

  • Most of the largest case groupings remain in nursing homes, prisons and food processing facilities, all places where social distancing is difficult. But as more of the country reopens, and as testing and contact tracing capabilities expand, outbreaks are emerging in new settings.

  • At least 26 workers on a construction site in Augusta, Maine, tested positive, along with at least 24 people at a Walmart distribution center in Colorado and at least 16 at a convenience store in Kansas. In Macon County, N.C., the site of recent outbreaks at a church and an inn, officials last week urged people to maintain social distancing even as restrictions eased.

  • In New Jersey, breweries and wineries can resume offering outdoor tastings on June 15, the date that restaurants and bars had already been cleared to reopen for outdoor dining, the governor said.

The N.B.A. owners approve a plan to restart the season in July, a key step.

N.B.A. owners on Thursday overwhelmingly approved the league’s plan to restart the season with 22 teams at Walt Disney World in Florida in July, according to a person familiar with the voting results.

The single-site proposal was ratified by a vote of 29-1, with the Portland Trail Blazers as the sole opposition, according to the person, who was not authorized to discuss the results publicly. According to league rules, 23 votes in favor from the 30 teams were required to pass the measure put forth by the N.B.A. commissioner, Adam Silver.

The N.B.A. would be among the largest and most-watched North American sports leagues to return, following announcements that the National Hockey League, Major League Soccer and the National Women’s Soccer League would resume play in the summer. The voting results were first reported by The Athletic.

The N.B.A.’s return-to-play plan, approved on what would have been the first day of the finals for this season, will next be reviewed by the National Basketball Players Association, which has scheduled a virtual meeting with its membership Friday afternoon, according to three people with knowledge of the timetable who spoke on condition of anonymity because they were not authorized to discuss the matter publicly.

It was not immediately clear whether the players would be asked to formally vote on the proposal, but the league is hopeful that the close working relationship Oklahoma City’s Chris Paul, the union president, maintains with Silver is indicative of the players’ eventual approval.

Despite the virus, hundreds jailed in N.Y.C. are held in cramped cells.



‘The Protesters Have a Civic Duty,’ Cuomo Says

Gov. Andrew M. Cuomo of New York urged protesters to get tested for coronavirus, saying the state will expand its testing facilities to meet the demand.

You have 30,000 people who’ve been protesting statewide. You look at the video as far — as well as I look at the video. Many of them wear masks. Thank God. But there’s no social distancing. You look at the encounters with the police. The police are right in their face. They’re right in the face of the police. Twenty thousand protesters in New York City, 1,000 protesters on Long Island. These are big numbers. And yes, they’re young people and they’re superheroes, and nothing can affect me. We’re going to open the testing facilities for all people who are at a protest. The protesters have a civic duty here also. Be responsible. Get a test. Go to the website. Find out the testing site nearest you. We have 700 in this state. You can get a test — get a test.

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Gov. Andrew M. Cuomo of New York urged protesters to get tested for coronavirus, saying the state will expand its testing facilities to meet the demand.CreditCredit…Jacquelyn Martin/Associated Press

Hundreds of people arrested in New York City since the police killing of George Floyd last week have been detained in cramped cells for more than 24 hours before seeing a judge, sometimes without masks, their health at risk in the midst of a pandemic, defense lawyers said.

The Legal Aid Society charged in a lawsuit this week that the prolonged detention of defendants — some arrested while looting, others while clashing with the police during largely peaceful demonstrations against racism and police brutality — violated state law and their constitutional rights.

Clarence Johnson, a 24-year-old chef from Harlem arrested on unlawful assembly charges at a protest in Manhattan on Monday, said he was held in a cell with about 30 people spaced only about two feet apart, a clogged toilet, no soap and no working sink.

Some detainees were coughing and others seemed sickly, he said. Mr. Johnson said that his brother, who was arrested with him, still had not seen a judge as of Wednesday evening.

Law enforcement authorities say they are trying to process people quickly but face logistical hurdles because of the virus shutdown and the number of arrests.

But public defenders say the police have clogged up the system by putting people through the courts who should have instead received summonses for minor offenses during the protests.

On Thursday, Justice James M. Burke of State Supreme Court in Manhattan denied Legal Aid’s demand that the city release people held for more than a day, noting the Police Department was coping with widespread civil unrest during a pandemic. “It is a crisis within a crisis,” Justice Burke said. “All writs are denied.”

Mr. Floyd himself had the virus in early April, nearly two months before his death, according to an official autopsy released in Minnesota on Wednesday. There is no indication that the virus played any role in his death, and the Hennepin County medical examiner said Mr. Floyd was likely asymptomatic at the time of his death.


Germany approves €130 billion in stimulus to restart its economy.

Credit…Emile Ducke for The New York Times

The government of Chancellor Angela Merkel of Germany, only a few months ago a fortress of fiscal conservatism, announced a package of tax cuts, aid to small business, cash payments to parents and other measures worth €130 billion — a move requiring substantial borrowing.

Ms. Merkel called the package, which was agreed to late Wednesday, a “bold response” to the pandemic downturn.

The plan also includes €5.3 billion for the social security system, €10 billion to help municipalities cover housing and other costs and €1.9 billion for cultural institutions and nonprofits.

The plan requires new borrowing. Ms. Merkel’s government abandoned its adherence to a balanced budget in March, when it passed a €750 billion rescue package that included taking on more than €150 billion of fresh debt.

“We need to get out of this crisis with an oomph,” the finance minister, Olaf Scholz, said. Here are some other developments from around the world.

  • The European Central Bank administered another dose of stimulus to the battered eurozone economy Thursday, saying it would step up its bond purchases by another 600 billion euros, or $675 billion, to a total of 1.35 trillion euros, a way of driving down market interest rates and making credit cheaper. The unemployment rate in the eurozone in April was 7.3 percent, according to data released Wednesday, a number that reflects the government-backed furlough programs designed to curb mass unemployment. But many national financial support programs are set to begin scaling back soon.

  • Israel’s Parliament, the Knesset, was suspended Thursday, and lawmakers and workers were told to stay away after a lawmaker said he had tested positive for the virus.

  • Italians, who often have to fight through throngs of tourists just to walk the street, are getting to experience something they had only dreamed of: a tourist-free visit to some of the world’s greatest — and most popular — museums.

  • The government of North Macedonia reimposed a nationwide curfew and a lockdown of its capital city, Skopje, to curb a spike in cases. A new daily record of 120 cases was reported on Thursday. Health Minister Venko Filipce blamed citizens’ “loosening discipline” for a resurgence of infections.

  • The traditional Bastille Day parade down the Champs-Élysées in Paris will be replaced by a smaller military ceremony because of the pandemic and will include a tribute to health workers, the French president’s office said on Thursday.

  • Iran freed Michael R. White, a Navy veteran who was arrested during a 2018 visit to the country, a day after the United States deported an Iranian scientist. Both men had been infected with the coronavirus while in custody.

Reporting was contributed by Rachel Abrams, Manuela Andreoni, Aurelien Breeden, Brian X. Chen, Michael Cooper, Maria Cramer, Melissa Eddy, Jack Ewing, Farnaz Fassihi, Jacey Fortin, Ellen Gabler, Rick Gladstone, David M. Halbfinger, Jack Healy, Tiffany Hsu, Andrew Jacobs, Joshua Keller, Michael H. Keller, Tyler Kepner, David D. Kirkpatrick, Alyson Kreuger, José María León Cabrera, Adam Liptak, Anatol Magdziarz, Iliana Magra, Apoorva Mandavilli, Raphael Minder, Andy Newman, Elisabetta Povoledo, Roni Caryn Rabin, Jan Ransom, Adam Rasgon, Luis Ferré Sadurní, Dagny Salas, Nelson D. Schwartz, Kaly Soto, Marc Stein, Eileen Sullivan, Mitra Taj, Derrick Bryson Taylor, Safak Timur, Noah Weiland and Karen Zraick.

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