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New outbreaks — and mixed messaging — leave some Americans questioning their shutdown sacrifices.
With new cases of the coronavirus suddenly surging across multiple states that had low and manageable caseloads just months ago, confusion and anger is swirling among those who obeyed lockdowns and drastic social measures out of a sense of civic duty to help bring the U.S. outbreak under control.
Nationwide, cases have risen 65 percent over the past two weeks. On Friday, the country reported more than 45,000 new infections, its third consecutive day of record new cases, and a number of states have also been seeing record new levels. On Saturday, Florida, Nevada and South Carolina reported their highest one-day case totals. Before this week, the country’s largest daily total had been 36,738 on April 24.
Many business owners and workers who lost their jobs say they believe their leaders failed to prepare for the economic devastation that followed shutdowns that states adopted, to differing degrees, since March. And they say that recent reopenings undercut their sacrifices.
In recent weeks, some conservatives said they had an additional concern: After weeks of being told that going to church, attending funerals, and participating in protests was a willful, careless spurning of science, political leaders and some public health officials condoned — and even joined — the crowds protesting the killing of George Floyd.
“It’s just a real social whiplash,” said Philip Campbell, vice president of a pest control company in Central Michigan, who took part in the first protests against the lockdown in Lansing in April from the cab of his truck. “Two weeks ago you can’t go out because you are going to kill grandma. Now it’s ‘you have an obligation to go out.’ It leaves me feeling that the science and the public health authorities have been politicized.”
A number of states are reconsidering their reopening plans. Florida and Texas reimposed limits on bars, banning drinking inside or closing the premises entirely, as they scrambled to control what appeared to be a brewing public health catastrophe. All this is leaving people with a strange sense of déjà vu and a bitterness at public officials for what felt like a fumbling of people’s sacrifices.
“Are we doing a full circle? Yes,” said Judy Ray, 57, a cosmetologist and hairdresser in Florida who was laid off from her job at a barbershop at Walt Disney World Resort in March.
Some fault the state and city leaders who rushed to reopen while the virus surged in other corners of the country and now face daunting outbreaks in their own backyards. Others fault a lack of federal leadership, and a White House that defies expert guidance.
At a news conference on Friday, Vice President Mike Pence deflected a question about whether the Trump administration was sending mixed messages by reiterating public health officials’ advice while resuming crowded campaign rallies and refusing to wear masks.
“Even in a health crisis the American people don’t forfeit our constitutional rights,” he said. “We were creating settings where people can choose to participate in the political process, and we will continue to do that.”
Houston’s county moves to red alert.
Harris County’s 4.7 million residents are now under the most severe coronavirus threat level, amid a steep rise in cases and official warnings that hospitals are nearing capacity.
An emergency alert was sent to the phones of Houston and other county residents on Friday evening, notifying them that the coronavirus threat level was bumped up to “LEVEL 1 (RED) SEVERE.” That means the outbreak is “severe and uncontrolled” and only getting worse, county officials said.
The county, by far Texas’s largest, has seen a sudden rise in reported cases in recent weeks. There have now been 28,255 cases in the county and 361 deaths, the majority of which have come within Houston’s city limits.
Gov. Greg Abbott has acknowledged that his reopening plan had gone awry. In an interview with KVIA-TV in El Paso on Friday evening, he said, “If I could go back and redo anything, it probably would have been to slow down the opening of bars.”
At a news conference the same day, Lina Hidalgo, the county judge, urged people to stay home unless absolutely necessary and said that the situation was more dire than it had been in previous months, before Mr. Abbott’s statewide stay-at-home order began yielding on May 1 to his phased reopening.
“We are in a worse situation now than we were back then, and the only thing that worked back then was flattening that curve by staying home,” Ms. Hidalgo said, adding bluntly that the rise in cases occurred because “we opened too quickly.”
But because Mr. Abbott’s reopening orders supersede hers, Ms. Hidalgo could only strongly request that residents stay at home, not order them to do so, as she had previously. Some are worried that residents may not heed the request.
At the moment the county’s alert buzzed on telephones on Friday evening, urging residents to remain at home, wear a mask and cancel gatherings, a significant number were otherwise occupied. The bumper-to-bumper vehicles crawling along a section of Interstate 610 resembled precoronavirus traffic.
And at a shopping plaza off Interstate 10 with a view of the downtown skyline, the parking lot was packed as shoppers headed in and out of a grocery store, liquor shop and salon.
Florida again reports a record number of new cases as Miami-area beaches prepare to close for the Fourth of July.
Florida on Saturday reported more than 9,500 new coronavirus cases, beating its record for new infections for the second consecutive day. The new numbers have pushed the state’s total past 130,000 cases.
Thursday had been a milestone of its own, with nearly 9,000 new cases, by far outpacing the state’s earlier single-day record of 5,508 cases, which had been set on Wednesday.
Mayor Carlos Gimenez of Miami-Dade County said he would sign an emergency order on Saturday closing beaches from July 3 to July 7, citing the surge of cases and fears that mass gatherings over the Fourth of July holiday weekend could push the total even higher.
The order will ban gatherings of more than 50 people, including parades, and will also close parks to public fireworks displays — which the mayor said “must be viewed from one’s home or parked vehicle.”
“The closure may be extended if conditions do not improve,” Mr. Gimenez said in a news release. “If people are not going to be responsible and protect themselves and others from this pandemic, then the government is forced to step in and restore common sense to save lives.”
Gov. Ron DeSantis said on Friday that drinking had been banned in bars because many businesses were not following social distancing restrictions. Bars can remain open to sell takeout alcohol and food if they have an appropriate license.
“There was widespread noncompliance, and that led to issues,” Mr. DeSantis said at a news conference in Fort Myers.
The return to stricter limits was one of the strongest acknowledgments yet that reopening has not gone as planned in a state where only days ago Mr. DeSantis had resisted calls to back down. Local officials expressed concern about whether residents would follow the rules, especially now, months into the crisis.
“People are tired of being in a stay-at-home environment, and they’re not going to be compliant,” said Carlos Migoya, the president and chief executive of the public Jackson Health System in Miami. “You can’t put the genie back in the bottle. We’ve got to deal with it being in the environment.”
In an apparent acknowledgment of the growing sense of anxiety over the surge in cases, Vice President Mike Pence decided to postpone a trip to Sarasota, Fla., that had been planned for early July.
Joe Gruters, a state senator from Tallahassee who leads the state Republican Party, said he learned of the decision on Saturday morning. The trip had been postponed as a safety precaution, but would be rescheduled for a later date, he said.
In other national news:
Cases in Ohio are trending steadily upward. In an interview on Friday, Gov. Mike DeWine said, “This is a very dangerous time,” adding, “I think what is happening in Texas and Florida and several other states should be a warning to everyone.”
Dr. Anthony S. Fauci, the country’s top infectious diseases expert, warned that outbreaks in the South and West could engulf the country. Also, in a brief interview on Friday, he said that officials were having “intense discussions” about a possible shift to “pool testing,” in which samples from many people are tested at once in an effort to quickly find and isolate those who are infected.
In California, which had one of the earliest stay-at-home orders in the United States, Gov. Gavin Newsom announced new restrictions on Imperial County, which has the state’s highest rate of infection. “This disease does not take a summer vacation,” he said.
Officials in Nevada and South Carolina on Saturday reported their highest single-day case totals. At least 980 new cases were added in Nevada, more than double its previous daily high. In South Carolina, officials announced more than 1,600 new cases, nearly 300 more than the previous record set a day earlier.
Citing the severity of the pandemic, a federal judge in Los Angeles on Friday ordered the release of migrant children held in the country’s three family detention centers by July 17. Two of the centers, run by Immigration and Customs Enforcement, are in Texas and one is in Pennsylvania The order came after plaintiffs in a long-running case reported that some of the children had tested positive for the coronavirus.
U.S cases pass 2.5 million, but new C.D.C. data shows current testing vastly undercounts actual infections.
But the real number in many parts of the United States is more than 10 times higher than the reported rate, according to data released Friday by the Centers for Disease Control and Prevention.
The analysis is part of a wide-ranging set of surveys initiated by the C.D.C. to estimate how far the virus has spread. It found, for instance, that in South Florida as of April 10, under 2 percent of people had been exposed to the virus. (The proportion is likely to be much higher now, given the surge of infections in the state.) The C.D.C. estimated 117,400 people in that region had been infected — about 11 times the reported number of 10,500 cases.
The results confirm what some scientists have warned about for months: that without wider testing, scores of infected people go undetected, and continue to circulate the virus.
“Our politicians can say our testing is awesome, but the fact is our testing is inadequate,” said Scott Hensley, a viral immunologist at the University of Pennsylvania who was not involved in the research.
The numbers indicate that even in areas hit hard by the virus, the overwhelming majority of people have not yet been infected, Dr. Hensley said.
“Many of us are sitting ducks who are still susceptible to second waves,” he said.
The difference between recorded infections and those that were missed was even more significant in Missouri, where about 2.65 percent of the population was infected with the virus as of April 26, although many people might not have felt sick. This number is about 24 times the reported rate: nearly 162,000 compared with the 6,800 believed to have been infected by then.
Dr. Robert R. Redfield, the director of the C.D.C., noted this trend on Thursday during a call with reporters.
“Our best estimate right now is for every case reported there were actually 10 other infections,” Dr. Redfield said.
The C.D.C. researchers tested samples from 11,933 people across six regions in the United States during discrete periods from March 23 through May 3: The Puget Sound region of Washington, where the first case in the country was diagnosed, as well as New York City, South Florida, Missouri, Utah and Connecticut.
The samples were collected at commercial laboratories from people who came in for routine screening such as cholesterol tests, and were evaluated for the presence of antibodies to the virus — which would indicate previous infection even in the absence of symptoms.
Cases in Egypt are soaring. Its mosques, cafes and restaurants are reopening anyway.
Egypt inched toward a semblance of normalcy on Saturday as mosques, cafes and restaurants reopened after three months, albeit under tight restrictions, even as the number of new coronavirus infections in the country continued to soar.
At dawn, masked worshipers flooded into Cairo’s ancient mosques, some over 1,000 years old, to say communal prayers for the first time in three months. Later, patrons slowly returned to the city’s coffees shops and restaurants, many with an evident sense of relief.
For months, business leaders have lobbied President Abdel Fattah el-Sisi to end the lockdown, arguing that the economic damage outweighed the health risks. On Friday, the International Monetary Fund approved a $5.2 billion loan to help Egypt get back on its feet, adding to an early promise of $2.8 billion at the start of pandemic.
Even so, tight limitations remain — restaurants are restricted to 25 percent capacity, water pipes are banned from cafes on sanitary grounds, and Friday prayers are still forbidden. The easing on Saturday had an anxious, tentative feel, with many Egyptians balancing their desire to socialize or worship together against an awareness that the disease was spreading fast.
“This has got to be a gradual process,” said Abdullah Mohammed, 33, a pharmacy worker sitting with friends by the Nile who had recently recovered from Covid-19.
Egypt’s health ministry has reported 62,755 infections and 2,620 deaths. With the infection rate touching new highs, doctors’ groups have warned of a crisis at overcrowded hospitals, where over 100 doctors have died for want of protective equipment and training.
Even so, Egypt’s airports are set to reopen on July 1. Later in the month, the government will restart flights to tourist resorts in three areas — southern Sinai, the Red Sea, and Marsa Matrouh on the Mediterranean coast.
The British police, facing repeated unauthorized gatherings, vow to crack down.
The police in Britain vowed to crack down on unauthorized gatherings this weekend after tens of thousands of people flocked to beaches, gathered outside for unauthorized parties and violated coronavirus restrictions in recent days.
In the country’s south, the police in several seaside cities issued dispersal orders after large numbers of beachgoers caused huge traffic jams and engaged in antisocial behavior this week — including brawls, excessive drinking and even defecating in public.
The police in London and other cities like Derby, in central England, vowed to robustly disperse any unauthorized gathering. Over 140 officers in London have been injured while patrolling protests and breaking up unsanctioned parties in recent weeks.
And in Liverpool, the police have been given the power to disperse any gathering of more than two people in the center of the city, after thousands of supporters flouted social distancing rules on Friday when celebrating their soccer club’s English Premier League championship title.
When fans turned out in large numbers for the second night in a row to celebrate Liverpool’s title — its first in 30 years — Mayor Joe Anderson denounced the presence of “too many people intoxicated and causing antisocial behavior.”
In other international news:
More than 191,000 new infections were reported around the world on Friday, a single-day record. The total number of confirmed cases is nearing 10 million, and total deaths have passed 494,000. India’s caseload surged past 500,000 on Saturday.
Venezuela is struggling to control its first major outbreak, amid fears that the virus will collapse the country’s dilapidated health care system and worsen its humanitarian crisis. Medical workers at hospitals in the second-largest city, Maracaibo, say they are overwhelmed with Covid-19 patients, and treatment is complicated by a lack of running water and protective equipment, and frequent power cuts. The government has acknowledged only 39 deaths and cracked down on local journalists and medical workers who question it.
In Brazil, the pandemic is easing in big cities but gaining momentum in smaller towns. The Ministry of Health, in its latest epidemiological bulletin last week, reported that 65 percent of cases were concentrated outside state capitals and warned the virus had reached 88.6 percent of the country’s 5,570 cities. An epidemiologist at the University of São Paulo, Paulo Lotufo, warned of a “boomerang effect” as the sick and unemployed from smaller towns gravitate to bigger cities for care or jobs.
Serbia’s defense minister has tested positive for the coronavirus, shortly after returning from a visit to Moscow, where he had attended a huge and mostly face mask-free military parade in Red Square. The defense ministry said in a statement that the minister, Aleksandar Vulin, who is known for his strongly pro-Russia views, had contracted the virus but was not feeling sick. It did not say where he had become infected.
Fears of a second wave of coronavirus infections in China have receded somewhat. As of Saturday morning, the authorities had reported 297 cases in an outbreak in Beijing, and linked cases in at least four provinces. But the recent surge confirmed fears of sporadic flare-ups even after countries tame their outbreaks.
As the virus jumps to new U.S. epicenters, travel restrictions follow.
When the coronavirus tore through states like New York, New Jersey and Louisiana during the first major wave of cases in April, governors in other regions were quick to place restrictions on travelers from states with early surges.
States like Florida and Arizona enacted laws requiring visitors from hot spots to quarantine for 14 days upon arrival — requirements that remain in place now, even as New York and New Jersey have sharply reduced their caseloads. In April, Gov. Greg Abbott of Texas authorized screening stations along the border with Louisiana, which have since been closed.
But as the virus has spread and caused immense surges across the Sun Belt, many governors who had previously enforced travel restrictions on visitors now find their own residents subject to similar measures elsewhere.
On Wednesday, the governors of New York, New Jersey, and Connecticut agreed to impose quarantines on visitors from any states where infections crossed a certain threshold. At the time of the announcement, Gov. Andrew M. Cuomo of New York said that list would include Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Utah and Texas, but would change based on rolling averages.
Mr. Cuomo said anyone found disobeying the quarantine could face a fine of $2,000.
This week, a provision of an order by Mr. Cuomo went into effect that would make New York employees ineligible for paid sick leave if they voluntarily traveled to states with high infection rates.
“If we are going to maintain the progress we’ve seen, we need everyone to take personal responsibility,” Mr. Cuomo said in a statement about the policy.
Other states that have so far succeeded in keeping cases low and managing periodic flare-ups are drawing lines based on their own criteria.
As of July 1, Vermont will require travelers from any state outside the Northeast to complete either a 14-day quarantine or a seven-day quarantine followed by a negative test. To date, Vermont has kept positive cases to just 1,198, according to data compiled by The New York Times.
Nursing home deaths make up 43 percent of those in the U.S.
A stunning proportion of coronavirus deaths in the United States — 43 percent — are linked to nursing homes and other long-term care facilities for older adults, according to a New York Times database, which found at least 54,000 residents and workers in such facilities had died. As of June 26, the virus had infected more than 282,000 people at some 12,000 facilities.
The share of deaths linked to these facilities is even starker at the state level. In 24 states, the number of residents and workers who have died accounts for either half or more than half of all deaths from the virus. In New Hampshire, for example, the share of such deaths is 80 percent, and in Minnesota it is 77 percent.
Nursing home populations are at a high risk of being infected by — and dying from — the coronavirus, according to the Centers for Disease Control and Prevention. Covid-19, the disease caused by the coronavirus, is known to be particularly lethal to adults in their 60s and older who have underlying health conditions. And it can spread more easily through congregate facilities, where many people live in a confined environment and workers move from room to room.
Infected people linked to nursing homes also die at a higher rate than the general population. The median case fatality rate — the number of cases divided by the number of deaths — at facilities with reliable data is 17 percent, significantly higher than the 5 percent case fatality rate nationwide.
In a parallel to H.I.V., studies find the coronavirus can deplete vital immune cells.
The coronavirus initially seemed to be another respiratory illness. But it has turned out to affect not just the lungs, but also the kidneys, heart and circulatory system — even, somehow, the senses of smell and taste.
Now, researchers have discovered yet another unpleasant surprise. In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V.
One of the more detailed studies, published as a preprint and under review at Nature Medicine, was conducted by Dr. Adrian Hayday, an immunologist at King’s College London.
He and his colleagues compared 63 Covid-19 patients with 55 healthy people, some of whom had recovered from coronavirus infections.
One of the most striking aberrations in Covid-19 patients, the researchers found, was a marked increase in levels of a molecule that sends T cells to areas of the body where they are needed.
The result: a confused response from the immune system.
Some experts have wondered whether antiviral treatment makes sense for severely ill Covid-19 patients, if their main affliction is an immune system overreaction. But if the virus directly causes the immune system to malfunction, Dr. Hayday said, then an antiviral makes sense.
Norway partly reopened some gyms. Here’s what happened.
Like many nations, Norway ordered all gyms to close in March to prevent the spread of the coronavirus. But the country also funded research to determine whether the closings were really necessary.
The randomized trial aimed to test whether people who work out at gyms with modest restrictions are at greater risk of infection than those who do not. The tentative answer after two weeks: No.
This week, in response to those findings, Norway reopened all of its gyms with the same safeguards in place that were used in the study.
The trial, begun on May 22, included five gyms in Oslo with 3,764 members, ages 18 to 64, who had no underlying medical conditions. Half were invited to go back to their gyms and work out, while the others were not allowed to.
The researchers found just one coronavirus infection, in a person who had not used the gym before he was tested; it was traced to his workplace. Some participants visited hospitals, but for conditions other than Covid-19.
Is there hope for gymgoers elsewhere?
“I personally think this is generalizable, with one caveat,” said Dr. Michael Bretthauer, a cancer screening expert at the University of Oslo who helped lead the study.
It is unlikely to be applicable, he said, in “places where there is a lot of Covid, or where people are less inclined to follow restrictions.”
Three long(-haired) months: barbershop before-and-afters.
The Times’s Claudio E. Cabrera was among the New Yorkers who rejoiced when the city’s salons and barbershops reopened this week. Here, he writes about the experience.
For the last three months, I’ve spent my Google Hangout work meetings wearing a Yankees cap.
Despite being a born-and-bred New Yorker, I am not a Yankees fan at all. But it was the only cap I had in my house to cover my lack of a shape-up, my lack of a haircut, with barbershops in the city closed because of the pandemic.
When people talk about the relationship between people of color and their barbers, they tend to forget that it’s not just that they raise your self-esteem and help you look good — they are people you can also share your life with, and who can share their life with you.
And they aren’t your typical friend. They don’t come out with you to the bar. You may never go on a guys’ trip with them. You have those friends.
But your barber is your part-time therapist, and sometimes you are his.
For months, the world perilously dismissed evidence of silent spreaders.
In late January, a doctor in Munich discovered Germany’s first coronavirus case, but the diagnosis made no sense. The patient reported only one possible contact with the infection: a business colleague visiting from China who had seemed healthy during her stay.
The visitor later told colleagues that she had not started feeling ill until after the flight back to China. Days later, she tested positive for the coronavirus.
Although it is now widely accepted that seemingly healthy people can spread the virus, scientists at the time believed that only people with symptoms could infect others.
“People who know much more about coronaviruses than I do were absolutely sure,” recalled Dr. Camilla Rothe, an infectious disease specialist at Munich University Hospital who diagnosed the businessman’s case.
The possibility of transmission from seemingly healthy people could strongly limit the ability of public awareness campaigns, airport screenings and stay-home-if-you’re sick policies to stop the virus.
Dr. Rothe and her colleagues were among the first to warn the world. But interviews with doctors and public health officials in more than a dozen countries showed that for two crucial months, Western health officials and political leaders played down or denied the risk of symptomless spreading. Leading health agencies provided contradictory and sometimes misleading advice.
It is impossible to calculate the human toll of that two-month delay, but models suggest that earlier action might have saved tens of thousands of lives. Though estimates vary, models using data from Hong Kong, Singapore and China suggest that 30 to 60 percent of spreading occurs when people have no symptoms.
“This was, I think, a very simple truth,” Dr. Rothe said. “I was surprised that it would cause such a storm. I can’t explain it.”
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Reporting was contributed by Reed Abelson, Manuela Andreoni, Matt Apuzzo, Nicholas Bogel-Burroughs, Julie Bosman, Claudio E. Cabrera, Tess Felder, Selam Gebrekidan, Manny Fernandez, Abby Goodnough, Andrew Higgins, Shawn Hubler, Miriam Jordan, Louis Keene, David D. Kirkpatrick, Gina Kolata, Anatoly Kurmanaev, Apoorva Mandivilli, Patricia Mazzei, Giulia McDonnell Nieto del Rio, Sarah Mervosh, Zach Montague, Dave Montgomery, Elian Peltier, Brad Plumer, Frances Robles, Somini Sengupta, Michael D. Shear, Jeanna Smialek, Mitch Smith, Sheryl Gay Stolberg, Sabrina Tavernise, Jim Tankersley, Declan Walsh and Vivian Wang.
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