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Surging Coronavirus Caseloads Put Strongmen on the Back Foot

Here’s what you need to know:

ImageWorkers disinfect a street in downtown Cairo last week.
Credit…Fadl AbuZaid/Picture Alliance, via Getty Images

For months, one enduring mystery of the coronavirus was why some countries with rickety health systems and crowded slums had managed to avoid the brunt of an outbreak that was hammering Europe and the United States.

But some of those countries are now tumbling into the pandemic’s maw.

As the pandemic’s global death toll approaches 400,000, known cases of the virus are growing faster than ever, at a rate of more than 100,000 a day. And the surge is concentrated in densely populated, low- and middle-income countries across the Middle East, Latin America, Africa and South Asia.

“In the early days, people were seeing patterns that were not really there,” said Ashish Jha, professor of global health at the Harvard T.H. Chan School of Public Health. “They were saying that Africa would be spared. But this is a highly idiosyncratic virus, and over time the idiosyncrasy goes away. There is no natural immunity.”

The pandemic’s new direction — away from Western countries — is bad news for strongmen and populists who once reaped political points by vaunting low infection rates as evidence of the virtues of their leadership.

In Egypt, for example, where the rate of new confirmed infections doubled last week, the pandemic has created friction between President Abdel Fattah el-Sisi and doctors who have revolted over a lack of protective equipment and training.

And in Brazil, the total death toll surpassed 32,000 on Thursday, with 1,349 deaths in a single day, dealing a further blow to President Jair Bolsonaro, who has continued to minimize the threat.

In other developments:

  • South Korea reported 39 new cases on Friday. Most were in and around Seoul, where a recent wave of infections has been traced to nightclubs and an e-commerce warehouse.

  • Thousands of people in Hong Kong flouted social distancing rules on Thursday as they gathered to memorialize the Tiananmen Square massacre.

  • The European Central Bank said it would step up its bond purchases by another 600 billion euros, to a total of 1.35 trillion euros.

  • Germany announced a package of tax cuts and other measures worth 130 billion euros.

  • Israel’s Parliament, the Knesset, was suspended after a lawmaker said he had tested positive for the virus.

Credit…George Frey/Reuters

The studies, published in The Lancet and The New England Journal of Medicine in May, had produced astounding results and altered the course of research into the pandemic.

The Lancet paper reported dismal findings about the use of chloroquine and hydroxychloroquine to treat Covid-19 patients. It led to the suspension of some clinical trials of the medications, including by the World Health Organization. (Some have since resumed.)

President Trump has repeatedly promoted hydroxychloroquine despite the lack of evidence that it works against the virus. His endorsement had the effect of politicizing scientific questions that normally would have been left to dispassionate researchers.

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.

Later on Thursday, The New England Journal of Medicine retracted a heart study that was published in May by the same authors, using data from the same registry. That study 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.

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 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.

Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, faced a barrage of questions on Thursday 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.

Here’s what else happened in the United States on Thursday:

  • Stocks on Wall Street inched lower, in a small retreat after days of back-to-back gains. The drop came after the U.S. government said the overall number of workers on state jobless rolls had increased last week, signaling continued strain on the economy even as some businesses reopen.

  • Supreme Court Justice Sonia Sotomayor temporarily suspended a trial judge’s rulings requiring the Trump administration to move more than 800 older or medically vulnerable inmates out of an Ohio prison where nine prisoners have died from the virus. An appeals court is scheduled to hear arguments in the case on Friday.

  • Mayor Bill de Blasio of New York City said 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.

  • The head of the U.S. Centers for Disease Control and Prevention, Dr. Robert Redfield, told House lawmakers 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. He said that up to 100,000 would be needed by September.

  • A U.S. federal appeals court 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.

Credit…Erin Schaff/The New York Times

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.

Credit…Adam Dean for The New York Times

Pandemic lockdowns have given nature a breather around the world, bringing animals to unexpected places. Cougars toured the deserted streets of Santiago, the Chilean capital. Wild boars have strolled through the lanes of Haifa, Israel. Fish catches off Vietnam are teeming again.

In Thailand, Khao Yai National Park, the country’s oldest, has been closed to human visitors for the first time since it opened in 1962. The upshot? Its 300 or so elephants have been able to roam freely, venturing onto paths once packed with humans.

With few cars around, the elephants, the park’s dominant species, stroll along roads, chomping on foliage without needing to retreat to dangerous corners of the forest where cliffs meet waterfalls. Rarely spotted animals, like the Asian black bear or the gaur, the world’s largest bovine, have emerged, too.

“The park has been able to restore itself,” said Chananya Kanchanasaka, a national park department veterinarian. “We are excited to see the animals are coming out.”

The reprieve is notable in part because Thailand is a country where the bond with nature has long been framed as one of domination — as the jungle consuming people or vice versa.

Beyond the pillaging of its own rainforests, Thailand is a key way station on global wildlife trafficking routes, with horns, tusks and scales from as far away as Africa making their way to China.

Credit…Francois Lenoir/Reuters

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.

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.”

Credit…Paul Ratje/Agence France-Presse — Getty Images

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.

Credit…John Minchillo/Associated Press

Extending the additional benefits that Congress has given to unemployed workers through the end of July would help the economy this year but hurt it next year, the Congressional Budget Office estimated on Thursday.

President Trump signed a law in March that gave an additional $600 per week to tens of millions of workers who had lost their jobs during the pandemic, in addition to the unemployment benefits that they would normally receive. Those expanded benefits expire July 31 and Congress is divided over whether to extend the higher payments.

Republicans have raised concerns that the more generous benefits would act as a disincentive for people to return to work as the economy recovered, because many workers are now earning more from unemployment than they did from their jobs. Democratic supporters of the benefits say they are cushioning workers against a shock and helping to keep up the level of consumer spending.

The budget office essentially found merit in both arguments. In a brief report prepared at the request of the Senator Charles E. Grassley, Republican of Iowa and the chairman of the Senate Finance Committee, the office said that if the benefits were to be extended, economic output would be higher in the second half of 2020 than if the benefits were to expire.

But it said output would be lower in 2021 if the benefits were extended, because fewer Americans would be working.

“An extension of the additional benefits would boost the overall demand for goods and services, which would tend to increase output and employment,” the office wrote. “That extension would also weaken incentives to work as people compared the benefits available during unemployment to their potential earnings, and those weakened incentives would in turn tend to decrease output and employment.”

Even as more states reopen and some businesses slowly start to rehire, 1.9 million people filed new claims for state unemployment benefits last week, the Labor Department reported on Thursday. The weekly tally continues to decline from the more than six million who submitted applications in a single week in March, but it underlines the persistent strain that the pandemic has put on the economy and the long climb ahead.

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 and the national caseload is approaching two million. Here’s a look around the country:

  • In Las Vegas several casinos reopened on Thursday, with the Bellagio reactivating its fountain and many welcoming gamblers back with social distancing and temperature screening measures put in place.

  • 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 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.

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.

Video

transcript

‘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.

KEY DATA OF THE DAY

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.

  • Frequently Asked Questions and Advice

    Updated June 2, 2020

    • Will protests set off a second viral wave of coronavirus?

      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

    • How do we start exercising again without hurting ourselves after months of lockdown?

      Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • How many people have lost their jobs due to coronavirus in the U.S.?

      More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


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. Brazil now has more than half a million known cases, second only to the United States.

  • 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.

  • 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. Its troubles were compounded last month by Cyclone Amphan, a deadly storm that tore through communities under lockdown. And this week, the country reported its first death from Covid-19 in a refugee camp: A 71-year-old Rohingya man who died while receiving treatment in an isolation center.

The U.S. Supreme Court 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.

Credit…Jim Wilson/The New York Times

Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, 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.

Credit…Dmitry Kostyukov for The New York Times

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.

“Given the exceptional situation that our country is currently going through and the uncertainties that remain as to the evolution of the Covid-19 pandemic in the coming weeks, the July 14 national day celebrations will be maintained but adapted to the circumstances,” the office said in a statement.

Every July 14, thousands of people crowd on the Champs-Élysées, the famous avenue that runs from Place de la Concorde to the Arc de Triomphe, to watch soldiers march by, tanks roll past and jets fly overhead. Mr. Trump attended in 2017.

There have been no signs of a second wave of infections in France so far, and restrictions have gradually been lifted.Most recently, cafes and restaurants around the country were allowed to reopen. But the authorities have warned that the epidemic is not over and have kept some limits in place, most notably a ban on large public gatherings.

This year’s Bastille Day parade will be replaced by a military ceremony on Place de la Concorde, with only about 2,000 participants and 2,500 guests, who will have to follow “the current physical distancing rules,” the president’s office said. An air force flyover will still be included.

The ceremony will also pay tribute to the French Army for contributing to the national coronavirus response — the military deployed a field hospital in the badly affected Alsace region and helped move patients around the country — as well as to French health workers and “all of the actors mobilized against the virus,” the presidency said. It was not immediately clear what shape that tribute would take.

Credit…Amos Ben Gershom/Knesset

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.

Officials said they had begun an epidemiological investigation and would examine security-camera images to identify anyone who had come into close contact with the lawmaker, Sami Abou Shahadeh, a member of the predominantly Arab political alliance known as the Joint List.

Shmulik Dahan, a Knesset spokesman, said the day’s two scheduled committee hearings were canceled but that the building had not been completely shut down. Normal activity would resume depending on the results of the epidemiological investigation, he said.

Mr. Abou Shahadeh, 44, had been photographed in crowds without a mask at a protest over the fatal police shooting of Iyad Halak, an unarmed, autistic Palestinian resident of East Jerusalem who was killed Saturday, and while paying his respects at the Halak family’s mourning tent.

In an interview, Mr. Abou Shahadeh said that he had been urging Israelis for weeks to follow the government’s rules for curbing the virus, even as the public’s diligence ebbed.

“I did everything I could,” he said. “People are seizing on those two photos, but it was right after I’d done interviews. There are dozens of other photos where I am wearing a mask.”

Mr. Abou Shahadeh said he and an aide, who tested positive after feeling tired last week, were not showing symptoms. “It could be that I’m just at the beginning, but I’m feeling well right now,” he said.

He said he had mixed with large numbers of people, including at two large funerals on May 28. One of them was for Ayman Safiah, a well-known dancer whose body was found on the beach near Haifa.

“I wore the mask at both funerals, except when Ayman’s mother spoke and I started to cry,” Mr. Abou Shahadeh said.

Mr. Abou Shahadeh announced his diagnosis on Twitter on Wednesday night, appealing “to anyone who was in my immediate area to go into isolation and get tested.”

Credit…Ben Stansall/Agence France-Presse — Getty Images

The British government hosted an online gathering on Thursday that aimed to raise at least $7.4 billion for the Global Alliance for Vaccines and Immunization, an initiative founded by the Bill and Melinda Gates Foundation 20 years ago, the alliance said in a statement.

Prime Minister Boris Johnson, who will be a keynote speaker at the meeting, is expected to say that the vaccine effort is the most “essential shared endeavor of our lifetimes.”

“I hope this summit will be the moment when the world comes together to unite humanity in the fight against disease,” Mr. Johnson will say, according to prepared remarks. The gathering will bring together heads of state and leading figures such as Mr. Gates and Ngozi Okonjo-Iweala, chairwoman of the vaccine alliance’s board, who said in a tweet that the coronavirus “is a reminder of the importance of resilient health systems.”

At least 39,728 people have died in Britain because of the virus, according to the British government, but the country has been gradually reopening. Lawmakers returned to Parliament on Tuesday. That decision was criticized after Alok Sharma, the business secretary, seemed unwell and sweated profusely during a statement he made in the House of Commons on Wednesday.

Mr. Sharma was subsequently tested and went home to self-isolate, a spokeswoman said today, adding that he had begun to feel unwell when he was in the chamber.

Credit…Victor J. Blue for The New York Times

George Floyd had the virus in early April, nearly two months before he died in police custody, according to a full autopsy released by the Hennepin County medical examiner on Wednesday.

Dr. Andrew M. Baker, the county’s top medical examiner, said that the Minnesota Department of Health had swabbed Mr. Floyd’s nose after his death, and that he had tested positive, but that it was likely a lasting positive result from his previous infection.

There is no indication that the virus played any role in his death, and Dr. Baker said Mr. Floyd was likely asymptomatic at the time of his death.

Dr. Michael Baden, a former New York City medical examiner who was among two doctors who conducted a private autopsy for Mr. Floyd’s family last week, said county officials did not tell him that Mr. Floyd had tested positive.

“The funeral director wasn’t told, and we weren’t told, and now a lot of people are running around trying to get tested,” Dr. Baden said. “If you do the autopsy and it’s positive for the coronavirus, it’s usual to tell everyone who is going to be in touch with the body. There would have been more care.”

The four police officers who were charged in Mr. Floyd’s death should also get tested, as should some of the witnesses, Dr. Baden said. “I’m not angry,” he said. “But there would have been more care.”

GLOBAL ROUNDUP

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. It includes incentives for electric vehicles, but none for gas- or diesel-fired engines, which Germany’s powerful automakers had sought.

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.

  • 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, Hannah Beech, 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, Mike Ives, 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, Nada Rashwan, Luis Ferré Sadurní, Dagny Salas, Nelson D. Schwartz, Kaly Soto, Marc Stein, Eileen Sullivan, Mitra Taj, Derrick Bryson Taylor, Safak Timur, Declan Walsh, Noah Weiland and Karen Zraick.

Source: NYT

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