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Models predicting expected spread of the virus in the U.S. paint a grim picture.
The coronavirus studies that appear to have convinced President Trump to prolong disruptive social distancing in the United States paint a grim picture of a pandemic that is likely to ravage the country over the next several months, killing close to 100,000 Americans and infecting millions more.
White House officials have not specifically said which of several epidemiological models by researchers around the world they used to persuade Mr. Trump to extend federal guidelines that call for people to remain in their homes, limit travel, work from home and refrain from gathering in groups of 10 or more. But the administration’s leading scientists — including Dr. Anthony S. Fauci and Dr. Deborah Birx, who is coordinating the coronavirus response — have said that several of the publicly available studies generally match their own conclusions about the deadly impact of the virus.
“We’ve reviewed 12 different models. And then we went back to the drawing board over the last week or two, and worked from the ground up, utilizing actual reporting of cases,” Dr. Birx told reporters during a briefing in the White House Rose Garden on Sunday. She said the evidence collected by the government experts “ended up at the same numbers.”
Dr. Birx and Dr. Fauci are expected to provide a detailed presentation about their conclusions during a briefing from the White House Tuesday evening. A senior administration official declined to reveal any information about those studies in advance. But the publicly available research suggests that even with the isolation efforts already underway to limit the spread of the virus, infections are almost certain to soar, straining the ability of hospitals to care for infected patients and leading to a growing number of deaths.
One of those models, created by scientists at the University of Washington’s Institute for Health Metrics and Evaluation, predicts that deaths from the virus in the United States will rise rapidly during the month of April, from about 4,000 to almost 60,000, even with the many restrictions on movement now in place. The study suggests that the pace of deaths will eventually slow down, reaching a total of about 84,000 by the beginning of August.
The model assumes that social distancing measures will be broadly effective across the country and uses the severe lockdown in Wuhan, China, to calibrate how the outbreak might play out in the United States. That approach has some critics because control measures imposed in the United States have generally been less stringent than those in Wuhan. While officials have told more than 250 million people to stay at home, some parts of the country, especially in the South, have resisted or delayed similar measures for fear of the economic consequences.
The University of Washington model is also considered simple by the standards of the field because it does not take into account the full geographic complexity of the outbreak, nor does it rely on detailed understanding of the basic biology of the disease, said Aaron A. King, a professor in the ecology of infectious disease at the University of Michigan. In the later stages of an outbreak, as some people recover or die from the disease and others change their behavior, more complex models can be more accurate, he said.
A second study, released on March 17 by the epidemic modeling group at Imperial College London and authored by 30 scientists on its coronavirus response team, predicted that if the United States had done nothing to prevent the spread of the virus, 2.2 million people could have died. If, however, the government tried to isolate people suspected of having the virus and people they were in contact with, the number of deaths could be cut in half, the researchers said.
They concluded that only a suppression effort across the entire country — an expanded version of efforts now underway across wide swaths of the country — might significantly further reduce the death toll. But they warned that such efforts might have to be maintained for long periods of time in order to ensure that the threat is over.
“The major challenge of suppression,” the British scientists concluded, is the length of time that intensive interventions would be needed, given that “we predict that transmission will quickly rebound if interventions are relaxed.”
Mr. Trump appears to have been affected by the grim statistics. During his appearance in the Rose Garden on Sunday, the president repeatedly mentioned the worst-case scenario from the Imperial College study, saying that hundreds of thousands of lives would be saved by making the decision to continue social distancing.
“Think of the number: 2.2 — potentially 2.2 million people if we did nothing. If we didn’t do the distancing, if we didn’t do all of the things that we’re doing,” Mr. Trump told reporters. He acknowledged that even 100,000 would be a “horrible number,” but that bringing the deaths down from possible millions would show “we all, together, have done a very good job.”
Trump says he “hasn’t heard about testing for weeks,” but governors say they still lack test kits.
A day after Mr. Trump said he “hasn’t heard about testing for weeks,” suggesting that a chronic lack of test kits was no longer a problem in the U.S., the Republican governor of Maryland said his state was “flying blind” in its fight against the virus because of a lack of available tests.
Gov. Larry Hogan, speaking on CNN on Tuesday morning, said that the dearth of testing kits had left Maryland “sort of guessing about where the outbreaks are and about what the infection rate in the hospitalization rates are.”
But Mr. Hogan was careful not to blame the federal government, and said Washington had taken “great steps” to address the testing issue: “Everyone of us is in this together,” he said.
Mr. Trump made his remark that he “hasn’t heard about testing in weeks” in a conference call with governors on Monday. America’s governors painted a different picture on the ground: one said that his state was “one day away” from not being able to test anyone at all.
Though the United States and South Korea both confirmed their first cases on Jan. 20, America has been much slower to ramp up testing. Last week, the United States surpassed the number of tests performed in South Korea, but the American population is more than six times larger, and Americans are much less likely to have been tested.
Mr. Hogan, who is chairman of the National Governors Association, also raised testing issues in an op-ed in The Washington Post, which he co-authored with Gov. Gretchen Whitmer, Democrat of Michigan. “There simply aren’t enough test kits,” they wrote.
Ms. Whitmer and Mr. Hogan also wrote that the nation’s governors need a testing site in the nation’s capital to help identify sick federal workers and prevent them from infecting their colleagues. Many of the more than 400,000 federal workers in the region, they said, are still reporting to work every day and cannot risk infection because of their “mission critical” jobs.
In Washington, lawmakers were debating whether to move forward with another round of emergency measure.
The Senate’s top Republican suggested on Tuesday that another round of government help might not be needed to confront the public health and economic crisis brought on by the pandemic, even as top Democrats press to move quickly on what they call “Phase 4.”
Senator Mitch McConnell, Republican of Kentucky and the majority leader, told the radio host Hugh Hewitt that lawmakers should “wait and see” whether such a measure is needed, while Speaker Nancy Pelosi, Democrat of California, has begun an aggressive push for it, saying that Congress must swiftly pass one.
The C.D.C. is reviewing its guidance on wearing masks.
The Centers for Disease Control is reconsidering its guidance that people not wear masks as new data shows that many individuals who show no symptoms are carrying the virus and infecting others.
The C.D.C. and the World Health Organization have repeatedly said that the general public does not need to wear masks. And as health care workers around the world face shortages of N95 masks and protective gear, public health officials have warned people not to hoard masks.
But Dr. Robert Redfield, the C.D.C. director, told NPR on Monday that the agency was reevaluating its guidelines based on data showing that as many as 25 percent of infected people remain asymptomatic. “That’s important, because now you have individuals that may not have any symptoms that can contribute to transmission, and we have learned that in fact they do contribute to transmission,” he said.
He suggested that masks might cut down on spread from those people, and said that is “being aggressively reviewed as we speak.”
He also said that people who are just becoming ill may already be infectious up to 48 hours before they show symptoms. “This helps explain how rapidly this virus continues to spread across the country, because we have asymptomatic transmitters and we have individuals who are transmitting 48 hours before they become symptomatic,” he added.
Places like Hong Kong and Taiwan that jumped into action early with universal mask wearing and social distancing have gotten their coronavirus cases under much greater control.
Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said on Sunday that the C.D.C. should put out designs for cloth masks for the general public. “The value of the mask isn’t necessarily to protect you from getting sick, although it may offer some protection,” he told CBS News, adding, “When someone who’s infected is wearing a mask, they’re much less likely to transmit infection.”
In the radio interview, Dr. Redfield also said that social distancing measures — including staying six feet or more away from others in public spaces, and staying home — were important to keep in place for now.
The U.S. death toll passes China’s as questions mount about some countries’ statistics.
The United States’ coronavirus death toll has moved past China’s official count, a bleak milestone hours before the Trump administration planned to release the models that fueled fears that as many as 200,000 Americans could die because of the pandemic.
Although the count from mainland China — 3,305 deaths — has been a subject of intense skepticism, and although Italy and Spain have reported more than 20,000 fatalities between them, the swelling toll in the United States is a grim indication of the outbreak’s scale.
The U.S., despite widespread concerns about the availability of testing for the virus, already had the highest known number of infections in the world, and the American toll was at least 3,430 deaths, as of late Tuesday morning.
But there are mounting concerns that some countries, including China, North Korea and Indonesia, are not being forthcoming about the scope of their outbreaks.
China on Tuesday announced more than 1,500 coronavirus cases that had not previously been made public, giving in to pressure for greater transparency nearly two weeks after officials there first announced zero new local infections.
Questions about the accuracy of China’s numbers have circulated since the start of the outbreak there, even as the country has touted its apparent success in bringing it under control. The 1,541 newly announced cases were people who had tested positive but were asymptomatic, according to an official at China’s National Health Commission.
China had not previously included asymptomatic patients in its public tallies of confirmed cases, even though the World Health Organization recommends doing so, and many within China and abroad had expressed fear about the true scale of the epidemic.
It was not immediately clear whether the 1,541 figure represented the total number of asymptomatic infections detected in China, or merely a fraction. The South China Morning Post, a Hong Kong-based newspaper, recently reported that asymptomatic cases could number as many as 43,000, or one-third of China’s total case count, citing classified government data.
In the case of North Korea, many observers doubt its claims to not have a single coronavirus case, though some attribute it to a lack of testing equipment. Others accuse the government of hiding an outbreak to preserve order.
In Indonesia, the government has for weeks reported zero cases. Yet in a sign that the virus is spreading there, Jakarta’s governor says deaths in the capital may be around 283, nearly four times the official count.
Asian countries see that success containing the virus can be tenuous, a worrisome sign for the rest of the world.
Across Asia, countries and cities that seemed to have brought the epidemic under control are suddenly tightening their borders and imposing stricter containment measures, fearful about a wave of new infections imported from elsewhere.
The moves portend a worrisome sign for the United States, Europe and the rest of the world still battling a surging outbreak: Any country’s success with containment could be tenuous, and the world could remain on a kind of indefinite lockdown.
Even when the number of new cases starts to fall, travel barriers and bans in many places may persist until a vaccine or treatment is found. The risk otherwise is that the infection could be reintroduced inside their borders, especially given the prevalence of asymptomatic people who might unknowingly carry the virus with them.
Following a recent uptick in cases tied to international travelers, China, Hong Kong, Singapore and Taiwan barred foreigners from entering altogether in recent days. Japan has barred visitors from most of Europe, and is considering denying entry to travelers from countries including the United States. South Korea imposed stricter controls, requiring incoming foreigners to quarantine in government facilities for 14 days upon arrival.
In China, international flights have been cut back so severely that Chinese students abroad wonder when they will be able to get home. In Singapore, recently returned citizens must share their phones’ location data with the authorities each day to prove they are sticking to government-ordered quarantines. In Taiwan, a man who had traveled to Southeast Asia was fined $33,000 for sneaking out to a club when he was supposed to be on lockdown at home.
“Even countries that have been relatively successful in managing the pandemic are only as safe as the weakest links in the system,” said Kristi Govella, an assistant professor of Asian studies at the University of Hawaii, Manoa, who added that in the absence of cooperation among countries, “closing borders is one of the ways that individual governments can control the situation.”
Cuomo says the federal government is bidding against states for needed ventilators, as the outbreak hits home for him.
In New York State — the center of the nation’s outbreak, with 1,550 deaths so far and the peak not expected for another one to three weeks — Gov. Andrew M. Cuomo said Tuesday that the country’s patchwork approach to the pandemic had made it harder to get desperately needed ventilators.
Mr. Cuomo said that New York had ordered 17,000 ventilators from China, only to find itself competing with other the other 49 states, other nations, and even the Federal Emergency Management Agency — leaving New York with a firm expectation of getting only 2,500 of its ordered ventilators over the next two weeks.
“We’re all trying to buy the same commodity, literally the same exact item,” Mr. Cuomo said, complaining that the competition was pitting the agencies against one another and driving up prices.
“What sense does this make?” he said “The federal government, FEMA, should have been the purchasing agent, buy everything, and then allocate it by need to the states. Why would you create a situation where the 50 states are competing with each other and then the federal government, and FEMA, comes in and competes with the rest of it?”
Mr. Cuomo, whose fact-filled, sometimes emotional coronavirus briefings have drawn a national audience in recent days, shared that the pandemic had now hit close as he commented Tuesday on the news that his younger brother, Chris Cuomo, the CNN anchor, had tested positive.
Governor Cuomo, who called Chris his “best friend,” said that his younger brother, who is 49, would be fine, saying that he was “young, in good shape, strong” — before teasing that he is “not as strong as he thinks.”
And he used his family anecdote to remind people that social distancing was important — saying how relieved he was that their 88-year-old mother, Matilda Cuomo, had stayed away from Chris and his family in recent days since she could have easily been infected.
Here’s what else Mr. Cuomo said:
The number of confirmed cases in New York increased by 9,298, bringing the statewide total to 75,795 statewide as of Tuesday. In New York City, 43,139 people have tested positive.
The number of patients hospitalized surpassed 10,900, up 15 percent from yesterday. Of those, 2,710 are currently in intensive care rooms with ventilators.
More than 18,000 people were tested overnight, pushing the total number of people tested to about 205,000, more than 1 percent of the state’s population.
Afghans meet coronavirus with kindness, waiving rent and distributing food and masks to their neighbors.
In a moment of need, ordinary Afghans have stepped up to generously share the little that they have, easing the pain of an impending health crisis that is turning into another test of survival for a country where life has been a daily fight for decades.
Across Afghanistan, many landlords have waived rent, in some cases indefinitely until the virus threat recedes. Tailors have handed out thousands of homemade face masks. Youth groups and athletes have delivered food to hospitals and families in destitution. Wedding halls and private schools have volunteered to be turned into hospitals.
The owner of a marketplace of 40 shops forgave rent not just for the month, but for as long as the epidemic continues. The governor of one province set up an emergency Covid-19 fund and in just one day received contributions of more than $100,000.
Mohamed Kareem Tawain, an 80-year-old dentist in Herat, the center of the outbreak in Afghanistan, said that he had experienced multiple wars and droughts in his lifetime, and that Afghanistan was better prepared to deal with the virus than those past scourges.
“I am not too terrified,” he said. “Although it is difficult times, if we join hands, God willing, the corona problem will pass.”
A week after meeting Putin, a Russian doctor leading the fight against the virus tests positive.
A doctor leading Russia’s fight against the virus — and who shook hands with President Vladimir V. Putin at a meeting last week — has tested positive..
Denis Protsenko, the head doctor at Hospital No. 40, Moscow’s main and most modern infectious diseases treatment facility, said on Facebook on Tuesday that he had gone into self-isolation in his office at the hospital, which Mr. Putin visited last Tuesday. He said he was feeling “quite well” and would continue working remotely.
Dr. Protsenko had greeted the president with a handshake, and neither man wore a face mask. Mr. Putin donned a protective suit and gas mask to visits wards containing virus patients, but also had extensive unprotected contact with the doctors and nurses.
Kremlin spokesman Dmitry Peskov, responding to news of Dr. Protsenko’s infection, said that Mr. Putin had been tested regularly for coronavirus and that “everything is OK,” the Interfax news agency reported.
The news of Dr. Protsenko’s infection was announced just a day after Moscow went into lockdown, with residents barred from leaving their homes except to buy food and medicine and walk their dogs within a hundred yards of their residence.
Dr. Protsenko had predicted that the coronavirus could reach its peak this week in Russia, which has reported fewer cases than western Europe and the United States, despite figures showing an accelerating rate of infection.
Russia on Tuesday reported 500 new confirmed cases, bringing its total to 2,337, a nearly fivefold increase over a week ago, with 17 deaths.
The captain of a Navy aircraft carrier pleads for help as the virus spreads onboard.
The captain of an American aircraft carrier deployed to the Pacific Ocean has pleaded with the Pentagon for more help as a coronavirus outbreak aboard his ship continues to spread, officials said Tuesday. Military officials say dozens of sailors have been infected.
In a four-page letter, first reported by The San Francisco Chronicle Tuesday, Capt. Brett E. Crozier of the U.S.S. Theodore Roosevelt laid out the dire situation unfolding aboard the warship, currently docked in Guam with more than 4,000 crew members, and what he said were the Navy’s failures to provide him with the proper resources to combat the virus by moving sailors off the vessel.
Captain Crozier recommended offloading his entire crew, and then quarantining and testing them while the ship was professionally cleaned. But that proposal raised a series of issues, especially as housing the number of people on the ship while also isolating them would be extremely difficult on the island.
The crisis aboard the Roosevelt played out like a slow-moving disaster and highlights the dangers to the Pentagon if the coronavirus manages to infiltrate some of its most important assets, such as bomber fleets, elite Special Operations units and the talisman of American military power, aircraft carriers.
In a statement, a Navy official said that the commanding officer of the Roosevelt “alerted leadership in the Pacific Fleet on Sunday evening of continuing challenges in isolating the virus.”
Stocks dip as Wall Street winds down its worst month since 2008.
U.S. stocks dipped and European indexes were unsteady on Tuesday as investors remained jittery after a period of staggering volatility in financial markets amid the coronavirus pandemic.
The S&P 500 dropped less than 1 percent, and stocks in Europe pared back most of their early gains.
Though the worst of the recent swings in asset prices seem to have subsided, financial markets are trying to find footing even as the number of coronavirus cases climbs worldwide. Stocks have rebounded off their lowest point of the month — including a surge last week — but March is likely to be the worst month for the S&P 500 since October 2008, when investors feared an economic collapse in the wake of the global financial crisis.
For other financial markets, the damage has been even more severe. Oil prices are down more than 50 percent this month, and other commodities have also slumped, reflecting expectations for a global economic slowdown.
As consumers stay home and factories are closed, millions of workers have lost their jobs. Wall Street economists and analysts continue to downgrade expectations for the economy, even after lawmakers in Washington enacted a $2 trillion spending plan.
Goldman Sachs now expects U.S. economic output to plunge at an annualized rate of 34 percent in the second quarter. The unemployment rate will hit 15 percent, the bank predicted in a research note on Tuesday.
Kenyan police are accused of abuses as they enforce an overnight curfew aimed at stopping the virus.
The authorities in Kenya are investigating a string of deaths and injuries related to the enforcement of a nationwide dusk-to-dawn curfew, one of several wide-ranging measures aimed at containing the spread of the coronavirus in the country.
The office of the director of public prosecutions announced on Tuesday that it had ordered an investigation into the killing of Yasin Moyo, a 13-year-old boy who was hit by a stray bullet and died of his injuries on Monday night as officers enforced the curfew in a neighborhood on the outskirts of Nairobi, the capital.
The inspector general of Kenya’s police force said he had asked investigators to undertake “a forensic analysis of all firearms” held by officers who were on duty in the area at time of the shooting.
The case is the latest to rock the East African nation since an overnight curfew was introduced on Friday. Hours before it began, images and videos shared on social media showed police officers firing tear gas and beating and detaining commuters at a ferry terminal in the coastal city of Mombasa. On Tuesday, the government-mandated Independent Police Oversight Authority said it would investigate the incident, along with other reports of excessive use of force by police.
The 7 p.m. to 5 a.m. curfew is among a raft of new policies aimed at halting the virus. Officials have also closed schools and universities, banned religious gatherings and suspended international flights. Kenya had 59 confirmed cases of the virus on Tuesday, and at least one death.
Police officials in Britain and elsewhere are also enforcing restrictions on movement and have sometimes been accused of overreach. There is “a strong temptation for the police to lose sight of their real functions and turn themselves from citizens in uniform into glorified school prefects,” Jonathan Sumption, a former Supreme Court judge, told the BBC on Monday.
The police in Britain have been given an extended set of powers, including the authority to instruct people to leave a place or return home, and issue fines to anyone who is out in public for anything other than necessary shopping, exercising once a day, or traveling to and from essential work. Officers have issued summons for people for taking drives “out of boredom” and reprimanded others for sitting in the park.
In France, more than a quarter of a million people have been fined since restrictions on movement were announced, according to Interior Ministry figures. And in Italy, the country hardest hit by the outbreak in Europe, anyone violating quarantine rules can be fined up to 3,000 euros, about $3,300.
A U.S. judge orders the release of some immigration detainees.
A federal judge ruled on Tuesday that more than a dozen people must be released from federal immigration detention facilities in Pennsylvania by the end of the day, because the detainees’ age or pre-existing health conditions put them at high risk of contracting the virus in the facilities.
Two of the plaintiffs were already showing symptoms, their lawyers said, but had not been tested for it. According to their legal complaint, the plaintiffs have been sleeping two or three to a small cell, or side-by-side in bigger rooms of more than 50, with bunk beds so close that they could bump into each other during the night.
“They ate shoulder to shoulder and had 60 people sharing four showers and four sinks with little sanitization in between uses,” said Vic Walczak, the legal director of the Pennsylvania chapter of the American Civil Liberties Union, which represented the plaintiffs. “If you have one infected person in that room, those kind of conditions are only going to guarantee that everybody else is going to be infected.”
The complainants in the case — who are from countries including Nigeria, Indonesia, Guatemala and India — were at especially high risk because of high blood pressure, diabetes, high cholesterol, heart stents and other chronic conditions.
In ordering their release, Judge John E. Jones III of the Federal District Court for the Middle District of Pennsylvania wrote, “Our world has been altered with lightning speed, and the results are both unprecedented and ghastly.” He continued, “The choices we now make must reflect this new reality.”
Seeing the pandemic test Trump, Democrats offer up their own policy ideas.
Former Vice President Joseph R. Biden Jr. and Senator Bernie Sanders of Vermont share a number of priorities regarding the outbreak.
Both have been sharply critical of Mr. Trump’s stewardship of the crisis. They have called on him to move to accelerate the production of critical medical gear for health care workers. They have urged him to listen to expert advice from scientists. And they have also expressed concerns about the economic impact of the outbreak, with both seeking housing-related protections for the public.
Mr. Biden and Mr. Sanders have both urged a moratorium on evictions and support temporary rent freezes.
There are also key differences between how they have navigated the crisis.
For Mr. Sanders, the outbreak has offered another reason to push for his signature single-payer health care proposal, “Medicare for all,” which Mr. Biden opposes. Mr. Sanders argues that the moment has revealed extraordinary weaknesses in the American public health system and underscored the need for universal health care.
Mr. Biden, who supports building on the Affordable Care Act with the addition of a public option, has sought to use the crisis to illustrate how he would govern as president, rolling out a public health advisory committee and spending hours receiving briefings focused on the virus and on the economy.
Yet despite ramping up his news media appearances and virtual events, Mr. Biden — the front-runner for the Democratic nomination — has sometimes found himself struggling to break through.
Here are images of a silent New York City.
The lights are still on in Times Square. Billboards blink and storefronts shine in neon. If only there were an audience for this spectacle.
But the thoroughfares have been abandoned. The energy that once crackled along the concrete has eased. The throngs of tourists, the briskly striding commuters, the honking drivers have mostly skittered away.
In their place is a wistful awareness that plays across all five of New York City’s boroughs: Look how eerie the brilliant landscape has become. Look how it no longer bustles.
This is not the New York City anyone signed up for.
Tips for getting through the coronavirus marathon
Experts keep saying to plan for this to last for a long time. And with many communities a week or more into being homebound, the novelty is wearing off. Here are some tips to help fight burnout, manage antsy teenagers, and even freshen up a home to make it better suit current needs.
Reporting and research were contributed by Michael Cooper, Alan Blinder, Karen Zraick, Michael D. Shear, James Glanz, David D. Kirkpatrick, Corina Knoll, Caitlin Dickerson, Elisabetta Povoledo, Mujib Mashal, Asadullah Timory, Najim Rahim, Aurelien Breeden, Constant Méheut, Selam Gebrekidan, Marc Santora, Megan Specia, Joanna Berendt, Benjamin Novak, Raphael Minder, Elian Peltier, Steven Erlanger, Iliana Magra, Donald G. McNeil Jr., Anna Schaverien, Maria Abi-Habib, Sameer Yasir, Raymond Zhong, Knvul Sheikh, Melissa Eddy, Choe Sang-Hun, Abdi Latif Dahir, Michael M. Grynbaum, Katie Glueck, Helene Cooper, Thomas Gibbons-Neff, Andrew Higgins, Adeel Hassan and Richard C. Paddock.