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200,000 Americans could die even if the U.S. takes aggressive action, Fauci says.
Two of the top doctors advising President Trump on the coronavirus pandemic warned on Sunday that as many as 200,000 Americans could die during the outbreak, even with much of the country already under stay-at-home orders and practicing social distancing.
Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and the nation’s leading infectious disease expert, said during a White House briefing that the grim projection was based on scientific modeling, and the forecasts had convinced Mr. Trump to extend social distancing guidelines through the end of April.
“I think it’s entirely conceivable that if we do not mitigate to the extent that we’re trying to do that you could reach that number,” Dr. Fauci said.
Dr. Deborah L. Birx, the lead coordinator of the White House’s coronavirus task force, said that without any precautionary measures, the same models projected that 1.6 million to 2.2 million Americans could die from complications of the virus.
“Some of them predicted half of the United States would get infected,” she said.
Dr. Birx said it was a huge sacrifice for Americans being asked to stay home another month.
“They have to know that we really built this on scientific evidence and the potential to save hundreds of thousands of American lives,” she said.
Trump extends the federal government’s social-distancing guidelines through the end of April.
President Trump said Sunday that the federal government’s guidelines for social distancing would last until April 30, backing down from his previous comments that he hoped the country could go back to work by Easter.
He had clashed with public health experts around the country when he suggested that the guidelines — which urge people to stay at home and not to gather in groups of more than 10 — might be relaxed by April 12. His announcement on Sunday indicated that he had backed down from that suggestion.
A commercial aircraft carrying gloves, masks, gowns and other medical supplies from Shanghai touched down at Kennedy International Airport in New York earlier on Sunday, the first of 22 scheduled flights that White House officials say will funnel much-needed goods to the United States by early April.
The plane carried 130,000 N95 masks, nearly 1.8 million surgical masks and gowns, 10 million gloves and more than 70,000 thermometers, said Lizzie Litzow, a spokeswoman for the Federal Emergency Management Agency. FEMA will provide the majority of the supplies to New York, New Jersey and Connecticut, with the rest going to nursing homes in the area and other high-risk areas across the country, a White House spokesman said.
While the supplies will be welcomed by hospitals and health care workers — some of whom have resorted to rationing protective gear or using homemade supplies — they represent just a tiny portion of what American hospitals need. The Department of Health and Human Services has estimated that the United States will require 3.5 billion masks in the event of a pandemic lasting a year.
The pandemic has started a race among foreign governments, American governors and mayors, good Samaritans and opportunists to acquire protective gear, ventilators and other goods from China, the source of more than one-third of medical supplies in the United States in 2019. While China’s own coronavirus epidemic has subsided since February, newly built factory lines in the country are beginning to churn out masks, gowns and gloves.
The flights are the product of a public-private partnership — led by Jared Kushner, Mr. Trump’s son-in-law and a White House senior adviser — in which the administration is looking to health care distributors like McKesson Corporation, Cardinal, Owens & Minor, Medline, and Henry Schein.
With pleas from state and city leaders for more medical supplies, and questions raised about his interactions with some of them, Mr. Trump on Sunday acknowledged that he would delegate calls to governors — typically Democrats — that he has had personal disagreements with, doubling down on his assertion that the governors need to treat him “fairly.”
“I don’t have to call because I’m probably better off not,” Mr. Trump said. “I get Mike Pence to call. I get the head of FEMA to call. I get the admiral to call.”
Covid-19 patients ‘don’t have to worry’ about big medical bills, health insurers say.
Two of the nation’s largest health insurers, Cigna and Humana, agreed to protect their customers from out-of-pocket costs if they need treatment for Covid-19, a decision that represents a rapid change in how companies are responding to the pandemic.
Describing the insurers’ decision as “a big deal,” President Trump on Sunday said the companies don’t “waive co-pays too easily, but we asked them and they did it.”
While insurers and government officials have taken steps in recent weeks to limit people’s out-of-pocket costs when they get tested, the bills associated with treatment for Covid-19 can run in the tens of thousands of dollars for a single hospital stay.
“Let’s take the economic burden and the economic uncertainty off the table,” said David M. Cordani, the chief executive of Cigna, in an interview before the White House briefing.
Under the new policy, customers “don’t have to worry about the financial burden of the virus while their lives are being turned upside down,” said Bruce Broussard, the chief executive of Humana.
Both Mr. Cordani and Mr. Broussard said they hoped other insurers would follow suit. Last week, another large insurer, Aetna, now part of CVS Health, said it would also waive cost-sharing related to hospital stays.
Employers that self-insure provide coverage to the majority of workers in this country, and they would not be affected by the insurers’ decision. They would have to decide individually whether they would take similar action. “It is going to be a client-by-client decision,” Mr. Cordani said.
Whether individuals will be completely free of any surprise medical bills is also unclear, given the frequent disputes that normally arise between insurers and hospitals and doctors. People who get care from doctors outside their plan’s network could also still potentially face unpaid bills.
‘I know we feel under attack,’ Cuomo tells New Yorkers rattled by quarantine talk.
President Trump’s discussion of a quarantine of the New York region over the weekend confused many tri-state area residents and raised questions about the limits of presidential power.
“I had a lot of phone calls yesterday when the president first suggested some form of quarantine,” Gov. Andrew M. Cuomo of New York said on Sunday. “I know we feel under attack.”
Mr. Trump backed away from the idea following criticism from Mr. Cuomo and other leaders. The Centers for Disease Control and Prevention instead issued a formal advisory Saturday night urging residents of New York, New Jersey and Connecticut to “refrain from nonessential domestic travel for 14 days effective immediately.”
The advisory does not apply to “employees of critical infrastructure industries,” the agency said. That includes trucking, public health professionals, financial services and food supply workers.
Mr. Trump denied on Sunday that the prospect of a quarantine was a threat. “I didn’t go around threatening,” he said during a White House briefing.
He raised the idea because the region has the most confirmed coronavirus cases in the United States, but he offered no details about how his administration would enforce it. Mr. Cuomo later questioned whether the federal government had the authority to order a quarantine.
“Yes, New York is the epicenter and these are different times, and many people are frightened,” Mr. Cuomo said on Sunday. “Some of the reactions you get from individuals, even from governments, are frightening and suggesting that they’ll take abrupt actions against New York. But look, this is New York and we are going to make it through this.”
As of Sunday evening, at least 141,096 people across every state, plus Washington, D.C., and four U.S. territories, have tested positive for the virus, according to a New York Times database. At least 2,469 patients with the virus have died. And at least 20 states now have more than 1,000 known cases within their borders.
New York remains by far the hardest hit. On Sunday, Mr. Cuomo said the total number of cases in New York was 59,513, an increase of nearly 7,200 confirmed from the day before. More than half of the cases, or 33,768, are in New York City.
The number of deaths in the state passed 1,000, up 272 from the day before — the largest one-day increase in deaths since the outbreak began.
About 8,500 people are currently hospitalized, an increase of 16 percent from Saturday to Sunday. Of those, 2,037 are in intensive care units, which are equipped with ventilators.
Syria reports its first coronavirus death.
As the coronavirus pandemic has sickened more than 700,000 people worldwide and killed over 30,000, the Syrian government reported the first death from the virus in its territory on Sunday, about a week after announcing its first confirmed case. The outbreak, if uncontrolled, could shred a health care system already enfeebled by more than nine years of civil war.
After the virus had struck neighboring countries, the Syrian government did not acknowledge any confirmed cases for weeks, even as rumors spread of hospitalizations and deaths from pneumonia-like diseases. But Syria has now confirmed 10 cases, including the patient who died on Sunday, according to a state news agency.
The government had already moved to fend off an outbreak before announcing its first case. It closed schools and universities, limited working hours, banned gatherings, postponed parliamentary elections and built quarantine centers. Syrians are now subject to a nightly curfew between 6 p.m. and 6 a.m.
But Syrians and recent visitors to the country said in interviews that daily life appeared to continue much as usual. Marketplaces and streets were crowded; few wore masks or gloves.
The health care system would be rapidly overwhelmed in a full-blown outbreak, aid workers say. Many doctors and nurses have fled the country, and hospitals were bombed and never rebuilt, leaving large swaths of the population with limited access to medical care. U.S. and European sanctions make it difficult to import supplies.
The W.H.O. has delivered testing kits and protective equipment for health care workers, but medical aid groups that operate in the country have found their efforts to prepare hampered by the new restrictions on working hours and on gathering.
“Basic services have been all but decimated,” said Rachel Sider, a Syrian policy adviser at the Norwegian Refugee Council. “It’s impossible to imagine how this country can cope with an outbreak.”
Public officials around the world have continued to struggle with the pandemic.
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In Russia, Moscow declared a lockdown starting Monday. People must not leave home except in an emergency or to go to the nearest grocery store or walk their dogs, going no further than 100 meters. People will still be able to enter and leave the city. Russia has reported 1,534 confirmed cases of coronavirus, far fewer than many Western countries, but the numbers have risen rapidly in recent days — particularly in Moscow, which accounts for most of the cases.
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The police in South Africa wrote on Twitter that it had set up roadblocks and were checking vehicles on Sunday to ensure that people across the country complied with the regulations of the 21-day lockdown.
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Italy reported more than 97,689 cases of the coronavirus, an increase of more than 5,200 from Saturday. The number of deaths totaled 10,779, an increase of 756 from Saturday.
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France reported 40,174 cases, an increase of 2,599 from the day before. The country reported 2,606 deaths, an increase of 292 from Saturday. But there has been a decline in the percentage increase in new deaths reported on each of the last three days, to 13 percent Sunday from 27 percent on Thursday. Two high-speed trains started carrying patients from eastern France, one of the more affected regions, to hospitals along France’s western coast, where the outbreak has been limited so far.
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England’s deputy chief medical officer said on Sunday that Britons may be under some form of lockdown for six months or longer, warning that the country faces a second wave of coronavirus if they are lifted too quickly. Britain had over 17,000 confirmed coronavirus cases as of Sunday — including Prime Minister Boris Johnson, who was initially reluctant to introduce social distancing measures in the country, and Prince Charles, the heir to the British throne.
A cruise ship on which passengers died heads to Florida from Panama.
The Zaandam, a Holland America cruise ship on which four passengers died, will be allowed to transit the Panama Canal, after authorities initially refused the ship entry because of illness onboard.
The ship was supposed to let its passengers disembark in Chile two weeks ago but was refused entry, so it headed to Fort Lauderdale, Fla., where the ship does not yet have permission to dock.
A week ago, people on the ship started getting sick. The company said on Friday that around 180 people, including 110 members of the crew, have flulike symptoms and two have tested positive for Covid-19, the disease caused by the coronavirus. Those who are sick and their close contacts will stay onboard, and everyone else will be transferred to the Rotterdam, another cruise ship, which arrived in Panama from Mexico to deliver supplies, coronavirus tests and doctors.
Crew members aboard the Rotterdam told The New York Times that they felt tricked because they were told they were going to Panama to deliver supplies only to learn that they would also take on hundreds of passengers who had been exposed to the virus. Some crew members have refused to come out of their cabins and were threatened with being in violation of their employment contracts, according to a crew member who spoke on the condition of anonymity because he feared reprisal.
Holland America, which is owned by Carnival Corp., did not return requests for further information.
“We are aware of reported permission for both Zaandam and Rotterdam to transit the Panama Canal in the near future,” the company said in a statement. “We greatly appreciate this consideration in the humanitarian interest of our guests and crew.”
The ship received special authorization from Panama’s Ministry of Health and will transit the canal under “special considerations and for humanitarian reasons,” the canal authority said on Twitter. Crossing the canal will allow the ship to save two travel days, the canal authority added.
Robert Rorison, a passenger from Surrey, British Columbia, said he was denied a transfer to the Rotterdam because he uses a CPAP machine to sleep, which disqualified him. “We get three meals a day, but every day we get less food,” he said in a text message. “We’re comfortable, but not knowing is difficult, and being in this small room for so long is a disaster.”
Pelosi and the White House exchange accusations of early denial of the coronavirus’s gravity.
On Sunday, Speaker Nancy Pelosi put the blame for the nation’s flawed response to the pandemic squarely on President Trump.
“His denial at the beginning was deadly,” Ms. Pelosi, a California Democrat, said on CNN’s “State of the Union.” “Now I think the best thing would be to do is to prevent more loss of life.”
“We really want to work in a unified way to get the job done here,” she added, “but we cannot continue to allow him to continue to make these underestimates of what is actually happening here.”
“Don’t fiddle while people die, Mr. President,” Ms. Pelosi said.
Hours later, a White House spokesman lashed out at Ms. Pelosi’s comments, alleging that it was the speaker and the media who had initially refused to acknowledge the severity of the outbreak, and using hyperbolic language to attack her negotiating position on the $2 trillion aid bill Mr. Trump signed on Friday.
“When she was faced with offering immediate relief to real Americans who are struggling, she blew up negotiations on the coronavirus relief bill with a shameful political attempt to tack radical leftist programs on to the bill,” said Hogan Gidley, the spokesman.
Democrats did hold up economic stimulus legislation for three days last week while Ms. Pelosi and Senator Chuck Schumer of New York, the minority leader, insisted on changes to secure the support of their caucuses, including increased oversight for a bailout fund for distressed businesses.
As reports of the coronavirus’s spread in China began to trickle out, Congress was dealing with Mr. Trump’s impeachment trial, but also hosted multiple briefings with administration officials to update lawmakers on the outbreak.
Mr. Trump, for his part, has played down the spread of the virus until recently, and has repeatedly touted unproven treatments while contradicting his administration’s scientific experts on how lethal the virus is and how quickly it may be contained in the United States.
Lawmakers are floating the possibility of another emergency response bill.
Over fewer than four weeks, Congress and the White House have agreed to billions of dollars in emergency aid, a significant expansion of the social safety net and a $2 trillion stimulus, the largest economic response package in modern American history.
But lawmakers, administration officials, industry groups and lobbyists are already outlining possible elements of a fourth piece of legislation to combat the spread of the coronavirus and bolster a shuddering economy.
“We have to pass another bill that goes to meeting the need more substantially than we have,” Speaker Nancy Pelosi said on CNN’s “State of the Union” on Sunday, ticking off a list of Democratic priorities, including increased protections for workers on the front lines and a further expansion of new paid sick-leave provisions.
Some officials who were involved in the negotiations over the earlier bills, including Treasury Secretary Steven Mnuchin, have cautioned that they may need to see how those laws are implemented before solidifying the components of new legislations. Still, the fourth package could include additional direct payments to taxpayers, as well as more funds for hospitals, states and local governments.
“If, for whatever reason, this takes longer than we think, we will go back to Congress and get more support for the American economy,” Mr. Mnuchin said on “Face the Nation” on CBS, adding that he hoped such a step was not needed.
Senator Mitch McConnell of Kentucky, the Republican majority leader, has instructed the senators “to stay nimble,” acknowledging that they may have to return sooner than the chamber’s next scheduled session on April 20.
India struggles through the world’s biggest lockdown.
Hundreds of thousands of migrant laborers in India have begun long journeys on foot to get home, having been rendered homeless and jobless by the world’s biggest lockdown.
In different parts of the country, more than a dozen laborers have died during the journeys, hospital officials said early Monday morning.
In the capital, Delhi, thousands of migrants, including whole families, packed their pots, pans and blankets into rucksacks, some balancing small children on their shoulders as they walked along interstate highways, in one of the biggest migrations in the country’s recent history. Some planned to walk hundreds of miles. But as they reached the Delhi border, many were beaten back by the police.
“You fear the disease, living on the streets. But I fear hunger more, not corona,” said Papu, 32, who came to Delhi three weeks ago for work and was trying to get to his home in Saharanpur in the state of Uttar Pradesh, 125 miles away.
On Sunday, Prime Minister Narendra Modi apologized to the country for imposing the nationwide lockdown, which was announced with just four hours’ notice on Tuesday.
So far, 980 people have tested positive for the coronavirus in India, with 24 dead, according to officials.
India already had one of the world’s largest homeless populations, and the lockdown may have tripled it overnight, workers for nongovernmental organizations say. A 2011 government census put the number of homeless at 1.7 million, almost certainly a vast underestimate in the country of 1.3 billion.
The lockdown, which includes a ban on interstate travel, left India’s enormous migrant population stranded in big cities, where jobs have lured them in vast numbers from the countryside.
Answers to your questions about staying fit.
Stuck at home? You don’t need access to a gym to stay active. You can (and should) go outside for a walk or run (or do push-ups and squats).
Reporting and research were contributed by Neil Vigdor, Frances Robles, Neil MacFarquhar, Alan Blinder, Michael D. Shear, Jesse McKinley, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas, Noah Weiland, Ali Watkins, Katie Van Syckle, Ana Swanson, Anton Troianovksi, Maria Abi-Habib, Austin Ramzy, Tess Felder, Yonette Joseph, Raphael Minder, Iliana Magra, Katie Glueck, Elisabetta Povoledo, Emily Cochrane, Reed Abelson, Constant Méheut and Vivian Yee.