NYT : Trump Threatens to Withhold Funding for World Health Organization

Coronavirus Live Updates:
April 7, 2020, 7:10 p.m.
By each recorded one-day highs for deaths. Boris Johnson, Britain’s prime minister, remained in intensive care. China ended the lockdown in Wuhan.

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Jack Dorsey plans to give $1 billion worth of his stake in Square, the payments company he helped found, to coronavirus relief efforts, he said in a tweet.

Trump attacked the W.H.O. for its handling of the coronavirus outbreak and its criticisms of his policy.
President Donald Trump and Vice President Mike Pence during the daily Coronavirus briefing in the White House briefing room on Tuesday.
Doug Mills/The New York Times

President Trump lashed out on Tuesday at the World Health Organization, creating a new enemy to attack and threatening to withhold funding from the world’s premier health institution even as a deadly virus ravages nations around the globe.

“We’re going to put a hold on money spent to the W.H.O.; we’re going to put a very powerful hold on it and we’re going to see,” Mr. Trump said, accusing the organization of having not been aggressive enough in confronting the dangers from the virus. “They called it wrong. They call it wrong. They really they missed the call.”

In effect, Mr. Trump was attempting to blame the W.H.O. for the very missteps and failures that have been leveled at him and his administration. Public health experts have said Mr. Trump’s public denials of concern about the virus slowed the American response, which included slow testing and a failure to stockpile protective gear.

In fact, the W.H.O. was sounding the alarm in the earliest days of the crisis, declaring a “public health emergency of international concern” a day before the United States secretary of health and human services announced its own public health emergency and weeks before Mr. Trump declared a national emergency because of the virus.

Mr. Trump appeared to be particularly angry at the W.H.O. for issuing a statement saying it did not support his decision on Jan. 31 to restrict some travel from China because of the virus. At the time, the group issued a statement saying that “restricting the movement of people and goods during public health emergencies is ineffective in most situations and may divert resources from other interventions.”

“Don’t close your borders to China, don’t do this,” Mr. Trump said, paraphrasing the group and accusing the organization of “not seeing” the outbreak when it started in Wuhan, China. “They didn’t see it, how do you not see it? They didn’t see it. They didn’t report it. If they did see it, they must have seen it, but they didn’t report.”

In fact, the W.H.O. repeatedly issued statements about the emergence of the virus in China and its movement around the world.

The budget for the W.H.O. is about $5 billion, which comes from member countries around the world. In 2017, the last year for which figures were available, the United States was required to spend $111 million based on the organization’s rules, but sent an additional $401 million in voluntary contributions.

It was unclear whether Mr. Trump planned to eliminate all of the money that the United States sends to the organization, or if he would follow through, but he said that “we’re going to look at it.” He added that his government will investigate the W.H.O. and said that “we will look at ending funding.”

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See How the Coronavirus Death Toll Grew Across the U.S.
The number of deaths from the virus doubled to more than 10,000 in fewer than five days, and two-thirds of the country’s metro areas have had at least one person succumb to the virus.
Trump effectively ousts the top watchdog for the $2 trillion in virus relief.

President Trump moved on Tuesday to oust the leader of a new panel of watchdogs charged with overseeing how his administration spends trillions of taxpayer dollars in coronavirus pandemic relief. It was the latest step in an unfolding White House power play over semi-independent inspectors general across the government.

The official, Glenn A. Fine, has been the acting inspector general for the Defense Department since before Mr. Trump took office. Last week, an umbrella group of inspectors general across the executive branch named him the chairman of a new Pandemic Response Accountability Committee with control of an $80 million budget to police how the government carries out the $2 trillion relief bill.

Drew Angerer/Getty Images

But Mr. Trump has now abruptly named a different federal official — Sean O’Donnell, the Environmental Protection Agency’s inspector general — to be the acting inspector general for the Defense Department. The move effectively removed Mr. Fine — a former Justice Department inspector general with a reputation for aggression and independence — from his role overseeing pandemic spending.

Democrats immediately condemned Mr. Fine’s sudden sidelining from the committee as “corrupt,” in the words of Senator Chuck Schumer of New York, the minority leader.

Representative Carolyn B. Maloney, Democrat of New York and the chairwoman of the House Oversight and Government Reform Committee, blasted Mr. Trump’s actions as “a direct insult to the American taxpayers — of all political stripes — who want to make sure that their tax dollars are not squandered on wasteful boondoggles, incompetence or political favors.”

And Senator Jack Reed of Rhode Island, the top Democrat on the Senate Armed Services Committee, said his panel had been given no justification or rationale for Mr. Fine’s replacement.

The acting Navy secretary resigns after an outcry over criticism of a virus-stricken crew.

Thomas B. Modly, the acting Navy secretary, resigned Tuesday following his bungled response to an outbreak of the virus aboard the aircraft carrier Theodore Roosevelt engulfed the Navy in a public relations disaster, Defense Department officials said.

Mr. Modly’s departure marks the latest in a string of events that began last week, after The San Francisco Chronicle published a letter in which the Roosevelt’s commander, Capt. Brett E. Crozier, pleaded with the Navy to help contain the virus that had spread rapidly through his ship.

The Navy has announced more than 170 coronavirus cases aboard the Roosevelt since the outbreak started in late March, after the ship had docked in Da Nang, Vietnam.

Mr. Modly fired Captain Crozier on April 2 after accusing him of circumventing the Navy’s traditional chain of command by copying more than 20 people on the emailed letter.

The firing sent shock waves through the crew, which was only exacerbated Monday when Mr. Modly flew to Guam, where the Roosevelt is now docked, and said Captain Crozier was “too naïve or too stupid to be a commanding officer of a ship like this.”

He also rebuked the crew for having cheered their captain as he left the ship.

President Trump said Tuesday that he had no direct involvement in Mr. Modly’s resignation, but he came to his defense, saying that he would not have asked him to resign, suggesting that he was disappointed in that decision.

“I would not have asked him. I don’t know him. I didn’t speak to him, but he did that,” Mr. Trump said. “I think just to end that problem. And I think in one, in really many ways, that was a very unselfish thing for him to do.”

Mr. Trump also criticized Captain Crozier. “The whole thing was very unfortunate,” Mr. Trump said. “The captain shouldn’t have written the letter. He didn’t have to be Ernest Hemingway.”

New York and New Jersey record one-day highs for deaths.

Five weeks into the coronavirus outbreak, officials in New York and New Jersey, the two states hit hardest by the pandemic, hoped that the number of virus-related deaths had reached a peak and would flatten or drop for a third straight day.

It did not happen.

Gov. Andrew M. Cuomo of New York said on Tuesday that 731 people had died of the virus since Monday, the state’s highest one-day total yet by more than 100.

“Behind every one of those numbers is an individual, is a family, is a mother, is a father, is a sister, is a brother,” Mr. Cuomo said at his daily briefing in Albany. “So a lot of pain again today for many New Yorkers.”

New Jersey’s toll also hit a new one-day high on Tuesday, with 232 people dying of the virus since the previous day, Gov. Philip D. Murphy said. On Sunday and Monday, deaths in the state were in the double digits.

More people have died in New York and New Jersey, by far, than in any other state. The two states together account for more than half of the virus-related deaths in the United States. New York’s toll was 5,489 as of Tuesday; New Jersey’s was 1,232.

“It’s almost unfathomable, folks, when you think about it,” Mr. Murphy said.

Mr. Cuomo emphasized that the death rate was a lagging indicator, and pointed to a falling rate of hospitalizations. He also said that the state was still projecting that the spread of the virus was plateauing.

The number of hospitalizations depends not only on the number of new arrivals but also on hospital admission standards. As hospitals have teetered on the brink of being overwhelmed, they have sent home people whom they would have admitted just a few weeks earlier, several New York doctors said in interviews.

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‘I Know It Feels Like a Lifetime,’ Cuomo Says of Coronavirus Crisis

Gov. Andrew M. Cuomo of New York said that coronavirus deaths hit a new one-day peak in the state, but that hospitalizations were slowing.

Total number of newly hospitalized is up from yesterday. But when you look at the three-day averaging of these numbers, the three-day average is down, which is good news. This is the three-day hospitalization rate. We tend not to look at any one day, day-to-day. It’s up somewhat. But if you look at the three-day average, it’s moving down, which is good news. The bad news is 5,489 New Yorkers have lost their lives to this virus. That is up from 4,758. That is the largest single-day increase. And we talk about numbers, but that’s 731 people who we lost — behind every one of those numbers is an individual, is a family, is a mother, is a father, is a sister, is a brother. So a lot of pain. Department of Health developed an antibody testing regimen that Department of Health has approved for use in New York State. That has to be brought to scale, and the Department of Health is going to be working with the F.D.A. to do just that. This tests the blood to determine whether or not you have the antibodies, which means you had the virus and resolved the virus. I know it feels like a lifetime. It’s been so disruptive. So abrupt. So frightening. So disorienting, but it’s only been 37 days, right? Everything in context and everything in perspective.

Gov. Andrew M. Cuomo of New York said that coronavirus deaths hit a new one-day peak in the state, but that hospitalizations were slowing.Mike Segar/Mike Segar

So even if the number of hospitalizations appears to have plateaued, that could be because the number of sick people turning up has lessened, or it may have to do with changing hospital admissions standards — or both.

Mr. Cuomo said that social distancing practices were working and that they had to continue.

The governor also said that planning was underway to restart the regional economy and that he had spoken to the governors of New Jersey and Connecticut about coordinating those efforts.

Britain is gripped by concern for the health of its prime minister, and questions of succession.
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Boris Johnson Is a ‘Fighter and He’ll Be Back,’ Raab Says

Britain’s foreign secretary, Dominic Raab, said that Prime Minister Boris Johnson was breathing without any assistance at a hospital as he battles the coronavirus.

Can I first give an update on the condition of the prime minister. I know a lot of people be concerned about that. I can tell you he’s receiving the very best care from the excellent medical team at St. Thomas’s Hospital. He remained stable overnight. He’s receiving standard oxygen treatment, and breathing without any assistance. He’s not required any mechanical ventilation or non-invasive respiratory support. He remains in good spirits, and in keeping with usual clinical practice, his progress continues to be monitored closely in critical care. I think it’s probably worth just remembering that as will be the case for many people up and down the country who know someone at work who’s fallen ill with the coronavirus, it comes as a shock to all of us. He’s not just the prime minister for all of us in cabinet. He’s not just our boss. He’s also a colleague, and he’s also our friend. So all of our thoughts and prayers are with the prime minister at this time with Carrie and with his whole family. And I’m confident he’ll pull through because if there’s one thing I know about this prime minister, he’s a fighter and he’ll be back at the helm leading us through this crisis in short order. Of course, for us in cabinet we know exactly what he wants from us, and what he expects from us right now. And following the cabinet discussion today, I can reassure the prime minister. And we can reassure the public that his team will not blink. And we will not flinch from the task at hand at this crucial moment. We’ll keep all of our focus and all of our resolve with calm determination on delivering the government’s plan to defeat the coronavirus.

Britain’s foreign secretary, Dominic Raab, said that Prime Minister Boris Johnson was breathing without any assistance at a hospital as he battles the coronavirus.Simon Dawson/Reuters

Prime Minister Boris Johnson of Britain remained in the intensive care unit of a London hospital on Tuesday battling symptoms, raising questions not just about the state of his health but about who would lead the country, gripped by a major outbreak, in his stead if that became necessary. In England alone, 758 patients were reported to have died in hospital in 24 hours, public health officials reported on Tuesday.

Mr. Johnson was transferred to the intensive care unit on Monday after his illness worsened. Aides said he had been moved in case he needed a ventilator to help his recovery. On Tuesday evening, the British foreign secretary, Dominic Raab, said that Mr. Johnson was “receiving standard oxygen treatment and breathing without any assistance,” like a ventilator.

As Britain has no written Constitution and no standard line of succession in the case of illness or death of the head of the government, it was for Mr. Johnson to decide who should stand in for him if he became ill. But the man he nominated, Mr. Raab, has been relatively untested, serving as the leader of the Foreign Office for less than a year.

While Mr. Johnson remains as the head of the government from his hospital bed, the seriousness of his illness means that could change quickly. At a time of extraordinary challenge, Mr. Raab is already serving as chairman of a key committee on the pandemic as the government battles to control the spread of the virus and stabilize an economy hit hard by the lockdown measures it has imposed.

Previous British prime ministers, including Tony Blair and Margaret Thatcher, have had health issues while in power, but had brief periods of absence for planned procedures.

Mr. Johnson could be hospitalized for some time, and at a moment when the government must make major decisions about its virus response. Though some British prime ministers have nominated deputies, Mr. Johnson chose not to do so when he took the role last year.

The last time Britain experienced such a power vacuum was in 1953, when Winston Churchill suffered a stroke and the truth of his condition was kept from the British public.

Before going into intensive care, Mr. Johnson asked Mr. Raab to stand in for him “where necessary.”

Another senior minister, Michael Gove — who has had a lead role in coordinating the government’s response, including giving interviews on Mr. Johnson’s state of health — announced on Twitter on Tuesday that he was self-isolating. He felt well, he said, but a member of his family showed symptoms of the virus.

Black Americans face alarming rates of infection in some states.

African-Americans are suffering virus infections at disturbing rates in some of the largest cities and states in the United States, emerging statistics show.

In Louisiana, about 70 percent of the people who have died are African-American, though only a third of the state’s population is black. In the county around Milwaukee, where 27 percent of residents are black, nearly twice as many African-American residents tested positive for the virus as white people. And in Chicago, where African-American residents make up a little less than a third of the population, more than half of those found to have the virus are black, and African-Americans make up 72 percent of those who have died of the virus.

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said Tuesday at a White House briefing that the figures were concerning. He said diseases like diabetes, hypertension, obesity, and asthma disproportionately affect African-Americans, and that patients with these diseases and coronavirus often have bad outcomes.

“It’s very sad,” Dr. Fauci said. “There’s nothing we can do about it right now except try and get them the best possible care to avoid those complications.”

Data on the race of those sickened by the virus has only been made public in a handful of places and is too limited to make sweeping conclusions. But racial disparities in cases and outcomes, researchers said, reflect what happens when a viral pandemic is layered on top of entrenched inequalities.

The data, researchers said, is partly explained by factors that could make black Americans more vulnerable in any outbreak: They are less likely to be insured, more likely to already have health conditions and more likely to be denied testing and treatment. There is also the highly infectious nature of the virus in a society where black Americans disproportionately hold jobs that do not allow them to stay at home, the researchers said.

“If you walk outside and see who is actually still working,” said Elaine Nsoesie, of Boston University’s School of Public Health, “the data don’t seem surprising.”

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Coronavirus Map: Tracking the Global Outbreak

The virus has infected more than 1.3 million people in at least 177 countries.

In an early test of virus-era voting, some voters in Wisconsin are waiting more than two hours.

Long lines, health jitters, flaring tempers and a dose of chaos and confusion marked Wisconsin’s presidential primary and local elections on Tuesday, as voters were forced to choose between staying safe during a pandemic and exercising their civic duty.

State Republican leaders, backed up by a conservative majority on the state Supreme Court, rebuffed the Democratic governor’s attempt to postpone in-person voting at a moment when the outbreak has prompted officials to recommend stay-at-home orders in most of the nation.

Voters in Milwaukee, the state’s Democratic base and most populous city, experienced significant disruptions. Election workers there expected more than 50,000 voters Tuesday, but the number of polling locations was drastically reduced, from more than 180 to just five. Some voters waited in line for more than two hours, spread out over blocks as they tried to practice social distancing.

In other parts of the state, especially in smaller communities that tend to be less Democratic, the in-person voting process was running relatively smoothly, with wait times more closely resembling a normal election.

It remained to be seen how the disruptions could affect the Democratic presidential primary contest between former Vice President Joseph R. Biden Jr. and Senator Bernie Sanders.

The political and legal skirmishing surrounding the Wisconsin balloting amounted to only the first round of an expected national fight over voting rights during the crisis.

Gov. Tony Evers of Wisconsin, a Democrat, had issued an executive order postponing in-person voting and extending to June the deadline for absentee ballots. But Republican leaders succeeded in getting the state’s top court to stay the decree.

And in a decision late Monday, the U.S. Supreme Court’s conservative-leaning majority dealt its own blow to Wisconsin Democrats. In a 5-4 vote, the majority ruled against extending the deadline for absentee voting, saying such a change “fundamentally alters the nature of the election.” The court’s four liberal members dissented, with Justice Ruth Bader Ginsburg writing that “the court’s order, I fear, will result in massive disenfranchisement.”

On Tuesday Mr. Biden criticized Mr. Trump’s stewardship of the crisis, a day after the two men spoke by phone over how to combat the outbreak.

“His failings and his delays continue,” Mr. Biden said by video to a virtual convention hosted by the Pennsylvania AFL-CIO. “We continue to see it. And it’s causing real pain for so many Americans.”

Mr. Biden, who has said that the presidential election must take place in November as required, raised the prospect of voting by mail.

“We cannot delay or postpone a constitutionally required November election,” Mr. Biden said during an earlier appearance on NBC. “We should be thinking now ahead — have all the experts, both political parties and academia laying out what it would take to have voting by mail. I’d much prefer to have, you know, in-person voting but it depends. It depends on the state of play.”

China ends a lockdown on Wuhan as the country reports its first day since January with no deaths.
Wuhan, China, had been sealed off since late January in an effort to limit the coronavirus outbreak’s spread. The city’s recovery could dictate how other places move forward.Roman Pilipey/EPA, via Shutterstock

China has ended its lockdown of Wuhan, the city where the coronavirus first emerged and a potent symbol in a pandemic that has killed tens of thousands of people. But the damaged city has a long way to go before it returns to normal.

The move came hours after China announced no new deaths from the virus for the first time since January, though doubts remain about the veracity of China’s statistics.

The Chinese authorities had sealed off Wuhan, an industrial hub of 11 million people, in late January, in a frantic attempt to limit the outbreak’s spread. At the time, many outsiders saw it as an extreme step, one that could be tried only in an authoritarian system like China’s. But as the epidemic has worsened, governments around the world have enacted a variety of stringent restrictions on their citizens’ movements.

Wuhan’s recovery could offer a window into how other places recover. Sickness and death have touched hundreds of thousands of lives. Businesses, even those that have reopened, face a wrenching road ahead, with sluggishness likely to persist. Neighborhood authorities continue to regulate people’s comings and goings, with no return to normalcy in sight.

Controls on outbound travel were officially lifted just after midnight on Wednesday in China. People can now leave after presenting to the authorities a government-sanctioned phone app that indicates, based on their home address, recent travels and medical history, whether they are a contagion risk. China’s national rail operator estimated that more than 55,000 people would leave Wuhan by train on Wednesday, according to a state-run broadcaster.

China has had 83,654 infections since the start of the outbreak, according to official figures collated by The New York Times. At least 3,331 people nationwide have died, with most other patients recovered.

But many believe the true death toll is far higher. American intelligence officers say that because midlevel officials in Wuhan and elsewhere have lied about infection rates, testing and death counts, even Beijing does not know the full extent of China’s outbreak. Those doubts are rife in Wuhan, where officials have suppressed online discussion of fatalities and pushed for quick, quiet burials of victims.

The Chinese Communist Party said on Tuesday that it was investigating an outspoken property tycoon who accused China’s top leader, Xi Jinping, of having mishandled the outbreak.

Party officials said the man, Ren Zhiqiang, was suspected of “serious violations of discipline and law,” a euphemism the authorities often use for corruption and other abuses of power.

Mr. Ren, a longtime party member, disappeared last month after having written an explosive essay describing Mr. Xi as a power-hungry “clown.” The essay, which circulated on Chinese social media sites, said that the party’s strict limits on freedom of speech and its silencing of the news media had exacerbated the epidemic.

A brief statement about the investigation of Mr. Ren, issued by party disciplinary officials in Beijing, did not provide Mr. Ren’s whereabouts, give details about the status of his case or make mention of the essay.

Amid some encouraging signs, major challenges remain in grappling with the virus.

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How Coronavirus Attacks the Body

It doesn’t take long for mild coronavirus symptoms to turn serious. These virtual reality images show how the virus can invade the lungs and kill.

You’re looking at a virtual reality image of a coronavirus patient at George Washington Hospital in Washington, D.C. The patient is a generally healthy 59-year-old man with high blood pressure. Just days before this image was created, he was asymptomatic. But now, those green areas show where the infection has damaged tissue in the lungs. For many, Covid-19 will be mild, but for others it’s deadly. This video is about the latter path: How the virus kills. We’ll start in China: 191 confirmed Covid-19 patients were in a hospital in Wuhan — 54 died. Of those 54, 50 had a condition known as ARDS, Acute Respiratory Distress Syndrome. It’s a condition that stops oxygen from reaching the organs. “You have air hunger.” “It means that they can’t breathe.” “There’s a very strong correlation between the people who develop ARDS and the people who die.” ARDS is not unique to Covid-19. “It’s such a long list of causes: infection, people with H.I.V./AIDS. If you get into a big motor vehicle accident and sustain multiple injuries to multiple organs, that causes ARDS, SARS and MERS. Now, things that you inhale and that can be toxic can cause ARDS: household bleach, you know, war gases, mustard gas and phosgene. To the people who vaped THC that was contaminated with vitamin E acetate, and those patients were also developing ARDS.” Here’s what’s actually happening when you get ARDS. When we breathe in air, oxygen goes down our windpipe and fills the lungs. Specifically, the small air sacs at the end of the lungs are the key to air exchange in the body. “So that’s why nature has created, or evolution has created, this very, very — the barrier is so thin. It’s just a few micrometers in size. So the oxygen has to go through just a little bit of collagen, the cell that lines the alveolus, into the red blood cell. Once it gets into the red blood cell, then the blood takes it back into the heart and from there to the rest of the body.” And this is the key to understanding why Covid-19 is killing people. “That entire wall of the air sac gets damaged by the virus. Think of it like a thick layer of paint on the inside of the walls of a room or a thick layer of mold on the walls on the inside of the room. That’s what it looks like.” As that wall becomes thicker, oxygen can no longer pass into the bloodstream, and your organs begin to suffocate. So if you are sick, you might be asking yourself: Am I on the mild path or the serious path? A good indication is whether you have severe shortness of breath and for how long. Those are indications the virus has progressed lower into the lungs. One small study of hospitalized patients in China found that zero to two days after development of symptoms, chest scans were coming back normal for more than half of patients. Keep in mind, these are patients that were sick enough to be in the hospital. But within three to five days after symptoms started, that flipped, and 91 percent of hospitalized patients had significant respiratory issues. “As you progress beyond the seven to 10 days stage, that’s when the ARDS seems to be developing. And once it develops, it develops rapidly fast compared to ARDS developing from let’s say another cause. And these patients seem to be doing much worse over a relatively faster period of time.” Many people have mild or even no symptoms with the virus. But the longer Covid-19 affects your lungs, the higher the risk of serious respiratory issues. “And the longer you’re on the ventilator, the less likelihood you will come off the ventilator. That is the blunt truth of this situation.” “When I saw this in our first patient, and you see the extent of the damage and how it affects both lungs and various parts of the lungs, and it’s much more striking even for somebody who’s been in practice for almost 20 years.” And that’s what happened to this patient. “Just about one week after being at our hospital, unfortunately he passed away. Really my goal of trying to get this out into the public is so that they understand the severity of the problem that we’re seeing, and why the social distancing and the flatten the curve, and every other hashtag that’s come up in the past couple weeks, is just so, so important — is because this is a community-wide problem. It’s a global problem, and it’s going to take a community solution. Right? Everybody has a role to play. And if you’re not in the health care field right now, your role is to stay home. All right? Because again, the virus doesn’t move on its own. People move. People transmit the virus.” Gov. Cuomo: “And the longer you’re on the ventilator, the less likelihood you will come off the ventilator.”

It doesn’t take long for mild coronavirus symptoms to turn serious. These virtual reality images show how the virus can invade the lungs and kill.

After weeks of unrelentingly bleak news, a few encouraging signs have begun to emerge in recent days suggesting that the spread of the virus is beginning to slow in at least some parts of Asia and Europe that have adopted strict social distancing measures.

Wuhan, the Chinese city where the virus first appeared, lifted its lockdown, and China announced no new deaths from the virus for the first time since January, though doubts remain about the veracity of its statistics. Two of Europe’s most battered countries, Italy and Spain, have seen hopeful signs that their rate of new infections may be slowing. And one framework that American policymakers are relying on to try to predict the course of the outbreak, by the Institute for Health Metrics and Evaluation at the University of Washington, was recently revised with generally less dire projections.

But the scope of the staggering challenges that remain was underscored Tuesday when New York, the hardest hit state in America, reported that another 731 people had died from the virus, the most deaths there in a single day since the crisis began.

It was a sobering reminder that, even amid signs that the spread of the virus may be beginning to level off in parts in some hard-hit places — and there have even been signs suggesting that it may be in New York — it is doing so at a very high level. Many people continue to die each day and many hospitals are stretched to their limits.

Gov. Andrew M. Cuomo of New York said that while the state’s new death toll was upsetting, he was encouraged by data showing that the rate of hospitalizations had fallen for several days, suggesting that the spread of the virus could be plateauing. But he cautioned against growing complacent or easing up on social distancing measures that seem to be working.

“To the extent that we see a flattening or a possible plateau,” Mr. Cuomo said, “that’s because of what we are doing and we have to keep doing it.”

And for all the places that seem to be making progress, there are other places where the crisis only seems to be growing.

France’s health minister said Tuesday that the country had not reached the peak of its epidemic and was “still in a worsening phase.” The country has recorded some 78,167 cases in total and 10,328 deaths, with the toll steadily rising.

Britain — where Prime Minister Boris Johnson, who has the virus, was moved into intensive care Monday — has been reporting high numbers of new infections. And several parts of the United States are bracing for worse outbreaks in the days and weeks to come.

A top White House official warned in January that a pandemic could imperil millions of Americans.

A top White House adviser starkly warned Trump administration officials in late January that the crisis could cost the United States trillions of dollars and put millions of Americans at risk of illness or death.

The memo by Peter Navarro — written on January 29 — suggested that millions of Americans could get ill or die if a pandemic occurred. At the time, President Trump was playing down the threat from the virus publicly, though he did announce the China restrictions on January 31.

Mr. Trump on Tuesday denied that he had seen the memo by Mr. Navarro, now Mr. Trump’s trade adviser, saying that “I didn’t look for them either,” but said that the memo’s warning that the virus might spark a pandemic came just before Mr. Trump took action to restrict travel from China.

“That was about the same time as I felt that we should do it. That was about the same time that I closed it down,” he said. “He wrote a memo. And he was right. And I haven’t seen the memo. I’ll see it later on after this, but it didn’t matter whether I saw it or not because I acted on my own,” Mr. Trump said.

The warning, in a memo by Navarro, Mr. Trump’s trade adviser, is the highest-level alert known to have circulated inside the West Wing as the administration was taking its first substantive steps to confront a crisis that had already consumed China’s leaders and would go on to upend life in Europe and the United States.

“The lack of immune protection or an existing cure or vaccine would leave Americans defenseless in the case of a full-blown coronavirus outbreak on U.S. soil,” Mr. Navarro’s memo said. “This lack of protection elevates the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans.”

Mr. Navarro said in the memo that the administration faced a choice about how aggressive to be in containing an outbreak, saying the human and economic costs would be relatively low if it turned out to be a problem along the lines of a seasonal flu.

But he went on to emphasize that the “risk of a worst-case pandemic scenario should not be overlooked” given the information coming from China.

In one worst-case scenario cited in the memo, more than a half-million Americans could die.

The demand for small business loans tests a U.S. agency.

Five days after the start of a $349 billion emergency effort to get money into the hands of small businesses, the agency at the heart of the program is emerging as its biggest bottleneck.

The Small Business Administration, lightly staffed and working with aging technology, has been caught unprepared for the onrush of demand from desperate small-business owners who urgently need these loans as the coronavirus stalls the economy. In a boom year, the agency backs $30 billion of small-business loans — about the same amount that banks are now seeking on behalf of their customers in a day.

Larry Kudlow, the director of the National Economic Council, said on Tuesday that 178,000 loans totaling $50 billion had been approved for small businesses through the Paycheck Protection Program that was unveiled Friday by the S.B.A. and the Treasury Department. But bankers, small-business owners and others participating in the program say very little of that money has actually reached companies seeking the cash. The delays are causing confusion and panic among borrowers, especially those who see Trump administration officials playing up the program’s success. They worry they are being left behind.

“The expectation that this $2 trillion package would go through Congress and that the money would be flowing three days later, that was never a realistic expectation,” said Patrick Ryan, the chief executive of First Bank, a lender based in New Jersey. “But I get why people are frustrated.”

On Tuesday, the Treasury Department asked Congress for another $250 billion for the program.

U.S. stocks ended slightly lower after an early rally faded late in the day.

The S&P 500 fell 0.2 percent at the close of trading. Earlier, stocks had been as much as 3 percent higher as investors took heart in continued signs that the coronavirus outbreak may be peaking in a number of hard-hit places.

Japan declared a state of emergency, but experts say it may have come too late.

For months, Japan has confounded the world by reporting a relatively low rate of infections without imposing the kind of stringent measures used by other nations.

As the country now declares a state of emergency in the face of a worrisome rise in cases, medical experts are wondering whether the move on Tuesday has come just in time to avoid calamity, or is too little, too late.

Prime Minister Shinzo Abe, in announcing that the declaration would apply to Japan’s biggest population centers for the next month, painted an optimistic picture. By asking citizens to significantly reduce human-to-human contact, he said, “the expansion of infections can be turned to a decline in two weeks.”

But some experts said the state of emergency amounted to a tacit admission that the approach the country had stood by for months was no longer working, as Japan reached 3,906 confirmed cases on Tuesday, exactly double the number a week earlier.

“Japan has been screwing up,” said Kenji Shibuya, director of the Institute for Population Health at King’s College London, adding that the confirmed cases are “just the tip of the iceberg.”

The declaration will depend largely on voluntary compliance, and Mr. Abe emphasized that it was not a lockdown, and that public transit would continue.

Maryland joins the states sending the National Guard to nursing homes.

Maryland will deploy new “strike teams,” including members of the National Guard, to nursing homes experiencing outbreaks of the coronavirus, Gov. Larry Hogan said Tuesday.

The decision moved Maryland into the ranks of states, like Georgia, Massachusetts and Wisconsin, that have sent soldiers to nursing homes during the epidemic.

Clusters in nursing homes have led to some of the deadliest outbreaks in the United States, including at a facility in Kirkland, Wash., which has been linked to 37 deaths. On Monday, Indiana health officials said at an outbreak at a nursing home there had killed 11 people.

As of Sunday, Maryland had reported outbreaks in 81 nursing homes and long-term facilities across the state. Pleasant View Nursing Home in Carroll County has experienced at least 14 deaths, with dozens of residents and staff testing positive for the virus.

The state strike teams will provide assistance with testing and triage, and will also include doctors and nurses.

“The goal here is not to replace a nursing home’s medical and clinical team,” Mr. Hogan said, “but to provide immediate support and assistance to help protect residents of these facilities.”

With Passover under lockdown, Israeli Jews are revising the rituals.

Singing outdoors. Participating remotely in a Zoom Seder. Leaving apartment doors open so solitary neighbors can hear the recitations.

On the first night of Passover, which falls on Wednesday, multigenerational families, relatives and friends traditionally gather for the ritual Seder feast to commemorate the Israelites’ liberation from bondage in ancient Egypt.

But in an extraordinary effort to prevent the spread of the virus, the government has tightened the general lockdown with additional restrictions targeted specifically at the holiday — temporarily banning intercity travel and requiring Israelis to remain in their own homes with no visitors allowed.

The restrictions come on top of existing measures that restrict people to within 100 meters of their homes except to shop for food or medical supplies or other essential trips.

Naftali Bennett, the defense minister, warned Israelis that children sneaking over to their parents’ for Seder night “could kill them.”

The religious questions arising from Zooming this year’s Seder gatherings set off a fiery debate among Israel’s rabbis because strictly observant Jews do not use electricity or technological devices on holy days.

A group of venerable rabbis of Moroccan descent presented a nuanced ruling in favor of allowing video chat for this year only, while Israel’s state rabbinical authority opposed that ruling, upholding the ban on the use of electronic devices.

Here’s how to help from home.

Sitting at home, it’s easy to feel like there’s nothing you can do to help those on the front lines of the pandemic. But there are many things you can do to help medical professionals, the people affected directly by the virus and your local businesses.

Chaos at the Afghan-Pakistan border overwhelms screening efforts.

In Afghanistan, thousands of people flooded through the border with Pakistan on Tuesday in chaotic scenes that overwhelmed any screening measures to identify cases and slow the spread of the disease.

The country’s weak management of borders has been a major issue. Even as the virus spread in neighboring Iran, hundreds of thousands of people still made it back to Afghanistan through its western borders, before spreading across the country. Now the rush of returnees from Pakistan, where nearly 4,000 cases have been confirmed, has exacerbated fears. By Tuesday morning, Afghanistan had reported 423 cases of the virus — but officials warn those numbers could not be an authentic indication of the spread, with testing starting late and remaining limited.

The border with Pakistan, shut for weeks, was temporarily opened on Monday to allow measured return of Afghans stuck on the other side. On the first day, officials even showed pictures of circles drawn on the ground to enforce distancing as returnees were checked to see if they had any symptoms. But early on Tuesday, the scenes were chaotic.

“Between 8,000 and 10,000 people rushed in all at once,” said Rahat Gul Ziarmal, the mayor in the border town of Torkham.

In Herat, the center of the virus in Afghanistan, officials said they had run out of testing kits, and that labs did not have the capacity to conduct any more tests until a new shipment arrives.

“Since this morning, we do not have any other testing in Herat province,” said Dr. Mohamed Rafiq Shirzay, a spokesman for the provincial health department.

Catch up: Here’s what else is happening around the world.
  • Turkey ordered everyone to wear masks when shopping or visiting crowded public places, and said it would deliver free masks to every family. Coronavirus infections have risen sharply in Turkey, a country of 80 million. The order is the latest in a gradual tightening of antivirus measures by the government, which has insisted that the virus is under control and has resisted a complete lockdown.
  • Weeks into their nationwide lockdowns, countries across Europe have begun considering a return to some semblance of normalcy as they weigh plans to lift restrictions on movement. Sebastian Kurz, the chancellor of Austria, introduced a timetable for the country to re-emerge from a lockdown and see some stores reopen after Easter. Denmark will soon allow its youngest children to return to day care and school. “It’s like walking a tightrope: If we stand still, we may fall,” Prime Minister Mette Frederiksen said. “If we go too fast it may soon go wrong.”
  • India appeared to soften its position on the export of hydroxychloroquine, a drug hailed as a possible treatment for the coronavirus. President Trump threatened Monday night to retaliate against India if it didn’t lift tough export restrictions imposed last month. India is the world’s largest producer of hydroxychloroquine, known as HCQ.

Reporting was contributed by Michael Cooper, Alan Blinder, Karen Zraick, Charlie Savage, Jonah Engel Bromwich, Alan Rappeport, Astead W. Herndon, Raymond Zhong, Javier C. Hernández, Carlotta Gall, Aurelien Breeden, Martin Selsoe Sorensen, Christopher F. Schuetze, Marc Santora, Megan Specia, Iliana Magra, Maggie Haberman, Mike Baker, Declan Walsh, Andrew Higgins, Carlotta Gall, Patrick Kingsley, Stephen Castle, Mark Landler, Adam Liptak, Rick Rojas, Abdi Latif Dahir, Sheila Kaplan, Katie Thomas, Vanessa Swales, Katie Glueck, Motoko Rich, Mike Ives, Richard C. Paddock, Hannah Beech, Jason Gutierrez, Muktita Suhartono, Elaine Yu and Zach Montague.

  • Frequently Asked Questions and Advice

    Updated April 4, 2020

    • 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.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

April 8, 2020 | 1 Comment » | 200 views

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1 Comment / 1 Comment

  1. The international organizations are so corrupted by leftist ideologies that something MUST be done to reverse this trend!

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