Coronavirus Live Updates: New York City Braces for a Deluge of Patients; Costs of Containment Grow

With more states across America ordering millions to stay home, and Britain joining the rest of Europe in shuttering nonessential businesses and placing its population under what one newspaper called “house arrest,” voices of disquiet over the economic cost of such measures grew louder, even as public health experts warned that relaxing restrictions could significantly increase the death toll.

Only one week after the White House released guidelines for all Americans to keep their distance, President Trump said it could soon be time to consider a more targeted approach.

“Life is fragile and economies are fragile,” the president said on Monday.

Millions have already lost their jobs and the foundations of the global economy have been shaken.

Mortgage markets showed signs of crumbling, companies struggled to sell debt and stresses plagued the entire financial system.

The Federal Reserve promised to buy as much government-backed debt as needed to bolster the markets on Monday, but stocks on Wall Street still fell. There were hopeful signs on Tuesday, however, as Asian markets rebounded smartly. Lawmakers in Washington expressed optimism that they would reach a deal on a nearly $2 trillion stimulus bill, although those efforts have until now fallen victim to partisan wrangling.

Public health officials continued to warn of impending disaster in the absence of stronger restrictions on movement, saying the uncontrolled spread of the virus could overwhelm health care systems around the world.

In New York, where 157 people have died and 2,600 remain hospitalized, officials raced to prepare for a coming tsunami of patients.

Dr. Deborah L. Birx, the White House coronavirus response coordinator, said the “attack rate” — the percentage of the population infected with the virus — was nearly one in 1,000 in the New York area, five times higher than in other parts of the country.

“To all of my friends and colleagues in New York, this is the group that needs to absolutely social distance and self-isolate at this time,” she said.

Across the Atlantic, even as the crisis grew in Spain and France and Britain prepared for worse days to come, health officials could point to first glimpses of hope.

Two weeks after Italy was completely locked down, its number of new cases and deaths declined for two days in a row.

The number of patients in the hospitals in Lombardy, the region that is by far the hardest hit in Italy, fell as well, to 9,266 from 9,439.

“We can say that today is the first positive day,” said Giulio Gallera, Lombardy’s leading health official. “It’s not the moment to sing victory, but we finally see light at the end of the tunnel.”

New York City has about a third of the nation’s confirmed coronavirus cases, making it the new epicenter of the outbreak in the United States.

And hospitals across the region reported increasing numbers of cases as workers warned about shortages in protective equipment.

Mr. Cuomo announced plans to send hundreds of thousands of masks, gloves and gowns to health care facilities, and said the Jacob K. Javits Convention Center in Manhattan would be repurposed as four “emergency hospitals.”

New York’s population density may help explain why the infection rate is so high.

New York is far more crowded than any other major city in the United States. It has 28,000 residents per square mile, while San Francisco, the next densest city, has 17,000, according to data from the U.S. Census Bureau.

All of those people, in such a small space, appear to have helped the virus spread rapidly through packed subway trains, busy playgrounds and apartment buildings, forming ever-widening circles of infections. The city now has more coronavirus cases per capita than even Italy.

Gov. Andrew M. Cuomo of New York is requiring hospitals to increase capacity by at least 50 percent. New York State saw a one-day increase of nearly 5,000 cases, putting the total at 21,689 as of Monday night.

With the epidemic in New York exploding, other states rushed to protect themselves.

Gov. Ron DeSantis of Florida said he was planning to sign an executive order requiring anyone flying to the state from New York or New Jersey to enter quarantine for 14 days.

Many cases in places like Miami, Fort Lauderdale and West Palm Beach have been tied to New York, and a recent uptick in travel from the region suggested New Yorkers were flying to Florida to flee shelter-in-place orders.

“Hopefully that will be a deterrent for people if you’re just trying to escape here,” Mr. DeSantis said. The quarantine will not apply to people arriving by car.

The Spanish army has found elderly people abandoned in several nursing homes, raising alarm for those most vulnerable and in need of care with much of life in the country shut down.

The government will be “forceful” in its response to those who abandon older people, Margarita Robles, Spain’s defense minister, said Monday in an interview with Telecinco, a Spanish television channel. Officials did not say how many had died or whether residents had succumbed to coronavirus-related illness or a lack of care.

Ms. Robles said that emergency military units dispatched to disinfect nursing homes had found there some residents “absolutely abandoned, if not dead in their beds.”

The defense ministry said that dead bodies had been found in multiple nursing homes that had discharged large number of employees in the wake of the outbreaks, but did not provide further details, El País, a daily broadsheet, reported.

Workers at nursing homes have been calling for protective equipment as residents and fellow employees became infected with the coronavirus, leaving them short-handed and at personal risk in their workplaces. Representatives of the industry have called on the government to support them, rather than criticize them.

José Manuel Ramírez, the president of a Spanish association of directors of social services, said that it was “shameful” for the Spanish defense minister to vilify nursing home employees, and that the government should instead take a close look at its own failure to protect these “heroes,” who have often been forced to leave their work after themselves contracting the coronavirus.

“Those in the field are working themselves to the bone without resources, without health support, without protective equipment,” he said, according to the newspaper El País.

Spanish prosecutors began investigating reports of nursing home residents living in poor sanitation conditions last week after at least 19 people died in the Monte Hermoso nursing home in Madrid.

Last weekend, the Spanish government announced that it would extend the country’s lockdown until at least April 11. Spain, with almost 2,700 deaths, remains the country hardest hit by the coronavirus in Europe after Italy.

The Senate’s top Democrat and the treasury secretary said on Monday night that they were close to a deal on a nearly $2 trillion economic stabilization package to respond to the coronavirus pandemic.

The announcement came hours after Democrats voted for the second time to block action until they had secured more worker protections and restrictions on bailed-out companies.

“We expect to have an agreement in the morning,” Senator Chuck Schumer, Democrat of New York and the minority leader, told reporters just before midnight, as he wrapped up a final meeting with Steven Mnuchin, the treasury secretary. “There are still a few little differences,” he said.

Mr. Mnuchin said the two sides were very close to a compromise, though both sides cautioned there was no final agreement and the negotiations remained fluid. The two men called President Trump just before they broke for the night.

Mr. Schumer said the president’s response had been “very positive,” despite a tweet just minutes before in which Mr. Trump accused Democrats, led by House Speaker Nancy Pelosi, of sabotaging the package and wanting “the virus to win.”

The apparent progress came after Mr. Mnuchin and Mr. Schumer spent hours haggling behind closed doors. Among other areas of contention, Democrats had demanded restrictions and oversight requirements over a proposed $500 billion fund to bail out distressed companies.

Democrats voted against moving forward with the plan Monday afternoon, sending markets plummeting. But after more discussion, late Monday night Mr. Schumer said he was hopeful that both sides could now come together quickly, with a vote possible by Tuesday evening.

The central Chinese city of Wuhan, where the global outbreak started, said on Tuesday that public transportation would resume within 24 hours and residents would be allowed to leave the city beginning April 8 as infections appeared to be dwindling after a weekslong lockdown.

Even as local infections across China appeared to approach zero, the Wuhan government on Tuesday said a hospital doctor had tested positive, adding to evidence that Hubei Province, of which Wuhan is the capital, has not beaten the virus.

In Wuhan, the authorities continue to turn up cases of people with the virus but without symptoms, fueling growing fears among the Chinese public that the government has failed to disclose or discover a much larger number of infections than the 81,171 cases that have been reported.

In China, officials only count patients with both symptoms and a positive test in the official tally of confirmed cases. The World Health Organization says that all people who test positive are confirmed to be infected, even if they show no symptoms.

China’s approach to counting raises questions about how many people with the virus are circulating freely. There is evidence that asymptomatic people can infect others.

The number of “silent carriers” — people who are infected but show delayed or no symptoms — could be as high as a third of those who test positive, the South China Morning Post, a Hong Kong newspaper, reported on Sunday, citing classified Chinese government data.

After social media accounts circulated over the weekend that China was suppressing the numbers by failing to acknowledge these “silent carriers,” authorities in Wuhan said a patient in the city had tested positive despite not having symptoms.

The Wuhan health commission also stated that infected patients with no symptoms still need to be isolated for 14 days and that “a small number may progress to confirmed cases.”

Last week, China reported no new local infections for the first time since the outbreak began three months ago. But it is now struggling with imported cases, which continue to rise.

But for many public health experts, these developments add to doubts that the virus will be fully eradicated in China in the near term.

President Trump, in a nearly two-hour coronavirus briefing, hinted on Monday that the economic shutdown meant to halt the spread of the virus across the country would not be extended.

“America will again and soon be open for business,” the president said, without providing a timeline for when he believes normal economic activity could resume. He later added, “I’m not looking at months, I can tell you right now.”

“If it were up to the doctors, they’d say let’s shut down the entire world,” Mr. Trump said. “This could create a much bigger problem than the problem that you started out with.”

Mr. Trump also suggested that he would soon re-evaluate the federal guidance urging social distancing. More states moved on Monday to impose their own sweeping stay-at-home orders, which will soon cover more than 158 million Americans in 16 states.

Washington, Indiana, Massachusetts, Michigan, Wisconsin, West Virginia and Oregon became the latest states to announce sweeping directives to keep more people home in an effort to slow the spread of the virus.

Mr. Trump sent mixed signals from the White House podium, agreeing at one point with his surgeon general and saying, “It’s going to be bad,” then suggesting that the response to the virus may have been overblown.

“This is going away,” Mr. Trump said, citing jobs, “anxiety and depression” and suicide as arguments for restoring the U.S. economy.

He compared deaths from the novel coronavirus so far to deaths from other causes — influenza and car accidents — suggesting that the scale of those preventable deaths means economic restrictions may not be appropriate.

While it is true that those causes of death outnumber deaths from the virus to date, projections from the Centers for Disease Control and Prevention estimated that deaths from Covid-19 could range from 200,000 to 1.7 million people. Estimates from other scientists place the potential deaths in a range from several hundred thousand to several million deaths, substantially more than annual deaths from car accidents and flu combined.

Facing a growing storm of criticism about his laissez-faire response to the fast-spreading coronavirus, Prime Minister Boris Johnson announced on Monday that he would place Britain under a virtual lockdown, closing all nonessential shops, banning meetings of more than two people, and requiring people to stay in their homes, except for trips for food or medicine.

People who flout the new restrictions, the prime minister said, would be fined by the police.

The steps, which Mr. Johnson outlined in a televised address to the nation, bring him into alignment with European leaders like President Emmanuel Macron of France and Chancellor Angela Merkel of Germany, who have all but quarantined their countries in a desperate bid to slow the outbreak.

“No prime minister wants to enact measures like this,” an ashen-faced Mr. Johnson said. “I know the damage that this disruption is doing and will do to people’s lives, to their businesses and to their jobs.”

But while these were the most draconian restrictions placed on the British people since World War II, Mr. Johnson is still leaving a bit of breathing room.

The prime minister said people could leave their houses for exercise, either alone or with family members, and he did not close parks in London, though several boroughs in the capital have closed the parks they control.

The number of confirmed cases in Britain rose to 6,650 on Monday, up from 5,683 a day earlier, while the death toll jumped by 54, to 335. British officials believe that those numbers are about to balloon.

President Rodrigo Duterte of the Philippines has been granted sweeping emergency powers to combat coronavirus, triggering fears in a nation that spent the 1970s and ’80s under brutal martial law.

Mr. Duterte, who has drawn international rebuke for his bloody and ruthless war on drugs, said he needed the powers granted to him in the legislation to address the crisis and unlock some $5.4 billion.

An earlier version of the bill would have allowed Mr. Duterte’s government to take over privately owned businesses. While the version that passed Tuesday was scaled back, some legislators have worried that Mr. Duterte will abuse the public funds.

“This limitless grant of emergency powers is tantamount to autocracy,” Concerned Lawyers for Civil Liberties, an association of rights lawyers, said in a statement. The group, which includes some of the Philippines’ top legal minds, pointed out that in the past Mr. Duterte had likened the constitution to a “scrap of toilet paper.”

On Tuesday, Prime Minister Prayuth Chan-ocha of Thailand declared a state of emergency, effective on Thursday, to combat the coronavirus, raising similar concerns about a potential abuse of power. Mr. Prayuth, a retired general who led an army coup in 2014, gave himself the authority to impose curfews, censor the media and prevent people from leaving their homes.

Mr. Prayuth, who announced the state of emergency while wearing a loose facial mask made of Thai silk, said that people should be careful when using social media, lest they spread rumors. So far the virus has killed four people and infected more than 820 people in the country.

Gov. Gavin Newsom estimates that California will be short about 17,000 hospital beds, although the state is frantically trying to source thousands more of them. And the pace of testing remains stubbornly slow in California.

New York State, with half the population of California, has conducted twice as many tests for the virus. As of Monday, New York has tested 78,289 people, including 33,000 in New York City. California had conducted 26,400 tests by Sunday, the most recent data available.

Officials in California have rushed to reopen hospitals that had been shuttered, buy motels to house the state’s more than 150,000 homeless people and retrofit college dormitories to serve as hospital wards.

Mr. Newsom said the state was also chartering flights to China to procure protective equipment and expressed concern for smaller states that might not have the same purchasing power. He has called up the National Guard to work at food banks, and President Trump ordered a Navy hospital ship, with a thousand beds, to sail to the Port of Los Angeles within a week.

A new front in the political fight over abortion has been sparked by the coronavirus pandemic.

Texas and Ohio have included abortions among the nonessential surgeries and medical procedures that they are requiring to be delayed, saying they are trying to preserve precious protective equipment for health care workers and to make space for a potential flood of coronavirus patients.

But abortion-rights activists said that abortions should be counted as essential and that people could not wait for the procedure until the pandemic was over.

On Monday, Ken Paxton, the attorney general of Texas, clarified that the postponement of surgeries and medical procedures announced by the governor over the weekend included “any type of abortion that is not medically necessary to preserve the life or health of the mother.”

Failure to do so, he said, could result in penalties of up to $1,000 or 180 days of jail time. It was not immediately clear if that included medication abortion, which involves providers administering pills in the earlier stages of pregnancy.

The move followed a similar action by health authorities in Ohio last week and has prompted a legal scramble by abortion rights groups to preserve access. Activists accused state leaders of using the coronavirus crisis to advance an existing agenda to restrict abortions.

Reporting and research were contributed by Raphael Minder, Megan Specia, Marc Santora, Melissa Eddy, Jason Gutierrez, Hannah Beech, Tiffany May, Sui-Lee Wee, Nick Fandos, Sabrina Tavernise, Thomas Fuller, Tim Arango and Jo Becker

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