As global infections soar, guidance on masks is reversed.
For months, health officials have been walking an awkward line on masks, saying they offered little or no protection to the public and should be reserved for health care workers.
That contradiction seems close to resolution now.
The White House, while stopping short of declaring an official policy, joined the mayors of Los Angeles and New York, several European nations and much of Asia in recommending that people wear cloth face masks in public, even if they have no symptoms.
That may help stop people from transmitting the coronavirus, but social distancing remains the best way to slow the spread, health officials say. Nearly four billion people on the planet — half of humanity — found themselves on Friday under some sort of order to stay in their homes.
But some U.S. states were still resisting such measures.
Dr. Anthony Fauci, the nation’s leading infectious disease expert, said that he believed that a nationwide lockdown order made sense.
“You know, the tension between federally mandated versus states’ rights to do what they want is something I don’t want to get into,” he told CNN on Thursday. “But if you look at what’s going on in this country, I just don’t understand why we’re not doing that.”
The lockdowns have led to a collapse of the global economy, vaporizing 10 million jobs in the United States in just two weeks. Global stocks, which had surged on Thursday after a wishful tweet from President Trump about the oil markets, dipped again on Friday amid growing fears that the pain will be profound and prolonged, while U.S. equity futures pointed lower.
Governments have promised trillions of dollars in a desperate effort to limit the damage.
None of that has stopped the virus’s ferocious global assault. At least one million infections have been detected worldwide, but experts suspect the true number is far larger because of asymptomatic cases and delays in widespread testing. The Australian medical chief estimated that there are between five million and 10 million cases.
As Beijing and Washington declared a détente in their sniping, it emerged that the C.I.A. had been warning the White House since at least February that China was vastly underestimating the scale of the crisis, limiting the usefulness of its data in predictive models.
Model makers are now being guided by other grim data, most of it coming from Europe.
The staggering death tolls in Italy and Spain, accounting for nearly half of the 53,000 deaths worldwide, rose yet again. But the crisis is deepening across the continent, with more than 5,000 deaths in France, nearly 3,000 in Britain, and more than 1,000 in both Germany and Belgium.
The number of recorded deaths in the United States topped 1,000 in a single day for the first time. In New York City, the center of the country’s outbreak, both hospitals and morgues struggled to meet surging demand.
Gov. Andrew Cuomo warned on Thursday that time was running out to find critical supplies, including the ventilators needed to sustain the most critically ill patients.
“If a person comes in and needs a ventilator and you don’t have a ventilator, the person dies,” Mr. Cuomo said at his daily briefing in Albany. “That’s the blunt equation here. And right now we have a burn rate that would suggest we have about six days in the stockpile.”
Britain is drawing up plans to issue an “immunity passport” for key workers that would certify those who have recovered from coronavirus — and carry antibodies identifiable by a blood test — that would allow them to resume a normal working life.
Although in its early stages, the idea could form part of a broader exit strategy from the countrywide lockdown, once the spread of the disease has been brought under control.
“We have a stream of work underway on immunity,” the health secretary, Matthew Hancock, told the BBC on Friday. “We are potentially having immunity certificates so that if people have been through it and when the science is clear about the point at which they are then immune, people can then start getting back to normal.”
The scale of any initiative is likely to depend on the government’s success in rolling out antibody tests that show whether people who experienced light symptoms — or none at all — are likely to be immune from the illness.
The government says that it is working to ensure that such tests are sufficiently accurate, but that not all are performing to required standards of reliability.
Prince Charles, the heir to the British throne, opened the country’s newest and largest hospital on Friday, with a capacity for 4,000 beds. The temporary facility, the N.H.S. Nightingale, is in an exhibition center in East London that was converted in just nine days.
Prince Charles, who earlier this week ended self-isolation following his own coronavirus diagnosis, opened the hospital via a video link from Scotland.
Prime Minister Boris Johnson, who said last week that he had contracted the coronavirus, still has symptoms — including a high temperature. He said on Friday that was extending his self-isolation period. Mr. Johnson delivered the news in a video statement, his voice audibly hoarse.
Data shows an income gap in limiting movement.
In cities across America, many lower-income workers continue to move around, while those who make more money are staying home and limiting their exposure to the coronavirus, according to smartphone location data analyzed by The New York Times.
Although people in all income groups are moving less than they did before the crisis, wealthier people are staying home the most, especially during the workweek. Not only that, but in nearly every state, they began doing so days before the poor, giving them a head start on social distancing as the virus spread, according to aggregated data from the location analysis company Cuebiq, which tracks about 15 million cellphone users nationwide daily.
The data offers real-time evidence of a divide laid bare by the coronavirus pandemic — one in which wealthier people not only have more job security and benefits but also may be better able to avoid becoming sick.
The outbreak is so new that the relationship between socioeconomic status and infection rates cannot be determined, but other data, including recent statistics released by public health officials in New York City, suggests that the coronavirus is hitting low-income neighborhoods the hardest.
How coronavirus is causing confusion with terms like ‘peaks,’ ‘testing’ and ‘lockdown.’
Making sense of the coronavirus pandemic requires getting up to speed on semantics as much as epidemiology.
Government officials and health care professionals toss off mentions of mortality rates, flattening the curve and lockdowns, assuming that we know what they mean. But the terms mean different things from country to country, state to state, even city to city and person to person.
Officials use the same phrases about mass testing, caseloads and deaths to describe very different situations. That makes it hard to give clear answers to vital questions: How bad are things? Where are they headed?
People search for insight by comparing their countries to those that are farther along in the epidemic. But if the terms are misleading or used in differing ways, the comparisons are flawed. Also, the statistics and vocabulary offer a false sense of precision while in reality, the information we have shows only a fraction of what’s going on.
“The new cases or deaths each day are given as exact numbers and we’re trained to take that at face value,” said Mark N. Lurie, an epidemiologist at Brown University’s School of Public Health. “But those are far from exact, they’re deeply flawed, and their meaning varies from place to place and from time period to time period.”
The New York Times infections database is open to the public.
The New York Times is engaged in an effort to track the details of every confirmed case in the United States, collecting information from federal, state and local officials around the clock. The numbers in this article are being updated several times a day based on the latest information our journalists are gathering from around the country. The Times has made that data public in hopes of helping researchers and policymakers as they seek to slow the pandemic and prevent future ones.
President Trump took aim on Thursday at the manufacturing giant 3M, which has been increasing production of N95 respirator masks that filter small particles and droplets from the air.
“We hit 3M hard today after seeing what they were doing with their Masks,” Mr. Trump said in a Twitter post. “Big surprise to many in government as to what they were doing — will have a big price to pay!”
At a White House briefing earlier in the day, Mr. Trump announced he was invoking the Defense Production Act, a 1950s law, to help shore up dwindling supplies of medical supplies. The move came after desperate pleas from governors and health care officials who are trying to handle the spike in coronavirus patients.
As the virus swept across the United States, 3M said that it was speeding up production of N95 masks and that it planned to increase output in the United States by 30 percent over the next year.
The company usually makes about 400 million masks a year.
It is unclear what set off Mr. Trump, but his trade adviser, Peter Navarro, made an oblique reference to 3M at the briefing, mentioning that “we’ve had some issues making sure that all of the production that 3M does around the world” ends up being sent “to the right places.”
Even as the United States grapples with a mask shortage, 3M has continued to sell the critical safety equipment abroad, according to someone with direct knowledge of the matter.
The Minnesota-based company did not respond to requests for comment.
Germany has been held up as a model across Europe as its laboratories work around the clock to process coronavirus tests, a key measure that has resulted in its relatively low number of casualties.
The widespread testing and other measures intended to slow the spread of the virus have not stopped it outright, however. The country’s death count passed 1,000 on Friday. But with 80,000 detected cases, the death rate remains only slightly higher than that of the flu — 0.23 percent, compared to more than 8 percent in Italy.
Chancellor Angela Merkel returned to her office on Friday, ending 14 days in quarantine after a doctor who administered a vaccine to her tested positive. The chancellor has seen her approval ratings jump over her government’s handling of the crisis.
As Ms. Merkel heads into what is supposed to be her final year in office, a survey commissioned by public broadcaster ARD showed 72 percent of Germans believed that her government was handling the crisis well and that the measures taken to stem the spread of the illness have been appropriate.
The approach has included issuing billions of euros in financial aid to individuals and businesses. But it also included closing the borders, leaving tens of thousands of seasonal farm workers unable to enter the county as the spring planting season begins.
To ensure the food supply and fill the labor gap, the government said it would recruit as many as 80,000 workers in East European countries by the end of May. All applicants will have to pass a medical test, then be flown directly from their home countries. Once in Germany, their movements will be restricted to their places of work.
At the end of seven hours in mask, gown and gloves at Bellevue Hospital Center on Monday, Dr. Richard Levitan finally had a chance to look at his phone.
Dr. Levitan, an emergency physician who lives in northern New Hampshire, had volunteered to work for 10 days at Bellevue, in Manhattan, as coronavirus patients besieged New York City hospitals. Monday was his first shift there.
A text had arrived from his older brother, who was letting him use an apartment on the Upper West Side. It read: “Hey Richard — We are so proud of you and your heroism. I hate to be the bearer of bad news but looks like our apartment building doesn’t want you staying in our apt.”
The building’s board of directors wanted him out.
That took a minute to sink in.
On the one hand, Dr. Levitan was answering the state’s urgent plea for help in the worst public health crisis in decades.
On the other, his brother was dealing with the idiosyncratic creature known as a New York City co-op, run by a board of apartment owners. Within their four walls, co-ops are tiny nation-states.
So, while Dr. Levitan was working to save the lives of strangers, his brother was pleading with his neighbors to let his sibling rest in the apartment. He got nowhere. The board had heard what he was doing and did not want him around.
That kind of thing is rampant and emerges in many shapes, if rarely so outrageously as the shunning of a medical volunteer. Governors were talking about pulling over cars with New York plates, and people in rural areas were mad about city residents who had fled to their second homes. In the city, people want to know if anyone in their building has tested positive, though with the virus so widespread, the only safe course is to assume that some neighbor has it or had it, and to take precautions.
As the Estonian public watched the authorities’ desperate attempts to contain a coronavirus outbreak on the island of Saaremaa, the government quietly enacted legislation that would send home all unemployed workers from outside the European Union.
The legislation was drafted by the Interior Ministry, which is led by Mart Helme, the head of the far-right Estonian Conservative People’s Party. Mr. Helme is a vocal critic of the large Russian minority in Estonia and is known for his rants against migrants and promoting the slogan: “If you’re black, go back.”
The bill is tied to an emergency aid package that Parliament is expected to approve by mid-April, despite criticism of its unclear and arbitrary provisions. It will terminate the visas and work permits of non-European Union citizens who lose their jobs and will be felt mostly by thousands of Russians, Ukrainians and migrants from Asia.
It also gives the government the power to decide which sectors are allowed to recruit workers from abroad.
Mr. Helme said that employers should always strive to use local workers.
“Our people are worth being offered jobs during a difficult time of increasing unemployment,” he said in a statement.
Eoin McNamara, a doctoral researcher in political science at the University of Tartu, said Mr. Helme and his party, which joined the coalition government last year, have long seen the Ukrainians as likely to integrate with and galvanize the Russian-speaking minority.
“They have been threatening this for a long time,” he said. “It looks like he took advantage of a politically opportune time to deal with this.”
Sweden drew attention in recent weeks for its unorthodox approach to the coronavirus outbreak, a holdout to the strict isolation measures being implemented across much of Europe.
But as the outbreak spreads in Sweden — with more than 500 new cases a day, some 430 people in intensive care units, and confirmed infections in several nursing homes — the public health agency has ramped up its recommendations to limit gatherings. The measures come as the country has “unfortunately reached a new level of new cases,” Anders Tegnell, a government epidemiologist, said on Thursday.
Public health officials have asked residents to postpone large private gatherings like weddings, baptisms and funerals. Ski lift operators were urged to close the slopes, something the country had initially resisted. Officials have urged people to stay home if they’re sick, work from home if they can and refrain from using public transportation during rush hours.
“It’s time for self-discipline,” Prime Minister Stefan Lofven said on Thursday, urging people to stay home over the Easter break.
The government last week banned public gatherings of more than 50 people, down from the earlier limit of 500. But Dr. Bjorn Olsen, an infectious disease specialist who is critical of Sweden’s soft approach, said the numbers on what constituted an appropriate sized group had been “pulled out of the air.”
He said Sweden should have followed the examples of its Nordic neighbors Denmark, Norway and Finland, which closed their borders and imposed strict quarantine rules early on.
Leo Segermark, a medical student at Lund University, said the public health agency should go further and demand that more people stay home.
“The focus is still on if you have symptoms,” Mr. Segermark said. “But that isn’t enough, and the rest of the world has understood this.”
The coronavirus outbreak touched a raw political nerve this week for Egypt’s autocratic leader, President Abdel Fattah el-Sisi, when Egyptians used social media to call for his lavish palaces to be turned into quarantine centers.
The hashtag #Sisispalacesforquarantine was trending on Twitter after the government directed all Egyptians returning from abroad to undergo a 14-day quarantine at their own expense at a luxury hotel near Cairo’s main airport.
The call to use Mr. el-Sisi’s residences instead was initiated by a Turkey-based television station linked to the outlawed Muslim Brotherhood. But it was quickly taken up by other Egyptians who contrasted the order with conditions at the palaces, echoing a theme that became the focus of rare antigovernment demonstrations in September.
A series of ambitious construction projects — among them a new capital in the desert outside Cairo, a new summer capital on the Mediterranean coast, and several new palaces — have become a hallmark of Mr. el-Sisi’s rule, but drawn protests of overspending and corruption.
Mr. el-Sisi responded to the outcry over the quarantine instructions by announcing that a government fund would cover the cost of the 14-day hotel stays. But the coronavirus threatens to upend his plans in other ways.
On March 22 and 23, the army announced that two senior generals with its Engineering Authority, which oversees major construction projects, had died from the virus.
This week, Arab Contractors, one of Egypt’s largest construction companies, dismissed opposition claims that work on the new capital had stopped because of infections among workers. Prime Minister Mostafa Madbouly on Wednesday urged the construction projects to continue “at full capacity,” while taking precautions to protect the health of workers.
Understanding the confusion about masks.
Should you wear a mask when you go out, or not? Both the World Health Organization and the Centers for Disease Control and Prevention previously said that ordinary citizens do not need to wear masks unless they are sick and coughing. But the official guidelines are shifting.
The World Health Organization has sounded the alarm about a spike in coronavirus cases across the Middle East and called on governments and citizens to do more to stop its spread.
In a statement released on Thursday, Dr. Ahmed Al-Mandhari, the W.H.O.’s regional director for the eastern Mediterranean, said the number of cases of Covid-19, the disease caused by the coronavirus, had risen to more than 58,000 from more than 32,000, in the week ending on April 2.
He urged countries in the region to “be more aggressive” in testing suspected cases, tracing how the infection may have spread, isolating confirmed cases and protecting health workers, while insisting that citizens stay home and practice rigorous hygiene.
But he acknowledged the difficulty of taking such measures in a region that encompasses 22 countries, including much of the Arab world, Iran, Pakistan and Afghanistan. Many of these countries have suffered through years of conflicts that have damaged their health systems, ravaged their economies and displaced millions of people.
Some corporate leaders are bristling at the potential terms of the grants and loans authorized by the stimulus legislation President Trump signed last week. Boeing’s chief executive, David Calhoun, for one has suggested that the aerospace company could raise money elsewhere if it found the government’s terms too onerous.
The Treasury Department, led by Steven Mnuchin, a former investment banker, might try to avoid imposing conditions that companies find burdensome. But if the aid appears too lenient, popular support for the rescue could evaporate as it did with the bailout of banks and other businesses after the 2008 financial crisis. And some lawmakers and experts argue that Mr. Mnuchin ought to resist the temptation to cut businesses too sweet a deal to prevent them from walking away from the government’s offer.
“Either they don’t need money, which means they shouldn’t get the money,” Senator Elizabeth Warren, Democrat of Massachusetts, said in an interview. “Or maybe they really do need it, in which case they should agree to some restrictions on how the money is spent.”
Taking a tougher line with companies could bolster the overall economic impact of the aid. Demanding that companies maintain hiring levels, for example, might mean that more people have money coming into their bank accounts, allowing them to spend on necessities and pay the rent or mortgage, said Phil Angelides, a former treasurer of California and chairman of the Financial Crisis Inquiry Commission, which was created by Congress in 2009.
Of course, with revenues falling off a cliff and losses piling up, some companies may be so desperate that their chief executives happily accept terms like a temporary ban on companies buying their own shares, a condition that airline executives have said they are willing to accept. Others may accept aid simply because the public wants them to.
One big difference between the economic problems of today and the 2008 financial crisis is that most of the companies in need of relief are not suffering from self-inflicted wounds. “That’s obvious to most people, and a C.E.O. will have this defense at his or her disposal,” said Tony Fratto, a former assistant secretary of the Treasury and a former deputy press secretary for President George W. Bush.
Right now, policymakers are keenly watching how airlines and Boeing might respond.
Reporting was contributed by Raphael Minder, Ben Hubbard, Declan Walsh, Christina Anderson, Joanna Berendt, Nada Rashwan, Melissa Eddy, Jim Dwyer, Stephen Castle, Jennifer Valentino-DeVries, Denise Lu and Gabriel J.X. Dance, Marc Santora, Megan Specia, Vindu Goel, Jeffrey Gettleman, Richard Pérez-Peña, Peter Eavis, Niraj Chokshi, David Gelles, Michael Corkery, Julia Jacobs and Maya Salam.