Live Covid-19 Global Updates – The New York Times

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The United States recorded over 98,000 coronavirus cases on Friday, a level reached for the first time since the pandemic began. After eight months battling the virus, two dozen states are reporting their worst weeks for new cases — and none are recording improvements.

Fourteen states reported single-day records for new cases on Friday: Wyoming, North Dakota, South Dakota, Utah, Montana, Illinois, Minnesota, Pennsylvania, West Virginia, Oregon, Kansas, Ohio, Colorado and Maine. And three states hit record deaths: Tennessee, Montana and New Mexico.

The outbreaks look different across the country, with states close in proximity sharing phases of the pandemic. Some, like North Dakota and South Dakota, have endured an extremely high number of cases for weeks — the Dakotas are ranked first and second nationally in recent cases per capita. Officials in North Dakota reported a single-day record Friday for the second day in a row. Neighboring Montana and Wyoming also hit single-day records for new cases on Friday.

In the Midwest, Illinois, Ohio and Michigan are experiencing swift, alarming rises in case counts. In Illinois, new cases have increased 70 percent in two weeks, with more than 8,010 new cases on Friday, the second single-day record in a row. Ohio reported 3,845 new cases on Friday, the second single-day record in a row. And Michigan has been averaging more than 2,800 cases per day for the past week — an increase of 91 percent from the average two weeks ago.

And the numbers in states like New Hampshire and Maine remain low, but they are backsliding after long periods of stability. Maine in particular has seen three of the four highest single day totals come this week. Rhode Island limited gatherings to 10 people Friday, after a single high school party in the state led to five positive coronavirus cases and 1,000 people in quarantine.

In Utah, where officials last week issued urgent pleas saying they were planning on opening a field hospital, the state reported more than 2,260 new cases on Friday, a single-day record. Officials deployed a statewide wireless emergency alert because of the rising case counts on Friday, which read: “Almost every county is a high transmission area. Hospitals are nearly overwhelmed.”

Hospitalizations and deaths are also trending upward. Across the nation, more than 46,600 people were hospitalized with the virus on Friday, an increase of about 25 percent over the last two weeks, according to the COVID Tracking Project. The country has averaged just over 800 deaths a day over the last week, up from about 700 a month ago.

On Thursday, more than 1,000 Americans died from Covid-19, an increase of 16 percent from two weeks ago. On the same day, the president’s son Donald Trump Jr. sought to downplay the severity of the virus, saying that deaths were “almost nothing” in an appearance on Fox News. In total, more than 229,000 Americans have died from the virus.

Cities, too, are issuing warnings as cases tick upward. San Francisco Mayor London Breed announced that the city was temporarily pausing the reopening of certain businesses and activities that were scheduled to resume on Tuesday — restaurants will now stay at 25 percent capacity for indoor dining, and indoor pools and locker rooms at gyms will remain closed, among other changes.

Yet experts warn that the variability may simply end with the virus resurging to high levels across the entire country.

“We’re going to see much less evidence of regionalization of this virus over the course of the next several weeks,” said Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota. “I think this is going to ultimately end up being an entire country on fire.”

This week, the United States reached its worst week for virus cases, with more than 500,000 new cases reported in the past week, and at least 90,000 new cases reported on Thursday. The country also crossed the threshold of nine million infections since the pandemic started. The virus still has the potential to infect millions more, since the country has not neared herd immunity, Dr. Osterholm said. “The virus is going to keep coming back,” he said.

The combination of pandemic fatigue, more indoor transmission of the virus during the winter months, and the reopening of businesses and activities, such as sports, could mean that states that aren’t seeing an increase in infections may see one soon. “I don’t see any location in the United States that’s going to be free of a major increase in cases,” he said. “And I think we’re just getting started.”

When high case counts emerge in communities, the spillover to surrounding populations is rapid, Dr. Osterholm said. The situation, he noted, can be likened to a “coronavirus forest fire.”

“A forest fire never burns evenly everywhere,” he said. “But if the embers are still around, they ignite again and then that area does burn eventually. And I think that that’s what we’re seeing here.”

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People who contract Covid-19 can quickly spread the virus through their households, the Centers for Disease Control and Prevention reported on Friday, based on a study of 101 patients in Tennessee and Wisconsin, and 191 of their household contacts.

And “substantial transmission” occurred, whether the first patient was an adult or a child, the researchers found. The transmission rate was high across all racial and ethnic groups.

The findings highlight the need for strict measures, even at home, to help control the spread of the disease. And they reinforce concerns raised by other studies and public health experts that parents exposed to the disease on the job and multi-generational households may pose risks for children.

The report urged that “persons who suspect that they might have Covid-19 should isolate, stay at home, and use a separate bedroom and bathroom if feasible.” Everyone in the home should wear a mask, especially in shared spaces where it’s difficult or impossible to socially distance.

Of the 191 household contacts in the study, 102 — or 53 percent — became infected within a week or so of the first patient’s diagnosis. Many who contracted the disease at home had no symptoms, “underscoring the potential for transmission from asymptomatic secondary contacts and the importance of quarantine,” the researchers wrote.

In 14 households, the first patient was younger than 18. Among those younger than 12 years, 53 percent appeared to have spread the disease. Of patients aged 12 to 17 years, 38 percent apparently infected someone else at home.

The study helps fill important gaps in the evidence about how the coronavirus spreads. There has not been much systematic study of household transmission, and data on disease spread from children has been limited, the researchers said.

Their findings have some limitations, including some uncertainty about which household member was actually infected first, and uncertainty about whether some of the infected household contacts might have picked up the virus outside the home, rather than from the infected person in their household.

  • Stocks fell on Friday, dropping for the fourth time in the past five days in a retreat that has added up to Wall Street’s worst week since March, as rising pandemic cases, new shutdowns and a sell-off in large technology stocks all dragged the major benchmarks lower.

  • The S&P 500 fell 1.2 percent, bringing its loss for the week to 5.6 percent. That’s its biggest weekly drop since the week through March 20, when stocks plunged 15 percent before they began to rebound after the Federal Reserve and lawmakers in Washington stepped in to bolster the economy. The Dow Jones industrial average fell 6.5 percent this week.

  • The latest sell-off has come as a second wave of cases forced more lockdowns in Europe, threatening the economic recovery and spooking investors around the world. In the United States, a record number of cases is prompting city and county governments to start imposing some curfews and limits on gatherings.

  • And trading has been volatile for much of October, with investors whipsawed by expectations about whether Congress and the White House would agree on a new economic relief plan, anticipation of a contested election next week and concern about the sharp rise in virus cases.

  • The decline on Friday leaves the S&P 500 with a gain of 1.2 percent for the year. As recently as Oct. 12, the index was up more than 9 percent for the year.

  • “The Covid infections are moving in the wrong direction at a pretty quick pace, not just here in the U.S., but globally as well, so there’s a lot of concern about that among investors,” said Chris Larkin, managing director of trading and investment products at E-Trade Financial.

  • Concern about the economic impact of any pandemic-related shutdown has been particularly evident in energy markets. West Texas Intermediate crude, the American benchmark, fell 1 percent on Friday, bringing its losses to 10 percent for the week, its biggest five-day decline since April.

  • In the stock market on Friday, big technology stocks led the retreat even after many of them reported a jump in profit. Twitter was the worst-performing stock in the S&P 500, dropping 21 percent, after its user growth fell short of expectations. Apple fell more than 5 percent, after it said a delay in the release of the iPhone 12 led to a drop in iPhone sales.

  • Facebook and Amazon were also sharply lower. Alphabet was the only one of the four tech giants that reported results on Thursday to gain, climbing more than 3 percent after reporting a rise in advertising on Google and YouTube. The Nasdaq composite fell 2.5 percent.

  • Shares in Europe were mixed on Friday, with the Dax in Germany and the FTSE 100 in Britain lower, while the CAC 40 index in France rose slightly.

  • Data published Friday showed Europe’s economy recorded its strongest rebound on record in the third quarter, jumping 12.7 percent from the previous quarter in countries that share the euro. But the latest lockdowns mean economists are now worried about a double-dip recession, if economic growth is wiped out by weeks of orders to stay at home and the closure of bars, restaurants and nonessential shops.

Credit…Suzanne DeChillo/The New York Times

The drug maker Regeneron said on Friday that it would stop enrolling very sick people in a trial of its antibody treatment in hospitalized patients with Covid-19, in another sign that the treatments appear to not work well in patients who have advanced forms of the disease.

The company said that an outside panel of experts had recommended that people who required high-flow oxygen or mechanical ventilation not be given the antibody treatment because the risks outweighed the benefits. But it said patients who were hospitalized but not as sick — those who needed either no or low-flow oxygen — could continue in the trial.

Earlier this week, Eli Lilly announced that hospitalized patients in one of its trials would no longer receive its antibody treatment after a similar finding that the therapy did not appear effective.

The news added further evidence to the theory that monoclonal antibodies work best when given to people early in the course of the disease, soon after they have been infected. This week, Regeneron released new data from a separate trial of outpatients that found that the treatment significantly reduced levels of the virus and the need for medical visits, and Eli Lilly has published similar results.

President Trump received Regeneron’s antibody treatment shortly after he tested positive for the virus.

Both Regeneron and Eli Lilly have applied to the Food and Drug Administration for emergency use of their antibodies in outpatients, and Regeneron said Friday’s news did not affect its study of the treatment in that group.

Credit…Gerald Herbert/Associated Press

A committee of experts advising Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, is considering a wide-scale vaccine distribution approach for people at high risk living in communities hit hardest by the virus. Those communities often are predominantly people of color who have been getting sick and dying from Covid-19 at a much higher rate than the rest of the population.

Citing principles of equity and justice, public health experts are urging that a portion of the first, limited supply of coronavirus vaccines be set aside for these people. The idea, which draws on other proposals, may be the first of its kind for broad vaccine distribution in the country.

The virus’s devastating spread across the United States overlapped with periods of great social unrest over police brutality, though few if any clusters of infections were linked to the protests themselves. In some ways, the concurrent national crises magnified the inequities in health care that has long existed across the country.

“I see this as a seismic shift,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania. “We can’t go back to colorblind allocation.”

A C.D.C. advisory group on immunizations is developing the plan, and members say it will not vote on a final proposal until a vaccine receives either full approval or an emergency use authorization from the Food and Drug Administration, likely weeks or months from now. There are currently four vaccines in late-stage trials in the U.S.

But priorities extend beyond those in hard-hit neighborhoods.

The advisers suggest a framework that divides the U.S. population into four broad groups for vaccine allocation when supplies are short, and a vaccine would be administered in phases, with the possibility of dedicating portions to people in the hardest-hit populations. The first phase would offer a vaccine to health care workers, a large group that constitutes at least 15 million people and includes low-wage workers, such as nursing assistants and housekeepers in nursing homes.

The second potential phase is made up of essential workers who are not in health care, a group that includes teachers. It also includes people in homeless shelters, and those who work in or are confined in correctional facilities. It also includes those with medical conditions that place them at high risk and people older than 65.

Subsequent phases include people at lower and lower risk levels until the final phase, which includes everyone not offered vaccines in the previous phases.

But any move to weave justice and equity into the distribution of a coronavirus vaccine raises difficulties. Its underlying concepts and execution must be further defined, and the approach may then face legal and political challenges, even as the medical system grapples with the anticipated logistical hurdles of distributing new vaccines.

new York Region Roundup

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New York has reached an agreement with school officials to allow public and private schools to reopen in areas at the heart of several small clusters of the virus in the state, even as other stringent restrictions remain in place, Gov. Andrew M. Cuomo announced on Friday.

The plan will clear a path for about 290 schools across the state to reopen in the coming weeks. It will largely affect Hasidic yeshivas in Rockland and Orange counties, which are just north of New York City, as well as Brooklyn. Hundreds of yeshivas were shuttered in early October after virus positivity rates spiked in areas with large populations of Orthodox Jews. Elected officials and parents in those communities have been calling on the governor to reopen the schools for weeks.

“The schools — private schools, Catholic schools, yeshivas, public schools — want to be open in the red and the orange zones,” Mr. Cuomo said on Friday about the areas with higher positivity rates. “And we’ve been working with them to try to find ways to keep people safe but allow children to go to school.”

Mr. Cuomo said the affected schools must start large-scale testing programs in order to reopen. The schools must test all returning staff and students, and must randomly test a quarter of all students and staff weekly. The state will supply rapid tests, which can return results in less than an hour without the need for sophisticated equipment, but are less accurate than slower laboratory tests.

Schools with relatively small student populations must close again if they have more than nine positive tests and schools in New York City that test more than 300 students will have to close if the positivity rate exceeds 2 percent. That threshold will be raised to 3 percent for schools outside the city.

Although rapid tests are cheap and convenient, experts have expressed concerns about their accuracy. They are worse at detecting the coronavirus when it is present at low levels in the body, raising the risk of false negatives. The products can also produce false positives, mistaking healthy people as infected.

Mr. Cuomo and Ms. Garvey did not say how soon schools may be allowed to reopen or how quickly tests would be provided to schools.

It also was not immediately clear how many public and private schools remain closed in New York. The state has a tiered system of restrictions that sorts areas with relatively high positive test rates into red, orange, and yellow zones.

In red and orange zones, all private and public schools have been restricted to remote learning. When Mr. Cuomo first announced the restrictions on Oct. 6, hundreds of schools were expected to be affected.

Restrictions will reman in place on businesses and houses of worship.

Statewide, Mr. Cuomo said that the seven-day rolling average positive test rate was at 1.4 percent, and that 1,085 people were hospitalized. These numbers represent a significant uptick over previous months, during which New York managed to keep its positivity rates at or below 1 percent, due in large part to vigilant testing.

In New York City, the school district became the first of the country’s largest to reopen all of its public schools for in-person instruction earlier this month, a major step in its recovery from having been the global epicenter of the pandemic and a hopeful sign for the country’s unsteady effort to return children to classrooms.

In other news from New York and the region:

  • Hospitalizations have been slowly but steadily rising in New York City, but thanks to widespread masking and social distancing, the level remains far lower than in the spring surge. Patients with serious cases are spending less time in the hospital on average and, with medical personnel more experienced and informed, fewer patients are dying: 139 people died from the virus in the four weeks ending on Oct. 24, compared to more than 800 confirmed and probable deaths at the spring peak.

  • New York City now has 200 testing sites, but disseminating information about them has been poor. The city’s wealthiest ZIP codes showed the highest rates of testing in September and October, and the poorest neighborhoods largely correlated with the lowest, according to research by a doctoral student in environmental health at Columbia, Wil Lieberman-Cribbin. Public-health experts note that high rates of positivity have emerged in areas with low rates of testing, suggesting infections could be much more widespread than they appear.

  • As of Thursday, three of Connecticut’s largest cities — New Haven, Bridgeport and Stamford — said they would roll back planned reopenings. The state has seen an average of 725 cases a day over the past week, more than double its average two weeks earlier, according to a Times analysis. Gov. Ned Lamont reported on Thursday that the state’s average positivity rate in the last week was 3.1 percent — a rate not seen there since early June. “There’s no good news in those numbers,” Mr. Lamont said.

Global Roundup

Credit…Valentin Bianchi/Associated Press

The prime minister of Belgium, which has one of the world’s highest Covid-19 infection rates, announced a national lockdown on Friday, calling it a “last chance” to keep the country’s health care system from collapse.

The announcement came a day after surges across Europe led France to reimpose a national lockdown and Germany to sharply increase restrictions.

Belgium, with 11 million inhabitants, has an average of 15,000 cases per day, and hospitals have been filling at an alarming rate for weeks. Doctors warned that unless radical steps were taken, intensive care units would be overwhelmed.

The government tried imposing a partial lockdown, closing bars and restaurants and instituting a nightly curfew. But the restrictions differed among the country’s three regions, which have a high level of autonomy, creating a chaotic patchwork of measures that were hard to understand.

The prime minister, Alexander de Croo, said Belgium’s lockdown would begin Sunday and last until mid-December. All nonessential businesses, including hairdressers and beauty salons, will be closed, but shops will be allowed to offer curbside pickups. Social contacts outside households must be limited to one person — with an exception for those living alone, who can see two people, but not at the same time.

Schools will remain closed until November 15, and traveling abroad is discouraged though not forbidden.

“At the moment, we have only one choice, to limit our physical contacts as much as possible,” Mr. de Croo said.

The measures are the strictest since the first wave of the pandemic hit the country in the spring. In those early months, Belgium also recorded one of the world’s highest infection rates, as well as one of the highest death rates, largely because thousands of nursing home residents were denied hospital care.

In other developments around the world:

  • The World Health Organization has warned that the pandemic has reached “an alarming juncture” in the Middle East region, where countries including Israel, Lebanon and Turkey have been grappling their highest weekly number of new cases since the beginning of the pandemic. Iran saw two days of record deaths this week, logging nearly 400 deaths on Thursday and bringing the reported death toll in the region’s worst-hit country to more than 34,000 — though officials have acknowledged that is likely an undercount. As a whole, the region has seen about three million confirmed cases and 75,000 related deaths.

  • Last Sunday, before Chancellor Angela Merkel of Germany announced a second national lockdown, a homemade bomb exploded in the early morning hours in central Berlin, close to a research institute that tracks virus cases and less than a mile from Ms. Merkel’s office. No one was hurt, but a letter threatened more of the same unless all measures aimed at stopping the spread of the virus were halted, the entire government resigned and new elections were held, the newsmagazine Der Spiegel reported on Thursday. In a speech to Germany’s Parliament the same day, Ms. Merkel condemned the lies and conspiracy theories around the virus, noting that they impeded the fight against the virus.

  • Ahead of a long holiday weekend, several cities and regions around Spain announced new restrictions on Friday, including the northwestern region of Galicia, where the authorities banned all city residents from traveling during the three-day vacation. In northeastern Catalonia, residents will have to stay within their municipalities not only this coming weekend, but also during the following ones. On Thursday, Parliament approved maintaining the country’s state of emergency until May, although the government is delegating to regional authorities many key decisions on new restrictions.

  • A small drop in reports of new daily infections in Finland over the last two weeks has raised the country’s hopes that it may be spared the upward trajectory of cases in many other European nations. The number of infections per 100,000 people over the past 14 days is 45.2, down from 52.9 over the previous 14 days, according to official data. On Thursday, Dr. Mika Salminen, the country’s director of health security said that the peak had passed, but that, “Naturally, we can’t be assured that the situation will prevail.” Indeed, as a reminder of both the volatility of virus trends and the uncertainty of a single day’s data, Finland reported its highest number of daily infections to date — 344 — on Friday.

  • Thousands of people left Paris on Thursday, just hours before France went into its second nationwide lockdown, clogging the city with massive traffic jams as many sought to be confined in the countryside and less crowded areas. Lines of cars stretched across hundreds of miles in the city and on the Boulevard Périphérique, the multilane ring road that circles around Paris, in scenes reminiscent of an exodus in the spring, when France imposed its first lockdown.

  • In Spain, a protest against the latest lockdown measures in Barcelona turned violent late Friday, as some demonstrators clashed with the police, resulting in the detention of a dozen people. At least 24 people were injured, including 20 police officers, according to the authorities. During the violent clashes, demonstrators hurled stones at the police and burned down street furniture.

Credit…Michael Conroy/Associated Press

With many colleges ending in-person instruction for the semester before Thanksgiving, public health officials are encouraging schools to help curb the spread of the coronavirus as students return home to their families.

The American College Health Association, which represents college health officers, issued public health guidelines on Thursday recommending that schools encourage students to get tested before their Thanksgiving departures, not travel if they test positive and quarantine for 14 days at home upon arrival.

Students should stay put and have a socially distant “Friendsgiving” on campus or celebrate virtually with their families if their school plans to resume face-to-face classes after Thanksgiving weekend, the association advised. Schools should also plan to keep quarantine housing open and provide support for students who test positive in the days just before dismissal.

Some colleges had already begun to make plans. The State University of New York announced this week that its students would have to test negative for the coronavirus during the 10 days before they leave campus; positive cases will be quarantined for a period prior to returning home. Pennsylvania State University and the University of Southern California are both offering free departure testing to students, though not mandating it.

More than a third of U.S. colleges invited students back for the fall with some degree of socially distanced campus housing and face-to-face instruction, and more than a quarter have been holding classes mostly or entirely in person, according to the College Crisis Initiative and the Chronicle of Higher Education. They have been tracking about 3,000 schools.

Many colleges have experienced serious outbreaks throughout the fall, though some hot spots have managed to contain the coronavirus in recent weeks. A New York Times survey of more than 1,700 American colleges and universities has found more than 214,000 cases since the pandemic began, with more than 50 colleges reporting at least 1,000 cases.

Credit…Lynne Sladky/Associated Press

Cruise ships can begin taking measures to set sail again beginning Sunday under a conditional order issued by American health officials that aims to mitigate the risk of coronavirus transmission, by imposing a regimen of testing and other safeguards aimed at keeping crews and passengers safe.

The order was issued on Friday by the Centers for Disease Control and Prevention and outlined a phased-in approach to allow for the resumption of cruises.

The federal agency had tried to extend until next February the no-sail order it had issued last March. But the White House blocked the extension in an apparent attempt to avoid alienating the powerful tourism industry in Florida, one of the swing states that could determine the outcome of the presidential election on Nov. 3.

Companies would need agency certification to resume full operations in U.S. waters, by first conducting simulated health and safety protocols on board with volunteers.

Those efforts would have to be evaluated by the agency to receive certification to set sail with commercial passengers.

“This framework provides a pathway to resume safe and responsible sailing,” said Dr. Robert R. Redfield, the director of the C.D.C. “It will mitigate the risk of Covid-19 outbreaks on ships and prevent passengers and crew from seeding outbreaks at ports and in the communities where they live.”

The world’s major cruise lines have been idled for months under no-sail orders.

And many cruise lines, like Royal Caribbean, had already announced they would not resume sailing until at least December. Some have canceled future sailings — Carnival Cruise, for example, has cancelled all sailings through Dec. 31, as well as some sailings in 2021 and 2022. But with cases rising to record levels in the United States, and European countries initiating new lockdowns as infections spread, an imminent return to cruise-ship travel remains in doubt.

The no-sail order has been extended several times since March but is set to expire on Saturday.

Also on Friday, French authorities allowed the cruise ship Le Jacques Cartier to set sail to France days after being grounded in Italy because crew members and passengers tested positive, according to a statement by PONANT, the French luxury cruise operator that owns the ship.

As of Friday, 10 crew members and three of the 72 passengers had tested positive. None showed critical conditions, the statement said. When they arrive in France, crew and passengers will be transferred to the care of French health authorities.

The company said that “strict sanitary protocols” had been applied to both crew members and passengers, including testing before boarding and temperature controls three times a day. The coronavirus shut down the cruise industry in the early months of the year, but by the summer, some European countries had relaxed no-sail orders, but ships have been sailing below capacity. PONANT said that since July 11, it had successfully operated more than 60 cruises, with 3,500 passengers.

Italian health authorities could not be reached for comment.

Credit…Andrew Seng for The New York Times

Like so many other plans this pandemic year, Halloween, at least as people have long known it, is canceled.

Would-be revelers across the United States are grappling with how to celebrate a holiday that is normally dependent on placing a great deal of trust in complete strangers at a time when social distancing is paramount.

The Centers for Disease Control and Prevention has warned that many traditional ways of marking Halloween, including trick-or-treating and crowding into haunted houses, are “higher risk” activities.

Some towns in Massachusetts, New Jersey and Texas, among other states, have banned door-to-door trick-or-treating altogether. Others are promoting reimagined celebrations like open-air costume parties or outdoor movie nights, which are considered “moderate risk.”

In New York City, Mayor Bill de Blasio said that Halloween should still be celebrated, trick-or-treating and all. He stressed that any festivities should take place outdoors, and with both ordinary face coverings and costume masks. But he expressed hope that Halloween would bring some relief to children weary of the pandemic.

“It can be exciting for our youngest New Yorkers,” the mayor said. “And they deserve it. They deserve it after everything they’ve been through.”

One parent, Christian Foster, a Bronx resident, said Halloween ranked high on the holiday list for his two school-aged children.

“These past six months have pretty much been disappointment after disappointment,” Mr. Foster said. “And you don’t want this to be another ‘maybe next year we’ll be happy again.’ But we also have to be real about the safety of it.”

Credit…James Estrin/The New York Times

As Covid cases rise around the United States and the holidays approach, mayors and governors have begun to preach a doctrine of mirthlessness to American families: This will be the year of pie eaten alone in front of an iPad.

But some will find a way to travel to places where they will sit at communal tables, conviviality unhindered.

The difference often comes down to testing.

Kim Kardashian West, for example, recently flew friends and family to a private island for her 40th birthday, after “2 weeks of multiple health screens,” she wrote on Twitter.

In New York City, the disparities are unmistakable.

Wil Lieberman-Cribbin, a doctoral student in environmental health at Columbia, tabulated the prevalence of testing in the city during September and October by ZIP code.

Overwhelmingly, he found, the wealthiest neighborhoods showed the highest rates of testing, and the poorest neighborhoods largely correlated with the lowest.

What concerns public-health experts is that high rates of positivity have emerged in areas with low rates of testing, which suggests that infection could be much more widespread than it appears. And while the city now has 200 testing sites, disseminating information about them has been poor.

In the view of Beverly Xaviera Watkins, a social epidemiologist at the University of California-Irvine, messaging in low-income communities of color has been “horrendous.’’ The authorities have had little success overriding suspicions of a medical class with a history of exploiting Black Americans or easing a broader mistrust of government.

Such doubt is amplified in public housing, where decades of neglect and deceit have resulted in buildings tainted with lead paint and mold and a vanished faith among people who live there that their well-being is anyone’s priority.

Surveying a sample of people living in three New York City Housing Authority complexes in Brooklyn, Dr. Watkins and Dawn Blondel, an environmental justice advocate, found that a vast majority of respondents had not been tested even though more than a third knew someone who had died of Covid-19.

“The thing is, you could get control of the virus everywhere in the city,” said Dr. Watkins, “but if you can’t get it down in public housing, you’ve lost the war.”

Credit…Chang W. Lee/The New York Times

Voters in several swing states are casting their ballots at the same time the coronavirus reaches new peaks in their communities, creating more uncertainty about how they will vote — and for whom.

The pandemic has killed nearly 230,000 people in the United States and upended the nation’s economy. Now it could help decide the presidential election.

Some electoral battlegrounds, like Michigan and North Carolina, are seeing record numbers of new cases and deaths. Hospitals in Wisconsin and other hard-hit areas are reaching capacity, pushing health care providers to the brink and leaving their workers reeling. Other swing states, like Pennsylvania, Florida and Arizona, are experiencing more mild upswings.

“Things are really running rampant, so there is a lot of discontent,” said Barry Burden, director of the Elections Research Center at the University of Wisconsin-Madison.

Wisconsin narrowly voted for President Trump in 2016, but the virus may change the outlook for him there.

“I do think it provides more of a challenge for Trump to try and win the state because any news about the pandemic — it’s not good for him,” Dr. Burden said.

Already, the pandemic has complicated the voting process.

Because of concerns the virus would hamper people’s ability to vote, several states have encouraged mail-in voting. About 1.64 million people had returned absentee ballots in Wisconsin as of Thursday, more than half of the total ballots cast in 2016.

In other battleground states like North Carolina, Florida and — this year — Texas, the president could see fading support from Republicans who feel frustrated by what they see as a lackluster federal response to the coronavirus. Those states may also see higher turnout among Democrats who opted to vote by mail for former Vice President Joseph R. Biden Jr.

“Enthusiasm for turning out for Trump among Trump supporters will wane somewhat, and so it will affect turnout somewhat,” said John Aldrich, a professor of political science at Duke University. “I don’t think it’s going to be a massive thing.”

Still, he said, in places where elections can come down to a few thousand votes, “everything matters.”

Credit…Lucy Nicholson/Reuters

The Los Angeles Unified School District, the country’s second-largest system, will probably not bring students back into classrooms until at least January, two members of the Board of Education said on Thursday.

The state requires a county to have no more than seven new daily cases per 100,000 people for two weeks before schools can fully reopen. In Los Angeles County, the daily case number is now about 18, and it has been climbing.

The president of the school board, Richard Vladovic, said that even if infections started declining soon, it would not make sense to reopen schools just as the holidays are about to begin. The news was first reported by The Los Angeles Times.

With the current county case numbers, Los Angeles schools are allowed to bring up to a quarter of students back onto campus, and can seek waivers to bring back all students in prekindergarten through second grade. But the district has not pursued those options.

Katie Braude, chief executive officer of Speak Up, a group that advocates for educational equity, said the district’s hands were tied because it had agreed with the teachers’ union that no teachers would be required to come back in person until schools were reopened for all students. The agreement expires on December 31.

Ms. Braude said the district, which has over 600,000 students, had done a lot of work to make the return to school safe, setting up an ambitious testing system for students and the staff and replacing ventilation systems.

“It’s just kind of ironic that the district has really gone out of its way on that front and they’re still not able to get kids back on campus who really need to be on campus,” she said, adding that “these kids are all losing out, and these are the kids who are already falling behind.”

The vice president of the Board of Education, Jackie Goldberg, said that even January was optimistic.

“It may be February or March,” she said.

And at that point, she said, the question may be whether it is worth starting in-person instruction if many children have to change teachers that late in the year.

The district has said that when it does reopen, it will use a hybrid model, in which students cycle between going to school buildings and learning at home.

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