Will Americans follow guidance to wear masks? Trump says he won’t.
The United States awoke Saturday under a federal recommendation that people wear cloth masks when they go out in public in many instances, the latest effort to contain the coronavirus pandemic that has seen at least 1 million people worldwide become infected.
But with the precise scope of the nation’s crisis unknown — and with President Trump having undercut the new guidance of the Centers for Disease Control and Prevention by immediately declaring that he would not wear a mask himself — it was far from clear how many Americans would embrace the recommendation, though some state and local officials have made a point of doing so. Some health officials feared that people would don masks but loosen their compliance with social distancing guidelines.
At least 276,000 people in the United States have tested positive for the virus, and officials believe the number of people who have been infected is far higher. More than 7,000 people have died, including at least 3,565 in New York State.
The global death toll also climbed on Saturday, passing 59,000. The British government reported 708 deaths — a grim national record for a 24-hour period — while the Spanish authorities said 809 people had died over a day, the country’s lowest toll in a week.
The recommendation for masks in the United States followed an intense West Wing debate over several days as a divided Trump administration wrestled with whether to request such a drastic change in Americans’ social behavior.
Ultimately, the C.D.C. suggested that people wear what it described as “simple cloth face coverings” when they are in places, like grocery stores and pharmacies, where it might be more challenging to keep away from others.
“It is critical to emphasize that maintaining 6-feet social distancing remains important to slowing the spread of the virus,” the C.D.C. wrote in its recommendation, which it said was partly intended to “help people who may have the virus and do not know it from transmitting it to others.”
But Mr. Trump, in an appearance at the White House on Friday evening, repeatedly described the recommendation as voluntary and made clear that he did not intend to wear a mask.
Around the country, the total number of coronavirus cases spiked sharply as of Friday afternoon, exceeding 275,000 — more than a quarter of a million people worldwide who have been infected.
The pressure on the holdouts in the Midwest and the South has mounted in recent days as fellow governors, public-health experts and even their own citizens urge them to adopt the sort of tougher measures that have been put in place across 41 states and in Washington, D.C.
Health experts warn that the coronavirus can easily exploit any gaps in a state-by-state patchwork of social distancing across the country.
By Friday, nine states had yet to issue formal statewide stay-at-home orders — the most direct and stringent measure available, instructing all residents to stay at home, except for necessities. In some of those states, cities and counties had stepped in to issue their own orders, leaving a patchwork of restrictions.
The contrast is starkest in five states — Arkansas, Iowa, Nebraska, North Dakota and South Dakota — where there are no such orders in place, either in major cities or statewide. Another four had partial restrictions issued locally in certain cities or counties.
At least 430,000 people have arrived in the United States on direct flights from China since that country disclosed the existence of a pneumonialike illness to international health experts on New Year’s Eve, according to an analysis of data collected in both countries.
Nearly 40,000 of them have come in the two months since President Trump imposed travel restrictions.
In total, 279 passenger flights have arrived from China since the restrictions, carrying Americans and others exempt from them. Even this past week, data show, the flights have continued.
Mr. Trump has heralded the restrictions as one of his administration’s most important decisions in light of the outbreak. And the bulk of the 430,000 passengers — of varying nationalities — arrived in January, before they were imposed. But the analysis of the flight and other data by The New York Times shows the travel measures, however effective, may have come too late, particularly in light of recent statements from officials that as many as 25 percent of infected people may never have symptoms.
And even with the restrictions, screening procedures have been uneven, interviews show.
“I was surprised at how lax the whole process was,” said Andrew Wu, 31, who landed at Los Angeles International Airport from Beijing on March 10. “The guy I spoke to read down a list of questions, and he didn’t seem interested in checking out anything.”
The Trump administration is using a Korean War-era law to redirect to the United States surgical masks manufactured by 3M in other countries as part of a heated pressure campaign to force the Minnesota company to cut off sales of surgical masks abroad.
The policy, embodied in an executive order the Trump administration issued on Friday evening, is a significant expansion of the American government’s reach. It is also a reversal of President Trump’s hesitant use of the Defense Production Act, which allows the administration to force a company to prioritize the U.S. government over competing orders.
But in this case, the administration is invoking the law to compel 3M to send the masks it makes in factories overseas to the United States, and to stop exporting U.S.-made masks. Those moves, some trade and legal experts fear, could backfire, possibly prompting foreign governments to clamp down on the flow of desperately needed medical necessities to the United States.
The Trump administration’s new executive order directs federal emergency management and health officials to use the law’s authority to preserve respirators, surgical masks and surgical gloves for domestic use.
At least 17 Egyptian doctors and nurses have tested positive for the coronavirus, the National Cancer Institute in Cairo said on Saturday, raising fears the pandemic could have a devastating effect on health facilities in the Arab world’s most populous country.
The outbreak was the first reported among medical workers in Egypt, which recorded an increase in the rate of infections over the weekend: The health ministry recorded 120 cases on Friday, raising the total to 985, with 66 deaths.
Cairo University, which runs the cancer hospital, said in a statement that all medical workers at the facility were being tested, and that the hospital would be closed and sanitized.
The Egyptian medical syndicate, an association representing hundreds of thousands of medical workers, said in a statement that it was “shocked” by the number of cases and urged the authorities to supply protection equipment and apply strict testing protocols.
It said in a post on Facebook that the infected medical workers had been placed in quarantine.
The coronavirus pandemic has sickened more than 1.1 million people, according to official counts. As of Saturday morning, at least 59,000 people have died, and the virus has been detected in at least 175 countries. Here’s the view from around the globe.
Spain: The European country with the second-highest number of cases after Italy said that 809 coronavirus patients, including a 5-year-old, had died overnight. It was the lowest toll in a week, bringing total deaths to 11,744. Spain also reported 7,026 new cases, for a total of 124,736. Also on Saturday, Prime Minister Pedro Sánchez said that the nationwide lockdown would be extended another 15 days.
Britain: Thousands of prisoners in Britain will be granted early release within weeks in an effort to contain the spread of the virus in cells and facilities where social distancing rules are impossible to maintain, the Ministry of Justice said. The announcement comes as the country reported a record 708 deaths overnight, bringing the total to more than 4,300.
Ecuador: The health minister said there was a “sharp rise” in coronavirus deaths on Friday in Guayaquil, the center of the country’s outbreak, with the toll rising to 1,500 from 700. The government has said it is building a “special camp” for coronavirus patients in Guayaquil, where residents are under strict quarantine and curfew measures, leaving police officers and soldiers to collect the bodies of the dead from homes — as many as 150 a day — and have been tasked with burying the dead.
Republic of Georgia: A 79-year-old woman in the South Caucasus region became the country’s first reported death related to the pandemic. Medical officials said she had other underlying conditions. Georgia, a nation of 3.7 million people, reported a total of 157 confirmed cases.
Germany: The country has identified 91,000 coronavirus infections, more reported cases than all but the United States, Spain and Italy. But thanks to widespread testing and other measures, its percentage of fatal cases has been remarkably low — 1.3 percent. By contrast, the reported rate is about 10 percent in Spain, France and Britain, 4 percent in China and 2.5 percent in the United States. Even South Korea, a model of flattening the curve, has a rate of 1.7 percent.
The weeks of locking down Italy, which has had the world’s deadliest coronavirus outbreak, may be starting to pay off, as officials announced this week that the numbers of new infections had plateaued.
That glimmer of hope has turned the conversation to the daunting challenge of when and how to reopen without setting off another cataclysmic wave of contagion. To do so, Italian health officials and some politicians have focused on an idea that might once have been relegated to the realm of dystopian novels and science fiction films.
Having the right antibodies to the virus in one’s blood — a potential marker of immunity — may soon determine who gets to work and who does not, who is locked down and who is free.
That debate is in some ways ahead of the science. Researchers are uncertain, if hopeful, that antibodies in fact indicate immunity. But that has not stopped politicians from grasping at the idea as they come under increasing pressure to open economies and avoid inducing a widespread economic depression.
An experimental vaccine is ready to test in people as soon as the Food and Drug Administration grants permission, researchers at the University of Pittsburgh Medical Center said.
“Testing in patients would typically require at least a year and probably longer,” Dr. Louis D. Falo Jr., a member of the research team, said. “This particular situation is different from anything we’ve ever seen, so we don’t know how long the clinical development process will take. Recently announced revisions to the normal processes suggest we may be able to advance this faster.”
Another vaccine, made by Moderna, is already in a clinical trial, which started March 15. Dozens more candidates are being developed by other companies.
The University of Pittsburgh’s vaccine will be given in an unusual way: through a small patch dotted with 400 “microneedles” made of sugar mixed with a coronavirus protein. The microneedles penetrate the skin and the sugar melts, releasing the full protein dose in 10 minutes or less, and alerting the immune system to start making antibodies to fight the virus.
“It’s not painful,” Dr. Falo said in an interview. “The needles don’t reach any nerves, nor do they reach blood vessels. They’re a little more than half a millimeter long, and the width of a human hair.”
This approach takes advantage of the skin’s ability to set off a powerful immune response. Skin is the body’s first line of defense against a constant bombardment of bacteria and viruses from the environment, and it is teeming with cells that act like scouts for the immune system, looking for things that shouldn’t be there.
A vaccination with microneedles uses a smaller dose than the usual shot in the arm requires, allowing more people to be immunized, Dr. Falo said. The vaccine, unlike most, does not have to be frozen or refrigerated, making shipping and storage easier and cheaper.
A report on the research was published in EBioMedicine.
“Once we have been given approval, we will be ready to go” with testing, Dr. Falo said.
Oil giants delay meeting, threatening to roil markets again.
A meeting planned for Monday between officials of the Organization of the Petroleum Exporting Countries, Russia and other oil producers, which had buoyed hopes for a deal to end the turmoil in energy markets, has been put off, according to two OPEC delegates.
The news comes as lingering tensions have resurfaced between Saudi Arabia, OPEC’s de facto leader, and Russia over who is to blame for the recent collapse in oil prices. On Friday, President Vladimir V. Putin of Russia partly blamed Saudi Arabia for the price drop; the Saudi ministers of foreign affairs and energy then responded angrily, blaming Russia.
News of the meeting’s delay may roil the markets when trading resumes on Monday. Expectations for a meeting had added to hopes that OPEC and Russia would agree on production trims.
The OPEC delegates indicated that further talks would be required before moving ahead with a meeting, which could be rescheduled for later in the week. Saudi Arabia had called for the meeting last Thursday, responding to pressure from President Trump.
In early March, Russia declined to go along with a Saudi-led OPEC proposal to further trim production to deal with the plummeting demand for oil because of the coronavirus epidemic, leading the Saudis to walk away from a three-year agreement with Moscow on production trims.
With slumping revenue, clinics that treat the poor are facing layoffs.
Since the 1960s War on Poverty, a network of community health clinics around the nation have served as a health care refuge for people with no health insurance and few financial resources. But the effects of the coronavirus pandemic have left many of these clinics in dire financial straits.
Around the country, nonprofit community health centers provide primary care to about 29 million people regardless of their ability to pay. But now they are laying off workers and cutting back in-person appointments because of a loss of revenues from the kinds of procedures that usually bring in money, such as dental work — all now canceled with the need for social distancing.
One clinic in rural Washington State has laid off more than a third of its work force. A network of clinics in the Boston area has cut back a fourth of its staff.
“I worry a lot,” said Chuck Jones, the chief executive of the Boston-area clinics, Harbor Health Services, “that if community health centers go away, we won’t as a society hear the struggles of these people.”
The Federal Emergency Management Agency, the office leading the U.S. government’s coronavirus response nationwide, is running short of employees who are trained in some of its most important front-line jobs, according to interviews with current and former officials.
At the same time, the agency has been forced to halt a major hiring initiative and has closed training facilities to avoid spreading the infection.
The number of available personnel qualified to lead field operations has fallen to 19 from 44 in less than six weeks, as many of those leaders have been assigned to run operations in states with virus-related disaster declarations. Additional staff members are also being pulled from responding to other disasters.
Training centers in Maryland and Alabama have been shuttered until mid-May, and an effort to recruit new employees is on hold, according to a senior administration official with direct knowledge of FEMA’s operations.
With wildfire season looming and hurricane season starting in less than two months, the shortfalls could complicate federal response to disasters nationwide.
Two French medical experts have been accused of racism after they suggested that coronavirus vaccines should be tested in Africa because the continent was underdeveloped.
One of the experts, Jean-Paul Mira, the head of the intensive care unit at Cochin Hospital in Paris, said in a television interview on Wednesday that Africa made sense as a testing site because countries there “haven’t got masks” or intensive care systems.
He also compared the use of a potential Covid-19 vaccine to tests of experimental AIDS treatments that have been administered to sex workers in African countries, saying that people on the continent “are highly exposed and don’t protect themselves.”
The other guest, Camille Locht of the national research institute Inserm, agreed. He said that trials would be conducted in African countries to test a tuberculosis vaccine against the new coronavirus.
The sequence drew an intense backlash on social media, and the hashtag #AfricansAreNotLabRats was still trending on Twitter as of Saturday.
“Do not take African people as guinea pigs,” the Ivorian soccer player Didier Drogba wrote.
Mr. Mira apologized on Friday. The Inserm institute, where Mr. Locht works, said the video had been shortened and misinterpreted. The institute said that trials against the new coronavirus were being conducted in Europe, and that if a vaccine were deployed, it would be tested in Europe as well as in Africa.
A 1918 flu epidemic informed Philadelphia’s response in 2020.
The United States was crippled by the brutal flu that swept through the country in the midst of World War I, but nowhere was hit more forcefully than the powerhouse industrial cities of Pennsylvania.
In Philadelphia alone, 20,000 people died — 7,500 in the first six months, 4,500 in one week and 837 in a single day. And then, as now, holding large public events in defiance of scientific advice to stay at home had shattering consequences.
Our reporters looked back at how the 1918 flu claimed lives, overwhelmed health care workers and morticians, and prompted ordinary people to rise to the moment in the fight against an invisible foe.
By the end of last week, coronavirus cases in Philadelphia had reached 2,430, with 26 deaths. And officials there were scrambling to secure the needed equipment, including ventilators.
But memories of the 1918 epidemic had already prompted an aggressive response from Philadelphia’s public health authorities. One result: Unlike some American cities, they expect to have enough hospital beds to withstand even a worst-case scenario.
“The state has handled it very differently, and the city handled it radically differently,” said Dr. Tony S. Reed, chief medical officer at Temple University Hospital. “Frankly, for us it’s going to make all the difference in the world.”
The Chinese government held a nationwide day of mourning on Saturday, the day of the annual Tomb Sweeping Festival, a traditional time for honoring ancestors. Flags flew at half-staff, and alarms and horns sounded for three minutes starting at 10 a.m. Xi Jinping and other leaders of the ruling Communist Party attended a ceremony in Beijing.
It will probably not be enough to soothe many families in the city of Wuhan, who have chafed against the state’s efforts to assert control over the grieving process.
Officials are pushing relatives to bury their dead quickly and quietly, and they are suppressing online discussion of fatalities as doubts emerge about the true size of China’s toll from the virus. If China’s tallies are vastly understated, as the C.I.A. has been warning the White House since at least early February, predictive modeling for the United States and other countries would be thrown off, or robbed of a major pool of data.
The police in Wuhan, where the pandemic began, have been dispatched to break up groups on WeChat, a popular messaging app, set up by relatives of coronavirus victims. Government censors have scrubbed social media of images that showed relatives lining up at Wuhan funeral homes to collect ashes. Officials have assigned minders to relatives to follow them as they pick burial plots, claim their loved ones’ remains and bury them, grieving family members say.
Liu Pei’en, whose father died after contracting the coronavirus in a Wuhan hospital, said officials had insisted on accompanying him to a funeral home to pick up his father’s remains. Later, they followed him to the cemetery where they watched him bury his father, he said. Mr. Liu saw one of his minders take photos of the funeral, which was over in 20 minutes.
“My father devoted his whole life to serving the country and the party,” Mr. Liu, 44, who works in finance, said by phone. “Only to be surveilled after his death.”
A leading researcher who fought a different virus; a prodigious songwriter still in his prime; the first black president of the Marseille soccer club; a jazz patriarch.
They are among those who died this week from Covid-19, and were profiled in our series about people lost to the pandemic.
Gita Ramjee: In South Africa, Dr. Gita Ramjee led AIDS studies and drug trials, hoping to overcome not only H.I.V. but also cultural barriers to stopping its spread. On Tuesday, another epidemic claimed her: She died of Covid-19 at a Durban hospital. She had fallen ill shortly after returning from a visit to her sons in London, local news accounts said. She was 63.
Adam Schlesinger: He made suburban characters shine for the band Fountains of Wayne and brought pop-rock perfection to the film “That Thing You Do!” Adam Schlesinger, an acclaimed performer who had an award-winning second career writing songs for film, theater and television, died on Wednesday at 52.
Pape Diouf: Mababa “Pape” Diouf, who became the only black president of a top-tier European soccer club when he was appointed to lead France’s Olympique de Marseille, died at 68 on Tuesday. He was a gifted orator and a defender of the club’s passionate fan base.
Ellis Marsalis: His sons Wynton and Branford gained national fame embodying a fresh-faced revival of traditional jazz. But Ellis Marsalis had been an influential musician and teacher in New Orleans long before that. He died on Wednesday at 85.
Reporting was contributed by Alan Blinder, Denise Grady, Michael Ives, Raphael Minder, Jason Horowitz, Elian Peltier, Nada Hussein, Constant Méheut, Christopher F. Schuetze, Katrin Bennhold, Yonette Joseph, Elaina Plott, Dan Barry, Caitlin Dickerson, Alisha Haridasani Gupta, Thomas Gibbons-Neff, Eric Schmitt, Matthew Haag, Peter Eavis, Niraj Chokshi, David Gelles, Christopher Flavelle, Zolan Kanno-Youngs, Nicholas Bogel-Burroughs, Stanley Reed, Alan Feuer, Helene Cooper, Katie Benner, Alan Rappeport, Michael D. Shear, Sheila Kaplan, Sarah Mervosh, Jack Healy, Amy Qin, Cao Li, Yiwei Wang, Albee Zhang, Alexandra Stevenson, Steve Eder, Henry Fountain, Michael H. Keller and Muyi Xiao.