New infections in U.S. soar and the nation is warned that 200,000 could die.
Faced with the grim prospect that 200,000 Americans could die even with aggressive action to slow the spread of the coronavirus, President Trump extended the guidelines on avoiding nonessential travel, staying away from work, visiting bars and restaurants and gathering in groups of more than 10 for at least another month.
“We can expect that by June 1, we will be well on our way to recovery,” Mr. Trump said on Sunday evening. “We think by June 1. A lot of great things will be happening.”
But the virus has already dashed Mr. Trump’s earlier rosy predictions, and as Americans entered their third week living in a work-from-home world, officials warned that the deepening crisis in New York was weeks from peaking.
“Thousands of people will pass away,” Gov. Andrew M. Cuomo warned.
“I wouldn’t be surprised if we saw over 100,000 deaths,” Dr. Anthony Fauci, the United States’ leading infectious disease expert, said on Monday.
The continuing agony in Italy and Spain showed that the peak of the outbreak in the United States could be prolonged and, in any case, would by no means mark the end of the fight.
In Spain, roughly 35 people died every hour over the weekend as the death toll passed 7,000.
With residents already under orders not to leave their homes unless absolutely necessary, Madrid called on Monday for even tighter enforcement, with officials saying they wanted the country to enter a period of “hibernation.”
Encouraging though the numbers were, officials cautioned that it would be some time before restrictions could be eased without risking widespread reinfection.
Elsewhere, most nations were tightening existing restrictions or adding new ones.
Russia closed border crossings on Monday and placed Moscow on lockdown.
With Prime Minister Boris Johnson of Britain in isolation after testing positive for the virus, officials there warned people to expect another six months of hardship, though the restrictions could be eased as conditions improve.
Even Mr. Trump, who for weeks sought to downplay the seriousness of the crisis, struck a decidedly more somber note over the weekend. He also revealed that a personal friend was sick.
“He’s a little older and he’s heavy,” Mr. Trump said. “But he’s a tough person, and we went to the hospital and a day later he’s in a coma.”
“The speed and the viciousness, especially if it gets the right person, it is horrible,” Mr. Trump added.
White House scientific advisers offer a grim outlook, leading Trump to extend social distancing guidelines.
Two of the top doctors advising the White House on the coronavirus pandemic went together to the Oval Office with some sobering data to present to President Trump: Even with the aggressive measures in place in to slow the spread of the virus, as many as 200,000 Americans could die during the outbreak.
“We showed him the data and he got it right away,” Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said Monday morning during an appearance on CNN.
Mr. Trump had expressed a hope to get the country back to normal by Easter, but the grim forecast made it clear that would be impossible.
“He shook his head,” Dr. Fauci recalled, “and said, ‘I guess we’ve got to do it.’”
Mr. Fauci said that the explosive rate of growth in New York, New Orleans and possibly now Detroit demonstrated the urgency of the moment.
“We felt strongly that it would have been the wrong decision to pull back,” he said. “We argued strongly with the president that he not withdraw those guidelines.”
Mr. Fauci said he was joined in the meeting by Dr. Deborah L. Birx, the lead coordinator of the White House’s coronavirus task force.
She told reporters on Sunday that even with precautions and restrictions, the government’s model estimated “between 80,000 and 160,000, maybe even potentially 200,000 people, succumbing” to Covid-19, the disease caused by the coronavirus.
She added that without any precautionary measures, the same models projected that 1.6 million to 2.2 million Americans could die from complications of the virus.
“Some of them predicted half of the United States would get infected,” she said.
Dr. Birx acknowledged that it was a huge sacrifice for Americans to stay home another month, but she said the measures had “potential to save hundreds of thousands of American lives.”
New York’s 911 system is overwhelmed by calls.
Even as hospitals across New York City become flooded with coronavirus cases, some patients are being left behind in their homes because the health care system cannot handle them all, according to dozens of interviews with paramedics, New York Fire Department officials and union representatives, as well as city data.
In a matter of days, the city’s 911 system has been overwhelmed by calls for medical distress apparently related to the virus. Typically, the system sees about 4,000 Emergency Medical Services calls a day.
Last Thursday, dispatchers took more than 7,000 calls — a volume not seen since the Sept. 11 attacks. The record for the number of calls in a day was broken three times in the last week.
If the rate of growth in cases in the New York area continues, it will suffer a more severe outbreak than those experienced in Wuhan, China, or the Lombardy region of Italy.
Because of the volume, emergency medical workers are making life-or-death decisions about who is sick enough to take to crowded emergency rooms and who appears well enough to leave behind. They are assessing on scene which patients should receive time-consuming measures like CPR and intubation, and which patients are too far gone to save.
And, they are doing it, in most cases they say, without appropriate equipment to protect themselves from infection.
Phil Suarez, a paramedic, was dispatched to two homes in Manhattan’s Washington Heights neighborhood, where entire families in cramped apartments, appeared to be stricken with the virus.
“I’m terrified,” said Mr. Suarez, who has been a paramedic in New York City for 26 years and had assisted in rescue efforts during the Sept. 11, 2001, terror attacks and later served in the Iraq war. “I honestly don’t know if I’m going to survive. I’m terrified of what I’ve already possibly brought home.”
Agony in Spain and Italy as deaths climb and lockdowns are extended.
Struggling to give its beleaguered medical workers a fighting chance to combat a virus that has torn through their own ranks in recent weeks, Spanish officials said on Monday that they would impose even more rigorous restrictions on residents’ movements, calling for a national period of “hibernation.”
The officials compared the tighter restrictions to those imposed in the Chinese city of Wuhan, where the virus was first detected last year. The measures there were perhaps the most draconian attempted anywhere in the world so far.
Prime Minister Pedro Sánchez of Spain said at the weekend that the tighter lockdown was needed to avoid the collapse of saturated hospitals in Madrid and a few other regions of the country.
“The most important thing is to slow down the number of people in hospitals, in the intensive care units,” he said. “I’m thinking especially of Madrid, where they are under a lot of pressure.”
The new restrictions — allowing only “essential workers” to leave their homes — will last until at least April 9 and come on top of the lockdown that was imposed on March 14.
Spain reported more than 812 new deaths on Monday, bringing the country’s death toll to nearly 7,400.
While Spanish hospitals were on the edge of collapse, Italian officials hoped that the burden on medical facilities might be starting to ease.
Luca Richeldi, a clinical pneumologist at the Gemelli hospital in Rome and a member of the government’s scientific advisory committee, said that the number of deaths had dropped every day over the weekend and that the number of new patients needing critical care had also gone down to 50, from 124.
“With our behavior, we save lives,” he said.
The April 3 deadline of the national lockdown would certainly be extended, Italian government officials said.
The health minister, Roberto Speranza, said that the government measures “will certainly be prolonged, and we will require a sacrifice that I don’t think will be too short.”
In a televised interview Sunday night, he said that the crisis was far from over and that decisions would be made with the input of the government’s scientific advisory board, which was meeting on Monday.
“There are some encouraging signals,” especially from the worst hit areas, Mr. Speranza said. “But it is not enough.” Opening up too soon, he added, could “burn everything we’ve obtained until now.”
A coronavirus slowdown in Seattle suggests that restrictions could be working.
The Seattle area, home of the first known coronavirus case in the United States and the place where the virus claimed 37 of its first 50 victims, is now seeing evidence that harsh containment strategies, imposed in the earliest days of the outbreak, are beginning to pay off — at least for now.
Deaths are not rising as fast as they are in other states. Significant declines in street traffic show that people are staying home. Hospitals have so far not been overwhelmed. And preliminary statistical models provided to public officials in Washington State suggest that the spread of the virus has slowed in the Seattle area in recent days.
While each infected person was spreading the virus to an average of 2.7 other people earlier in March, that number appears to have dropped, with one projection suggesting that it was now down to 1.4.
The researchers who are preparing the latest projections, led by the Institute for Disease Modeling, a private research group in Bellevue, Wash., have been watching a variety of data points since the onset of the outbreak. They include tens of thousands of coronavirus test results, deaths and mobility information to estimate the rate at which coronavirus patients are spreading the disease to others.
The progress is precarious, and the data, which was still being analyzed and has yet to be published, is uncertain. But the findings offer a measure of hope that the emergency measures that have disrupted life in much of the nation can be effective in slowing the spread of the disease.
“We made a huge impact — we slowed the transmission,” Seattle’s mayor, Jenny Durkan, said in an interview. She cautioned that any lifting of restrictions would bring a quick rise in new cases, and that she expected distancing requirements to continue in some form for months.
“There is evidence that doing the aggressive measures can have a benefit,” Gov. Jay Inslee said in an interview, discussing the overall numbers he is seeing.
But the governor said that the state was far from turning a corner. While there are indications of improvement, he said, he has also seen numbers in the last few days that still have him worried, including a rise in positive test results statewide and new cases in rural areas.
As the U.S. receives first shipments of Chinese medical equipment, other nations say some is faulty.
Chinese companies have kicked into overdrive to supply masks, respirators, testing kits and other protective gear to tackle the fast-moving global pandemic. With its own outbreak seemingly under control, it has looked to sell or donate gear to improve its image on the global stage.
But some faulty products are showing up in the supply chain, prompting governments in the Netherlands, Turkey and the Philippines to complain.
A commercial aircraft carrying gloves, masks, gowns and other medical supplies from Shanghai touched down at Kennedy International Airport in New York on Sunday, the first of 22 scheduled flights that White House officials say will funnel much-needed goods to the United States by early April.
The plane carried 130,000 N95 masks, nearly 1.8 million surgical masks and gowns, 10 million gloves and more than 70,000 thermometers, said Lizzie Litzow, a spokeswoman for the Federal Emergency Management Agency.
The quality of the gear that was received, however, is unknown.
Faulty protective equipment could endanger the lives of health care workers and malfunctioning tests could prevent sick people from getting essential treatment.
The Netherlands on Saturday recalled hundreds of thousands of face masks from China, after it was revealed that they did not meet standards set by the Dutch health authorities. Spanish officials said last week that hundreds of thousands of testing kits delivered by a Chinese company had only a 30 percent accuracy rate. The Chinese Embassy later said that the company was not on its official list of certified suppliers.
In the Czech Republic, for example, a local newspaper cited medical workers who had complained that as many as 80 percent of the rapid coronavirus tests that the government ordered from China did not work properly.
In the Philippines, a Department of Health official said an early first batch of tests sent from China were defective but later walked back his comments after the Chinese Embassy denied the test kits were part of a donation to the Philippines and said its donations had been assessed by the Research Institute for Tropical Medicine.
The Turkish health authorities have also spoken publicly about their concern about testing kits from China without offering details.
Indian officials deny rumors of a lengthy lockdown as hundreds of thousands try to head home.
Officials in India denied on Monday that an abrupt nationwide lockdown that has thrown the country of 1.3 billion people into chaos would last more than three weeks.
The lockdown, announced last Tuesday by Prime Minister Narendra Modi, was imposed with just four hours notice and followed reports that India may be in the early stages of community transmission. With the suspension of India’s train and bus services, hundreds of thousands of migrant workers found themselves trapped in cities like New Delhi without food or money.
Rajiv Gauba, the cabinet secretary, told reporters that he was “surprised” to read reports suggesting that the severest restrictions would remain in place beyond April 15.
“There is no such plan,” he told Asian News International, a local news outlet.
In what has been described as the largest migration in recent history, huge masses of people began long journeys by foot to their home villages, balancing bags on their heads and children on their shoulders. As of Sunday, just one of India’s 36 states and territories had made arrangements to bring migrants home.
Since the lockdown was announced, thousands of people have been seen waiting at bus stops on the outskirts of New Delhi, packed together without protective gear, before being turned away for lack of space.
Many are panicking about the spread of the virus. In one northern Indian city, migrants were sprayed down with a chemical solution on the roadside by people in hazmat suits, according to local reporters.
How is China counting its cases? Asymptomatic patients do not get included in the national tally.
Discussion in China is swirling about the true extent of the coronavirus outbreak in the country and the risk of asymptomatic infections.
Caixin, an influential Chinese newsmagazine that has aggressively reported on the coronavirus pandemic, published a commentary that urged the government to disclose the number of asymptomatic infections in the country, a figure that has been kept secret.
In China’s official count of confirmed coronavirus cases, people who test positive but show no symptoms are excluded; they are added to the tally only if they start to feel sick.
The magazine’s commentary came after confirmation of a case on Sunday in Henan Province, who apparently was infected by a person who did not show symptoms and was not counted in the official tally released to the public.
The Caixin commentary said revealing the scale and spread of asymptomatic cases was important for research and informing the public of continuing possible risks.
China has reported several days with no new cases outside those brought in from overseas. The case reported in Henan on Sunday suggests that the virus continues to spread among people who might not be included in the public tally.
Observers have also scrutinized the country’s death toll. Caixin reported last week that thousands of urns were sent to funeral homes in Wuhan, the center of the outbreak, in recent days, raising questions about whether the death toll in the city could be higher than the official figure of 2,547.
Some world leaders scoff at the virus, even suggesting vodka and saunas as a cure.
As countries around the world enact lockdowns in an attempt to curb the pandemic, some leaders have scoffed at containment efforts.
In Belarus, the authoritarian President Aleksandr G. Lukashenko called the coronavirus “nothing else but a psychosis” and has joked that a shot or two of vodka a day will poison the virus, advice rejected by medical experts.
Mr. Lukashenko has even suggested that farm work in a tractor, eating breakfast at a particular time or sitting in a sauna can help prevent infection.
While all of Europe and many other parts of the world have suspended professional soccer and other sports leagues, Belarus’s premier league has continued to play, a reflection of the country’s lax coronavirus response.
President Jair Bolsonaro of Brazil has also argued that concerns over the pandemic are overblown.
He visited shopkeepers outside of Brasília, the capital, on Sunday and argued that people must continue their jobs to survive, even while older people should stay home.
“I advocate that you work, that everyone works,” he said, the newspaper Folha de São Paulo reported.
He repeated his argument that the harm to the economy from efforts to curb its spread can be worse than the pandemic itself.
“Sometimes, too much medicine becomes poison,” he added.
Mr. Bolsonaro has called the virus a simple cold and questioned the death toll in São Paulo, the country’s largest city. Brazil has recorded 4,256 confirmed cases of Covid-19 and 136 deaths as of Sunday.
Mr. Lukashenko has also questioned the harm of coronavirus response efforts, saying he endorsed President Trump’s comments that the cure to the pandemic cannot be worse than the disease itself.
“I really like his recent statements,” Mr. Lukashenko said of Mr. Trump on Friday, according to the state media. “He said that unemployment can claim more lives than coronavirus itself unless they reopen businesses and get Americans back to work. Now you have understood why I did not authorize closures of businesses.”
Mr. Trump has since pulled back from his suggestion that the United States should ease restrictions by Easter and has extended social distancing guidelines through the end of April.
Reporting was contributed by Elisabetta Povoledo, Raphael Minder, Elian Peltier, Ali Watkins, Marc Santora, Michael D. Shear, Thomas Fuller, Megan Specia, Austin Ramzy, Neil Vigdor, Kate Taylor, Vivian Yee, Mike Baker, Rick Rojas, Vanessa Swales, Michael Levenson, Aimee Ortiz, Suhasini Raj and Kai Schultz.