Coronavirus Live Updates: State and City Leaders Clamor for Medical Supplies as U.S. Cases Top 135,000

Coronavirus Live Updates: State and City Leaders Clamor for Medical Supplies as U.S. Cases Top 135,000

As the coronavirus pandemic has sickened more than 678,900 people worldwide and killed at least 31,971, the Syrian government reported the first death from the virus in its territory on Sunday, about a week after announcing its first confirmed case. The outbreak, if uncontrolled, could shred a health care system already enfeebled by more than nine years of civil war.

After the virus had struck neighboring countries, the Syrian government did not acknowledge any confirmed cases for weeks, even as rumors spread of hospitalizations and deaths from pneumonia-like diseases. But Syria has now confirmed 10 cases, including the patient who died on Sunday, according to a state news agency.

The government had already moved to fend off an outbreak before announcing its first case. It closed schools and universities, limited working hours, banned gatherings, postponed parliamentary elections and built quarantine centers. Syrians are now subject to a nightly curfew between 6 p.m. and 6 a.m.

But Syrians and recent visitors to the country said in interviews that daily life appeared to continue much as usual. Marketplaces and streets were crowded; few wore masks or gloves.

The health care system would be rapidly overwhelmed in a full-blown outbreak, aid workers say. Many doctors and nurses have fled the country, and hospitals were bombed and never rebuilt, leaving large swaths of the population with limited access to medical care. U.S. and European sanctions make it difficult to import supplies.

The W.H.O. has delivered testing kits and protective equipment for health care workers, but medical aid groups that operate in the country have found their efforts to prepare hampered by the new restrictions on working hours and on gathering.

“Basic services have been all but decimated,” said Rachel Sider, a Syrian policy adviser at the Norwegian Refugee Council. “It’s impossible to imagine how this country can cope with an outbreak.”

Public officials around the world have continued to struggle with the pandemic.

  • In Russia, Moscow declared a lockdown starting Monday. People must not leave home except in an emergency or to go to the nearest grocery store or walk their dogs, going no further than 100 meters. People will still be able to enter and leave the city. Russia has reported 1,534 confirmed cases of coronavirus, far fewer than many Western countries, but the numbers have risen rapidly in recent days — particularly in Moscow, which accounts for most of the cases.

  • The police in South Africa wrote on Twitter that it had set up roadblocks and were checking vehicles on Sunday to ensure that people across the country complied with the regulations of the 21-day lockdown.

  • Italy reported more than 97,689 cases of the coronavirus, an increase of more than 5,200 from Saturday. The number of deaths totaled 10,779, an increase of 756 from Saturday.

  • France reported 40,174 cases, an increase of 2,599 from the day before. The country reported 2,606 deaths, an increase of 292 from Saturday. But there has been a decline in the percentage increase in new deaths reported on each of the last three days, to 13 percent Sunday from 27 percent on Thursday. Two high-speed trains started carrying patients from eastern France, one of the more affected regions, to hospitals along France’s western coast, where the outbreak has been limited so far.

  • England’s deputy chief medical officer said on Sunday that Britons may be under some form of lockdown for six months or longer, warning that the country faces a second wave of coronavirus if they are lifted too quickly. Britain had over 17,000 confirmed coronavirus cases as of Sunday — including Prime Minister Boris Johnson, who was initially reluctant to introduce social distancing measures in the country, and Prince Charles, the heir to the British throne.

The Zaandam, a Holland America cruise ship on which four passengers died, will be allowed to transit the Panama Canal, after authorities initially refused the ship entry because of illness onboard.

The ship was supposed to let its passengers disembark in Chile two weeks ago but was refused entry, so it headed to Fort Lauderdale, Fla., where the ship does not yet have permission to dock.

A week ago, people on the ship started getting sick. The company said on Friday that nearly 140 people, including 85 members of the crew, have flulike symptoms and two have tested positive for Covid-19, the disease caused by the coronavirus. Those who are sick and their close contacts will stay onboard, and everyone else will be transferred to the Rotterdam, another cruise ship, which arrived in Panama from Mexico to deliver supplies, coronavirus tests and doctors.

Crew members aboard the Rotterdam told The New York Times that they felt tricked because they were told they were going to Panama to deliver supplies only to learn that they would also take on hundreds of passengers who had been exposed to the virus. Some crew members have refused to come out of their cabins and were threatened with being in violation of their employment contracts, according to a crew member who spoke on the condition of anonymity because he feared reprisal.

Holland America, which is owned by Carnival Corp., did not return requests for further information.

“We are aware of reported permission for both Zaandam and Rotterdam to transit the Panama Canal in the near future,” the company said in a statement. “We greatly appreciate this consideration in the humanitarian interest of our guests and crew.”

The ship received special authorization from Panama’s Ministry of Health and will transit the canal under “special considerations and for humanitarian reasons,” the canal authority said on Twitter. Crossing the canal will allow the ship to save two travel days, the canal authority added.

Robert Rorison, a passenger from Surrey, British Columbia, said he was denied a transfer to the Rotterdam because he uses a CPAP machine to sleep, which disqualified him. “We get three meals a day, but every day we get less food,” he said in a text message. “We’re comfortable, but not knowing is difficult, and being in this small room for so long is a disaster.”

On Sunday, Speaker Nancy Pelosi put the blame for the nation’s flawed response to the pandemic squarely on President Trump.

“His denial at the beginning was deadly,” Ms. Pelosi, a California Democrat, said on CNN’s “State of the Union.” “Now I think the best thing would be to do is to prevent more loss of life.”

“We really want to work in a unified way to get the job done here,” she added, “but we cannot continue to allow him to continue to make these underestimates of what is actually happening here.”

“Don’t fiddle while people die, Mr. President,” Ms. Pelosi said.

Hours later, a White House spokesman lashed out at Ms. Pelosi’s comments, alleging that it was the speaker and the media who had initially refused to acknowledge the severity of the outbreak, and using hyperbolic language to attack her negotiating position on the $2 trillion aid bill Mr. Trump signed on Friday.

“When she was faced with offering immediate relief to real Americans who are struggling, she blew up negotiations on the coronavirus relief bill with a shameful political attempt to tack radical leftist programs on to the bill,” said Hogan Gidley, the spokesman.

Democrats did hold up economic stimulus legislation for three days last week while Ms. Pelosi and Senator Chuck Schumer of New York, the minority leader, insisted on changes to secure the support of their caucuses, including increased oversight for a bailout fund for distressed businesses.

As reports of the coronavirus’s spread in China began to trickle out, Congress was dealing with Mr. Trump’s impeachment trial, but also hosted multiple briefings with administration officials to update lawmakers on the outbreak.

Mr. Trump, for his part, has played down the spread of the virus until recently, and has repeatedly touted unproven treatments while contradicting his administration’s scientific experts on how lethal the virus is and how quickly it may be contained in the United States.

Over fewer than four weeks, Congress and the White House have agreed to billions of dollars in emergency aid, a significant expansion of the social safety net and a $2 trillion stimulus, the largest economic response package in modern American history.

But lawmakers, administration officials, industry groups and lobbyists are already outlining possible elements of a fourth piece of legislation to combat the spread of the coronavirus and bolster a shuddering economy.

“We have to pass another bill that goes to meeting the need more substantially than we have,” Speaker Nancy Pelosi said on CNN’s “State of the Union” on Sunday, ticking off a list of Democratic priorities, including increased protections for workers on the front lines and a further expansion of new paid sick-leave provisions.

Some officials who were involved in the negotiations over the earlier bills, including Treasury Secretary Steven Mnuchin, have cautioned that they may need to see how those laws are implemented before solidifying the components of new legislations. Still, the fourth package could include additional direct payments to taxpayers, as well as more funds for hospitals, states and local governments.

“If, for whatever reason, this takes longer than we think, we will go back to Congress and get more support for the American economy,” Mr. Mnuchin said on “Face the Nation” on CBS, adding that he hoped such a step was not needed.

Senator Mitch McConnell of Kentucky, the Republican majority leader, has instructed the senators “to stay nimble,” acknowledging that they may have to return sooner than the chamber’s next scheduled session on April 20.

The C.D.C. issued a formal advisory late Saturday night urging the residents of New York, New Jersey and Connecticut to “refrain from nonessential domestic travel for 14 days effective immediately.”

The advisory does not apply to “employees of critical infrastructure industries,” the agency said. That includes trucking, public health professionals, financial services and food supply workers.

Earlier on Saturday, Mr. Trump had suggested the states might be quarantined — a more severe restriction — but offered no details about how his administration would enforce it. Hours later, Mr. Trump said on Twitter that he had spoken to the governors of the three states and that the quarantine “will not be necessary.” He said that he had asked the C.D.C. to issue the “strong” travel advisory to be implemented by the governors.

Speaking to CNN, Gov. Andrew Cuomo of New York had criticized the idea of the quarantine, calling it “a declaration of war on states.”

He also questioned the logistical challenges, as well as the message, that such an order would present. “If you start walling off areas all across the country, it would just be totally bizarre, counterproductive, anti-American, antisocial,” he said.

The specter of a federal quarantine followed a wave of governors who, fearful about the virus spreading further through their states, ordered people who had traveled from New York to isolate themselves for two weeks after their arrivals.

Texas, Florida, Maryland and South Carolina are among the states that have ordered people arriving from New York to self-quarantine. In Texas, the authorities said on Friday that Department of Public Safety agents would make surprise visits to see whether travelers were adhering to the state’s mandate, and they warned that violators could be fined $1,000 and jailed for 180 days.

Mr. Lamont, the Connecticut governor, last week urged all travelers from New York City to self-quarantine for two weeks upon entering the state, but he stopped short of issuing an order requiring it.

Late Saturday, the governor of Rhode Island, Gina Raimondo, a Democrat, said she would repeal an earlier executive order that had singled out New York residents for self-quarantine, after an outcry and threats of a lawsuit from Mr. Cuomo. A new order from Ms. Raimondo asked that all out-of-state visitors to Rhode Island self-quarantine for 14 days.

Former Vice President Joseph R. Biden Jr. said Sunday that all states “should be beginning to plan” for the possibility of conducting their elections by mail because of the coronavirus pandemic, and suggested there was a chance the general election this fall would need to be conducted by mail-in ballots.

“I don’t want to go that far ahead, but that is possible,” Mr. Biden, who is seeking the Democratic nomination for president, said on NBC’s “Meet the Press.” “I think we should be looking into all-mail ballots across the board to begin with, because it’s an easier way for people to vote, but whether or not that’s required across the board in all 50 states and territories, I’m not sure yet.”

Mr. Biden also said that if he were president, he would be using the Defense Production Act more aggressively to secure needed items like masks and ventilators, suggesting that President Trump was not doing all he could to help doctors, nurses and emergency responders.

“Why are we waiting?” he asked. “We know they’re needed. They’re going to be increasingly needed.”

Mr. Biden did not criticize Mr. Trump directly but suggested that, as president, he would be more aggressive in seeking even more money to help businesses and struggling workers. He said the $2 trillion relief bill, which the president signed into law on Friday, would not be sufficient to save the nation’s economy in the wake of the virus. “That’s not going to be enough to get us all the way through this.”

Mr. Biden also shrugged off poll numbers that show that Mr. Trump’s approval rating has improved in recent weeks. “I think that’s a typical American response. In every single crisis we’ve had that I’ve been around, going back to Jimmy Carter and the hostages, all the way through to this moment, presidents’ ratings have always gone up in a crisis,” he said. “But you know the old expression, the proof, you know, is going to be in the pudding.”

Without naming Mr. Trump directly, Mr. Biden added: “Let’s get away from the childishness of this and focus on the problem.”

An infant who tested positive for the coronavirus has died in Chicago, the authorities said on Saturday. It was the first known death of a child younger than a year old with the virus in the United States, although the authorities in some states do not release details about people who die.

In Louisiana, an inmate at a federal prison also died from the coronavirus, according to an employee at the facility. The death is the first involving an inmate in the Federal Bureau of Prisons system.

Newborns and babies have seemed to be largely unaffected by the coronavirus, but three new studies suggest that the virus may reach the fetus in utero.

“There has never before been a death associated with Covid-19 in an infant,” said Dr. Ngozi Ezike, the director of the Illinois Department of Public Health. “A full investigation is underway to determine the cause of death.” Older adults, especially those in their 80s and 90s, have been viewed as the most vulnerable in the outbreak, but younger people have also died.

Corey Trammel, a president of the local prison union at the Federal Correctional Complex in Oakdale, La., said that more than 10 inmates from the prison had been hospitalized and more than 60 were in isolation with symptoms or were in quarantine. He said at least six staff members at the prison were thought to have the virus.

“We need to do something to get ahead of this,” he said. “And the community is being left in the dark.”

The Bureau of Prisons website currently lists five inmates and no staff members at the Oakdale prison as having tested positive for the virus. The bureau did not respond to an email about the death. In the federal system, at least 27 inmates and prison workers across the country have tested positive for the virus, according to the bureau’s website.

As of Sunday morning, deaths in the United States had surpassed 2,100, including at least 50 in Illinois. More than 3,500 cases of the virus have been identified in Illinois.

The director of the U.S. health department’s civil rights office has said his office is opening a series of investigations to ensure that states do not allow medical providers to discriminate on the basis of disabilities, race, age or certain other factors when deciding who receives lifesaving medical care during the coronavirus emergency.

The civil rights office released a new bulletin days after disability rights advocates filed complaints arguing that protocols to ration lifesaving medical care adopted by Alabama and Washington State were discriminatory.

Many states and hospitals are developing plans for how to ration care if the number of critically ill coronavirus patients exceeds capacity. Patients who develop severe respiratory distress from coronavirus infection often require support from mechanical ventilators for days to weeks, and the machines are expected to be in short supply in the United States.

Many plans would prioritize patients who were most likely to survive their immediate illness, and who also had a better chance of long-term survival. Some assign patients a score based on calculations of their level of illness, with decisions between patients who have the same score made by random selection. Some plans instruct hospitals not to offer mechanical ventilators to people above a certain age or with particular health conditions.

“Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism,” Roger Severino, the office’s director, said in a statement this weekend. People with disabilities, those with limited English skills and older people “should not be put at the end of the line for health care during emergencies,” he said.

He said his office had heard from “a broad spectrum of civil rights groups, pro-life groups, disability rights groups, from prominent members of Congress from both sides of the aisle, from ordinary people who are concerned about their civil rights in this time of crisis.”

Concerned that thousands of migrant children in federal detention facilities could be in danger of contracting the coronavirus, a federal judge in Los Angeles late on Saturday ordered the government to “make continuous efforts” to release them from custody.

The order, from Judge Dolly M. Gee of the United States District Court, came after plaintiffs in a long-running case over the detention of migrant children cited reports that four children being held at a federally licensed shelter in New York had tested positive for the virus.

“The threat of irreparable injury to their health and safety is palpable,” the plaintiffs’ lawyers said in their petition, which called for migrant children across the country to be released to outside sponsors within seven days unless they represent a flight risk.

Around the United States, about 3,600 children are in shelters operated under license by the federal Office of Refugee Resettlement, and about 3,300 more at three detention facilities for migrant children held in custody with their parents, operated by the Immigration and Customs Enforcement agency.

Hundreds of thousands of migrant laborers in India have begun long journeys on foot to get home, having been rendered homeless and jobless by the world’s biggest lockdown.

In different parts of the country, more than a dozen laborers have died during the journeys, hospital officials said early Monday morning.

In the capital, Delhi, thousands of migrants, including whole families, packed their pots, pans and blankets into rucksacks, some balancing small children on their shoulders as they walked along interstate highways, in one of the biggest migrations in the country’s recent history. Some planned to walk hundreds of miles. But as they reached the Delhi border, many were beaten back by the police.

“You fear the disease, living on the streets. But I fear hunger more, not corona,” said Papu, 32, who came to Delhi three weeks ago for work and was trying to get to his home in Saharanpur in the state of Uttar Pradesh, 125 miles away.

On Sunday, Prime Minister Narendra Modi apologized to the country for imposing the nationwide lockdown, which was announced with just four hours’ notice on Tuesday.

“I would firstly like to seek forgiveness from all my countrymen,” he said in a radio address. “Possibly many would be angry at me for being locked in their homes,” he added, saying that there was no other way “to wage a war against corona.”

So far, 980 people have tested positive for the coronavirus in India, with 24 dead, according to officials.

India already had one of the world’s largest homeless populations, and the lockdown may have tripled it overnight, workers for nongovernmental organizations say. A 2011 government census put the number of homeless at 1.7 million, almost certainly a vast underestimate in the country of 1.3 billion.

The lockdown, which includes a ban on interstate travel, left India’s enormous migrant population stranded in big cities, where jobs have lured them in vast numbers from the countryside.

As the coronavirus spread across the United States between late January and early March, large-scale testing of people who might have been infected did not happen because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels.

The three federal health ag​​​encies responsible for detecting and combating ​pandemic threats failed to prepare quickly enough, a Times investigation found. Even as scientists looked at China and sounded alarms, none of the agencies’ directors conveyed the urgency required to spur a no-holds-barred defense, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.

Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, trusted the agency’s veteran scientists to develop a test for the coronavirus. But when the test turned out to have a flaw, it took the C.D.C. much of February to settle on a solution. In the meantime, the virus was spreading undetected.

Dr. Stephen Hahn​, the commissioner of the Food and Drug Administration, was supposed to help build national testing capacity by approving diagnostic tests developed by the private sector. Yet he enforced regulations that paradoxically made it tougher for hospitals and laboratories to deploy ​such tests in an emergency.

Alex ​M. ​Azar​ II​, ​the health and human services secretary, oversaw the ​two other agencies and coordinated the government’s public health response to the pandemic. ​Yet he ​did not manage to push the C​.​D​.​C​.​ or F​.​D​.​A​.​ to speed up or change course.

Together, the challenges resulted in a lost month, when the United States squandered its best chance of containing the coronavirus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

Stuck at home? You don’t need access to a gym to stay active. You can (and should) go outside for a walk or run (or do push-ups and squats).

Reporting and research were contributed by Frances Robles, Neil MacFarquhar, Alan Blinder, Michael D. Shear, Jesse McKinley, Abby Goodnough, Sheila Kaplan, Sheri Fink, Katie Thomas, Noah Weiland, Ali Watkins, Katie Van Syckle, Ana Swanson, Anton Troianovksi, Maria Abi-Habib, Austin Ramzy, Tess Felder, Yonette Joseph, Raphael Minder, Iliana Magra, Katie Glueck, Elisabetta Povoledo, Emily Cochrane, Constant Méheut and Vivian Yee.

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