President Trump returned to the White House on Monday night, staging a defiant, made-for-television moment in which he ripped off his face mask and then urged the nation to put aside the risks of the deadly coronavirus that has swept through his own staff and sent him to the hospital for three days.
Just hours after his press secretary and two more aides tested positive, making the White House the leading coronavirus hot spot in the nation’s capital, Mr. Trump again dismissed the pandemic that has killed more than 210,000 people in the United States, telling Americans “don’t be afraid of it” and saying that he felt “better than 20 years ago.”
The words and visuals were only the latest ways Mr. Trump has undermined public health experts trying to persuade Americans to take the pandemic seriously. Even afflicted by the disease himself, the president who has wrongly predicted that it would simply disappear appeared unchastened as he pressed America to reopen and made no effort to promote precautions.
“We’re going back to work. We’re going to be out front,” Mr. Trump said in a video shot immediately after his return and then posted online. “As your leader, I had to do that. I knew there’s danger to it, but I had to do it. I stood out front. I led. Nobody that’s a leader would not do what I did. And I know there’s a risk, there’s a danger, but that’s OK. And now I’m better and maybe I’m immune, I don’t know. But don’t let it dominate your lives.”
Mr. Trump’s statement was meant to cast his illness as an act of courage rather than the predictable outcome of recklessness. He took no responsibility for repeatedly ignoring public health guidelines by holding campaign rallies and White House events without masks or social distancing, like the Supreme Court announcement at the White House last month that may have infected a wide array of his aides and allies.
The regret-nothing approach demonstrated that the president intended no pivot in his handling of the pandemic despite his own medical crisis and the growing number of infections among his inner circle. The White House press secretary, Kayleigh McEnany, and two of her deputies were the latest to test positive.
Mr. Trump’s message, in effect, was that Americans should live their lives and not worry about catching the virus because “we have the best medicines in the world,” never mind that he has had access to experimental treatment and high-quality health care not available to most people.
The president’s dismissal of a virus that in recent weeks has been killing another 700 people each day in the United States set off alarm bells among health specialists who worried that it would send the wrong message to the public.
Kristin Urquiza, who addressed the Democratic National Convention in August after her father died of the coronavirus, responded on Twitter to the president’s admonishment to Americans not to be afraid of Covid-19, the disease caused by the coronavirus. “At this point the only thing we should be afraid of is you,” she wrote.
Critics also noted the president’s bravado is bolstered by care that isn’t available to most people, including an experimental antibody treatment that is still being tested in clinical trials and has been given to only a few hundred people. The manufacturer, Regeneron, has said that most of those who have gotten the cocktail have done so as participants in the trials, although in a handful of cases they have received it outside of the studies, as Mr. Trump did.
Mr. Trump pressured his doctors to release him from Walter Reed National Military Medical Center in suburban Maryland, but it did not indicate that he had escaped jeopardy, only that he could be treated at the White House, where he has 24-hour medical care. Dr. Sean P. Conley, the White House physician, acknowledged that the president “may not entirely be out of the woods yet,” adding that it would be another week until doctors could feel confident that he had passed the danger point.
Public health experts had hoped that President Trump, chastened by his own infection with the coronavirus and the cases that have erupted among his staff members, would act decisively to persuade his supporters that wearing masks and social distancing were essential to protecting themselves and their loved ones.
But instead, tweeting on Monday from the military hospital where he had been receiving state-of-the-art treatment for Covid-19, the disease caused by the virus, the president yet again downplayed the deadly threat.
“Don’t be afraid of Covid,” he wrote. “Don’t let it dominate your life.”
The president’s comments drew outrage from scientists, ethicists and doctors, as well as some people whose relatives and friends were among the more than 210,000 people who have died in the United States.
“I am struggling for words — this is crazy,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania. “It is just utterly irresponsible.”
Fiana Garza Tulip, 40, who lives in Brooklyn and lost her mother to the virus, wrote in a text message that she was “reeling” after reading Mr. Trump’s tweet, which she described as a “slap in the face” and a “painful reminder that our president is unfit for office and that he does not care about human life.”
“My mom, a respiratory therapist, couldn’t get tested at her hospital where she worked, she had to look for two days for a testing site while feeling the effects of Covid, she didn’t want to go to a hospital because she said it was worse there and she didn’t want to call an ambulance because it was too expensive. So she stayed home for a week and lost her pulse as soon as the medics put her on a gurney.”
Shane Peoples, 41, whose parents, Darlene and Johnny Peoples, died of the coronavirus on the same day in September, said the president’s comments were frustrating.
“Is he actually trying to put more lives at risk?” Mr. Peoples said. “He needs to be held accountable for the deaths that could have been prevented if he never downplayed it.”
Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical School in Tennessee, called the president’s message “dangerous” because it encouraged his followers to ignore basic recommendations to keep themselves safe.
“It will lead to more casual behavior, which will lead to more transmission of the virus, which will lead to more illness, and more illness will lead to more deaths,” Dr. Schaffner said.
Mr. Trump has often ignored the recommendations of public health experts, repeatedly mocking people for wearing masks, for example.
“I don’t wear masks like him,” he said of the Democratic presidential candidate, Joseph R. Biden Jr., at their debate in Cleveland last week. “Every time you see him, he’s got a mask. He could be speaking 200 feet away from them, and he shows up with the biggest mask I’ve ever seen.”
Upon Mr. Trump’s return on Monday evening from the Walter Reed medical center, he climbed the steps of the White House, turned to face the TV cameras that were carrying the news live, and removed his mask.
For more than a century, Secret Service agents have lived by a straightforward ethos: They will take the president where he wants to go, even if it means putting their bodies in front of a bullet.
But that guiding principle has been tested in recent days by President Trump’s desire to get back to work, play or campaigning, despite an active coronavirus infection that could pose a serious threat to those around him.
The problem came into focus on Sunday, when a masked Mr. Trump climbed into a hermetically sealed, armored Chevy Suburban with at least two Secret Service agents so the president could wave to supporters outside Walter Reed National Military Medical Center in Bethesda, Md., where he was hospitalized from Friday to Monday.
Medical experts said the move put agents at risk. Secret Service personnel have privately questioned whether additional precautions will be put in place to protect the detail from the man they have pledged to protect.
“It’s on everybody’s mind,” said W. Ralph Basham, a former director of the Secret Service and the commissioner of U.S. Customs and Border Protection in the George W. Bush administration. “The ones no longer there are happy they’re not there. These are tough decisions to have to make.”
Central to the job of Secret Service agents is a willingness to say yes to the president no matter what he asks. Now, that means subjecting an agent’s health to Mr. Trump’s whims.
Critics say the president is not repaying his protectors’ dedication with anything like care or consideration. While agents have volunteered to sacrifice themselves for those they protect, they do so knowing that there is a low chance they will need to step in between a gunman and the president.
“If they’re on the protection detail, they’ll take a bullet for their protectee,” said Janet Napolitano, President Barack Obama’s first homeland security secretary. “There’s a difference between that and being unnecessarily exposed to risk,” she added, one that extends to their families.
Top White House officials are blocking strict new federal guidelines for the emergency release of a coronavirus vaccine, objecting to a provision that would almost certainly guarantee that no vaccine could be authorized before the election on Nov. 3, according to people familiar with the approval process.
Facing a White House blockade, the Food and Drug Administration is seeking other avenues to ensure that vaccines meet the guidelines. That includes sharing the standards with an outside advisory committee of experts — perhaps as soon as this week — that is supposed to meet publicly before any vaccine is authorized for emergency use. The hope is that the committee will enforce the guidelines, regardless of the White House’s reaction.
The struggle over the guidelines is part of a monthslong tug of war between the White House and federal agencies on the front lines of the pandemic response. White House officials have repeatedly intervened to shape decisions and public announcements in ways that paint the administration’s response to the pandemic in a positive light.
That pattern has dismayed a growing number of career officials and political appointees involved in the administration’s fight against a virus that has killed more than 209,000 people in the United States.
The vaccine guidelines carry special significance: By refusing to allow the F.D.A. to release them, the White House is undercutting the government’s effort to reassure the public that any vaccine will be safe and effective, health experts fear.
“The public must have full faith in the scientific process and the rigor of F.D.A.’s regulatory oversight if we are to end the pandemic,” the biotech industry’s trade association pleaded on Thursday, in a letter to President Trump’s health secretary, Alex M. Azar II, asking for release of the guidelines.
Gov. Andrew M. Cuomo of New York refused on Monday to allow New York City to close nonessential businesses in nine hot spots in Brooklyn and Queens where the coronavirus has spiked, pre-empting a plan announced the day before by Mayor Bill de Blasio.
The governor suggested that the ZIP codes that were being used to identify hot spots were too imprecise to guide shutdowns. The more pressing problem, he said, lay in schools and houses of worship, including many that cater to Orthodox Jews, rather than businesses that “are not large spreaders.”
The dissonance in messages from the state’s two most prominent politicians created confusion for residents, business owners and parents in the affected areas and drew scrutiny to the conflict between city and state over how to tackle early signs of a second wave of the virus in its onetime epicenter.
The governor’s announcement also seemed to be yet another manifestation of his long feud with Mr. de Blasio. Mr. Cuomo has frequently second-guessed or overruled the mayor, who is also a Democrat, during their tenures. Those clashes were cast in sharp relief during the early days of the pandemic, with the city and state at odds over the timing of shutting down the city’s businesses and its schools, among other issues.
On Monday, that disconnect continued, as Mr. Cuomo accelerated the mayor’s plan to close schools in newly hard-hit areas, moving the closure date up a day to Tuesday, and forcing parents in those areas to again rejigger their schedules to accommodate changes in their children’s routines. Mr. Cuomo said he spoke with Mr. de Blasio and Michael Mulgrew, the president of the city’s teachers’ union, among other local officials, on Monday morning and added that all were in agreement on the need for additional data on cases at specific schools.
Mr. Cuomo did not rule out closing nonessential businesses or public spaces in the near future, and top aides suggested a state plan could be unveiled as soon as Tuesday. Mr. Cuomo said his administration was reviewing how best to do it without relying on geographic delineations from ZIP codes, which he said were arbitrary and might not accurately capture the areas where new cases are going up.
“A ZIP code is not the best definition of the applicable zone,” he said. “If you have to circumscribe an area, make sure you have the right boundaries.”
Cuomo administration officials later suggested that the boundaries for business closures could even exceed the ZIP codes where the increases are now occurring.
On Monday afternoon, not long after the governor’s news conference, Mr. de Blasio said at a news conference of his own that he still planned to close nonessential businesses in the nine ZIP codes. He added later that “we obviously will follow state law, and if the state does not authorize restrictions we’re not going to act. But I find that very unlikely at this point.”
Mr. Cuomo had also announced that the state would take over supervision of enforcement of mask and social-distancing rules in the hot spot clusters, presumably putting the State Police in charge of New York City Police Department officers. He added that local governments would need to provide personnel.
The mayor said that he did not believe that the state could seize control of enforcement from local governments but that he agreed with Mr. Cuomo on the need for aggressive enforcement and “stronger restrictions that will allow us to turn the tide.”
Despite almost daily disclosures of new coronavirus infections among President Trump’s close associates, the White House is making little effort to investigate the scope and source of its outbreak.
According to a White House official familiar with the plans, the administration has decided not to trace the contacts of guests and staff members at the Sept. 26 Rose Garden celebration for Judge Amy Coney Barrett, Mr. Trump’s Supreme Court nominee. At least 11 people who attended the event, including the president and the first lady, have since tested positive.
Instead, it has limited its efforts to notifying people who came in close contact with Mr. Trump in the two days before his Covid diagnosis on Thursday evening. The White House official, who declined to be identified because he was not authorized to speak about the matter, said that the administration was following guidelines from the C.D.C.
The contact tracing efforts have consisted mostly of emails notifying people of potential exposure, rather than the detailed phone conversations necessary to trace all contacts of people who have been exposed. These efforts, typically conducted by the C.D.C., are being run by the White House Medical Unit, a group of about 30 doctors, nurses and physician assistants, headed by Dr. Sean Conley, the White House physician.
“This is a total abdication of responsibility by the Trump administration,” said Dr. Joshua Barocas, a public health expert at Boston University, who has advised the city of Boston on contact tracing. “The idea that we’re not involving the C.D.C. to do contact tracing at this point seems like a massive public health threat.”
Iran’s coronavirus crisis worsened on Monday, with a record numbers of deaths and new infections, as the capital, Tehran, went into partial shutdown for a week.
The restrictions in Tehran, which went into effect on Saturday, include fines for anyone not wearing a mask in public. The government ordered the shutdown of schools, gyms, cafes, cinemas, beauty salons, museums and mosques, even for Friday prayers.
The health ministry on Monday reported 235 deaths from the virus, the highest daily count in Iran since the disease was first reported there in February. Masoud Mardani, a member of the government’s coronavirus committee, told the newspaper Etemad that the true death toll was several times higher than the official tally.
The ministry reported 3,902 new infections on Monday — another record — and 2,000 people hospitalized. Doctors warned on state TV that hospitals across the nation had reached full capacity and there were no more empty beds in intensive care units in Tehran.
President Hassan Rouhani announced the new restrictions as his government came under fire for taking a relatively passive stance on the crisis, referred to as the “inshallah” approach, from the Arabic expression meaning “God willing” or “if God wills.”
“Unfortunately, Tehran in terms of enforcing health regulation is like a city with nobody in charge,” said Hossein Kermanpour, the spokesman for the country’s regulatory body for health care.
In other global developments:
A top World Health Organization official said Monday that about 10 percent of the world’s population may have already contracted the coronavirus. That estimate — which works out to about 760 million people — far exceeds the confirmed global caseload of about 35 million. “This varies depending on country, it varies from urban to rural, it varies between different groups,” the official, Dr. Mike Ryan, said at a special session of the agency’s executive board in Geneva. “But what it does mean is that the vast majority of the world remains at risk.” Another agency official said Monday that the 10 percent estimate had been calculated based on an average of antibody studies from around the world.
Two midsize cities in Spain, León and Palencia, were ordered on Monday by the regional authorities to apply lockdown restrictions similar to those that came into force in Madrid last weekend, underlining the extent to which a second wave of infections is spreading beyond Spain’s capital region. The new restrictions mean that residents of León and Palencia, which are in the northwestern region of Castile and León, will not be able to leave their cities as of Tuesday.