Home featured Fauci says the treatment Trump called a ‘cure’ may well work, but...

Fauci says the treatment Trump called a ‘cure’ may well work, but needs more testing.

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President Trump departing the Walter Reed Medical Center on Monday.
Credit…Doug Mills/The New York Times

The antibody cocktail for Covid-19 that President Trump touted on Wednesday afternoon was developed with cells originally derived from fetal tissue, a practice that the president had repeatedly condemned.

In June 2019, the Trump administration suspended federal funding for most new scientific research involving fetal tissue derived from abortions.

“Promoting the dignity of human life from conception to natural death is one of the very top priorities of President Trump’s administration,” the Department of Health and Human Services said in a prepared statement.

“Intramural research that requires new acquisition of fetal tissue from elective abortions will not be conducted,” the statement added.

Mr. Trump last week received Regeneron’s cocktail of monoclonal antibodies — essentially, antibodies synthesized in living cells and administered to help the body fight off the infection.

To develop the antibodies, Regeneron relied on 293T, a human cell line once derived from fetal tissue. At least two companies racing to produce vaccines against the coronavirus, Moderna and AstraZeneca, also are using the cell line.

Remdesivir, an antiviral drug Mr. Trump received, also was tested using these cells.

“293Ts were used in testing the antibodies’ ability to neutralize the virus,” said Alexandra Bowie, a spokeswoman for Regeneron. “They weren’t used in any other way, and fetal tissue was not used in the research.”

In a video released Wednesday, Mr. Trump praised Regeneron’s treatment, calling it a “cure” for Covid-19 and promising to provide it free to any patient who needed it. The company said on Wednesday that it had applied to the Food and Drug Administration for emergency use authorization.

Scientists noted that the trials of the antibody cocktail are far from complete, and that Mr. Trump is taking a variety of drugs that may have explained why he said he felt better.

The White House did not immediately respond to a request for comment.

In July, the International Society for Stem Cell Research sent a letter to the Human Fetal Tissue Research Ethics Advisory Board at the National Institutes of Health, urging the board to allow fetal tissue to be used to develop treatments for Covid-19 and for other diseases.

“Fetal tissue has unique and valuable properties that often cannot be replaced by other cell types,” the letter said.

In August, the board rejected 13 of the 14 proposals involving fetal tissue. The approved proposal relied on tissue that had already been acquired.

Senate Majority Leader Mitch McConnell said he had not visited the White House since Aug. 6.
Credit…Anna Moneymaker for The New York Times

Senator Mitch McConnell, Republican of Kentucky and the majority leader, said on Thursday that he had been avoiding the White House since midsummer because of concerns that officials there were not taking proper precautions to guard against the spread of coronavirus.

“My impression was that their approach to how to handle this was different from mine and what I insisted that we do in the Senate, which is to wear a mask and practice social distancing,” Mr. McConnell told reporters in Hebron, Ky., on Thursday.

He said he had not visited the White House since Aug. 6, when he met with President Trump to discuss the status of negotiations over additional stimulus legislation.

The decision appears to have been a prudent one now that the White House has become a virus hot spot, with Mr. Trump the most prominent to contract the disease. More than a dozen White House guests and employees, including two of Mr. McConnell’s fellow Senate Republicans, were infected after attending an event Mr. Trump held last month to announce his Supreme Court nominee, Judge Amy Coney Barrett. Mr. McConnell, who is leading the drive to confirm Judge Barrett, had been noticeably absent from the largely maskless large group gathering.

The majority leader did not specifically comment on Judge Barrett’s nomination ceremony.

Though he has closely aligned himself with Mr. Trump politically, Mr. McConnell has consistently struck a different, more sobering tone when discussing the coronavirus. He has publicly urged Americans to wear masks, repeatedly warned that the pandemic’s grip will be long and stated that he believes a vaccine will not be widely available until next year.

“This is not over,” Mr. McConnell said again on Thursday. “We are going to have to work through it.”

President Barack Obama awarded the Presidential Medal of Freedom to William Foege in 2012 during a ceremony at the White House.
Credit…Kevin Lamarque/Reuters

William Foege, a famed epidemiologist and the former director of the Centers for Disease Control and Prevention, said Thursday that President Trump and Vice President Mike Pence have “their knees on the neck of the public health community,” and called on the current C.D.C. director to stand up to them — even at the risk of getting fired.

“Silence becomes complicity and I think the one person that might have turned this around would be the director of the C.D.C.,” said Dr. Foege, who served Republican and Democratic presidents, in an interview.

Dr. Foege, 84, helped lead the successful effort to eradicate small pox in the 1970s and ran the C.D.C. under Presidents Jimmy Carter and Ronald Reagan and is considered a giant in the world of public health. U.S.A. Today published a private letter earlier this week that he wrote to the current C.D.C. director, Dr. Robert R. Redfield, telling him to speak out about the administration’s failures

In his first extensive comments since then, he reiterated that sentiment, saying that beyond coming clean with the public, Dr. Redfield must work to shore up his beleaguered staff and restore the institution’s battered reputation.

“I think he would level with C.D.C. employees and let them know what the White House has actually done — some of it is public — the fact that they were willing to put things on the C.D.C. website, that they would overrule the recommendation of C.D.C.,” Dr. Foege said, adding, “If he said, ‘I will stand behind you for as long as I’m here,’ and then if he gets fired he gets fired with his head held high.”

The White House rejected the agency’s initial plan for reopening the country and pressured the C.D.C. to play down the risk of sending children back to school. More recently, a disputed guidance pulling back on coronavirus testing was posted on the C.D.C.’s website over the objections of career scientists.

And on Wednesday, the White House released an unusual letter written by Dr. Redfield that vouched for Mr. Pence’s health in advance of the vice-presidential debate. Dr. Foege said he was unaware of it, “but it sounds very manipulative.”

Dr. Foege suggested that Dr. Redfield was in a nearly impossible situation, working for a president who has declared all-out war on his agency and accused its scientists are being part of a “deep state” conspiracy against him.

“I like the man, and I am impressed that he wants to do the right thing — that this is not someone who is deliberately trying to do the wrong thing,” Dr. Foege said, adding “but he’s with this great contingent of people who can’t stand up to a bully, and that’s something I don’t understand.”

Dr. Foege’s letter, dated Sept. 23, opened by saying he woke up every day thinking of the “terrible burden” on Dr. Redfield. He said Thursday that he wrote it out of “frustration” that had been “building up” and that he never intended for it to become public. In the interview, Dr. Foege said that he and Dr. Redfield have had an exchange about the letter, though he declined to provide specifics about their conversations.

Dr. Redfield has had no comment.

New York State has shut down nonessential businesses in the hardest-hit areas of Brooklyn, Queens and the city’s northern suburbs as the virus takes hold again.
Credit…James Estrin/The New York Times

As new restrictions went into effect in areas of New York City just two days after they were announced, Mayor Bill de Blasio said Thursday he knew questions remained for residents in the affected parts of Queens and Brooklyn, which have high virus positivity rates.

The state’s rules, which have also drawn significant backlash in Orthodox Jewish areas over limited capacities at houses of worship, were divided into three color-coded zones and shut down nonessential businesses in the hardest-hit areas of Brooklyn, Queens and the city’s northern suburbs. Restaurants and bars in a red zone, which has the most severe rules, can only offer takeout and delivery, just like in the spring. Schools have also been closed in some of those areas.

The zoned restrictions — identified as red, orange or yellow — will be in place for at least two weeks, at which point Mr. de Blasio said the city would work with the state to reassess whether a longer timetable were needed. The rules came as city and state officials grappled with how to tamp down the threat of a second wave of infections in the region, which some fear has already begun. In New York City, there have been more than 23,800 virus-related deaths.

“This is a turnaround that, if we do it right, could only take a few weeks,” Mr. de Blasio said Thursday. “If we don’t do it right, it could go a lot longer.”

The city shut down 61 public school sites on Thursday, he said, and that, in total, 153 locations had been closed in the red and orange zones.

Earlier in the week, Gov. Andrew M. Cuomo announced that schools in nine ZIP codes in Brooklyn and Queens had to be closed for in-person instruction on Tuesday. But when the state released updated guidance, some of those schools fell into yellow zones, in which schools can remain open. Mr. de Blasio said on Thursday that 16 schools in those areas will remain closed for now.

“We’re going to keep those schools closed too because the city believes fundamentally those schools have to be closed as part of the overall strategy,” the mayor said.

The rules elicited both confusion and criticism, particularly after the mayor and governor offered different plans that applied to differing geographic areas this week. The city has made a searchable online database of addresses available for New Yorkers to determine in which zone they are.

Some parents, unhappy about the closure of P.S. 130 in the Windsor Terrace neighborhood of Brooklyn, gathered to speak out on Thursday outside the school’s main entrance. The school fell into an orange zone and was forced to abruptly halt its schedule that had allowed students back into the classroom.




North Corona

Jackson

Heights

Queensboro

Hill

Lefrak City

Forest Hills

Middle Village

Forest Hills Gardens

Richmond

Hill

Sunset Park

East Flatbush

Borough Park

Georgetown

Mill Basin

Fort Hamilton

Bensonhurst

Mill Island

Far Rockaway

Bath Beach

Manhattan Beach

Coney Island

Restrictions: Major Minor

North Corona

Jackson

Heights

Queensboro

Hill

Lefrak City

Forest Hills

Middle Village

Forest Hills Gardens

Richmond

Hill

Sunset Park

East Flatbush

Borough Park

Georgetown

Mill Basin

Fort

Hamilton

Bensonhurst

Mill Island

Far Rockaway

Bath Beach

Manhattan Beach

Coney Island

Restrictions: Major Minor

North Corona

Forest Hills

Sunset Park

Far Rockaway

Coney Island

Restrictions: Major Minor


Over the last two nights, protests have also formed in the Borough Park neighborhood against the restrictions — which limit houses of worship in red zones to 25 percent capacity, or a maximum of 10 people — reflecting anger among Orthodox Jewish and other religious leaders who said they were not consulted before the measures were announced.

Mr. de Blasio also said that the seven-day average rate of positive virus test results was 1.56 percent, slightly lower than the rate reported on Wednesday.

Statewide, the daily positivity rate was 1.26 percent, Mr. Cuomo said, adding that hospitalizations were up from the previous day, to 754.

The Sabbatsbergsbyn nursing home in Stockholm, which is owned and operated by Sweden’s largest for-profit operator of nursing homes, struggled to control the spread of the coronavirus.
Credit…Felix Odell for The New York Times

In the popular imagination, Sweden does not seem like the sort of country prone to accepting the mass death of grandparents to conserve resources in a pandemic.

Swedes pay some of the highest taxes on earth in exchange for extensive government services, including state-furnished health care.

Yet among the nearly 6,000 people whose deaths have been linked to the coronavirus in Sweden, 2,694, or more than 45 percent, had been among the country’s most vulnerable citizens — those living in nursing homes.

That tragedy is in part the story of how Sweden has, over decades, gradually yet relentlessly downgraded its famously generous social safety net.

Since a financial crisis in the early 1990s, Sweden has slashed taxes and diminished government services. It has handed responsibility for the care of older people — mostly living at home — to strapped municipal governments, while opening up nursing homes to for-profit businesses. They have delivered cost savings by relying on part-time and temporary workers, who typically lack formal training in medicine and elder care.

Sweden has also substantially reduced its hospital capacity over the last two decades. During the worst of the initial outbreak, elderly people in nursing homes were denied access to hospitals for fear of overwhelming them.

Some nursing home operators assert that residents have been the victims of the government’s failure to limit the spread of the virus. The country avoided the lockdowns imposed in much of the rest of Europe. Though the government recommended social distancing, it kept schools open along with shops, restaurants and nightclubs. It did not require that people wear masks.

“There’s been more society transmission, and it’s been more difficult to hinder it from entering the care homes,” said Joacim Rocklov, an epidemiologist at Umea University. “The most precious time that we lost, our mistake was in the beginning.”

Global Roundup

Downtown São Paulo on Wednesday. Life has started to return to normal in Brazil’s biggest cities, but concerns remain about a second wave of the virus.
Credit…Sebastiao Moreira/EPA, via Shutterstock

Seven months after its first case of the coronavirus, Brazil on Wednesday passed the five million mark. The milestone comes as the spread of the virus has been slowing down for over a month, an achievement many public health experts believe has little to do with the Brazilian government’s handling of the crisis, but rather how thoroughly the virus has ravaged the country.

Nearly 150,000 people have died from the virus in Brazil.

As the virus eased its grip on the country’s biggest cities, like Rio de Janeiro and São Paulo, life started to go back to normal, with restaurants and parks reopening. Almost half of Brazilian states have authorized schools to reopen, albeit with many restrictions.

Meanwhile, concerns of a second wave of the virus are still heightened. In the city of Manaus, in the state of Amazonas, one of the most severely hit by the virus, the number of cases started to go up again, especially among young people, in recent weeks. But deaths haven’t shot up again, and government statistics show the city’s hospitals are coping well with demand.

The path to recovery, however, is still unclear. Unemployment numbers reached a new record during the pandemic, with almost 14 million Brazilians looking for jobs, and capital flight more than doubled as foreign investors sought safer havens.

But the Brazilian government did send over 60 million citizens emergency cash transfers that many believe helped propel President Jair Bolsonaro’s popularity, despite his questionable handling of the pandemic.

To retain his popularity, now at almost 40 percent according to recent polls, an all-time high for him, the president and his allies have struggled to come up with a social program that would write at least part of the popular emergency relief into law.

But the efforts have spooked investors, who fear the country won’t honor its debts as it faces the consequence of a GDP contraction of 5.8 percent this year.

Even as it praised the Brazilian government for avoiding a deeper economic downturn by helping its poor earlier this month, the International Monetary Fund said the country’s economy faces “exceptionally high” risks.

In other developments around the world:

  • The European Union signed a deal with Gilead, the California-based pharmaceutical company, to ensure uninterrupted access to an antiviral drug being used to treat Covid-19. Veklury, also known as remdesivir, has been authorized by more than 50 countries, including the United States and in Europe, for the treatment of Covid-19 patients needing supplemental oxygen. The deal signed between Gilead and the European Commission, the executive arm of the European Union, would allow all members of the European Union, as well as the United Kingdom, Iceland, Liechtenstein, Norway and several Balkan countries to buy up to 500,000 treatment courses in the next six months.

  • Poland will make face masks mandatory in public spaces starting Saturday in response to a second day of record-high case numbers, Prime Minister Mateusz Morawiecki announced on Thursday. “The second wave has reached us, and we need to face it in a decisive way,” Mr. Morawiecki said. The new rule will not apply in forests, parks and beaches. Poland had implemented a lockdown early in the pandemic, but loosened restrictions over the summer, and bars and restaurants remain open.

President Trump released another video message on Thursday, promising to make the experimental treatment that he received for Covid-19 “available immediately” and “all free.”

Mr. Trump addressed the video, which was taped outside the White House and posted on Twitter, to senior citizens, whom he called “my favorite people in the world.”

Repeating a claim he made yesterday, the president referred to a treatment, which he did not name, as a “cure.” There is no known cure yet for the coronavirus.

Mr. Trump also repeated a suggestion that treatments could soon be authorized by the Food and Drug Administration for emergency use.

“We’re taking care of our seniors — you’re not vulnerable, but they like to say ‘the vulnerable,’ but you’re the least vulnerable,” the president said. “But for this one thing you are vulnerable, and so am I.”

Polling suggests that Mr. Trump is struggling to win over seniors, who make up a crucial voting bloc for Republicans. Although he led Hillary Clinton by five points among the cohort in 2016, several polls this week show the president trailing Joe Biden among seniors by at least 20 points.

The president also repeated calls to hold China responsible for the pandemic. “We are making tremendous progress with this horrible disease that was sent over by China,” he said. “China will pay a big price for what they did to the world and us.”

Restaurant and bar owners in Lille, France, protested new restrictions last month. The government is tightening rules in a number of cities to halt a second wave of infections.
Credit…Pascal Rossignol/Reuters

The French authorities are tightening virus restrictions in a growing number of big cities as cases rise and hospitals come under increasing strain.

The Paris and Marseille regions have already been placed on the country’s highest alert level, which requires the closure of all bars, gyms and clubs for at least two weeks. Classrooms and universities are limited to half capacity and restaurants can only remain open if they follow a strict health protocol.

“Unfortunately, the health situation continues to deteriorate in France,” Olivier Véran, France’s health minister, said on Thursday as he announced that four cities — Lille, Grenoble, Lyon and Saint-Etienne — also would be placed on maximum alert as of Saturday.

France is bracing itself for a return to restrictions that were put into place when the virus first hit the country, although there have been protests against the idea in the south of the country. According to a survey published on Sept. 26 by IFOP, one of France’s leading polling firms, 72 percent of French citizens would be in favor of a new, nationwide lockdown.

France reported a record daily count of more than 18,700 new cases on Wednesday, according to a Times database, and Covid-19 patients now occupy a quarter of intensive care unit beds nationwide, said Aurélien Rousseau, the head of the health authority for the Paris region.

In total, there have been nearly 654,00 coronavirus cases in France, and almost 32,500 people have died, the Times database shows.

On Thursday, hospitals in the Paris region activated emergency measures that were used previously in March and April to cope with an influx of patients. The efforts involved postponing non-urgent surgeries and calling staff members back from leave.

Rousseau said that enacting such measures was “an important decision” that “means that we are going to face a very strong wave, and that we have to put all forces into the battle.”

An empty retail space on Madison Avenue in New York. Economists warn that without more aid, layoffs will rise again.
Credit…Vincent Tullo for The New York Times

Applications for jobless benefits in the United States remained high last week, even as the collapse of stimulus talks in Washington raised fears of a new wave of layoffs.

More than 804,000 Americans filed new claims for state unemployment benefits last week, the Labor Department said Thursday. That is up from 799,000 the week before, before accounting for seasonal patterns. Another 464,000 people applied for benefits under the federal Pandemic Unemployment Assistance program, which covers freelancers, self-employed workers and others left out of the regular unemployment system.

For the second week in a row, the reported number will carry an asterisk: California last month announced that it would temporarily stop accepting new unemployment applications while it addresses a huge processing backlog and puts in place procedures to weed out fraud.

In the absence of up-to-date data, the Labor Department is assuming California’s claim number was unchanged from its pre-shutdown figure of more than 225,000 applications, or more than a quarter of the national total. The state began accepting new filings this week, and is expected to resume reporting data in time for next week’s report, though it isn’t yet clear how the backlog of claims filed this week will be reflected.

While the lack of data from California makes week-to-week comparisons difficult, the larger trend is clear: After falling swiftly from a peak of more than 6 million last spring, weekly jobless claims have stalled at a level far higher than the worst weeks of past recessions.

“The level of claims is still staggeringly high,” said Daniel Zhao, senior economist at the career site Glassdoor. “We’re seeing evidence that the recovery is slowing down, whether it’s in slowing payroll gains or in the sluggish improvement in jobless claims.”

A police checkpoint this month in Madrid, where a lockdown had been imposed by Spain’s central government.
Credit…Oscar Del Pozo/Agence France-Presse — Getty Images

Madrid’s highest regional court on Thursday annulled a lockdown imposed by Spain’s central government on the capital region in order to contain its Covid-19 infections.

In its ruling, the court said that the central government did not have jurisdiction to institute restrictions that affected fundamental rights and the freedom of movement.

The ruling is a major setback for the central government, and underlines both the political tensions and legal uncertainty in Spain over how to respond to the latest wave of virus cases.

The central government issued a decree imposing new nationwide restrictions last Friday, after a dispute with the regional government of Madrid, which had instead introduced a limited lockdown on about one million residents of some of its worst-affected areas, in mostly working-class neighborhoods.

Spain was put under full lockdown last March, under a state of emergency that gave the central government full authority to decide how to handle the virus. But since late June, when the state of emergency was lifted, Spain’s 17 regional administrations have regained control over how to manage their health care.

After Thursday’s ruling, Salvador Illa, Spain’s health minister, called on Madrid’s regional government to hold emergency talks over how to resolve the standoff, which comes ahead of a long holiday weekend in Spain. Mr. Illa said it was essential to have judicial decisions that “best protect health.”

The central government’s decree had meant that about 4.8 million residents of the Madrid region were forbidden to travel to another part of Spain, unless for work or other exceptional reasons.

A man sits on a nearly empty Waikiki Beach in Honolulu, Friday, Oct. 2, 2020.
Credit…Caleb Jones/Associated Press

The state of Hawaii is preparing to loosen some of the strict pandemic restrictions that have hammered its tourism industry, including the requirement that arriving travelers spend 14 days in quarantine.

Starting on Oct. 15, travelers will be allowed to skip the quarantine if they can show a negative virus test result from an approved source, taken no more than 72 hours before arrival. The pre-travel testing program had been set to begin over the summer, but was postponed when the virus surged on the islands.

Travelers who do not want to be tested can still opt to quarantine instead, raising concerns that untested travelers could infect tested passengers on flights to the islands.

A negative test is not a guarantee of lack of infection: It can take several days after exposure for the amount of virus in an infected person’s body to rise high enough to produce a positive result. The state said it would randomly test 10 percent of incoming passengers four days after arrival to assess the plan’s effectiveness.

Hawaii has reported more than 13,000 cases of the virus, and more than 160 deaths, according to a New York Times database. The state will continue to require wearing a mask in public, and some inter-island travel will remain restricted.

The new measures are meant to help revive the state’s tourism industry, which makes up about a quarter of its economy. The Hawaii Tourism Authority reported in August that travel to the islands the previous month was down almost 98 percent compared with the same month in 2019.

“It’s important that people know we welcome them as long as they’ve gotten their test,” Lt. Gov. Josh Green told The Associated Press. Mr. Green, an emergency room doctor, is heading the new testing program. He recently recovered from Covid-19.

President Trump and former Vice President Joe Biden held their first presidential debate in Cleveland last week.
Credit…Ruth Fremson/The New York Times

President Trump on Thursday said he would not participate in a virtual debate, speaking on Fox Business Network minutes after the Commission on Presidential Debates announced that the next debate would be virtual because of virus concerns.

Mr. Trump and Mr. Biden were scheduled to debate on the same stage in Miami on Oct. 15, but the commission is now preparing for the candidates and moderators to appear remotely.

Mr. Trump, who tested positive for the virus last week, has said he planned to go to the debate, even as health experts say he may not be fully recovered from Covid-19. Mr. Biden has said he would not debate Mr. Trump in Miami if the president was still infected.

“The second presidential debate will take the form of a town meeting, in which the candidates would participate from separate remote locations,” the commission said in a statement, citing “the health and safety of all involved.”

But Mr. Trump immediately dismissed the concept in a television interview on Thursday morning, saying: “I’m not going to waste my time on a virtual debate, that’s not what debating is all about. You sit behind a computer and do a debate — it’s ridiculous.”

“That’s not acceptable to us,” Mr. Trump told the anchor Maria Bartiromo on Fox Business of the virtual debate format. “I’m not going to do a virtual debate.”

Mr. Trump said he only learned of the debate commission’s decision on Thursday morning, minutes before he got on the phone for an interview. He accused the commission of “trying to protect Biden.”

“For the swamp creatures at the Presidential Debate Commission to now rush to Joe Biden’s defense by unilaterally canceling an in-person debate is pathetic,” Mr. Trump’s campaign manager, Bill Stepien, said in a statement on Thursday. “Here are the facts: President Trump will have posted multiple negative tests prior to the debate, so there is no need for this unilateral declaration.”

Mr. Stepien’s claim about Mr. Trump testing positive over the next week is unsubstantiated, because the virus is notoriously unpredictable.

Mr. Biden’s campaign issued a more receptive statement on Thursday. “Vice President Biden looks forward to speaking directly to the American people,” said Kate Bedingfield, a Biden deputy campaign manager.

The moderator, Steve Scully of C-SPAN, will still conduct the proceedings from Miami at the Adrienne Arsht Center for the Performing Arts, the commission said.

Lothar Wieler, the head of the Robert Koch Institute, at a news conference in Berlin on Thursday.
Credit…Pool photo by Christian Marquardt

The head of the German federal institute responsible for tracking the coronavirus warned on Thursday that the country could soon see an “uncontrolled” spread of the virus.

“It is possible that we see more than 10,000 new cases per day,” the official, Lothar Wieler, who leads the Robert Koch Institute, said during a news conference. “It is possible that the virus spreads uncontrolled.”

Germany recorded at least 4,000 new daily cases on Wednesday and has a daily average of at least 2,600 new cases over the past week, according to a New York Times database.

Speaking at the same news conference on Thursday, Jens Spahn, Germany’s health minister, said the authorities were still in control of the virus and called on Germans to be more vigilant in following restrictions.

“It’s up to all of us whether we make it,” he said, comparing the challenge of beating back the virus to a “test of character for society.”

A testing site in Hong Kong last month.
Credit…Anthony Kwan/Getty Images

A Hong Kong health official said Thursday that the city was considering options for mandatory testing as it prepared for a new wave of coronavirus infections.

“From a public health perspective, if we think that if testing is needed and people are not willing to take a test, that hinders our work,” said Sophia Chan, the health secretary.

She said the authorities were considering legal options for mandating testing if necessary, while acknowledging that members of the public might have concerns about any such arrangement.

Last month Hong Kong eased some restrictions, allowing gyms and spas to reopen and expanding the limit on group gatherings to four people. But health authorities say they are preparing for another possible spike in infections.

“We don’t think the situation is looking good because of the increased number of confirmed cases,” said Ms. Chan.

She noted that research by the University of Hong Kong showed the rate of the coronavirus spread was increasing once again. On Thursday, Hong Kong reported 18 new coronavirus cases, 14 of which were locally transmitted.

Hong Kong has reported 5,143 cases since the start of the pandemic, which works out to 69 cases per 100,000 people, according to a Times database. Of those cases, 56 were reported in the last seven days, a rate of less than 1 case per 100,000 people. For comparison, the per capita rate in the United States is 2,285 per 100,000.

A pub in Manchester, Britain, last month.
Credit…Phil Noble/Reuters

The British government is considering a tiered system that would tighten restrictions on pubs and restaurants in the areas of England with the highest rates of infection, according to the BBC and other media outlets.

A ban on overnight stays away from home could also be introduced for the worst-affected areas, but schools would remain open.

Despite local lockdowns in several cities in the north of England, the country’s coronavirus caseload has continued to increase, with Britain reporting an average of 13,000 new cases a day over the past week.

Cities in the north of England, where infection rates are the highest, would likely be targeted by these new restrictions. But the mayors of Liverpool and Manchester said on Twitter that they had not been consulted about any plans.

Mary Harrison, interim health director for the Choctaw Health Center, with her daughter, Logan Denson, in Choctaw, Miss.
Credit…Rory Doyle for The New York Times

The coronavirus has torn through the Mississippi Band of Choctaw Indians unabated, sickening more than 10 percent of the tribe’s 10,000 residents and killing at least 81 people. Now the tribe is bracing for a second wave and more devastation.

Since April, the cases have kept rising, along with the death toll. In May, 30 people died. In June, another 33.

Through last month, Neshoba County, where most of the tribe’s residents live, had the highest death rate per capita in Mississippi from the coronavirus, according to data tracked by The New York Times. And despite making up 18 percent of the county’s residents, tribal members have accounted for more than half of the county’s virus cases and about 64 percent of the deaths.

“We aren’t just losing family members or an aunt or uncle, we are losing parts of our culture,” said Mary Harrison, interim health director for the Choctaw Health Center. “We’ve lost dressmakers, we’ve lost artists, elders who are very fluid in our language — so when you think about an individual we’ve lost, these are important people in our community.”

The Choctaw have been among the hardest hit in the state — like many other tribal nations across the United States.

The Navajo Nation, the country’s largest reservation, has recorded at least 560 deaths — a tally larger than the coronavirus-related deaths in 13 states and a death rate higher than every state.

While communities of color have been disproportionately affected by the virus, it appears to be especially deadly in some tribal nations, where poverty, multigenerational housing and underlying health conditions such as diabetes and heart disease have been contributing factors.

The Rev. John I. Jenkins, the University of Notre Dame president, tested positive for the virus after attending a White House ceremony without wearing a mask. 
Credit…Robert Franklin/South Bend Tribune, via Associated Press

The Rev. John I. Jenkins, the University of Notre Dame’s president and a 66-year-old Catholic priest, was among the first college leaders to invite students back to campus, arguing in a New York Times Op-Ed in May that the college had a moral obligation to not be crippled by fear of the virus.

He also seemed humble about the challenge: When he forgot social-distancing rules as he posed for pictures with students returning to the South Bend, Ind., campus in August, he issued a public apology.

Now Father Jenkins faces a storm of protest over the news that he not only violated his own health rules — appearing without a mask at a White House reception last month for Judge Amy Coney Barrett, a Supreme Court nominee and former Notre Dame Law School professor — but also is infected with the coronavirus himself.

Students have petitioned for his resignation, angry over what they consider his hypocrisy, as well as the rising tide of infections on campus. Others have reported him to a coronavirus hotline for violating his own mask mandate. And the faculty senate stopped one vote short on Tuesday night of considering a vote of no confidence in his leadership.

“I haven’t seen people this outraged in my whole career, and I’ve been here since 2001,” said Eileen Hunt Botting, a political-science professor.

In a statement posted last week on the Notre Dame website, Father Jenkins said: “I regret my error of judgment in not wearing a mask during the ceremony and by shaking hands with a number of people in the Rose Garden.”

Some faculty members have expressed empathy for Father Jenkins, who is certainly not the first college president to get the virus. “Father Jenkins is already sick,” one person wrote. “That is enough punishment.”

But many others bristled with resentment that he visited Washington when their own travel has been forbidden.

“I have not seen my aging parents in over a year,” one faculty member said. Others said they had canceled research trips and vacations. One had missed the birth of a first grandchild.

A coronavirus outbreak in the White House spread to the Marine Corps on Wednesday.
Credit…Oliver Contreras for The New York Times

The person in charge of the White House security office contracted a severe case of the coronavirus last month and has been hospitalized ever since, according to an administration official with knowledge of the situation.

The security office head, Crede Bailey, whose office handles a number of duties, including approving certain security clearances, coordinating with the Secret Service and handling credentials for people to be able to come onto the White House grounds, was taken to the hospital in late September, the administration official said.

Bloomberg News previously reported on the situation.

Mr. Bailey’s case is not seen as connected to an outbreak that officials believe stemmed from the Sept. 26 events at the White House honoring Judge Amy Coney Barrett, President Trump’s nominee to replace Justice Ruth Bader Ginsburg on the Supreme Court.

Still, the case, and another positive test involving the No. 2 official in the Marine Corps that was revealed on Wednesday, is an additional reminder of how pervasive the virus has become at the most famous, and protected, address in the country over the past several weeks.

The corps announced the positive test of Gen. Gary L. Thomas, the assistant commandant of the Marine Corps, in a statement. General Thomas was among the group of senior military leaders who have been quarantining after they were exposed to the virus during a visit to the White House on Sept. 27 for a reception for Gold Star families. The event was also attended by Mr. Trump and the first lady, Melania Trump.

On Tuesday, the Pentagon announced that Adm. Charles Ray, the vice commandant of the Coast Guard, had tested positive. Admiral Ray also attended the White House reception, Defense Department officials said.

Nearly every member of the Joint Chiefs of Staff is now in quarantine in their homes or in other locations, officials said, after having contact with people who have tested positive.

A testing site in Mesa, Ariz., for treatments made by Regeneron and Eli Lilly.
Credit…Adriana Zehbrauskas for The New York Times

Dr. Anthony S. Fauci, the nation’s leading expert on infectious diseases, said that President Trump might be right that the experimental treatment he received and promoted has helped him in his fight with Covid-19 — but that his case alone doesn’t prove it.

“I think it’s a reasonably good chance that the antibody that he received, the Regeneron antibody, made a significant difference in a positive way in his course,” Dr. Fauci, who is not involved in the president’s care, said on Thursday during an interview on MSNBC.

He pushed back against Mr. Trump’s claim that the treatment has now been shown to be a “cure” for the disease, which has killed more than 210,000 Americans so far.

“When you have only one, you can’t make the determination that that’s a cure,” he said. “You have to do a clinical trial involving a large number of individuals, compared either to a placebo or another intervention.”

The manufacturer, Regeneron, has applied to the Food and Drug Administration for emergency approval of the experimental treatment, a cocktail of monoclonal antibodies.

Mr. Trumped received the Regeneron cocktail on Friday after he announced that he had tested positive for coronavirus. He has also received other treatments that are used for patients with severe cases of Covid-19, including remdesivir and dexamethasone.

In a five-minute video on Wednesday, Mr. Trump said that it was a “blessing from God” that he had been infected with the coronavirus and that the Regeneron cocktail had suddenly made him feel better. “I felt unbelievable,” he said. “I felt good immediately.”

The president said he would make sure that hundreds of thousands of doses would be available to Americans soon, free of charge, and he gave the impression that he would push the F.D.A. to approve the treatment. The company, however, has said that access to the treatment would be extremely limited at first, with only enough doses for 50,000 patients.

The president’s true condition is unclear. The White House doctor overseeing his care, Dr. Sean P. Conley, has admitted that he misled the public when Mr. Trump was hospitalized at Walter Reed National Military Medical Center.

In the televised interview, Dr. Fauci said it was known that a Covid-19 patient can feel good one day and go downhill quickly the next.

“The chances of that happening? I don’t know,” Dr. Fauci said of Mr. Trump’s case. “As good as he looks, I don’t think that’s going to happen, but I don’t know.”

Earlier in the week, in a virtual event for Cornell University, his alma mater, Dr. Fauci spoke about the dangers of sending the public conflicting signals on important health issues like new treatments for Covid-19.

“I try to, the best of my ability, in being very consistent in my messaging based on facts and scientific data,” Dr. Fauci said, according to The Cornell Daily Sun. “But when there are mixed messages coming out of any institution, including the federal government, there is confusion as to what people should do.”

He added, “Personally contradicting the president of the United States publicly is not a good thing if I want to get my job done.”

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