Home featured Explosive Growth of Virus Is Recorded Across U.S.

Explosive Growth of Virus Is Recorded Across U.S.

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Refrigerated temporary morgue trailers parked next to a cemetery in El Paso last week.
Credit…Joel Angel Juarez for The New York Times

Maps tracking new coronavirus infections in the continental United States were bathed in a sea of red on Friday morning, with every state showing the virus spreading with worrying speed and health care workers bracing for more trying days ahead.

More than 250,000 people have died in the United States, a number that grew by another 1,962 on Thursday. The Covid Tracking Project reported that more than 80,000 people were in the hospital, the highest number since the pandemic began.

An urgent message from officials in El Paso County, Texas, seeking to hire a temporary morgue attendant drove home the reality of what the soaring numbers will mean for communities across the country.

“All applicants must be able to lift between 100 to 400 pounds, with assistance,” the job notice said, according to The Texas Tribune. “Not only is the assignment physically taxing, but it may be emotionally taxing as well.”

As the picture across the country grew more dire, and the Centers for Disease Control and Prevention warned people against traveling and visiting family for the Thanksgiving holiday, the White House coronavirus task force appeared in public for the first time in months, along with Vice President Mike Pence, who said the country was in fine shape.

“America has never been more prepared to combat this virus than we are today,” Mr. Pence declared. “We approach this moment with the confidence of experience. We know the American people know what to do.”

He did not wear a mask and did not take questions.

By contrast, the Trump administration’s coronavirus response coordinator, Dr. Deborah L. Birx, appearing at the same news briefing, issued a dire assessment of the pandemic, urging Americans to “increase their vigilance” as they await the approval of a vaccine.

Dr. Birx came armed with alarming statistics and a still-more-alarming map of the country that was a vast expanse of bright red.

She implored Americans to practice social distancing and to wear masks, one of which she wore herself as she delivered her remarks.

“Every American needs to be vigilant in this moment,” she said, “because we know when you are we can mitigate this virus and stop the spread together.”

But togetherness eluded the politically divided nation. State and local governments continued to go their own way in fighting the pandemic, and President-elect Joseph R. Biden Jr. was still arguing in vain for the access that might prepare him to do his job.

After meeting with health care workers on Thursday, he lambasted President Trump for blocking “access to all the information we need” about vaccinations and other virus data.

“There is no excuse not to share the data and let us begin to plan,” he said.

Mr. Biden vowed quick action after he takes office but promised not to impose a national shutdown. Asked about the president’s erratic behavior as he fights to overturn the results of a free and fair election, Mr. Biden responded, “Totally irresponsible.”

A Covid-19 testing site in Oakland, Calif., on Thursday.
Credit…Jim Wilson/The New York Times

The pandemic had been raging for months when the United States reported 100,000 daily coronavirus cases for the first time on Nov. 4.

It was a stunning number that showed a virus spreading out of control.

Less than three weeks later, the country is edging closer to reporting 200,000 newly detected infections every day — at the very moment that cold weather is driving people indoors in many parts of the country and the holiday season beckons people to gather together.

More than 187,000 cases were announced nationwide on Thursday, another single-day record, and daily tallies have been rising in 47 states, according to a New York Times database. 

In California alone, officials reported more than 13,000 cases, a single-day record, prompting the state to announce a 10 p.m.-to-5 a.m. curfew for all but essential workers.

Even if the current seven-day national average of about 166,000 daily cases were to hold until the end of the year, nearly seven million more people would contract Covid-19. That is roughly equivalent to about 2 percent of the U.S. populations.

The potential consequences — in a nation where 250,000 people with the coronavirus have already died — are devastating.

Many health care systems are close to buckling under the strain, and soaring hospitalizations inevitably mean more fatalities. The Covid Tracking Project reported on Thursday that there were more than 80,000 Covid-19 patients in U.S. hospitals, more than ever before.

A recent study by the Kaiser Family Foundation noted that Covid-19 had become the nation’s third-leading cause of death, behind heart disease and cancer. If current trends continue, the death toll could reach 300,000 by New Year’s Eve.

Though talk of effective vaccines has dominated the news cycle in recent days, they are not yet available.

“We are in for a rough period through the end of February,” said Dr. Jessica E. Justman, a professor of epidemiology at Columbia University. “It looks hard to find a way to break it.”

To some extent, the upward curve in new cases had been expected as colder weather drove people to spend more time indoors, where the virus spreads more readily. But wintry conditions are not the only culprit.

Epidemiologists and other experts say the equation for reining in the runaway spread of the virus ought to be simple: The more people wear masks, keep a physical distance from others, wash their hands and avoid crowds (especially indoors), the better the chances of bending the infection curve downward.

But as each state and many cities set their own rules and make their own plans, the nation has no unified approach and no coordinated strategy for balancing the pandemic’s economic and human effects.

Credit…Illustration by Mark Weaver, Photograph by Erin Schaff/The New York Times

Elisabeth Rosenthal, a former New York Times correspondent, worked as an emergency room physician before becoming a journalist. She interviewed Dr. Anthony S. Fauci, the top infectious disease expert in the United States, for the Times’s Opinion section.

As a health journalist, a physician and a former foreign correspondent who lived through SARS in Beijing, I often get questions from friends, colleagues and people I don’t even know about how to live during our current pandemic. Do I think it’s safe to plan a real wedding next June? Would I send my kids to school, with appropriate precautions? When will I trust a vaccine?

To the last question I always answer: When I see Tony Fauci take one.

He’s a straight shooter, with no conflicts of interest — political or financial — or, at 79, career ambition. He has no interests, other than yours and mine.

So I asked him how Americans might expect to live in the next six to nine months. How should we behave? And what should the next administration do? Some answers have been edited for clarity and brevity.

Are there two or three things you think a Biden administration should do on Day 1?

There were some states in some regions of the country that somehow didn’t seem to have learned the lessons that could have been learned or should have been learned when New York City and other big cities got hit. And that is to do some fundamental public health measures. I want to really be explicit about this, because whenever I talk about simple things like uniform wearing of masks, keeping physical distance, avoiding crowds (particularly indoors), doing things outdoors to the extent possible with the weather, and washing hands frequently, that doesn’t mean shutting down the country. You can still have a considerable amount of leeway for business, for economic recovery, if you just do those simple things. But what we’re seeing, unfortunately, is a very disparate response to that. And that inevitably leads to the kind of surges that we see now.

Do you think we need a national policy like a national mask mandate? The current administration has left a lot of Covid-19 management to the states.

I think that there should be universal wearing of masks. If we can accomplish that with local mayors, governors, local authorities, fine. If not, we should seriously consider national. The only reason that I shy away from making a strong recommendation in that regard is that things that come from the national level down generally engender a bit of pushback from an already reluctant populace that doesn’t like to be told what to do. So you might wind up having the countereffect of people pushing back even more.

When do you think we’ll all be able to throw our masks away?

I think that we’re going to have some degree of public health measures together with the vaccine for a considerable period of time. But we’ll start approaching normal — if the overwhelming majority of people take the vaccine — as we get into the third or fourth quarter [of 2021].

Global Roundup

People participating in a large-scale trial of the Sinopharm coronavirus vaccine in August in Manama, Bahrain.
Credit…Mazen Mahdi/Agence France-Presse — Getty Images

As China rushes to keep up with the global race to find a coronavirus vaccine, a state-owned drugmaker is reporting promising results for a candidate after administering doses to nearly a million people in the country.

For the past few months, the company, Sinopharm, has been inoculating people — including its employees and their families — outside of the traditional testing process as part of an emergency-use policy, even though its two vaccine candidates have not been formally proved safe or effective.

China’s push to be the first country to bring a vaccine to market before the completion of late-stage trials has prompted scientists to warn that the government is gambling with the health of its people.

Sinopharm’s chairman, Liu Jingzhen, told the local news media on Tuesday that only a few people had reported mild symptoms from one of its vaccines, and that no one had suffered serious adverse reactions. “Our progress so far, from research and development to clinical trials and production and emergency use, is leading the world in all aspects,” he said without offering evidence.

Though members of the public in China have long been skeptical of vaccines after a spate of quality scandals, many have been lining up to be inoculated. Last week, Mr. Liu said that 56,000 people who had taken the company’s vaccine had traveled abroad, and that none contracted Covid-19.

The coronavirus is largely under control in China, so local drugmakers have looked abroad to recruit trial participants. Mr. Liu told Chuanguan News on Tuesday that Sinopharm had inoculated nearly 60,000 people as part of late-stage human testing that it was conducting in 10 countries, including Bahrain, Egypt and the United Arab Emirates. He said that 40,000 of those inoculated showed promising results, though he did not provide details.

The report comes as two American drugmakers pulled ahead this week in the global vaccine race. Moderna announced on Monday that its vaccine was 94.5 percent effective, while Pfizer said on Wednesday that the results of its late-stage trial showed its vaccine was 95 percent effective with no serious side effects. China has four candidates in late-stage human testing.

In other news around the world:

  • South Korea reported 363 new coronavirus cases on Friday, its highest caseload since late August, when the country was hit by a second wave of infections. Prime Minister Chung Sye-kyun urged the public to avoid social gatherings and to stay home as much as possible. He also warned that the latest spike, which is concentrated mainly in the Seoul metropolitan area, was threatening the country’s vaunted K-Quarantine strategy of fighting the virus while keeping the economy running.

William O’Brien, a Michigan freshman, and his mother, Karen O’Brien, packed up his dorm room on Monday. About 3,000 students will be allowed back into university housing.
Credit…Erin Kirkland for The New York Times

The University of Michigan’s flagship campus in Ann Arbor opened the fall semester with great expectations. Thousands of students were welcomed back to the dorms in August.

Pessimists were asked to reserve judgment. Parents worried that students would not be safe.

Sure enough, by midsemester, coronavirus clusters were erupting on and off campus. In October, county health authorities ordered the whole campus to shelter in place, citing “social gatherings” on or near campus as a major source of infections.

Now, after more than 2,540 Covid-19 cases among students and staff, the university is shifting course drastically. It has asked students not to come back to campus in January unless they have to. Instruction will be remote in 90 percent of classes. Students who violate certain health rules will face tougher sanctions, including automatic probation, and coronavirus tests will be mandatory for anyone coming to campus.

In many ways, the school’s chaotic fall has typified the struggles of big state universities that tried to maintain some semblance of normalcy amid contagion, allowing intercollegiate sports, Greek life and off-campus housing — often without the kind of mandatory coronavirus testing considered crucial to containing outbreaks.

Though the virus has proved to be less lethal among young people, it has also spread like wildfire on many campuses. A New York Times survey has revealed at least 321,000 cases at 1,700 colleges across the country.

And like Michigan, many of those universities are now looking to batten down their hatches for the winter and spring semesters.

When classes resume in 2021, Michigan will de-densify the dorms and ramp up testing. Only about 3,000 students will be allowed back into university housing, and anyone who comes onto campus, symptomatic or not, will have to be cleared via a saliva-based test processed by a faculty-founded start-up in Ann Arbor.

“If they don’t,” said the university’s president, Mark Schlissel, a physician, “we’ll inactivate their ID cards.”

With schools closed again in New York, Nicole Subran, a Brooklyn resident, has no one to look after her children.
Credit…Stephanie Keith for The New York Times

The Trump administration stressed its opposition on Thursday to closing schools as a means to combat the coronavirus, even as some of the largest districts in the United States were closing anew or postponed reopening.

“We do not support closing schools,” Vice President Mike Pence said at a White House news conference, arguing that such measures carried a “real cost” to children, a viewpoint echoed by other members of the White House coronavirus task force.

The vice president’s comments came on the same day that schools across New York City, the country’s largest public school system shut their doors after being open for in-person instruction for a little less than eight weeks.

New York City, having lived through one of the worst outbreaks in the country in the spring, had taken one of the most cautious stances toward school closings. As soon as the city reached a 3 percent test positivity rate over a rolling, seven-day average, the policy called for schools to close. When that mark was hit this week, in-person classes were over for 1.1 million students at 1,800 schools.

Other large school districts, including in Chicago and Los Angeles, remain closed, although Chicago tentatively set a January deadline for its students to return to classrooms. Philadelphia recently delayed reopening schools, and Detroit also suspended in-person instruction.

Some states have taken a multitrack approach.

In Rhode Island, Gov. Gina Raimondo allowed elementary and middle schools to remain open during a two-week shutdown scheduled to begin on Nov. 30, but said high schools must close unless the local administration presented an enforceable risk-mitigation plan.

Elementary schools have not proved to be major spreaders, the governor noted, and younger students benefit especially from being in the classroom. High schools are “more problematic,” Ms. Raimondo said, because teenagers are more mobile, more exposed to the virus through outside jobs or sports, and generally less inclined to wear masks.

Mississippi is taking it on a case-by-case basis. Of the state’s 1,200 schools, more than 65 had to go back to virtual learning because of outbreaks, Dr. Paul Byers, the state epidemiologist, said at a news conference this week. The trigger for a school to move to remote learning is three Covid-19 cases, he said.

As the task force gathered at the White House on Thursday, the discussion of schools echoed a controversial guidance document issued by the federal Centers for Disease Control and Prevention on the importance of schools being open. The guidance was written by political appointees in the Trump administration.

Dr. Robert R. Redfield, the head of the C.D.C., said Thursday that the agency did not recommend that schools close back in the spring — and that it was not doing so now.

“Clearly the data strongly supports that K-12 schools, as well as institutes of higher learning, really are not where we’re having our challenges,” he said. “The infections we identified in schools when they have been evaluated were not acquired in schools. They were acquired in the community and in the household.”

However politicized American health policy decision making has become, and however much President Trump’s real goal may be to shore up the economy, the administration is not alone in it views on the wisdom of keeping schools open.

A new report by UNICEF, based on surveys from 140 countries, found that school closures did little to slow the spread of the virus and did much to cause long-term harm. “Unless the global community urgently changes priorities, the potential of this generation of young people may well be lost,” the agency warned.

“Evidence shows that the net benefits of keeping schools open outweigh the costs of closing them,” the report said. “Data from 191 countries show no consistent association between school reopening status and COVID-19 infection rates.”

“The longer schools are closed, the more children suffer from extensive learning losses with long term negative impacts, including future income and health,” the report said.

Some of the data seemed to contradict Dr. Redfield’s conclusion, with only elementary schools not seeming to seed outbreaks. Plus much of the evidence is observational or a result of random testing, unaccompanied by the sort of careful contact tracing that would support his assertion.

Vials of the antiviral drug remdesivir at a Gilead manufacturing site in the United States.
Credit…Gilead Sciences, via Associated Press

The World Health Organization on Thursday recommended against using the antiviral remdesivir, a drug that had generated intense interest as a treatment for Covid-19.

An expert panel “concluded that remdesivir has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement,” the W.H.O. announced. The panel published its review in the journal The BMJ. The report did not rule out the use of the drug altogether as a Covid treatment, but said evidence was lacking to recommend its use.

Gilead Sciences, manufacturer of remdesivir, whose trade name is Veklury, said in a statement that its drug “is recognized as a standard of care for the treatment of hospitalized patients with Covid-19 in guidelines from numerous credible national organizations, including the U.S. National Institutes of Health and Infectious Diseases Society of America, Japan, U.K., and Germany.” It added that there are “multiple randomized, controlled studies published in peer-reviewed journals that demonstrate the clinical benefits of Veklury.”

The potential utility of remdesivir had been the subject of debate and skepticism for months, and especially in recent weeks, after the Food and Drug Administration approved it as the first treatment for Covid-19 in late October. One large study, sponsored by the National Institutes of Health, found that the drug reduced recovery time in hospitalized patients from 15 to 11 days. Two other trials the agency considered, sponsored by Gilead, did not include placebo controls, which are considered critical to judging effectiveness.

President Trump was administered remdesivir along with other treatments last month when he was hospitalized with Covid.

For the new analysis, the panel reviewed evidence from four trials, including one conducted by the N.I.H. and another sponsored by the W.H.O. and recently posted to a preprint server, which included some 5,000 patients, the largest to date. The paper has not been peer-reviewed or published in a scientific journal.

The results from that trial “brought into question some of the benefit that had been seen earlier, in the N.I.H. study,” said Dr. Bram Rochwerg, an associate professor of medicine at McMaster University in Hamilton, Ontario, and a co-chair of the W.H.O. panel.

Remdesivir has been authorized for emergency use since the spring in the United States, and in October, Gilead reported that it had generated $873 million in revenue thus far this year.

Anthony J. Tata, who tested positive for the coronavirus, will isolate at home for the next 14 days, the Defense Department said.
Credit…Bill Clark/CQ-Roll Call, via Getty Images

Anthony J. Tata, a senior Pentagon official, has tested positive for the coronavirus after meeting with a visiting Lithuanian official who also met with the acting American defense secretary and other high-level U.S. military officials.

In a statement on Thursday night, a Pentagon spokesman, Jonathan Hoffman, said the Defense Department was notified earlier in the day that the Lithuanian defense minister, Raimundas Karoblis, who visited Washington on Nov. 13, had tested positive for the virus.

After tests were performed on the American officials, Mr. Tata was the only one so far found to be infected, the Defense Department said, adding that he would isolate at home for the next 14 days.

While at the Pentagon, Mr. Karoblis also met the acting secretary of defense, Christopher C. Miller, as well as the secretaries of the Army and the Air Force. Three days later, he met with the secretary of the Navy.

All have since tested negative and are not quarantining, despite their exposure, the Pentagon said.

“We have and are continuing to conduct further contact tracing of D.O.D. personnel who have had close contact with the Lithuanian delegation or Mr. Tata, and are taking appropriate precautions in accordance with CDC guidelines,” the statement said.

Although Mr. Tata has been described as “performing the duties of the under secretary of defense for policy,” he does not, in fact, hold that post. His nomination for the job was withdrawn over the summer, in part when it emerged that he had called President Barack Obama a “terrorist leader.”

But in an end run around lawmakers, the Trump administration appointed Mr. Tata, a retired Army one-star general turned Fox News commentator, to a temporary senior position that did not require Senate approval. He is among a group of hard-line Trump loyalists installed into senior jobs at the Pentagon in recent days.

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