U.S. States Backtrack on Reopening as Coronavirus Cases Climb

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Credit…Erin Trieb for The New York Times

The coronavirus continued its surge across the South and West, threatening to quickly overwhelm areas that had until recently been spared the worst of the pandemic. Some Mississippi intensive care units are at capacity as coronavirus cases climb and residents of Texas’s largest county received an emergency alert of the highest level, urging residents to remain at home, wear a mask and cancel gatherings. Houston’s mayor has said that I.C.U.s there were nearly at capacity. And at the University of Mississippi Medical Center, the I.C.U. is completely full, said Dr. Alan Jones, the assistant vice chancellor for clinical affairs.

“We’re very worried about the trajectory that we’re on and what’s going to happen in the next couple of weeks,” Dr. Jones said.

Mississippi already suffers from a lack of I.C.U. resources, particularly in rural communities, so urban hospitals like the University of Mississippi Medical Center were crowded even before the pandemic, Dr. Jones said. Now, doctors are coming up with non-traditional ways to create more space for intensive-care patients, like transforming the anesthesia recovery area into a makeshift I.C.U.

Dr. Thomas Dobbs, the state health officer, said at a news conference Thursday that the state had seen its highest number of hospitalizations in recent days.

Officials said that many state residents aren’t social distancing or wearing masks, and that they’re still coming together for large social gatherings.

In Texas, Harris County’s 4.7 million residents are now under the most severe coronavirus threat level, amid a steep rise in cases and official warnings that hospitals are nearing capacity.

An emergency alert was sent to the phones of Houston and other county residents on Friday evening, notifying them that the coronavirus threat level was bumped up to “LEVEL 1 (RED) SEVERE.” That means the outbreak is “severe and uncontrolled” and only getting worse, county officials said.

The county, by far Texas’s largest, has seen a sudden spike in reported cases in recent weeks. There have now been 28,255 cases in the county and 361 deaths, the majority of which have come within Houston’s city limits.

Gov. Greg Abbott has acknowledged that his reopening plan had gone awry. In an interview with KVIA-TV in El Paso on Friday evening, he said, “If I could go back and redo anything, it probably would have been to slow down the opening of bars.”

At a news conference the same day, Lina Hidalgo, the county’s elected leader, urged people to stay home unless it was absolutely necessary to leave and said that the situation was more dire than it had been in previous months, before Mr. Abbott’s statewide stay-at-home order began yielding on May 1 to a phased reopening.

“We are in a worse situation now than we were back then, and the only thing that worked back then was flattening that curve by staying home,” Ms. Hidalgo said, adding bluntly that “we opened too quickly.”

The city of Galena Park, which is also in Harris County, has announced a curfew from 10 p.m. to 5 a.m., starting Saturday “until further notice.”

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Credit…Andrew Testa for The New York Times

In late January, a doctor in Munich discovered Germany’s first coronavirus case, but the diagnosis made no sense. The patient reported only one possible contact with the infection: a business colleague visiting from China who had seemed healthy during her stay.

The visitor later told colleagues that she had not started feeling ill until after the flight back to China. Days later, she tested positive for the coronavirus.

Although it is now widely accepted that seemingly healthy people can spread the virus, scientists at the time believed that only people with symptoms could infect others.

“People who know much more about coronaviruses than I do were absolutely sure,” recalled Dr. Camilla Rothe, an infectious disease specialist at Munich University Hospital who diagnosed the businessman’s case.

The possibility of transmission from seemingly healthy people could strongly limit the ability of public awareness campaigns, airport screenings and stay-home-if-you’re sick policies to stop the virus.

Dr. Rothe and her colleagues were among the first to warn the world. But interviews with doctors and public health officials in more than a dozen countries showed that for two crucial months, Western health officials and political leaders played down or denied the risk of symptomless spreading. Leading health agencies provided contradictory and sometimes misleading advice.

It is impossible to calculate the human toll of that two-month delay, but models suggest that earlier action might have saved tens of thousands of lives. Though estimates vary, models using data from Hong Kong, Singapore and China suggest that 30 to 60 percent of spreading occurs when people have no symptoms.

“This was, I think, a very simple truth,” Dr. Rothe said. “I was surprised that it would cause such a storm. I can’t explain it.”

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Credit…Gavin McIntyre for The New York Times

With new cases of the coronavirus suddenly surging across multiple states that had low and manageable caseloads just months ago, confusion and anger are swirling among those who obeyed lockdowns and drastic social measures out of a sense of civic duty to help bring the U.S. outbreak under control.

Nationwide, cases have risen 65 percent over the past two weeks. On Friday, the country reported more than 45,000 new infections, a record. By Saturday evening, more than 41,000 cases of the coronavirus had been announced across the United States, including single-day records in Florida, Nevada and South Carolina. It was the third consecutive day with more than 40,000 new cases in the country.

Before this week, the country’s largest daily total had been 36,738 on April 24.

Many business owners and workers who lost their jobs say they believe their leaders failed to prepare for the economic devastation that followed shutdowns that states had adopted, to differing degrees, since March. And they say that recent reopenings undercut their sacrifices.

In recent weeks, some conservatives said they had an additional concern: After weeks of being told that going to church, attending funerals and participating in protests was a willful, careless spurning of science, political leaders and some public health officials condoned — and even joined — the crowds protesting the killing of George Floyd and other black Americans.

“It’s just a real social whiplash,” said Philip Campbell, vice president of a pest control company in Central Michigan, who took part in the first protests against the lockdown in Lansing in April from the cab of his truck. “Two weeks ago you can’t go out because you are going to kill grandma. Now it’s ‘you have an obligation to go out.’ It leaves me feeling that the science and the public health authorities have been politicized.”

A number of states are reconsidering their reopening plans. Florida and Texas reimposed limits on bars, banning drinking inside or closing the premises entirely, as they scrambled to control what appeared to be a brewing public health catastrophe. All of this has left people with a bitterness toward public officials for what feels like a fumbling of their constituents’ sacrifices.

“Are we doing a full circle? Yes,” said Judy Ray, 57, a cosmetologist and hairdresser in Florida who was laid off from her job in March.

Some fault the state and city leaders who rushed to reopen while the virus surged in other corners of the country and who now face daunting outbreaks in their own backyards. Others fault a lack of federal leadership, and a White House that defies expert guidance.

At a news conference on Friday, Vice President Mike Pence deflected a question about whether President Trump was sending mixed messages by reiterating public health officials’ advice while resuming crowded campaign rallies and refusing to wear a mask.

“Even in a health crisis, the American people don’t forfeit our constitutional rights,” he said. “We were creating settings where people can choose to participate in the political process, and we will continue to do that.”

U.S. Roundup

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Residents in Florida and Texas are facing long wait times and are being turned away at coronavirus testing sites that have reached capacity.

On Saturday, Stefano West drove more than an hour from Killeen, Texas, to Austin to find a testing site, noting that there weren’t many available closer to him. He said he then waited about four and a half hours in his car at the testing site in Austin, where officials spent anywhere from 10 to 45 minutes attending to each car.

“I was annoyed,” Mr. West said. “There wasn’t really communication. No one explained the process.”

In Houston, two stadium testing sites reached capacity just hours after opening on Saturday, according to the city’s health department.

Joi Ross-Moore, who lives in Houston, tried to get tested at a drive-through facility on Tuesday. She arrived at 8 a.m., she said, and was soon told that people had been waiting to get tested since 4 a.m., and that no more tests would be conducted that day.

At the Orange County Convention Center in Orlando, Fla., the first car found its spot in line for testing on Saturday at 12:30 a.m., according to the Florida Association of Public Information Officers. Testing didn’t start until 9 a.m. At a site in Jacksonville, Fla., the testing line was cut off in the early afternoon, before closing time, the association tweeted.

Florida on Saturday reported more than 9,500 new coronavirus cases, beating its record for new infections for the second consecutive day. The numbers have pushed the state’s total past 130,000 cases.

Mayor Carlos Giménez of Miami-Dade County said he would sign an emergency order closing beaches from July 3 to 7, citing the surge of cases and fears that mass gatherings over the Fourth of July holiday weekend could push the total even higher.

The order will ban gatherings of more than 50 people, including parades, and will also close parks to public fireworks displays — which the mayor said “must be viewed from one’s home or parked vehicle.”

“The closure may be extended if conditions do not improve,” Mr. Giménez said in a Friday news release.

Gov. Ron DeSantis said on Friday that drinking had been banned in bars because many businesses were not following social distancing restrictions.

“There was widespread noncompliance, and that led to issues,” Mr. DeSantis said at a news conference in Fort Myers.

In an apparent acknowledgment of the growing sense of anxiety over the surge in cases, Vice President Mike Pence postponed coming campaign stops in Arizona and Sarasota, Fla. Mr. Pence is still expected to make official visits in the coming days to Texas, Arizona and Florida to meet with governors and their health care teams, a senior administration official said.

In other national news:

  • Officials in Nevada and South Carolina on Saturday reported their highest single-day case totals. At least 980 new cases were added in Nevada, more than double its previous daily high. In South Carolina, officials announced more than 1,600 new cases, nearly 300 more than the record set a day earlier.

  • In Arizona, where a flood of new cases has overwhelmed testing centers, state health officials said Saturday that 87 percent of hospital I.C.U. beds were now in use. The state’s reopening has not been paused, but the governor recently allowed cities and counties to require masks to be worn in public.

  • With coronavirus cases rising, officials in Washington announced on Saturday a pause for the eight counties that were eligible to move into phase four of the state’s reopening plans. Gov. Jay Inslee said the fourth phase “would mean a return to normal activity and we can’t do that now due to the continued rise in cases across the state.”

  • A stunning proportion of coronavirus deaths in the United States — 43 percent — are linked to nursing homes and other long-term care facilities for older adults, according to a New York Times database. Infected people linked to nursing homes also die at a higher rate than the general population. As of June 26, the virus had infected more than 282,000 people at some 12,000 facilities.

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A Starbucks barista in San Diego has more than $65,000 to fuel his dream of teaching dance after an online fund-raiser was created in response to a customer who was not wearing a mask complaining on Facebook about the company’s policies and her interaction with him.

The barista, Lenin Gutierrez, said in a Facebook video he posted on Wednesday that it had all started when he was working at the front register and asked the customer, Amber Lynn Gilles, if she had a face mask.

“No, I don’t need one,” Ms. Gilles told him, according to the video. She replied before he could show her a paper explaining the company’s mask policy during the coronavirus pandemic.

He said she started “cursing up a storm” and called people “sheep” before walking out. A few minutes later, she came back, he said, and asked for his name, took a photo of him and said she would call the corporate offices.

“I thought that was going to be the end of it,” said Mr. Gutierrez, who has worked at Starbucks since 2017. “I didn’t think it was going to come to this.”

Widely shared videos of customers arguing about not wearing masks at stores show how resistance is not uncommon and how businesses are trying to encourage compliance.

Starbucks said it had taken measures to keep employees and customers safe, including asking customers to wear facial coverings at its shops. A Starbucks representative said on Saturday that the company was abiding by guidance from the Centers for Disease Control and Prevention and local mandates. Since May 1, San Diego County has required face coverings in many public areas.

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Credit…Khaled Elfiqi/EPA, via Shutterstock

Egypt inched toward a semblance of normalcy on Saturday as mosques, cafes and restaurants reopened after three months, albeit under tight restrictions, even as the number of new coronavirus infections in the country continued to soar.

At dawn, masked worshipers flooded into Cairo’s ancient mosques, some over 1,000 years old, to say communal prayers for the first time in three months. Later, patrons slowly returned to the city’s coffees shops and restaurants, many with an evident sense of relief.

For months, business leaders have lobbied President Abdel Fattah el-Sisi to end the lockdown, arguing that the economic damage outweighed the health risks. On Friday, the International Monetary Fund approved a $5.2 billion loan to help Egypt get back on its feet, adding to an early promise of $2.8 billion at the start of pandemic.

Even so, tight limitations remain — restaurants are restricted to 25 percent capacity, water pipes are banned from cafes on sanitary grounds, and Friday prayers are still forbidden. The easing on Saturday had an anxious, tentative feel, with many Egyptians balancing their desire to socialize or worship together against an awareness that the disease was spreading fast.

“This has got to be a gradual process,” said Abdullah Mohammed, 33, a pharmacy worker sitting with friends by the Nile who had recently recovered from Covid-19.

Egypt’s health ministry has reported 62,755 infections and 2,620 deaths. With the infection rate touching new highs, doctors’ groups have warned of a crisis at overcrowded hospitals, where over 100 doctors have died for want of protective equipment and training.

Even so, Egypt’s airports are set to reopen on July 1.

Global RoundUP

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Credit…Peter Byrne/Press Association, via Associated Press

The police in Britain vowed to crack down on unauthorized gatherings this weekend after tens of thousands of people flocked to beaches, gathered outside for unauthorized parties and violated coronavirus restrictions in recent days.

In the country’s south, the police in several seaside cities issued dispersal orders after large numbers of beachgoers caused huge traffic jams and engaged in antisocial behavior this week — including brawls, excessive drinking and even defecating in public.

The police in London and other cities like Derby, in central England, vowed to robustly disperse any unauthorized gathering. Over 140 officers in London have been injured while patrolling protests and breaking up unsanctioned parties in recent weeks.

And in Liverpool, the police have been given the power to disperse any gathering of more than two people in the center of the city, after thousands of supporters flouted social distancing rules on Friday when celebrating their soccer club’s English Premier League championship title.

When fans turned out in large numbers for the second night in a row to celebrate Liverpool’s title — its first in 30 years — Mayor Joe Anderson denounced the presence of “too many people intoxicated and causing antisocial behavior.”

In other international news:

  • More than 191,000 new infections were reported around the world on Friday, a single-day record. The total number of confirmed cases is nearing 10 million, and total deaths have passed 498,000.

  • On Sunday, India reported 19,906 new cases, its highest one-day total. The country has had a total of 528,859 cases and 16,095 deaths.

  • Venezuela is struggling to control its first major outbreak, amid fears that the virus will collapse the country’s dilapidated health care system and worsen its humanitarian crisis. Medical workers at hospitals in the second-largest city, Maracaibo, say they are overwhelmed with Covid-19 patients, and treatment is complicated by a lack of running water and protective equipment, and frequent power cuts.

  • In Brazil, the pandemic is easing in big cities but gaining momentum in smaller towns. The Ministry of Health, in its latest epidemiological bulletin last week, reported that 65 percent of cases were concentrated outside state capitals and warned the virus had reached 88.6 percent of the country’s 5,570 cities.

    And Brazilian officials announced a deal with Oxford University and the pharmaceutical company AstraZeneca on Saturday that will see the nation producing a coronavirus vaccine that is one of about a dozen in the early stages of human testing. Fiocruz, a state-owned health research institute that has experience producing vaccines, will produce 100 million vaccines for Brazil, which has about 210 million residents.

  • Serbia’s defense minister, Aleksandar Vulin, has tested positive for the coronavirus, shortly after returning from a visit to Moscow, where he had attended a huge and mostly face mask-free military parade in Red Square.

  • On Sunday, voters in Poland will head to the polls in a tightly contested presidential election, the European Union’s first since the outbreak of the virus.

  • Fears of a second wave of coronavirus infections in China have receded somewhat. As of Sunday morning, the authorities had reported 311 cases in an outbreak in Beijing, and linked cases in at least four provinces. But the recent surge confirmed fears of sporadic flare-ups even after countries tame their outbreaks.

  • A randomized trial in Norway that aimed to test whether people who work out at gyms with modest restrictions are at greater risk of infection than those who do not has a tentative answer after two weeks: no. This week, in response to those findings, Norway reopened all of its gyms with the same safeguards in place that were used in the study. The trial, begun on May 22, included five gyms in Oslo with 3,764 members, ages 18 to 64, who had no underlying medical conditions. Researchers found just one coronavirus infection, in a person who had not used the gym before he was tested; it was traced to his workplace.

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On Saturday, the number of coronavirus infections in the U.S. shot past 2.5 million, according to a New York Times database.

But the real number in many parts of the United States is more than 10 times higher than the reported rate, according to data released Friday by the Centers for Disease Control and Prevention.

The analysis is part of a wide-ranging set of surveys initiated by the C.D.C. to estimate how far the virus has spread. It found, for instance, that in South Florida as of April 10, under 2 percent of people had been exposed to the virus. (The proportion is likely to be much higher now, given the surge of infections in the state.) The C.D.C. estimated that 117,400 people in that region had been infected — about 11 times the reported number of 10,500 cases.

The results confirm what some scientists have warned about for months: that without wider testing, scores of infected people would go undetected and continue to circulate the virus.

“Our politicians can say our testing is awesome, but the fact is our testing is inadequate,” said Scott Hensley, a viral immunologist at the University of Pennsylvania who was not involved in the research.

The numbers indicate that even in areas hit hard by the virus, the overwhelming majority of people have not yet been infected, Dr. Hensley said.

“Many of us are sitting ducks who are still susceptible to second waves,” he said.

The difference between recorded infections and those that were missed was even more significant in Missouri, where about 2.65 percent of the population was infected with the virus as of April 26, although many people might not have felt sick. This number is about 24 times the reported rate: nearly 162,000 compared with the 6,800 believed to have been infected by then.

Dr. Robert R. Redfield, the director of the C.D.C., noted this trend on Thursday during a call with reporters.

“Our best estimate right now is for every case reported there were actually 10 other infections,” Dr. Redfield said.

  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.