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Coronavirus Live Updates: With Death Toll Rising, Leaders Wrestle With How Soon to Lift Restrictions - The New York Times

Credit...Luke Sharrett for The New York Times

President Trump has said he is eager to see stay-at-home orders lifted and businesses reopened soon, and is spending the weekend weighing whether to push state governors to start doing so by May — a timeline that some experts say may be too hasty.

Dr. Anthony S. Fauci said on Sunday that reopening the country would not be an “all or none” proposition. Appearing on CNN, Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that restrictions must be lifted in a gradual manner to prevent a resurgence of coronavirus cases. Models show that lifting all social-distancing measures at once nationally may set the stage for a rebound sometime in July.

“If all of a sudden we decide, ‘OK, it’s May, whatever, and we just turn the switch on, that could be a real problem,” Dr. Fauci said.

He said governors will need to manage a “rolling re-entry,” guided by testing results and local risk levels. “I think it could probably start, at least in some ways, maybe next month,” he said on the network’s “State of the Union” program, though he added, “Don’t hold me to it.”

On Saturday, the United States reached a grim milestone, surpassing Italy in the total number of confirmed coronavirus deaths with more than 20,500.

Already the pandemic has put more than 16 million people out of work in the United States, forcing Mr. Trump to grapple simultaneously with the most devastating public health and economic crises in a lifetime. He finds himself pulled in opposite directions, with bankers, corporate executives and industrialists pleading with him to reopen the country as soon as possible, while medical experts beg for more time to curb the coronavirus. The country’s death toll, which has more than doubled over the past week, is now increasing by nearly 2,000 most days.

Tens of thousands more could die. Millions more could lose their jobs. And the president’s handling of the crisis appears to be hurting his political support in the run-up to the November election. Yet the decision on when and how to reopen is not entirely his. The stay-at-home edicts keeping most Americans indoors were issued by governors state by state.

Weeks after ordering a shutdown across the state, Gov. Andrew M. Cuomo of New York said on Saturday that the efforts were beginning to pay off and that the curve of new coronavirus cases was continuing to flatten.

But, as the focus began to turn to reopening the state and New York City, Mr. Cuomo emphasized that it would be premature to look too far ahead. While the number of hospitalizations because of the virus were down in New York, as were intubations — considered an important marker of the severity of the crisis — the daily death toll remained steady, with 783 more deaths in the state.

“Reopening is both an economic question and a public health question,” he said. “And I’m unwilling to divorce the two. You can’t ask the people of this state or this country to choose between lives lost and dollars gained.”

Policymakers should be thinking about the coronavirus as an 18-month problem, said Neel Kashkari, a Federal Reserve president who helped lead the response to the 2008 financial crisis as a Treasury Department official.

“This could be a long, hard road that we have ahead of us,” he said, adding that waves of flare-ups could make this last for 18 months, and officials should prepare for that by considering how to reopen the economy piecemeal.

“If it ends up being shorter than that, that’s great,” he said. “We should prepare for the worst-case scenario.”

Mr. Kashkari, who is president of the Federal Reserve Bank of Minneapolis, said that if the economic pain lasts, it could spill into the banking sector, even necessitating government intervention.

“People don’t pay their mortgage, a coffee shop doesn’t pay their landlord, the landlord then can’t pay the bank’s mortgage,” he said.

“Right now the banks are well capitalized relative to where they were in 2006,” he said, but if “this goes on long enough, it could produce strains on the banking sector, and then the Fed, and Congress and Treasury, would have to step in to make sure that the banks are sound.”

Millions of Americans tuned in to online church services Sunday morning to celebrate one of the holiest days of the Christian calendar. For most Christian denominations, today is Easter. (Most Orthodox churches will mark Easter on April 19.)

The vast majority of churches celebrated virtually, while a handful of pastors in states like Louisiana and Mississippi defied stay-at-home guidance and hosted in-person worship services, risking the health of their followers and their own arrests.

Others attempted something in between, an attempt to maintain some semblance of communal ritual. In Franklin, Ky., Victory Hill Church hosted a service at a drive-in movie theater, where people worshiped in their cars.

In an empty St. Patrick’s Cathedral in New York, Cardinal Timothy M. Dolan prayed over the communion cup and wine, his voice echoing across empty pews to the locked front door, as parishioners watched online.

President Trump said on Twitter that he would watch the online service of First Baptist Dallas, led by Robert Jeffress, a prominent Trump supporter who has said that non-Christian religions are sending their followers to hell. Vice President Pence said he would also attend church virtually, from his living room.

On Sunday morning Mr. Trump posted a short video urging people to follow social distance guidelines on the holiday.

In Dallas, Mr. Jeffress thanked Mr. Trump from the pulpit of First Baptist for defending religious liberty. In his service on Sunday, Mr. Jeffress portrayed Mr. Trump as a supporter of religion, although the president does not regularly attend church or exhibit deep knowledge about the Bible.

Mr. Jeffress has lashed out at other faiths, calling the Catholic Church an instrument of Satan, describing the Church of Jesus Christ of Latter-Day Saints as “a cult,” claiming that Islam “promotes pedophilia”and saying that Jews, Muslims and others would go “to Hell.”

On the National Mall in Washington, a few people gathered on the steps of the Lincoln Memorial to sing hymns and watch the sun rise.

Restrictions on mass gatherings have frustrated a small number of religious conservatives, who see the rules as attempts to limit Christian practice. In Kentucky, a federal judge on Saturday blocked the mayor of Louisville, Greg Fischer, from restricting drive-in church services, noting that drive-in liquor stores were still open.

The Supreme Court of Kansas ruled late Saturday night to uphold Gov. Laura Kelly’s order limiting the size of church services on Easter Sunday to 10 people. Republican legislators had argued it restricted their constitutional freedoms.

The Department of Justice may take action next week against local leaders who have specifically restricted in-person gatherings. Attorney General William Barr is “monitoring” government regulation of religious services, a Department of Justice spokeswoman said in a tweet on Saturday night.

“While social distancing policies are appropriate during this emergency, they must be applied evenhandedly & not single out religious orgs,” the spokeswoman, Kerri Kupec, wrote. “Expect action from DOJ next week.”

Gov. Andrew M. Cuomo said on Sunday that 758 more people had died in New York State, but that other data showed that the state was slowing the virus’s spread.

The governor’s morning update tracked closely with news from the state over the last week: daily death tolls staying in the high 700’s and the rate of hospitalizations continuing to fall. The governor himself compared his experience of the outbreak to the film “Groundhog Day,” saying that each day felt like a repeat of the day before.

Mr. Cuomo again criticized the federal response to the coronavirus, saying that money had been misdirected, with states that were less hard-hit getting a disproportionate share.

He said that he would sign an executive order requiring employers at essential businesses to provide employees with cloth or surgical face masks to wear when interacting with the public.

In all, the state has now had 9,385 deaths related to the coronavirus, the governor said.

Throughout January, as President Trump repeatedly played down the seriousness of the virus and focused on other issues, an array of figures inside his government — including top White House advisers and experts deep in the cabinet departments and intelligence agencies — identified the threat, sounded alarms and made clear the need for aggressive action.

Dozens of interviews and a review of emails and other records by The New York Times revealed many previously unreported details of the roots and extent of his halting response:

  • The National Security Council office responsible for tracking pandemics received intelligence reports in early January predicting the spread of the virus, and within weeks raised options like keeping Americans home from work and shutting down large cities.

  • Despite Mr. Trump’s denial, he was told at the time about a Jan. 29 memo produced by his trade adviser, Peter Navarro, laying out in striking detail the potential risks of a coronavirus pandemic.

  • The health and human services secretary directly warned Mr. Trump of the possibility of a pandemic during a call on Jan. 30, the second warning he delivered to the president about the virus. The president said he was being alarmist.

  • The health secretary publicly announced in February that the government was establishing a “surveillance” system in five American cities to measure the spread of the virus. It was delayed for weeks, leaving administration officials with almost no insight into how rapidly the virus was spreading.

Asked on Sunday morning whether lives would have been saved if Mr. Trump had followed recommendations on social distancing in late February, Dr. . Fauci, said on CNN, “It is what it is; we are where we are right now.” He added: “Obviously you could logically say that if you had a process that was ongoing and you started mitigation earlier, you could have saved lives, nobody’s going to deny that.”

Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health said on “Fox News Sunday” that “if we had acted on some of those warnings earlier, we would be in a much better position in terms of diagnostics and possibly masks and personal protective equipment and getting our hospitals ready.”

Coronavirus antibody tests have not always been accurate in other countries, and the U.S. should be careful not to approve their use too quickly, Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, said on Sunday.

Antibody tests are not designed to detect whether someone is infected now; they tell doctors whether the person has been exposed to the virus at some point, and may have acquired some degree of immunity. So far, the F.D.A. has approved only one such test, which looks for protective antibodies in a finger-prick of blood.

“There are a number on the market that we haven’t validated,” Dr. Hahn said on the ABC program “This Week.” “We do expect that relatively soon.”

Referring to reports from other countries of inaccurate antibody tests, he added: “I think it’s really important for the American people to know that we need tests that are accurate, reliable and reproducible. That’s what F.D.A. does in a science- and data-driven way.”

In an appearance on the NBC program “Meet the Press,” Dr. Hahn said, “What we don’t want are wildly inaccurate tests.”

Last month, the F.D.A. began allowing manufacturers to distribute coronavirus tests for a limited time before receiving emergency authorization.

Prime Minister Boris Johnson of Britain, who contracted the coronavirus and spent time in intensive care, showered praise on his country’s often-criticized National Health Service after being released from the hospital on Sunday.

It was a major step forward in his recovery and a welcome relief for a nation whose death toll from the pandemic has surpassed 10,000 and whose political leadership has been hard hit by the contagion.

In a video posted on Twitter, he credited the National Health Service with saving his life, calling it “the beating heart of this country.”

“It’s hard to find words to express my debt,” he said, looking a bit wan but speaking with his usual vigor.

He thanked Britons for adhering to social distancing measures and said that were helping to slow the spread of the virus. And he singled two nurses — Jenny, from New Zealand and Luis, from Portugal — who “stood by my bedside for 48 hours when things could have gone either way.”

Weeks before Florida ordered people to stay at home, the coronavirus was well into its insidious spread in the state, infecting residents and visitors who days earlier had danced at beach parties and reveled in theme parks. Only now, as people have gotten sick and recovered from — or succumbed to — Covid-19, the disease caused by the coronavirus, has the costly toll of keeping Florida open during the spring break season started to become apparent.

Gov. Ron DeSantis, a Republican, has blamed travelers from New York, Europe and other places for seeding the virus in the state. But the reverse was also true: People got sick in Florida and took the infection back home.

The exact number of people who returned from leisure trips to Florida with the coronavirus may never be known. Cases as far away as California and Massachusetts have been linked to the Winter Party Festival, a beachside dance party and fund-raiser for the L.G.B.T.Q. community held March 4-10. As of last week, 38 people had reported that they were symptomatic or had tested positive for the coronavirus in the weeks following the event, according to the organizer, the National L.G.B.T.Q. Task Force.

Another California man died after going to Orlando for a conference and then to a packed Disney World. Two people went to Disney and later got relatives sick in Florida and Georgia.

Slow action by Florida’s governor left local leaders scrambling to make their own closure decisions during one of the busiest and most profitable times of the year for a state with an $86 billion tourism economy. The result was that rules were often in conflict, with one city canceling a major event while a neighboring city allowed another event to continue.

The governor, who did not order people to stay home until April 1, has said the state supported local governments that ordered event cancellations and beach closures, but that it was not his role to step in first.

As the coronavirus tears through the country, scientists are studying the role of superspreaders, a loosely defined term for people who may infect a disproportionate number of others, whether as a consequence of genetics, social habits or simply by being in the wrong place at the wrong time.

Understanding how they work could help in containing outbreaks.

The virus carriers at the heart of what are being called superspreading events, can drive and have driven epidemics, researchers say, making it crucial to figure out ways to identify spreading events or to prevent situations, like crowded rooms, where superspreading can occur.

At the end of February, for example, when 175 Biogen executives gathered for a conference at the Boston Marriott Long Wharf Hotel, at least one was infected with the coronavirus. Two weeks later, seventy five percent of the 108 Massachusetts residents infected with the virus were associated with or employed by Biogen.

But just as important are those at the other end of the spectrum — people who are infected but unlikely to spread the infection.

Distinguishing between those who are more infectious and those less infectious could make an enormous difference in the ease and speed with which an outbreak is contained, said Jonathan Zelner, a statistician at the University of Michigan.

Responding to Mr. Trump’s threat that the United States might withhold funding from the World Health Organization, one of the group’s top officials said Sunday that it would be “so unfortunate” if anything happened to lessen the cooperation between the organization and Washington.

On Tuesday, Mr. Trump accused the W.H.O. of not having been aggressive enough in confronting the coronavirus, suggesting he would put “a very powerful hold” on the funding the United States provides the organization.

The budget for the W.H.O. is about $6 billion, and in 2019, the last year for which figures were available, the United States contributed about $553 million.

Dr. David Navarro, the special envoy to the W.H.O., said on NBC’s “Meet the Press” that he hoped “that all nations will not find any reason to make threats or other such things that will undermine our capacity to bring together all the best knowledge that we can find.”

He added, “We’ve worked with United States scientists for years. I personally have huge respect for what you bring and what you offer. And that would be so unfortunate, if anything happened to lessen that cooperation.”

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The Brooklyn Hospital Center’s maternity floor is a place of anxiety for staff and patients. But amid the fear, mothers with Covid-19 are experiencing moments of joy and gratitude.CreditCredit...Victor J. Blue for The New York Times

The obstetrics unit at Brooklyn Hospital Center, which delivers about 2,600 babies a year, is typically a place of celebration and fulfilled hopes. But amid the coronavirus pandemic, it has been transformed.

Nearly 200 babies have arrived since the beginning of March, according to Dr. Erroll Byer Jr., chairman of the department of obstetrics and gynecology. Twenty-nine pregnant or delivering women have had suspected or confirmed cases of Covid-19, the disease caused by the virus. They have been kept separate from other patients, and medical workers wear protective clothing when attending to them. Mothers-to-be are confined to their rooms, and visitors are kept to a minimum. Multiple doctors and nurses in the department have fallen ill.

Even healthy pregnant women are anxious. “They don’t feel the happiness and joy that many people experience” at this time of life, Dr. Byer said. Worse, some pregnant patients who become sick are so scared of coming into the hospital — citing fear of the virus or of being alone — that they have delayed doing so. A few of them have become dangerously ill.

As at other New York hospitals, the surge of new patients with Covid-19 flattened this past week. But nearly 90 patients at the Brooklyn hospital who were confirmed or suspected to have the virus have died since March 1, 30 of them from Monday to Friday last week. Five staff members have also died. The crisis is not over, Dr. Byer and other physicians warned.

Pregnant women are thought to be at a similar risk for severe illness from Covid-19 as other people. But Dr. Byer said that more research was needed, particularly in communities, like Brooklyn, where obesity, diabetes and hypertension are common among expectant mothers.

But he is grateful: So far, not one mother or baby has been lost.

Standing in line used to be an American pastime, whether it was camping outside movie theaters before a “Star Wars” premiere or shivering outside big-box stores to be the first inside on Black Friday.

The coronavirus has changed all that.

Now, millions of people across the country are risking their health to wait in tense, sometimes desperate, new lines for basic needs. The lines of carefully spaced people stretch around blocks and clog two-lane highways.

The scenes are especially jarring at a moment when freeways are empty and city centers are deserted. Public health officials are urging people to slow the transmission of the coronavirus by avoiding each other.

“It’s worrisome,” said Carl Bergstrom, a biologist at the University of Washington who studies pandemics. “It’s setting up unnecessary opportunities for transmission.”

In Milwaukee, Catherine Graham, who has a bad heart and asthma, left her apartment on Tuesday for the first time since early March to vote in the Wisconsin primary election.

“It was people, people, people,” Ms. Graham, 78, said. “I was afraid.”

She said she nearly turned back when she saw the line, but waited for two hours to cast a ballot. Every day since, she has been watching for symptoms of the coronavirus.

Strapped by the same problems facing health care workers around the world, including a limited supply of personal protective equipment, hospital beds and ventilators, Guam’s government is contending with how to help the crew of infected sailors on the aircraft carrier U.S.S. Theodore Roosevelt, which arrived on March 27. The outbreak on the ship ended up creating a moral crisis for the military.

As an American territory roughly 7,200 miles from the continental United States, Guam is home to Joint Region Marianas, a military command made up of Andersen Air Force Base on the northern part of the island that supports stealth-bomber rotations, and Naval Base Guam to the south, where four attack submarines are stationed to counter Chinese military expansion in the South China Sea.

Local residents, sailors from the Roosevelt and their loved ones described a complicated situation on the island. Guam is providing logistical support to the Navy while also trying to protect the local population from the coronavirus, which could quickly overwhelm Guam’s fragile health care system.

Pope Francis livestreamed Easter Mass, and spoke of a “contagion of hope,” in the midst of a “pandemic severely testing our whole human family.” The outbreak is fanning anti-Muslim attacks in India. As the demand for tulips dropped precipitously, Dutch growers found themselves having to destroy their flowers.

Reporting was contributed by Knvul Sheikh, Sheri Fink, Jonah Bromwich, Peter Baker, Elizabeth Dias, Katie Van Syckle, Jeanna Smialek, Nancy Coleman, Jack Healy, Tara Parker-Pope, Johnny Diaz, Patricia Mazzei, Frances Robles, Carl Hulse and Gina Kolata.

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