Here’s what you need to know:
- New C.D.C. data suggests the virus death toll is higher than reported.
- Trump wants to keep open meat plants, many of which are virus hot spots.
- The U.S. surpasses 1 million known coronavirus cases.
- A big mall operator is planning to reopen shopping centers.
- Fauci says U.S. is ‘not ready’ yet for sports.
- Few states are considering opening schools before the summer.
- Pence doesn’t wear a face mask at the Mayo Clinic.
New C.D.C. data suggests the virus death toll is higher than reported.
The number of total deaths in seven states hit hard by the coronavirus was nearly 50 percent higher than normal over a five-week span during the pandemic, according to new statistics released by the Centers for Disease Control and Prevention on Tuesday. There were 9,000 more deaths in those states than the official counts of coronavirus deaths suggest.
The newly released data is partial and most likely undercounts the recent death toll, but it still illustrates how the virus is causing a surge in deaths in the places it has struck.
From March 8 through April 11, provisional deaths from all causes spiked far above their normal levels in Colorado, Illinois, Maryland, Massachusetts, Michigan, New York and New Jersey.
The gap between total mortality and the official count of coronavirus deaths probably reflects both an undercounting of coronavirus deaths and a surge in deaths from other causes. There is increasing evidence that stresses on the health care system and fears about catching the disease have caused some Americans to die from ailments that are typically treatable.
While no mortality statistics are perfect, the C.D.C. uses detailed death certificates to code the causes of death for everyone who dies in the United States. But that process typically takes more than a year to complete. For now, measures of total deaths are the most useful tool, several epidemiologists said, for measuring the impact of the coronavirus in the United States.
U.S. Coronavirus Death Toll Is Far Higher Than Reported, C.D.C. Data Suggests
In seven hard-hit states, total deaths are nearly 50 percent higher than normal, according to new C.D.C. statistics, suggesting that the virus has killed far more people than the number in official counts.
Trump wants to keep open meat plants, many of which are virus hot spots.
President Trump on Tuesday declared meat processing plants “critical infrastructure,” in an effort to ensure that facilities around the country remained open as the government tried to prevent looming shortages of pork, chicken and other products as a result of the coronavirus.
The action comes as meat plants have turned into coronavirus hot spots, sickening thousands of workers. The head of Tyson Foods, one of the country’s largest processors, has warned that millions of pounds of meat would simply disappear from the supply chain.
In an executive order, Mr. Trump said recent closures of meat processing facilities “threaten the continued functioning of the national meat and poultry supply chain, undermining critical infrastructure during the national emergency.”
The president said his administration would “take all appropriate action” to ensure that meat and poultry processors “continue operations” consistent with federal health and workplace safety guidance.
While Mr. Trump said the step would ensure an ample supply of “protein for Americans,” the announcement provoked swift backlash from unions and labor advocates, who said the administration needed to do more to protect workers who often stand shoulder to shoulder in refrigerated assembly lines. At least 20 workers have already died of the coronavirus, the United Food and Commercial Workers International Union said.
“Using executive power to force people back on the job without proper protections is wrong and dangerous,” Richard Trumka, the president of the A.F.L.-C.I.O., wrote on Twitter, saying he echoed calls by the food workers union to “to put worker safety first.”
As of Thursday, 13 meatpacking and food processing plants had closed at some point in the past two months, resulting in a 25 percent reduction in the nation’s pork slaughter capacity and a 10 percent reduction in beef slaughter capacity, according to the food workers’ union. Farmers have begun killing pigs and chickens they can no longer sell to companies for processing.
The U.S. surpasses 1 million known coronavirus cases.
The United States on Tuesday surpassed one million known coronavirus cases, showing how an outbreak that began with a small trickle of cases in January has exploded into a national crisis.
The bleak milestone was yet another sign of how the virus has upended life in America, taking lives, destroying families, spreading through meat plants, prisons and nursing homes, forcing businesses and schools to close, and causing more than 26 million people to lose their jobs in the past five weeks. The country’s death toll is now more than 50,000.
The true number of infections is much higher than the one million figure, which does not include untold thousands of Americans who contracted the virus but were not tested, either because they did not show symptoms or because of a persistent national testing shortage.
Some disease researchers have estimated that the true number of infections may be about 10 times the known number, and preliminary testing of how many people have antibodies to the virus seems to support that view.
Roughly one in every 330 people in the United States has now tested positive for the virus, which has retreated in some hard-hit places, including Seattle and New Orleans. But other parts of the country, including Chicago and Los Angeles, continued to report persistently high numbers of new infections.
In rural America, many outbreaks have been tied to meatpacking plants or other workplaces.
In Cass County, Ind., the number of known cases has surged from 52 to 1,025 over 10 days. In Dakota County, Neb., where there were no known cases until April 12, there are now more than 600. And in the county that includes Green Bay, Wis., where there are outbreaks at three meatpacking facilities, cases more than octupled in a two-week stretch, to 853.
Coronavirus in the U.S.: Latest Map and Case Count
A detailed county map shows the extent of the coronavirus outbreak, with tables of the number of cases by county.
A big mall operator is planning to reopen shopping centers.
Simon Property Group, the biggest operator of malls in the United States, has come up with a game plan for reopening 49 shopping centers across 10 states starting on Friday.
Security officers and employees will “actively remind and encourage shoppers” to maintain a proper distance from others and to refrain from shopping in groups. Food court seating will be spaced to encourage social distancing, and reusable trays will be banished. Play areas and drinking fountains will be temporarily closed, mall-provided strollers will not be available and, in restrooms, every other sink and urinal will be taped off. Regular audio announcements will be made “to remind shoppers of their part in maintaining a safe environment for everyone.”
A company memo given to retailers provides a glimpse of how the broader American shopping experience is likely to look as the country begins to slowly reopen. But the success of such an approach depends largely on whether retailers will also decide to quickly reopen stores and whether the public will feel comfortable going to malls when tests for the virus remain difficult to get.
Simon Property, which has seen the future of brick-and-mortar retail seriously threatened by the pandemic, plans to open the shopping centers between Friday and Monday. The majority are in Texas, Indiana, Georgia and Missouri. Properties in Tennessee, South Carolina, Oklahoma, Arkansas, Alaska and Mississippi will also be reopened.
It is not clear how many retailers with stores in those malls will open their doors. Gap Inc., which owns its namesake brand as well as Athleta, Banana Republic and Old Navy and is a tenant in some of the properties being reopened, said on Tuesday that it was not opening any stores this weekend. Macy’s, also a Simon Property tenant, currently has all of its stores closed. On Tuesday, it said it had no update on when they would reopen.
Simon Property, which is based in Indianapolis and at the end of last year owned more than 200 properties in 37 states and Puerto Rico, did not respond to requests for comment.
Fauci says U.S. is ‘not ready’ yet for sports.
Dr. Anthony S. Fauci, the the federal government’s top infectious disease expert, said it might be very difficult for professional sports teams to return to action, despite proposals by various leagues and organizations to restart play.
A key variable, he said in an interview with The New York Times, would be the availability of access to tests for the virus that are plentiful and provide results immediately.
“Safety, for the players and for the fans, trumps everything,” he said. “If you can’t guarantee safety, then unfortunately you’re going to have to bite the bullet and say, ‘We may have to go without this sport for this season.’”
In North Carolina, Gov. Roy Cooper said during his daily briefing on Tuesday that NASCAR could hold the Coca-Cola 600 at Charlotte Motor Speedway without fans on Memorial Day weekend as long as the public health conditions did not deteriorate.
He said that NASCAR and raceway officials had presented social distancing plans to state health officials, who made some recommendations of their own, but were otherwise poised to accept them.
“We believe that unless health conditions go down that we can have the Coca-Cola 600 on Memorial Day weekend,” Mr. Cooper said.
But the Baseball Hall of Fame induction ceremony, which had been expected to be headlined by Derek Jeter in July, appears to be in serious jeopardy of being postponed.
Don’t expect a virtual enshrinement of Jeter, the retired Yankees captain, or Larry Walker. Hall of Fame officials have ruled out a made-for-television event.
“We would not have a made-for-television or a virtual program,” said Tim Mead, president of the Hall of Fame. “That induction ceremony is a special moment for the baseball community.”
Mr. Trump has urged sports commissioners to return to play as soon as possible, while governors of California, New York and other hard-hit states have reacted cautiously.
“If we let our desire to prematurely get back to normal, we can only get ourselves right back in the same hole we were in a few weeks ago,” said Dr. Fauci, a fan of the Yankees and the Washington Nationals.
“I would love to be able to have all sports back,” Dr. Fauci said. “But as a health official and a physician and a scientist, I have to say, right now, when you look at the country, we’re not ready for that yet.”
Few states are considering opening schools before the summer.
With students languishing, the economy stagnating and working parents straining to turn their kitchen tables into classrooms, the nation’s public schools have been working to bring children back to their desks, lockers and study halls.
But despite President Trump’s prediction that “I think you’ll see a lot of schools open up,” all but a few states have suspended in-person classes for the rest of the academic year, and some are preparing for the possibility of shutdowns or part-time schedules in the fall.
Gov. Gavin Newsom of California raised the idea on Tuesday that the next academic year could start as soon as July, to make up for the abbreviated spring term. But he cautioned that “if we pull back too quickly,” a fresh wave of the coronavirus could erupt.
Illinois officials have gone even further, warning that remote learning could continue indefinitely. “This may be the new normal even in the fall,” said Janice Jackson, the chief executive of Chicago Public Schools.
Gov. Philip D. Murphy of New Jersey, who like Mr. Newsom has school-age children at home, is one of the few state leaders who has left open the prospect of schools reopening this spring — if several benchmarks are first met.
Whenever students do come back, classes are unlikely to look anything like the school days they remember. There may be staggered half-day classes or one-day-on, one-day-off schedules so desks can be spread out and buses can run half-empty.
Students can expect school equipment to be sterilized and meals to be served at their desks or in socially distanced lunchrooms. Masked teachers and temperature checks at school doorways may be common. Forget note-passing, study groups and recess. And if new outbreaks surface, virtual classes may abruptly start up again.
Pence doesn’t wear a face mask at the Mayo Clinic.
Vice President Mike Pence on Tuesday flouted the Mayo Clinic’s policy that all visitors wear protective face masks when he toured the facility in Minnesota without covering his face.
During the tour, Stephen Hahn, the Food and Drug Administration commissioner, and other administration officials wore masks; all employees around Mr. Pence were wearing face masks, and a patient wore a mask. Mr. Pence stood out as the only person with his face uncovered as he toured the virology laboratory’s labeling area, thanking employees and then participating in a round table with local officials and Gov. Tim Walz of Minnesota.
After the visit, the Mayo Clinic tweeted that it had “informed @VP of the masking policy prior to his arrival today.” The clinic then deleted the tweet.
Mr. Pence defended his own behavior. “As vice president of the United States, I’m tested for the coronavirus on a regular basis, and everyone who is around me is tested for the coronavirus,” he told reporters.
He said he was following C.D.C. guidelines that indicated that masks were good for preventing the spread of the virus by those who had it.
He also wanted to look workers and researchers “in the eye and say thank you,” he said, although surgical masks do not cover eyes.
Public health experts said his argument for not wearing a mask in public settings was faulty.
Even for Covid-19 patients who are showing symptoms, diagnostic tests may detect the virus only 75 percent of the time, said Dr. Mark Loeb, a microbiologist and infectious disease specialist at McMaster University. It is unclear how sensitive the tests are in asymptomatic cases.
Cuomo faults others for not sufficiently warning about the virus.
At his daily briefing, Gov. Andrew M. Cuomo of New York faulted a raft of other forces, including the World Health Organization, various federal agencies and the news media, for not doing their part to caution the world of the pandemic threat.
He targeted the National Institutes of Health and the Centers for Disease Control and Prevention — “the N.I.H, the C.D.C., that whole alphabet soup of agencies,” he called them — and the nation’s intelligence community for not issuing more urgent advisories late last year, before health officials in China had even publicly identified the virus.
“Where was everyone?” he said, suggesting that intelligence agents had not recognized that “this is in China, and they have something called an airplane, and you can get on an airplane and you can come to the United States.”
Mr. Cuomo’s remarks, which also included critiques of news organizations, bore a passing resemblance to critiques leveled by Mr. Trump at federal agencies and institutions and came as the number of virus patients newly admitted to hospitals in New York State has fallen more than 70 percent since the outbreak’s peak this month, according to state statistics on Tuesday.
The latest number was below 1,000 for the first time in over a month, down from more than 3,000 on April 7, providing further evidence that the outbreak is waning.
Deaths from the virus remained flat — 335 more people died, Mr. Cuomo said, down by more than 50 percent from the peak, when nearly 800 people per day were dying of the virus.
Massachusetts extends its restrictions while some states press to reopen.
As some states moved forward with plans to let some businesses reopen, Gov. Charlie Baker of Massachusetts, a Republican, announced on Tuesday that he would extend the limit on gatherings and the closures of nonessential businesses in his state until May 18.
“We’re all incredibly eager to move on from this phase of our lives, but if we act too soon, we could risk a spike in infections that could force our state to revert to serious restrictions again,” Mr. Baker said at a news conference. “And this scenario would be far worse for our economy, and for our communities, and for our people.”
He spoke as more than a dozen states moved ahead with tentative plans to gradually reopen their economies, despite a lack of widespread testing that public health experts say will be needed to identify, track and contain new outbreaks. Even as they pressed ahead, there was no agreed-upon strategy for the best way to safely navigate from lockdowns to some form of new normal.
In Alabama, Gov. Kay Ivey, a Republican, announced Tuesday that when the state’s stay-at-home order expires April 30, it will be replaced by a “safer-at-home” order that will allow many businesses to reopen, but will not go as far as some other states in the South.
In Florida, Gov. Ron DeSantis, a Republican, whose stay-at-home order expires on Friday, plans to announce on Wednesday his plan for what he calls a gradual reopening.
During a meeting in the Oval Office Tuesday with Mr. Trump, Mr. DeSantis struck a very different note from other governors who have said that more testing capacity will be needed before they can ease restrictions. Mr. DeSantis said that “our ability to test exceeds the current demand,” which Mr. Trump called “a fantastic thing.”
In North Carolina, protesters in downtown Raleigh who were calling on Gov. Ray Cooper to lift his stay-at-home order were met by a small group of health care workers urging him to keep nonessential businesses closed. Some, in masks and scrubs, carried signs reading “Stay Home For Me.”
Many U.S. citizens married to undocumented immigrants are ineligible for relief funds.
Undocumented immigrants are not eligible for federal stimulus money connected to the pandemic — and neither, it turns out, are more than a million American citizens who are married to them.
A provision in the legislation that created the stimulus fund, which received little attention while it was under debate, prohibits payments to people who file taxes jointly with someone who uses an individual taxpayer identification number, a common substitute for a Social Security number used mostly by immigrants without legal status.
The result is that American citizens who are married to undocumented immigrants will not receive financial support from the federal government, including $1,200 for adults and $500 bonus payments for each dependent child under 16 living in their home.
Such is the case for Luz María Ortíz de Pulido, whose husband, four children and grandchild are all United States citizens. Were it not for Ms. Pulido’s lack of legal status, the family would have received money from the I.R.S. to help cover its bills, which would have helped to make up for the income she has lost as a house cleaner.
Money has always been tight in their home in Del Valle, Texas, but now the situation is dire.
“We needed that money,” Ms. Pulido said. “It’s seven people in my house, and just me who doesn’t have papers, and we are all punished. It’s hard.”
Mnuchin says big companies could face ‘criminal liability.’
Treasury Secretary Steven Mnuchin said on Tuesday that companies that received more than $2 million in small business loans would be audited by the Small Business Administration and could face “criminal liability” if it turns out they were not eligible to apply for the relief money.
Mr. Mnuchin’s comments come as backlash grows over big, publicly traded companies taking millions of dollars of loans while small businesses have been left out and unable to gain access to the $660 billion pot of bailout money.
“We want to make sure this money is getting to where it should be,” Mr. Mnuchin said on CNBC.
The second round of the small business loan program started on Monday and it was marred by technical glitches and frustration among banks and borrowers. The program has also suffered from Treasury’s lack of clear guidance to banks and borrowers about who is eligible to receive funds from the $660 billion Paycheck Protection Program.
Last week, the Treasury and the S.B.A. clarified the certification requirements for borrowers to dissuade big companies that have access to other forms of capital from applying, saying that only firms without access to other forms of capital — such as selling shares or debt — would qualify.
Several companies returned their loan money in recent days amid the backlash, including the Los Angeles Lakers basketball franchise, which on Monday said it had given back its $4.6 million loan. Mr. Mnuchin said on Tuesday that he thought it was “outrageous” that the Lakers had taken money and warned other public companies that they could face criminal liability if they did not refund the loans by May 7.
“The purpose of this program was not social welfare for big business,” Mr. Mnuchin said.
The Treasury secretary noted that banks had been encouraged to process the loans as quickly as possible and that the onus is on the borrowers to honestly assess if they are eligible for the loans, which are meant for businesses with fewer than 500 workers.
“It’s really the fault of the borrowers,” Mr. Mnuchin said. “It’s the borrowers who have criminal liability if they made this certification and it’s not true.”
So far, at least 116 public companies have disclosed receiving loans over $2 million and haven’t returned those funds.
Companies that returned loans:
Administration officials tell a House committee the country still lacks supplies.
The United States continues to face shortages in personal protective equipment and testing supplies, according to a summary of briefings that senior administration officials gave to Congress that directly undercut recent statements by President Trump that the country is “loaded up” on such equipment.
David Bibo, the Federal Emergency Management Agency’s deputy associate administrator for response and recovery, told the House Oversight and Reform Committee on April 21 that the demand for medical equipment and testing materials “outstrips supply considerably,” and that FEMA has been forced to prioritize urgent needs and recommend reusing protective equipment.
On Tuesday, Mr. Bibo told the same committee that “while things are improving, there is still more demand than there is supply, especially for particular pieces of P.P.E.” like medical gowns, according to a statement from the Oversight Committee.
Despite consistent complaints from governors that they do not have nearly enough tests, Mr. Trump has claimed the states have adequate resources to begin reopening their economies and schools. “They had everything they needed. They had their ventilators; they had their testing,” Mr. Trump said on Monday after a call with governors. “We’re getting them what they need.”
But Mr. Trump’s own administration seems to be disputing those assertions. Dr. Carl Newman of the Department of Health and Human Services told the House committee on Tuesday that he was concerned about “access to swabs” and “access to reagents” needed for testing. He added that the administration would work with states to “meet their testing goals.”
“Officials from FEMA and H.H.S. directly contradicted President Trump’s claims, admitting that we do not have enough tests or protective equipment and that critical shortages are likely to continue,” said Representative Carolyn B. Maloney of New York, the chairwoman of the Oversight Committee. “The president’s failed response to the coronavirus crisis has already caused untold suffering and chaos. He needs to start being honest with the American people and come up with a nationwide plan to get the resources we need to prevent more Americans from dying.”
Federal officials have been flying in protective gear procured from overseas by the private sector after the federal government this month effectively exhausted a national stockpile of such medical gear, like masks, gloves and face shields. The project has been lauded by senior administration officials but criticized by some state leaders for its overreliance on the private sector and opaque criteria of choosing which jurisdictions receive most of the supplies.
State leaders and local hospitals have also continued to struggle to procure protective gear because of widespread shortages, fraud and increased competition from other states and the federal government.
Cancer patients are at greater risk for severe Covid-19, a study says.
Coronavirus patients with lung cancer, blood cancer or cancer that has spread beyond its original site are at greater risk than cancer-free patients for severe Covid-19, according to a new study of patients in Hubei Province in China.
The findings add to suspicions that cancer patients may have unique vulnerabilities to the virus. But experts cautioned that the research was far from definitive.
It included only 105 cancer patients over all, and the number of patients with each type of cancer was very small.
The researchers studied the medical records of Covid-19 patients with cancer at 14 hospitals in Wuhan, China, comparing them with 536 Covid-19 patients of similar age who did not have cancer and were treated at the same hospitals.
Patients with cancer died at twice the rates of cancer-free patients, the researchers estimated. Cancer patients had nearly twice the risk of having severe symptoms and nearly three times the risk of requiring mechanical ventilation, the investigators found.
Patients who had had surgery appeared to be at higher risk for severe outcomes, but those who had undergone radiation therapy did not appear to have worse outcomes. One disturbing finding was that patients who had undergone immunotherapy experienced the most severe illness and the highest death rates.
The study, which was peer reviewed, was presented at a virtual conference of the American Association for Cancer Research and published in the organization’s journal, Cancer Discovery.
The C.D.C. expands the list of symptoms, and the W.H.O. warns of a long road ahead.
For weeks, most people in the United States have been told that they qualify for a coronavirus test only if they have three symptoms associated with the disease: high fever, cough and shortness of breath.
As health experts have gained more experience with Covid-19, they are finding that many infected people have no fevers or that their fevers wax and wane over a period of weeks and are sometimes accompanied by chills.
The C.D.C. has now expanded the list of symptoms to include repeated shaking with chills, muscle pain, headache, sore throat and a loss of taste or smell.
That differs from the guidance of the World Health Organization, which says that the most common symptoms are fever, dry cough and tiredness.
“Some patients may have aches and pains, nasal congestion, sore throat or diarrhea,” the W.H.O. says. “These symptoms are usually mild and begin gradually.”
The Jenner Institute at Oxford University is scheduling tests of a new vaccine on more than 6,000 people by the end of next month, hoping to show not only that it is safe, but also that it works.
The Oxford scientists say that with an emergency approval from regulators, the first few million doses of their vaccine could be available by September — at least several months ahead of any of the other announced efforts — if it proves to be effective.
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Reporting was contributed by Pam Belluck, Ken Belson, Alan Blinder, Jonah Engel Bromwich, Emily Cochrane, Michael Cooper, Michael Corkery, Maria Cramer, Caitlin Dickerson, Nicholas Fandos, Michael Gold, Elizabeth A. Harris, Jack Healy, Shawn Hubler, Andrew Jacobs, Zolan Kanno-Youngs, Annie Karni, Josh Katz, Tyler Kepner, denise Lu, Neil MacFarquhar, Sapna Maheshwari, Jonathan Martin, Victor Mather, Patricia Mazzei, Jesse McKinley, Sarah Mervosh, Anahad O’Connor, Michael Powell, Roni Carn Rabin, William K. Rashbaum, Brian M. Rosenthal, Michael Rothfeld, David Sanger, Margot Sanger-Katz, Marc Santora, Dionne Searcey, Eileen Sullivan, Vanessa Swales, Ana Swanson, Neil Vigdor, James Wagner, Ali Watkins, Karen Weise and David Yaffe-Bellany.