President Trump’s doctor said in a memo released Saturday night that he was “no longer considered a transmission risk to others,” as the president prepared to resume campaign activities this week.
The memo from Dr. Sean P. Conley, the White House physician, said he was releasing information with Mr. Trump’s permission. But the amount of information he provided was limited, in keeping with restrictive presentations to the public that Dr. Conley has made throughout Mr. Trump’s battle with symptoms of the coronavirus since officials made his diagnosis public early on Oct. 2. Dr. Conley last released an update on the president’s condition on Thursday.
Experts have repeatedly called into question the true severity of Mr. Trump’s illness. According to guidelines released by the Centers for Disease Control and Prevention, people with severe Covid-19, the disease caused by the coronavirus, may need to isolate for up to 20 days. And the president’s health could still deteriorate in the next few days.
“I don’t think he’s out of the woods for certain,” said Dr. Krutika Kuppalli, an infectious disease physician based in South Carolina. Men of Mr. Trump’s age, 74, and weight are at higher risk for severe cases of Covid-19. His recent course of steroids, which suppress certain parts of the immune system, could also make him vulnerable to other infections, Dr. Kuppalli added. “I would still be careful with someone like him.”
The start date of Mr. Trump’s symptoms has also remained unclear. By Dr. Conley’s assessment, Mr. Trump would have needed to show signs of his illness on Wednesday, Sept. 30, for Saturday to qualify as 10 days after the onset of symptoms. Most people stop being infectious by the 10th day after they start feeling ill, according to the C.D.C.
“This evening I am happy to report that in addition to the president meeting C.D.C. criteria for the safe discontinuation of isolation, this morning’s Covid P.C.R. sample demonstrates, by currently recognized standards, he is no longer considered a transmission risk to others,” Dr. Conley wrote. “Now at day 10 from symptoms onset, fever-free for well over 24 hours and all symptoms improved, the assortment of advanced diagnostic tests obtained reveal there is no longer evidence of actively replicating virus. In addition, sequential testing throughout his illness has demonstrated decreasing viral loads that correlate with increasing cycle threshold times, as well as decreasing and now undetectable subgenomic mRNA.”
Several experts expressed skepticism at the wording describing Mr. Trump’s diagnostic tests, which did not explicitly categorize the president as “negative” for the coronavirus. P.C.R., a laboratory technique that detects the virus’s genetic material, can give researchers a rough sense of how much virus remains within a person’s body, or the viral load. Dr. Conley’s note suggested Mr. Trump’s viral load was dropping, but appeared to still be detectable.
The subgenomic mRNA mentioned by Dr. Conley is a part of the virus that can be detected by laboratory techniques, and that suggests the presence of actively replicating virus, said Susan Butler-Wu, a clinical microbiologist at the University of Southern California. But “there are zero cleared tests that look at subgenomic mRNA” from the coronavirus, she added, which means the procedure is “experimental at this point.”
Another, more traditional, approach to determine whether Mr. Trump still harbored actively replicating virus in his body might be to take a sample from the president’s airway and see if the coronavirus could be grown from the sample in a lab. But this technique was not mentioned in Dr. Conley’s memo.
There is also no test that can definitively show if a person at the end of a coronavirus infection is still contagious and poses a risk to others, said Melissa Miller, a clinical microbiologist at the University of North Carolina School of Medicine.
Dr. Conley said he would continue to monitor the president in the coming days.
Mr. Trump is to speak at a campaign event on Monday, which could ignite concerns that he might still infect people.
It was unclear when Mr. Trump last had a fever or whether his symptoms were resolved or merely better than they were before. He was treated with an experimental antibody cocktail, the antiviral remdesivir and dexamethasone, a heavy steroid that appeared intended to reduce inflammation in his lungs. He has said he is off medication now.
Mr. Trump’s voice has grown stronger since he was released from Walter Reed National Military Medical Center on Monday. But other than on his trips to and from the hospital, he had not been seen in public before Saturday, when he appeared on a balcony for nearly 20 minutes before a crowd of a few hundred people gathered on the South Lawn of the White House.
President Trump, whose progress in recovering from Covid-19 remains unclear, stood on a White House balcony on Saturday afternoon to greet several hundred supporters gathered on the South Lawn, his first in-person event since announcing that he had tested positive for the coronavirus.
“I’m feeling great!” Mr. Trump told the crowd.
Regarding the pandemic, which is flaring up in several states and around the globe, he once again insisted: “It’s going to disappear. It is disappearing.”
Outside medical experts had issued cautions about the gathering, saying that an inappropriately expedited return to the public arena could endanger the president’s own health and risk infecting others.
The White House has not been transparent about the severity of Mr. Trump’s illness, which makes it hard to know how much longer C.D.C. guidelines would suggest he should remain in isolation. Mr. Trump was hospitalized Oct. 2 and received some treatments typically reserved for those who are severely ill, an indication that he may need to isolate until Oct. 21.
White House officials said the president would speak for 30 minutes, but he kept his remarks to just 18 minutes in total. A typical Trump rally, in contrast, often runs for at least 90 minutes. A large bandage on top of his right hand was a reminder of the treatments and infusions he has received over the past week.
Attendees at the South Lawn event were supposed to fill out a screening questionnaire and also have their temperatures taken before they could join the crowd. Masks were required, and many in the crowd complied.
Some White House advisers did not, however. Dr. Scott W. Atlas, the commentator whose views playing down the threat of the coronavirus have been solicited by Mr. Trump, was seen standing about 20 feet from the crowd with no face covering.
The gathering was also the latest effort by the president to show he was not as sick as news outlets, including The New York Times, reported last weekend, when he was said to have been administered supplemental oxygen. In a Fox News interview on Friday night, Mr. Trump denied that he had experienced any trouble breathing and said he was no longer taking any medications.
In several phone calls last weekend from the presidential suite at Walter Reed National Military Medical Center, Mr. Trump shared an idea he was considering: When he left the hospital, he wanted to appear frail at first when people saw him, according to people with knowledge of the conversations. But underneath his button-down dress shirt, he would wear a Superman T-shirt, which he would reveal as a symbol of strength when he ripped open the top layer. He ultimately did not go ahead with the stunt.
Saturday’s event was the first large-scale gathering held at the White House in two weeks. On Saturday, Sept. 26, a large ceremony was held to nominate Judge Amy Coney Barrett to the Supreme Court, and the following day, Gold Star families were honored. After those events, infections among White House staff, military officials and other attendees were announced almost daily.
Dr. Anthony S. Fauci, the nation’s top expert on infectious diseases, said the White House had held a “super spreader event,” an apparent reference to the nomination ceremony.
Both the nomination ceremony and Saturday’s event violated Washington’s mandates prohibiting gatherings of more than 50 people. But because the White House is on federal property, it is exempt from such rules.
In the week after the nomination ceremony for Judge Barrett, the White House also decided not to trace the contacts of guests and staff members.
The world recorded more than one million new cases of the coronavirus in just the last three days, the highest total ever in such a short span, a reflection of resurgences in Europe and the United States and uninterrupted outbreaks in India, Brazil and other countries.
The number of new cases is growing faster than ever worldwide. Deaths and hospitalizations in some countries are also beginning to rise, a warning signal of the widespread impact of the current wave. The pandemic has sickened more than 37 million people and more than one million people have died globally, according to a New York Times database.
A hot spot has emerged in Britain, which has suffered the highest number of virus-related deaths in Europe. Spain and France, which set a record Friday with 20,339 new cases and then again Saturday with 26,896, are experiencing a second wave of infections. Russia on Saturday also set a one-day record of 12,673 new cases. Argentina, which has seen more than 90,000 new cases in the past seven days, is a hot spot in South America, as are Brazil and Colombia.
However, the United States is one of the largest contributors to the surging global tally. On Saturday, the country recorded more than 590 new deaths and more than 51,000 new cases. That tally included single-day case records in five states: Missouri, Alaska, Indiana, Minnesota and Oklahoma. All of those states except Oklahoma announced more cases this week than in any other seven-day stretch of the pandemic, as did Colorado, Idaho, Montana, New Mexico, North Dakota, South Dakota and Utah.
Within the United States, uncontrolled outbreaks continue to spread in the Upper Midwest and Rocky Mountains, and the Northeast is seeing early signs of a resurgence. In Wisconsin, a long-dormant field hospital at the state fairgrounds is being readied for patients. In New York, officials fear clusters in some neighborhoods and suburbs could spread further.
Still, the number of new cases nationally remains below the levels seen in late July, when the country averaged more than 66,000 per day. Deaths, though still well below their peak spring levels, have averaged around 700 per day in October. That is far more than the toll in early July.
The new highs in the United States come one week after President Trump himself tested positive for the virus and was hospitalized. Though he has returned to the White House and said repeatedly that he feels “great,” he has continued to play down the effectiveness of masks and routinely sidelined his own public health experts. Mr. Trump plans to resume his schedule of campaign rallies and events, which often violate local guidelines on social distancing. He hosted a large outdoor gathering at the White House on Saturday.
Globally, the United States has led the ranking of nations with the highest number of coronavirus infections since late May. However, the spread of the virus in India — which has roughly four times the population of the United States — has put the country on course to overtake the United States. On Sunday, India reported 74,383 new infections, taking its total past seven million, while the United States has more than 7.7 million cases. Infections are rippling into the rural corners of India, with more than 500,000 cases in the past seven days among the nation’s 1.3 billion people. In comparison, the United States has added more than 330,000 cases over the same period of time, according to a New York Times database.
Senate Republicans revolted over the contours of a $1.8 trillion relief proposal that is the Trump administration’s latest and largest offer to House Democrats, further jeopardizing already dim prospects for an agreement on a broad stimulus bill before Election Day.
Even as House Speaker Nancy Pelosi insisted that the offer remained inadequate, many Republican senators lashed into the administration’s approach to the revived negotiations during a conference call on Saturday morning between close to half of the chamber’s Republicans and top administration officials.
The $1.8 trillion proposal that Steven Mnuchin, the Treasury secretary, put forward on Friday was the administration’s biggest offer since bipartisan negotiations began in late summer. The proposal came just days after President Trump abruptly ended negotiations and then, facing a backlash, reversed course and began urgently seeking to secure Democratic support for a deal.
The stark divisions between most Senate Republicans and the White House undercut the potential for an agreement before the election on Nov. 3, even as the country’s economic recovery continues to falter and tens of thousands of Americans, businesses and schools struggle to weather the pandemic without federal relief.
The Republican criticism on Saturday was so severe that Mark Meadows, the White House chief of staff, at one point told the senators on the conference call that he would relay their concerns to Mr. Trump, but that then “you all will have to come to my funeral.” (Mr. Mnuchin concurred.)
Details of the call were described in some manner by seven people briefed on the discussion, who all insisted on anonymity to disclose details of a private conversation.
Most of the senators who spoke on the call signaled an openness to continuing negotiations. However, there was widespread dissatisfaction with how expensive the administration’s offer had become, as well as with the perception that Mr. Mnuchin, in talks with Ms. Pelosi, was relying far more on the Democrats’ proposed $2.2 trillion plan as a baseline than the two more limited proposals put forward by Senate Republicans.
“There’s no appetite right now to spend the White House number or the House number,” Senator Lamar Alexander of Tennessee said on the call, reflecting longstanding concerns among senators eager to protect their credentials as fiscal hawks and stave off primary challengers in the next election cycle.
Senator Marsha Blackburn of Tennessee warned that accepting a bill with Ms. Pelosi’s support would amount to a “death knell” for Republican ambitions to retain their majority in the Senate and would “deflate” the party’s base.
Ms. Pelosi, for her part, informed Democratic lawmakers on Saturday that she found elements of Mr. Mnuchin’s proposal to be inadequate, writing in a letter that “this proposal amounted to one step forward, two steps back.”
“When the president talks about wanting a bigger relief package, his proposal appears to mean that he wants more money at his discretion to grant or withhold,” Ms. Pelosi wrote, adding “at this point, we still have disagreement on many priorities.” She ticked off a number of unresolved issues, including what she said was insufficient funding for unemployment benefits, child care, funding for state and local governments and “reckless” liability protections that Republicans have insisted are a priority.
The Trump administration is considering reducing the time that travelers from abroad must quarantine when landing in the United States by providing tests at airports, a move that could lead to the easing of travel restrictions on foreign nations.
The administration is considering partnering with other countries on a pilot program that would require travelers to be tested at their airports of departure on the day they fly and again a week after they arrive in the United States, according to the draft documents obtained by The New York Times. Travelers who receive a negative test result four to seven days after arriving in the United States would be allowed to end their quarantine.
American citizens or permanent residents and their children arriving in the United States from more than two dozen European countries, as well as from China or Iran, are currently required to quarantine for 14 days. Foreigners from those nations have been barred from traveling to the United States.
But that could soon change.
“This pilot is expected to be a partnership between the U.S. government, a trusted foreign government and the air transport industry,” the draft briefing said. “It is intended to test whether the air transport industry can adequately reduce the risk of disease transmission and importation by incorporating a testing program into its existing predeparture process.”
The briefing, which was presented to officials in the Department of Homeland Security this week, listed New York and London as two cities that could participate in the pilot, a development previously reported by The Wall Street Journal.
The Homeland Security Department’s public affairs office issued a statement saying the agency was in “the early stages of working with our interagency partners, the industry, and our international partners for means to safely encourage trans-Atlantic travel while mitigating public health risks.”
The program would begin with just three flights to “gather data on participation and outcomes,” according to the documents. After assessing those findings, the administration could expand the program and potentially remove travel restrictions on some countries.
Officials wrote in the briefing that it remained unclear whether the departing traveler would need to pay for the test at the airport before boarding a flight. American citizens returning to the United States would still have the option of not taking the tests and quarantining for 14 days.
This article was produced in partnership with the Pulitzer Center on Crisis Reporting.
The Navy on Friday night abruptly shut down the church, schools, gym and most places where people congregate at its base at Guantánamo Bay, Cuba, returning to the strict restrictions it had imposed earlier in the coronavirus pandemic.
The base was “awaiting results from tests sent off site,” a spokeswoman, Nikki L. Maxwell, said Saturday night. She declined to say how many residents were suspected of being infected by the coronavirus at the base of 6,000 residents. The military generally declines to disclose infection figures at specific sites but has made exceptions in the Pacific.
On Thursday, base officials closed the Bayview fine-dining restaurant in the officers’ club complex, citing “some key staff feeling under the weather,” although Ms. Maxwell said those illnesses were unrelated to the virus. The next night, the base health department announced that “as an extra precautionary measure,” it was imposing a protection level of Charlie, which the military defines as signifying the risk of “sustained community transmission” in the pandemic.
Base notices reminded residents to stay at home and to call the hospital rather than go there “if you feel sick, have a fever, cough or experience any shortness of breath.”
By Saturday, base officials had closed the school for the sailors’ children, gyms for prison guards and other residents, the church complex, the barbershop, ball fields and swimming pools and were requiring restaurants to offer only takeout. The commissary remained open, with shoppers limited in number.
Hundreds of troops and Navy families have arrived at the base throughout the pandemic and have spent their first two weeks in quarantine as a protective measure.
Most of the estimated 240 students on the base had returned to the classroom last month for the first time since early spring. Over the weekend, the school told families it would revert to remote learning, with elementary classes delayed until Wednesday.
Despite Gov. Greg Abbott’s loosening of coronavirus restrictions this week, two top fellow Republicans and hundreds of others participated in a “Free Texas” protest outside the governor’s Austin home on Saturday, calling for a complete reopening of the state.
Among those gathered were Allen West, chairman of the Republican Party of Texas, and Sid Miller, the state’s agriculture commissioner, a Republican elected official.
“Quite frankly, governor, your cure is worse than the disease,” Mr. Miller said during a speech at the event, according to a Texas Tribune report.
Over the past week, there have been an average of 4,416 cases per day, an increase of 3 percent from the average two weeks earlier.
This week, Mr. Abbott issued an executive order that would allow all business establishments that had previously been allowed to operate at 50 percent to open at 75 percent capacity, except businesses in “areas with high hospitalization” rates which are only allowed to operate at 50 percent.
Mr. Abbott has faced Republican-led protests over restrictions before, as coronavirus cases in Texas fluctuated over the last few months. He has closed bars, then opened, then closed them again. His latest order allowed bars, which had been closed since July, to operate at 50 percent capacity. This change will be effective Oct. 14, he said, and each county has the ability to opt in or out of the openings.
“Even with additional business openings, even with more students returning to school and more gatherings like football games, Texans have shown that we can contain the spread of Covid,” Mr. Abbott said in a Facebook video announcing the latest order.
An executive order in July made masks mandatory around the state, but in footage of the “Free Texas” protest there did not appear to be many attendees wearing face coverings.
It has been a tough couple of days for Mr. Abbott, whose move to limit Texas counties to one ballot drop-off site each was blocked by a federal judge on Friday. On Saturday, a federal appeals court issued a temporary stay allowing the limit on ballot drop-off sites to remain in place while the state appeals the lower court’s order. The Texas League of United Latin American Citizens and other civil rights organizations had sued the governor over the order, which the judge ruled “likely violates their fundamental right to vote.”
Early voting in Texas begins on Tuesday.
President Trump on Wednesday portrayed the experimental antibody cocktail he took as a miracle “cure” for his case of Covid-19, which had landed him in the hospital just days before. Mr. Trump returned to the White House three days after taking the drug.
But the antibody treatment, made by the drug company Regeneron, has not yet been proven effective against the coronavirus by rigorous clinical trials in people.
Dr. Taison Bell, a critical care physician at the University of Virginia, noted that it was not yet possible to tell whether the treatment actually “cured,” or even significantly benefited, the president.
Doctors administered it to Mr. Trump alongside other therapies, including an antiviral called remdesivir and a steroid called dexamethasone.
“From a scientific standpoint, it makes it extremely hard to figure out what benefit came from which of the three medications,” Dr. Bell said.
Medical experts were also quick to point out that Mr. Trump’s touting of the treatment was at least the third time this year that the president has exaggerated the benefits of an unapproved Covid-19 therapy. He had previously promoted hydroxychloroquine and convalescent plasma, and on Wednesday advocated making the antibody treatment “free” for anyone who needed it.
Dr. Megan Ranney, an emergency medicine physician at Brown University, said that the endless cycle of talking up new treatments — many of which might not pan out — could erode public trust in science and medicine.
“It’s like the boy who cried wolf,” she said. “It’s going to make it more difficult to get the real changers.”
Pressure is mounting on the leaders of the Centers for Disease Control and Prevention to speak publicly against the White House’s manhandling of C.D.C. research and public health decisions, with demoralized career scientists talking of quitting if President Trump wins re-election.
The situation came to a boiling point this week when William H. Foege, a giant in public health who led the C.D.C. under Democratic and Republican presidents, called for its current director, Dr. Robert R. Redfield, to “stand up to a bully” — he meant Mr. Trump — even at the risk of being fired.
“Silence becomes complicity,” he said in an interview, after a private letter he wrote to Dr. Redfield leaked to the news media.
Dr. Redfield’s recent memo clearing Vice President Mike Pence to participate in the vice-presidential debate on Wednesday, even as the White House became a coronavirus hot spot, infuriated health experts. Nearly a dozen current and former C.D.C. officials called the letter highly inappropriate.
And Senator Patty Murray of Washington, the ranking Democrat on the Senate health committee, said she told Dr. Redfield in a private telephone conversation last month that he had to take a stand.
“What I said to him was that my concern was about the agency’s credibility today — and the agency’s credibility that we need as a country in the future,” Ms. Murray said in an interview. “This isn’t just about right now. If we lose all the really good scientists there, if people don’t believe the C.D.C. when they put out guidance, what happens in the next flu outbreak? What happens in the next public health crisis?”
C.D.C. scientists know that their work will invariably collide with politics, but they have never seen anything quite like what is happening under Mr. Trump.
The White House successfully pressured the agency to revise guidelines on matters like school reopenings, church gatherings and whether cruise ships can sail. The C.D.C. was forced, over the objections of its own scientists, to post guidelines that suggested asymptomatic people should not be tested. (That was ultimately reversed.) And the White House thwarted a C.D.C. plan to require individuals to wear masks on all U.S. commercial transportation.
“What has happened at C.D.C. has been horrifying to see,” said Dr. Mark Rosenberg, who pioneered public health research into gun violence at the C.D.C. but was pushed out after Republicans in Congress effectively cut off funding for his work. “It’s been terribly demoralizing to people who have been working 16- and 17-hour days for weeks or months at a time while taking on Covid-19.”
Dr. Redfield declined to comment.
What faint hopes remained that Europe was recovering from the economic catastrophe delivered by the pandemic have faded as the virus has resumed spreading rapidly across much of the continent.
After sharply expanding in the early part of the summer, Britain’s economy grew far less than anticipated in August — 2.1 percent compared with July, the government reported on Friday, adding to worries that further weakness lies ahead.
Earlier in the week, France, Europe’s second-largest economy, downgraded its forecast for the pace of expansion for the last three months of the year from an already minimal 1 percent to zero. The national statistics agency predicted that the economy would contract 9 percent this year.
The diminished expectations are an outgrowth of alarm over the revival of the virus, which has prompted President Emmanuel Macron to announce new restrictions, including a two-month shutdown of cafes and bars in Paris and surrounding areas.
In July, with infection rates down and lockdowns lifted, many European economies expanded strongly as people returned to shops, restaurants and vacation destinations. The most optimistic economists began celebrating a so-called V-shaped recovery, featuring a bounce-back just as steep as the plunge that preceded it.
But Spain’s central bank governor said this week that new restrictions to slow the virus’s accelerating spread could produce an economic contraction of as much as 12.6 percent this year.
And the European Central Bank’s chief economist said on Tuesday that the 19 countries that share the euro currency might not recover from the disaster until 2022, with those that are dependent on tourism especially vulnerable.
President Trump’s campaign has started airing a television ad focused on his coronavirus infection, an attempt to reset the way voters view the president on a major issue in the election.
A majority of voters have a negative view of Mr. Trump’s handling of the virus, according to public opinion polls. The spot seeks to use his release from Walter Reed National Military Medical Center as evidence that he is on top of a virus he has repeatedly played down.
“President Trump is recovering from the coronavirus, and so is America,” the ad’s narrator says. “Together, we rose to meet the challenge, protecting our seniors, getting them lifesaving drugs in record time, sparing no expense. President Trump tackled the virus head-on, as leaders should.”
The ad then cuts to Dr. Anthony S. Fauci, the country’s top epidemiologist, saying in an interview in late March, when the virus was just starting, “I can’t imagine that anybody could be doing more.” Dr. Fauci has tangled with the White House for much of the year over its coronavirus response.
The ad concludes: “We’ll get through this together. We’ll live carefully, but not afraid.”
Chris Christie, the former governor of New Jersey, said in a tweet on Saturday that he had been released from the hospital that morning, one week after testing positive for the coronavirus.
Mr. Christie is one of at least a dozen people who tested positive in the days after attending a Sept. 26 Rose Garden event for Judge Amy Coney Barrett, President Trump’s Supreme Court nominee, and had huddled with Mr. Trump and his close advisers during debate preparations just days before the president tested positive.
Mr. Christie, who is overweight and has a history of asthma, said last week that he had checked himself into Morristown Medical Center in consultation with his doctors.
“I am happy to let you know that this morning I was released from Morristown Medical Center,” he wrote on Twitter. “I want to thank the extraordinary doctors & nurses who cared for me the last week. Thanks to my family & friends for their prayers.”
He ended his message with an intriguing pledge: “I will have more to say about all of this next week.”
I am happy to let you know that this morning I was released from Morristown Medical Center. I want to thank the extraordinary doctors & nurses who cared for me for the last week. Thanks to my family & friends for their prayers. I will have more to say about all of this next week.
— Governor Christie (@GovChristie) October 10, 2020
In Palm Tree, N.Y., a town of 26,000 residents where life revolves around family, religious services and prayer, the percentage of coronavirus tests coming back positive is at least 15 percent, among the highest in New York. There are more than 200 active cases, enough to place this Orthodox Jewish community northwest of New York City into a state-ordered “red zone” with strict new restrictions on synagogue capacity and public gatherings.
Yet on Wednesday, as men and boys streamed out of prayer services at Congregation Yetev Lev D’Satmar for the holiday of Sukkot, most were not wearing face masks.
Dina Aker, 67, walked by the synagogue, also not wearing a mask. Her husband, 73, caught the coronavirus in May, despite being mainly confined to their home, she said. That left her feeling that there was no utility to masks and that new lockdown measures would only prolong the disease’s spread.
“I pray every day, ‘Please, my lovely God, make it finish,’” she said.
The peaceful scenes during Sukkot, where families gather in open-air, leaf-covered booths in a celebration of the fall harvest, were interrupted by a loudspeaker atop a town police car outside a shopping center, with a recording in Yiddish and English warning of a spike in cases in the area and emphasizing the importance of wearing masks.
A police officer standing near the car handed out disposable masks.
Public health officials and experts say that factors driving an uptick in the ultra-Orthodox enclaves north of the city include a distrust of scientific messaging and secular authority, a dedication to communal life, dense living conditions, and fatalism about the virus brought by a traumatic spring of death and sickness.
Under pressure from the federal government, Nevada health officials have rescinded a statewide order directing nursing homes to halt the use of two government-issued rapid coronavirus tests that the state had deemed to be inaccurate.
The reversal came shortly after the United States Department of Health and Human Services issued a threatening letter, dated Oct. 8, to Nevada’s department of health. The federal document noted that swift punitive actions could be taken if the state did not promptly revoke its ban, which Adm. Brett Giroir, the Trump administration’s testing chief, called “unwise, uninformed and unlawful” and a violation of the Public Readiness and Emergency Preparedness Act.
In a statement released on Friday, Dr. Ihsan Azzam, Nevada’s chief medical officer, said that he and his colleagues were “very disappointed by the letter received today.”
The two brands of rapid tests, manufactured by Quidel and Becton, Dickinson and Company, had been shipped en masse to nursing homes around the country in August to address the delays and equipment shortages that for months had stymied laboratory testing. Both companies reported no false positives from their products.
But among a sample of 39 positive antigen test results collected from nursing homes across Nevada, 23 were found to be false positives when confirmed by a more accurate laboratory test.
The false positives that had emerged, Adm. Giroir said, were not only expected but “actually an outstanding result.” No test is perfect, he said.
The state’s nursing facilities can resume use of BD’s and Quidel’s products, according to a new Nevada directive issued on Oct. 9. But Nevada’s department of health also recommended that all antigen test results, positive or negative, be confirmed by a laboratory test that relies on a slow but very accurate and reliable technique called polymerase chain reaction, or P.C.R.
“We need to better understand the issue before encouraging mass use of such tools among our most vulnerable citizens,” Dr. Azzam said. “We are not saying the tests have no use, we are just saying pause for further review and additional training.”
This week, Joseph R. Biden Jr. dismissed President Trump’s reluctant attitude toward wearing masks as “this macho thing.”
Tomi Lahren, a conservative commentator and Fox Nation host, countered that Mr. Biden “might as well carry a purse with that mask.”
Some experts who study masculinity and public health say the perception that wearing masks and following social distancing guidelines are unmanly has carried a destructive cost. The virus has infected more men than women and killed far more of them.
Men’s resistance to showing weakness — and their tendency to take risks — was demonstrated by scientists long before the pandemic. Studies have shown men are less likely than women to wear seatbelts and helmets, or to get flu shots. They’re more likely to speed or drive drunk. They are less likely to seek out medical care.
Some initial research indicates a similar pattern is playing out with the coronavirus. Surveys have found that women are more likely than men to wear masks in the United States.
If you wear a mask, said Peter Glick, a professor of social sciences at Lawrence University in Wisconsin, “the underlying message is: ‘I’m afraid of catching this disease.’”
The Centers for Disease Control and Prevention drafted a sweeping order last month requiring all passengers and employees to wear masks on all forms of public and commercial transit in the United States, but it was blocked by the White House, according to two federal health officials.
The order would have been the toughest federal mandate to date aimed at curbing the spread of the coronavirus, which continues to infect more than 40,000 people in America each day. The officials said that it had been drafted under the agency’s “quarantine powers” and that it had the support of the secretary of health and human services, Alex M. Azar II, but the White House Coronavirus Task Force, led by Vice President Mike Pence, declined to even discuss it.
The two officials said the order would have required face coverings on airplanes, trains, buses and subways, and in transit hubs such as airports, train stations and bus depots.
A task force official said the decision to require masks should be left up to states and localities.
The thwarting of the mask rule is the latest C.D.C. action to be stalled or changed by the White House. Late last month, the coronavirus task force overruled an order by the agency’s director to keep cruise ships docked until mid-February. That plan was opposed by the tourism industry in Florida, an important swing state in the presidential election.
Political appointees at the White House and the Department of Health and Human Services have also been involved in rewriting the agency’s guidelines on reopening schools and testing for the virus, bypassing the agency’s scientists.