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Coronavirus Live Updates: Some Governors Look to Lift Restrictions, Despite Lags in Testing - The New York Times

Credit...Scott McIntyre for The New York Times

Facing mounting economic damage and with encouragement from President Trump, governors of some states have started to announce plans for businesses to tiptoe back into operation on May 1, even as cases surge in some parts of the country.

Public health experts are warning against premature decisions to force the economy into motion again, and fear that vast stretches of the country still lack crucial supplies and systems — like expanded testing capacity that governors have said they do not have — to counter the risks of reopening.

Just as much of the country entered life under quarantine in a patchwork fashion, it is poised to ease restrictions the same varied way, responding to the local needs to fight the virus.

Beaches in Duval County, Fla., where infections appear to be slowing, will reopen with restrictions at 5 p.m. on Friday. In New York, where Gov. Andrew M. Cuomo said Thursday that the state’s sweeping shutdown would last until at least May 15, an order requiring people to don facial coverings in public will take effect Friday evening.

In Michigan, Gov. Gretchen Whitmer, who imposed one of the strictest stay-at-home orders in the nation, said Friday that she hoped to loosen the regulations in two weeks’ time, on May 1.

But Ms. Whitmer, a Democrat who has faced criticism from some residents and business leaders, said that any decision would depend on what the data on infections says as that date approaches. Her state trails only New York and New Jersey in the number of residents whose deaths have been tied to the virus.

“It’s two weeks away, and the information and the data and our ability to test is changing so rapidly, it’s hard to predict precisely where we’ll be in a week from now, let alone two weeks,” the governor said on ABC’s “Good Morning America” days after thousands of demonstrators, who mostly remained in vehicles, protested outside the State Capitol in Lansing and accused Ms. Whitmer of going too far.

In some states where the number of cases announced each day has flattened or is waning, elected officials are taking cautious, but concrete, steps by allowing companies to open again or detailing conditions for the future.

Gov. Tony Evers of Wisconsin said on Thursday that golf courses could open with certain restrictions and that for-hire lawn care could be carried out if it was performed by one person. Stores selling materials to make face masks can open for curbside pickup, he said.

In Idaho, Gov. Brad Little has said businesses that were once deemed nonessential, such as craft stores, candle shops or dog groomers, could open to allow for curbside or delivery services until at least the end of the month. He noted that they should prepare to reopen altogether in May with social distancing and sanitation rules in place.

Gov. Gavin Newsom of California has suggested that restaurant patrons would have to submit to having their temperatures taken before being seated once that state begins a gradual reopening.

More than 22 million Americans have lost their jobs in recent weeks — a toll that roughly matches the entire cumulative workforce of 23 states — and many governors, as well as Mr. Trump, fear the mounting economic repercussions of sustained shutdowns.

But tackling the economic catastrophe requires getting a handle on the public health crisis.

Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, told CNN on Thursday night that surveillance to give communities early warning signs of local transmission would need to be enhanced, diagnostic testing capabilities expanded and contact-tracing efforts bolstered.

“Any one piece by itself will not be able to accomplish what we need,” she said.

As the coronavirus continued to inflict a devastating toll on the U.S. economy, President Trump on Thursday proposed lifting restrictions imposed to slow its spread in areas where there are few cases.

The guidelines, outlined in a call with governors and announced in a White House news conference, were billed as a step-by-step approach that depended on complicated public health criteria. It will be up to governors to reopen their states, even as testing kits and protective medical gear remain in short supply.

Read the Guidelines

The Trump administration offered three steps for states to consider as they look at reopening.

The ideas and criteria in the guidance are not new; parts of it were embedded in earlier plans by Dr. Scott Gottlieb, former head of the Food and Drug Administration, and Dr. Tom Frieden, former head of the Centers for Disease Control and Prevention. But those plans were conservative, saying that states could reopen once they had robust testing capacity, enough equipment to protect health care workers and the means to reach out to anyone who was exposed to the virus to warn them to isolate, a process known as contact tracing.

Reopening before those issues are resolved, though, risks endangering the few places that have managed to dodge the virus, and would be accompanied by significant scientific concerns:

Testing is still spotty. Most of the country is not conducting nearly enough testing to track the virus in a way that would allow Americans to return to work safely. Without widespread testing and surveillance, said Angela Rasmussen, a virologist at Columbia University in New York, “we won’t be able to quickly identify and isolate cases in which the patients are presymptomatic or asymptomatic, and thus community transmission could be re-established.”

Waiting periods of 14 days are required. States wishing to loosen rules are asked to meet certain criteria every two weeks. But if someone were infected toward the end of the 14th day, it is possible he or she could seed an outbreak as restrictions were lifted.

Shortages of protective equipment persist. Communities in which restrictions are eased will be at greater risk for outbreaks. Mr. Trump has said that the federal government has distributed millions of masks, gloves and gowns to health care workers, but those on the front lines say they are still put in harm’s way because of shortages of personal protective equipment. “People are still dying,” said Zenei Cortez, president of National Nurses United, the country’s largest nurses’ union. “This is no time pat ourselves on the back and say the emergency is over.”

Piecemeal reopenings are risky. Mr. Trump suggested that the relaxing of restrictions may occur in a fragmented way, even county by county. The notion that some places have a “problem” with the outbreaks while some do not misunderstands the contagious nature of the virus. Even in rural regions where the population is less dense, large clusters of infections — even hundreds in a single workplace — have erupted in states that had seen relatively few cases. Recent history in South Dakota — where hundreds of infections have been traced to a single pork processing plant — shows that a single site can ignite a firestorm of cases.

Stocks in the United States rallied on Friday, with efforts to reopen the economy taking center stage and investors undeterred by more data showing the economic damage of the coronavirus pandemic.

The gains came after President Trump told governors on Thursday that they could begin reopening businesses in their states by May 1 or earlier, and Boeing — one of the nation’s largest manufacturers — said it plans to bring about 27,000 employees back to work in Washington State to resume aircraft production.

The S&P 500 rose about 2 percent in early trading. European markets were also trading 3 to 4 percent higher after an upbeat day in Asia.

After global stock markets nose-dived earlier this year, they have been rebounding since late March, as investors have routinely looked past evidence of the damage caused by stay-at-home orders and business shutdowns, and instead focused on hopes for an eventual recovery.

On Friday, the rally came after China reported that its economy — the world’s second largest — shrank for the first time in decades. And data on car sales in Europe showed they collapsed.

Some also saw hopeful signs in a report by the medical news website STAT that a drug from Gilead Sciences showed early — and, thus far, unproven — promise in fighting the coronavirus. According to STAT, the antiviral drug, remdesivir, has helped patients with severe symptoms recover rapidly in a clinical trial at a Chicago hospital. Gilead’s shares jumped more than 11 percent, making it the best performing stock in the S&P 500.

Still, without data from rigorous trials with control groups, it is impossible to know how effective the drug actually is. The National Institutes of Health is conducting a trial in which patients receive remdesivir or a placebo. The results will be known within weeks.

Coroners in some parts of the United States are overwhelmed. Funeral homes in coronavirus hot spots can barely keep up. Newspaper obituary pages in hard-hit areas go on and on. Covid-19 is on track to kill far more people in the United States this year than the seasonal flu.

But determining just how deadly the new coronavirus will be is a key question facing epidemiologists, who expect resurgent waves of infection that could last into 2022.

As the virus spread across the world in late February and March, the projection circulated by infectious disease experts of how many infected people would die seemed plenty dire: around 1 percent, or 10 times the rate of a typical flu.

But according to various unofficial Covid-19 trackers that calculate the death rate by dividing total deaths by the number of known cases, about 6.4 percent of people infected with the virus have now died worldwide.

In Italy, the death rate stands at about 13 percent, and in the United States, around 4.3 percent, according to the latest figures on known cases and deaths. Even in South Korea, where widespread testing helped contain the outbreak, 2 percent of people who tested positive for the virus have died, recent data shows.

Those supposed death rates also appear to vary widely by geography: Germany’s fatality rate appears to be roughly one-tenth of Italy’s, and Los Angeles’s about half of New York’s. Among U.S. states, Michigan, at around 7 percent, is at the high end, while Wyoming, which reported its first two deaths this week, has one of the lowest death rates, at about 0.7 percent.

Virology experts say there is no evidence that any strain of the virus, officially known as SARS-CoV-2, has mutated to become more severe in some parts of the world than others, raising the question of why there appears to be so much variance from country to country.

On Jan. 24, the eve of the Chinese New Year, Dr. Jian Zhang, the chief executive of San Francisco’s Chinese Hospital, saw an alarming photograph on WeChat. An old medical school colleague was about to join more than 100 other health care providers being rushed to Wuhan to help manage the coronavirus outbreak.

Dr. Zhang immediately recognized the threat.

“Twelve hours,” she recalled thinking. “We have direct flights from Wuhan to San Francisco, and it only takes 12 hours.” She knew those who were visiting family in China during the Lunar New Year would soon be back.

A perfect storm seemed to be headed for the 22 square blocks that make up Chinatown, one of the most densely populated neighborhoods in the United States. Many of the neighborhood’s older residents live in cramped single-room-occupancy hotels. Travel between Chinatown and China is constant.

But Chinatown has thus far held off the virus.

Chinese Hospital, an acute care facility in the heart of the neighborhood, admitted its first Covid-19 patient on March 26, three weeks after patients had been hospitalized in other parts of San Francisco. As of mid-April, at least 34 cases of Covid-19 had been detected in 22 S.R.O.s around San Francisco. None of these cases were within the neighborhood, although three were on its border.

Chinese Hospital was at the center of an effort to coordinate barriers for entry of the virus. These involved almost every major institution in Chinatown, including the Chinese-language press and deeply engaged neighborhood institutions, all of whom were imprinted with memories of earlier infectious disease outbreaks. Deep links to front-line health workers in China were invaluable as Chinese Hospital worked to avoid what everyone thought was coming.

“It’s kind of amazing,” said Aaron Peskin, a San Francisco supervisor who represents the neighborhood. “Chinatown, knock on wood, is looking pretty darn good.”

Israel Sauz of Tulsa, Okla., couldn’t wait to see his first child, a baby boy named Josiah. And he couldn’t wait for the world to see him, too. So he got in close and took a picture for Facebook of his son, fast asleep in a green onesie, shortly after the boy came into the world one Sunday last month.

Just 21 days later, on April 5, Mr. Sauz was dead. He was 22.

The cause was complications related to Covid-19, the disease caused by the coronavirus, according to family friends and the school district where he attended high school.

Many in Tulsa may not have recognized his name, but they knew the smiling face — he was an assistant night manager at a busy QuikTrip gas station and convenience store about a mile east of downtown Tulsa. He was still a teenager when he first started working for QuikTrip, a popular chain based in Tulsa.

He lived in the Tulsa suburb of Broken Arrow. He and his wife, Krystal, had celebrated their first wedding anniversary two weeks before Josiah was born.

Berna Lee got the call from the nursing home in Queens on April 3: Her mother had a fever, nothing serious. She was assured that there were no cases of coronavirus in the home. Then she started calling workers there.

“One said, ‘Girl, let me tell you, it’s crazy here,’” Ms. Lee said. “‘Six people died today.’”

In a panic, Ms. Lee drove from her home in Rhode Island to the nursing home, beginning a two-week scramble for information, as workers at the facility, Sapphire Center for Rehabilitation and Nursing of Central Queens, told her privately that many residents had died, and that most of the home’s leadership was out sick or in quarantine.

Finally, she banged on her mother’s first-floor window to see if she was OK. It was unclear whether her mother understood what was happening, Ms. Lee said.

“I didn’t know how bad it was,” she said. “People told me bodies were dropping.”

The crisis at Sapphire highlighted the desperate state of nursing homes in the New York region and illustrated what relatives of residents said was a deeply troubling lack of information about what was going on inside the homes.

The $349 billion government program meant to keep small businesses afloat during the pandemic and economic meltdown ran out of money on Thursday, even as many small-business owners were desperately trying to apply for loans. Now they are trying to figure out how to keep their businesses alive while Congress negotiates the possible release of additional rescue funds.

Doug Martin, a sports marketer in Long Beach, Calif., approached three banks to try to get a loan through the program. Each turned him down for different reasons. As a last resort, he tried a fourth bank with the help of his financial adviser, but didn’t hear back.

“This morning, I read that the money’s gone, and I’m like, heck, I didn’t even get a shot at this,” Mr. Martin said.

The program, administered by the Small Business Administration through participating banks, was marred by technical glitches from the start, and overwhelming demand and confusion about how it would all work slowed down the approval process. Around the country, would-be borrowers were turned away by banks because there were too many applicants. Some lost valuable time because their bankers didn’t know all the details about how the program would work, while others couldn’t find a lender that would deal with them.

More money is expected to come, but when is an open question. Congressional leaders and the Trump administration were discussing adding hundreds of billions of dollars to replenish the program, but have so far failed to reach an agreement.

If your income has fallen or been cut off completely, we’re here to help. Here is some basic information you’ll need to get through the current crisis, including guides to government benefits, free services and financial strategies.

Face masks have become an emblem in the fight against the coronavirus, with officials in the United States and elsewhere recommending — and in some cases mandating — that people wear them to help slow the spread of the deadly outbreak.

Figuring out what to wear is not so easy. N95 and medical masks, which offer the most protection and are heavily in demand, should be reserved for health care workers who are regularly exposed to infected patients.

Here’s a look at some of the types of masks you might encounter, how they work, what to consider when making your own and the level of protection they could provide.

For students in the class of 2020, the coronavirus crisis arrived just as they were receiving college acceptance letters, dreaming about new jobs, gearing up to leave high school — and making plans for prom, which, for most students, has been canceled.

We photographed 10 students from Omaha in the outfits they had planned to wear to the dance. They talked to us about their prom dreams, hopes and disappointments.

The cultural rite of passage, which they’ve largely experienced through movies and television shows, books and Mom’s old photographs, was their chance to feel like adults — or at least like they were on the brink of adulthood — for the first time.

Now, it feels like high school is ending on a whimper.

The Bureau of Prisons is putting a field hospital inside a penitentiary in California that has more inmates with confirmed cases of the coronavirus than any other federal prison.

Sixty-nine inmates and 22 staff members at the penitentiary, Lompoc, which is near Santa Barbara, have the coronavirus, according to the bureau. The prison houses about 1,500 male inmates in a medium-security penitentiary and adjacent minimum-security satellite camp.

A spokeswoman for the bureau said the prison was reaching a contract for additional medical staff and a 25-bed mobile hospital that could be expanded up to 100 beds. She added that prison employees were retrofitting unused office space to create isolation rooms for inmates with the most serious coronavirus cases.

The virus is spreading rapidly in prisons and jails across the country, and critics say efforts to release people are happening too slowly. Hundreds of inmates have been infected at a jail in Chicago and 18 federal inmates have died.

Follow updates on the coronavirus pandemic from our international correspondents.

Reporting was contributed by Kate Taylor, Marc Santora, Matt Stevens, John Leland, Amy Julia Harris, Tracey Tully, Michael Cooper, Emily Flitter, Roni Caryn Rabin, Knvul Sheikh, Manny Fernandez, Adeel Hassan, Peter Baker, Alyson Stamos and Meiying Wu.

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