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Coronavirus Live Updates: State Dept. Expected to Warn Against International Travel - The New York Times

Credit...Kyle Grillot for The New York Times

The State Department is preparing to announce that American citizens abroad should either return home or stay in place as the new coronavirus pandemic grows, American officials said.

The department plans to raise to level four its global travel advisory. Officials did not give an exact time on when this would happen, but said it is imminent. Level four is the top-tier warning, usually reserved for nations with war zones or beset by serious disruptions.

The global advisory is now at level three. The announcement would be a recommendation, not a requirement. Millions of Americans are still overseas, and many would likely choose to remain in place.

Some tourists or American citizens without long-term living arrangements or support networks abroad have been trying to get back to the United States, but have found that difficult because of border closings or the cutting of flight routes and other transportation shutdowns.

President Trump, asked during a briefing on Thursday about Americans stranded abroad and trying to re-enter the United States, said that the administration is working with the military to get them home.

The State Department used five charter flights sent from the United States to evacuate American citizens from Wuhan, China, the epicenter of the outbreak, but has no plans at the moment to run similar evacuation flights elsewhere. American diplomats who have returned to the United States from countries where large outbreaks have occurred have done so mostly on commercial flights.

Politico first reported the State Department’s plans on Thursday.

Some other countries have already issued travel advisories telling their citizens to return home or not go abroad. Canada did so last Friday, as Prime Minister Justin Trudeau was in a 14-day period of self-quarantine because his wife, Sophie Trudeau, had tested positive for the new coronavirus. Canada and many other countries have also closed borders to nonessential traffic in an effort to limit the spread of the virus.

Mr. Trump, whose administration has been under immense pressure to increase testing capacity as cases of cases of coronavirus soar in the United States, said on Thursday that his administration had “slashed red tape” to develop vaccines and therapies “as fast as it can possibly be done” and scaling access to treatments that had shown promise, despite the fact that many of the treatments are in their early stages.

Mr. Trump, flanked by Dr. Stephen Hahn, the Food and Drug Administration commissioner; Dr. Deborah Birx, the White House coronavirus response coordinator; and Jerome Adams, the surgeon general, repeated an announcement from earlier this week that human testing on a vaccine trial had begun, and said that the government would be pursuing more antiviral therapies to treat the virus.

“Essentially we’re looking at things to make people better, or at the earliest stages they didn’t even know they had it,” Mr. Trump said. “I’ve directed the F.D.A. to eliminate outdated rules and bureaucracy so this work can proceed rapidly, quickly, and I mean fast.”

Mr. Trump said that the F.D.A. had approved “compassionate use” for a number of patients, which is the approval for ill patients to use a drug that has not yet been approved by the F.D.A. Compassionate use is typically used to grant access to not-yet-approved experimental drugs to give potentially lifesaving treatments to patients who might otherwise die.

After the president spent a significant of time extolling the virtues of treatments for the disease and declaring that his administration had slashed regulatory tape surrounding treatment testing, Dr. Hahn took the stage and gently couched Mr. Trump’s assertions.

“What’s also important is not to provide false hope,” he said. “We may have the right drug, but it might not be in the appropriate dosage form right now, and it might do more harm than good.”

There is no proven drug treatment for the new coronavirus, and doctors around the world have been desperately testing an array of medicines in hopes of finding something that will help patients, especially those who are severely ill. Several antiviral drugs have been considered possible treatments, though so far none has proved effective.

During the briefing, the president and Dr. Hahn said that the F.D.A. had approved the use in coronavirus patients of the prescription drugs chloroquine and hyroxychloroquine, which are normally used to treat rheumatoid arthritis.

There have not been clinical trials to determine whether those drugs actually work for the disease, and Dr. Hahn did not explain why the F.D.A. is supporting their use, nor he did not explain whether today’s action was actually a formal approval of the drug for this new use. Dr. Hahn said that the president had directed the F.D.A. to look at available malaria treatments including chloroquine, but again reiterated that experts would be doing this within the context of a clinical trial.

Doctors in China and France have said there were indications they might help, and many hospitals in the United States had already begun using them. The drugs are inexpensive and relatively safe. Because they were already approved for other illnesses, doctors in the U.S. were free to use them in an “off-label” way based on their own judgment.

“We know that if things don’t go as planned it’s not going to kill anybody,” Mr. Trump said. “When you go with a brand-new drug you don’t know if that’s going to happen.”

Dr. Hahn also said the F.D.A. was considering the use of “convalescent plasma,” meaning blood from people who have recovered from the disease, which contains antibodies against the coronavirus that might be able to help other patients fight the disease.

Mr. Trump and Dr. Hahn also said they planned to allow patients to gain access to an experimental antiviral drug, remdesivir, through compassionate use. The agency will be able to collect data about how well it works. Dr. Hahn said that remdesivir is undergoing clinical trials in the United States, but warned that the trials were in early stages.

“What we really need to do is understand what the data and science are in order to make the appropriate decisions about safety and effectiveness,” Dr. Hahn said.

Mike Pence, the vice president, said that he and the president would meet by teleconference with the nation’s governors later Tuesday at FEMA headquarters, and said the organization would “take the lead” in the nation’s coronavirus response.

Mr. Pence said that testing is available in all 50 states, and “tens of thousands of tests” are being performed every day, despite widespread reports that Americans are struggling to access testing. Mr. Pence said companies including Honeywell and 3M would increase “by the millions” the number of available N-95 masks for health care workers, and said that the government was working to increase the number of ventilators that could be stockpiled to assist the patients with severe cases of the virus.

“We’ve identified tens of thousands of ventilators that can be converted to treat patients,” Mr. Pence said.

Dr. Birx said that a large backlog of pending tests would be released in the next two to three days. She said that 50 percent of reported coronavirus in the United States have come from 10 counties, and praised health care workers for prioritizing available tests for people who show symptoms, adding that the number of positive results had increased as a result.

Mr. Trump did not commit to a suggestion that he could prevent corporate executives from receiving bonuses and from allowing stock buybacks should his administration’s massive relief package be approved by Congress.

“As far as I’m concerned, conditions like that would be OK with me,” he said.

The president punted to Mr. Pence when asked if it was acceptable that current guidelines for health care workers include reusing masks. “We’re seeing a dramatic increase in production” of masks, Mr. Pence said, though he did not directly respond to a question from the president about when the masks would be in the hands of workers.

When asked when he could expect American lives to go back to normal, the president said, “I would hope very soon.” Mr. Trump blamed China for not sharing information with the public on the virus. The virus, he said, “could have been stopped easily if we had known and if everybody had known about it a number of months before people started reading about it.” Two days ago, Mr. Trump said that he had known that the coronavirus would become a pandemic all along.

Mr. Trump also said that he had signed into law a congressional relief package to help American workers, families and small businesses, which includes sick leave and medical leave for those affected by the virus. He also said that a $1 trillion stimulus package would be enough if “we can stop it in its tracks,” he said of the virus. If not, he said, negotiations on a higher amount could continue. Earlier, the president was wistful about the state of the economy, again saying that he thinks the economy will go up very rapidly.

Mr. Trump also said that he would use the Defense Production Act only if needed. On Wednesday, Mr. Trump invoked the Korean-era law, which authorizes a president to take extraordinary action to force American industry to ramp up production of critical equipment and supplies such as ventilators, respirators and protective gear for health care workers. When asked why he hadn’t yet compelled companies to do this, the president told reporters, “You don’t know what we have done.”

Mr. Trump, who dined with several people at Mar-a-Lago, his Palm Beach, Fla., club, who later tested positive for the coronavirus, said he was tested for Covid-19 because the press was “going crazy.”

The president’s grievances with the media were a significant theme of a briefing that lasted over an hour. Mr. Trump praised a reporter from One America News Network for treating him “very nicely.” That reporter suggested that American journalists have “teamed up” with the Chinese Communist Party to criticize the president.

The United States ran a detailed exercise testing the federal government’s response to a fictional respiratory virus for nine months last year. The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.

That scenario, code-named “Crimson Contagion,’’ was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August.

In the scenario, the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead. It was not the first time in recent years that the government had studied its capacity for dealing with a pandemic.

The draft report, marked “not to be disclosed,” laid out in stark detail repeated cases of “confusion” in the exercise. Federal agencies jockeyed over who was in charge. State officials and local hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own way on school closings.

The number of deaths in Italy soared to 3,405 on Thursday, outstripping the death toll in China, which reported its first day with no new locally transmitted coronavirus infections. The march of the affliction gathered pace as nations throughout the world braced for a surge of infections and, ultimately, deaths.

For the Fusco family in Freehold, N.J., the dangers of the virus and its pernicious exploitation of human connection were laid bare when Grace Fusco, 73, died Wednesday night, hours after her son and five days after her daughter. Four other family members are hospitalized, three of them in critical condition, from an infection traced to a routine family gathering.

No one is safe.

Two members of Congress tested positive and were in isolation on Thursday. While older people remain at gravest risk worldwide, a C.D.C. report found that 38 percent of those who required hospitalization in the U.S. were aged 20 to 54. The number of known cases in the United States soared past 10,000 on Thursday as testing expanded and the virus spread.

Mr. Trump signed a relief package to provide sick leave, unemployment benefits and free coronavirus testing, and lawmakers were drafting an even more sweeping $1 trillion economic stabilization package.

But even as the federal government invoked wartime powers to speed the production of surgical masks, protective body suits, testing kits and, especially, ventilators, essential medical equipment remained in short supply.

World leaders escalated pleas to the only ones who can ultimately help buy time: everyone.

“It’s down to each and every one of us,” Chancellor Angela Merkel of Germany said in a televised address. “We are not doomed to helplessly watch the spread of the virus. We have a means to fight it: we must practice social distancing.”

Failure to do so could result in even more stringent lockdowns that Germany has so far avoided, she said. “We are a democracy. We don’t live by force, but by shared knowledge and cooperation.”

In California, more than nine million people have been told not to leave their homes. Gov. Andrew M. Cuomo of New York resisted taking such a drastic step, even as he ordered businesses to compel employees to work from home.

In Spain, violations of isolation orders are enforced with fines. Russia is using facial-recognition technology to track down and fine people who violate mandatory quarantines. Beaches in Barcelona are closed, but many Americans were heading to sandy shores for Spring Break.

Even as nations wrestled with a public health emergency, the economic crisis grew darker. Overnight, the European Central Bank introduced a huge bond-buying program aimed at preventing economic calamity.

The volatile markets only added to the deepening anxiety felt by people increasingly cut off from their support networks.

But, as Ms. Merkel said, even as a society in isolation, “we will show that we are there for one another.”

Senate Republicans racing to agree on a $1 trillion economic rescue package to prevent the country from teetering into economic collapse could have a draft ready as early as Thursday.

The majority leader, Senator Mitch McConnell of Kentucky, said that his party was near a deal with the White House that would be the starting point for negotiations with Democrats.

The Trump administration’s proposal includes $500 billion for two waves of direct payments to taxpayers and an additional $500 billion in loans for businesses. Speaker Nancy Pelosi has told colleagues that she is aware of concerns about including provisions on unemployment insurance, increased Medicaid funding and further assistance to small businesses.

Treasury Secretary Steven Mnuchin said that the economic relief plan included payments of $1,000 for American adults and $500 per child sent within three weeks. It is not clear if Americans of every income bracket will be eligible for the payments or how they will be disbursed to those who do not have bank accounts. The Trump administration has proposed sending $500 billion directly to Americans in two waves.

“What we’re really focused on is providing liquidity to American businesses and American workers,” Mr. Mnuchin said on the Fox Business Network on Thursday. “This is an unprecedented situation.”

Mr. Mnuchin insisted that the Treasury and the Federal Reserve were working in lock step and were prepared to do whatever was necessary to provide liquidity to American companies so that they can weather the crisis without laying off workers.

He said that businesses that take advantage of emergency loans would be given loan forgiveness if they cannot pay them back.

He also suggested that the federal government was open to taking equity stakes in companies.

A new study reports that people who became sick with Covid-19 in Wuhan, the Chinese city where the outbreak began, had a lower death rate than previously thought.

The study, published Thursday in the journal Nature Medicine, calculated that people with coronavirus symptoms in Wuhan had a 1.4 percent likelihood of dying. Some previous estimates have ranged from 2 percent to 3.4 percent.

Assessing the risk of death in Wuhan is instructive because it provides a snapshot of the epidemic from the beginning, when doctors were scrambling to treat people with a brand-new virus and hospitals were overwhelmed.

Some experts say that such a benchmark — known as the case fatality rate — could be lower in countries like the United States if measures like widespread business and school closures and appeals for social distancing have the desired effect of slowing the spread of the disease.

But a 1.4 percent case fatality rate still means a lot of deaths. By comparison, the average seasonal flu kills about 0.1 percent of the people it infects in the United States.

Also, on Thursday, China reported no new local infections for the previous day for the first time since the coronavirus crisis began, a milestone in its costly battle with the outbreak that has since spread around the world.

Officials said 34 new coronavirus cases had been confirmed, all of them involving people who had come to China from elsewhere.

In signaling that an end to China’s epidemic might be in sight, the announcement could pave the way for officials to focus on reviving the country’s economy, which nearly ground to a halt after the government imposed travel restrictions and quarantine measures. In recent days, economic life has been resuming in fits and starts.

But China is not out of danger. Experts have said that it will need to see at least 14 consecutive days without new infections for the outbreak to be considered over. It remains to be seen whether the virus will re-emerge once daily life restarts and travel restrictions are lifted.

“It’s very clear that the actions taken in China have almost brought to an end their first wave of infections,” said Ben Cowling, a professor and head of the division of epidemiology and biostatistics at Hong Kong University’s School of Public Health. “The question is what will happen if there’s a second wave, because the kind of measures that China has implemented are not necessarily sustainable in the long term.”

To contain the outbreak, the authorities shut schools and workplaces, imposed travel restrictions, and ordered quarantines on broad swaths of the population and many visitors from abroad. Since January, more than 50 million people in the central province of Hubei, including its capital, Wuhan, where the outbreak began, have been subjected to a strict lockdown.

American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 cases in the United States.

The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients were at greatest risk of becoming seriously ill or dying. But of the 508 coronavirus patients known to have been hospitalized in the United States, 38 percent were between 20 and 54. And nearly half of the 121 sickest patients studied — those admitted to intensive care units — were adults under 65.

“I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University. “It’s not just going to be the elderly.”

Dr. Deborah Birx, coordinator of the Trump administration’s coronavirus task force, appealed on Wednesday for younger people to stop socializing in groups and to take care to protect themselves and others.

“You have the potential then to spread it to someone who does have a condition that none of us knew about, and cause them to have a disastrous outcome,” Dr. Birx said.

In the C.D.C. report, 20 percent of the hospitalized patients and 12 percent of the intensive care patients were between the ages of 20 and 44, basically spanning the millennial generation.

Stocks were volatile on Thursday as policymakers in the United States and Europe took more steps to offset the sharp decline gripping their economies.

The S& P 500 climbed into positive territory after earlier having fallen more than 3 percent, but it struggled to hold onto those gains. Shares in Europe also recovered after trading lower for most of the day. Oil prices, which had fallen by more than 20 percent on Wednesday, rebounded on Thursday.

The uneven trading followed a steep drop across financial markets on Wednesday and came as the steady drumbeat of bad news about the spread of the coronavirus continued. Speaking at a White House press briefing, Mr. Trump acknowledged that the economy would experience a rapid fall before it climbs back. He also praised efforts to speed up the approval of potential treatments for Covid-19, the illness caused by the new coronavirus.

“I believe in the V curve,” Mr. Trump said, referring to how some economists describe a sharp falloff and rebound in economic growth. “When this is defeated, this hidden scourge is defeated, I think we’re going to go up very rapidly.”

In the United States, the number of workers filing first-time claims for unemployment insurance surged, government data released on Thursday showed. Those figures don’t reflect the sharp cuts made in the past few days as companies quickly scale down operations as efforts to contain the coronavirus keep consumers at home and force factories to close.

Gov. Andrew M. Cuomo of New York on Thursday waived mortgage payments for 90 days for people facing hardship and ordered businesses to keep 75 percent of workers home.

Earlier in the day, he warned that the fight to control the spread of the coronavirus risked also spreading other contagions: fear and panic.

“We are battling two things,” Mr. Cuomo said on CNN. “And I am as afraid of the fear and panic as I am of the virus.”

While he said that it was necessary for the government to act with the urgency of a nation at war when it came to manufacturing critical supplies like ventilators, he said that people needed to be given better guidance.

“I spend half my day knocking down rumors that we are going to lock people in their homes,” he said, noting that New York City seemed to be at “near panic levels.”

“I am not going to imprison anyone in the state of New York in their homes,” he said. “I am not going to declare martial law in the state of New York.”

He was critical of the term “shelter in place.”

“Do you know where that came from: nuclear war,” he said. “You go into a room with no windows until you get an all clear sign.”

That was not what was called for to fight the virus, he said.

At the same time, public health officials expressed growing alarm that the coronavirus was spreading quickly in tightly knit Hasidic Jewish communities in Brooklyn, saying that they were investigating a recent spike in confirmed cases.

More than 100 people have recently tested positive for the coronavirus in Borough Park and Williamsburg, two Brooklyn neighborhoods with sizable Hasidic populations.

Across the state, the number of new infections continued to grow exponentially, something health officials said to expect across the nation as testing increases.

Of the 14,597 people to be tested so far, nearly 5,000 were tested on Tuesday, helping explain why the number of new cases jumped for 1,000 in just 24 hours to 2,382 people.

Hundreds of doctors, nurses and others are rallying on social media with the hashtag #GetMePPE, begging for public help with an acute shortage of personal protective equipment like masks, gowns and face shields at hospitals and medical offices.

“The situation is terrible, really terrible,” said Dr. Niran Al-Agba, a pediatrician in Washington State who is treating her patients at curbside. “I don’t think we were prepared.”

Someone anonymously left two boxes of masks on her doorstep, and she has been spraying them with alcohol to make them last.

“After practicing for 20 years and being a third-generation doctor, I can tell you this is new territory,” Dr. Al-Agba said. “I don’t know if we’ve ever had to go to work and fear for our lives in the same way. “

On Feb. 23, Jason Horowitz, The Times’s bureau chief in Rome, was driving with a photographer for an assignment about the effects of global warming and his family for a vacation at a ski lodge.

Then an editor called, telling him about the coronavirus outbreak in the northern region of Lombardy and ordering to get to the area as soon as possible.

He kissed his family goodbye and left them under the Matterhorn, he writes in a first-person account. It was the last time he would touch them for a month, he said.

“I had to cover Italy’s coronavirus outbreak,” he wrote. “All I had was a ski mask.”

The situation changed rapidly, with thousands dead and the movements of 60 million people restricted. But, he writes, “I’ve been lucky. I am not sick. My family in Rome is not sick either.”

Editors in London immediately provided a supply of masks and hand sanitizer for Mr. Horowitz; Andrea Mantovani, the photographer; and Emma Bubola, another reporter based in Rome.

“Friends and family back in the United States or around Europe check in with me, asking how we’re doing,” he writes. “They sign off ‘Stay safe’ — the ‘Sincerely’ of the coronavirus age. But in some notes I detect a hint of appeal, a search for insights and instructions from my experience reporting on the front line of a crisis that is coming to them.”

Congressional leaders are under mounting pressure to rethink their plans to bring the House of Representatives back to Washington, after two lawmakers reported testing positive for the virus.

In back-to-back statements on Wednesday, Representative Mario Diaz-Balart, Republican of Florida, and Representative Ben McAdams, Democrat of Utah, both announced that they had fallen ill after voting on the House floor early Saturday, and subsequently tested positive for the virus.

Soon after, Representative Steve Scalise, the No. 2 Republican, and Representative Drew Ferguson, his top deputy, said they would self-quarantine.

The news stoked anxiety that has been building among the 435 members of the House for days about the wisdom of gathering — in defiance of public health guidelines that warn against meetings of 10 people or more — to debate and vote in the House chamber.

Speaker Nancy Pelosi has said that the House would return to Washington to consider additional economic relief legislation, and the Senate is in talks with the White House on a $1 trillion plan that could be approved within days.

Ms. Pelosi and other top Democrats have discussed instituting social distancing to limit the number of lawmakers on the House floor at one time, but resisted the idea of allowing members to vote remotely. News of the virus’s spread among lawmakers has fueled calls for her to change course.

“In. Person. Voting. Should. Be. Reconsidered,” Representative Debbie Mucarsel-Powell, Democrat of Florida, wrote on Twitter on Wednesday. “For the safety of our communities, during this emergency, we must be able to legislate from our districts.”

At 93 years old, Queen Elizabeth II has lived through the Great Depression and World War II. But the spread of the coronavirus has presented a challenge unlike any other that she or her nation have faced during her 68 years on the throne.

The queen’s age puts her squarely in the high-risk category, and the palace is moving to ensure she is isolated.

A planned visit by the emperor and empress of Japan was postponed “in the current circumstances,” Buckingham Palace said on Thursday.

The palace announced this week that, “as a sensible precaution,” several changes would be made to the queen’s schedule, and that she and her husband, Prince Philip, would move to Windsor Castle.

Initially reluctant to impose widespread restrictions on Britain, Prime Minister Boris Johnson said that schools would close beginning Friday. He has also ordered 20,000 members of the military be put on standby to assist in the days ahead.

London has been the center of the outbreak in Britain, with more than one-third of the country’s 2,626 confirmed cases. By Wednesday, at least 103 coronavirus patients had died.

Train services will also be curtailed this week, with some 40 tube stations across the city closing to limit the number of people moving around the city.

The country’s national health service, already strained, is bracing for an influx of patients. With new cases mounting daily, many have criticized Mr. Johnson for being slow to implement the stringent measures seen across much of Europe.

Prince Albert II of Monaco on Thursday tested positive for the new coronavirus, the palace said in a statement, adding that the prince’s health condition was not worrying and that he would continue to work from his private apartment.

In Georgia, all members of the state legislature were asked to self-quarantine on Thursday after a state senator who voted at the Capitol this week tested positive for the coronavirus.

The senator, Brandon Beach, a Republican from the Atlanta suburbs, began experiencing symptoms last week and was tested over the weekend. Feeling better, he participated in a vote at the Capitol on Monday during a special session to ratify the governor’s order for a public health emergency. By Wednesday, he said, his results had come back positive.

“I felt better by Monday and thought I was in the clear,” Mr. Beach told The Atlanta Journal-Constitution.

“I know many Georgians are praying hard as we weather this crisis together,” he added. “Frankly, I’d ask that they pray for me, as well as all the others in our state who are going through this right now — and those who soon will.”

The announcement set off a chain of events in the Georgia General Assembly. The lieutenant governor, who also serves as president of the Senate, announced that he would self-quarantine, and lawmakers and staffers of the House and the Senate were asked to do the same until March 30.

State Representative Scot Turner, a Republican, condemned Mr. Beach for “irresponsibly” going to the Capitol and exposing others.

“I’m shaking with rage,” Mr. Turner said in a statement on Facebook, adding that he shared a home with a hospice patient. “I cannot remember the last time I’ve been this angry.”

The Georgia General Assembly had previously suspended the 2020 legislative session because of the virus.

Reporting and research were contributed by Michael Cooper, Katie Rogers, Elisabetta Povoledo, Niki Kitsantonis, David E. Sanger, Eric Lipton, Eileen Sullivan, Michael Crowley, Aurelien Breeden, Javier C. Hernández, Alisa Dogramadzieva, Marc Santora, Megan Specia, Melissa Eddy, Lara Jakes, Ana Swanson, Nicholas Fandos, Emily Cochrane, Megan Twohey, Steve Eder, Mariel Padilla and Marc Stein.

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