New York Appears to Be Past the Plateau of Virus Cases, Cuomo Says – The New York Times

Facing criticism, President Trump both defended current testing capacity and promised to facilitate more.

President Trump on Sunday said the administration was preparing to use the Defense Production Act to compel an unspecified U.S. facility to increase production of test swabs by over 20 million per month.

The announcement came during his Sunday evening news conference, after he defended his response to the pandemic amid criticism from governors across the country claiming that there has been an insufficient amount of testing to justify reopening the economy any time soon.

We are calling in the Defense Production Act, Mr. Trump said. He added, Youll have so many swabs you wont know what to do with them.

He provided no details about what company he was referring to, or when the administration would invoke the act. And his aides did not immediately respond when asked to provide more details.

We already have millions coming in, he said. He added, In all fairness, governors could get them themselves. But we are going to do it. Well work with the governors and if they cant do it well do it.

Public health experts have said testing would need to at least double or even triple to justify even a partial reopening of the countrys economy, and business leaders reiterated that message in a conference call with Mr. Trump last week.

Seema Verma, the Medicaid and Medicare administrator, also announced on Sunday night that the administration was set to release guidelines for reopening the health care system to allow for elective procedures and surgeries.

Not everything can be addressed by telehealth, she said. Maybe a woman who needs surgery for breast cancer. Somebody who has cataracts in their eyes, and sometimes the doctor needs to be able to listen to their patients heart.

She cautioned that every state and local official would have to assess the situation on the ground before reopening.

Those state and local officials have been struggling to balance restrictions meant to curb the spread of the coronavirus against economic damage.

In Maryland and Virginia, governors said stay-at-home orders would remain in effect until they see decreases in the number of Covid-19 cases. And elsewhere in the nation, state officials said were seeking far more testing before easing restrictions, but continue to face shortages of supplies and testing kits.

We are fighting a biological war, Gov. Ralph Northam of Virginia said on the State of the Union program on CNN. He added that governors have been forced to fight that war without the supplies we need.

Mr. Northam, a Democrat, said that Virginia lacked enough swabs for the amount of testing needed.

Gov. Gretchen Whitmer of Michigan, another Democrat, said her state would like to double or triple the current number of tests if we had the swabs or reagents.

And Gov. Larry Hogan, a Maryland Republican, said Its not accurate to say theres plenty of testing out there and the governors should just get it done.

Dr. Deborah Birx, the coronavirus response coordinator for the White House, pushed back against criticism that not enough people were being tested, saying Sunday morning that not every community required high levels of testing. She said on the CBS program Face the Nation that the government was trying to predict community by community the testing that is needed.

There are currently about 150,000 diagnostic tests conducted each day, according to the Covid Tracking Project. Researchers at Harvard estimated last week that in order to ease restrictions, the nation needed to at least triple that pace of testing.

More than 2,000 people gathered at the State Capitol to challenge Washington States stay-at-home mandates. Organizers touted that the gathering was on the anniversary of the shot heard round the world that triggered the Revolutionary War.

The event drew some far-right groups, including the Three Percenters militia, named after the supposed fraction of colonists who took up arms during the war. With signs and speeches, the attendees called on the governor to lift the mandates.

We will not tolerate this as the new normal, said Tyler Miller, who led the gathering. He likened the group to the minutemen.

The Washington State Patrol estimated that 2,500 people attended the gathering. Few attendees wore masks, and many gathered tightly around speakers against the guidance of public health officials who recommend a six-foot distance to limit the spread of the virus.

At least three Republican state lawmakers participated in the events, including Representative Robert Sutherland, who called for revolution if the governor didnt lift mandates. He later said that a violent revolution was not the intention Sunday but that the people have a moral obligation to fight back against abusive government.

Gov. Jay Inslee said that while these have been difficult and frustrating times, he said now was not the time to stop progress in combating the virus.

I support free speech, but crowd counts or speeches wont determine our course, Mr. Inslee said. This isnt about politics. It can only be about doing what is best for the health of all Washingtonians.

The Washington protest is one of several rallies by people opposed to mandatory social distancing. In Denver on Sunday, two health care workers blocked the cars of protesters who had converged on the State Capitol to challenge stay-at-home orders, according to the photojournalist Alyson McClaran, who posted images of the exchange on social media. The workers wore scrubs and N95 masks.

They were blocking the roads until the police force stepped in, Ms. McClaran said. People were putting their cars right up against them.

President Trump on Sunday night again defended protesters in Michigan, Minnesota and Virginia, who have been protesting stay-at-home orders, even as the Democratic governors of those states have been receiving death threats.

They have got cabin fever, Mr. Trump said, denying that he was inciting violence by offering them support online. They want their life back. Their life was taken away from them.

Peter Navarro, the hawkish White House trade adviser, accused China on Sunday of profiting off the coronavirus pandemic by hoarding global supplies of personal protective equipment and selling them at exorbitant prices around the world.

President Trump has put Mr. Navarro, the author of Death by China, in charge of streamlining Americas medical supply chain as the federal government works to distribute masks, medicines and ventilators across the country. The comments, made on the Fox Business Network, represent the latest escalation in the Trump administrations efforts to publicly blame China for the health crisis that has caused thousands of deaths and is crippling the world economy.

China is sitting on that hoard of P.P.E., where it cornered the market, and its profiteering, Mr. Navarro said. I have cases coming across my desk where 50-cent masks made in China are being sold to hospitals here in America for as much as $8.

Mr. Navarro also attempted to stir allegations that China lied about the origins of the coronavirus, which was discovered in Wuhan in December. Health experts have said the virus likely jumped from an animal to a human in a market, but he stoked speculation on Sunday that the virus actually originated in a laboratory.

What we know is that the ground zero for this virus was within a few miles of that lab, Mr. Navarro said of a research lab in Wuhan that studies infectious diseases. If you simply do an Occams razor approach that the simplest explanation is probably the most likely, I think its incumbent on China to prove that it wasnt that lab.

Mr. Trump has also raised the possibility that the origins of the virus in China were not mere happenstance. He suggested that if an investigation found that China has not been forthright with the world, it could face punishment.

A mistake is a mistake, Mr. Trump said at a news conference on Saturday. But if it were knowingly responsible, yeah, then there should be consequences.

Asked on the CBS program Face the Nation on Sunday about the possibility that the virus was the result of a lab accident, Dr. Deborah Birx, the White Houses coronavirus response coordinator, was much more cautious.

I dont have any evidence that it was a laboratory accident, she said. I also dont know precisely where it originated.

The United States has seen a rollout of blood tests for coronavirus antibodies in recent weeks. The tests, which are meant to detect past exposure and possible immunity, not current cases of Covid-19, have been widely heralded as crucial tools in assessing the reach of the pandemic in the United States.

But for all their promise, the tests are already raising alarms. Officials fear the effort may prove as problematic as the deployment of earlier diagnostic tests.

Criticized for a tragically slow and rigid oversight of those tests months ago, the federal government is now faulted by public health officials and scientists for greenlighting the antibody tests too quickly and without adequate scrutiny.

Tests of frankly dubious quality have flooded the American market, said Scott Becker, executive director of the Association of Public Health Laboratories.

Twenty-five youths who are being held at a juvenile detention center in Virginia have tested positive for the coronavirus, officials at the facility recently confirmed.

The outbreak at the Bon Air Juvenile Correctional Center in Richmond is the largest at a youth detention facility in the country, according to criminal justice watchdogs, who have called on the Virginia governor, Ralph S. Northam, to release people from the center to further prevent the spread of the virus.

Dr. Christopher Moon, the chief physician for the Virginia Department of Juvenile Justice, said in a statement on Friday that 21 of the 25 youths who tested positive for the virus did not show any symptoms. He said that the other four people had symptoms no more severe than a cold or flu.

Any resident who tested positive was immediately placed in medical isolation, Dr. Moon said, adding that 13 of the residents were no longer in isolation.

He said that the correctional center, which serves male offenders usually between the ages of 14 to 20 and has a capacity for 284 people, was following the guidelines of the state health department.

Liz Ryan, the chief executive of the Youth First Initiative, a group opposed to juvenile incarceration, called on Mr. Northam on Thursday in a phone message to release the residents at the center. She posted a video on Twitter of her leaving the voice mail for Mr. Northam.

It is really urgent, Ms. Ryan said. Young people are at heightened risk of getting Covid-19 or being exposed to it. Our young people can be safely served in their communities.

A spokeswoman for Mr. Northam said the governor had called on the Department of Juvenile Justice to look at release options for certain offenders.

Many of these children have determinate sentences that cannot be altered by the Department of Juvenile Justice, Alena Yarmosky, Mr. Northams spokeswoman, wrote in an email on Sunday. But she said that Mr. Northam has directed the department to continue to carefully review all cases and release individuals who are eligible, have safe home plans and do not pose a threat to public safety.

Medical officials with the juvenile justice system said that Bon Air residents are screened for the virus twice each day and that anyone who tests positive is placed in isolation in the central infirmary or an alternate medical unit on campus.

All residents must wear masks when outside their rooms and staff members must also wear masks inside the living units or when interacting with residents, officials said.

A month after the Trump administration recommended that all elective medical care be put on hold nationwide because of the coronavirus, it issued guidance Sunday for how hospitals and doctors offices could start offering such care again as part of a phased reopening of the country.

The new guidance, issued by the Centers for Medicare and Medicaid Services, applies only to medical providers in communities that have relatively low and stable numbers of coronavirus cases and otherwise meet the conditions for entering Phase One of a national reopening plan. It says that before resuming nonessential care, medical providers should make sure that they can still address surges of coronavirus patients, screen patients and health care workers for the virus, have appropriate cleaning in place and observe social distancing inside their facilities.

Every state and local official has to assess the situation on the ground, said Seema Verma, the C.M.S. administrator. This wont be like a light switch. It will be like a sunrise, where it will be a gradual process. Health care systems need to decide what services should be made available.

The recommendations to delay all nonessential medical, surgical, and dental procedures, issued on March 18, effectively froze all but the most urgent care as the pandemic took hold. The financial toll on physician practices and many hospitals has been significant, although some have continued conducting appointments by phone or videoconference.

A coalition of physician groups on Friday announced that it, too, was releasing a roadmap for how to resume elective procedures, noting in a statement that patients pent-up demand to resume their elective surgeries will be immense.

Ms. Verma also announced a new requirement that nursing homes inform patients and their families if there are cases of Covid-19 inside their facility, and that they report any such cases directly to the Centers for Disease Control and Prevention.

House Speaker Nancy Pelosi and the Senate minority leader, Chuck Schumer, said on Sunday they were nearing agreement with the White House to break a political logjam and provide more emergency aid for small businesses and hospitals, as well as to expand testing.

Omitted from the bill is any direct aid for states or cities that are struggling to cope with the pandemic, an issue that drew pointed remarks from Mayor Bill de Blasio of New York.

The $349 billion small-business emergency fund ran out of money last week, and Republicans and Democrats have been negotiating over the weekend about the terms for replenishing it. On the ABC program This Week, Ms. Pelosi said the two sides were very close to agreement.

Mr. Schumer said a deal could come as soon as Sunday night. Weve made very good progress, and Im very hopeful we could come to an agreement tonight or early tomorrow morning, Mr. Schumer said on the CNN program State of the Union. He added that many of the Democrats requests, including money for testing and hospitals, theyre going along with, so we feel pretty good.

Treasury Secretary Steven Mnuchin said on CNN Sunday that he was hopeful that the Senate could pass legislation as soon as Monday and that the House would take it up for a vote on Tuesday.

The bill would include $300 billion to replenish the Paycheck Protection Program, $50 billion for the Small Business Administrations disaster relief fund, $75 billion for hospitals and $25 billion for testing. Democrats wanted the plan to also include money for states and municipalities, but Mr. Mnuchin said that would be included in a future relief package.

Mr. de Blasio derided President Trump on Sunday for failing to speak out about federal aid to municipalities.

Whats going on? Cat got your tongue? Mr. de Blasio said during his daily briefing. Youre usually really talkative. You usually have an opinion on everything. How on earth do you not have an opinion on aid to American cities and states?

The mayor, who said earlier in the week that New York City would have to slash more than $2 billion in municipal services over the next year, compared President Trumps silence with President Gerald Fords dismissal of New York Citys plight during the fiscal crisis of the 1970s.

There was that famous Daily News cover that said Ford to City: Drop Dead, Mr. de Blasio said. So my question is, Mr. Trump, Mr. President, are you going to save New York City or are you telling New York City to drop dead? Which one is it?

You are failing to protect the very people you grew up around, Mr. de Blasio added.

As with much of life around the world, film and television production has ground to a halt because of the coronavirus pandemic, leaving actors, stylists, directors, studio chiefs, grips, writers, set builders, trailer cutters, agents and scores of other specialized Hollywood workers at home and confronting the same question: Now what?

Across the industry, shooting is not expected to resume until August a the soonest, in part because of the time it will take to reassemble casts and crews once the coronavirus threat subsides.

That leaves a vast number of people without work. Hollywood supports 2.5 million jobs, according to the Motion Picture Association of America, and many of the workers are freelancers, getting paid project to project.

I keep telling myself, Panicking is not going to help, said Muffett Brinkman, an associate casting director who has been unemployed for more than a month. Hopefully things restart before Im completely financially ruined.

The pandemic has hit Americas biggest cities hard, with the coronavirus finding found fertile ground in their density, just as major urban centers were already losing their appeal for many Americans. Skyrocketing rents and changes in the labor market have been pushing the countrys youngest adults toward suburbs and smaller cities. Will that current turn into a flood?

The countrys three largest metropolitan areas New York, Los Angeles and Chicago have all lost population in the past few years, according to an analysis by William Frey, a demographer at the Brookings Institution. And over all, growth in the countrys major metropolitan areas fell by nearly half over the past decade, Mr. Frey found.

Now, as local leaders contemplate how to reopen, the future of life in Americas biggest, most dense cities is unclear.

Mayors warn of precipitous drops in tax revenue because so many people are now unemployed and so many businesses are closed. Public spaces like parks and mass transit systems, the central arteries of urban life, have become danger zones. And with vast numbers of professionals working remotely, some may reconsider whether they need to live and work in the middle of a big city.

This pandemic has stretched the fabric that was already tearing, said Aaron Bolzle, the executive director of Tulsa Remote, a program that offers $10,000 to remote workers who relocate to Tulsa, Okla.

Of course, the same financial uncertainty that would encourage a move may also make it more difficult. And in general, recessions recent ones, at least have tended to be good for cities. But a pandemic makes the equation different, and hard to predict.

The coronavirus pandemic has hit African-Americans and Hispanics especially hard, including in New York, where the virus is twice as deadly for those populations. So in the midst of a national quarantine, civil rights activists are organizing campaigns at home from their laptops and cellphones.

Collectively, the goals are targeted legislation, financial investments, and government and corporate accountability. The Rev. Jesse Jackson, the longtime civil rights leader, is calling for the creation of a new Kerner Commission to document the racism and discrimination built into public policies that make the pandemic measurably worse for some African-Americans.

Its really hard to overstate the critical moment we are in as a people, given how this virus has ripped through our community, said Rashad Robinson, the president of Color of Change, the nations largest online racial justice organization with 1.7 million members. We know the pain will not be shared equally.

Mr. Robinsons organization and others, such as the National Urban League and the N.A.A.C.P., have hosted telephone and virtual town halls, drafted state and federal policy recommendations and sent letters to legislators.

Smaller local groups are working around social distancing restrictions to rally support. And across the country, individuals are making direct pleas for all to help slow the outbreaks spread.

I am trying to sound the alarm because I see the devastation in the black community, Michael Fowler, the coroner of Dougherty County, said hours after the Georgia countys 91st Covid-19 death. Preachers, a judge, a church choir member, all walks of life are dying. My job is to pronounce death, but I believe in trying to save lives.

The Trump administration said late Sunday that the United States would defer certain tariff payments for 90 days to help some importers who have been hurt by the pandemic.

For weeks, American businesses, trade groups and lawmakers of both parties have lobbied the White House to roll back the tariffs President Trump had placed on hundreds of billions of dollars of foreign products, saying the taxes were compounding financial pain for companies struggling with economic fallout from the virus.

But the deferral will not apply to the tariffs that businesses have criticized the most including those that Mr. Trump has placed on more than $250 billion of Chinese products, as well as on foreign steel, aluminum, washing machines and solar panels. The 90-day delay also excludes a large class of tariffs that the United States levies against foreign producers who receive unfair subsidies or sell their products at unfairly low prices.

Mr. Trump, who has proclaimed himself a tariff man, has frequently rebuffed calls to roll back tariffs, falsely stating that the levies are paid for solely by foreign firms. In fact, numerous studies have shown that American businesses and consumers bear the brunt of the tariffs.

The executive order allows the administration to defer tariff payments for goods imported in March and April. The option will only be available for importers with significant financial hardship, U.S. Customs and Border Protection said in a statement.

India has pursued its lockdown the worlds largest with remarkable zeal.

People arent just dutifully following the law. Many are going above and beyond it. Volunteer virus patrol squads are popping up everywhere, casting an extra net of vigilance over the entire country. Neighborhoods are imposing extra rules and sealing themselves off.

The volunteer efforts could help India protect its people from the pandemic. But theres a downside: concerns about overzealous enforcement targeting the poor and minorities.

Lower castes are being shunned more than usual. The term social distancing plays straight into centuries of ostracism of certain groups who until recently were called untouchable. Muslims, a large minority in a Hindu-dominated land, are facing a burst of bigotry and attacks.

This is one of the problems of overzealousness, said Adarsh Shastri, a politician in the Indian National Congress, the leading opposition party. People get a chance to enforce the laws per their own personal prejudice.

Elsewhere:

At least 40 staff members in Afghanistans presidential palace have tested positive for Covid-19, forcing President Ashraf Ghani to isolate himself and attend events via video conference amid a raging war with the Taliban.

About 100,000 people in Bangladesh ignored a nationwide lockdown to attend the funeral of Maulana Jubayer Ahmed Ansari, a senior member of an Islamist party, amid fears that the virus could spread quickly through the densely populated country.

In France, pride in the countrys aircraft carrier, the Charles de Gaulle, has given way to finger-pointing and investigations over an outbreak that tore through the vessels cramped quarters, infecting more than 1,000 sailors.

Paul McKay, a molecular immunologist at the Imperial College School of Medicine in London, checks a dish of bacteria containing genetic material from the new coronavirus. He and his team are testing a candidate vaccine. Tolga Akmen/AFP via Getty Images hide caption

Paul McKay, a molecular immunologist at the Imperial College School of Medicine in London, checks a dish of bacteria containing genetic material from the new coronavirus. He and his team are testing a candidate vaccine.

Right now scientists are trying to accomplish something that was inconceivable a decade ago: create a vaccine against a previously unknown virus rapidly enough to help end an outbreak of that virus. In this case, they're trying to stop the spread of the new coronavirus that has already infected tens of thousands of people, mainly in China, and given rise to a respiratory condition now known as COVID-19.

Typically, making a new vaccine takes a decade or longer. But new genetic technologies and new strategies make researchers optimistic that they can shorten that timetable to months, and possibly weeks and have a tool by the fall that can slow the spread of infection.

What's the urgency?

"Vaccines are really our most successful tool to prevent an infectious disease," says David Weiner, executive vice president and director of the Vaccine & Immunotherapy Center at the Wistar Institute in Philadelphia.

It used to take a long time to make vaccines, because scientists had to isolate and grow the virus in the lab. But now, it's possible to skip that step altogether and build a vaccine based on a virus' genetic sequence.

Chinese scientists made that genetic sequence from the new coronavirus public in early January, just weeks after the first infections with the virus were reported. That prompted several labs to start work on building a vaccine.

Vaccines work by teaching an individual's immune system to recognize an invading virus and neutralize it. The vaccine that Weiner and his colleagues are developing is what's called a DNA vaccine.

They'll first turn pieces of the new coronavirus' genetic code (which is RNA) into complementary snippets of DNA. These snippets will then be injected into someone's skin, where they will be taken up by skin cells. The skin cells will then turn those DNA sequences into proteins identical to the ones a virus would produce, and those will be what "teaches" the immune system to recognize the new virus.

Weiner and his colleagues are in the process of determining which viral sequences produce the best "teachers."

This isn't Wistar's first stab at rapid vaccine development. Weiner and his team worked on a vaccine for Ebola after an outbreak of that virus in 2014.

Including the initial time needed for animal testing and human safety testing, "We were able to go from no vaccine to a vaccine tested in the clinic in about 18 months 15 to 18 months," he says. They also made a vaccine against the coronavirus that causes Middle East respiratory syndrome, after an outbreak in South Korea. "And we were able to design and develop and move into the clinic in 11 months."

Weiner says he's hoping to halve that time with the vaccine they are making against the new coronavirus.

Keith Chappell at the University of Queensland in Brisbane, Australia, thinks he can do even better. He, too, has a vaccine that's based on the virus' genetic sequence. The Queensland team has come up with an approach it calls the molecular clamp. It works by improving the body's immune response to certain viral proteins.

"Our goal was to be able to hit 16 weeks from sequence information to having a product that is shown to be safe and effective [in lab tests] and is ready for administration to the first humans," Chappell says.

Right now, Chappell and his colleagues are also trying to figure out which genetic sequences will be most effective at helping the immune system recognize the coronavirus.

"Next steps will be moving into animal models for testing and also working out how to scale up to get to the levels that would be required in humans and beyond," he says.

Both Chappell's team in Australia and Weiner's team in Philadelphia, in collaboration with the pharmaceutical company Inovio, are getting financial support from a fairly new organization called CEPI, the Coalition for Epidemic Preparedness Innovations. CEPI is a global partnership of public, private and philanthropic organizations; it's also supporting efforts at the biotech companies Moderna and CureVac.

Ami Patel, a research assistant professor at the Wistar Institute, is working with David Weiner and others on a DNA vaccine against the new coronavirus. The team is in the process of determining which viral sequences produce the best "teachers" to help the human immune system defeat the virus. Darien Sutton hide caption

Among other vaccine efforts worldwide, the pharmaceutical giant Johnson & Johnson is working on a vaccine, and GSK has also offered to help new vaccine efforts. Researchers at Imperial College London have developed a vaccine that's already being tested in animals, and vaccine efforts are also reportedly underway in China.

CEPI CEO Richard Hatchett says the organization was created when people realized that an Ebola vaccine had been under development for a decade and it still took more than a year to get it to people when the 2014 Ebola outbreak occurred in western Africa.

"There were a number of enlightened global public health leaders who said, 'You know, that shouldn't happen. We should have some kind of an organization to develop vaccines against epidemic diseases,'" he says.

Even in the rosiest of scenarios, Hatchett says, once the vaccine is in hand, it still needs to get to the people who need it, and that takes time at least weeks to months, depending on the urgency.

Naturally, public health officials would like to have a vaccine as soon as possible. If the coronavirus outbreak pattern is anything like those of flu outbreaks, it will tend to taper off when the weather gets warmer and pick up as winter approaches and people spend more time indoors.

"We are making very aggressive efforts in the hopes of having a vaccine available some form of vaccine available, potentially, as early as this fall," Hatchett says.

Dr. Sonia Macieiewski (R) and Dr. Nita Patel, Director of Antibody discovery and Vaccine development, look at a sample of a respiratory virus at Novavax labs in Rockville, Maryland. Photo: Andrew Caballero-Reynolds/AFP via Getty Images

Were committed to keeping our readers informed.Weve removed our paywall from essential coronavirus news stories. Become a subscriber to support our journalists. Subscribe now.

The world is watching the medical science community closer than ever, looking for every morsel of hope as researchers race to develop a treatment for COVID-19. Just this week, the CEO of Moderna, a biotech company with a vaccine that began human trials last month, said that her company could begin distributing its vaccine to health-care workers as soon as this fall. On Thursday, Stat News reported that an antiviral medicine developed by Gilead Sciences is getting positive results in clinical trials on severe coronavirus patients. On Friday, French drugmaker Sanofi said that it could produce 600 million doses of its vaccine next year, if it clears its clinical trials. To sort through all of the news, Intelligencer spoke to Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of Texas Childrens Hospital Center for Vaccine Development, where he is developing a coronavirus vaccine.

What do you make of the news that patients in a remdesivir trial are making rapid recoveries?

Remdesivir is an interesting drug because it actually works by inhibiting an enzyme that the virus needs to replicate, so it makes sense that this could have some antiviral activity. This is opposed to things like chloroquine or ivermectin some of the other things youve been hearing about where there would be no specific reason why they would work for COVID-19. Remdesivir is actually designed as an antiviral drug, so the fact that you are seeing some clinical-therapeutic effect is a good sign.

This was a study of about 125 patients with COVID-19. Of those, 113 had severe disease and they were treated with daily infusions of remdesivir. The point is, most of those patients have been discharged and only two of the patients died. Thats a fairly low mortality rate for 113 patients. The problem is, this is not a published study. We dont have a lot of information about what actually happened from these results. Theres some initial promise but, again, were going to need a lot more information before we can say anything definite.

We talk a lot about the timeline of vaccines, what about treatments like remdesivir what kind of role will they play in reducing the death toll of a second wave?

Something like remdesivir, right now, as its currently being looked at, is a treatment for ill patients its not really being used as a preventive. Thats not to say it couldnt one day be advanced as a preventive. What do I mean by preventive? We have, for instance, for HIV/AIDS, things like PrEP. Were not there yet, but there is evidence that this is showing some benefit. Well have to see.

What kind of timeline are we looking at for a treatment like that? Can we look for something in the fall?

Potentially. It all depends on how quickly we can accumulate the data. Right now, the attack rate is pretty high so were going to get a lot more information over the next few weeks. Remember, this may be our one window when well be able to get that information. If everybody practices social distancing, and transmission goes down, it will be more difficult to enroll lots of patients after June.

What do you think of chloroquine as a treatment?

Its not a matter of what I think. I havent seen any large, well-controlled studies that point to its effectiveness. Theres been a couple of small studies with a hint of effectiveness, which have been shown to exhibit replication in the laboratory. But its fairly toxic at high doses and theres no particular reason why the drug would work, other than the fact that it has shown some effects of inhibiting the replication of the virus in the test tube. But it did that for influenza as well and it never really panned out. Given that history, and the fact that weve only really had a few small studies and its fairly toxic at high doses, and theres no particular reason why it should work against the virus, I would put chloroquine at a much lower likelihood.

Are there any other promising treatments in trials right now?

Im a vaccine person, not a small molecule drug person, but there are other antiviral drugs being looked at right now. In fact, theres something that the WHO has called the solidarity study. This is a solidarity clinical trial for treatments. There are 90 countries that are participating and theyre looking at remdesivir, chloroquine, and a combination of antiviral drugs called lopinavir and ritonavir, and then theyre looking at it with an interferon beta.

Earlier this week, Dr. Fauci said that its possible a vaccine could be available sooner than the 12-to-18-month window he and many others have talked about. What do you think accounts for that possibility?

Were making a vaccine and were working late into the night and up early in the morning trying to move this vaccine into clinical trials, trying to meet Dr. Faucis aspirational goal. Were going to do our best but it really depends on how things progress in terms of evidence of safety and also efficacy.

The CEO of Moderna reportedly told Goldman Sachs that the companys vaccine could be available for emergency use on health-care workers as early as this fall. How would a limited roll-out like that work?

I dont know. As it is, 12 to 18 months would be a record. It is possible, after a year or 18 months, to get an efficacy signal that a vaccine shows some effect to prevent the infection? The key is going to be showing that its safe. To show all of those things in a year to 18 months would be unprecedented. I dont know what kind of data hes looking at in particular.

Our vaccine could be ready by the fall as well. Well have up to 200,000 doses. But unless youve shown that it actually works and unless youve shown that its safe, youre not going to do that. Without having the efficacy and safety data, I think you have to be really careful about bold statements like that. As I often like to say, these nucleic acid vaccines have been around for 30 years and they offer great promise, they work in laboratory animals, but, historically, they have not worked well in people. Maybe now theres been modifications to improve that. Lets wait and see.

Should we be concerned that this expediency factor, loosening regulations or foregoing animals trials, might impact public safety?

The biotechs are being very aggressive in their press statements. What theyre doing is talking to their investors. I think you have to filter that away from what the FDA is thinking. A wishlist from the CEO of a biotech or a pharma company means nothing to me. Its what the clinical trialists are finding in collaboration with the FDA that matters.

So theres nothing that the FDA has done to the process that significantly changes the safety standards of these trials.

I dont know. I dont have access to that information. But the branch of the FDA called the Center for Biologics Evaluation and Research has been around for a while and has some of the smartest vaccine scientists that Ive ever worked with. Im fairly confident they would not do anything that would jeopardize the health and safety of Americans. I tend not to pay attention to the statements from the CEOs of biotech and pharma companies. Theyre talking to their shareholders.

Once a vaccine is available, how will it be administered in the United States?

Ultimately, there will be more than one vaccine. There could be several vaccines that have different uses. Some vaccines might be used for older Americans at risk of disease or those with underlying comorbid conditions like diabetes or obesity. There might be some use for younger adults. Maybe some for health-care workers. Same with the other technologies that were talking about, like remdesivir, there may be a prophylactic use for it as well. All of this is being accelerated through a lot of studies in parallel and well have to see how the target product profiles will look.

Is everyone going to go to Walgreens at once? Or will it be gradually expanded by targeting vulnerable populations?

I dont think those kinds of decisions have been made yet. Right now, theres a focus on trying to shape the target product profile on the populations that have to be prioritized. You also have to worry about the fact that COVID-19 is a global health problem. Some of these vaccines are very high tech and may not be available for people in the poorest countries places like India, Bangladesh, and Ecuador. Thats one of the things were trying to do, develop the first global health vaccine

Whats the biggest challenge to doing that?

Let me give you the flip side of that. Our vaccine uses the same technology as the recombinant protein hepatitis B vaccine thats made all over the world. Its made in Brazil, its made in India. We did that deliberately so we could have a global health vaccine that could be made locally. Right now, Im not aware of any capability of that capacity for some of the vaccines now being ruled out. Its not so much that its hard to make a piece of DNA or RNA, its the kind of unique packaging that theyre doing to make it work in people. In the past, RNA and DNA vaccines have worked well in mice, but not well in people. They say they have evidence through the different kinds of the constructs they have in the packaging that it can improve efficacy. How easy it is to scale that up for low and middle income countries, for me, is a total unknown.

Will we experience anything that resembles everyday life before a vaccine is distributed?

I think so. I think what were going to see is, as transmission goes down because of the social distancing and the economy opens up, youll see parts of American life restored to some level of normalcy. It will be different in the sense that well probably have to figure out a way to do testing on a regular basis and then have individuals responsible for tracing down contacts, and the contacts of the contacts of infected individuals. There will need to be some adjustment. And the virus could come back next year or the year after that. Theres some models coming out of Harvard to suggest thats a high probability. Things wont be the same for a couple of years. Its not clear that this virus will be around forever and well have a whole array of new technologies to apply to it.

The one piece that were focusing on that youre not hearing anything about is the fact that were all focused on what to do for the United States. I understand that emphasis, but Im very worried when I hear stories of bodies piling up in Guayaquil, Ecuador. Or how are you going to implement social distancing in the crowded urban areas of Mumbai, Dhaka, or Lagos. Thats where were coming in. Were using our expertise in developing low-cost global health vaccines to see how we can also take on that component of the pandemic. The frustration that we have is that even now were still struggling to raise money to do our clinical trials. Thats unfortunate, even at this stage.

Daily news about the politics, business, and technology shaping our world.

At a string of small reopen America protests across the country this week, mask-less citizens proudly flouted social distancing guidance while openly carrying semiautomatic rifles and waving American flags and signs with ironic swastikas. They organized chants to lock up female Democrat governors and to fire the countrys top infectious disease experts. At one point during protests at the Michigan Capitol, the groups orchestrated gridlock blocked an ambulance en route to a nearby hospital.

For those whove chosen to put their trust in science during the pandemic its hard to fathom the decision to gather to protest while a deadly viral pathogen transmitted easily by close contact and spread by symptomatic and asymptomatic people alike ravages the country. But it shouldnt come as a surprise. This weeks public displays of defiance a march for the freedom to be infected are the logical conclusion of the modern far-rights donor-funded, shock jock-led liberty movement. It was always headed here.

Few demonstrate this movement better than Alex Jones of Infowars one of the key figures of Saturdays You Cant Close America rally on the steps of the Capitol building in Austin, Tex. For decades, Mr. Jones has built a thriving media empire harnessing (real and understandable) fear, paranoia and rage, which in turn drive sales of vitamin supplements and prepper gear in his personal store. The Infowars strategy is simple: Instill a deep distrust in all authority, while promoting a seductive, conspiratorial alternate reality in which Mr. Jones, via his outlandish conspiracies, has all the answers. Hes earned the trust of a non-trivial number of Americans, and used it to stoke his ego and his bank account. And he never lets reality get in the way (case in point, holding a stay-at-home order protest in Texas the day after the state announced it would begin efforts to carefully reopen in coming weeks).

Former employees have described Mr. Jones to me as master of manipulating the truth into a convenient worldview in which Infowars and its listeners are constantly victimized by powerful institutional forces. We kept saying Were the underdogs that was our mantra, one former employee told me in 2017. To make this work, Mr. Jones molds the days news into conspiratorial fables.

A novel virus about which so much is unknown and where expert opinion is constantly shifting is a near perfect subject for Infowars to fit the news to its paranoid narrative. Uncertainty over the viruss origins in China is a springboard to float unproven theories about bioweapons. Discussions about a vaccine to end the epidemic become conspiracies about billionaire tech leaders pushing population control. Changing epidemiological models that show fewer projected Covid-19 deaths (because social distancing has worked to slow infections) provide an opening for Mr. Jones to rant about stay-at-home lockdowns. Genuine fears about deeply unfair job losses and economic recession become reckless theories about Democrat-led plans to punish American citizens by driving them into poverty.

Jones opportunistic rantings fit neatly into a larger right-wing strategy, which has grown alongside Infowars. Just as Infowars rallies are tied to the media outlets financial interest in antigovernment paranoia, a few of this weeks rallies have been underwritten by political organizations with ties to the Republican Party and the Trump administration. Regardless of whos behind them, the intent is to sow division and attempt to reshape public opinion. As Voxs Jane Coaston wrote, theyre designed to pit Republican-voting areas of states against their Democratic-voting neighbors, even rural Republicans against urban Republicans.

Its important to note that the reopen protests have been generally small (at most, hundreds of people in states of millions of citizens responsibly staying at home) and dont even reflect the polled opinions of many conservatives. But they fit neatly into a larger campaign playbook and take on outsize importance. They take place frequently in swing states or states with Democratic governors and are plastered across social media, reported in mainstream organizations, openly cheered on by Fox News and right-wing media, and ultimately end up amplified (tacitly or explicitly) by the president. The strategy has worked well in recent years, consolidating support among the Trump base.

As a political movement, the Make America Great Again crowd relishes turning criticism from ideological opponents into a badge of honor. Confrontation of any kind is currency and people taking offense to their actions is a surefire sign that theyre correct. The MAGA mind-set prioritizes freedom above all especially the freedom from introspection, apologizing or ever admitting defeat. But the movement, which has been building since the Tea Party protests, has created a reflexive response among both Joness audience and far-right Trump supporters.

This response is disguised as an expression of liberty, but its a twisted, paranoid and racialized version. Slate editor Tom Scocca defined it recently as a political ideology where supporters are conditioned to believe that thinking about other peoples needs or interests in any way is tyranny by definition. This wholesale rejection of collective thinking is, as Vices Anna Merlan notes, the cornerstone of the anti-vaccine and health freedom movements, which reject public health because they dont think their choices affect other people.

Unmentioned by the protesters are the workers actually keeping America open, many of them afraid for their health, with no choice and in communities devastated by the virus. The result, as my Times colleagues described Saturday, is images of nearly all-white protesters demanding the governor relax restrictions while hoisting Trump signs and Confederate battle flags, as the virus disproportionately impacts Michigans black residents.

This coronavirus protest movement is merely the confluence of this perverted liberty ideology honed and pushed by Mr. Jones, right-wing interest groups and pro-Trump media and the dynamics of an online information ecosystem that prioritizes conflict to generate attention. When Infowars-style tactics meet online platforms the result is a flattening of all nuanced arguments of science and politics into a simplified struggle between patriots and tyrants. Small protests incorrectly blossom into a false national narrative.

And so here we are in 2020, protesting statewide lockdowns intended to save lives while thousands of Americans across the country grow sick and die each day. That a virus that demands a united front where our public health is only as strong as our least vigilant citizens should come at a moment of extreme polarization is a tragedy. But this moment is what weve been headed toward for years. And so the reopen America protests feel unconscionable and yet completely predictable. The playbook isnt new. The only thing thats changed are the stakes, which get higher every day.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email:letters@nytimes.com.

Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram.

This week, my father and siblings had an Easter like no other. We held an online "HouseParty" with the whole family, which was a chaotic but fun thing to do, and my sister's children went Easter egg hunting in my parents garden. We were hoping that with the return of warm weather, we could see each other all again in person by summer. But my father threw some cold water on that hope though he did give us a good explanation why.

Dear Nele, Johan, and Peter,

We just had a beautiful Easter weekend, with great weather and a longing to go outside and meet family and friends. In our case, we found again a creative solution for the grandchildren to come by: on Sunday morning, we hid Easter eggs in the garden, and in the afternoon, the children came to look for them, while we looked from a safe distance. It's not the same as before, but for both the children and for us, it was a nice experience.

I think we'll have to get creative like this for another few months, and certainly through thesummer. As you know, we will only have a lasting solution when we get to herd immunity, and the safest way to achieve it is by developing acoronavirusvaccine. We would all want this vaccine to be there sooner rather than later, but my assessment is that a vaccine will likely not be widely available until2021, and possibly later. In the meanwhile, we have to hope for an effective drug byfall. To help you understand this, I thoughtI'd explain the various phases and techniques to get to a vaccine.

Courtesy of Peter Vanham

I'll try to make this as straightforward as possible, but it does require you to sit down and read attentively. In return, I'll summarize some basic insights of decades of virology research and development into an understandable text. If after reading this letter you still want to read more about the specific case of a SARS-CoV2 vaccine (the novel coronavirus' scientific name), I recommend this excellent paper by Fatima Amanat and Florian Krammer SARS-CoV-2 Vaccines: Status Report. Now, let's start!

The main distinction you need to understand is between the initialdevelopment of vaccine candidates and their pre-clinical (non-human) testing, and the subsequentvariousphases of human testing,followed byproduction, distribution, and administration. Forall but three vaccine candidatesfor SARS-CoV-2, we are still in the non-human phase, and many candidates may be 'stuck' in there for weeks, months, or even years, possibly not getting through at all. It's only when they get through the initial phasethat candidates really get to the start of the 'race to the vaccine'.

Compare it, if you will, to the audition rounds ofAmerica's Got Talent, versus the live shows. To extend that analogy a bit, consider that 'Vaccine's Got Talent' welcomes candidates using different methods. But instead of singing, dancing, stand-up, and magic tricks, vaccine candidates can come fromsixdifferent categories: 'live attenuated' or 'inactivated' virus vaccines, 'recombinant protein' vaccines, or 'DNA', 'RNA' or 'vectored' vaccines. Let's look at those a bit more in detail.

Source:Amanat and Krammer,SARS-CoV-2 Vaccines: Status Report, Immunity (2020)

Live attenuated and inactivated vaccinesare easy to make. They are the 'classic vaccines' that we know from the measles and the flu. You isolate a little bit of virus, weaken or 'inactivate' it, and then inject itintoa humanbeingin a portion that is small enough to trigger a reaction from your body. Production capacity for such vaccines exists since the 1950s. If such a vaccine would work, you can go to market relatively quickly.

We also have experience withrecombinant protein vaccines: this method is used, for example, for the human papillomavirus that causes cervical cancer, or for the hepatitis B vaccine. The latter vaccine exists since the 1980s I was vaccinated against Hepatitis B in the 1980s in Belgium and that makes them 'second generation' vaccines. This type ofvaccinedoesn't use the virus itself, but the proteins on the outside of it. In the case of the coronavirus, these vaccines would use the 'spikes of the crown' of the virus, to give you a visual image. It is this 'spike' or 'crown' that the virus uses to attach itself to our cells. If you inject a vaccine that will make us produce antibodies to block the protein from attaching itself, then, the virus might not be able to enter our cells.

Source:Amanat and Krammer,SARS-CoV-2 Vaccines: Status Report, Immunity (2020)

There is a trick with them: it's notcertainwhether human antibodies, elicited against those 'spike', 'surface' or 'envelope' proteins,will protect you from the virus. With HIV,for example, my specialization, we've tried a similar technique for more than 30 years, and we still haven't found one that works. But for the novel coronavirus, there are good signs it could work: for SARS and MERS, notably, two other coronaviruses, the technique did work in some animal models (though the vaccines weren't used widely; the virus died before the vaccine was produced for humans). Still, if this technique works, it might take a little longer to set up the industrial production and administration, but it is certainly possible sinceit'salready in use for papilloma and hepatitis B.

Finally, if one of the above three principlesdoesn'twork, there are also theDNA,RNAorVectored vaccines. The principle for all of them is that you take a piece of the genetic coding of the virus, namely one that would trigger your immune system to get alerted, and inject it intothe human body, where it is taken up by your cells and they produce the 'spike protein' of the virus, against which your immune system will make the antibodies. The technique is new and complicated, and it is part of the 'third generation' of vaccines. Only very recently[starting 2015 in trials, and resulting in anapproved vaccinein late 2019]'viral vector-based' vaccines were used for the first time in humansto control the Ebola outbreak in the east of the Democratic Republic of the Congo with apparent success. Clearly, thistechnique could work, but we have less experience with it, especially to produce and use it at scale. It would, therefore, take more time, but, reportedly, a Chinese company CanSinoBiologicsis moving such avaccinealready into a preliminary human trial.

Over all,these techniques combined, there are currentlymore than 70 vaccine candidatesfor SARS-CoV-2being worked on. That may sound like a lot, but bear in mind that the analogy withAmerica's Got Talentstops here. In the talent show, you'd end up with a winner no matter how many candidates initially signed up. For a new vaccine, however, you can't be sure if there will be a 'winner' at all. You typically need up to 100 vaccine candidates, to get to one winner: one vaccine that works, isn't toxic, and is easy to produce and administer. The 'attrition rate',as we call it, would in such case be 99per cent.

With all but a few of the candidates we currently have, we would normally first need to run 'pre-clinical tests' before wegoto the human test phases. In these pre-clinical tests,the vaccine candidate is given to animals that are sensitive to the virus, and that would get sick if they had the virus and developed the disease. That way, you can test not only if the vaccine candidates create antibodies, but whether they protect against the disease infection. For many SARS-CoV-2 vaccine candidates, this pre-clinical trial is the first real hurdle.

An ethical commission, such asthe National Institutes of Health in the US, or theCoalition for Epidemics Preparedness Innovationin Switzerland, would have to decide whether the various vaccine candidates have to do testing with animals for safety. If the technique is deemed safe, it will go quickly. If you are more experimental, you'll need to do a toxicity test with bunnies (which arethetypical 'guinea pigs') and two other animals, possibly ferrets and hamsters. Such tests can take at least six months in a traditional programme. The vaccine candidate that can't pass this hurdle, will likely lose the race. It will be a first separation between the more than 70candidates, though most will pass this test. As I said, three candidate vaccines already cleared this hurdle. They are currently the 'front-runners'.

After this phase, the real race to a vaccine starts, with clinical tests on humans. It starts withPhase I, with a few dozen patients, in which you look for the best dose of the vaccine in humans, while observing minimal side effects. It is asafety phase. This Phase I takes various weeks, probably at least two months,becauseyou first need to inject the vaccine to a small number of patients, and wait a week or longer to get results. Then you do the same with another few people, and with a higher dose, and again you wait, and so on, until you get to a target dose you will use for the Phase II and Phase III trials.

ThencomesPhase II, with hundreds of patients, to prove the vaccine candidate createsanti-bodiesand createsimmunity response. This phase uses healthy people who are not necessarily faced with the virus, and it will also take a few months. You probably need to give multiple doses, particularly for the RNA, DNA, vector and recombinant vaccines,becausethey break down typically before creating strong immunity. You need a 3-4 week interval in between each 'boost', and see how the body reacts (that can take a week or two). So for thisphase again you need at least two months, and more probably,three months.

Then comesPhase III, where you do a real test foreffectiveness, andprotective immunity: can the vaccine immunity protect against the infection for the disease?This is the 'make or break' phase that will determine whether we have an initial 'winner'. But the phase will take even longer, as you'll need to include a lot of people in your trial to know effectiveness: some will get the real vaccine, and others the placebo, and you need to follow them over time to know if there's a difference in infection between the two groups. That, of course, is a problem: many societies have either strict lockdown measures in place (in much of Europe, the Americas, and the Middle East). Or they have very few infections anymore (in China, Korea, Singapore, and other parts of East Asia).

Either way, this phase willeasily last six months, and again, possibly (much) longer, and for the front-runners, will likely start in thefall of 2020. When it takes place, you can see two logical candidates for trial groups: people who live in homes for the elderly, where there are a lot of infections, and people who work in the health sector. Thethe second group isthe most logical,becausethey are healthy and likely to get exposed to the virus. But you will have to make sure to choose those healthcare workers who haven't gotten the virus before.

So where are we with the vaccine candidatesfor the novel coronavirustoday? There are 78 candidates. That means there are 78 products, for which an analogue exists for other infectious diseases, that create an immune response there. They are all variants of thesixmethods I described above, where you can copy-paste what existed for the previous candidate, by taking the DNA code of the new virus, and apply one of the techniques I mentioned. Almost all of the candidates are based on the 'spike protein' or 'crown', as that protein would fix to the cell, and if you have an anti-body against that, it cannot fix to the cell.

Most of the candidates are still in the non-human development and testingphase.But there is one RNA vaccine currently in Phase I with humans, namely the vaccine of Moderna in Seattle.Another DNA vaccine focusing on the protein isabout to start its Phase I, namely that of Inovio in Pennsylvania. One caveatis that these vaccines by themselves may not be strong enough to reach immunity in humans, and may need to be combined with another, recombinant protein vaccine.Hong Kong'sCanSinoBiologicssays it is about to start a Phase II trial, using the viral vector technique, though no details are known about its Phase I results.

Imagine that any of these frontrunners, or any of the 75 other candidates, successfully make it through Phase III. If they manage to do that, they go to theApproval phase. That is when an institution like the Food and Drug Administration (FDA) in the US, the European Medicines Agency (EMA) in Europe, or the National Medical Products Administration (NMPA) in China, give their'blessing'to the vaccine. Sometimes this phase can take half a year, but in this case, we can assume it will be treated with utmost speed, and then it can be done in a few short weeks.

Then you go tomanufacturing, distribution and administration. Those are the economic and logistical aspects. How long this phase lasts, depends on the category that comes through. Here, the frontrunners may lose time, and the laggards may win time: the vaccines using live and attenuated virus, as well as those using the dead virus, have been produced and administrated at large scale before, whereas the others haven't, at least not at the same scale and speed. For the first-generation vaccines, large pharma companies have the capacity to ramp up their production quickly. But if it is a smaller company, maybe it will take longer.You can look at a few to many months. A good example is the influenza virus. That is being made every year in a couple of months.

In the end, SARS-CoV2 vaccines will not be realistically available for another 12-18 months. And even then, we must be lucky every step of the way.

Take the example of H1N1or the 'Swine flu' virusin 2009. It is the only example in recent history where we managed to make a new vaccine insixmonths (because the winning candidate was very quickly identified, and Phase I, II and III were not necessary), and even then, the vaccine came too late to affect the second wave of infections. To end on a note of optimism, though, the more I read about this virus, the more I also think we may find a vaccine on a rather quick timelinebecausethere are enough vaccines that have worked for similar viruses.

In the meanwhile, we must hope for the development of an efficient drug, and until then, manage very well the existing spread, with varying degrees of lockdown, testingand tracing, and social distancing measures. One drug that could help us a lot, as it looks promising, isRemdesivir. It has worked for SARS and MERS, and similar drugs are being used against hepatitis and HIV. It stops the multiplication of the virus. So,there's a good chance that this one, or a variant, will work against thecoronavirus. If you can give this at the first point of infection, it will work very well. It could be that this drug will be on the market by the fall.

Until then, we better get ready for a summer like no other. We may not see each other again for another couple of months, and when we do, it will have to be more like the Easter egg hunt, than sitting together at a table, close to each other. But on the bright side, we're learning to use Zoom, WhatsApp and HouseParty, so we can all come together anyway.

Dad, Guido Vanham

Guido Vanham is Professor of Virology at the University of Antwerp, and former Head of Virology at the Institute of Tropical Medicine in Antwerp, Belgium. His son, Peter Vanham, is Head of the International Media Council at the World Economic Forum, and a member of its COVID Taskforce.

This article is part of the COVID Action Platform for Media, a coalition of over 20 media from around the world. The Platform aims to create meaningful and constructive content on the COVID pandemic, and syndicates it through its media partners.

This is CNBC's live blog covering all the latest news on thecoronavirus outbreak.This blog will be updated throughout the day as the news breaks.

The data above was compiled by Johns Hopkins University as of 7:41 a.m. Beijing time.

All times below are in Beijing time.

Unemployment rates in Asia-Pacific could surge by well over 3 percentage points more than twice in an average recession as social distancing measures hit job creation, says S&P Global Ratings in a report published on Monday.

"Surging unemployment in Asia-Pacific would mean a shallower recovery once the pandemic is contained and, in some economies, credit stress for leveraged households," said Shaun Roache, Asia-Pacific chief economist at S&P Global Ratings. "Historical data show that jobs lost are not easily won back."

The service sector is the most important employer in Asia-Pacific, accounting for 55 in 100 jobs,according to S&P. Many of the new service sector jobs have been created by small- and mid-sized enterprises and they usually have fewer resources to draw on to weather a sudden economic stop, said S&P. Access to finance in particular, is a constant challenge and likely to worsen due to economic uncertainty.

"As revenues collapse, to stay alive, these firms will be forced to cut whatever expenses they can. In many cases, their largest expense will be the wage bill," said S&P.

Even if workers do hang onto their jobs, they may suffer a cut in their hours and wages, added the ratings agency. Huileng Tan

Fears over disruptions to supply chains amid the pandemic have led to some degree of hoarding among countries and consumers that's given coffee prices a much-needed boost.

It's good news for farmers in key coffee-producing regions, who have been struggling as coffee prices have been slumping in recent years.Since 2016, prices have dropped 30% below the average for the past decade, according to theInternational Coffee Organization.

But prices of Arabica, the world's most commonly produced coffee, rose last month due to concerns over its availability, said the ICO. Weizhen Tan

France's Prime Minister Edouard Philippe said on Sunday that people will need to "learn to live with the virus" after the country lifts its lockdown on May 11, the Associated Press reported.

People would likely be required to wear face masks when taking public transport, while those who can work from home should continue to do so, according to Philippe, the AP said, adding that the prime minister warned the economic crisis "will be brutal."

France is one of several European countries that has been hit hard by the pandemic, with the total number of cases at more than 154,000 and over 19,700 people have died, data from Johns Hopkins University shows. Saheli Roy Choudhury

China's National Health Commission said there were 12 new cases of infection, with eight of them attributed to travelers from overseas. No new deaths were reported but there were 49 additional cases of asymptomatic infection, where a person tested positive for the virus but did not show any of the usual symptoms associated with the illness.

There were at least 82,747 cases of infection on the Chinese mainland since the outbreak was first reported in the Hubei province late last year. While China says most of them have been cured, around 4,632 people have died. The death toll climbed last week after Wuhan, the epicenter of the outbreak, revised its figures that raised the death toll by 50%. Saheli Roy Choudhury

Singapore reported 596 new cases of Covid-19 as of noon local time on April 19. Most of them are linked to infection clusters in dormitories that house foreign workers typically men from other Asian countries who carry out labor-intensive construction jobs to support their families back home.

General view of the Toh Guan Dormitory, a purpose-built migrant workers dormitory that has been gazetted as an isolation area on April 19, 2020 in Singapore.

Ore Huiying | Getty Images

Sunday's numbers brought the total cases in the city-state to 6,588, a sharp spike in infections from early March as more people, particularly those living in dormitories, have been tested in recent weeks. Almost all nonessential services in Singapore are temporarily closed while residents have been told to venture outside only for essential tasks, such as buying groceries.

The health ministry said 768 people have fully recovered from the infection and have been discharged from hospitals and community isolation facilities while 11 patients have died to-date. Saheli Roy Choudhury

The total number of infections worldwide has risen to 2,394,291 and at least 164,938 people have died from the disease, according to the latest figures from Johns Hopkins University.

The United States has most number of reported infections, with 755,533 cases in the country, Hopkins data showed.

Spain, Italy, France, and Germany have each reported more than 145,000 cases each.Cases in the United Kingdom climbed to over 121,000 according to Hopkins, and more than 16,000 people there have died.

India, which is in an extended period of lockdown until May 3, has reported more than 17,600 cases and 559 deaths, Hopkins data showed. Saheli Roy Choudhury

All times below are in Eastern time.

The total number of coronavirus cases in the U.S. is currently at755,533, according to data from Johns Hopkins University. The virus has now killed more than 40,000 people in the U.S., nearly a quarter of all deaths from Covid-19 across the globe, according to JHU data.

New York, the current epicenter of the outbreak in the U.S., is recording over 500 deaths a day. President Donald Trump said at a press conference that his administration is looking at helping rural hospitals which have been hurt very badly. He also said he was going to use the Defense Production Act to increase swab production at one facility amid coronavirus testing shortage. The president's announcement comes aftergovernors demanded federal helpto ramp up testing across the U.S. Riya Bhattacharjee, Noah Higgins-Dunn

United Airlineshas struck a deal with an Asian aircraft leasing firm to sell and then lease back 22 aircraft. Neither United nor the Bank of China Aviation revealed the financial terms of the deal announced Sunday morning.

The move will help United conserve cash and give its balance sheet greater flexibility as it faces mounting losses due to coronavirus causing a global plunge in airline travel.

Earlier this week, United CEO Oscar Munoz said business has essentially dropped to zero. "We expect to fly fewer people during the entire month of May than we did on a single day in May 2019," Munoz wrote in a note to employees outlining plans to cut its schedule by 90% in May.Phil LeBeau

Read CNBC's coverage from the U.S. overnight:US death toll surpasses 40,000 as cases hit 750,000

The coverage on this live blog has ended but for up-to-the-minute coverage on the coronavirus outbreak, visit the live blog from CNBC's Asia-Pacific team.

The data above was compiled by Johns Hopkins University.

All times below are in Eastern time.

President Donald Trump shows a packaging containing a swab to be used for coronavirus testing during the daily coronavirus task force briefing at the White House in Washington, U.S. on April 19, 2020.

Alexander Drago I Reuters

The total number of coronavirus cases in the U.S. is currently at755,533, according to data from Johns Hopkins University. The virus has now killed more than 40,000 people in the U.S., nearly a quarter of all deaths from Covid-19 across the globe, according to JHU data.

New York, the current epicenter of the outbreak in the U.S., is recording over 500 deaths a day. President Donald Trump said at a press conference that his administration is looking at helping rural hospitals which have been hurt very badly. He also said he was going to use the Defense Production Act to increase swab production at one facility amid coronavirus testing shortage. The president's announcement comes after governors demanded federal help to ramp up testing across the U.S. Riya Bhattacharjee, Noah Higgins-Dunn

Ireland is highly unlikely to allow large gatherings this year and the "cocooning" of people over 70 years old in their homes may persist for quite a while, Health Minister Simon Harris said on Sunday.

"What's not going to come back quickly are scenarios in which we can't safely socially distance," Harris told the Sunday Independent newspaper in an interview. "I can't see how people can be in packed pubs again as long as this virus is still with us and we don't have a vaccine or an effective treatment."

Ireland's chief medical officer declared on Thursday that the first wave of the coronavirus outbreak had been contained in the population at large. That raised hopes that stay-at-home restrictions could begin to be rolled back from May 5.

But Harris cautioned that any easing back of the most severe constraints will be done on a slow and phased basis. "I'd like to see a situation where you could expand somewhat the areas in which people can go beyond their home," he said.Reuters

Neiman Marcus is preparing to seek bankruptcy protection as soon as this week, becoming the first major U.S. department store operator to succumb to the economic fallout from the coronavirus outbreak, people familiar with the matter said.

The debt-laden Dallas-based company has been left with few options after the pandemic forced it to temporarily shut all 43 of its Neiman Marcus locations, roughly two dozen Last Call stores and its two Bergdorf Goodman stores in New York.

Neiman Marcus is in the final stages of negotiating a loan with its creditors totaling hundreds of millions of dollars, which would sustain some of its operations during bankruptcy proceedings, according to the sources. It has also furloughed many of its roughly 14,000 employees.Reuters

Health ministers from the Group of 20 major economies discussed weaknesses in health systems that made the world vulnerable to the coronavirus outbreak and other pandemics, a statement said after a virtual meeting on Sunday.

The Saudi G20 secretariat said that the ministers shared their national experiences, addressed necessary actions to improve preparedness and discussed systemic weaknesses exposed by the pandemic.

"Health Ministers recognised that the COVID-19 pandemic has highlighted systemic weaknesses in health systems," the statement said. "It also has shown vulnerabilities in the global community's ability to prevent and respond to pandemic threats."

The statement said the ministers adopted preventative measures to contain the pandemic, but did not elaborate.

A planned virtual news conference was cancelled as Saudi Health Minister Tawfiq al-Rabiah had to attend "an urgent Covid-19 KSA (Saudi) taskforce meeting." Saudi Arabia is the current chair of the G20.

In opening remarks provided via video to media, Rabiah said urgent actions included the need for collaboration and engagement of global organisations for coordinated responses to the novel coronavirus pandemic, with an emphasis on supporting countries in need, and investing in research and discovery to produce technology, tools, vaccines and therapies.Reuters

United Airlines has struck a deal with an Asian aircraft leasing firm to sell and then lease back 22 aircraft. Neither United nor the Bank of China Aviation revealed the financial terms of the deal announced Sunday morning.

The move will help United conserve cash and give its balance sheet greater flexibility as it faces mounting losses due to coronavirus causing a global plunge in airline travel.

Earlier this week, United CEO Oscar Munoz said business has essentially dropped to zero. "We expect to fly fewer people during the entire month of May than we did on a single day in May 2019," Munoz wrote in a note to employees outlining plans to cut its schedule by 90% in May.Phil LeBeau

A nurse wipes away tears as she stands outside NYU Langone Medical Center on 1st Avenue in Manhattan as New York Police Department (NYPD) Mounted Police and other units came to cheer and thank healthcare workers at 7pm during the outbreak of the coronavirus disease (COVID-19) in New York City,

Mike Segar | Reuters

The coronavirus has now killed more than 40,000 people in the U.S., nearly a quarter of all deaths from Covid-19 across the globe, according to data from Johns Hopkins University. The coronavirus has infected more than 735,000 people in the U.S., the most of any country. While the number of deaths continues to climb, President Donald Trump has said that officials now expect the total death toll to be "substantially under" initial estimates, which indicated the U.S. could see at least 100,000 deaths from Covid-19.

The number of deaths in New York, the epicenter of the outbreak in the nation, have been on the decline in the past week, although the state is still recording over 500 deaths a day, Gov. Andrew Cuomo said. Globally, more than 162,000 people have died from the virus.Noah Higgins-Dunn

Local fishermen (L) offer a container with food to other fishermen, who said they were refused entry at two ports after a nationwide lockdown was imposed to fight the coronavirus disease (COVID-19), after they travelled in the Arabian Sea to reach their home state of Maharashtra from the western state of Gujarat, in Dahanu, Palghar district, Maharashtra, India, April 17, 2020.

Prashant Waydande | Reuters

India's Maharashtra state, the country's largest regional economy, will allow a limited number of sectors to resume business on Monday, after a weeks-long shutdown to slow the spread of coronavirus left millions out of work.

Maharashtra, home to financial centre Mumbai, has the biggest share of India's caseload of 15,713 infections, including a large number now ripping through its densely-packed slums.

Chief Minister Uddhav Thackeray told a news conference on Sunday that some activity would be permitted in the least-affected parts of the state while observing a strict lockdown in the red zones that have the maximum number of cases.

"We need to start the economic wheels again. We are giving selective permissions from tomorrow, especially in orange zones and green zones," he said, referring to areas with lower levels of infection.

Indian Prime Minister Narendra Modi has extended the nationwide lockdown that began late last month until May 3, but the federal government has allowed states to restart activity as amid economic distress in rural areas.Reuters

New York Governor Andrew Cuomo gives his a press briefing about the coronavirus crisis on April 17, 2020 in Albany, New York.

Matthew Cavanaugh | Getty Images

New York Gov. Andrew Cuomo said on Sunday that the state plans to roll out antibody testing this week to determine who has been infected with Covid-19, conducting the "largest survey of any state population that has been done."

Cuomo said the U.S. Food and Drug Administration approved the state's antibody test, which is designed to detect whether a person has developed the antibodies to fight Covid-19 and indicates they may be immune against the disease, and said the state will conduct "thousands" of tests this week.

"We'll take thousands of tests, antibody tests, over this next week all across the state to give us a real snapshot, a real baseline, of exactly how many people were infected by coronavirus and have the antibodies," Cuomo said. "So we'll have the first real statistical number on exactly where we are as a population."

The antibody tests will give the state its "first true snapshot" of how many people in the state have been infected with Covid-19, Cuomo said. Melissa DeRosa, secretary to the governor, later tweeted that the state antibody testing will begin on Monday and will sample 3,000 people.Noah Higgins-Dunn

Vice President Mike Pence on Sunday said the problems surrounding the delayed coronavirus tests from the U.S. Centers for Disease Control at the beginning of the nation's outbreak were resolved by early February.

On Saturday, The Washington Post reported that the CDC's coronavirus testing kits were delayed due to "a glaring scientific breakdown" at the agency's central lab. The error was "devastating to the country" and "really a terrible black mark on the CDC," James Le Duc, a former CDC officer, told The Post.

Pence, speaking with NBC's "Meet the Press," said he saw the reports but believes the issues surrounding that particular test were resolved by early February. He added that those "slow, lab-based tests" that are typically conducted by the CDC and the states' public health labs would "never have been able to meet the testing in this coronavirus epidemic."Noah Higgins-Dunn

Wynn Resorts Chief Executive Officer Matt Maddox on Sunday called on the Nevada governor to begin to reopen the Las Vegas Strip in mid- to late May with extensive safety measures in place, assuming the state is in line with certain benchmarks around the spread of the coronavirus.

In an opinion column published on the Nevada Independent news website, Maddox said Governor Steve Sisolak should reopen parts of the local economy in early May.

"Begin with reduced occupancy, physical distancing measures in place, temperature checks and no large gatherings," Maddox wrote. "We all need to wear a mask."

He also laid out Wynn's health and safety guidelines for reopening, which include allowing a maximum of four people to ride in an elevator at one time; and requiring guests to enter the resort through doors that are either propped open, are automated or manually operated by an employee.

Sisolak ordered all casinos and other nonessential businesses in the state to close for 30 days beginning March 18. He extended that order until April 30, and last week said he has no specific date for when nonessential businesses might be allowed to reopen.In Nevada, there have been at least 3,725 people confirmed to have the coronavirus and 155 deaths.Reuters

New York Governor Andrew Cuomo on Sunday said that the state is "past the high point" of coronavirus cases as data shows a decline in the rate of infection."If the data holds and if this trend holds, we are past the high point and all indications at this point are that we are on a descent," Cuomo said at a press briefing.

"We are on the other side of the plateau and the numbers are coming down."The governor said that 507 people died of the virus in New York in the last 24 hours, down from 540 deaths reported on Saturday, which marks the state's lowest daily death toll in over two weeks.Still, 1,300 people were hospitalized on Saturday Cuomo said. At least 13,869 people have died in New York, the epicenter of the virus."It's no time to get cocky, and it's no time to get arrogant," Cuomo said. "We still have a long, long way to go and a lot of work to do." Emma Newburger

Coronavirus patient Maria Josefa Arias, 76, is lifted into an Ambuiberica ambulance by her son Ander Maria Dominguez Arias and emergency technician Marisa Arguello de Paula during the coronavirus disease (COVID-19) outbreak, in Llodio, Spain, April 19, 2020. REUTERS/Vincent West TPX IMAGES OF THE DAY

Vincent West | Reuters

Spain's death toll from the new coronavirus outbreak rose by 410 on Sunday, the lowest daily increase in about a month in one of the world's hardest hit countries, prompting cautious optimism from the government that the figures are on a downward path.

The daily increase in deaths was the lowest since March 22. It is far below the highest daily increase - 950 deaths reported on April 2 - in a sign of a slowdown of the spread of the virus after Spain imposed a strict lockdown in mid-March.

The total number of deaths reached 20,453 on Sunday, the Health Ministry said. It is the third-highest toll worldwide after the United States and Italy.

The overall number of coronavirus cases rose to 195,944 from 191,726 on Saturday. Health workers account for 15.6% of those infected, health emergency chief Fernando Simon told a press briefing.

"Data confirms the breaking of the curve, even with an increased number of tests," said health minister Salvador Illa, referring to the evolution of the death toll. "It is still a difficult stage, but we are going in the right direction".

Spain is conducting around 40,000 coronavirus tests daily, one of the highest numbers among European countries, Illa said. Close to a million tests had been conducted as of April 13.Reuters

New York Gov. Andrew Cuomo renewed his call to the federal government for $500 billion in aid to the country's state and local governments whose funding has been exhausted from the coronavirus outbreak. The National Governors Association, a bipartisan group of U.S. governors, has called on Congress to allocate relief funding for state governments to offset drastic revenue shortfalls. Previous relief funding legislation didn't provide funding to offset the states' drastic revenue shortfalls, and any lack of future aid could result in reduced funding for schools, police and fire departments, transit systems and even hospitals, Cuomo said.

He said that New York is looking at cutting education funding by nearly 50%, as well as funding cuts for the state's hospitals. "You're talking about cuts to hospitals from the state," Cuomo said. "I mean how ludicrous would it be to now cut hospital funding from state governments?" On Sunday, Treasury Secretary Steven Mnuchin said the White House and Congress could reach a deal today on supplemental funding for the Paycheck Protection Program to provide additional funding for small businesses, although money for state and local governments will not be included in the package. Mnuchin said President Trump is prepared to discuss funding for state and local governments in the next bill.Noah Higgins-Dunn

Firefighters and paramedics with Anne Arundel County Fire Department transport a patient experiencing COVID-19 symptoms on April 13, 2020 in Glen Burnie, Maryland.

Alex Edelman | AFP | Getty Images

Maryland Gov. Larry Hogan, a Republican and chair of theNational Governors Association, dismissed as "absolutely false" Trump administration claims that states have adequate coronavirus testing capacity to begin gradually reopening their economies.

Hogan, speaking on CNN's "State of the Union," described the lack of testing as the biggest problem in the nation since the coronavirus pandemic hit the United States. The Maryland governor said he has "repeatedly" made that argument on behalf of America's governors on both sides of the political aisle to leaders in Washington.

"The administration I think is trying to ramp up testing, they are doing some things with respect to private labs, but to try to push this off to say that the governors have plenty of testing and they should just to get to work on testing, somehow we are not doing our job is just absolutely false," said Hogan, who once considered challenging Trump for the 2020 Republican presidential nomination.Anna Hecht

The coronavirus situation in France is improving "slowly but surely," French Prime Minister Edouard Philippe said, while warning that the health crisis was far from over.

Philippe said there were signals that pressures on hospitals were easing, after the number of people in intensive care dropped for several days in a row.

France, which has recorded close to 20,000 deaths as a result of the coronavirus pandemic, has been in virtual lockdown for nearly five weeks, but is due to start easing some confinement measures from May 11.

Philippe said that an economic crisis was only just starting as a result of the outbreak, adding that it would be "brutal."Reuters

Pope Francis leads the Easter vigil Mass in St. Peter's Basilica with no public participation due to the outbreak of coronavirus at the Vatican

Remo Casilli I Reuters

Pope Francis is urging the faithful to use the coronavirus pandemic's "time of trial" to prepare for a future where inequalities are abolished and the poorest are no longer left behind.

"This is not some ideology," Francis said. "It is Christianity."

Francis traveled a few blocks outside the Vatican walls on Sunday to celebrate Mass at a nearby church to mark a special feast day dedicated to mercy. Only a few priests were in the pews given Italy's strict virus lockdown.

While people infected with the coronavirus often experience mild or moderate symptoms, possible complications like pneumonia can put their lives at risk.

In his homily, Francis said the grave, global toll of the pandemic has reminded the world that there are no borders between those who suffer, no differences in nationalities among those who are struck or spared.

"We are all frail, all equal, all precious," he said.

"May we be profoundly shaken by what is happening all around us," he said from the altar of the Santo Spirito church. "The time has come to eliminate inequalities, to heal the injustice that is undermining the health of the entire human family!"Associated Press

Deaths from the COVID-19 epidemic in Italy rose by 433 on Sunday, the lowest daily tally in a week, and the number of new cases also slowed to 3,047 from a previous 3,491, the Civil Protection Agency said.

The death toll had risen by 482 on Saturday, down from 575 on Friday.

The daily tallies of deaths and cases extend the broadly stable situation in place over the last two weeks.

This plateau is down considerably from peaks reached around the end of March, but the downtrend has not proceeded as fast as was hoped in a country that has been in lockdown for almost six weeks.

Sunday's number of deaths marked the lowest daily rise since April 12, when it came in at 431, before rising again during the week.

The total death toll since the outbreak came to light on Feb. 21 rose to 23,660, the second highest in the world after that of the United States. Total confirmed cases stood at 178,972.Reuters

A "Temporarily Closed" sign hangs in the window of Nordstrom Inc. store in the Midtown neighborhood of New York, U.S., on Friday, March 20, 2020.

Gabby Jones | Bloomberg | Getty Images

America's department stores are on a sinking ship, racing for a lifeboat that might not be big enough for all of them.

ForJ.C. Penney,the bankruptcy clock is ticking after it skipped a mid-April interest payment. Its turnaround plans have been sidelined bythe coronavirus pandemic, which has forced the closure of all of its stores.Macy's, with liquidity drying up, hastapped advisors at investment bank Lazard and law firm Kirkland & Ellis to explore options that include new financing.Nordstromin early April raised $600 million by placing a handful of its real estate assets into a separate company and borrowing against the new entity by issuing bonds.

High-end department store chain Neiman Marcus also on April 15 missed a payment on some of its bonds, according to a letter sent to the retailer's board from Marble Ridge Capital, which owns a significant portion of the $137.7 million in bonds that mature in October 2021. Neiman Marcusnow has until the middle of Mayto make the interest payment. After that, pending no payment, the company could be pushed into bankruptcy court by its bondholders.

The company is currently preparing to seek bankruptcy protection as soon as this week,Reuters reported Sunday morning.

A spokesperson for Neiman Marcus declined to comment.Lauren Thomas

Thecoronavirusepidemic has so ravaged travel, live entertainment and physical retail that companies across those industries have frozen their marketing, causing ad prices to plunge.

Meanwhile, online beauty brandInsert Name Hereis generating so much business that it's snapping up ad space at a discount.

Based in Los Angeles, Insert Name Here sells hair extensions and wigs, which are in high demand now that women are unable to visit their hairstylists. To reach all those consumers who are stuck at home, Insert Name Here is working with social media influencers to create do-it-yourself styling videos for Instagram as well asFacebook, Tik Tok,Snapchatand YouTube.

Kevin Gould, Insert Name Here's co-founder, said prices for digital ads are currently down by about 35%, and the company has bolstered its spending, which is in the millions of dollars a year, by about 50% to 100%.Ari Levy, Megan Graham

The cruise ship Costa Deliziosa is anchored off the Greek island of Mykonos in the Aegean Sea June 13, 2019.

Soeren Stache | picture alliance | Getty Images

Passengers on a luxury liner's around-the-world cruise, begun before the globe was gripped by the coronavirus pandemic, are finally approaching the end of their odyssey after 15 weeks at sea.

The ship, the Costa Deliziosa, was heading Sunday toward a port in Spain before ending its journey in Italy both countries devastated by the coronavirus outbreak.

Costa Crociere, an Italian cruise company, said that the Deliziosa, which set sail from Venice in early January with 1,831 passengers, had no cases of COVID-19 aboard.

Dr. Rhonda Flores looks at protein samples at Novavax labs in Rockville, Maryland, one of the labs developing a vaccine for the coronavirus, COVID-19. ANDREW CABALLERO-REYNOLDS/AFP via Getty Images hide caption

Dr. Rhonda Flores looks at protein samples at Novavax labs in Rockville, Maryland, one of the labs developing a vaccine for the coronavirus, COVID-19.

According to new White House guidelines, a state, city, or county has to show a decreasing rate of confirmed coronavirus cases for 14 days before reopening their economy.

A year may seem like a long time to develop a vaccine for the coronavirus, but vaccine development typically takes longer. NPR's Joe Palca explains why it's so hard and what researchers are doing to speed things up.

Food banks around the country have been stretched, including one in San Antonio. Last week it served 10,000 families, many of whom are dealing with joblessness and food insecurity caused by the pandemic.

Plus, the man who developed the N95 mask filter technology comes out of retirement.

Find and support your local public radio station

Sign up for 'The New Normal' newsletter

This episode was produced by Anne Li, Gabriela Saldivia, and Brent Baughman, and edited by Beth Donovan.

The coronavirus is spreading from Americas biggest cities to its suburbs, and has begun encroaching on the nations rural regions. The virus is believed to have infected millions of citizens and has killed more than 34,000.

Yet President Trump this week proposed guidelines for reopening the economy and suggested that a swath of the United States would soon resume something resembling normalcy. For weeks now, the administrations view of the crisis and our future has been rosier than that of its own medical advisers, and of scientists generally.

In truth, it is not clear to anyone where this crisis is leading us. More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews. When can we emerge from our homes? How long, realistically, before we have a treatment or vaccine? How will we keep the virus at bay?

Some felt that American ingenuity, once fully engaged, might well produce advances to ease the burdens. The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers and eventually an effective vaccine.

Still, it was impossible to avoid gloomy forecasts for the next year. The scenario that Mr. Trump has been unrolling at his daily press briefings that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full is a fantasy, most experts said.

We face a doleful future, said Dr. Harvey V. Fineberg, a former president of the National Academy of Medicine.

He and others foresaw an unhappy population trapped indoors for months, with the most vulnerable possibly quarantined for far longer. They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.

My optimistic side says the virus will ease off in the summer and a vaccine will arrive like the cavalry, said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University medical school. But Im learning to guard against my essentially optimistic nature.

Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.

Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.

Covid-19, the illness caused by the coronavirus, is arguably the leading cause of death in the United States right now. The virus has killed more than 1,800 Americans almost every day since April 7, and the official toll may be an undercount.

By comparison, heart disease typically kills 1,774 Americans a day, and cancer kills 1,641.

Yes, the coronavirus curves are plateauing. There are fewer hospital admissions in New York, the center of the epidemic, and fewer Covid-19 patients in I.C.U.s. The daily death toll is still grim, but no longer rising.

The epidemiological model often cited by the White House, which was produced by the University of Washingtons Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.

While this is encouraging news, it masks some significant concerns. The institutes projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.

The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White Houses phased plan for reopening will surely raise the death toll no matter how carefully it is executed. The best hope is that fatalities can be held to a minimum.

Reputable longer-term projections for how many Americans will die vary, but they are all grim. Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48 percent to 65 percent of all Americans, with a fatality rate just under 1 percent, and would kill up to 1.7 million of them if nothing were done to stop the spread.

A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the United States by September under the same circumstances.

By comparison, about 420,000 Americans died in World War II.

The limited data from China are even more discouraging. Its epidemic has been halted for the moment and virtually everyone infected in its first wave has died or recovered.

China has officially reported about 83,000 cases and 4,632 deaths, which is a fatality rate of over 5 percent. The Trump administration has questioned the figures but has not produced more accurate ones.

Fatality rates depend heavily on how overwhelmed hospitals get and what percentage of cases are tested. Chinas estimated death rate was 17 percent in the first week of January, when Wuhan was in chaos, according to a Center for Evidence-Based Medicine report, but only 0.7 percent by late February.

In this country, hospitals in several cities, including New York, came to the brink of chaos. Officials in both Wuhan and New York had to revise their death counts upward this week when they realized that many people had died at home of Covid-19, strokes, heart attacks or other causes, or because ambulances never came for them.

In fast-moving epidemics, far more victims pour into hospitals or die at home than doctors can test; at the same time, the mildly ill or asymptomatic never get tested. Those two factors distort the true fatality rate in opposite ways. If you dont know how many people are infected, you dont know how deadly a virus is.

Only when tens of thousands of antibody tests are done will we know how many silent carriers there may be in the United States. The C.D.C. has suggested it might be 25 percent of those who test positive. Researchers in Iceland said it might be double that.

China is also revising its own estimates. In February, a major study concluded that only 1 percent of cases in Wuhan were asymptomatic. New research says perhaps 60 percent were. Our knowledge gaps are still wide enough to make epidemiologists weep.

All models are just models, Dr. Anthony S. Fauci, science adviser to the White House coronavirus task force, has said. When you get new data, you change them.

There may be good news buried in this inconsistency: The virus may also be mutating to cause fewer symptoms. In the movies, viruses become more deadly. In reality, they usually become less so, because asymptomatic strains reach more hosts. Even the 1918 Spanish flu virus eventually faded into the seasonal H1N1 flu.

At the moment, however, we do not know exactly how transmissible or lethal the virus is. But refrigerated trucks parked outside hospitals tell us all we need to know: It is far worse than a bad flu season.

The lockdowns will end, but haltingly.

No one knows exactly what percentage of Americans have been infected so far estimates have ranged from 3 percent to 10 percent but it is likely a safe bet that at least 300 million of us are still vulnerable.

Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.

Then the emergency rooms will get busy again.

Theres this magical thinking saying, Were all going to hunker down for a while and then the vaccine we need will be available, said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

In his wildly popular March 19 article in Medium, Coronavirus: The Hammer and the Dance, Tomas Pueyo correctly predicted the national lockdown, which he called the hammer, and said it would lead to a new phase, which he called the dance, in which essential parts of the economy could reopen, including some schools and some factories with skeleton crews.

Every epidemiological model envisions something like the dance. Each assumes the virus will blossom every time too many hosts emerge and force another lockdown. Then the cycle repeats. On the models, the curves of rising and falling deaths resemble a row of shark teeth.

Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.

The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.

Even the Opening Up America Again guidelines Mr. Trump issued on Thursday have three levels of social distancing, and recommend that vulnerable Americans stay hidden. The plan endorses testing, isolation and contact tracing but does not specify how these measures will be paid for, or how long it will take to put them in place.

On Friday, none of that stopped the president from contradicting his own message by sending out tweets encouraging protesters in Michigan, Minnesota and Virginia to fight their states shutdowns.

China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the viruss incubation period. Compared with China or Italy, the United States is still a playground.

Americans can take domestic flights, drive where they want, and roam streets and parks. Despite restrictions, everyone seems to know someone discreetly arranging play dates for children, holding backyard barbecues or meeting people on dating apps.

Partly as a result, the country has seen up to 30,000 new case infections each day. People need to realize that it's not safe to play poker wearing bandannas, Dr. Schaffner said.

Even with rigorous measures, Asian countries have had trouble keeping the virus under control.

China, which has reported about 100 new infections per day, recently closed all the countrys movie theaters again. Singapore has closed all schools and nonessential workplaces. Japan recently declared a state of emergency. (South Korea has struggled at times, too, but on Sunday reported only eight new cases, the first single-digit increase in two months.)

Resolve to Save Lives, a public health advocacy group run by Dr. Thomas R. Frieden, the former director of the C.D.C., has published detailed and strict criteria for when the economy can reopen and when it must be closed.

Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals.

We need to reopen the faucet gradually, not allow the floodgates to reopen, Dr. Frieden said. This is a time to work to make that day come sooner.

Imagine an America divided into two classes: those who have recovered from infection with the coronavirus and presumably have some immunity to it; and those who are still vulnerable.

It will be a frightening schism, Dr. David Nabarro, a World Health Organization special envoy on Covid-19, predicted. Those with antibodies will be able to travel and work, and the rest will be discriminated against.

Already, people with presumed immunity are very much in demand, asked to donate their blood for antibodies and doing risky medical jobs fearlessly.

Soon the government will have to invent a way to certify who is truly immune. A test for IgG antibodies, which are produced once immunity is established, would make sense, said Dr. Daniel R. Lucey, an expert on pandemics at Georgetown Law School. Many companies are working on them.

Dr. Fauci has said the White House was discussing certificates like those proposed in Germany. China uses cellphone QR codes linked to the owners personal details so others cannot borrow them.

The California adult-film industry pioneered a similar idea a decade ago. Actors use a cellphone app to prove they have tested H.I.V. negative in the last 14 days, and producers can verify the information on a password-protected website.

As Americans stuck in lockdown see their immune neighbors resuming their lives and perhaps even taking the jobs they lost, it is not hard to imagine the enormous temptation to join them through self-infection, experts predicted. Younger citizens in particular will calculate that risking a serious illness may still be better than impoverishment and isolation.

My daughter, who is a Harvard economist, keeps telling me her age group needs to have Covid-19 parties to develop immunity and keep the economy going, said Dr. Michele Barry, who directs the Center for Innovation in Global Health at Stanford University.

It has happened before. In the 1980s, Cuba successfully contained its small AIDS epidemic by brutally forcing everyone who tested positive into isolation camps. Inside, however, the residents had their own bungalows, food, medical care, salaries, theater troupes and art classes.

Dozens of Cubas homeless youths infected themselves through sex or blood injections to get in, said Dr. Jorge Prez vila, an AIDS specialist who is Cubas version of Dr. Fauci. Many died before antiretroviral therapy was introduced.

It would be a gamble for American youth, too. The obese and immunocompromised are clearly at risk, but even slim, healthy young Americans have died of Covid-19.

The virus can be kept in check, but only with expanded resources.

The next two years will proceed in fits and starts, experts said. As more immune people get back to work, more of the economy will recover.

But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative.

Dr. Fauci has said the virus will tell us when its safe. He means that once a national baseline of hundreds of thousands of daily tests is established across the nation, any viral spread can be spotted when the percentage of positive results rises.

Detecting rising fevers as they are mapped by Kinsas smart thermometers may give an earlier signal, Dr. Schaffner said.

But diagnostic testing has been troubled from the beginning. Despite assurances from the White House, doctors and patients continue to complain of delays and shortages.

To keep the virus in check, several experts insisted, the country also must start isolating all the ill including mild cases.

In this country, patients who test positive are asked to stay in their homes but keep away from their families.

Television news has been filled with recuperating personalities like CNNs Chris Cuomo, sweating alone in his basement while his wife left food atop the stairs, his children waved and the dogs hung back.

But even Mr. Cuomo ended up illustrating why the W.H.O. strongly opposes home isolation. On Wednesday, he revealed that his wife had the virus.

If I was forced to select only one intervention, it would be the rapid isolation of all cases, said Dr. Bruce Aylward, who led the W.H.O. observer team to China.

In China, anyone testing positive, no matter how mild their symptoms, was required to immediately enter an infirmary-style hospital often set up in a gymnasium or community center outfitted with oxygen tanks and CT scanners.

There, they recuperated under the eyes of nurses. That reduced the risk to families, and being with other victims relieved some patients fears. Nurses even led dance and exercise classes to raise spirits, and help victims clear their lungs and keep their muscle tone.

Still, experts were divided on the idea of such wards. Dr. Fineberg co-wrote a New York Times Op-Ed article calling for mandatory but humane quarantine processes.

By contrast, Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health, opposed the idea, saying: I dont trust our government to remove people from their families by force.

Ultimately, suppressing a virus requires testing all the contacts of every known case. But the United States is far short of that goal.

Someone working in a restaurant or factory may have dozens or even hundreds of contacts. In Chinas Sichuan Province, for example, each known case had an average of 45 contacts.

The C.D.C. has about 600 contact tracers and, until recently, state and local health departments employed about 1,600, mostly for tracing syphilis and tuberculosis cases.

China hired and trained 9,000 in Wuhan alone. Dr. Frieden recently estimated that the United States will need at least 300,000.

Even though limited human trials of three candidates two here and one in China have already begun, Dr. Fauci has repeatedly said that any effort to make a vaccine will take at least a year to 18 months.

All the experts familiar with vaccine production agreed that even that timeline was optimistic. Dr. Paul Offit, a vaccinologist at the Childrens Hospital of Philadelphia, noted that the record is four years, for the mumps vaccine.

Researchers differed sharply over what should be done to speed the process. Modern biotechnology techniques using RNA or DNA platforms make it possible to develop candidate vaccines faster than ever before.

But clinical trials take time, in part because there is no way to rush the production of antibodies in the human body.

Also, for unclear reasons, some previous vaccine candidates against coronaviruses like SARS have triggered antibody-dependent enhancement, which makes recipients more susceptible to infection, rather than less. In the past, vaccines against H.I.V. and dengue have unexpectedly done the same.

A new vaccine is usually first tested in fewer than 100 young, healthy volunteers. If it appears safe and produces antibodies, thousands more volunteers in this case, probably front-line workers at the highest risk will get either it or a placebo in what is called a Phase 3 trial.

It is possible to speed up that process with challenge trials. Scientists vaccinate small numbers of volunteers, wait until they develop antibodies, and then challenge them with a deliberate infection to see if the vaccine protects them.

Challenge trials are used only when a disease is completely curable, such as malaria or typhoid fever. Normally, it is ethically unthinkable to challenge subjects with a disease with no cure, such as Covid-19.

But in these abnormal times, several experts argued that putting a few Americans at high risk for fast results could be more ethical than leaving millions at risk for years.

Fewer get harmed if you do a challenge trial in a few people than if you do a Phase 3 trial in thousands, said Dr. Lipsitch, who recently published a paper advocating challenge trials in the Journal of Infectious Diseases. Almost immediately, he said, he heard from volunteers.

Others were deeply uncomfortable with that idea. I think its very unethical but I can see how we might do it, said Dr. Lucey.

The hidden danger of challenge trials, vaccinologists explained, is that they recruit too few volunteers to show whether a vaccine creates enhancement, since it may be a rare but dangerous problem.

Challenge trials wont give you an answer on safety, said Michael T. Osterholm, director of the University of Minnesotas Center for Infectious Disease Research and Policy. It may be a big problem.

Dr. W. Ian Lipkin, a virologist at Columbia Universitys Mailman School of Public Health, suggested an alternative strategy. Pick at least two vaccine candidates, briefly test them in humans and do challenge trials in monkeys. Start making the winner immediately, even while widening the human testing to look for hidden problems.

As arduous as testing a vaccine is, producing hundreds of millions of doses is even tougher, experts said.

Most American vaccine plants produce only about 5 million to 10 million doses a year, needed largely by the 4 million babies born and 4 million people who reach age 65 annually, said Dr. R. Gordon Douglas Jr., a former president of Mercks vaccine division.

But if a vaccine is invented, the United States could need 300 million doses or 600 million if two shots are required. And just as many syringes.

People have to start thinking big, Dr. Douglas said. With that volume, youve got to start cranking it out pretty soon.

Flu vaccine plants are large, but those that grow the vaccines in chicken eggs are not suitable for modern vaccines, which grow in cell broths, he said.

European countries have plants but will need them for their own citizens. China has a large vaccine industry, and may be able to expand it over the coming months. It might be able to make vaccines for the United States, experts said. But captive customers must pay whatever price the seller asks, and the safety and efficacy standards of some Chinese companies are imperfect.

India and Brazil also have large vaccine industries. If the virus moves rapidly through their crowded populations, they may lose millions of citizens but achieve widespread herd immunity well before the United States does. In that case, they might have spare vaccine plant capacity.

Alternatively, suggested Arthur M. Silverstein, a retired medical historian at the Johns Hopkins School of Medicine, the government might take over and sterilize existing liquor or beer plants, which have large fermentation vats.

Germany, seeking a path out of lockdown, begins broad random testing for antibodies.

While other nations are still struggling to test for infections, Germany is doing that and more. It is aiming to sample the entire population for antibodies in coming months, hoping to gain valuable insight into how deeply the virus has penetrated the society at large, how deadly it really is, and whether immunity might be developing.

In Munich, residents of 3,000 households chosen at random are being asked to allow monthly blood tests for Covid-19 antibodies for a year. Its an ambitious study whose central aim is to understand how many people even those with no symptoms have already had the virus, a key variable to make decisions about public life in a pandemic.

The Munich research is the largest of several regional studies being rolled out in various corners of the country, which has become a leader among Western nations figuring out how to control the contagion while returning to something resembling normal life.

The government hopes to use the findings to unravel a riddle that will allow Germany to move securely into the next phase of the pandemic: Which of the far-reaching social and economic restrictions that have slowed the virus are most effective and which can be safely lifted?

The same questions are being asked around the world. Other countries like Iceland and South Korea have tested broadly for infections, or combined testing with digital tracking to undercut the spread of the virus. But even the best laid plans can go awry; Singapore attempted to reopen only to have the virus re-emerge.

The antibody testing has its limits. Scientists caution that there is no proof yet that the detection of antibodies signals effective immunity. And even antibodies were proven to offer immunity, there is no clarity on how long it might last.

And the country is still struggling with its outbreak. Germany recorded a fourth straight day of a spike in new infections on Saturday. Data from the Robert Koch Institute for infectious diseases showed that coronavirus cases rose by 3,609, for a total of 137,439. The death toll rose by 242, to 4,110.

Netanyahu says some restrictions in Israel will be relaxed.

With mortality rates relatively low but the unemployment rate at more than 26 percent, Israel is set to begin easing restrictions imposed to fight the coronavirus, Prime Minister Benjamin Netanyahu announced Saturday night.

From tomorrow, we start opening up both the personal sphere and the economic sphere, he said in a televised appearance.

Outdoor prayer will be permitted in spread-out groups of up to 10 people, he said, and exercise will be allowed for people in pairs up to 500 meters from their homes, up from 100 meters.

An eclectic list of retail establishments will be allowed to reopen, including electrical and office supply stores, laundries, bookstores, housewares dealers and opticians. But malls will remain locked, meaning only permitted businesses with their own storefronts will reopen. And shops will be limited to serving two customers at a time and required to install physical barriers between customers and cashiers.

Restaurants, hairdressers, clothing, shoe and toy stores all remain closed.

Other businesses will be allowed to bring up to 30 percent of their workforces back to their positions, up from 15 percent.

A new purple seal certification will allow employers to resume operations contingent on meeting conditions like requiring workers to wear face masks, have regular temperature checks and regularly disinfect surfaces; barring meetings of more than eight people; documenting who works where and when; and forcing the entire workplace to shut down if anyone there gets sick.

Mr. Netanyahu urged Israelis age 67 and older to stay home for the time being, and pleaded with Muslim citizens to avoid feasts and other gatherings during the monthlong celebration of Ramadan, which begins Thursday night.

Iran lifts Tehrans lockdown, despite warnings from health officials.

With the coronavirus outbreak still raging within its borders, Iran on Saturday lifted the lockdown on its capital and called on government and private-sector employees to return to work.

The rest of Irans provinces had lifted a two-week lockdown and travel restrictions a week earlier. Schools and sporting events remain closed, and restaurants have been restricted to takeout.

President Hassan Rouhani has called his return-to-work policy a smart distancing strategy that will fight two enemies: the pandemic and the collapse of an economy that was already strained by international sanctions.

Our message is the great people of Iran and all private and government entities, labor workers and engineers, despite fighting the coronavirus on one front, are also continuing the economic development of our country, he said on Thursday.

More than 5,000 people with the virus have died in Iran, including some of the countrys top officials, and about 80,000 have been infected, according to government figures. But local experts and health officials say that many others who showed symptoms of the virus have died or fallen ill without being tested.

Health officials say that easing the restrictions too soon risks another surge in infections.

Irans military held annual parades on Friday in Tehran and other cities. The parade typically shows off military hardware, but this year soldiers marched in protective gear, and ambulances and medical equipment replaced missiles and drones.

In Italy, the number of I.C.U. patients had dropped to 2,812 by Friday, and hospitalizations for Covid-19, the disease caused by the virus, had fallen from a high of 29,010 patients on April 4 to 25,786, reflecting a steady decline in one of the worlds hardest-hit countries, attributed to the national lockdown imposed on March 10.

In Spain, Prime Minister Pedro Snchez said he would extend the countrys state of emergency to May 9 but would on April 27 ease a stringent lockdown on children that had raised fears of long-term psychological damage.

Queen Elizabeth II of Britain turns 94 on Tuesday, but the traditional artillery salute to mark her birthday has been canceled. The queen, who has sequestered herself at Windsor Castle since mid-March, said she did not feel it appropriate in the current circumstances, according to Buckingham Palace.

In Canada, Prime Minister Justin Trudeau said the United States agreed to keep their border closed for another 30 days. Recent suggestions by President Trump that the border with Canada might be reopened soon were not well received there. Absolutely not, Doug Ford, Ontarios premier, said when asked if he would like Americans to re-enter Canada soon. I dont want them in Ontario.

The Trump administration has charged forward with its aggressive immigration enforcement agenda, though the pace appears to have slowed. The U.S. Immigration and Customs Enforcement has carried out 2,985 removals of foreign nationals so far in April. In March, I.C.E. completed 17,965 removals.

Guatemala has counted dozens of cases of coronavirus among people deported by U.S. Immigration and Customs Enforcement since late March, and the U.S. authorities have said they were suspending removals to Guatemala pending an investigation.

In Nigeria, the presidents chief of staff, Mallam Abba Kyari, has died from Covid-19, one of the highest-profile deaths from the pandemic in Africa. Mr. Kyari, whose national power was considered second only to that of President Muhammadu Buhari, died on Friday after battling the virus for nearly a month, a presidential spokesman said Saturday on Twitter.

In Japan, more than 50,000 people have signed a petition requesting that people made homeless by emergency policies to fight the coronavirus be given shelter at the Olympic Village.

More than a dozen leading pro-democracy activists and former lawmakers in Hong Kong were arrested on Saturday in connection with the protests that raged in the city last year, the biggest roundup of prominent opposition figures in recent memory.

The high-profile arrests were made as Hong Kong battles to contain the coronavirus outbreak, which has helped quiet down the huge street protests but fueled further distrust of the authorities in the semiautonomous Chinese territory. The virus has halted protests around the world, forcing people to stay home and giving the authorities new power to limit public gatherings and detain people with little fear of public blowback.

Those arrested in Hong Kong included the veteran lawyers Martin Lee and Margaret Ng, the media tycoon Jimmy Lai and the former opposition legislators Albert Ho, Lee Cheuk-yan and Leung Kwok-hung, political parties and aides said. They were among 15 activists rounded up on suspicion of organizing, publicizing or taking part in unauthorized assemblies from August to October and will face prosecution, the police said on Saturday.

Lau Siu-kai, vice president of the Chinese Association of Hong Kong and Macau Studies, a powerful Beijing advisory group, said the arrests represented an early step toward a broader crackdown by Beijing on the Hong Kong opposition. They also reflect an assessment by Beijing that protests in Hong Kong over the past year pose such a threat to national security that it is worthwhile to defy American threats of retaliation if a crackdown takes place, he said.

Now Beijing is calling the U.S.s bluff and taking the initial steps against the Hong Kong opposition, and there will be more steps to shrink their space, Mr. Lau said.

The virus deals a heavy blow to Canadas nursing homes.

The harrowing details about the Rsidence Herron nursing home in suburban Montreal continued to mount this week: Medical workers who had abandoned hungry and desperately ill patients. An owner with a long criminal history. Thirty-one dead in less than a month five from confirmed cases of coronavirus.

Across Canada, nursing homes have been devastated by the virus. This week, Canadas chief public health officer, Dr. Theresa Tam, attributed about half of the countrys coronavirus deaths which had reached over 1,300 as of Saturday morning to long-term care homes.

The scale of deaths at these facilities has raised a difficult question: Beyond the obvious insidiousness of a highly contagious virus, how has this been possible in Canada, a country with a vaunted universal health care system and a culture of humanism?

Dr. Susan Bartlett, a clinical psychologist and professor of medicine at McGill Medical School, has counseled families about caring for their older parents. In addition to her professional expertise, she has a personal interest in the Rsidence Herron catastrophe: Her 94-year-old mother was a resident at the Herron in 2018. The nursing home is now under police investigation amid accusations of gross negligence.

Dr. Bartlett said that while her mothers care had initially been satisfactory, conditions at the residence deteriorated as the owners went on an aggressive cost-cutting spree and struggled to find qualified employees.

She said it was hard to fathom that the body bags leaving the residence amid the pandemic had not raised alarms sooner. Why didnt anyone scream at the top of their lungs? she said.

U.S. roundup: Protests against states stay-at-home orders keep sprouting, even though most Americans agree with caution.

As millions of Americans continued to shelter in their homes to slow the spread of coronavirus, several dozen protesters in Texas converged on the steps of the Capitol building in Austin on Saturday to call for the reopening of the state and the country.

The You Cant Close America rally followed a wave of similar protests at statehouses and in city streets this past week. Other people also defied isolation orders by protesting on Saturday in Indianapolis, Carson City, Nev., and Annapolis, Md.

The United States has the worlds largest known outbreak, with more than 717,000 confirmed cases and more than 34,000 deaths.

With more than 22 million unemployment claims nationwide in the past four weeks, some conservatives have begun voicing displeasure with the moribund economy. The protests they have fanned have been encouraged by President Trump.

By merely assembling, the protesters were in violation of the stay-at-home orders replicated across the United States in a bid to save lives.

The protests do not appear to represent a broad swath of the country. A Pew Research Center poll released on Thursday showed that two-thirds of Americans expressed more concern that the economy would reopen too quickly and allow the coronavirus to keep spreading, rather than that it would open too slowly, causing undue strain. Even among most Republicans, bringing things back online too fast was the greater source of concern.

In Austin, at least 100 people gathered on the statehouse grounds in hats and shirts with President Trumps slogan, Make America Great Again. Some carried American flags, and few wore masks that are mandated by the city.

The urgency of the rally was dampened somewhat on Friday by Gov. Greg Abbott, a Republican, who announced that he would do precisely what protesters are demanding: reopen Texas.

The largest of the recent protests, by far, was on Wednesday in Lansing, Mich., where thousands of people protested Gov. Gretchen Whitmers stay-at-home order in a campaign that organizers called Operation Gridlock.

Also in the United States:

Gov. Andrew M. Cuomo of New York, the pandemics global epicenter, said that the states daily death toll from the virus had fallen to 540, its lowest in more than two weeks. If you look at the past three days, you could argue we are past the plateau and starting to descend, Mr. Cuomo said. The state has lost more than 13,000 people to the virus. Read the latest updates from New York.

Doctors are scrambling to handle an unanticipated crisis as a surge in Covid-19 patients with kidney failure has led to shortages of machines, supplies and staff required for emergency dialysis.

Democrats sent the Trump administration a compromise offer late Friday evening in an effort to break an impasse over replenishing funds for a new loan program, created as a way to help businesses weather the pandemic.

The Pentagon announced that it would prolong a national and international travel ban, stopping military units from deploying overseas and returning until June 30. The original ban was set to expire in mid-May.

With much of the world staying at home to contain the coronavirus, animals in the wild are finding new terrains to roam and sleep.

This week, a pride of lions was spotted lying across traffic-free roads at Kruger National Park in South Africa. The park was closed on March 25 just as the country prepared to go into a lockdown that forced most of its 59 million people to stay at home except when seeking to buy medicine and food or to collect social benefits.

Visitors to the part dont usually see the lions, since they live in a different area of the park. But the park said on Twitter, This afternoon they were lying on the tar road just outside.

Across the world, animals have ventured into desolate streets and emptied-out cities as people practice social distancing and remain in lockdown. Great Orme Kashmiri goats have been spotted in Wales, along with coyotes in San Francisco and swarms of rats where tourists once thronged in the French Quarter of New Orleans.

While the sightings of the lions delighted many on social media, the images highlight the dangers facing Africas multibillion-dollar tourism industry. The sector is a major source of revenue, and national lockdowns, visa restrictions and border closures have led to mass unemployment on the continent. With reduced staffing in national parks, poaching has also increased.

In the United States, President Trumps mercurial messages have been widely contrasted with the detailed briefings by Gov. Andrew M. Cuomo of New York. But elsewhere in the world, leaders have also taken approaches that run the gamut from dismissive to serious to somber to combative offering insights into governing in a time of crisis.

In one of his first news conferences about the virus, Mr. Johnson talked about a clear plan for Britain to contain it but detailed few concrete measures.

Early on, Mr. Johnson also talked about the values of herd immunity, suggesting that allowing many in Britain to be exposed to the virus would help build immunity. Days later, he reversed course, putting the nation on lockdown and ordering Britons to stay at home.

Ms. Merkel shocked some during one of her earliest news briefings on the outbreak when she outlined a stark possibility: In a worst-case situation, she said, up to 70 percent of the German population could become infected.

At a time when other leaders were hoping to lessen the blow in their messaging, she stood out. But her frankness preserved the trust of Germans, and her approval ratings have gone through the roof.

For autocrats and strongmen, the pandemic has become an excuse to consolidate power further and extend their reach. In the Philippines, it is Mr. Dutertes latest reason to greenlight extrajudicial killings. More than 5,000 people have been killed in his war on drugs.

Initially dismissive of the coronavirus, Mr. Duterte reversed course late last month, introducing stringent measures, including a lockdown. Critics have accused him of simply pursuing his often-stated ambition of imposing martial law. He threatened those who considered breaking the lockdown, instructing the police and military to shoot them dead.

Theyre self-isolating at sea. But even floating around the Caribbean has its downsides.

Simon Fowler, a British events organizer, is sitting out the pandemic with his wife in a catamaran anchored offshore of a deserted beach in the Bahamas. But it has not been idyllic.

Being out here in a pandemic is actually a lot harder and more stressful than you might think, Mr. Fowler, 60, said. It has been quite nasty.

The seas may be the ultimate self-isolating destination, but people aboard everything from solo craft to superyachts say they also bring logistical hurdles and ethical dilemmas. Then there is social media: the comments and tweets calling them entitled, clueless about the struggles of the day.

David Geffen, the Hollywood billionaire, posted a photo of the Caribbean sunset from his $590 million yacht, Rising Sun, with the message Isolated in the Grenadines avoiding the virus. The response made other secretive superyacht owners even less disclosing of their whereabouts.

Mr. Fowler suffered his own online kicking after noting on Facebook that he and his wife plan to flee the hurricane season by making the weeklong journey to Bermuda.

I got an absolute tsunami of abuse saying how selfish I was, he said. People were vulgar and vile.

Bobby White, a sailing blogger from the United States who is now anchored in the U.S. Virgin Islands, bares all about his current voyage. Traffic to his YouTube videos, his source of income, has soared.

People are bored stuck at home and have nothing better to do than watch YouTube so thats great for me, Mr. White said. I understand that some people are going to be negative so I try not to post too much of: Hey look at me, I am having fun out on the water.

A Republican election strategy increasingly is to shift blame to China.

The strategy could not be clearer: From the Republican lawmakers blanketing Fox News to new ads from President Trumps super PAC to the biting criticism on Donald Trump Jr.s Twitter feed, the G.O.P. is attempting to divert attention from the administrations heavily criticized response to the coronavirus by pinning the blame on China.

With the death toll from the pandemic already surpassing 34,000 Americans and unemployment soaring to levels not seen since the Great Depression, Republicans increasingly believe that elevating China as an archenemy culpable for the spread of the virus may be the best way to salvage a difficult election.

Mr. Trumps own campaign aides have endorsed the strategy, releasing an attack ad last week depicting Joseph R. Biden Jr., the presumptive Democratic nominee, as soft on China. The ad relied heavily on images of people of Asian descent, including former Gov. Gary Locke of Washington, who is Chinese-American, and it was widely viewed as fanning the flames of xenophobia.

But there is a potential impediment to the G.O.P. plan the leader of the party himself.

Eager to continue trade talks, uneasy about further rattling the markets and hungry to protect his relationship with President Xi Jinping at a moment when the United States is relying on Chinas manufacturers for lifesaving medical supplies, Mr. Trump has repeatedly muddied Republican efforts to fault China.

Even as the president tries to rebut criticism of his slow response to the outbreak by highlighting his January travel restrictions on China, he has repeatedly called Mr. Xi a friend and said we are dealing in good faith with the repressive government. Yet in private, he has vented about the country.

Mr. Biden, for his part, has criticized Mr. Trumps warm words for China. On Friday, his campaign released a video assailing the president for not pressing Mr. Xi to let the Centers for Disease Control and Prevention into his country and for being more worried about protecting his trade deal with China than he was about the virus.

Malaysia is asked to stop turning away Rohingya refugees.

Human rights advocates are calling on Malaysia, which turned away at least two boats filled with Rohingya refugees, to reverse itself and start accepting the migrants.

Human Rights Watch said in a statement Saturday that Malaysia can be mindful of the coronavirus pandemic without endangering the lives of refugees as it responds to it.

On Thursday, the Malaysian navy intercepted a boat with 200 Rohingya refugees, and prevented it from entering Malaysian waters, according to The Associated Press. Its unclear what happened to that boat.

The day before, the Bangladesh Coast Guard intercepted another boat with 382 refugees, who had been turned away from Malaysian waters weeks prior, survivors said. Although many of the refugees were removed from that boat, at least 30 people died before the rescue.

Malaysias National Security Council on Saturday defended its decision to turn away the boat over concerns the refugees would be exposed to the coronavirus. An official for the council said refugees were given food and fresh water before being turned away.

In March, Malaysia started banning the entry of foreign nationals to curb the outbreak in the country. Malaysia, a nation of more than 30 million people, has 5,251 confirmed cases with 86 deaths, according to the World Health Organization.

Malaysias claims to support the rights of the Rohingya mean shockingly little when they push desperate refugees back to sea, said Phil Robertson, the deputy Asia director for Human Rights Watch.

The pandemic has intensified the misery of the Rohingya, who are confined in Myanmar and in camps in Bangladesh, Mr. Robertson said, adding that the Malaysian government can both protect against the spread of the virus and ensure that those risking their lives at sea are rescued and given a chance to seek asylum.

Singapore records another daily high.

Singapore on Saturday announced a record rise in new coronavirus infections for the third time this week, with most of the 942 new cases coming from crowded dormitories for migrant laborers.