Brazil Passes 1 Million Coronavirus Cases, Adding 54,000 in a Day


Brazil on Friday became the second country to pass one million coronavirus cases, recording a staggering 54,771 cases in the past 24 hours — an increase the country’s Health Ministry attributed at least in part to a lag in reporting from three states. The United States has reported more than 2.2 million cases.

More than 48,954 people in Brazil have died of Covid-19, second only to the total in the United States, according to a New York Times database. If the trend lines hold, some epidemiologists project the death toll of the epidemic in Brazil could surpass that in the United States by late July. Latin America has become an epicenter of the coronavirus pandemic in recent weeks, largely because of Brazil’s ballooning caseload.

About half of Friday’s increase was due to delayed reporting in three states, including São Paulo, health officials said.

The country’s response to the crisis has been widely criticized at home and abroad. President Jair Bolsonaro has dismissed the danger posed by the virus, sabotaged quarantine measures adopted at the state level and called on Brazilians to continue working to keep the economy from collapsing.

On Friday, Gov. Ron DeSantis of Florida, a Republican, sought to allay concerns about the spike in cases. He attributed the rise to an increase of infections among people under 40, many of whom, he stressed, were asymptomatic and less likely to put a strain on hospitals. The majority of deaths in the state were among residents 65 and older, and were centered at long-term care facilities, where Mr. DeSantis said the number of cases was declining.

He said an increase in testing across the state had also contributed to the rise, even as he cautioned that there had been an “erosion of social distancing among the younger population.” “As you test more, you find more,” he said.

The Trump administration has made a misleading claim that the recent jumps are a result of more aggressive testing.

But public health officials point to the easing of restrictions at businesses such as bars and restaurants, and a lack of social distancing among many beachgoers, among other factors, to help explain the rise. Some businesses in the state have had to reclose after employees fell ill. Apple on Friday said it was temporarily closing 11 retail stores across four states — Florida, South Carolina, North Carolina and Arizona — amid the surge in infections.

Eric Rosengren, the president of the Federal Reserve Bank of Boston and an influential policy maker within the central bank system, cited the rising caseloads in South Carolina and Florida as he warned of the economic impact of states’ reopening before the virus is under control.

Mr. Rosengren said that because of the virus’s continued spread “and the acceleration of new cases in many states, I expect the economic rebound in the second half of the year to be less than was hoped for at the outset of the pandemic.”

Scientists generally agree that wearing face masks can help curb the spread of the virus. For politicians and businesses, however, the decision of whether to require masks is growing increasingly contentious, with some viewing the requirements as an essential safety measure while others call them an infringement on personal liberty.

The court said that because Oklahoma’s reopening plan, put in place on June 1, allowed businesses to use their discretion when instituting social distancing measures, such restrictions were not mandatory.

At the same time, city officials rescinded a three-night curfew, after Mr. Trump said on Twitter that he had spoken with the mayor, “who informed me there will be no curfew tonight or tomorrow for our many supporters” — a chaotic about-face from the previous plans.

The only day with more new cases in the state was Thursday, when 450 were reported. The third-highest number, 259, came on Wednesday.

Asked at his daily news briefing on Friday exactly how much activity he would deem safe, Mayor Bill de Blasio put the onus on New Yorkers to decide for themselves.

“This is a very personal decision that people need to make, and I’d say to anyone who feels cautious or uncomfortable, listen to that — and less is more, right?” Mr. de Blasio said. “We are going through stages — we’re feeling our way.”

A short time later, Gov. Andrew M. Cuomo ended his run of more than 100 consecutive daily news conferences, with an address from his office. After confirming that New York City would ease more restrictions on Monday, he presented a montage of New Yorkers during the crisis that featured his own narration.

During his address, Mr. Cuomo warned that “Covid isn’t over” — there were 25 additional deaths reported statewide — and said more work was needed to contain it. But he also struck a reflective and celebratory tone, citing continued low levels of virus-related infections, hospitalizations and deaths.

“I’m so incredibly proud of what we all did together, and as a community,” Mr. Cuomo said. “We reopened the economy and we saved lives.”

Here’s what else is happening in the U.S.:

  • A Navy investigation has concluded that the two top officers aboard the aircraft carrier Theodore Roosevelt made poor decisions in response to the outbreak of the virus on board the warship. As a result of the findings, Capt. Brett E. Crozier, will not be restored to command of the virus-stricken ship, and his boss on board, Rear. Adm. Stuart P. Baker, will have a promotion to two-star admiral put on hold. There will be no other punitive action against Captain Crozier.

  • The virus kills by filling the lungs with fluid and robbing the body of oxygen, yet the Biomedical Advanced Research and Development Authority, a federal health agency known as BARDA, notified companies and researchers this month that it was halting funding for new treatments for this severe form of Covid-19, the disease caused by the virus.

  • In Washington, the mayor said that some restrictions in the nation’s capital would ease on Monday, allowing gatherings of up to 50 people, limited indoor dining, and reopening playgrounds and fitness centers.

  • In New Jersey, residents of nursing homes and other long-term care facilities can begin seeing visitors on June 21, state officials announced. As of Friday, more than 6,150 deaths had been reported in long-term care facilities, almost half the total number of deaths in the state. The overall death toll grew by 37 statewide.

  • Cruise lines won’t sail from U.S. ports until Sept. 15, the Cruise Lines International Association said, after its members agreed to extend a suspension that was to expire on July 24.

  • Two Major League Baseball clubs, the Philadelphia Phillies and the Toronto Blue Jays, and a professional hockey team, the Tampa Bay Lightning, shut down their training facilities in Florida this week, after several players and staff members tested positive and others showed symptoms consistent with the virus.

Italian scientists on Friday said they found traces of the virus in samples of sewage water collected in December, further suggesting that the virus was already circulating in the country months before the outbreak at the end of February.

Researchers at the Italian National Institute of Health discovered the presence of the RNA of the virus in samples taken in the northern cities of Milan and Turin on Dec. 18, more than two months before the country’s first case was diagnosed on Feb 20. Traces were also found in samples from the city of Bologna, about 125 miles (200 kilometers) south of Milan, on Jan. 29.

“We showed that the virus was already circulating,” said Lucia Bonadonna, an official at the institute. “Probably in asymptomatic or little-symptomatic forms before we had our first local case.”

While the new findings shift the virus’s timeline earlier in Europe, they do not significantly change the pandemic’s known timeline. Chinese officials reported the outbreak in Wuhan on Dec. 31, but later traced cases that emerged as far back as Dec. 1.

Italian scientists and officials have long suspected that the virus had moved undetected in the northern region of Lombardy, an economic hub where there is frequent trade with China, at least weeks before the contagion came to light.

Similar evidence has recently emerged around the world, indicating that by the time the authorities were aware of an outbreak, the virus was already more widespread than initially believed.

In France, a sample taken from a patient on Dec. 27 tested positive last month. And in California, health officials discovered a virus-linked death on Feb. 6, weeks before the earliest recorded case of U.S. community transmission.

Health experts worry that in the race to find drugs and vaccines, a substantial proportion of studies may be excluding older subjects, purposely or inadvertently, even as 80 percent of American deaths have occurred in people over age 65.

“A year from now, when these trials are published, I don’t want to see that there’s no one in them over 75,” said Dr. Sharon K. Inouye, a geriatrician at Harvard Medical School and Hebrew SeniorLife. “If they create a drug that works really well in healthy 50- and 60-year-olds, they’ve missed the boat.”

She and her team have reviewed 241 interventional Covid-19 studies that have been undertaken in the United States and are listed on clinicaltrials.gov, a site maintained by a division of the National Institutes of Health.

They found that 37 of these trials — which test drugs, vaccines and devices — set specific age limits and would not enroll participants older than 75, 80 or 85. A few even excluded those over 65.

Another group of 27 trials set no maximum age but used study designs that could nevertheless disqualify many older adults. Some excluded people with illnesses common among the older population, like hypertension or diabetes, even if participants controlled the disease through medication. “Surrogates for age exclusion,” Dr. Inouye said.

There is a long history of older people being excluded from clinical trials, even when the diseases in question disproportionately affected this group.

“Ideally, the patients enrolled in a randomized clinical trial reflect the demographics of the disease,” said Dr. Mark Sloan, a hematologist leading a Covid-19 drug study at Boston Medical Center, in an email. “Unfortunately, this is seldom the case.”

Genetic analysis of the coronavirus spreading in Beijing indicates that it has recent roots in Europe, Chinese government scientists have told the World Health Organization.

That is a strong suggestion that “the disease was probably imported from outside Beijing at some point,” though not that Europe was the origin of the new outbreak, Dr. Michael Ryan, executive director of the health emergency services program at the W.H.O., said on Friday.

Chinese researchers have posted the genomic sequence to online databases for further analysis, Dr. Ryan said.

Officials have been racing to explain and contain the new outbreak in the Chinese capital, a cluster of more than 180 infections at the vast Xinfadi wholesale market that emerged after 56 days of no new locally-transmitted cases.

There has been no wholesale lockdown, but the city’s schools have been shut and strict limitations imposed in high-risk neighborhoods. On Thursday, thousands of restaurant workers lined up around the city to get tested.

  • Updated June 16, 2020

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • Will protests set off a second viral wave of coronavirus?

      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


Travelers are being required to show proof of a negative nucleic acid test taken within seven days of boarding planes or trains out of Beijing, and the wait-list at some hospitals stretches into September, according to Caixin, a Chinese investigative news outlet.

One person near me was without a face covering, another kept shuffling closer, and a third — her surgical mask pulled down below her chin — was yelling in my direction. That was 13 days ago, one day short of the standard coronavirus incubation period.

But I’m fine. I think. And maybe that odd and unsettling feeling is just what this phase of the pandemic feels like for all of us — not quite panic-stricken, not quite normal.

We’ve seen upticks in cases of the virus in some places but others escaped relatively unscathed, and no one seems to be able to tell us exactly why. At the same time, countries where the pandemic’s curve had appeared flattened are now seeing rises in case numbers.

Australia’s Victoria State, where at least three protesters have contracted the virus, on Wednesday recorded its largest single-day increase in infections in over a month.

What’s now clear is that there’s a cost in returning to normal, and that in some cases, we might only be a misstep or two away from another surge.

So as we tiptoe out into the world, how much risk should we take?

Some of us operate on the assumption that if they follow regulations, they will be fine. Others feel frustrated by the inconsistencies in official advice, or that rushing back to normal life before a vaccine is available would be dangerous.

“Everything we’re doing is unknown territory,” said Hassan Vally, an epidemiologist and senior lecturer in public health at La Trobe University in Melbourne.

“What we do know,” he added, “is that as a society we can’t survive in complete lockdown until we get a vaccine: We have to get back to normal.”

When I got home after the recent protest, I removed my mask carefully. I scrubbed my hands for 20 seconds. I changed my sweater. I washed my face. That night, I went out to eat with friends for the first time in weeks. There were no masks to remind me of the pandemic.

After a beer, and laughing face-to-face with a group for the first time in weeks, it was even easier to forget. Since then, I’ve begun to feel my hypervigilance fade even further. I don’t wipe down my door handles as often, or my phone, and I’m still fine. For now.

The Treasury Department, which jointly administers the loan program with the S.B.A., did not say when the new information would be made public, but some of the demographic data will be included in loan forgiveness applications, which might not be submitted for months.

The events surrounding Captain Crozier, who has been viewed as a hero by his crew for putting their lives above his career, seized the nation’s attention.

The decision to suspend investment in lung treatments blindsided academic researchers and executives at small biotech companies, who said they spent months pitching their proposals to BARDA. The change in policy was posted without fanfare on a government website on June 3, and was not announced in a statement.

Some clinicians and bioethicists contend that BARDA should continue supporting research into treatments for lung conditions, while other experts contend the new policy is a sensible use of limited federal dollars.

About 95 percent of the patients hospitalized for Covid-19 at Northwell Health in New York, a system of 23 hospitals at the epicenter of the region’s epidemic this spring, have developed severe respiratory distress, said Dr. Mangala Narasimhan, the regional director of critical care medicine at Northwell.

“You’re going to need other forms of treatments for a lot of those people, and I feel like that’s where there’s going to be a gaping hole,” she said.

Reporting was contributed by Livia Albeck-Ripka, Manuela Andreoni, Maggie Astor, Brooks Barnes, Dan Bilefsky, Keith Bradsher, John Branch, Gillian R. Brassil, Aurelien Breeden, Emma Bubola, Chris Buckley, Nancy Coleman, Maria Cramer, Karen Crouse, Michael Crowley, Gillian Friedman, Thomas Gibbons-Neff, Jenny Gross, Mohammed Hadi, Rebecca Halleck, Annie Karni, Sarah Kliff, Jesse McKinley, Raphael Minder, Elian Peltier, Alan Rappaport, Motoko Rich, Eric Schmitt, Jeanna Smialek, Mitch Smith, Kaly Soto, Paula Span, Matt Stevens, Katie Thomas, Neil Vigdor, Daisuke Wakabayashi, David Waldstein and Mihir Zaveri.



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