Fauci describes the virus as his ‘worst nightmare’ and discusses possible vaccines.
The nation’s top infectious disease expert, Dr. Anthony S. Fauci, delivered a grim assessment of the devastation wrought around the world by the virus, describing Covid-19 on Tuesday as his “worst nightmare” — a new, highly contagious respiratory infection that causes a significant rate of illness and death.
“In a period of four months, it has devastated the whole world,” Dr. Fauci told biotech executives during a conference held by the Biotechnology Innovation Organization. “And it isn’t over yet.”
His discussion with a moderator was conducted remotely and videotaped for conference participants. Although Dr. Fauci said he had known that an outbreak like this could occur, one aspect surprised him: “how rapidly it just took over the planet.”
An efficiently transmitted disease can spread worldwide in six months or a year, but “this took about a month,” Dr. Fauci said. He attributed the rapid spread to the contagiousness of the virus and extensive world travel by infected people.
Vaccines are widely regarded as the best hope of stopping or at least slowing the pandemic, and Dr. Fauci said he was “almost certain” that more than one would be successful. Several are already being tested in people, and at least one is expected to move into large, Phase 3 trials in July.
But much is still unknown about the disease and how it attacks the body, research that Dr. Fauci described as “a work in progress.” Another looming question, he said, was whether survivors who were seriously ill would fully recover.
Dr. Fauci said that he had spent much of his career studying H.I.V., and that the disease it caused was “really simple compared to what’s going on with Covid-19.”
The differences, he said, included Covid’s broad range of severity: no symptoms at all to critical illness and death, with lung damage, intense immune responses and clotting disorders that have caused strokes even in young people, as well as a separate inflammatory syndrome causing severe illness in some children.
“Oh my goodness,” Dr. Fauci said. “Where is it going to end? We’re still at the beginning of it.”
A top expert at the World Health Organization on Tuesday walked back her earlier assertion that transmission of the coronavirus by people who did not have symptoms was “very rare.”
Dr. Maria Van Kerkhove, who made the original comment at a W.H.O. briefing on Monday, said that it was based on just two or three studies and that it was a “misunderstanding” to say asymptomatic transmission was rare globally.
“I was just responding to a question; I wasn’t stating a policy of W.H.O. or anything like that,” she said.
Dr. Van Kerkhove said that estimates of transmission from people without symptoms come primarily from models, which may not provide an accurate representation. “That’s a big open question, and that remains an open question,” she said.
Scientists had sharply criticized the W.H.O. for creating confusion on the issue, given the far-ranging public policy implications. Governments around the world have recommended face masks and social-distancing measures because of the risk of asymptomatic transmission.
A range of scientists said Dr. Van Kerkhove’s comments did not reflect the current scientific research.
“All of the best evidence suggests that people without symptoms can and do readily spread SARS-CoV-2, the virus that causes Covid-19,” scientists at the Harvard Global Health Institute said in a statement on Tuesday. “Communicating preliminary data about key aspects of the coronavirus without much context can have tremendous negative impact on how the public and policymakers respond to the pandemic.”
A widely cited paper published in April suggested that people are most infectious about two days before the onset of symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms.
Dr. Van Kerkhove and other W.H.O. experts reiterated the importance of physical distancing, personal hygiene, testing, tracing, quarantine and isolation to control the pandemic.
The debate over transmission erupted a day after the W.H.O. said that cases had reached a new single-day global high: 136,000 on Sunday, with three-quarters in just 10 countries, mostly in the Americas and South Asia. The virus has already sickened more than 7 million people worldwide and killed at least 405,400, according to a New York Times database.
The Pan American Health Organization said on Tuesday that 3.3 million people in the Americas had been infected with the virus. Dr. Carissa F. Etienne, the agency’s director, said that many areas were experiencing exponential growth in infections and death.
In India, health experts are warning of a looming shortage of hospital beds and doctors to treat patients as the country grapples with a sharp surge of infections. India reported 10,000 new infections in the last 24 hours, for a total of at least 266,500, and has surpassed Spain to become one of the five countries with the highest caseloads.
Rajnish Sinha, the owner of an event management company in Delhi, struggled to find a hospital bed for his 75-year-old father-in-law, who tested positive for the virus on Tuesday.
“This is just the beginning of the coming disaster,” Mr. Sinha said. “Only God can save us.”
Gov. Philip D. Murphy of New Jersey said on Tuesday that he was lifting the stay-at-home order that he issued in March and increasing the limits on how many people can gather indoors and outdoors.
“With more and more of our businesses reopening, we are no longer requiring you to stay at home, but we are asking you to continue to be responsible and safe,” he said.
Taken together, the moves Mr. Murphy announced are a major milestone for New Jersey, which was among the states hardest hit by the virus, with more than 164,000 cases and more than 12,000 deaths. After peaking at more than 4,000 new cases a day in April, New Jersey has seen that number gradually decline. The number of new daily cases has remained below 1,000 so far in June and dipped below 500 for the past three days.
The governor also said indoor gatherings could resume with up to 50 people or 25 percent of a building’s capacity, a move that would allow religious institutions to restart services, but not include indoor dining or performance venues. He said masks or face coverings must be worn at indoor events.
Mr. Murphy also raised the limit on outdoor gatherings from 25 people to 100. Gatherings like political protests of “any persuasion” and outdoor religious services will be able to include more than 100 people, Mr. Murphy said. The easing of restrictions does not include fans gathering at sporting events like minor league baseball games.
The limit will be raised to 250 people by June 22 and to 500 people by July 3. Mr. Murphy said that meant school graduation ceremonies, which will be allowed on July 6, can plan to have as many as 500 people present.
But he said state officials might recall the decision to allow bigger gatherings “should we see any troubling signs in the data indicating a spike in cases or a backslide in our fight against Covid-19.”
Mr. Murphy said state officials needed more data to assess the spread and urged residents to get tested, especially those who had participated in the recent protests and demonstrations against police brutality and racism.
Moscow is recording over 1,000 new cases per day, but abruptly ends its stay-at-home order.
Moscow’s tough lockdown ended abruptly on Tuesday as a nationwide vote on extending President Vladimir V. Putin’s rule loomed. The Russian capital continues to report more than 1,000 new virus cases a day.
Barbershops, beauty parlors, veterinary clinics and photography studios were allowed to reopen on Tuesday, and the city’s intricate system of digital permits for leaving one’s house stopped operating. A day earlier, Mayor Sergei S. Sobyanin said the spread of the virus in the capital had slowed to the point that the city’s shelter-in-place measures, some of the world’s most stringent outside of China, could be lifted.
Libraries and agencies including real estate, advertising and consulting will be allowed to reopen next Tuesday, Mr. Sobyanin said, along with museums and zoos as long as they sell tickets online. Sporting events will reopen to spectators at 10 percent capacity, and restaurants and cafes will be able to serve customers seated outdoors. Gyms, pools and kindergartens will fully open on June 23.
“The battle is not yet over,” Mr. Sobyanin told Muscovites on his website. “Nevertheless, I would like to congratulate you with our latest joint victory and with a major step toward returning to full-fledged life.”
But critics said Mr. Sobyanin was declaring victory far too soon and pointed to possible pressure from the Kremlin. Last month, Mr. Putin postponed the military parade celebrating the 75th anniversary of Soviet victory in World War II; it will be held June 24. And Mr. Putin rescheduled to July 1 a constitutional referendum that would allow him to stay in office until 2036.
Here’s what else is happening around the world:
The president of the United Nations General Assembly said Monday that world leaders would not come to New York for their annual gathering in September, a first in the U.N.’s 75-year history.
The British government on Tuesday abandoned plans to bring back all primary school students before the summer holidays. The Department of Education had aimed for all primary schoolchildren to spend four weeks in school before the summer holidays, but many schools have said they are already full and cannot accommodate more children safely.
The Hong Kong government is bailing out Cathay Pacific Airways by injecting nearly $4 billion and taking a direct stake in its operations.
Residents of Spain will have to continue to wear face masks even after the country officially lifts its state of emergency on June 21, the health minister, Salvador Illa, announced Tuesday, as the government presented its “new normalcy” plan. Citizens must “learn to cohabit with the virus” and maintain hygiene rules “until we conclusively defeat the virus,” Mr. Illa told a news conference.
In France, where the virus has killed over 29,000 people, the Paris prosecutor has opened an investigation into dozens of complaints over the authorities’ response to the coronavirus epidemic. The investigation will focus on complaints against officials or institutions on issues like mask shortages to determine if any crimes were committed. But neither President Emmanuel Macron, who is immune to prosecution, nor his government are targets.
Antarctica remains the only continent that has not reported any cases of the virus. In an effort to keep it that way, Antarctica New Zealand, the government agency responsible for carrying out New Zealand’s activities on the continent, will cut back on research trips, it said in a statement on Tuesday.
Delivery apps portray themselves as restaurants’ saviors. But their fees are putting some out of business.
But once lockdowns began, the apps became essentially the only source of business for the barroom restaurant he ran with a partner in Columbus, Ohio. That was when the fees to the delivery companies turned into the restaurant’s single largest cost — more than what it paid for food or labor.
Pierogi Mountain’s primary delivery company, Grubhub, took more than 40 percent from the average order. That flipped his restaurant from almost breaking even to plunging deeply into the red. In late April, Pierogi Mountain shut down.
For many restaurants, the fees have taken on a particularly bitter taste as delivery apps have begun campaigns proclaiming they will help save them.
Some restaurants have closed, while others have cut off the apps and are looking for other ways to take orders.
All the delivery services are also facing anger from smaller restaurants for giving restaurant chains priority in the apps because of the volume the chains can bring — unless smaller restaurants pay additional fees. Adding to the discord, chains generally pay the apps lower fees.
Grubhub, Uber Eats and DoorDash have all reduced the fees they charge local restaurants, although some of the companies have put time limits on the discounts.
Senators are debating whether to extend a substantial package of unemployment benefits enacted as part of the stimulus bill to help Americans weather the pandemic, after the latest jobs report showed an unexpected rebound in hiring that could sap support for continuing the aid.
The Senate Finance Committee is holding a hearing on Tuesday to discuss how to handle the expiration of the $600-a-week benefit, which will lapse at the end of July and has become a bone of contention among lawmakers as they contemplate the contours of another relief package to bolster the economy.
With tens of millions still out of work, several Democrats are pushing to extend the aid beyond the July deadline, warning that curtailing or eliminating it altogether would risk undermining the potential for a recovery.
“It’s pretty clear that the mission is not accomplished,” said Senator Ron Wyden, Democrat of Oregon, speaking on a press conference call Tuesday morning. “You don’t take your foot off the gas right now.”
Republicans argue that the extra funds discourage people from returning to work, and have relayed stories of businesses in their states, now slowly reopening, that have struggled to hire employees.
“The $600 is relatively generous — most people on unemployment insurance are making more staying on UI then they can going back to work,” said Senator Rob Portman, Republican of Ohio, in a recent interview.
He has floated the idea of replacing the jobless benefits with a so-called “back-to-work” bonus, which has garnered attention from the White House and some Democrats, that would temporarily give a $450 weekly payment to people returning to work.
With all of New York State now reopened in some capacity, officials on Tuesday preached caution, warning that as hundreds of thousands of people returned to work, the risk of spreading the virus remained.
“We’re in a new phase,” Gov. Andrew M. Cuomo said. “Reopening resets the whole game.”
The governor unveiled a new online dashboard that he said would show the percentage of positive cases by region and county. The information would signal “tremors of a spike” in infections if one were on the horizon, he said.
In New York City, which began reopening this week, Mayor Bill de Blasio offered a similar message. Based on the timeline outlined by the state, it is technically possible that the city could move into Phase 2 on June 22. But the mayor has targeted early July for that next step, and on Tuesday he continued to emphasize patience.
Any missteps, he added, could lead to a resurgence of the virus that would put the city under “fuller restrictions or worse.”
“I do not want to unduly raise expectations,” the mayor said. “We are not like the other regions of state.”
Here’s what else is happening in New York:
Mr. de Blasio and the city’s first lady, Chirlane McCray, said New York City would expand its mental health services, aiming to support 10,000 more people in the second half of the year.
Reports of child abuse cases in New York City have dropped 51 percent compared with the same time period a year ago, a concerning trend for child welfare advocates who worry an unseen epidemic of abuse is spreading behind locked doors.
Teachers, pediatricians, social workers and camp counselors, for example, are typically the first to discover bruises or signs of hunger or mistreatment of children. But the virus has changed those interactions to virtual ones. In the first eight weeks of spring 2019, New York City’s child welfare agency received an average of 1,374 cases of abuse or neglect to investigate each week. In the same period this year, that number fell to 672, a decline of 51 percent.
A report released Tuesday by the Food Bank for New York City offered a stark picture of how many people were flooding pantries and soup kitchens at the peak of the pandemic and how operators were struggling to meet demand. By mid-April, closures of those facilities peaked at more than 39 percent citywide, the report said. Since the beginning of the pandemic in New York City, Food Bank has distributed about 21 million meals, a 20 percent increase compared with the same period last year.
Arts and sports roundup
‘God understands you can’t sing right now’: Choirs search for a safe way to return.
The most obvious reason singing is a risk for transmission is that droplets of saliva containing the virus can spray from someone’s mouth. But a potentially bigger issue comes from tiny particles, called aerosols, that are so light that they travel on air currents. There is uncertainty over whether aerosols spread the virus, but some scientists say that outbreaks among choir groups suggest they played a role, especially when singers said they had followed social-distancing rules.
Lucinda Halstead, the president-elect of the Performing Arts Medical Association, said if “it’s a small group and it’s outside and the wind is not at your back,” the risk of catching the virus while singing would be reduced.
But she said that choirs probably cannot return to their past ways without a vaccine or rapid testing. “This is only temporary.” she said. “God understands you can’t sing right now.”
Here are other arts- and sports-related developments:
The Salzburg Festival announced on Tuesday that it would go forward in August, but in modified form. The original plan — more than 200 performances over 44 days — will become 90 performances over 30 days. Audiences of up to 1,000, about half the capacity of its main theater, will sit in staggered formation.
The first women’s golf major championship of this year, the Evian Championship, was canceled on Tuesday because of travel restrictions and quarantine requirements related to the pandemic. The L.P.G.A. Tour has canceled or postponed nearly two dozen tournaments and has not held an event since the Women’s Australian Open in February.
Chicago canceled all arts performances and festivals in parks through Labor Day, including Lollapalooza, Chicago SummerDance and the Chicago Jazz Festival.
The N.F.L. has detailed the steps that teams must take before players can return to training facilities, the latest effort by the league to return to business as usual in an off-season that has largely been conducted virtually.
Visitors can once again enter the Pantheon in Rome after the monument joined a growing list of sites that reopened their doors after weeks of lockdown. In Milan, the building housing Leonardo’s “Last Supper” also reopened Tuesday, as did the Capodimonte Museum in Naples.
The chairman of the Senate health committee wants the nation better prepared for the next pandemic.
The chairman of the Senate health committee, hoping to pass legislation this year to address future pandemics, released a set of proposals Tuesday for beefing up the nation’s ability to respond to a public health crisis — and is crowdsourcing suggestions from the public.
In a white paper entitled “Preparing for the Next Pandemic,” Senator Lamar Alexander, Republican of Tennessee, identified five priorities: accelerating research and development of tests, treatments, and vaccines; expanding disease surveillance capability; rebuilding the strategic national stockpile; beefing up state and local public health departments; and improving coordination of federal agencies during a public health emergency.
“In this internet age attention spans are short,” Mr. Alexander said in a statement. “Even with an event as significant as Covid-19, memories fade and attention moves quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for the next pandemic.”
Public health experts have been warning for decades that it was only a matter of time before a deadly pandemic emerged. In 2015, Susan Rice, national security adviser to President Barack Obama, created a “global health security and biodefense unit” inside the White House. But Mr. Trump disbanded the team.
Mr. Alexander’s white paper steered clear of laying blame for the lack of preparedness for Covid-19. But he said the federal government must play a critical role in preparedness, noting, for example, that “only the federal government can fund research at the scale necessary to create tests, treatments, and vaccines” and “coordinate the distribution of supplies and information at the national level.”
Mr. Alexander, who has held his Senate seat since 2003 and will retire when his term expires early next year, said he hoped that the paper would spark discussion among lawmakers and the public. Anyone with ideas may submit them, no later than June 26, to PandemicPreparedness@help.senate.gov.
Nursing home workers need to get tested often. There’s a debate over who should pay.
Nursing homes in the United States have been devastated by the virus, and regular testing of their workers is seen as one of the most important ways to contain outbreaks. But who should pay for testing the employees?
The question has become a hot-button labor issue. Nursing home employees are some of the lowest paid workers in the health care industry and often work by the hour, and for multiple facilities. Many do not have health insurance, and about 42 percent of workers who care for older people receive some kind of public assistance.
Nursing homes, which have received nearly $5 billion in federal stimulus funding to cover virus expenses — including testing — have pushed back against paying for the tests, and asked for more government help. Insurers have also said they should not be required to pay.
Like so many aspects of the U.S. response to the pandemic, the effort has been stymied by a lack of federal coordination and a patchwork of state policies. Even at the federal level, different agencies are offering conflicting advice.
Nowhere is this playing out more dramatically than in New York, where workers like Shikilia Davis are required to be tested twice a week. Last month, Ms. Davis said her employer, Apex Rehabilitation & Healthcare on Long Island, sent her home after she refused to provide her insurance card before getting tested. She said the nursing home wanted to bill her health insurer rather than paying for the test itself, even though Ms. Davis’s insurer has declined to cover the tests.
“This is a bill I do not want to get stuck with,” said Ms. Davis, who works as a dietary aide. “I don’t have money lying around.”
In Connecticut, Gov. Ned Lamont announced Monday that he would order an independent review of how the pandemic was handled by nursing homes. Mr. Lamont’s office said he wants the analysis to be completed before the fall, in case of a potential second wave.
More than 60 percent of the state’s total virus-related deaths have occurred in nursing homes, according to state numbers.
Faced with a crisis unlike any other in memory, central bankers have gone beyond what the monetary authorities did even in the darkest days of the 2008 global financial crisis.
Central bankers entered the current crisis with low interest rates, leaving them less room to goose growth using their tried-and-true tools. With limited options, experimentation may prove even more crucial in the months and years ahead as the world embarks on what could be a long slog back to prosperity.
France, Germany, the United States and many other countries have poured trillions of dollars into their economies through tax cuts, cheap credit and cash handouts. Monetary policy and fiscal policy can act as complements during a crisis to get economies back on track.
But appetite for further fiscal action is eroding in some places, including the United States. And the next stage — the recovery — could pose a fresh test for the world’s central banks, forcing them to get more creative as they try to keep pandemic aftershocks causing permanent damage.
Reporting was contributed by Ian Austen, Ken Belson, Ronen Bergman, Aurelien Breeden, Emily Cochrane, Maria Cramer, Abdi Latif Dahir, Jack Ewing, Denise Grady, Mike Ives, Aaron Krolik, John Leland, Iliana Magra, Apoorva Mandavilli, Alex Marshall, Jesse McKinley, Raphael Minder, Paul Mozur, Bill Pennington, Elisabetta Povoledo, Scott Reyburn, Jeanna Smialek, Kaly Soto, Matt Stevens, Alexandra Stevenson, Nikita Stewart, Katie Thomas, Anton Troianovski, David Waldstein, Edward Wong, Sameer Yasir, Ceylan Yeginsu, Raymond Zhong and Karen Zraick.