Trump tells governors they will decide when to reopen, while N.Y. extends shutdown to May 15.
New Yorkers venturing out in public on Friday will be confronted by yet another new reality in a world transformed by the coronavirus: masks for all.
The law requiring people to cover their faces in public went into effect the morning after President Trump told governors that they could begin reopening businesses, restaurants and other elements of daily life by May 1 or earlier if they wanted.
However, the official set of nonbinding guidelines released by the White House did not address a host of complicated questions confronting the nation — among others, how to expand testing and how to pay for it, what to do with stores and restaurants, and when to lift international travel restrictions.
The death toll from the coronavirus in the United States increased by more than 2,000 for a total of more than 30,000 on Friday, and the financial pain also deepened.
In the hours before Mr. Trump spoke, the $349 billion fund for small businesses ran out of money and a new labor report revealed that 22 million Americans had filed for unemployment in just the last month. Basic necessities like food, shelter and medical care, long taken for granted by most people, were suddenly at risk for millions.
But tackling the economic catastrophe requires getting a handle on the public health crisis.
And the persistent problem in implementing widespread testing, an essential step on the path to recovery, was just one challenge.
Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, told CNN on Thursday night that surveillance to give communities early warning signs of local transmission would need to be enhanced, diagnostic testing capabilities expanded and contact-tracing efforts bolstered.
“Any one piece by itself will not be able to accomplish what we need,” she said.
While Mr. Trump asserted only three days ago that “the president of the United States calls the shots,” he essentially ceded control over easing restrictions to the states.
“We are not opening all at once, but one careful step at a time,” Mr. Trump told reporters during a briefing at the White House.
And just as the country entered life under quarantine in a patchwork fashion a month ago, it will most likely re-emerge in a similar way.
Gov. Andrew M. Cuomo of New York said that the state’s sweeping shutdown would last until May 15, and that a “new normal” of changed work routines, social distancing and curtailed public life would last for the foreseeable future.
“What happens after then? I don’t know,” Mr. Cuomo said of his new end date for the restrictions. “We will see depending on what the data shows.”
The guidelines, outlined in a call with governors and announced in a White House news conference, were billed as a step-by-step approach that depended on complicated public health criteria. They will allow some governors to reopen their states — perhaps as early as Friday — even as testing kits and protective medical gear remain in short supply.
The ideas and criteria in the guidance are not new; parts of it were embedded in earlier plans by Dr. Scott Gottlieb, former head of the Food and Drug Administration, and Dr. Tom Frieden, former head of the Centers for Disease Control and Prevention. But those plans were conservative, saying that states could reopen once they had robust testing capacity, enough equipment to protect health care workers and the means to reach out to anyone who was exposed to the virus to warn them to isolate, a process known as contact tracing.
Reopening before those issues are resolved, though, risks endangering the few places that have managed to dodge the virus, and would be accompanied by significant scientific concerns:
Testing is still spotty. Most of the country is not conducting nearly enough testing to track the virus in a way that would allow Americans to return to work safely. Without widespread testing and surveillance, said Angela Rasmussen, a virologist at Columbia University in New York, “we won’t be able to quickly identify and isolate cases in which the patients are presymptomatic or asymptomatic, and thus community transmission could be re-established.”
Waiting periods of 14 days are required. States wishing to loosen rules are asked to meet certain criteria every two weeks. But if someone were infected toward the end of the 14th day, it is possible he or she could seed an outbreak as restrictions were lifted.
Shortages of protective equipment persist. Communities in which restrictions are eased will be at greater risk for outbreaks. Mr. Trump has said that the federal government has distributed millions of masks, gloves and gowns to health care workers, but those on the front lines say they are still put in harm’s way because of shortages of personal protective equipment. “People are still dying,” said Zenei Cortez, president of National Nurses United, the country’s largest nurses’ union. “This is no time pat ourselves on the back and say the emergency is over.”
Piecemeal reopenings are risky. Mr. Trump suggested that the relaxing of restrictions may occur in a fragmented way, even county by county. The notion that some places have a “problem” with the outbreaks while some do not misunderstands the contagious nature of the virus. Even in rural regions where the population is less dense, large clusters of infections — even hundreds in a single workplace — have erupted in states that had seen relatively few cases. Recent history in South Dakota — where hundreds of infections have been traced to a single pork processing plant — shows that a single site can ignite a firestorm of cases.
Coroners in some parts of the United States are overwhelmed. Funeral homes in coronavirus hot spots can barely keep up. Newspaper obituary pages in hard-hit areas go on and on. Covid-19 is on track to kill far more people in the United States this year than the seasonal flu.
But determining just how deadly the new coronavirus will be is a key question facing epidemiologists, who expect resurgent waves of infection that could last into 2022.
As the virus spread across the world in late February and March, the projection circulated by infectious disease experts of how many infected people would die seemed plenty dire: around 1 percent, or 10 times the rate of a typical flu.
But according to various unofficial Covid-19 trackers that calculate the death rate by dividing total deaths by the number of known cases, about 6.4 percent of people infected with the virus have now died worldwide.
In Italy, the death rate stands at about 13 percent, and in the United States, around 4.3 percent, according to the latest figures on known cases and deaths. Even in South Korea, where widespread testing helped contain the outbreak, 2 percent of people who tested positive for the virus have died, recent data shows.
Those supposed death rates also appear to vary widely by geography: Germany’s fatality rate appears to be roughly one-tenth of Italy’s, and Los Angeles’s about half of New York’s. Among U.S. states, Michigan, at around 7 percent, is at the high end, while Wyoming, which reported its first two deaths this week, has one of the lowest death rates, at about 0.7 percent.
Virology experts say there is no evidence that any strain of the virus, officially known as SARS-CoV-2, has mutated to become more severe in some parts of the world than others, raising the question of why there appears to be so much variance from country to country.
Chinese officials on Friday said the world’s second-largest economy had shrunk in the first three months of the year, ending a streak of untrammeled growth that survived the Tiananmen Square crackdown, the SARS epidemic and even the global financial crisis.
The data reflects China’s drastic efforts to stamp out the coronavirus, which included shutting down most factories and offices in January and February as the outbreak sickened tens of thousands of people.
The stark numbers make clear how monumental the challenge of getting the global economy back on its feet will be, and may help to explain why world leaders — including President Trump — are so eager to restart their own economies. Since it emerged from abject poverty and isolation more than 40 years ago, China has become perhaps the world’s most important growth engine.
But the leaders in Beijing have faced criticism over a lack of transparency in their handling of the epidemic.
Faced with mounting skepticism over its official figures, China on Friday revised up its death toll in the central city where the coronavirus first emerged.
Officials in the city, Wuhan, placed the new tally at 3,869 deaths, an increase of 1,290, or 50 percent, from the previous figure. The number of confirmed infections in the city was also revised upward to 50,333, an increase of 325.
Officials in Wuhan said the revised death toll now included those who died at home in the early days of the outbreak, as well as deaths that were not properly reported by hospitals or registered on death certificates.
Berna Lee got the call from the nursing home in Queens on April 3: Her mother had a fever, nothing serious. She was assured that there were no cases of coronavirus in the home. Then she started calling workers there.
“One said, ‘Girl, let me tell you, it’s crazy here,’” Ms. Lee said. “‘Six people died today.’”
In a panic, Ms. Lee drove from her home in Rhode Island to the nursing home, beginning a two-week scramble for information, as workers at the facility, Sapphire Center for Rehabilitation and Nursing of Central Queens, told her privately that many residents had died, and that most of the home’s leadership was out sick or in quarantine.
Finally, she banged on her mother’s first-floor window to see if she was OK. It was unclear whether her mother understood what was happening, Ms. Lee said.
“I didn’t know how bad it was,” she said. “People told me bodies were dropping.”
The crisis at Sapphire highlighted the desperate state of nursing homes in the New York region and illustrated what relatives of residents said was a deeply troubling lack of information about what was going on inside the homes.
The $349 billion government program meant to keep small businesses afloat during the pandemic and economic meltdown ran out of money on Thursday, even as many small-business owners were desperately trying to apply for loans. Now they are trying to figure out how to keep their businesses alive while Congress negotiates the possible release of additional rescue funds.
Doug Martin, a sports marketer in Long Beach, Calif., approached three banks to try to get a loan through the program. Each turned him down for different reasons. As a last resort, he tried a fourth bank with the help of his financial adviser, but didn’t hear back.
“This morning, I read that the money’s gone, and I’m like, heck, I didn’t even get a shot at this,” Mr. Martin said.
The program, administered by the Small Business Administration through participating banks, was marred by technical glitches from the start, and overwhelming demand and confusion about how it would all work slowed down the approval process. Around the country, would-be borrowers were turned away by banks because there were too many applicants. Some lost valuable time because their bankers didn’t know all the details about how the program would work, while others couldn’t find a lender that would deal with them.
More money is expected to come, but when is an open question. Congressional leaders and the Trump administration were discussing adding hundreds of billions of dollars to replenish the program, but have so far failed to reach an agreement.
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The Centers for Disease Control and Prevention plan to hire hundreds of contact tracers, who locate those who have been exposed to the coronavirus, as part of President Trump’s push to reopen the country, a top government official said.
The C.D.C. is also in discussions to divert 25,000 Census Bureau workers to do contact tracing in the coming weeks and months. The census workers, who had been hired to go door to door collecting household data for the 2020 census, would turn to contact tracing for perhaps two months, according to a federal official. The Census Bureau on Monday asked for a delay in collecting and delivering data; its field offices have been closed since mid-March and will not reopen until June at the earliest.
The census workers would join some 500 C.D.C. workers who are already embedded in the states and who will now turn to contact tracing, the official said. In addition, the C.D.C. will provide grants to states to hire additional contact tracers; Peace Corps volunteers who have returned from posts around the world because of the virus might join the effort, too.
Reporting was contributed by Marc Santora, John Leland, Amy Julia Harris, Tracey Tully, Michael Cooper, Emily Flitter, Roni Caryn Rabin, Marc Santora, Knvul Sheikh.