Fauci warns that the U.S. could see 100,000 new cases a day, and officials aim to counter vaccine skeptics.
Dr. Anthony S. Fauci, the nation’s top infectious disease expert, warned Tuesday that the number of new infections in the United States could more than double to 100,000 a day if the country fails to contain the surge that is now underway in many states.
He noted that the recent sharp rise in cases, largely in the South and the West, “puts the entire country at risk.”
“We are now having 40-plus thousand new cases a day,” Dr. Fauci said. “I would not be surprised if we go up to 100,000 a day if this does not turn around. And so I am very concerned.”
Dr. Fauci made the stark warning at a Senate hearing on Tuesday where health officials spoke about the need to reassure people about the safety of vaccines. Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, told Senate lawmakers that the agency had spent around three months developing a plan to rebuild “vaccine confidence,” an attempt to win over a large slice of Americans still hesitant about inoculation.
Skepticism of vaccines came up repeatedly at the hearing, which was framed as an update on the safety of returning to school. “I think it’s very important that we have an integrated plan for this vaccine,” Dr. Redfield told the Senate’s health and education committee, adding that the plan could be released in the coming weeks.
Senator Patty Murray, the panel’s top Democrat, implored him to speed up the work.
“We need to see that plan,” she said. “We need to know what it is, the public needs to know what it is.”
Dr. Redfield appeared with Dr. Fauci; Dr. Stephen M. Hahn, the Food and Drug Administration commissioner; and Adm. Brett P. Giroir, the assistant secretary for health.
Dr. Fauci said that the federal government had a “community engagement program” embedded at the sites of vaccine trials to help build trust in them.
“It is a reality: a lack of trust of authority, a lack of trust in government, and a concern about vaccines in general,” Dr. Fauci said. He added that there need to be “boots on the ground,” especially near minority communities that he said “have not always been treated fairly by the government.”
Dr. Fauci also said school administrators should take into account virus activity in their areas when they consider reopening plans for the fall. And Dr. Redfield also took a pointed shot at American Airlines, expressing disappointment that the air carrier has begun selling middle seats on its flights.
But vaccines appeared to be a major concern.
“Public confidence in vaccines is so important,” Dr. Hahn, the F.D.A. commissioner, said. “We have an obligation to use all of our scientific knowledge, regulatory framework to ensure that any vaccine that comes before us, whether for authorization or approval, meets our stringent standards for safety and effectiveness.”
Seven in 10 Americans have said they would get vaccines against the virus if immunizations were free and available to everyone, according to recent polling, a number that health officials fear may not be enough to achieve “herd immunity,” a term that signifies that a vast majority of a population has protection against infection. At least 70 percent will need to be immune to the virus to reach that point, according to researchers at Johns Hopkins University.
Dr. Redfield said that the plan was being developed with Operation Warp Speed, the Trump administration’s crash vaccine program that aims to have 300 million doses of a vaccine by early next year. Officials at the Defense Department and the Department of Health and Human Services involved in that project have spent significant time discussing a public-relations campaign that will, among other things, try to win over Americans suspicious of a coronavirus vaccine, according to a senior administration official.
The F.D.A. took steps to try to reassure people that the sped-up process would not come at the expense of safety, with Dr. Hahn announcing at the hearing that the F.D.A. would release guidelines to aid in the development and production of Covid-19 vaccines.
The F.D.A. will require that manufacturers prove their products are safe and effective through a clinical trial, and that the vaccine be at least 50 percent more effective than a placebo to win agency approval. The agency will also require manufacturers to track individuals who have been vaccinated for a year, to monitor them for any adverse reactions. There are currently more than 140 vaccines being developed against the coronavirus.
The number of new virus cases in the United States has gone up 80 percent in the past two weeks, according to a New York Times database, a troubling trend for states that have been moving forward with plans to reopen. The increase in cases has mostly been concentrated in the South and West, where some cities are facing dire situations and a shrinking number of hospital beds.
Case counts have climbed sharply in many of the states that were the first to reopen, including Florida and Texas, which recently forced bars to close again. More than 4,600 new cases of the virus were announced on Tuesday in Arizona, by far that state’s most in a single day. California’s case count has exploded, surpassing 220,000 known infections. And even states that had reported improvements are starting to see the number of new cases rise, causing governors to rethink their plans to get residents back to work.
The Midwest, which in June started seeing declines in virus cases, is now seeing the beginnings of a resurgence. Six states in the region had increasing case numbers as of Monday. And even in places like Illinois and Minnesota, where case numbers have remained mostly flat, new hot spots have emerged.
In Kansas, the governor on Monday ordered residents to wear masks as case numbers lurched back toward their peak levels. In Wisconsin, new cases in the Madison area have reached a troubling new high. And in Ohio, the cases in counties that include Cincinnati and Cleveland have been doubling in the past two weeks. Gov. Mike DeWine, a Republican, said the Ohio increases were not the result of more testing, contradicting the messaging from the White House and some other Republican governors.
“If the spread of this virus remained at a low level, more testing should show a lower positivity — there simply wouldn’t be as many cases to pick up with testing,” said Mr. DeWine, who asked for federal help responding to upticks in the Cincinnati and Dayton areas. “Instead, the creeping up of our positivity rate even as we are doing more testing means that we are likely picking up signs of broader community spread.”
Masks — and President Trump’s refusal to wear one — were a central topic of the Senate health committee hearing on Tuesday, as Senator Lamar Alexander of Tennessee, the committee chairman, called on the president to set a better example by occasionally covering his face.
At the outset of the hearing, Mr. Alexander, a Republican, lamented that wearing a mask had “become part of the political debate,” and said he had “suggested that the president occasionally wear a mask, even though in most cases” Mr. Trump does not need to do so.
“The president has plenty of admirers,” Mr. Alexander said. “They would follow his lead, it would help end this political debate. The stakes are too high for this political debate about pro-Trump, anti-Trump to continue.”
The senator’s remarks, an echo of comments he made over the weekend, were a striking example of a Republican criticizing the president by name. As they have in the past, health experts emphasized that masks were essential to containing the virus, though they avoided direct mention of Mr. Trump.
“We recommend masks for everyone on the outside, anyone who comes into contact in a crowded area,” Dr. Fauci said at the hearing. “You should avoid crowds where possible. And when you’re outside and do not have the capability of maintaining distance, you should wear a mask at all times.”
Senator Chris Murphy, Democrat of Connecticut, also noted the mixed messaging.
“While our panelists tell us the importance of wearing masks, the president of the United States is retweeting articles — he retweets people that are criticizing how folks look when they wear masks,” Mr. Murphy said.
“So we have these two parallel messaging operations, and I just think it’s worth stipulating that everything we’re hearing today is based on evidence,” the senator continued. “But the representatives today have social media followings of about five million people. The president of the United States has a following of around 82 million. You can understand why folks are confused out there.”
E.U. reopens borders July 1, barring travelers from Russia, Brazil and the U.S., in a rebuke of Trump.
The European Union will open its borders to visitors from 15 countries as of Wednesday, but not to travelers from the United States, Brazil or Russia, putting into effect a complex policy that seeks to balance health concerns with politics, diplomacy and the desperate need for tourism revenue.
The list of nations that European Union countries have approved includes Australia, Canada and New Zealand, while travelers from China will be permitted if China reciprocates.
The plan was drawn up based on health criteria, and European Union officials went to great lengths to appear apolitical in their choices, but the decision to leave the United States off the list — lumping travelers from there in with those from Brazil and Russia — was a high-profile rebuke of the Trump administration’s handling of the coronavirus crisis.
Travelers’ country of residence, not their nationality, will be the determining factor for their ability to travel to countries in the European Union, officials said, and while the policy will not be legally binding, all 27 member nations will be under pressure to comply. If not, they risk having their European peers close borders within the bloc, which would set back efforts to restart the free travel-and-trade zone that is fundamental to the club’s economic survival.
The bloc implemented its own travel ban in mid-March and gradually extended it as the pandemic spread to other parts of the world. It had set July 1 as the date to begin allowing non-European Union travelers to return, even as Portugal and Sweden, both members, and Britain, which will be treated as a member until the end of the year, still grapple with serious outbreaks. Other members, such as Germany, are seeing new localized outbreaks drive up their national caseloads.
The full list of the first 15 countries that the European Union will open up to includes Algeria, Australia, Canada, Georgia, Japan, Montenegro, Morocco, New Zealand, Rwanda, Serbia, South Korea, Thailand, Tunisia, Uruguay and China, provided that China also opens up to travelers from the bloc. It also includes four European microstates, Andorra, Monaco, San Marino and the Vatican.
Only a few weeks ago, thousands of Southern Californians were flocking to beaches, Disneyland was announcing it would soon reopen, and Whoopi Goldberg was lauding Gov. Gavin Newsom on “The View” for the state’s progress in combating the coronavirus. The worst, many in California thought, was behind them.
In fact, an alarming surge in cases up and down the state was only just beginning.
Over the past week California’s case count has exploded, surpassing 220,000 known infections, and forcing Mr. Newsom to roll back the state’s reopening in some counties. On Monday, he said the number of people hospitalized in California had risen 43 percent over the past two weeks. More than 7,000 new cases were announced across California on Monday, the highest single-day total of the pandemic.
Los Angeles County, which has been averaging more than 2,000 new cases each day, surpassed 100,000 total cases on Monday, with the virus actively infecting one in every 140 people, according to local health officials. More than 2,800 cases were announced in the county on Monday, the most of any day during the pandemic.
On Sunday, Mr. Newsom shut down bars in a half-dozen counties, including Los Angeles County and in the Central Valley, and recommended that another eight counties voluntarily close their nightspots and gathering places. And Disneyland has rescinded its decision to open its gates.
California was the first state to shut down and one of the most aggressive in fighting the virus. But the state that was so proactive in combating the spread of the coronavirus is now forced to ask itself what went wrong.
“To some extent I think our luck may have run out,” said Dr. Bob Wachter, a professor and chair of the department of medicine at the University of California, San Francisco. “This is faster and worse than I expected.”
In other news from around the United States:
Gov. Andrew M. Cuomo of New York announced that visitors from an additional eight states — California, Georgia, Idaho, Iowa, Louisiana, Mississippi, Nevada and Tennessee — would need to quarantine for 14 days upon arrival to the state, which has brought its numbers down dramatically. People traveling from Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah and Texas had already been required to quarantine. The restrictions now cover travelers from some of the busiest airports in the country, including in Atlanta, Los Angeles and Dallas/Fort Worth.
More than 80 soldiers tested positive for the virus on Monday after three weeks of grueling survival training in North Carolina, according to a current defense official and a former one, who spoke on condition of anonymity. The roughly 110-person class was quickly quarantined at Fort Bragg in North Carolina, but those who tested negative for the virus were allowed to leave, the former official said.
The F.B.I. has issued a warning about scammers who advertise fraudulent Covid-19 antibody tests, which they use as a way to obtain personal information that can be used for identity theft or medical insurance fraud. Scammers are advertising the fake or unapproved tests online, in person and over the phone, the F.B.I. said. The agency recommends that those looking to take an antibody test — which is used to determine whether a person has had the coronavirus — consult a list of tests and testing companies that the Food and Drug Administration has approved.
Starting July 15, people traveling to Puerto Rico have to bring proof of a negative Covid-19 test taken within three days of their arrival, the governor announced Tuesday. Anyone who doesn’t have one will be tested, and those who test positive will have to quarantine for two weeks, and must assume all medical and housing costs.
A United Auto Workers union local has asked General Motors to temporarily close an S.U.V. assembly line in Arlington, Texas as a health measure following a surge of cases in that area. The factory employs about 4,900 people.
As school districts across the country begin to reveal their plans for this fall, with many anticipating a mix of in-person and online classes, the American Academy of Pediatrics has released guidelines saying that it “strongly advocates” the goal of having students “physically present in school.”
The organization is known for its generally conservative, careful approach to children’s health and safety. In some places, though, its guidance does not align with the advice from the Centers for Disease Control and Prevention, which says the safest approach is remote schooling, as well as the emerging plans of many school districts.
While the C.D.C. advises six feet of distance between seated students, the academy says that three feet of distance may be sufficient if students are masked. For preschoolers, the academy says that masking may be impractical, and that reducing playful interactions between classmates “may not provide substantial Covid-19 risk reduction.”
The group laid out a number of concerns with remote learning, such as lack of socialization, educational deficits, a decreased ability for schools to monitor problems like depression and abuse, and less access for students to physical activity and to affordable or free food. It warns that social distancing may have a negative impact on children’s development, without providing much upside in terms of health.
For secondary students, the pediatric group advises conducting high-risk activities like singing and exercise outdoors. It suggests having teachers rotate between groups of students who stay mainly in place, while allowing students to work on different electives in smaller groups within a single classroom, which would require more physical space.
While acknowledging how quickly the science on the virus is changing, the guidelines refer to emerging research suggesting that children are not only much less likely than adults to suffer severe consequences from the coronavirus, but are also less likely to transmit it to others.
The document illustrates a new difficulty for local education officials who must choose when and how to reopen schools: the fact that experts disagree about the most prudent course of action.
Complicating matters, teachers and their unions have been strong voices for a slower approach to reopening physical schools, pointing out that schools are workplaces where adults come into close contact with one another, risking transmission.
The Paycheck Protection Program is ending with money to spare.
After a stumbling start three months ago, the U.S. government’s centerpiece relief program for small businesses is ending with money left over.
The Paycheck Protection Program is scheduled to wrap up on Tuesday after handing out $520 billion in loans meant to preserve workers’ jobs during the pandemic. But as new outbreaks spike across the country and force many states to rethink their plans to reopen businesses, the program is closing down with more than $130 billion still in its coffers.
“The fact that it was able to reach so far into the small-business sector is a major achievement, and those things are worth acknowledging, and celebrating,” said John Lettieri, the chief executive of the Economic Innovation Group, a think tank focused on entrepreneurship. “But we’re still in a public health crisis.”
The hastily constructed and frequently chaotic aid program, run by the Small Business Administration but carried out through banks, handed out money to nearly five million businesses nationwide, giving them low-interest loans to cover roughly two and a half months of their typical payroll costs. Those that use most of the money to pay employees can have their debt forgiven.
The program appears to have helped prevent the nation’s staggering job losses from growing worse. Hiring rebounded more than expected in May as companies in some of the hardest-hit industries, especially restaurants, restored millions of jobs by recalling laid-off workers and hiring new ones.
Lenders cited two main reasons there was money left over. First, most eligible companies that wanted a loan were ultimately able to obtain one. (The program limited each applicant to only one loan.) Also, the program’s complicated and shifting requirements dissuaded some qualified borrowers, who feared they would be unable to get their loan forgiven.
Three days after a 78-year-old man, Adriano Trevisan, died on Feb. 21 and became the first registered victim of the coronavirus in Italy, the government imposed a 14-day quarantine on Vo’, the small town near Padua where he lived.
Backed by the Veneto region, scientists swab-tested nearly all of the town’s 3,275 residents, both at the beginning and at the end of the lockdown.
On Tuesday, the results of the study were published in the journal Nature. It found that 42.5 percent of the cases showed no symptoms, indicating that asymptomatic cases might have been important — if unwitting — spreaders of the pandemic, and confirming the importance of widespread testing.
The study also found that local outbreaks could be controlled “by combining the early isolation of infected people with community lockdown.”
Andrea Crisanti, the top scientific consultant on the virus in Veneto and a professor at the University of Padua and Imperial College London, co-led the study and has been a forceful advocate of widespread testing. He argued in the paper that the Veneto region’s testing and tracing approach had a “tremendous impact on the course of the epidemic in Veneto compared to other Italian regions.”
“The experience of Vo’ shows that despite the silent and widespread transmission of SARS-CoV-2, transmission can be controlled,” the authors wrote.
The study showed that at the start of the quarantine, 73 residents of Vo’, or 2.6 percent of the population, tested positive for the virus. Two weeks later, that number had dropped to 29 people, eight of which were new cases, but in both rounds of testing, 40 percent of the positive cases had been asymptomatic.
Transmission in the absence of symptoms poses clear challenges for the control of Covid-19 without strict social distancing measures or epidemiological surveillance comprising, for instance, a test, trace and isolate strategy, the study noted.
Most infected people don’t pass on the coronavirus to someone else. But a small number pass it on to many others in so-called superspreading events.
“You can think about throwing a match at kindling,” said Ben Althouse, a scientist at the Institute for Disease Modeling in Bellevue, Wash. “You throw one match, it may not light the kindling. You throw another match, it may not light the kindling. But then one match hits in the right spot, and all of a sudden the fire goes up.”
Understanding why some matches start fires while many do not will be crucial to curbing the pandemic, scientists say. They’re trying to answer three questions: Who are the superspreaders? When does superspreading take place? And where?
Biological factors might be part of the answer, but some doctors suspect circumstances play a more important role.
They’ve found that a lot of transmission seems to happen in a narrow window of time starting a couple days after infection, even before symptoms emerge. If people aren’t around a lot of people during that window, they can’t pass it along.
And certain places seem to lend themselves to superspreading. A busy bar, for example, is full of people talking loudly. Any one of them could spew out viruses without ever coughing. And without good ventilation, the viruses can linger in the air for hours.
Scientists are optimistic that it may be possible to avoid crippling, across-the-board lockdowns by targeting superspreading events.
“By curbing the activities in quite a small proportion of our life, we could actually reduce most of the risk,” said Adam Kucharski, an epidemiologist at the London School of Hygiene and Tropical Medicine.
The pandemic is now advancing across much of Russia’s vast hinterland, but that has not dimmed the Kremlin’s determination to hold a nationwide vote on constitutional amendments that, among other things, would let President Vladimir V. Putin stay in power until 2036.
With Moscow seemingly over the worst of the outbreak, Mr. Putin has declared victory over the virus and mobilized huge resources to make sure the referendum, already put off once, goes ahead no matter what. Voting officially started last Thursday but the big day is Wednesday, which has been declared a national holiday in the hope that more people will vote.
The situation outside the capital looks very different. Over the past week, the pandemic entered its worst stage so far in a diverse set of Russian regions, including the Republic of Tyva on the border with Mongolia, and the Republic of Karachay-Cherkessia, an isolated area in the North Caucasus.
Despite this, the local authorities have largely followed the lead of Moscow, which went into strict lockdown at the end of March but has now lifted most restrictions.
In other news from around the world:
Prime Minister Narendra Modi of India announced on Tuesday that more than 800 million citizens would receive free food aid through the fall, in a move intended to mitigate hardship for those affected by the virus. Mr. Modi also said that the country’s restrictions, which were first put into effect in late March, would be further eased this week.
Canada extended its ban on most travelers coming from places outside of the United States until July 31. A separate measure barring people coming across the border with the United States is in effect until July 21. Citizens and permanent residents are among the people exempt from both measures.
Australia, which showed early signs of quashing the coronavirus, is now battling spikes in its second-most-populous state, Victoria, leading the authorities to announce lockdowns in the greater Melbourne area starting Wednesday night. On Tuesday, Victoria recorded 60 new cases, its 14th consecutive day of double-digit increases. Australia, with a population of 25 million, reported just seven cases in its other states on Tuesday.
In a sign of Britain’s re-emerging cultural life, the National Gallery announced on Tuesday that it would reopen on July 8, becoming the first of the country’s major museums to do so. It will be followed by the Barbican on July 13, the Royal Academy on July 16 and the Tate Modern and Tate Britain art museums on July 27. The announcements come weeks after museums reopened in Germany, Italy and other European countries. Although museums in Britain are allowed to reopen starting Saturday, many are taking a more cautious approach. The British Museum has yet to announce a reopening date.
Biden assails Trump’s response to the virus in a speech.
Former Vice President Joseph R. Biden Jr., the presumptive Democratic presidential nominee, laced into President Trump on Tuesday over his handling of the coronavirus amid rising cases in many states.
In an afternoon speech in Wilmington, Del., Mr. Biden was expected to say that Mr. Trump “has called himself a wartime president but is surrendering to the virus,” according to the Biden campaign.
“Americans social-distanced and did their part to bend the curve — but Trump didn’t lead,” the Biden campaign said, offering a preview of the address. The campaign added that with infection rates rising, the president was “outright ignoring the crisis — golfing, holding rallies and telling a suffering country that he’s the victim.”
Mr. Biden has made only sporadic in-person appearances since the pandemic upended Americans’ daily routines, and his campaign is refraining from holding rallies with large crowds, which are typically a staple of the campaign trail. He has repeatedly criticized Mr. Trump over his response to the crisis, and this month, he outlined an eight-part plan for reopening the economy.
H1N1 is highly transmissible and spread around the world in 2009, killing about 285,000 people and morphing into seasonal flu. The newer strain, known as G4 EA H1N1, has been common on China’s pig farms since 2016 and replicates efficiently in human airways, according to the study.
So far, the virus has infected some people without causing disease, but health experts fear that could change without warning.
“It may be that with further change in the virus it could become more aggressive in people much as SARS-CoV-2 has done,” said Ian H. Brown, who heads the virology department at Britain’s Animal and Plant Health Agency and reviewed the study before it was published. SARS-CoV-2 is the scientific name of the new coronavirus.
For the study, published online in the journal Proceedings of the National Academy of Sciences, researchers took blood samples from hundreds of workers on pig farms in China from 2016 to 2018. More than 10 percent of the workers tested positive for antibodies to the virus, G4 EA H1N1, and workers between the ages of 18 and 35 tested positive for antibodies at a rate of over 20 percent.
Eurasian variations of H1N1 have been circulating in pigs in Europe and Asia for decades, the study said, but the incidence of so-called G4 viruses in farmed Chinese pigs with respiratory symptoms began rising sharply after 2014.
“G4 viruses have all the essential hallmarks of a candidate pandemic virus,” the study said, adding that controlling the spread in pigs and closely monitoring human populations “should be urgently implemented.”
The study was a collaboration among government agencies in China, the World Health Organization, and scientists from universities in China and Britain.
Asked about the new virus at a U.S. Senate hearing on Tuesday, Dr. Anthony Fauci, the nation’s top infectious disease expert, said that the virus was not an “immediate threat” but “something we need to keep our eye on the just the way we did with in 2009 with the emergence of the swine flu.”
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Reporting was contributed by Livia Albeck-Ripka, Ian Austen, Michael Cooper, Stacy Cowley, Thomas Fuller, Thomas Gibbons-Neff, Dana Goldstein, Abby Goodnough, Andrew Higgins, Shawn Hubler, Mike Ives, Thomas Kaplan, Cao Li, Iliana Magra, Alex Marshall, Patricia Mazzei, Ivan Nechepurenko, Elisabetta Povoledo, Kai Schultz, Jeanna Smialek, Mitch Smith, Matina Stevis-Gridneff, Sheryl Gay Stolberg, Eileen Sullivan, Noah Weiland, Elizabeth Williamson, Carl Zimmer and Karen Zraick.