Months into the pandemic, many U.S. cities still lack testing capacity.
In the early months of the outbreak in the United States, testing posed a significant problem, as supplies fell far short and officials raced to understand how to best handle the virus. Since then, the country has vastly ramped up its testing capability, conducting nearly 15 million tests in June, about three times as many as it had in April.
But in recent weeks, as cases have surged in many states, the demand for testing has soared, surpassing capacity and creating a new testing crisis.
In many cities, officials said a combination of factors was now fueling the problem: a shortage of certain supplies, backlogs at laboratories that process the tests, and skyrocketing growth of the virus as cases climb in almost 40 states.
Fast, widely available testing is crucial to controlling the virus over the long term, experts say, particularly as the country reopens. With a virus that can spread through asymptomatic people, screening large numbers of people is seen as essential to identifying those who are carrying the virus.
Testing in the United States has not kept pace with other countries, notably in Asia, which have been more aggressive. When there was an outbreak in Wuhan in May, for instance, Chinese officials tested 6.5 million people in a matter of days.
In Arizona, where reported cases have grown to more than 100,000, a shortage of testing has alarmed local officials, who say they feel ill equipped to help residents on their own.
“The United States of America needs a more robust national testing strategy,” Mayor Kate Gallego of Phoenix said in an interview.
Dr. Anthony S. Fauci, the nation’s top infectious disease expert, warned on Monday that the country was still “knee-deep in the first wave” of the pandemic, as the number of coronavirus deaths in the United States passed 130,000 and cases neared three million. Texas and Idaho set daily records for new cases, according to a New York Times database.
The federal government will pay the vaccine maker Novavax $1.6 billion to expedite the development of 100 million doses of a coronavirus vaccine by the beginning of next year, the company said Tuesday.
The deal is the largest that the Trump administration has made so far with a company as part of Operation Warp Speed, the sprawling federal effort to make coronavirus vaccines and treatments available to the American public as quickly as possible. In doing so, the government has placed a significant bet on Novavax, a company based in Maryland that has never brought a product to market.
Operation Warp Speed is a multiagency effort that seeks to carry out President Trump’s pledge to make a coronavirus vaccine available by the end of the year, but the full extent of the project is still unclear. Officials have declined to list which vaccines and treatments are part of Operation Warp Speed.
In an interview on Sunday, Novavax’s president and chief executive, Stanley C. Erck, initially said he was not sure where in the government the $1.6 billion was coming from. A Novavax spokeswoman later said the money was coming from a “collaboration” between the Health and Human Services Department and the Defense Department.
In May, the administration announced it was awarding up to $1.2 billion as part of Operation Warp Speed to the British drugmaker AstraZeneca, which has said that its vaccine could be available by October. Four other companies — Moderna Therapeutics, Johnson & Johnson, Merck and Sanofi — have also received federal assistance for their experimental coronavirus vaccines.
“Adding Novavax’s candidate to Operation Warp Speed’s diverse portfolio of vaccines increases the odds that we will have a safe, effective vaccine as soon as the end of this year,” Alex M. Azar II, the health and human services secretary, said in a statement.
Nurses who traveled from across the United States to work in New York City hospitals saw the horrors of the coronavirus up close. They rushed patients to overcrowded intensive care units, monitored oxygen levels and held the hands of the sickest ones as they slipped away.
But now that many of the nurses have returned home to states in the South and the West, they’re facing a new challenge: persuading friends and family to take the virus seriously.
“A few times I’ve lost my temper,” said Olumide Peter Kolade, a 31-year-old nurse from California who grew up in Texas and spent more than three months treating patients in New York. “When someone tells me that they don’t believe the virus is real, it’s an insult. I take it personally.”
For nurses, the widespread skepticism about something they have witnessed is jarring. The United States has hit daily case records three times in the first six days of July.
For months in New York City, streets were deserted and ambulance sirens blared at all hours, a constant reminder of the coronavirus threat. But in cities that have not completely shut down, people can more easily ignore the risk.
Heather Smith, a nurse from Topsail Island, off the coast of North Carolina, worked at Elmhurst Hospital Center in Queens. She struggled to hold back tears when describing how she felt when her brother said he did not believe the virus was real. When Ms. Smith started typing a rant on Facebook, she said, “I realized how angry I was.” She said she could not get out of her mind the images of patients who died alone: “No one understands how serious and how traumatizing it is.”
The virus death toll in India surpassed 20,000 on Tuesday, and, with more than 719,500 confirmed cases, the country has overtaken Russia to become the third hardest-hit, after the United States and Brazil.
Officials said India recorded 22,252 new cases and 467 deaths in the past 24 hours. The country is now averaging 450 deaths each day, double what it was seeing in the first week of June.
The Ministry of Health and Family Welfare said the average number of positive cases in New Delhi, India’s capital, had increased from 5,481 to 18,766 in about a month. The situation in New Delhi and Mumbai remains particularly dire as state-run hospitals are overflowing with the sick.
India is one of many developing nations where leaders feel the economic situation means they have no choice but to prioritize reopening despite surging infections. But its public health system is severely strained, and experts believe it may reach a breaking point as Prime Minister Narendra Modi’s government continues to ease a nationwide lockdown.
Vasudev Venugopal, a health expert in the southern Indian city of Chennai, said the increasing number of cases was largely because of the infection’s spread in densely populated areas of major cities, with crowded marketplaces and almost no social distancing. India has nearly 720,000 cases in total, according to a New York Times database.
“The more the virus travels to populous states, the greater the number of cases,” Mr. Venugopal said. “The worst, it seems, is yet to come.”
Correction: Because of an editing error, an earlier version of this item misattributed a distinction to the coronavirus outbreak in India. The country’s total number of confirmed cases is now the world’s third-largest, not its number of deaths.
Brazil’s president, a noted virus skeptic, says he will be tested after developing symptoms.
President Jair Bolsonaro of Brazil, who has repeatedly dismissed the danger posed by the coronavirus, said Monday night that he had gone to the hospital for a lung scan and would take a new test for the virus.
Mr. Bolsonaro took those steps after developing symptoms of Covid-19, including a fever and an abnormal blood oxygen level, according to a report from CNN Brasil.
Even as several of his aides tested positive for the virus in recent months, the president often rejected precautions like wearing a mask and social distancing, most recently at a lunch on Saturday hosted by the American ambassador to Brazil to celebrate the Fourth of July.
A photo taken during the lunch and posted on Twitter by Foreign Minister Ernesto Araújo shows the president sitting next to the American ambassador, Todd Chapman, giving a thumbs-up sign at a table decorated with an American flag design.
The president’s office said Mr. Bolsonaro’s test results were expected on Tuesday. “The president, at this time, is in good health and remains at his residence,” the statement said.
Also on Monday night, the U.S. Embassy signaled concern that the ambassador might have been exposed to the virus, saying that Mr. Chapman does not have any symptoms but intends to get tested and “is taking the proper precautions.”
While he awaits the test results, Mr. Bolsonaro, 65, cleared his schedule on Tuesday, according to several Brazilian press reports.
Melbourne, Australia’s second-biggest city, will be locked down for six weeks after a record number of daily coronavirus cases, officials said on Tuesday.
The state of Victoria reported 191 new cases on Tuesday, an “unsustainably” high number, said Daniel Andrews, the state’s premier. Most of the cases were in Melbourne, a city of 4.9 million people and the capital of Victoria.
“Ultimately we have to take this as seriously as we take bushfire,” Mr. Andrews said. “This is binary. It is life and death.”
Starting late Wednesday night, residents will be allowed to leave their homes only for essential work, shopping and exercise. Another regional area, Mitchell Shire, will also be locked down.
Australia has had a comparatively small outbreak, with fewer than 8,600 reported cases and only 106 deaths. But emerging hot spots in Melbourne in recent weeks have alarmed officials, who locked down 300,000 people in suburban neighborhoods last week. They also immediately quarantined 3,000 residents of public housing towers on Saturday after coronavirus infections were found in 12 households.
Other states have also reacted to the flare-up. New South Wales, Australia’s most populous state, will close its border with Victoria on Wednesday and send police and military officers to patrol crossings. South Australia, which shares a border with Victoria, said it would bar Victorian travelers at midnight Wednesday.
Returning citizens have also brought cases to New Zealand in recent weeks, and the country’s airline, Air New Zealand, temporarily froze ticket sales for three weeks on Tuesday. The move, requested by the government, will ensure the country has space to quarantine all travelers, the airline said in a statement. Like Australia, New Zealand has had a relatively small outbreak, with 1,536 reported cases and 22 deaths.
A million jobs lost: A ‘heart attack’ for New York City’s economy.
New York City, hit hard by the pandemic, is mired in its worst economic slump since the financial crisis of the 1970s, when it nearly went bankrupt.
The city is staggering toward reopening with some workers back at their desks or behind cash registers, and on Monday it began a new phase of reopening, allowing personal-care services like nail salons and some outdoor recreation to resume. Even so, the city’s unemployment rate is hovering near 20 percent — a figure not seen since the Great Depression.
What was intended as a “pause” has dragged on so long that for many workers, furloughs are turning into permanent job losses.
The layoffs continued in June as some employers gave up hope of a quick recovery or ran out of the federal aid they were using to maintain their payrolls.
The pandemic set off an immediate and sweeping reversal of fortune that the city has never endured, economists said. Most past financial crises were “like a prolonged illness,” said Frank Braconi, a former chief economist for the city comptroller’s office.
“This was like a heart attack,” he said.
Many businesses, including restaurants and hotels, are expected to close for good. The picture has grown even grimmer after officials delayed indefinitely the reopening of indoor dining.
While the national unemployment rate fell to 11.1 percent in June, New York City’s rate reached 18.3 percent in May, the highest level in the 44 years that such data has been collected. (In the Depression, unemployment is estimated to have reached 25 percent.) The numbers for June will be released next Thursday.
The losses have been particularly significant among people of color: About one in four of the city’s Asian, Black and Hispanic workers were unemployed last month, compared with about one of every nine white workers, the city comptroller’s office said.
“New York City is experiencing deep and enduring unemployment, mostly by low-income workers of color, and the city is facing a sluggish recovery with double-digit unemployment,” said James Parrott, director of economic and fiscal policies at the Center for New York City Affairs.
Mr. Parrott estimated that the city’s total job loss since February — counting all the undocumented and gig workers — could be as high as 1.25 million.
Prime Minister Boris Johnson of Britain drew furious reactions from health care professionals and opposition lawmakers after he suggested on Monday that “too many care homes didn’t really follow the procedures in the way that they could have,” while pleading for better organization and support for the sector.
A spokesman later said that the hasty comments weren’t intended to blame those working in nursing homes. They came as total coronavirus deaths of nursing home residents in England and Wales approached 20,000, with the figure expected to become much higher.
Mr. Johnson’s remarks were criticized as cowardly and unfair by nursing home leaders. Nadra Ahmed, the chair of the National Care Association, told The Guardian that Mr. Johnson’s words were “a huge slap in the face for a sector that looks after a million vulnerable people.”
The pandemic has struck nursing homes hard in various European countries, including France, Italy and Spain, and Britain hasn’t been exempt. Although the British authorities have argued that they threw “a protective ring” around nursing homes and gave the first instructions in February, staff members have repeatedly said that they felt abandoned compared with hospital workers.
More than half of nursing homes in England have reported coronavirus cases, and in facilities where the virus moved in, one patient out of five was infected, according to official statistics.
As the British authorities ease confinement restrictions but continue to fear new waves of infections, they have announced that nursing home residents will be tested for the coronavirus monthly, with staff members tested weekly.
Mr. Johnson’s government also pledged 600 million pounds, or $749 million, in support of the country’s nursing homes in May, in addition to £3.2 billion — $4 billion — to local governments for key public services like nursing-home facilities.
The virus may be airborne. Here’s what that means, and how to better protect yourself.
The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, growing scientific evidence suggests.
This risk is highest in crowded indoor spaces with poor ventilation, and may help explain superspreading events reported in meatpacking plants, churches and restaurants.
What does it mean for a virus to be airborne?
For a virus to be airborne means that it can be carried through the air in a viable form. For most pathogens, this is a yes-no scenario. H.I.V., too delicate to survive outside the body, is not airborne. Measles is airborne, and dangerously so: It can survive in the air for up to two hours.
For the coronavirus, the definition has been more complicated. Experts agree that the virus does not travel long distances or remain viable outdoors. But evidence suggests it can traverse the length of a room and, in one set of experimental conditions, remain viable for perhaps three hours.
How are aerosols different from droplets?
Aerosols are droplets, droplets are aerosols — they do not differ except in size. Scientists sometimes refer to droplets fewer than five microns in diameter as aerosols. (By comparison, a red blood cell is about five microns in diameter; a human hair is about 50 microns wide.)
From the start of the pandemic, the World Health Organization and other public health agencies have focused on the virus’s ability to spread through large droplets that are expelled when a symptomatic person coughs or sneezes.
These droplets are heavy, relatively speaking, and fall quickly to the floor or onto a surface that others may touch. This is why public health officials have recommended maintaining a distance of at least six feet from others, and frequent hand washing.
Should I begin wearing a hospital-grade mask indoors? And how long is too long to stay indoors?
Health care workers may all need to wear N95 masks, which filter out most aerosols. For the rest of us, cloth face masks will still greatly reduce risk, as long as most people wear them.
As for how long is safe, a lot depends on whether the room is too crowded to allow for a safe distance from others and whether there is fresh air circulating through the room.
Is a safe cookout possible?
With the virus raging in many parts of the United States, new restrictions have left many wondering about the safety of a backyard barbecue or picnic. Here are some tips to help.
Reporting was contributed by Manuela Andreoni, Letícia Casado, Manny Fernandez, Michael Gold, Jenny Gross, Isabella Kwai, Ernesto Londoño, Apoorva Mandavilli, Patrick McGeehan, Sarah Mervosh, Elian Peltier, Katie Thomas and Sameer Yasir.