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18 states set single-day case records over the last week, driving the U.S. toward another national peak.

California. South Carolina. North Dakota, Kentucky. Hawaii. Those are among the 18 states that set single-day case records in the last week, putting the country on track to breaking a national single-day record for new coronavirus cases set less than two weeks ago.

More than 73,500 cases were reported on Friday, according to a New York Times database, approaching the country’s record of 75,697 cases, set on July 16. Since June 24, the seven-day average has more than doubled, to more than 66,100 on Friday from 31,402.

The other states with rapidly growing caseloads are Alabama, Alaska, Indiana, Kansas, Minnesota, Mississippi, Missouri, Montana, New Mexico, North Carolina, Oklahoma, Utah and West Virginia. A 19th state, Louisiana, also set a record, but because it reported a backlog of cases on Monday. A total of 40 states have seen 14-day increases in cases per capita.

As the number of cases has continued to climb, so has the number of hospitalizations, which dipped briefly below 28,000 in mid-June but is now skirting its own April record. Deaths are also rising: Friday was the fourth consecutive day with more than 1,100 reported U.S. deaths, which are trending upward in 30 states. On Saturday, South Carolina announced 80 new deaths, a single-day record.

On Friday, the number of people known to be hospitalized with the coronavirus in the country was 59,670, according to the Covid Tracking Project, a few hundred short of the record of 59,940 reported by the database on April 15.

A surge in Starr County, a rural, impoverished area in South Texas, near the border with Mexico, offers a grim example of the type of hospital crisis looming. The county’s infection rate of about 2,350 per 100,000 people is far higher than in more populous parts of Texas, including Houston. The county’s single hospital cannot handle the crush of Covid patients, and ethics committees have been formed to help determine which patients should be treated and which should be sent home to die.

Pentagon officials have dispatched Army and Navy personnel to the Starr County hospital and other medical centers in border cities to provide support, and state and federal officials have sent morgue trailers, ventilators, testing teams and surgical masks to the Rio Grande Valley.

Only a few weeks ago, as the virus spread across many Sun Belt states that had opened quickly in late spring, Arizona was leading the nation in coronavirus infections per capita.

Facing a mounting crisis, Gov. Doug Ducey, a Republican, reversed himself and allowed cities and counties to order residents to wear masks. He also rolled back some earlier reopenings, and directed bars, indoor gyms, water parks and movie theaters to shut down again — but held back from full lockdown.

Now the number of patients hospitalized with the virus is starting to decline. As of Friday afternoon, Arizona was the only state where known new daily cases were decreasing, which reflects, in part, just how dire conditions had been.

“In some ways, it is like a large-scale version of a clinical trial,” said Dr. Tom Inglesby, the director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health. “Arizona is one of the states involved and is going through crisis and now is taking a certain set of interventions, and we are seeing if those interventions work.”

Arizona is still leading the nation in deaths per capita, which are seen as a lagging indicator of the current state of the virus, but nevertheless offer a stark reminder of the devastation brought on the state after a swift reopening. Cases are now plateauing at a level much higher than when Arizona initially shut down in March, and the number of people on ventilators on Thursday, 575, was down from a high of 687 a week earlier.

“We’ve stabilized at 95 miles an hour, and that is not the speed that we want to be going,” said Dr. Joshua LaBaer, director of the Biodesign Institute at Arizona State University. “Ideally, we don’t want this car moving at all.”

A preliminary report on four Covid-19 patients published in the medical journal JAMA offers intriguing clues about why some healthy young men become severely ill from the infection, and why men in general are more prone than women to serious effects of the disease.

Very rare genetic defects that weaken the immune system may have played havoc in the four patients — two sets of brothers ages 21 to 32 from unrelated families in the Netherlands. All, previously in good health, were admitted to intensive care units between March 23 and April 25. One, age 29, died.

Genetic analyses of the patients and their families identified flaws in a gene that enables cells to make molecules called interferons, which stir the immune system to fight off viruses. Without this line of defense, the researchers speculated, the patients struggled to fight the infection.

These genetic defects they were found to have are too rare to account for many other inexplicably severe cases of Covid-19, the researchers said, but the findings point to the possibility that other genetic variations may also influence susceptibility.

The findings also offer hints about why men in general may be more vulnerable than women to severe cases of Covid-19.

The gene that was flawed in the four young men in the study is located on the X chromosome. Men have one copy of that chromosome, while women have two — and if one X in a woman carries the gene defect, her other X may have a normal form of the gene, enabling the creation of enough interferons to stay healthy.

Having two copies of the normal gene — as most women do — may also give them an advantage over men.

An editorial accompanying the report said additional studies like this one could help explain how the disease develops, and enable researchers to find better treatments.

The virus is exacting a particularly high toll on the Amazon.

The Amazon River is South America’s essential life source, the central artery in a vast network of tributaries that sustains some 30 million people across eight countries, moving supplies, people and industry deep into forested regions often untouched by road.

But once again, in a painful echo of history, it is also bringing disease.

The pandemic has overwhelmed Brazil, with more than two million infections and more than 84,000 deaths, an outbreak second only to the United States in severity. The six Brazilian cities with the highest coronavirus exposure are all on the Amazon River, according to an expansive new study from Brazilian researchers that measured antibodies in the population.

A Times photographer traveled the river for weeks, documenting how the virus has spread so quickly and thoroughly along the river that in remote fishing and farming communities like Tefé, people have been as likely to get the virus as in New York City, home to one of the world’s worst outbreaks.

“It was all very fast,” said Isabel Delgado, 34, whose father, Felicindo, died of the virus shortly after falling ill in the small city of Coari.

In the past four months, as the epidemic traveled from the biggest city in the Brazilian Amazon, Manaus, with its high-rises and factories, to tiny, seemingly isolated villages deep in the interior, the fragile health care system has buckled under the onslaught.

Cities and towns along the river have some of the highest deaths per capita in the country — often several times the national average.

The virus is exacting an especially high toll on Indigenous people, in a parallel to the past. Since the 1500s, waves of explorers have traveled the river, seeking gold, land and converts — and later, rubber, a resource that helped fuel the Industrial Revolution. But with them, these outsiders brought violence and diseases like smallpox and measles, killing millions and wiping out entire communities.

“This is a place that has generated so much wealth for others,” said Charles C. Mann, a journalist who has written extensively on the history of the Americas, “and look at what’s happening to it.”

A small California company called Vaxart made a surprise announcement last month: A coronavirus vaccine it was working on had been selected by the U.S. government to be part of Operation Warp Speed, the flagship federal initiative to quickly develop drugs to combat Covid-19.

Vaxart’s shares soared. Company insiders, who weeks earlier had received stock options worth a few million dollars, saw the value of those awards increase sixfold. And a hedge fund that partly controlled the company walked away with more than $200 million in instant profits.

In the race to develop a vaccine, some companies and investors are betting that the winners stand to earn vast profits from selling hundreds of millions — or even billions — of doses to a desperate public.

Across the pharmaceutical and medical industries, senior executives and board members are capitalizing on that dynamic.

They are making millions of dollars after announcing positive developments, including support from the government, in their efforts to fight Covid-19. After such announcements, insiders from at least 11 companies — most of them smaller firms whose fortunes often hinge on the success or failure of a single drug — have sold shares worth well over $1 billion since March, according to figures compiled for The New York Times by Equilar, a data provider.

In some cases, company insiders are profiting from regularly scheduled compensation or automatic stock trades. But in other situations, senior officials appear to be pouncing on opportunities to cash out while prices are sky high. And some companies have awarded stock options to executives shortly before announcements about vaccine progress.

The sudden windfalls highlight the powerful financial incentives for company officials to generate positive headlines in the race for coronavirus vaccines and treatments, even if the drugs might never pan out.

Global roundup

Asia has seen a sharp rise in piracy, raising questions about how the pandemic is shifting crime.

Armed attacks against ships have nearly doubled in Asia so far this year, according to a report by a 20-nation network that works to prevent piracy in the region.

The study noted 51 incidents of piracy, referring to attacks in international waters, or armed robbery, meaning attacks in national waters, between January and June, compared with 28 in the same period in 2019. Of those, 16 occurred in the Singapore Strait, a busy traffic hub where vessels appeared to be especially vulnerable.

The findings, from the Regional Cooperation Agreement on Combating Piracy and Armed Robbery against Ships in Asia, document the latest challenge for some countries in Asia already struggling to combat the pandemic at home. India, Bangladesh and the Philippines, where the number of incidents increased this year, have faced recent hurdles in their coronavirus response as cases continue to pile up across the continent.

The report also adds to emerging questions about how crime rates have shifted in general as countries deal with the fallout from the pandemic and the resulting economic downturn.

While some crime fell as lockdowns around the world kept people indoors, some criminal activity has increased. Many of the largest cities in the United States have recorded staggering increases in murders during the first half of this year, even as other violent crimes have fallen. Murder rates have spiked in cities like Chicago, New York and Philadelphia, and the White House has sent federal agents to some of them to work with local authorities to confront the rise in shootings and other violence.

Cybercrime appears to be more common. For instance, scammers have siphoned off billions of dollars in unemployment claims in the United States. And reports of domestic abuse have risen around the world, including in Britain, Spain, France, Mexico and China.

In other news from around the globe:

  • South Korea, another country hailed as a virus success story, reported 113 new infections on Saturday — its highest daily total since March, and its first over 100 since April. But the new cases included 36 South Korean construction workers who had returned from Iraq, and 32 Russian sailors from a fishing vessel docked for repair.

  • Vietnam, which had gone 100 days without reporting a case of local transmission of the coronavirus, said on Saturday that a 57-year-old grandfather in the central city of Danang had tested positive. Officials said they had tested and quarantined people who had been in close contact with the patient and were tracing others without finding the source.

  • Indoor gyms and leisure centers in England were permitted to reopen on Saturday as the British government continued a planned gradual exit from lockdown. Britain has recorded more than 45,000 coronavirus deaths, and Prime Minister Boris Johnson, who has previously strongly defended his government’s approach, told a BBC interviewer on Friday that there were “very open questions” about whether the country had locked down too late.

  • As Spain struggles with hundreds of local outbreaks, particularly in the northeast of the country, it is also facing renewed travel restrictions imposed by fellow European countries, which could further cripple the tourism sector that is a cornerstone of its economy.

  • The Czech Republic reimposed some virus restrictions on Saturday, according to the news agency Reuters, including a face-mask mandate at indoor events with over 100 people, as its daily number of confirmed cases surpassed 150 in the last five days and Prague was trying to contain an outbreak from a nightclub.

A hurricane bearing down on southern Texas on Saturday morning was expected to bring harsh winds and rain to Corpus Christi and the surrounding area, where officials are already struggling to contain the coronavirus.

Powerful winds from Hanna, which has strengthened from a tropical storm to a Category 1 hurricane, were expected to thrash Texas’ coast beginning on Saturday morning.

The National Hurricane Center issued a warning on Friday night for the coastal region near Corpus Christi and extending about 30 miles in either direction. A storm surge warning reached even farther north, to about 75 miles south of Houston.

The new threat comes as coronavirus cases have been rising in several counties in the path of the hurricane, the first of the Atlantic season. In Nueces County, which includes Corpus Christi and is home to about 362,000 people, the number of virus cases and deaths reported each day has trended upward in recent weeks, fueled in part by visitors who flocked to the beach city because of its low case count.

About 10,000 people in Nueces County have been infected with the virus; more than a fifth of those cases were reported in the past week. At least 124 people have died in the county.

Indiana on Friday recorded more than 1,000 new coronavirus cases for the first time since the pandemic began. Over the past week, the state’s average number of cases per day has increased 71 percent from two weeks earlier, according to a New York Times database.

Gov. Eric Holcomb signed an executive order this week requiring residents to wear face coverings beginning Monday. “Some counties in the past that have never even been a blip on the radar screen for positive tests,” Mr. Holcomb noted on Wednesday at a news conference, are now “reporting regular double-digit Covid-19 positive cases.”

Mr. Holcomb emphasized that the positivity rate in Indiana was steadily increasing.

Indianapolis in particular is also seeing an upward trend in infection — over the last week, the city’s positivity rate jumped by nearly 50 percent, Mayor Joe Hogsett said on Thursday. Transmission is occurring mostly indoors at places like gyms and bars, he said.

Though increased positivity rates have not yet led to an uptick in hospitalizations and deaths, the mayor said, those numbers for the city and the state could soon rise, too. “If you don’t believe that, look at what is happening in places like Florida and Texas to see how wrong you are,” Mr. Hogsett said. Bars and nightclubs that don’t serve food must shut down again beginning Friday until at least Aug. 12, the mayor said.

Close to 40 percent of people who tested positive for the coronavirus in Indiana had not had symptoms, according to Dr. Lindsay Weaver, the chief medical officer for the state Department of Health.

As of Saturday morning, there have been at least 62,000 cases and 2,884 deaths in Indiana since the beginning of the pandemic, according to the Times database.

It’s well established that people who are hospitalized with severe cases of Covid-19 can suffer symptoms for weeks or longer. Now a new report from the Centers for Disease Control and Prevention shows that people with mild cases — including young adults with no underlying conditions — can also suffer symptoms that linger for weeks.

The C.D.C. conducted a telephone survey of nearly 300 adults who had coronavirus tests come back positive two to three weeks earlier, but had not been admitted to a hospital for treatment. While 90 percent of flu patients recover within two weeks of a positive test result, more than a third of the Covid-19 patients were still suffering symptoms, including fatigue, cough and shortness of breath.

The percentage was smaller but still evident for younger patients. “Even among young adults aged 18-34 years with no chronic medical conditions, nearly one in five reported that they had not returned to their usual state of health 14-21 days after testing,” the report states.

The phone interviews were conducted from April 15 to June 25, and the C.D.C. released the report on Friday.

In many parts of the country, younger people have made up a growing percentage of new coronavirus cases. The pattern has contributed to the decision by some public officials to delay or reverse the reopening of bars or restaurants.

Along with preventive measures like social distancing and mask wearing, the report recommended “effective public health messaging targeting these groups.”

In New York City, where gyms are still closed and Netflix is the safest evening entertainment, the phenomenon of stay-at-home weight gain — playfully called the Quarantine 15 by some — has brought an unexpected windfall for some tailors. Some say they have seen business rise by as much as 80 percent, with customers asking for buttons to be moved, waistbands lengthened and jackets made more roomy.

Business was bleak at Woodside Tailor Shop in Queens during the long months of pandemic lockdown. There was no need for party dress alterations, or any pressure for slacks to be hemmed.

But things started picking back up in June, with one particular service in sudden demand: People needed a bit more breathing room in their clothing.

“Everybody got fat!” said Porfirio Arias, 66, a tailor at the Woodside shop. “It’s not only in New York. It’s all over the world that people got fat.”

The boost in business has been welcome for many tailors, who often operate in storefronts shared with dry cleaners, which have suffered mightily during the pandemic. Dry cleaning businesses at the peak of the pandemic lost an estimated 80 to 90 percent in sales compared to previous years, and are still down about 40 to 50 percent, according to data collected by the North East Fabricare Association.

Many tailors fear that the industry may not bounce back even as more people return to work, if the traditional workplace culture shifts to the new work-from-home ethos — meaning more sweatpants and fewer bespoke suits that need to be cleaned, pressed or altered.

Of course, not all New Yorkers have been able to work from home, and the ability to sequester has largely fallen along socioeconomic lines: Putting on pandemic pounds is a small downside of what is in essence a tremendous privilege.

Afghanistan’s minister of public health has urged Afghans to stay in their homes next week during Eid al-Adha, one of the biggest holidays of the Islamic calendar, to avoid risking a resurgence of the virus.

Celebrations for a previous holiday — Eid al-Fitr, marking the end of Ramadan and its month of fasting — had spread the virus, the minister, Ahmad Jawad Osmani, warned.

“Before Eid al-Fitr, the positive cases were less, but two weeks after the Eid, we reached the peak of Covid-19, because people didn’t stay indoors during the Eid and it caused spread of the virus,” Mr. Osmani said at a news conference on Thursday.

Afghanistan was now “in a better position in the fight against Covid-19,” the minister said. “The number of infected people coming to hospitals and the number of critical patients is dropping.”

The Ministry of Public Health has recorded more than 36,000 positive cases of Covid-19 across the country, with 1,247 deaths, 505 of them in the capital, Kabul. Forty-eight positive cases were registered across the country in the past 24 hours, with 22 people dying from the virus in that time. But experts warn that official numbers are not even close to an indication of the real spread.

Eid al-Adha, which is celebrated 70 days after Ramadan, falls on July 31 this year.

During the pandemic, a growing number of medical workers have been helping patients register to vote.

Alister Martin, a 31-year-old emergency room doctor at Massachusetts General Hospital, established a project last year called VotER, setting up kiosks in the hospital that included iPads loaded with TurboVote software and posters with QR codes that patients can scan with cellphones, automatically bringing up a website where they can register.

His project is spreading across the country as traditional in-person voter-registration efforts have been curbed because of the spread of the virus. Since May, more than 3,000 health care providers have requested kits to register their patients to vote, including at flagship hospitals across the country.

“There will be a time where, above the din of suffering, we ask, ‘How can we use this to make something better of our situation?’” said Dr. Martin, who always wears a “Ready to Vote?” badge around his neck.

After months of watching the mismanagement of the response, and fearing for their own lives as well as their patients’, many doctors and nurses now see the connection between their work and politics more clearly.

“Previously, physicians taking a political stance was seen as possibly unprofessional,” said Kelly Wong, a medical student who is part of Patient Voting, a Rhode Island-based effort to provide hospitalized patients with information that can help them navigate the gantlet of voting from a hospital bed. “Civic engagement of our patients and our communities is really important to changing health outcomes.”

Eight outdoor pools across New York City’s five boroughs opened on Friday, despite the pandemic and budget cuts. In nearly 80 years, the pools had never missed a season. But this year, it was a close call.

In April, Mayor Bill de Blasio announced that outdoor public pools would stay closed for the summer in an effort to save money. But in June, he reversed that decision, providing nearly $10 million to the Department of Parks and Recreation to reinstate 15 of the city’s 53 outdoor pools.

Eight outdoor pools across New York City’s five boroughs opened on Friday, and seven more were set to open next Saturday.

The pools are operating at 70 percent capacity, and attendees must wear face coverings at all times, except in the water. Social-distancing ambassadors are stationed at locker rooms and poolside to watch for overcrowding, as they also do at beaches. Swimmers are expected to keep six feet away from others in the pool.

At Sunset Pool in Brooklyn on Friday, Jimmy Ren, 35, almost forgot to take off his face mask before jumping in. He gently placed it on top of his flip-flops and then — splash.

Mr. Ren’s 4-year-old son, Steven, was more hesitant. He learned to swim a year ago at Sunset Pool, but couldn’t seem to make the leap on Friday. After a little persuasion, he slid into the water, and the two laughed and played.

Here are other developments from the New York area:

  • At least two dozen lifeguards from Long Beach Island, N.J., tested positive for the coronavirus after attending social events together, according to a report from NJ.com.

  • Gov. Andrew Cuomo said on Saturday that the number of people hospitalized with the virus in New York had dropped to the lowest levels since the pandemic began. According to Mr. Cuomo’s statement, 996 people in the state were hospitalized on Friday, the first time that figure had fallen below 1,000 since March 18.

How to move during a pandemic.

Here are answers to your questions about how to safely and ethically change your location.

Reporting was contributed by Fahim Abed, Manuela Andreoni, Aman Batheja, Nicholas Bogel-Burroughs, Chau Doan, Choe Sang-Hun, Jesse Drucker, David Gelles, Denise Grady, Tyler Hicks, Juliana Kim, Nicholas Kulish, Adam Liptak, Giulia McDonnell Nieto del Rio, Sarah Mervosh, Raphael Minder, Sarah Maslin Nir, Zach Montague, Richard C. Paddock, Elian Peltier, Simon Romero, Farah Stockman, Derrick Bryson Taylor, Julie Turkewitz and Jeremy White.

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