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Assessing the Real Coronavirus Death Rate: Live Updates - The New York Times

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Hospitals in Austin, Texas, could be “overrun” within two weeks if current trends hold, Mayor Steve Adler warned on Sunday.

“If we don’t change the trajectory, we are within two weeks of having our hospitals overrun,” the mayor said on the CNN program “State of the Union.” He said intensive care units could fill up even sooner, perhaps within 10 days.

Houston’s mayor, Sylvester Turner, issued the same two-week warning in an appearance on the CBS program “Face the Nation,” noting that roughly one in four coronavirus tests in the city was now positive and the demand for testing was exceeding capacity.

The coronavirus is spreading rapidly in Texas, which has broken daily records for new cases several times in the past week after being one of the first states to lift stay-at-home orders and reopen businesses. More than 195,000 cases have been identified over the course of the pandemic in the state, hitting a single-day high on Wednesday with more than 8,100 new cases.

Travis County, Austin’s home, has confirmed more than 11,000 cases since the pandemic began, according to a database maintained by The New York Times, and Harris County, Houston’s home, has reported 35,913.

But the virus has moved beyond the state’s mainly liberal cities, reaching into the deep-red regions of the state that have resisted aggressive public health regulation.

In Lubbock, more people tested positive in the last three weeks than in the previous three months combined. Two months ago, on the day that Gov. Greg Abbott began to reopen the state, the city recorded eight positive tests. On Wednesday, there were 184.

Mr. Adler said that the most important thing about the order Governor Abbott signed on Thursday making masks mandatory in most counties was that people would now be getting the same guidance from both state and local officials. “It’s the messaging,” he said. “It’s the singular voice from both parties saying to our community, ‘This is important, you have to do it, it works.’”

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Our correspondent Sheri Fink goes behind the scenes at Houston Methodist Hospital as coronavirus cases rise.CreditCredit...Erin Schaff/The New York Times

Many conservative Texans do not share that view, including some of the state’s top leaders. On Tuesday, Lt. Gov. Dan Patrick declared himself tired of Dr. Anthony S. Fauci, the nation’s top infectious disease doctor. “I don’t need his advice anymore,” Mr. Patrick said.

That sentiment was echoed outside a popular, newly opened hamburger restaurant in Wolfforth, just outside Lubbock, where even Mr. Abbott, a Republican, came under harsh criticism. “It seems like he’s been influenced by Fauci and the left,” Mark Stewart said.

But in the biggest cities in Texas, Governor Abbott’s directives don’t go far enough.

“I’m sure a mask order will make some difference, and I’m grateful that that’s happened now,” Judge Lina Hidalgo, a Democrat who is effectively the chief executive of Harris County, said on the ABC program “This Week.” “That said, as long as we’re doing as little as possible and hoping for the best, we’re always going to be chasing this thing, we’re always going to be behind.”

Some Texans are worried about a political event on the horizon: The executive committee of the state’s Republican Party voted on Thursday to go ahead with an in-person convention in Houston next week. In response, the Texas Medical Association said it would withdraw from the event as an advertiser.

“With or without masks, an indoor gathering of thousands of people from all around the state in a city with tens of thousands of active COVID-19 cases poses a significant health risk,” the organization’s president, Dr. Diana L. Fite, said in a statement on Friday.

Even Mr. Patrick said that holding an in-person convention in Houston was not a good idea, citing the risks of exposing people to Covid-19. But he added that he respected the vote of the committee. “I will be there,” he said in a statement in Friday.

Credit...Cheriss May for The New York Times

On Sunday, public health experts and officials disputed President’s Trump’s characterizations of the coronavirus caseload in the United States.

In an Independence Day speech on Saturday at the White House, Mr. Trump sought to dismiss widespread criticism of his administration’s slow and ineffective response to the virus. He repeated his false claim that an abundance of testing made the country’s cases look worse than they were, asserting that 99 percent of the nation’s coronavirus cases were “totally harmless.”

Coronavirus cases have risen steeply in recent weeks, and infections announced across the United States last week totaled more than 330,000 — a record high that included the five highest single-day totals of the pandemic.

On Sunday, the former F.D.A. commissioner Dr. Scott Gottlieb said that “certainly more than 1 percent of people get serious illness” if they are infected. Speaking on the CBS program “Face the Nation,” he estimated that when all cases were counted, including asymptomatic ones, between 2 and 5 percent of infected people become sick enough to require hospitalization.

Dr. Stephen Hahn, the commissioner of the Food and Drug Administration, sidestepped repeated questions about that statement on three television news shows, saying at one point: “I’m not going to get into who is right and who is wrong.”

Even some Republicans pushed back. “The virus is not harmless,” Miami’s mayor, Carlos Giménez, said on “Face the Nation,” noting that positivity rates in Miami-Dade County — the share of coronavirus tests that come back positive — were now above 20 percent. Florida has reached record highs for new cases several times in the past 10 days, reporting more than 11,400 new cases on Saturday alone, according to a New York Times database.

Mr. Trump and other administration officials have also highlighted the country’s lowering death rate. Dr. Ashish Jha, the director of the Harvard Global Health Institute, said improvements in care may have caused the decline, but also described deaths as a “lagging indicator.”

“By the time somebody gets infected, it takes a couple weeks before they get hospitalized and get really sick, and another week or 10 days before they die, ” he said. He added that many of the people currently getting infected were younger adults and less likely to develop severe illness.

Overall, the president’s speech on Saturday, and another at Mount Rushmore on Friday, focused less on the coronavirus and more on political talking points. He used exaggerated, apocalyptic language to tar nationwide protests against entrenched racism and police brutality and signaled that he would exploit cultural flash points in his re-election campaign, including a renewed debate over honoring symbols of the Confederacy.

Senator Tammy Duckworth, a Democrat from Illinois and a former Army lieutenant colonel, condemned those remarks and said his priorities were “all wrong” in the middle of a global pandemic.

“We should be talking about the fact that Covid-19 is experiencing a resurgence,” she said on CNN’s “State of the Union.” “I’m more worried about the 130,000 who have lost their lives recently and the thousands and thousands more Americans who are currently sick than I am about our historical past.”

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Despite good weather and low fuel prices across much of the United States, many Independence day celebrations over the long weekend have been muted. Bars in dozens of cities were shuttered, fireworks were canceled and many Americans scratched plans to visit family members.

In Miami, Los Angeles and other coastal cities, pristine beaches sat largely untouched at a time when families usually flock to them. Even as the sun heated Galveston, Texas, to 93 degrees on Saturday, the city’s beaches remained mostly vacant, in keeping with an official closure.

“It’s just surreal,” said Chief Peter Davis of the Galveston Island Beach Patrol. “In all the years I’ve been here, I’ve never seen the beaches empty on the Fourth of July.”

But some people gathered anyway. There were sizable crowds for President Trump’s speeches at Mount Rushmore, in South Dakota, and the White House, and at the National Mall for military flyovers and a fireworks display.

At a parade in Eagar, Ariz., firearms far outnumbered masks. Residents cheered as floats, flame-spewing hot rods and a blonde cowboy-hatted parade queen passed by.

“Got to die of something,” said Bruce Benge, a corrections officer who lives in nearby Pinetop and who left his mask on the front seat of his Ford pickup truck, which he had festooned with a Trump 2020 flag.

In Galveston, a small group of protesters assembled, mostly without masks, to protest the beach closure, carrying signs that read “Stop Government Overreach,” and “Beach Lives Matter.” A handful ventured into the water. One man carried an American flag with him into the surf.

On Beale Street, Memphis’s famed entertainment district, crowds poured from restaurants and other venues onto the street Saturday evening. Many wore masks, but many did not. Later in the evening, some set off fireworks near Beale Street, drawing nearby police officers.

Independence Day ended in bloodshed in Greenville, S.C., where a shooting at Lavish Lounge, a nightclub, around 2 a.m. on Sunday left two people dead and eight injured. About 200 people were at the club at the time of the shooting, a sheriff’s deputy said, even though state officials have not yet allowed nightclubs in the state to reopen.

One distinctly American tradition continued over the weekend, in socially distanced form: the annual pilgrimage of competitive eaters to Coney Island for the Nathan’s Famous Hot Dog Eating Contest.

The crowds were turned away this year because of the virus. So when Joey Chestnut won his 13th title after eating a record 75 hot dogs in 10 minutes, he did it without raucous cheers he had grown accustomed to.

Credit...Rafiq Maqbool/Associated Press

More than six months into the pandemic, the coronavirus has infected more than 11 million people worldwide, killing more than 525,000. But despite the increasing toll, scientists still do not have a clear answer to one of the most fundamental questions about the virus: How deadly is it?

A firm estimate could help governments predict how many deaths would ensue if the virus spread out of control. The figure, usually called the infection fatality rate, could tell health officials what to expect as the pandemic spreads in densely populated nations like Brazil, India and Nigeria.

In poorer countries, the number could help officials decide whether to spend more on oxygen concentrators and ventilators, or on measles shots and mosquito nets.

At present, countries have very different case fatality rates, which measure deaths among patients known to have had Covid-19. In most cases, that number is highest in countries that have had the virus the longest.

According to data gathered by The New York Times, China had reported 90,294 cases as of Friday and 4,634 deaths, a case fatality rate of 5 percent. The United States, which has had a record number of new daily cases six times in the past two weeks, has had 2,811,447 cases and 129,403 deaths, about 4.6 percent.

Ten sizable countries, most in Western Europe, have tested bigger percentages of their populations than the United States has. Their case fatality rates vary wildly: Iceland’s is less than 1 percent, New Zealand’s and Israel’s are below 2 percent. Belgium, by comparison, is at 16 percent, and Italy and Britain are at 14 percent.

Before last week, the World Health Organization had no official estimate for the infection fatality rate. Instead, it had relied on a mix of data sent in by member countries and academic groups, and on a meta-analysis done in May by scientists at the University of Wollongong and James Cook University in Australia.

Those researchers looked at 267 studies in more than a dozen countries and then chose the 25 they considered the most accurate, weighting them for accuracy, and averaged the data. They concluded that the global infection fatality rate was 0.64 percent.

That percentage of the world’s population equals 47 million people, including two million Americans.

Other recent scientific developments:

  • A six-gene segment of the human genome that increases the risk of severe illness from the coronavirus was inherited from Neanderthals, according to a new study. The variant is common in Bangladesh, and may explain why Covid-19 patients of Bangladeshi descent are dying at a high rate in Britain. Only 8 percent of Europeans carry it, and it is almost completely absent in Africa.

  • Researchers reported new evidence that a variant of the virus that has come to predominate in much of the world did so partly because it is more transmissible than other variants. The variant carries a mutation that stabilizes the virus’s spike proteins, which it uses to infect human cells. While the report notes that the findings aren’t definitive, the lead author, Bette Korber, a theoretical biologist, said, “It is the dominant virus in the world, it only took about a month for that to happen, and it’s now the one we should be looking at.”

Credit...David Crosling/EPA, via Shutterstock

The Australian state of Victoria has locked down nine public housing towers in Melbourne, its capital, telling about 3,000 residents that they must not leave their homes for any reason for at least five days.

The strict quarantine — which is the first of its kind in Australia during the pandemic and is being monitored by hundreds of police officers — started immediately on Saturday afternoon after 23 coronavirus infections were found in 12 of the towers’ households. Public health officials said everyone in the towers would be tested over the next few days.

“There is a lot of intermingling of the people between those towers for work, for family, for community events,” said Dr. Paul Kelly, Australia’s acting chief medical officer.

He called the towers “vertical cruise ships” with the potential to cause a major surge in cases at a time when Australia’s infections are already rising because of an outbreak across several Melbourne suburbs.

Some residents of the towers objected to being quarantined without notice. Abdi Ibrahim, who lives there with his five children, including 7-month-old twins, told The Australian that the lockdown had been imposed so quickly that it gave him no time to buy groceries for his family. He also had to cancel his Sunday shift at a logistics company.

“If I don’t work, I don’t get paid,” he said, adding: “We are so isolated — you know what I mean, it’s like a prison.”

Officials said they would provide tower residents with food, cash compensation and rent relief.

As the towers were being locked down, officials also added two more Melbourne postal codes to the 10 others already under stay-at-home orders, affecting a total of more than 300,000 people. Unlike residents of the towers, people in these areas are allowed to leave their homes for work or education, exercise, medical care, caregiving or shopping for essential supplies.

Australia’s total case count remains relatively small, but public health officials have become increasingly alarmed by the outbreak in Melbourne. About 200 new cases emerged in and around the city over the past two days, a growth rate not seen since March.

Credit...Eugene Hoshiko/Associated Press

In rewarding Tokyo’s first female governor, Yuriko Koike, with a second term on Sunday, voters endorsed her highly visible leadership as the sprawling metropolis has avoided the kind of spiraling death toll from the coronavirus seen in other world capitals.

But a recent resurgence in cases in Tokyo has made clear that her challenge is far from over.

Even as Ms. Koike, 67, cruised to victory on Sunday, with exit polls by the Japanese news media showing her winning 60 percent of the vote, Tokyo reported 111 new infections, its fourth straight day over 100.

The creeping increase in cases has started to raise anxieties that the capital may have to reinstate elements of the nearly two-month state of emergency that it emerged from at the end of May. That growing caseload was felt in the election on Sunday, as voter turnout dipped below 35 percent.

During the emergency period, in which the government issued voluntary requests for businesses to limit operations and residents to stay home, Ms. Koike made herself the face of Tokyo’s response to the virus. She anchored near nightly news conferences to deliver daily test figures and advice on how to avoid infections.

In contrast to Prime Minister Shinzo Abe, who often appeared stiff in front of the news media, Ms. Koike was a much more relaxed presence when she appeared in conversation with Japan’s most famous YouTube star, Hikakin.

“Seeing her face on television every day made me feel comfortable,” Yuki Matsuura, 70, said as she voted in the Setagaya ward of Tokyo. “I think that she is doing the best that she can in a very difficult situation.”

Credit...Francisco Seco/Associated Press

Some survivors of Covid-19 have a long road to recovery even after discharged from the hospital, and the illness can leave long-lasting effects that are just beginning to be recognized and understood. It is still too early to know the trajectory for these patients, but scientists are beginning research that could predict those effects, and have an impact on how doctors treat the illness.

In Britain, the National Institute for Health Research, the University of Leicester and university hospitals in the city of Leicester have started a study of about 10,000 patients, which the university says makes it the largest of its kind in the world.

“As we continue our fight against this global pandemic, we are learning more and more about the impact the disease can have not only on immediate health, but longer-term physical and mental health too,” Matt Hancock, the health secretary said, in a statement on Sunday.

Chris Brightling, a professor of respiratory medicine at the University of Leicester and chief investigator for the study, said that “it is vitally important that we rapidly gather evidence on the longer-term consequences of contracting severe Covid-19 so we can develop and test new treatment strategies for them and other people affected by future waves of the disease.”

Mr. Hancock told the BBC on Sunday that long-term effects are a “really serious problem for a minority of people who’ve had Covid, thankfully not me,” describing them as a “post-viral fatigue syndrome.”

Credit...Chang W. Lee/The New York Times

An estimated 22,000 seasonal workers tend and harvest crops in New Jersey, nicknamed the Garden State for its robust agriculture industry. Many of these laborers follow the ripening crops up the Eastern Seaboard, starting in Florida, where migrant living quarters have been ravaged by the coronavirus, and working their way north to Maine.

Making life even more perilous, they have been deemed essential workers — exempt from stay-at-home orders and a 14-day quarantine rule in New Jersey for people coming from states where the virus is spreading quickly. Each influx of workers brings the risk of a fresh outbreak.

Barring rain, they work seven days a week.

In New Jersey, 3,900 farmworkers had been tested as of Thursday and 193 were positive for the virus, according to the state’s Department of Health. Of these, 14 who had nowhere to remain isolated were placed into quarantine at a state-run field hospital at the Atlantic City Convention Center.

“It’s a little dangerous,” said Felix Nieves, 56, a supervisor at Atlantic Blueberry Company in Hammonton. The 1,300-acre farm is considered the biggest blueberry producer in the Northeast.

The first round of testing at Atlantic Blueberry was done early in the season, before most workers arrived. Three of the first 56 people tested were found to have the virus.

Atlantic Blueberry purchased 3,000 bandannas and gave each worker two — one to wear, one to wash — and hung fire-retardant cloth between beds in the dormitories where hundreds of laborers live during the season. The farm also bought additional buses to create extra space on the shuttles that run to and from the fields.

“Farming never stops,” Mr. Nieves said. “The fruit will not wait for this to pass.”

Credit...Karsten Moran for The New York Times

The standard American shopping mall was built around department stores. But the pandemic has been devastating for the retail industry, and many of those stores are disappearing at a rapid clip.

Some chains are unable to pay rent, prominent department store chains have filed for bankruptcy protection, and as they close stores, it could cause other tenants to abandon shopping centers.

Add to that the pressure that malls were already facing from online shopping, and analysts say that hundreds are at risk of closing in the next five years. That has the potential to reshape the suburbs, with many communities already debating whether abandoned malls can be turned into local markets or office space, even affordable housing.

“More companies have gone bankrupt than any of us have ever expected, and I do believe that will accelerate as we move through 2020, unfortunately,” said Deborah Weinswig, founder of Coresight Research, an advisory and research firm that specializes in retail and technology.

“And then those who haven’t gone bankrupt are using this as an opportunity to clean up their real estate,” added Ms. Weinswig, who estimated that about 25 percent of the country’s nearly 1,200 malls were in danger.

Vince Tibone, a retail analyst at Green Street, said he was pessimistic about the ability of most malls to fill vacant spaces, especially during the pandemic. Entertainment options like Dave & Buster’s are off the table, for instance.

“The reality,” he said, “is there are going to be dark boxes for some time.”

Credit...Bryan Denton for The New York Times

Alarmed at China’s stranglehold over supplies of masks, gowns, test kits and other essential tools for tackling the coronavirus, countries around the world have set up their own factories to cope with both this pandemic and future ones.

When the outbreak subsides, those factories may struggle to survive. But China has laid the groundwork to dominate the market for protective and medical supplies for years to come.

Before the pandemic, China was already exporting more respirators, surgical masks, medical goggles and protective garments than the rest of the world combined, the Peterson Institute for International Economics estimated.

Beijing’s coronavirus response has only added to that dominance. It increased mask production nearly 12-fold in February alone. It can now make 150 tons per day of the specialized fabric used for masks, said Bob McIlvaine, who runs a research and consulting firm in Northfield, Ill. That is 15 times the output of U.S. companies even after they ramped up production this spring.

“The Chinese have been successful weaving global personal protection equipment dominance with supply-chain command and control,” said Omar Allam, a former Canadian trade official trying to establish production of in-demand N95 medical respirators in his country.

American companies have been reluctant to make big investments in fabric manufacturing because they worry that demand for masks will be temporary. Yet officials across the country are increasingly calling for the wearing of face coverings in public.

“It is a huge mistake,” Mr. McIlvaine said, “to assume that the market will disappear.”

Credit...Suzie Howell for The New York Times

Two hours by boat from the seaside town of Lowestoft on the east coast of England, over 100 giant windmills loom more than 500 feet above the sea. High atop the new towers, technicians in red-and-black protective suits have been working to hook them up to the British power system.

Britain has been under various stages of lockdown since March. But work on this wind farm, called East Anglia One, has charged ahead. Contractors rented holiday cabins and reached agreements with hotels near Lowestoft, the operations base, so that they could house some of the offshore workers there and keep them isolated. Workers were taken out by boats to the wind farm for 12-hour day and night shifts.

Producers of clean energy are pushing hard to get their projects up and running; they want to make money on their investments as soon as possible. And while the virus has reduced demand for electricity overall — the oil and gas industry in particular has been rocked by plummeting prices — renewable power tends to win out over polluting energy sources because of low costs and favorable regulatory rules.

The green energy industry suffered major setbacks during the financial crisis of 2008 and 2009. But analysts say that businesses have consolidated since then, and the industry has continued to bring down costs. The turbines at East Anglia One are 15 times as powerful as those installed in the first offshore wind farms almost 30 years ago, and so they produce much more revenue per unit.

“The outlook for renewables looks really quite resilient, despite all the Covid restrictions,” said Sam Arie, a utilities analyst at UBS, an investment bank. “We have seen a few companies with minor interruptions,” he added. “But relative to other sectors the impacts here have been very limited.”

When it’s time to invite people over or arrange a play date, hosts face tough conversations with friends, neighbors and family on their standards for avoiding coronavirus infection. Here are some strategies to help.

Reporting was contributed by Pam Belluck, Nicholas Bogel-Burroughs, Nellie Bowles, Keith Bradsher, Damien Cave, Emily Cochrane, Jacey Fortin, J. David Goodman, Maggie Haberman, Rebecca Halleck, Hikari Hida, Makiko Inoue, Annie Karni, Iliana Magra, Sapna Maheshwari, Apoorva Mandavilli, Donald G. McNeil, Bryan Pietsch, Roni Caryn Rabin, Stanley Reed, Motoko Rich, Rick Rojas, Lucy Tompkins, Tracey Tully, Hisako Ueno and Carl Zimmer.

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