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Pandemic’s Toll Is Worse Than the Numbers Suggest, Study Says

LiveUpdated Oct. 21, 2020, 6:01 a.m. ET
Oct. 21, 2020, 6:01 a.m. ET
Argentina, Brazil, Britain, France, India, Russia and the United States have helped push the global total of coronavirus cases to more than 40.7 million.
Heres what you need to know:
In the past seven days, seven countries Argentina, Brazil, Britain, France, India, Russia and the United States have reported at least 100,000 new cases of the coronavirus, helping to push total cases worldwide to more than 40.7 million, according to a New York Times database.
In many cases, these countries are seeing numbers that are much higher than they were during the height of the pandemic in the spring. At that point most countries locked down, stopping movement and much interpersonal contact. Strategies have changed, and today local lockdowns are the way forward for most. There is more testing, giving a clearer picture of the pandemic. But the numbers continue to grow.
Over the past week in the United States, there have been 421,114 new cases, illustrating that the long-predicted fall wave of the virus is well underway.Midwestern and Rocky Mountain states are struggling to control major outbreaks. And the national trajectory is worsening by the day, as the cooler weather drives more people to stay indoors where the virus spreads easily. In some states, hospitals are almost full.
India reported 411,718 over the past seven days, but numbers have been falling since mid-September. On Monday, the country recorded fewer than 50,000 cases, the lowest number since July, the government said. But the lower numbers, which would seem at first glance to be good news, have raised questions. The government recently approved the use of rapid coronavirus testing based on gene-editing technology, hoping to increase its testing capabilities. But experts question the reliability of rapid tests.
In France, which has added 174,273 cases in the past seven days, a curfew has been implemented in Paris and eight other regions. Still, more than 11,000 virus patients are hospitalized, and 2,000 are in intensive care, a threshold that had not been reached since May. (The country currently has 5,800 intensive care beds.)
Brazil, which has reported 160,326 cases in the past seven days, is among the countries with the lowest testing rates and still lacks a clear contact tracing policy. Despite being the country with the second-highest death toll, about eight million Brazilians had received laboratory tests by mid-October according to the Ministry of Health, less than a tenth of the number of people tested in the United States. But, as in India, the disease has been trending downward in Brazil since early August. The country is now reporting an average of 500 deaths a day, half of the daily toll it reported two months ago. Most big cities have eased most social-distancing measures and opened some schools, restaurants, and beaches.
The number of daily recorded infections in Britain, which includes England, Northern Ireland, Scotland and Wales, has nearly tripled since the beginning of October. In the past seven days, Britain has reported 127,622 new cases. Hospitalizations and deaths are also rising, and in some parts of the country, intensive care units are being stretched to their limits. The countries that make up Britain are each forging their own paths: England has implemented a tiered alert system; Northern Ireland is ramping up restrictions for pubs and restaurants, and closing schools; Scotland implemented a two-week tightening of restrictions; and Wales was preparing to enter a two-week national lockdown.
Russia has added 103,992 new cases in the past seven days.. The government, however, has resisted imposing even local lockdowns, although it has started to enforce mask-wearing requirements. The capital, Moscow, is recording about one-third of the countrys daily new cases. Health authorities there have opened temporary hospitals in a city park and in a large car-dealership center.But Mayor Sergei Sobyanin said curfews and business closings are absolutely unacceptable and impossible for us.
Argentina has reported 101,964 cases in the past seven days. It is the fifth country to surpass one million total cases.The country received praise early in the pandemic by imposing a strict quarantine in mid-March, and although certain restrictions have been relaxed, much of the country is still under some type of lockdown order. Still, the virus which was once concentrated in the Buenos Aires area, has since expanded to much of the country, including remote areas with scarce medical resources.
Kaly Soto, Eileen Sullivan, Sameer Yasir, Antonella Francini, Manuela Andreoni, Anna Schaverien, Anton Troianovski and Daniel Politi
The pandemic has caused nearly 300,000 deaths in the United States through early October, the Centers for Disease Control and Prevention said in a report released Tuesday. The tally includes not only deaths directly caused by the coronavirus but also nearly 100,000 fatalities that are indirectly related but would not have occurred if not for the virus.
The study is an attempt to measure excess deaths fatalities from all causes that statistically exceed those normally occurring in a certain time period.
Many experts believe this measure tracks the pandemics impact more accurately than the case fatality rate. The figure includes deaths from Covid-19 that were misclassified or missed and deaths from emergencies like heart attacks that went untreated because people were afraid to go to the hospital.
Hidden in the new numbers from the C.D.C. is a statistic that may not mean as much as it appears: While the pandemic has taken the greatest toll on older citizens, the biggest percentage increase in excess deaths has occurred among young adults ages 25 to 44, among whom there was a 26.5 percent increase as compared with an increase of 14.4 percent in those over 85, a group with a large proportion of the nations excess deaths.
But in nonpandemic times, the death rate among people in that age group is very low, so a disaster such as Covid-19 can easily bump up their death statistics without adding up to large numbers of excess deaths.
Excess deaths among Black people and Hispanics of all age groups also rose compared with previous years, the C.D.C. reports. Hispanics experienced a 54 percent increase, while Black people saw a 33 percent rise.
By comparison, the increase for white Americans was 12 percent, according to the C.D.C.
Another report, published in the Proceedings of the National Academy of Sciences, found that in April nearly half of the nations excess deaths were in New York and New Jersey. A third were in people over age 85.
But excess deaths are only part of the story, noted the authors of that paper, led by Amy Finkelstein, a professor of economics at M.I.T. While deaths last spring were concentrated in New York and New Jersey, the economic ravages from the pandemic extended nationwide, even in states with almost no deaths.
Job losses in New York and New Jersey were just a small fraction 7 percent of job losses throughout the country. And while deaths were concentrated in older people, half of those who lost their jobs nationwide were ages 25 to 44.
Concentrating on case counts or death counts, they conclude, provides only a partial picture of the pandemics devastation.
Health crises concentrated in one part of the country and one age group may have substantial economic spillovers that are felt throughout the rest of the country and on other age groups, the authors wrote.
Roni Caryn Rabin and Gina Kolata
Dr. Stephen Hahn, the F.D.A. commissioner, is caught between pressure from the White House and distraught agency scientists who wonder if he can protect their work.Credit…Oliver Contreras for The New York Times
In what might be the final months of the Trump administration, Dr. Stephen M. Hahn, the head of the Food and Drug Administration, seems to be trying to save the agency from the fate of the Centers for Disease Control and Prevention, whose scientists have been stripped of much of their authority and independence in responding to the pandemic.
To many F.D.A. scientists, Dr. Hahn has been a disappointment. Under his leadership, the F.D.A. authorized hydroxychloroquine for hospitalized Covid-19 patients despite a lack of evidence, only to reverse the decision once the drug was tied to severe side effects.
In late August, Dr. Hahn made a significant error at a news conference with the president announcing the approval of plasma treatments for Covid-19, greatly exaggerating its benefits. He later publicly corrected the record.
That debacle seems to have been a turning point for Dr. Hahn and agency scientists.
On Sept. 10, F.D.A. directors wrote a joint statement, warning that political interference could destroy the agencys credibility. Dr. Hahn tweeted his support of the statement, and later that day noted that new vaccine guidelines were coming.
Experts in the Office of Vaccines Research and Review drafted new guidelines, to make its standards unmistakable to drugmakers and reassure jittery Americans that the agency would not cut corners when assessing a vaccines safety and effectiveness.
Within days of submitting the guidelines to the White House, F.D.A. scientists, fearing they would never be made public, decided to include them in the briefing materials for an outside group of vaccine experts scheduled to meet on Oct. 22. They slipped a version into the appendix of the committees briefing materials, with a new title.
Executives from Johnson & Johnson and Merck, each with vaccine candidates, called for the guidelines release. Dr. Albert Bourla, Pfizers top executive, wrote on Twitter that he had faith in the F.D.A.s ability to set standards.
The same morning, the materials were quietly posted online. The White House was given about an hours notice, according to a senior administration official. Later that day, the White House abruptly cleared the guidelines, which were then posted to the F.D.A. website.
Sheila Kaplan, Sharon LaFraniere, Noah Weiland and Maggie Haberman
Senator Mitch McConnell, the majority leader, privately told Republican senators on Tuesday that he had warned the White House not to strike a pre-election deal with Speaker Nancy Pelosi on a new round of stimulus, moving to head off an agreement that President Trump has demanded but most in his party oppose.
Mr. McConnells remarks, confirmed by four Republicans familiar with them, threw cold water on Mr. Trumps increasingly urgent push to enact a new round of pandemic aid before Election Day. They came just as Ms. Pelosi offered an upbeat assessment of her negotiations with Steven Mnuchin, the Treasury secretary, telling Democrats that their latest conversation had yielded common ground as we move closer to an agreement.
The cost of their emerging compromise on a new round of aid to hard-pressed Americans and businesses has steadily climbed toward $2 trillion, inching closer to Ms. Pelosis demands even as it far exceeds what most Senate Republicans have said they can accept.
With coronavirus cases continuing to rise across the country and tens of millions of American families and businesses going without critical federal benefits they relied on for much of the year, economists and the chair of the Federal Reserve have said now is the time for a substantial infusion of federal money to fuel a still-shaky economic recovery.
A majority of voters agree, saying they would support a $2 trillion stimulus package. And Mr. Trump, who only two weeks ago scuttled the bipartisan talks, is now also pushing urgently for Congress to go big, as he grasps for political advantage in the waning days of his re-election race.
The latest White House offer would cost nearly $1.9 trillion, White House officials said, nearly four times the size of the $500 billion package that Senate Republicans hoped to advance on Wednesday in a bid to show voters that they were willing to provide some aid just not what Democrats and Mr. Trump have been discussing. (Democrats were likely to object to the package as inadequate and prevent it from clearing the 60-vote threshold it would need to advance.)
Emily Cochrane and Nicholas Fandos
As New York City faces its first notable increase in coronavirus infections since a springtime surge killed more than 20,000, residents are again looking at their neighborhoods and wondering, after each rise in numbers, each passing siren: Is this a second wave?
The recent increase prompted Mayor Bill de Blasio and Gov. Andrew M. Cuomo to order lockdowns in several parts of Brooklyn and Queens where the infection rate has risen most sharply. The restrictions mostly affected neighborhoods with large Orthodox Jewish populations. But other neighborhoods faced partial lockdowns, including the canceling of indoor dining.
The increases have rattled many people in those neighborhoods and beyond, reminding them of the dark days of March and April when it was impossible to meet friends, eat out at a restaurant, go to church or visit parents. Some residents are back to stockpiling medicine and rubbing alcohol, while others are putting their plans to return to their offices on indefinite hold.
Some New Yorkers see the rise in cases as a harbinger, the footfalls that announce an intruders arrival.
I feel like the second wave is here that same kind of doomsday feeling, said Anya Ferring, 40, a fashion production consultant who lives in Far Rockaway, Queens, one of the neighborhoods experiencing a partial lockdown.
In several interviews in the past several weeks, city residents shared deep frustrations with their fellow New Yorkers who dont appear to be following the same rules on wearing masks and social distancing. The solidarity forged in the springtime outbreak appears, in some neighborhoods, to have fractured in the fall.
Zoe Neuschatz, in Bedford-Stuyvesant, said she and her boyfriend have been mostly staying at home since the pandemic began, and they have no plans of letting up and have even considered stockpiling supplies.
Maybe its my post-trauma stress from the spring, she said. Im a nerd about it. I take it seriously, always.
Michael Wilson
Global Roundup
Thailand welcomed more than 10 million tourists from China last year. This week, tourism officials were pleased to announce the arrival of 39.
It was the first group of foreign tourists to arrive in the kingdom in more than six months.
Thailand took a big hit to its economy after it closed its borders to foreign tourists in April to contain the coronavirus. Officials have been trying for months to bring back tourists through a special visa and quarantine program and, after several false starts, the group of 39 arrived from Shanghai on Tuesday.
The travelers went directly into quarantine at a Bangkok hotel, where they will remain for 14 days at their own expense.
The governor of the Tourism Authority of Thailand, Yuthasak Supasorn, said in an interview on Wednesday that he hopes the groups arrival will open the door to travelers from other low-risk countries, such as Australia, Japan, New Zealand and South Korea. The new visa allows stays of up to 270 days.
Thailand was the first country after China to report a case of coronavirus, which was brought by a tourist from Wuhan in January. But the kingdom has been among the most successful in containing the virus, reporting only 3,709 cases and 59 deaths.
The challenge now is to revive the economy.
During the second quarter of this year, Thailand suffered its biggest contraction since the late 1990s as the economy shrank by 12.2 percent, according to the state planning council.
Although tourists were barred, thousands of Thais returned from abroad and went through quarantine. Hundreds have tested positive without any reports of the virus spreading into the community.
That is why we are confident in bringing tourists in at this time, Mr. Yuthasak said.
For now, the arrivals may throw a lifeline to a few hotels that have set themselves up as quarantine centers, but it will do little to help the struggling tourist economy. Many hotels are closed, and others are operating at a loss to satisfy demands from their lenders.
In other developments around the world:

  • About seven million people in the north of England will soon be living under the countrys toughest virus restrictions as large parts of the region are moved to the highest alert level in Britains new tiered response system. South Yorkshire will rise to the very high alert starting this weekend, a local official announced on Wednesday. Greater Manchester, Britains second-largest urban area, will also move to the highest alert level starting Friday after local leaders failed to agree on a deal with the central government in London.

Richard C. Paddock
Alaska is concerned about the spread of the coronavirus as weather sends people inside at restaurants and other gathering sites.Credit…Ash Adams for The New York Times
This past summer, Alaska recorded some of the fewest coronavirus cases per capita in the nation. Credit isolation and wide-open spaces. But officials had also done more testing than almost every other state and then tracked every person who came back positive with an army of contact tracers.
Now, as temperatures begin dipping back below freezing, the virus has seized new opportunities.
Alaskas struggles provide an early warning that winter could bring the most devastating phase of the pandemic. On Friday, the weekly case average in the state reached its highest point of the year.
Along with cold-season gatherings moving into more confined spaces, there is evidence that the coronavirus is more virulent in colder weather and lower relative humidities.
The state also faces some particular challenges, with officials fearing outbreaks in remote villages. Dr. Anne Zink, Alaskas chief medical officer, described one small community with no running water that is currently dealing with an outbreak, and weather has prevented officials from getting supplies in.
One of the challenges that Dr. Zink has consistently faced is convincing residents to wear masks and stay distanced. In May, when Gov. Mike Dunleavy lifted statewide restrictions, he left decisions about how to manage the pandemic to local jurisdictions.
In the town of Wasilla over the weekend, people gathered at a bar for an Oktoberfest celebration. While the outdoor seating offered views of snow-capped mountains, the weather was near freezing, so people crowded inside, where no one was wearing masks.
And at a youth hockey tournament this month in Anchorage, videos showed some parents watching from the stands without masks. When the tournament was over, the Anchorage Health Department announced it was investigating a cluster of cases linked to the games.
Mike Baker
Nearly two weeks ago, President Trump told Americans that they would soon be getting an antibody treatment that he had promoted, without evidence, as a cure for the coronavirus. Last weekend, as the country braced for another major wave of coronavirus infections, Mr. Trumps health secretary promised such therapies were just around the corner.
But these statements are misleading, at best. Even if the drugs are proven to work still a big if theres little chance that they will soon be widely available. A smooth distribution of the antibody treatments will be dependent on the very same factors that have so far bedeviled the countrys response to Covid-19: fast and plentiful testing, coordination between state and federal officials, and equitable access to health care.
Supply will be extremely limited at first, even though the pool of patients who might benefit is vast, raising messy questions about who should be first in line for treatment. The drugs are believed to work best in people who have recently been infected and are not yet very sick.
Roughly 60,000 Americans are testing positive for the coronavirus every day, yet the company that provided the presidents antibody treatment, Regeneron, has said it will have only 50,000 doses initially. Eli Lilly, which is developing a similar product, has said it will have 100,000 doses at first. Regeneron will eventually have 300,000 doses, and Eli Lilly will have up to one million before the end of the year. Both companies have applied to the Food and Drug Administration for emergency authorization of their products.
Katie Thomas
More than 240 people who were quarantined for the coronavirus in hotels in the Australian state of Victoria are being contacted for testing for blood-borne viruses including H.I.V., after it was found that single-use blood testing devices were used on multiple people.
The revelation is part of the fallout of a failed program to quarantine Australians returning to the country in state-run hotels. The mismanagement of the scheme is widely regarded to have led to a second wave of the virus in Victoria. The outbreak put Melbourne, which is in the state of Victoria and is the second-largest city in Australia, into lockdown for over three months.
During an inquest into the program on Monday, the authorities said that blood glucose monitoring devices intended for use by one person were used on multiple guests held in the hotels between March and August. The tests were used by people with diabetes to monitor blood sugar levels.
Blood glucose level testing devices intended for use by one person were used across multiple residents, Safer Care Victoria, the states health care quality assurance agency, said in a statement. This presents a low clinical risk of cross-contamination and blood borne viruses Hepatitis B and C, and H.I.V.
The agency said it did not believe the needles used for the finger-prick tests were used multiple times but said the bodies of the devices can retain microscopic amounts of blood, creating a low risk of transmission.
Victoria has reported at least 20,000 coronavirus cases and more than 800 deaths, with the majority of these occurring in its second wave. The state is currently easing out of its strict lockdown as daily infection numbers drop into the single digits.
Yan Zhuang
Reporting was contributed by Anna Schaverien.read more

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