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Italy has imposed a lockdown, deployed the army and risked its economy to try to stop the spread of the coronavirus.

Yet the virus’s toll is growing more staggering by the day: On Saturday, officials reported 793 additional deaths, by far the largest single-day increase. Italy has surpassed China as the country with the highest death toll, becoming the epicenter of a shifting global pandemic.

And the virus’s effects are being felt throughout Europe. Poland has reported fewer than 500 cases, but one of the country’s hospitals was shut down and evacuated on Saturday after 30 patients and staff members were found to have the virus. France, one of the hardest-hit countries in Europe, raised its totals to 14,459 confirmed cases and 562 deaths, and said it had ordered over 250 million face masks from French and foreign suppliers.

The governor of the German state of Baden-Württemberg asked hospitals to estimate capacity in their intensive care units so that French patients in need of respirators from the heavily hit Alsace region, just across the border, can be transferred for treatment.

The German authorities barred people in Berlin from meeting in groups of more than 10, with the exception of lawmakers, courts and those providing essential services. And Spain’s health ministry reported a surge in the number of coronavirus deaths to 1,326 and total cases to 25,000, a rise of about 25 percent from a day earlier.

In the Madrid region, which has had 60 percent of Spain’s cases, hospitals are overflowing and facing equipment shortages. Officials ordered that a field hospital with about 5,500 beds be set up in the Spanish capital’s main exhibition center. In the Valencia region, three field hospitals have been added, with a combined 1,000 beds. Hotels have also been converted into hospitals in Madrid and Catalonia, where 122 people have died.

But Italy’s struggle remains among the world’s most pronounced. Is increasingly being seen as a tragic warning for other countries to heed, in part because it is paying the price of early mixed messages by scientists and politicians. The people who have died in staggering numbers recently — more than 2,300 in the last four days — were mostly infected during the confusion of a week or two ago.

The White House signaled Saturday that American companies were increasing efforts to restock hospitals with crucial supplies during the pandemic, but it again stopped short of more assertive steps that some state and local leaders have been demanding.

Vice President Mike Pence said at a news conference at the White House that the federal government had ordered hundreds of millions of N-95 masks for health care facilities, but he did not say when they would be delivered.

The White House’s moves appeared unlikely to satisfy calls for more aggressive action as the nation grappled with a reorientation of American life. More than 21,000 cases have been confirmed in the United States, a number expected to soar in the coming weeks.

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President Trump discussed his approval of a major disaster declaration for the State of New York, attempts to address medical supply shortages and other developments in the pandemic.CreditCredit…Al Drago for The New York Times

Officials in a number of states, including New York and California, have warned of dwindling supplies of crucial gear, like protective equipment, and what they believe will be a vast demand for ventilators.

Mr. Trump has sent conflicting signals on how the federal government might address the supply issues. On Saturday, he said that he had not used the Defense Production Act — which empowers the government to mobilize the private sector to increase the production of scarce goods — because companies were stepping up voluntarily. He cited Hanes and General Motors, which he said would make masks and ventilators.

“We want them on the open market from the standpoint of pricing,” Mr. Trump said.

A Hanes spokesman said the company had agreed to make up to six million masks a week along with a group of other yarn and clothing companies after Trump administration officials reached out about a week ago. The masks will not be the highly sought-after N-95 masks. Hanes is negotiating a contract with the U.S. government to supply the masks at market rates, the spokesman said.

Other companies the administration announced coordination with include Honeywell and 3M. Mr. Trump also said Pernod Ricard USA had repurposed production facilities in four states to manufacture hand sanitizer, with the first delivery expected on Tuesday. Tim Cook, Apple’s chief executive, said on Saturday that the company would donate millions of masks to health professionals in the U.S. and Europe.

Also on Saturday, a spokesman for Mr. Pence said he and his wife had tested negative for the coronavirus. They were tested after an official in Mr. Pence’s office was confirmed to be infected.

Officials on Sunday reported the first two coronavirus cases in the densely populated Gaza Strip, where aid workers say the virus’s spread could quickly lead to a public health disaster.

Two Palestinian men who had been in Pakistan and then entered Gaza via Egypt have tested positive for the virus, said Yousef Abu Al-Reesh, the deputy health minister in Gaza. The men, age 53 and 78, are being treated in a field hospital in Rafah.

Health officials said they had quarantined a number of people who interacted with the men.

International aid groups have been bracing for the arrival of the coronavirus in Gaza, an impoverished coastal enclave where medical facilities have eroded under a 13-year blockade maintained by Israel and Egypt.

The United Nations has been leading an effort to obtain testing kits and protective gear for medical workers for Gaza, and a team was headed there on Sunday to assess whether its quarantine and intensive care facilities were up to the task, said Jamie McGoldrick, the U.N.’s humanitarian coordinator for Palestine.

He said that about 1,000 people had returned to Gaza from abroad during the coronavirus pandemic; 2,000 more are still expected and will need to be screened and quarantined as they arrive.

Officials of Hamas, the militant group that controls Gaza, said this weekend that they would close all restaurants, wedding halls and weekly markets.

Just days ago, funerals in Gaza were still drawing large crowds, Mr. McGoldrick said. “Hopefully, this will ring an alarm bell and people will become much more worried and disciplined in how they move around,” he said.

Gov. David Ige of Hawaii on Saturday ordered a mandatory 14-day quarantine for everyone arriving in Hawaii, including tourists and returning residents.

Starting on Thursday, returning residents are to quarantine in their homes, and visitors are to stay in their hotel rooms or rented lodgings. They are to leave only to seek medical care.

“The threat of Covid-19 is extremely serious, and it requires extreme actions,” Mr. Ige said in a news conference.

Mr. Ige said in a Facebook post that failure to follow the order would be punishable by a fine of up to $5,000, up to a year’s imprisonment or both. The Hawaii Department of Health on Saturday reported 48 cases of coronavirus in the state, an increase of 11 from the day before.

The governor said the delay in implementing the order was to give tourists time to cancel or postpone their trips, which he said he hoped they would do.

“We know that our economy will suffer from this action,” he said, adding that the move was necessary so that the state’s health care system is not overwhelmed.

The international sports calendar has been wiped almost clean by the coronavirus pandemic, but organizers of the Summer Olympics in Tokyo — seemingly unwilling to meddle just yet with years of planning and billions of dollars in anticipated revenue — insist the Games can begin in late July as scheduled.

But athletes, fans and national Olympic officials are increasingly calling for a delay.

One of the biggest cracks in the usual Olympic solidarity came Friday when U.S.A. Swimming, which governs the sport in the United States, called for a postponement because the restrictions imposed to fight the virus were creating obstacles to training. The next day, U.S.A. Track & Field also requested a delay.

Norway’s national Olympic committee, in a statement on Friday, became the first to clearly state a preference for the Olympics to be delayed until the pandemic can be brought under control. The Brazilian Olympic committee on Saturday endorsed postponing the Games until 2021.

There were also signs of pressure within Japan, with a member of its Olympic committee coming out in favor of a postponement.

“Opening the Olympics at a time when athletes could not train as much as they wanted to runs counter to the motto of ‘athletes first,’” Kaori Yamaguchi, a member of the Japanese Olympic committee board who won a bronze medal in judo in the 1988 Seoul Olympics, said in an interview with The Asahi Shimbun. “The Games should be postponed.”

Thomas Bach, the International Olympic Committee’s president, said in an interview on Thursday that the Games would not be canceled. And while he left open the possibility of postponing them, he said a decision did not have to be made soon.

Doctors need to wear gloves, gowns, eye gear and masks when treating coronavirus patients. But hospitals have been running dangerously low on essential suppliesfor weeks, and many medical professionals on the front lines do not have adequate protection.

Why is this happening?

A widespread buying of masks by anxious consumers and the prolonged outbreak in China diminished the supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold but continues to hold onto its supply.

The outbreak also came after a particularly mask-intensive few months. Wildfires in California and in Australia had diminished some humanitarian organizations’ supplies.

Ideally, clinicians would be using a new, tightly sealed respirator like the N95 with each patient. These are thicker than standard surgical masks and are designed to fit more tightly around the mouth and nose to block out much smaller particles.

The Food and Drug Administration said that neither surgical masks nor N95s should be shared or reused, but the C.D.C. updated its recommendations to optimize the limited supply of protective gear.

“As a last resort,” the C.D.C. said “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.

Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.

Australia’s largest state began a major lockdown of nonessential services on Sunday, fencing off beaches all over Sydney and calling for people to stay home, as national health officials announced that the number of confirmed coronavirus cases in the country had risen to 1,098.

The stricter measures for the state, New South Wales, suggest that officials in the country were shifting away from an initial moderate approach — in part because the public was not complying. On Friday, thousands flooded Bondi Beach in Sydney despite warnings against large gatherings, leading to an outright ban on beachgoing up and down the coast.

New South Wales health officials on Sunday confirmed a spike in cases to 533, with clusters from a mix of sources: a beachfront bar in Bondi Beach; a church service in western Sydney; and five cruise ships that have docked in Sydney since March 7. One cruise ship, the Ruby Princess, which arrived in Sydney on March 19, has 18 confirmed cases.

The state of Victoria, which includes Melbourne, said that schools would be shut down as of Tuesday. South Australia said that any new arrivals would be required to self-quarantine for 14 days.

“As we enter the next phase of the epidemic in Australia, we are taking broad-ranging action to stay ahead of the curve,” said Stephen Wade, South Australia’s health minister.

New restrictions were also being imposed elsewhere in the Asia Pacific. Singapore, which reported its first two deaths from the virus on Saturday, said it would stop letting short-term visitors enter or transit through the country as of late Monday. Foreigners with valid work visas will be allowed in only if they perform essential services such as health care.

Schools and businesses have closed, local economies have unraveled and medical facilities are facing a shortage of crucial supplies — but there are ways to lend a helping hand.

For those seeking to give money, GlobalGiving connects nonprofits, donors and companies. Money received will help send emergency medical workers to communities in need.

Relief International focuses on supporting medical professionals with supplies. It operates in 16 countries and recently focused its efforts on helping Iran, where more than 20,000 infections have been reported. Similarly, Heart to Heart International is distributing equipment and medication to its global partners.

The outbreak has caused a severe blood shortage, according to the American Red Cross. It’s asking healthy donors to give blood, platelets or plasma.

Keeping families and children fed while schools are closed is a concern for many communities. World Central Kitchen works to distribute meals to children in New York City, Washington, D.C. and Little Rock, Ark. The program will expand to Los Angeles on Monday. The Covid-19 Response fund from Feeding America will support thousands of food pantries and hundreds of food banks across the country.

There are also organizations dedicated to supporting children, including UNICEF, Save the Children and First Book, which aims to deliver seven million books to children in the United States while schools are closed.

The chief executives of major airlines, UPS and FedEx said in a letter to congressional leaders on Saturday that they would postpone mass layoffs and stock buybacks and dividends if Congress secured a large enough bailout for their industry.

“We are united as an industry and speaking with one voice,” wrote the group, which included the heads of Southwest Airlines, Delta Air Lines, United Airlines and American Airlines. “We urge you to swiftly pass a bipartisan bill with worker payroll protections to ensure that we can save the jobs of our 750,000 airline professionals.”

If Congress approves at least $29 billion in grants for the industry, the executives said they would commit to no furloughs or layoffs through August. If an equal amount in loans is passed, they would commit to limiting executive compensation and freezing stock buybacks and dividends for the life of the loan.

In a separate letter to senators on Saturday, Sara Nelson, the president of the Association of Flight Attendants union, echoed the call for grants tied to employment, criticizing Senate Majority Leader Mitch McConnell’s plan to provide the industry with loans.

“Federal aid designed for payroll is the only way to prevent massive layoffs,” she said. “Loans won’t cut it.”

Ms. Nelson said that such aid should be tied to limits on buybacks, executive pay and dividends, as well as protecting union contracts.

President Trump sent a letter to North Korea’s leader, Kim Jong-un, expressing willingness to help the North battle the coronavirus, according to North Korea, which responded by expressing gratitude.

“I would like to extend sincere gratitude to the U.S. president for sending his invariable faith to the Chairman,” said Kim Yo-jong, the North Korean leader’s sister and policy aide, in a statement carried by the North’s state-run Korean​ Central​ News Agency. Ms. Kim lauded Mr. Trump’s decision to write the letter as “a good judgment and proper action.”

In the letter, Mr. Trump “wished the family of the Chairman and our people well-being,” Ms. Kim said, referring to his brother by one of his official titles. She said Mr. Trump had also expressed a desire to move relations between the two countries forward.

The White House confirmed that Mr. Trump had sent Mr. Kim a letter but did not comment on its specifics.

Mr. Trump and Mr. Kim have repeatedly touted their unusual relationship. But relations between Pyongyang and Washington ​have cooled since the leaders’ second summit meeting, held in Vietnam in February of last year, collapsed over differences regarding how quickly North Korea should dismantle its nuclear weapons program and when Washington should ease sanctions.

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With restrictions tightened on businesses and daily activity, residents are grappling with uncertainty about resources, health care and their paychecks.CreditCredit…Yousur Al-Hlou/The New York Times

The Federal Emergency Management Agency issued a Major Disaster Declaration for New York, meaning billions of dollars in federal aid could be coming to the state as the rising number of coronavirus cases shows no sign of abating.

As of Saturday, 10,356 New York State residents had tested positive for the virus. With 6 percent of the U.S. population, the state accounts for nearly half of the cases in the country, according to tallies by The New York Times.

Stay-at-home orders in New York, New Jersey and Connecticut are set to go into effect over the next couple days. New Jersey’s took effect at 9 p.m. Saturday, with New York’s following at 8 p.m. on Sunday and Connecticut on Monday at 8 p.m. Nonessential businesses are ordered closed and residents are asked to remain indoors unless exercising or shopping for food or medicine.

On Friday, Gov. Andrew M. Cuomo said that one million N-95 protective masks were being sent to hospitals in New York City and another 500,000 to Long Island. The state has also identified about 6,000 ventilators from “places all across the globe” for purchase, the governor said.

With the coronavirus threatening to overwhelm New York hospitals, state officials are considering turning landmark locations like the Jacob K. Javits Convention Center into makeshift hospitals.

The U.S. Army Corps of Engineers is also looking at other locations, including two at State University of New York campuses on Long Island, and at the Westchester Convention Center. The Army Corps is expected to outfit the centers with hospital equipment as soon as Mr. Cuomo tours and approves the locations, officials said.

The chief medical officer at Virginia Mason Memorial in Yakima, Wash., warned on Saturday that the hospital could run out of life-preserving ventilators by April 8 if the case projections do not improve and the hospital cannot acquire other machines.

The official, Dr. Marty Brueggemann, said he had witnessed a jarring juxtaposition of what is going on inside the hospital — which is controlling visitors and preparing for an onslaught of patients — and out in the community, where people have still been gathering in large groups. He said the general population wasn’t grasping the gravity of the situation.

“We will have to decide who gets a ventilator and who doesn’t,” Dr. Brueggemann said. “That’s only 19 days away.”

Washington’s Department of Health has told local leaders that only the highest-priority areas will have access to the government’s reserves of protective equipment, including N95 masks.

Long-term care facilities with confirmed infections and hospitals with the largest number of confirmed cases are at the top of the list, while sites lower down include homeless shelters or medical facilities that don’t have confirmed cases. The agency cautioned that not all requests will be fulfilled, and leaders at places like neighborhood health clinics have already seen weeks pass without requests being approved.

Federal grant programs have helped hospitals, states and the Veterans Health Administration develop what are essentially rationing plans for a severe pandemic. Now those plans, some of which may be outdated, are being revisited for the coronavirus outbreak.

In California, even as officials have pushed for widespread testing, health authorities have issued guidance to hospitals to restrict testing, reflecting a lack of testing kits and crucial medical supplies like masks and gowns.

The shift suggests that the state may never get a handle on exactly how many people are infected, because many who have only mild symptoms or believe they were in contact with an infected person but are not themselves sick are being told they do not qualify for testing.

The United States was late to identify the severity of the crisis, and officials say it is too late to pursue the strategy of South Korea, which instituted widespread testing to contain the pandemic. Instead, in California and other states, the focus is on identifying those who are the most sick and trying to save lives.

Many Americans seem to be following the recommendations of public health officials to clean and sterilize countertops, doorknobs, faucets and other frequently touched surfaces in their homes. But many are then tossing disinfectant wipes, paper towels and other paper products into the toilet.

The result has been a coast-to-coast surge in backed-up sewer lines and overflowing toilets, according to plumbers and public officials, who have pleaded with Americans to spare the nation’s pipes from further strain.

Most urban sewage systems depend on gravity and water flow to move toilet paper and waste. They were not designed to accommodate disinfectant wipes and paper towels, which do not break down as easily and clog the system, officials say.

Many say the problem has been compounded by the dearth of toilet paper on store shelves, which is leading some to use paper towels, napkins or baby wipes instead.

Partisan differences in Americans’ perception of the coronavirus outbreak have started to narrow.

In early March, when the number of U.S. cases was still low, Republicans generally told pollsters they were unworried, while Democrats sounded alarmed. Since then, the share of Republicans who said they were “not concerned at all” about an outbreak in their area has fallen sharply, according to a daily tracking poll by Civiqs.

Concerns about the virus are rising among people of both parties as the toll has risen and the stock markets have plunged. Political scientists expect that in short order, Republicans’ and Democrats’ views on the subject may converge.

“While the effects of partisanship are incredibly pronounced, I think they also hit their limits,” said Brian Schaffner, a political scientist at Tufts University.

Reporting was contributed by Katie Rogers, Mariel Padilla, Vanessa Friedman, Jessica Testa, Maggie Haberman, David M. Halbfinger, Iyad Abuheweila, Kate Taylor, Andrew Keh, Matt Futterman, Tariq Panja, Motoko Rich, Amelia Nierenberg, Mike Baker, Sheri Fink, Damien Cave, Austin Ramzy, Derrick Bryson Taylor, Niraj Chokshi, Aurelien Breeden, Melissa Eddy, Raphael Minder, Joanna Berendt, Jason Horowitz, Elisabetta Povoledo, Choe Sang-Hun, Tim Arango, Michael Levenson, Emily Badger and Kevin Quealy.

Source: https://www.nytimes.com/2020/03/22/world/coronavirus-news.html

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