Coronavirus Live Updates: Italy’s Death Toll Surpasses China’s as State Dept. Is Expected to Warn Against Travel Abroad

As U.S. cases soared past 10,000 and doctors pleaded for protective gear, the president said the government had “slashed red tape” to try to expand trials for possible treatments. Last year, the U.S. tested its pandemic response and found substantial shortcomings that have been further exposed by the current crisis.

The number of deaths in Italy soared to 3,405, outstripping China’s death toll.

Here’s what you need to know:

Milan on Thursday. Italy reported 427 deaths on Thursday, bringing the total to 3,405.
Milan on Thursday. Italy reported 427 deaths on Thursday, bringing the total to 3,405.Credit…Alessandro Grassani for The New York Times

Italy, which has been one of the hardest-hit countries in the world since the coronavirus first began to spread, passed a grim milestone on Thursday: it announced that deaths from the virus had soared to 3,405, outstripping the toll in China, where the virus first hit.

With the crisis mounting, Italy is increasingly turning to its military for help.

Cemeteries in the northern city of Bergamo are so overwhelmed that the army was called in to transport bodies elsewhere to be cremated, and the army sent 120 doctors and health professionals to help in Bergamo and nearby Lodi, two cities in the Lombardy region, while field hospitals and emergency respiratory units are being set up elsewhere in the north.

The spread of the virus in Italy has been swift, and terrifying, even after the country became the first in Europe to impose strict limits on people’s movements to try to curb the outbreak. As the death toll grew, traditional funeral services were outlawed as part of the national restrictions against gatherings.

The country tallied 902 deaths in the last two days alone: 475 Wednesday and 427 on Thursday. Most of those who died had serious pre-existing conditions, officials said. Italy now has 41,035 cases.

The Italian Prime Minister, Giuseppe Conte, said in an interview in Corriere della Sera Thursday that he expected the government’s restrictive measures to limit movement would be extended past the current April 3 deadline.

“The restrictive measures are working, and it’s obvious that when we reach a peak and the contagion begins to descend, at least in percentages, hopefully in a few days, we won’t immediately be able to return to our regular lives,” he said.

In the face of relentlessly bad news, Italians have risen to meet the crisis — the worst the country has faced since World War II — with fortitude, and creative attempts to keep their spirits up. Some housebound Italians, trying to follow social distancing rules in a famously social country, began serenading one another from their balconies in the evenings. And many began taking to their balconies to applaud the doctors and medical workers risking their own lives on the front lines, a show of communal gratitude later emulated by Spain and other countries.

In a video news conference Thursday, António Guterres, secretary general of the United Nations, told reporters that the coronavirus pandemic presented a global health crisis unlike any in the organization’s 75-year history and that a worldwide recession is a “near certainty.”

Mr. Guterres implored leaders of the world’s biggest economies to coordinate their battle plans for defeating the scourge. “We are in an unprecedented situation and the normal rules no longer apply,” he said.INSIDE ITALYHere’s what it was like to report on Italy’s outbreak, while in quarantine.

Travelers at Charlotte International Airport in Charlotte, N.C., on Wednesday.
Travelers at Charlotte International Airport in Charlotte, N.C., on Wednesday.Credit…Kyle Grillot for The New York Times

The State Department is preparing to announce that American citizens abroad should either return home or stay in place as the new coronavirus pandemic grows, American officials said.

The department plans to raise to level four its global travel advisory. Officials did not give an exact time on when this would happen, but said it is imminent. Level four is the top-tier warning, usually reserved for nations with war zones or beset by serious disruptions.

The global advisory is now at level three. The announcement would be a recommendation, not a requirement. Millions of Americans are still overseas, and many would likely choose to remain in place.

Some tourists or American citizens without long-term living arrangements or support networks abroad have been trying to get back to the United States, but have found that difficult because of border closings or the cutting of flight routes and other transportation shutdowns.

President Trump, asked during a briefing on Thursday about Americans stranded abroad and trying to re-enter the United States, said that the administration is working with the military to get them home.

The State Department used five charter flights sent from the United States to evacuate American citizens from Wuhan, China, the epicenter of the outbreak, but has no plans at the moment to run similar evacuation flights elsewhere. American diplomats who have returned to the United States from countries where large outbreaks have occurred have done so mostly on commercial flights.

Politico first reported the State Department’s plans on Thursday.

Some other countries have already issued travel advisories telling their citizens to return home or not go abroad. Canada did so last Friday, as Prime Minister Justin Trudeau was in a 14-day period of self-quarantine because his wife, Sophie Trudeau, had tested positive for the new coronavirus. Canada and many other countries have also closed borders to nonessential traffic in an effort to limit the spread of the virus.

State Department representatives did not answer a request for comment on the travel advisory plans.

Meanwhile, the U.S. military is halting deployments into Iraq for at least the next 14 days, military officials said Thursday. The move follows similar initiatives in Afghanistan as the Pentagon wrestles with the spread of the coronavirus.

The change comes at a time when U.S. troops in Iraq are contending with a recent spate of rocket attacks launched by Iranian-linked militias, and as the U.S.-led coalition in the country closes several smaller bases throughout the country.

The decision means some of the more than 5,000 U.S. troops currently in Iraq will have to stay longer than expected.

‘We Have To Remove Every Barrier,’ Trump Says of F.D.A. TestsThe White House coronavirus task force shared the latest updates on the virus and its impact on the country.CreditCredit…Doug Mills/The New York Times

As coronavirus cases soared in the United States and health care workers complained of shortages of critically-needed supplies, President Trump said Thursday that his administration had “slashed red tape” to expand trials for possible treatments but gave mixed signals about whether he would move to compel private industry to produce medical equipment.

With the development of a usable coronavirus vaccine at least a year off, Mr. Trump, surrounded at the White House by leading federal health officials, said that they had been working to swiftly expand trials of several antiviral therapies they hoped would prove effective against the coronavirus.

“I’ve directed the F.D.A. to eliminate outdated rules and bureaucracy so this work can proceed rapidly, quickly, and I mean fast,” said an enthusiastic Mr. Trump, who said that several drugs could turn out to be a “game changer,” before adding a note of caution: “and maybe not.”

Dr. Stephen Hahn, the Food and Drug Administration commissioner, gently tamped down some of Mr. Trump’s optimism, saying that while it was important for doctors to give hope, it was also important “not to provide false hope.”

“We need to make sure the sea of new treatments will get the right drug to the right patients at the right dosage at the right time,” Dr. Hahn said, citing the importance of establishing the safety and efficacy of possible treatments. “As an example we may have the right drug but may not be near appropriate dosage form right now and that may do more harm than good.”

There is no proven drug treatment for the new coronavirus, and doctors around the world have been desperately testing an array of medicines in the hopes of finding something that will help patients, especially those who are severely ill.

During the briefing, the president and Dr. Hahn said that the F.D.A. had approved the use in coronavirus patients of the prescription drugs chloroquine and hydroxychloroquinewhich have been used for malaria. There have not been clinical trials to determine whether those drugs actually work for the disease, and Dr. Hahn did not explain why the F.D.A. is supporting their use, nor he did explain whether today’s action was actually a formal approval of the drug for this new use.

Doctors in China and France have said there were indications they might help, and many hospitals in the United States had already begun using them. The drugs are inexpensive and relatively safe. Because they were already approved for other illnesses, doctors in the U.S. were free to use them in an “off-label” way based on their own judgment.

Dr. Hahn also said the F.D.A. was considering the use of “convalescent plasma,” meaning blood from people who have recovered from the disease, which contains antibodies against the coronavirus that might be able to help other patients fight the virus.

Mr. Trump and Dr. Hahn also said they planned to allow patients to gain access to an experimental drug, remdesivir, through a policy known as “compassionate use.” Compassionate use is typically used to grant access to not-yet-approved experimental drugs to give potentially lifesaving treatments to patients who might otherwise die.

When the president was asked if it was acceptable that there were such shortages of masks some health care workers were being urged to reuse them, he turned to Vice President Mike Pence. Mr. Pence said that there had been “a dramatic increase in production” in masks, but did not say when they would be in the hands of health care workers.

Mr. Trump gave mixed signals on whether he would use the Defense Production Act, which authorizes presidents to take extraordinary action to force American industry to ramp up production of critical equipment and supplies. In this case, the list could include ventilators, respirators and protective gear for health care workers.

When asked why he hadn’t yet compelled companies to do this — especially given the projected shortages of masks and lifesaving ventilators — the president first told reporters that governors were responsible for buying equipment for their states.

“Nobody in their wildest dreams would have thought we would need tens of thousands of ventilators,” he said. But he said he would use the power if needed, before adding ambiguously, “You don’t know what we have done.”

Dr. Deborah Birx, the White House coronavirus response coordinator, said that a large backlog of pending tests would be released in the next two to three days.

She said that 50 percent of reported coronavirus cases in the United States have come from 10 counties, and praised health care workers for prioritizing available tests for people who show symptoms. She added that the number of positive results had increased as a result.

The Health and Human Services Department’s coronavirus operations center in Washington. The department ran an extensive exercise last year simulating a pandemic.
The Health and Human Services Department’s coronavirus operations center in Washington. The department ran an extensive exercise last year simulating a pandemic.Credit…Al Drago for The New York Times

The United States ran a detailed exercise testing the federal government’s response to a fictional respiratory virus for nine months last year. The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.

That scenario, code-named “Crimson Contagion,’’ was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August.

In the scenario, the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead. It was not the first time in recent years that the government had studied its capacity for dealing with a pandemic.

The draft report, marked “not to be disclosed,” laid out in stark detail repeated cases of “confusion” in the exercise. Federal agencies jockeyed over who was in charge. State officials and local hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own way on school closings.A LACK OF ACTIONA cascade of warnings went unheeded before the outbreak.

Outside the Capitol on Wednesday.
Outside the Capitol on Wednesday.Credit…Alyssa Schukar for The New York Times

Senate Republicans, racing to fill in the details of a $1 trillion or larger economic stabilization package requested by the White House, have drafted a plan that would send payments of $1,200 to individual taxpayers and $2,400 to families, with another $500 per child, according to two people familiar with the negotiations who insisted on anonymity to describe an emerging proposal.

The direct payments, they said, would begin phasing out for those earning more than $75,000. Individuals who made more than $99,000 and families earning more than $198,000 would not be eligible.

Steven Mnuchin, the Treasury secretary, said earlier Thursday that the administration wants to send two waves of $1,000 checks to each American, and another $500 per child — one in April and another in May should the coronavirus crisis continue.

The details could change as fast-paced talks on the package proceed. They emerged as Republicans huddled privately to hammer out a proposal that would be the starting point for negotiations with Democrats on the stabilization package, which leaders hope can be signed into law within days.

The number of known coronavirus cases in the United States surged past 10,000 on Thursday, rippling into Capitol buildings and the homes of mayors and prompting sweeping action even from state leaders who only days ago had been reluctant to order radical changes to daily life.

In Texas, Gov. Greg Abbott issued an executive order on Thursday stopping dine-in service at restaurants and bars, officially shutting down all schools and gyms, and barring gatherings of more than 10 people statewide. The order, effective at midnight, brings some of the strongest recommendations in the nation to the sprawling state’s 28 million residents.

Known for its independent spirit and pro-business stance, Texas had previously left it to local officials to decide what restrictions were necessary, even as other states took strong stands. But by Thursday, Mr. Abbott said serious action had become necessary, with more than 140 cases and at least three deaths from the virus in Texas, numbers that had rapidly accelerated over the past week.

The state also declared a public health disaster for the first time since 1901, Mr. Abbott said.

“The traditional model that we have employed in the state of Texas for such a long time so effectively does not apply to an invisible disease that knows no geographic or jurisdictional boundaries,” he said.

In Georgia, all members of the State Legislature were being asked to self-quarantine on Thursday after a state senator who voted at the Capitol earlier this week tested positive for the coronavirus. In Kentucky, the Louisville mayor reported that his wife had tested positive for the virus. And in New York, Gov. Andrew M. Cuomo waived mortgage payments for 90 days for people facing hardship, while also warning against fear and panic.

“I spend half my day knocking down rumors that we are going to lock people in their homes,” Mr. Cuomo said, noting that New York City seemed to be at “near panic levels.”

“I am not going to imprison anyone in the state of New York in their homes,” he said. “I am not going to declare martial law in the state of New York.”

Some states were also recognizing the ongoing need for basic necessities, including food, by classifying grocery store workers as emergency personnel. In Minnesota this week, Gov. Tim Walz passed an executive order recognizing store clerks, stockers, food preparation personnel, cleaning staff and deli staff as “Emergency Tier 2” workers, which will allow the workers to receive free child care.

Vermont is also planning to reimburse private child care centers that are looking after children of emergency workers. The state’s public safety commissioner, Michael Schirling, said he would add grocery store workers to the growing list of essential employees that would receive free child care.

Medical workers with patients who recovered from the coronavirus, outside of a hospital in Wuhan this week.
Medical workers with patients who recovered from the coronavirus, outside of a hospital in Wuhan this week.Credit…Agence France-Presse — Getty Images

A new study reports that people who became sick with Covid-19 in Wuhan, the Chinese city where the outbreak began, had a lower death rate than previously thought.

The study, published Thursday in the journal Nature Medicine, calculated that people with coronavirus symptoms in Wuhan had a 1.4 percent likelihood of dying. Some previous estimates have ranged from 2 percent to 3.4 percent.

Assessing the risk of death in Wuhan is instructive because it provides a snapshot of the epidemic from the beginning, when doctors were scrambling to treat people with a brand-new virus and hospitals were overwhelmed.

Some experts say that such a benchmark — known as the case fatality rate — could be lower in countries like the United States if measures like widespread business and school closures and appeals for social distancing have the desired effect of slowing the spread of the disease.

But a 1.4 percent case fatality rate still means a lot of deaths. By comparison, the average seasonal flu kills about 0.1 percent of the people it infects in the United States.

Also, on Thursday, China reported no new local infectionsfor the previous day for the first time since the coronavirus crisis began, a milestone in its costly battle with the outbreak that has since spread around the world.

Officials said 34 new coronavirus cases had been confirmed, all of them involving people who had come to China from elsewhere.

In signaling that an end to China’s epidemic might be in sight, the announcement could pave the way for officials to focus on reviving the country’s economy, which nearly ground to a halt after the government imposed travel restrictions and quarantine measures. In recent days, economic life has been resuming in fits and starts.

But China is not out of danger. Experts have said that it will need to see at least 14 consecutive days without new infections for the outbreak to be considered over. It remains to be seen whether the virus will re-emerge once daily life restarts and travel restrictions are lifted.

“It’s very clear that the actions taken in China have almost brought to an end their first wave of infections,” said Ben Cowling, a professor and head of the division of epidemiology and biostatistics at Hong Kong University’s School of Public Health. “The question is what will happen if there’s a second wave, because the kind of measures that China has implemented are not necessarily sustainable in the long term.”

To contain the outbreak, the authorities shut schools and workplaces, imposed travel restrictions, and ordered quarantines on broad swaths of the population and many visitors from abroad. Since January, more than 50 million people in the central province of Hubei, including its capital, Wuhan, where the outbreak began, have been subjected to a strict lockdown.A FLATTER CURVE China goes from ‘patient zero’ to zero patients.

A drive-through testing center for Covid-19 in West Palm Beach, Fla., this week.
A drive-through testing center for Covid-19 in West Palm Beach, Fla., this week.Credit…Saul Martinez for The New York Times

American adults of all ages — not just those in their 70s, 80s and 90s — are being seriously sickened by the coronavirus, according to a report on nearly 2,500 cases in the United States.

The report, issued Wednesday by the Centers for Disease Control and Prevention, found that — as in other countries — the oldest patients were at greatest risk of becoming seriously ill or dying. But of the 508 coronavirus patients known to have been hospitalized in the United States, 38 percent were between 20 and 54. And nearly half of the 121 sickest patients studied — those admitted to intensive care units — were adults under 65.

“I think everyone should be paying attention to this,” said Stephen S. Morse, a professor of epidemiology at Columbia University. “It’s not just going to be the elderly.”

Dr. Deborah Birx, coordinator of the Trump administration’s coronavirus task force, appealed on Wednesday for younger people to stop socializing in groups and to take care to protect themselves and others.

“You have the potential then to spread it to someone who does have a condition that none of us knew about, and cause them to have a disastrous outcome,” Dr. Birx said.

In the C.D.C. report, 20 percent of the hospitalized patients and 12 percent of the intensive care patients were between the ages of 20 and 44, basically spanning the millennial generation.STRIKING THE YOUNG A virus that kills the old is sickening the young.

Traders on the floor of the New York Stock Exchange on Thursday.
Traders on the floor of the New York Stock Exchange on Thursday.Credit…Bryan R. Smith for The New York Times

Stocks were volatile on Thursday as policymakers in the United States and Europe took more steps to offset the sharp decline gripping their economies.

The S& P 500 climbed into positive territory after earlier having fallen more than 3 percent, but it struggled to hold onto those gains. Shares in Europe also recovered after trading lower for most of the day. Oil prices, which had fallen by more than 20 percent on Wednesday, rebounded on Thursday.

The uneven trading followed a steep drop across financial markets on Wednesday and came as the steady drumbeat of bad news about the spread of the coronavirus continued. Speaking at a White House press briefing, Mr. Trump acknowledged that the economy would experience a rapid fall before it climbs back. He also praised efforts to speed up the approval of potential treatments for Covid-19, the illness caused by the new coronavirus.

“I believe in the V curve,” Mr. Trump said, referring to how some economists describe a sharp falloff and rebound in economic growth. “When this is defeated, this hidden scourge is defeated, I think we’re going to go up very rapidly.”

In the United States, the number of workers filing first-time claims for unemployment insurance surged, government data released on Thursday showed. Those figures don’t reflect the sharp cuts made in the past few days as companies quickly scale down operations as efforts to contain the coronavirus keep consumers at home and force factories to close.

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