Live with someone vulnerable? ‘You need to really consider wearing a mask at home,’ Birx says.
As the Trump administration struggles to contain the coronavirus pandemic, and the U.S. economy continues to reel, two of the administration’s top health experts on Sunday encouraged more people to voluntarily wear masks.
Dr. Deborah L. Birx, the Trump administration’s coronavirus coordinator, said that people living in the growing number of places where cases are increasing should consider wearing a mask if they live with someone who is especially vulnerable.
“If you have an outbreak in your rural area or in your city, you need to really consider wearing a mask at home, assuming that you’re positive if you have individuals in your household with co-morbidities,” Dr. Birx said on the CNN program “State of the Union.”
Adm. Brett P. Giroir, the assistant secretary for health, speaking on the NBC program “Meet the Press,” said, “Wearing a mask is incredibly important, but we have to have like 85 or 90 percent of individuals wearing a mask and avoiding crowds.” Those percentages, he said, give “you the same outcome as a complete shutdown.”
Asked if he was recommending a national mask mandate, Admiral Giroir said, “The public health message is we’ve got to have mask wearing.” He added: “If we don’t do that, and if we don’t limit the indoor crowded spaces, the virus will continue to run.”
Dr. Birx told CNN that the country is in a “new phase” of the pandemic and said, “What we are seeing today is different from March and April. It is extraordinarily widespread.” She added, “So everybody who lives in a rural area, you are not immune.”
Many states have traced new outbreaks to the loosening of the economically costly restrictions aimed at stopping the spread of the virus.
The United States recorded more than 1.9 million new infections in July, nearly 42 percent of the more than 4.5 million cases reported nationwide since the pandemic began and more than double the number documented in any other month, according to data compiled by The New York Times.
The previous monthly high came in April, when more than 880,000 new cases were recorded.
Late last month the number of coronavirus patients hospitalized throughout the country nearly topped the record set in April, before leveling off in recent days, according to a database compiled by The Atlantic. Deaths linked to the virus, though, remain very high — over 1,000 for six days in a row — according to the Times database.
The country’s limited testing capacity has also hampered efforts to fight the spread of the disease, health officials said.
Dr. Ashish Jha, the director of the Harvard Global Health Institute, said on CNN that “our testing system is under such strain that we just can’t even deliver the test today that we were doing two weeks ago.”
Admiral Giroir defended the nation’s testing program, but noted that testing and contact tracing were not particularly helpful in large, communitywide outbreaks.
It begins with a mild fever and malaise, followed by a painful cough and shortness of breath. The infection prospers in crowds, spreading to people in close reach. Containing an outbreak requires contact tracing, as well as isolation and treatment of the sick for weeks or months.
This insidious disease has touched every part of the globe. It is tuberculosis, the biggest infectious-disease killer worldwide, claiming 1.5 million lives each year.
Until this year, T.B. and its deadly allies, H.I.V. and malaria, were on the run. The toll from each disease over the previous decade was at its nadir in 2018, the last year for which data are available.
Yet now, as the coronavirus pandemic spreads around the world, consuming global health resources, these perennially neglected adversaries are making a comeback.
“Covid-19 risks derailing all our efforts and taking us back to where we were 20 years ago,” said Dr. Pedro L. Alonso, the director of the World Health Organization’s global malaria program.
It’s not just that the coronavirus has diverted scientific attention from T.B., H.I.V. and malaria. The lockdowns, particularly across parts of Africa, Asia and Latin America, have raised insurmountable barriers to patients who must travel to obtain diagnoses or drugs, according to interviews with more than two dozen public health officials, doctors and patients worldwide.
Fear of the coronavirus and the shuttering of clinics have kept away many patients struggling with H.I.V., T.B. and malaria, while restrictions on air and sea travel have severely limited delivery of medications to the hardest-hit regions.
In April, with hospitals overwhelmed and much of the United States in lockdown, the Department of Health and Human Services produced a presentation for the White House arguing that rapid development of a coronavirus vaccine was the best hope to control the pandemic.
“DEADLINE: Enable broad access to the public by October 2020,” the first slide read, with the date in bold.
Given that it typically takes years to develop a vaccine, the timetable for the initiative, called Operation Warp Speed, was incredibly ambitious. With tens of thousands dying and tens of millions out of work, the crisis demanded an all-out public-private response, with the government supplying billions of dollars to pharmaceutical and biotechnology companies, providing logistical support and cutting through red tape.
It escaped no one that the proposed deadline also intersected nicely with President Trump’s need to curb the virus before the election in November.
The ensuing race for a vaccine — in the middle of a campaign in which the president’s handling of the pandemic is the key issue after he has spent his time in office undermining science and the expertise of the federal bureaucracy — is now testing the system set up to ensure safe and effective drugs to a degree never before seen.
Under constant pressure from a White House anxious for good news and a public desperate for a silver bullet to end the crisis, the government’s researchers are fearful of political intervention in the coming months and are struggling to ensure that the government maintains the right balance between speed and rigorous regulation, according to interviews with administration officials, federal scientists and outside experts.
President Rodrigo Duterte of the Philippines on Sunday ordered Manila and its suburbs to re-enter lockdown for two weeks as the health department reported 5,032 new cases of the coronavirus.
Group gatherings were prohibited, and residents were advised to stay at home. Public transportation was halted, domestic flights and inter-island ferries remained suspended, and the government encouraged biking. Schools will remain shut.
Infections spiked after the government eased lockdown rules and gradually opened up in an effort to jump-start the economy. But instead of managing the numbers, it has resulted in grim results, with hospitals overwhelmed and doctors warning they were reaching a breaking point. In an appeal to the government on Saturday, the Philippine College of Physicians, the country’s main organization of doctors, warned that the health system “has been overwhelmed.”
This came shortly after Manila’s city government ordered the temporary closure of its two hospitals, citing the growing number of health care workers who have been infected. It said that the city’s health care workers are burned out “with the seemingly endless number of patients trooping to our hospitals for emergency care and admission.”
Total cases in the country now stand at 103,185, with 2,059 deaths.
Mr. Duterte told officials to “strictly enforce the quarantine, especially the lockdown.”
“I have heard the call of different groups from the medical community for a two-week enhanced community quarantine in mega Manila,” he said. “I fully understand why your health workers would like to ask for such a timeout period. They have been in the front lines for months and are exhausted.”
In other news from around the world:
Russia plans to launch a nationwide vaccination campaign in October with a coronavirus vaccine that has yet to complete clinical trials, raising international concern about the methods the country is using to compete in the global race to inoculate the public.
Officials in Melbourne, Australia’s second-largest city, announced stricter measures on Sunday in an effort to stem a coronavirus outbreak that is raging despite a lockdown that began four weeks ago. For six weeks, residents of metropolitan Melbourne will be under curfew from 8 p.m. to 5 a.m. except for purposes of work or giving and receiving care.
India’s biggest film star, Amitabh Bachchan, was discharged from the hospital on Sunday after recovering from Covid-19, and the country’s powerful home minister, Amit Shah, announced that he had tested positive. Mr. Bachchan, 77, was hospitalized for three weeks.
Kosovo’s prime minister, Avdullah Hoti, said on Sunday that he had contracted Covid-19 and would self-isolate at home for two weeks, Reuters reports. “I have no signs, except a very easy cough,” he wrote on Facebook.
One-third of New York’s small businesses may be gone forever.
Five months into the pandemic, an expanding universe of distinctive small businesses that give New York’s neighborhoods their unique personalities and are key to the city’s economy are starting to topple.
More than 2,800 businesses in New York City have permanently closed since March 1, according to data from Yelp, the business listing and review site, a higher number than in any other large American city.
About half the closings have been in Manhattan, where office buildings have been hollowed out, its wealthier residents have left for second homes and tourists have stayed away.
When the pandemic eventually subsides, roughly one-third of the city’s 240,000 small businesses may never reopen, according to a report by the Partnership for New York City, an influential business group. So far, those businesses have shed 520,000 jobs.
While New York is home to more Fortune 500 headquarters than any city in the country, small businesses are the city’s backbone. They represent roughly 98 percent of the employers in the city and provide jobs to more than three million people, which is about half of its work force, according to the city.
When New York’s economic lockdown started in March the hope was that the closing of businesses would be temporary and many could weather the financial blow.
But the devastation to small businesses has become both widespread and permanent as the economy reopens at a slow pace. Emergency federal aid has failed to provide enough of a cushion, people remain leery of resuming normal lives and the threat of a second wave of the virus looms.
Reporting was contributed by Reed Abelson, Peter Baker, Benedict Carey, Jason Gutierrez, Matthew Haag, Annie Karni, Andrew E. Kramer, Sharon LaFraniere, Apoorva Mandavilli, Azi Paybarah, Katie Thomas, Noah Weiland and Sameer Yasir.