Some White House officials suggest deaths are overcounted. Experts disagree.
As the United States continues its advance toward 100,000 coronavirus deaths, a grim milestone expected in the coming days, President Trump and members of his administration have begun questioning the official coronavirus death toll, suggesting the numbers are inflated.
Last Friday, Mr. Trump told reporters that he accepted the current death toll, but that the figures could be “lower than” the official count, which is now above 95,000.
But most statisticians and public health experts say the death toll is probably far higher than what is publicly known. People are dying at their houses and nursing homes without ever being tested, they say, and deaths early this year were likely misidentified as influenza or described only as pneumonia.
Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, has said publicly that the American health care system incorporates a generous definition of a death caused by Covid-19.
“There are other countries that if you had a pre-existing condition, and let’s say the virus caused you to go to the I.C.U., and then have a heart or kidney problem — some countries are recording that as a heart issue or a kidney issue and not a Covid-19 death,” she said at a White House news conference last month.
In a brief interview on Thursday, Dr. Birx stressed that there had been no pressure to alter data. But concerns about official statistics are not limited to the death toll, or to administration officials.
Epidemiologists said they were stunned to learn that the C.D.C. was combining data from tests that detect active infection with those that detect recovery from Covid-19 — a system that muddies the picture of the pandemic but raises the percentage of Americans tested as Mr. Trump boasts about testing.
Experts said that data from antibody tests and active virus tests should never be mixed.
“It just doesn’t make any sense,” said Natalie Dean, a biostatistician at the University of Florida. “All of us are really baffled.”
Epidemiologists, state health officials and a spokeswoman for the C.D.C. said there was no ill intent; they attributed the flawed reporting system to confusion and fatigue in overworked state and local health departments that typically track infections — not tests — during outbreaks.
China on Saturday reported no new coronavirus deaths or symptomatic cases, the first time that both tallies were zero on a given day since the country’s outbreak began. But in the city of Wuhan, the original epicenter of the outbreak, the virus is still high on residents’ minds.
For the past two weeks, thousands of Wuhan’s 11 million residents have stood in line outside rows of tents in neighborhood alleys. They’ve been waiting to have their noses and throats swabbed after the government announced an ambitious plan to test everyone in the city for the virus.
The so-called “10-day battle,” which was launched on May 14, is a push by the government to obtain a truer picture of the epidemic in Wuhan, most crucially of people who have the virus but display no symptoms. Some public health experts are closely watching the campaign to see whether it can form a model for other governments that want to return their societies to some level of normalcy.
“If you can quickly establish that a particular area is free of disease, that will give people more confidence to go out,” said Raina MacIntyre, who heads the biosecurity program at the Kirby Institute of the University of New South Wales in Sydney, Australia.
In reality, Wuhan’s “10-day battle” is not as rigid as some reports have suggested. Neighborhoods have staggered their start dates. Many residents appeared to be supportive of the tests, which are free. But others declined, fearing that they could become infected again as they waited for tests.
Between May 14 and May 20, about 3 million Wuhan residents were tested, according to government data. Ninety-nine of them had no symptoms.
In some districts, local officials went door to door to register residents and herded them to testing stations nearby. Organizers distributed fliers and made announcements on loudspeakers and social media urging residents to register.
The testing drive mobilized thousands of health workers. One nurse, who had worked from 9 a.m. to 4 p.m. without a lunch break, was caught on video sobbing.
It was not clear what authority President Trump was invoking on Friday when he marched into the White House briefing room and called for states “to allow our churches and places of worship to open right now.” He threatened to “override” any governors who did not.
Declaring places of worship “essential” operations, Mr. Trump said they should be permitted to hold services in person this weekend, regardless of state quarantine orders stemming from the coronavirus pandemic that has killed nearly 96,000 people in the United States.
“The governors need to do the right thing and allow these very important, essential places of faith to open right now for this weekend,” Mr. Trump said, reading from a prepared text before leaving after just about a minute without taking questions. “If they don’t do it, I will override the governors. In America, we need more prayer, not less.”
The White House could not explain what power the president actually has to override the governors, and legal experts said he did not have such authority, but he could take states to court on religious freedom grounds, which could be time-consuming. Attorney General William P. Barr, a strong advocate of religious rights, already has been threatening legal action against California.
In California, more than 1,200 pastors signed a declaration protesting the state’s restrictions on in-person services and pledged to reopen their churches by May 31 even if the restrictions are not lifted. Gov. Gavin Newsom, a Democrat, said Friday that the state was working with faith leaders on guidelines to reopen in “a safe and responsible manner,” which he said would be released by Monday at the latest.
Pandemics are often described as crises of communication, when leaders must persuade entire populations to suspend their lives because of an invisible threat. Prime Minister Jacinda Ardern of New Zealand excels at that — by brightening epidemiology with empathy, and leavening legal matters with mom jokes.
It’s been strikingly effective.
Ms. Ardern helped coax New Zealanders — “our team of five million,” she says — to buy into a lockdown so severe that even retrieving a lost cricket ball from a neighbor’s yard was banned. Now the country, despite some early struggles with contact tracing, has very nearly stamped out the virus, exiting isolation with just 21 deaths and a few dozen active cases.
Halos can make heretics out of legitimate critics, including epidemiologists who argue that New Zealand’s lockdown went too far, that other countries suppressed the virus with less harm to small businesses.
And Ms. Ardern’s canonization diminishes two powerful forces behind her success: Her own hard work at making connections with constituents, and the political culture of New Zealand, which in the 1990s overhauled how it votes, forging a system that forces political parties to work together.
“You need the whole context, the way the political system has evolved,” said Helen Clark, a former prime minister who hired Ms. Ardern as an adviser more than a decade ago. “It’s not easily transferable.”
Elian Peltier covered the coronavirus pandemic in Spain before returning to his home country, France. We asked him to tell us about a visit to his grandparents.
When France went under lockdown in March, my mother was relieved. Her parents were in a nursing home, and with travel restrictions suddenly in place, she and her sister could no longer drive the 80 miles south of Paris every weekend to visit them.
At least in the home, my grandparents would get the care they needed.
Then the virus slipped inside nursing homes, and relief turned to alarm. Had a move to protect my grandparents instead condemned them?
So began a long vigil of daily calls, weekly video chats and customized postcards created online.
When I told my grandfather about reporting in Spain, I omitted mention of the bodies taken out of apartment buildings in Barcelona and of health care workers in hazmat suits disinfecting nursing homes in isolated villages. It felt better to update him on the uncertain fate of European soccer leagues, and to reminisce about our penalty-kick practices in his garden in Beaugency, where I spent my summers as a child.
The coronavirus has killed about 14,000 residents of France’s nursing homes — half of the country’s death toll. We are lucky that, so far, none of those deaths occurred at my grandparents’ home, where the caregivers were vigilant about social distancing.
As France began easing its lockdown last week, we were finally able to visit, or rather sit outside the home, as my grandparents sat inside, a few feet away. To allow us to hear each other, the staff opened the door, but placed a table with a Plexiglas partition in the doorway.
We could see my grandparents only one at a time, since they are in different parts of the home that can no longer socially mix. My grandfather, a former stone mason, misses many things that we cannot yet deliver, like shorts, because of the home’s strict rules. It is my grandmother’s company he misses most.
My grandmother, once a wonderful cook known for her poulet basquaise and cherry cakes, has Alzheimer’s. When she struggled to recognize me, I broke the rules and took down my mask for a second. A nurse gently caressed her hair as we spoke. My mother and I were a little envious that the nurse could do what we could not.
For now, I plan to finally read my grandfather’s journals of his military service in Chad when he was around my age. He gave them to me at Christmas; I thought I had plenty of time to read them. That was before he had a stroke, and before the pandemic created a new normal.
The coronavirus is taking a “different pathway” in Africa compared with its trajectory in other regions, the World Health Organization said on Friday.
Mortality rates are lower in Africa than elsewhere, the W.H.O. said, theorizing that the continent’s young population could account for that.
The virus has reached all 55 countries on the continent, which recently confirmed its 100,000th case, with 3,100 deaths. When Europe’s infection count reached that point, it had registered 4,900 deaths.
“For now, Covid-19 has made a soft landfall in Africa, and the continent has been spared the high numbers of deaths which have devastated other regions of the world,” said Dr. Matshidiso Moeti, the organization’s regional director for Africa.
More than 60 percent of people in Africa are under 25, and Covid-19 hits older populations particularly hard. In Europe, around 95 percent of virus deaths have been among those 60 and older.
Many health experts have cast doubt on the W.H.O.’s numbers, however, saying that most African countries’ testing capability is extremely limited — partly because they struggle to obtain the diagnostic equipment they need — and that deaths as a result of Covid-19 are undercounted.
In some places, they say, low official numbers for cases and deaths mask a much graver reality.
When India imposed a national lockdown on March 25, thousands upon thousands of migrant laborers, bereft of work, began long, treacherous journeys from India’s cities, often on foot.
But Mohan Paswan, a rickshaw driver from a lower rung of India’s caste system, had been injured in a traffic accident in January and could barely walk. He and his 15-year-old daughter, Jyoti Kumari, had no transport and nearly no money as they looked to make their way home from New Delhi to their village, halfway across India.
Their saving grace was a $20 purple bike bought with the last of their savings. Starting on May 8, Jyoti pedaled for 700 miles with her father on the back, delivering them both safely home last weekend.
Many days they had little food. They slept at gas stations. They lived off the generosity of strangers. The biking wasn’t easy. Her father is big, and he was carrying a bag. Sometimes people teased them, upsetting him.
The nation’s press has seized upon the feel-good story of Jyoti the “lionhearted.”
On Thursday, the Cycling Federation of India, which scouts young talent and sends the best to international competitions, including the Olympics, tracked Jyoti down through a journalist and invited her to New Delhi for a tryout with the national team.
Reached by phone on Friday in her village of Sirhulli, in Bihar, one of India’s poorest states, Jyoti said in a scratchy, exhausted voice: “I’m elated, I really want to go.”
How to have a safer Memorial Day weekend.
This is Memorial Day weekend in the United States, when beaches and backyard barbecues beckon. Though many places continue to reopen, you still shouldn’t gather in groups — but since many people will, here is some guidance for lowering your coronavirus risk.
Reporting was contributed by Jeffrey Gettleman, Suhasini Raj, Damien Cave, Peter Baker, Michael Cooper, Sui-Lee Wee, Louis Lucero, Jennifer Jett, Jin Wu, Elian Peltier, Maggie Haberman, Noah Weiland, Abby Goodnough, Sheryl Gay Stolberg, Sheila Kaplan and Sarah Mervosh.