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W.H.O., in Reversal, Affirms Covid May Be Airborne Indoors: Live Updates - The New York Times

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The World Health Organization on Thursday formally acknowledged that droplets carrying the coronavirus may be airborne indoors and that people who spend long periods in crowded settings with inadequate ventilation may be at risk of becoming infected, a reversal that many scientists said was long overdue.

The agency also acknowledged unequivocally that the virus can be transmitted by people who do not have symptoms.

Apoorva Mandavilli reports on the admission, which came after a push by more than 200 experts prompted the agency to update its description of how the virus is spread. The agency now says transmission of the virus by aerosols, or tiny droplets, may have been responsible for “outbreaks of Covid-19 reported in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking, or singing.”

The W.H.O. still largely emphasizes the spread of the virus by larger droplets that are coughed or inhaled, or from contact with a contaminated surface, also known as “fomite transmission.” And in a longer document on the scientific evidence, the agency still maintains that “detailed investigations of these clusters suggest that droplet and fomite transmission could also explain human-to-human transmission within these clusters.”

In addition to avoiding close contact with infected people and washing hands, people should “avoid crowded places, close-contact settings, and confined and enclosed spaces with poor ventilation,” the W.H.O. has said. It said homes and offices should ensure good ventilation.

“It is refreshing to see that W.H.O. is now acknowledging that airborne transmission may occur, although it is clear that the evidence must clear a higher bar for this route compared to others,” said Linsey Marr, an aerosol expert at Virginia Tech.

Still, the updated guidance is not as extensive as many experts hoped to see.

The W.H.O. had previously maintained that airborne spread is a concern only when health care workers are engaged in certain medical procedures that produce aerosols. But mounting evidence has suggested that in crowded indoor spaces, the virus can stay aloft in the air for hours and infect others when inhaled, and may even seed super-spreader events.

It has been widely accepted for months that seemingly healthy people can spread the virusas evidence for asymptomatic transmission building. But from the beginning of the pandemic, the W.H.O. has maintained that asymptomatic cases were infrequent, and that asymptomatic transmission, while it may occur, was “very rare.”

On Thursday, however, the agency said: “Infected people can transmit the virus both when they have symptoms and when they don’t have symptoms.”

The statement provides an explicit rationale for everyone to wear masks — the W.H.O. endorsed them only in early June, long after most national governments did — and for more widespread testing even of people without apparent symptoms.

Credit...Nitashia Johnson for The New York Times

As President Trump continued to press for a broader reopening, the United States set another record for new cases on Wednesday, with more than 59,400 infections announced, according to a New York Times database. It was the fifth national record in nine days.

The previous record, 56,567, was reported last Friday.

On Thursday, cases were decreasing in only two states — Vermont and New Hampshire. In 14 states and territories, the number of cases was mostly the same. And in the rest of the country new cases were on the rise. More than 2,200 cases were announced Thursday in Alabama, a single-day record, and officials in Montana reported 95 new cases, also a single-day record.

The country reached a total of three million cases on Tuesday as the virus continued its resurgence in the South and West. At least five states — Missouri, Tennessee, Texas, Utah and West Virginia — set single-day records for new infections on Wednesday.

As of Tuesday, the country’s daily number of new cases had increased by 72 percent over the past two weeks. And by Wednesday, 24 states had reported more cases over the past week than in any other seven-day stretch of the pandemic.

Texas reported more than 9,900 cases on Wednesday, the state’s third consecutive day with a record total of new infections. According to Dr. Deborah L. Birx, the Trump administration’s virus response coordinator, the state’s rate of positive tests was hovering around 20 percent at the beginning of July, double what it was a month before.

In Arizona, a fast-spreading outbreak is putting pressure on hospital capacity, with the state having reported more deaths in recent days. New cases in Arizona have been trending upward since the beginning of June, and this week the state has been averaging more than 3,600 new cases a day, a record.

Dr. Anthony S. Fauci, the government’s top infectious disease expert, said in an interview on Wednesday with The Wall Street Journal: “Any state that is having a serious problem, that state should seriously look at shutting down. It’s not for me to say, because each state is different.”

Dr. Fauci spoke as medical facilities across the nation, under pressure from the surge in cases, continued to face a dire shortage of respirator masks, isolation gowns and disposable gloves that protect front-line medical workers from infection.

Schools, too, are at the center of conflicting messaging about how they can safely welcome back students. The Centers for Disease Control and Prevention on Wednesday said that it would issue new guidelines, after Mr. Trump criticized its previous ones.

A threat from Mr. Trump to cut off federal aid to schools that refuse to fully reopen comes as scientists grapple with rising concerns about transmission of the virus in indoor spaces.

Credit...Audra Melton for The New York Times

As the White House, the nation’s pediatricians and many worn-out, economically strapped parents push for school doors to swing open this fall, local education officials say they are being crushed by the costs of getting students and teachers back into classrooms safely.

Mr. Trump threatened this week to cut off federal funding to districts that do not reopen, though he controls only a sliver of the money for schools.

Betsy DeVos, the secretary of education, said Thursday on Fox News that the Trump administration is not suggesting pulling funding from education. Instead, she said, “let the families take that money and figure out where their kids can get educated if their schools are going to refuse to open.”

Administrators say they are already struggling to cover the logistical and financial challenges of retrofitting buildings, adding staff and protective gear, and providing students with the proper academic and emotional support after a traumatic disruption to their lives.

The federal relief package passed in March dedicated $13.5 billion to K-12 education — less than 1 percent of the total stimulus. But education groups estimate that schools will need many times that, and with local and state budgets already depleted by the pandemic, it’s unclear where the funds can be found.

Exactly how much money the nation’s schools need to reopen is also a matter of debate, complicated by the conflicting, sometimes shifting guidelines that administrators have received from government agencies and medical authorities.

Regardless of which guidelines are followed, reopening schools will require changes. An average-sized district of 3,700 students can expect $1.8 million in pandemic-related costs for 2020-2021, representing 3 to 4 percent of a typical annual budget, according to an estimate from AASA, the School Superintendents Association.

Credit...Andrew Caballero-Reynolds/Agence France-Presse — Getty Images

Federal health officials in the United States are trying to decide who will get the first doses of any effective coronavirus vaccines, which could be on the market this winter but may require many additional months to become widely available to Americans.

The Centers for Disease Control and Prevention and an advisory committee of outside health experts have been working on a ranking system for what may be an extended rollout. According to a preliminary plan, any approved vaccines would be offered to vital medical and national security officials first, then to other essential workers and those considered at high risk — the elderly instead of children, people with underlying conditions instead of the relatively healthy.

Agency officials and the advisers are also considering what has become a contentious option: putting Black and Latino people, part of the population that has disproportionately fallen victim to Covid-19, ahead of others in the population.

Some medical experts are not convinced there is a scientific basis for such an option. They foresee court challenges or worry that prioritizing minority groups would erode public trust in vaccines at a time when immunization is seen as crucial to ending the pandemic.

“Giving it to one race initially and not another race, I’m not sure how that would be perceived by the public, how that would affect how vaccines are viewed as a trusted public health measure,” said Claire Hannan, executive director of the Association of Immunization Managers, a group represented on the committee.

To report on the exploding outbreak in Florida, the news staff at a Miami television station does not have to look far: At least nine station employees, including one of its news anchors, have come down with Covid-19 or have tested positive, and another 150 people linked to the station were awaiting test results.

In a report broadcast on Wednesday, WPLG Local 10 interviewed the news anchor, Nicole Perez, and her husband, Roy Ramos, a reporter for the station, about the symptoms they were experiencing. Both are quarantined at home.

Mr. Ramos, who said he was otherwise healthy and had been running and lifting weights just a few days earlier, told viewers that he would be going to a hospital for a chest X-ray because his condition was worsening. He described a 15-minute coughing fit he had that morning, when he said he couldn’t catch his breath.

Ms. Perez said she was beginning to improve, but became teary when talking about Mr. Ramos. “The hardest part for me is worrying a lot about — about him,” she said, leaning into his shoulder as they sat together on camera.

The virus has been spreading rapidly in Florida since the state began to reopen in May.

On Thursday, the state reported more than 8,930 new cases, according to a Times database; a month earlier, the daily figure was just over 1,000. The state also set a single-day record of new deaths, 120, on Thursday, exceeding the mark of 83 deaths reported on April 28. Those figures bring the state’s totals to more than 232,700 cases and more than 4,000 deaths so far.

Calvin Hughes, Ms. Perez’s co-anchor, told viewers on Wednesday: “This is not a political message here, this is a personal one. Please, please, wear your mask.”

GLOBAL ROUNDUP

Credit...Fabio Bucciarelli for The New York Times

The intensive care unit at the Papa Giovanni XXIII hospital in Bergamo, one of the Italian provinces most affected by the virus, hit a milestone this week: It had no Covid-19 cases, for the first time in 137 days.

The hospital marked the occasion on Wednesday by commemorating the dead with a moment of silence, followed by a round of applause for those who had been cured.

“Then I told them, ‘Well done, now back to work,’” said Ferdinando Luca Lorini, the director of emergency services at the hospital.

The milestone was important to observe, he said, “not so much for the outside world, but instead for all the people who worked around the clock for 137 days, giving their all, to celebrate that we’d won the battle.”

It was a slow road to a Covid-free status. Patients began arriving in February and didn’t stop. On March 16, a date etched in Dr. Lorini’s memory, more than 100 patients crowded the intensive care unit, with another 144 on ventilators in other wards.

“It’s now back to the way things were,” he said.

Workers have shed the protective gear they wore for months: double gloves, masks, double white coats. They took showers before and after each shift. “Now we move around freely, dressed like doctors and nurses,” he said.

Of the 88 patients currently in the intensive care unit, a small number are former virus patients, who are still grappling with the aftermath of the virus. The hospital will soon begin to follow up with patients who have been released, to see how they are faring, Dr. Lorini said.

In other news from around the world:

  • India recorded nearly 25,000 new infections on Thursday, its highest single-day total, as new research showed that the country’s virus reproduction rate had increased since lockdowns were eased. India’s caseload is the world’s third-largest after the United States and Brazil, and it is averaging about 450 Covid-19 deaths a day, according to a Times database.

  • Australia stepped up its efforts to isolate the outbreak spreading through Melbourne on Thursday, as the state of Queensland shut its doors to people trying to flee the city’s six-week lockdown. Most of Australia is now off limits to people from the state of Victoria, of which Melbourne is the capital. The state authorities reported 165 new cases on Thursday, including six infections tied to a school where a cluster has now spread to 113 people.

  • Hong Kong announced new social-distancing measures on Thursday as it recorded 42 new cases, another daily high this week. Starting on Friday for two weeks, restaurants and nightclubs may not be more than 60 percent full, while the number of people permitted at each table has been restricted to eight at eateries and four at bars.

Listen to ‘The Daily’: A Missed Warning About Silent Coronavirus Infections

Why an early scientific report of symptom-free cases went unheeded.

Credit...Bethany Mollenkof for The New York Times

In the last decade, dozens of enormous warehouses and distribution centers for companies like Amazon and Walmart have gone up across what was a patchwork of ranches and inexpensive tract housing in the area of Southern California known as the Inland Empire.

The region has grown rapidly as people have fled steep housing costs closer to the coast. From 2010 to 2019, the Riverside-San Bernardino metro area added more residents than any other metro area in California over that time.

Infections across the state have hit alarming new highs in recent days, and the spike comes as Americans continue to rely heavily on e-commerce giants to deliver their necessities during the pandemic, and the need for people to sort, package, ship and deliver goods has grown.

And with that demand comes a hazardous downside.

Warehouse workers are more likely to toil in conditions that put them at greater risk of infection. A recent report from the Labor Center at the University of California, Berkeley, found that, nationwide, Latino and Black workers were far overrepresented in warehouse jobs.

Consistent demographic data about Covid-19 cases has been difficult to compile, but in Riverside County, the rate of confirmed cases among Hispanic or Latino residents is two and a half the rate of cases among white people, according to the public health department. Statewide, Black people accounted for 9.1 percent of Covid-19 deaths, but roughly 6 percent of the population.

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Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general, urged global leaders to unify in the fight against coronavirus.CreditCredit...Pool photo by Fabrice Coffrini

The same week the United States began the process of withdrawing from the W.H.O., the group’s leader made an emotional appeal on Thursday for international solidarity to fight the raging pandemic.

“The greatest threat we face is not the virus itself,” said Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general, his voice cracking, during a briefing at the organization’s headquarters in Geneva. “Rather, it is the lack of leadership and solidarity at the global and national levels.”

While not mentioning the United States directly, Dr. Tedros noted some countries have struggled to contain the virus as infections have soared over the last several weeks. Others have been able to suppress the number of infections and deaths with a diligent and united effort.

Dr. Tedros, who has often lamented the lack of international cohesion, said the virus “thrives on division.” “How is it difficult for humans to unite to fight a common enemy that’s killing people indiscriminately?” he said, and appeared to wipe a tear from his cheek.

The United States is the W.H.O.’s largest donor. According to the organization’s bylaws, the withdrawal cannot take place for one year. Mr. Trump has been critical of the W.H.O.’s handling of the pandemic and accused it of favoring China in its response. Mr. Trump said in May he planned to withdraw, raising alarm around the world. Dr. Tedros announced on Thursday the appointment of a blue-ribbon panel, led by former president of Liberia, Ellen Johnson Sirleaf, and Prime Minister Helen Clark of New Zealand to evaluate the response to the pandemic.

He said the world required an honest reflection to learn the big lessons, but asked, “Can we honestly do it?”

Credit...Melissa Bunni Elian for The New York Times

In January, as a frightening new virus filled hospital wards in Wuhan, China, Stephanie Giordano, a 25-year-old researcher at the drugmaker Regeneron, in a suburb of New York City, began working on a treatment.

By March, the virus had hit home. Fearing she would get infected on her commute, she moved from her apartment in East Harlem to an Airbnb near the company’s headquarters in Westchester.

Then her mother, a nurse’s assistant, was reassigned to a Covid-19 ward, where she tended to older people struggling to breathe. No drug could help them — or her, if she were to fall ill.

“I had somebody on the line that I really cared about,” Ms. Giordano recalled. “And I wanted to see her make it through this.”

Ms. Giordano, the youngest member of the company’s five-person rapid response team for infectious diseases, helped develop what many consider one of the most promising new treatments for Covid-19.

She worked 90 hours a week screening thousands of antibodies — the weapons of the immune system that seek out and destroy viruses — in search of the most powerful. The result was a cocktail of two antibodies that might not only treat the virus, but could prevent it by giving the body the same natural defenses that people infected with it produce on their own.

The Trump administration gave a major boost to Regeneron’s treatment this week, awarding the company $450 million to manufacture and supply doses. That’s in addition to $160 million in federal money the company had already received to run clinical trials and ramp up manufacturing. After the treatment passed an initial safety study, Regeneron’s broader trials to evaluate the product’s efficacy got underway.

Regeneron is one of several companies pursuing antibody treatments. The drug giant Eli Lilly has also begun clinical trials, and others working on antibody treatments include partnerships of Amgen and Adaptive Biotechnologies and also Vir Biotechnology and GlaxoSmithKline. But drug development is notoriously unpredictable, and it’s unclear which of these projects — if any — will succeed.

BUSINESS ROUNDUP

Credit...Elaine Thompson/Associated Press

Just over 1.3 million laid-off workers in the United States filed new claims for state unemployment benefits last week, the government reported on Thursday.

New claims in the Labor Department’s weekly tally have not dropped below a million since the pandemic started — levels that are far above previous records.

Another one million new claims were filed last week under the federal Pandemic Unemployment Assistance program, which is designed to funnel jobless benefits to freelancers, the self-employed and other workers normally ineligible for state unemployment insurance.

Hiring nationwide has picked up in recent weeks, and the overall jobless rate dipped in June to 11.1 percent from a peak of 14.7 percent in April.

But most of the payroll gains were because temporarily laid-off workers were rehired. The number of people whose jobs have disappeared and who must search for new ones has increased.

And the Organization for Economic Cooperation and Development said this week that high unemployment in the United States and other developed countries would probably persist at least until 2022. On Wednesday, United Airlines warned that it might furlough as many as 36,000 workers this fall, nearly 40 percent of its global work force.

Wall Street faced another day of unsteady trading on Thursday, with stocks swinging from gains to losses as investors assessed the latest data on unemployment claims in the United States. The S&P 500 was slightly lower by midmorning, after an early gain. Shares in Europe were mostly higher, led by Germany’s DAX.
In other business news:

  • Starbucks said it would require face masks inside all U.S. locations beginning July 15. It said that in some locations not under government mandates, customers without masks would be able to place orders at drive-throughs or with curbside pickup. It said it was “committed to playing a constructive role in supporting health and government officials as they work to mitigate the spread of Covid-19.”

  • Sur La Table, the upscale cookware company, filed for Chapter 11 bankruptcy on Wednesday. In court filings, the company said it expected to sell more than half of its locations to Fortress Investment Group, and would also shutter 51 of its 121 U.S. stores.

  • Bed Bath & Beyond said on Wednesday that it would permanently close 200 stores over the next two years, starting later this year, as it tries to weather the pandemic. The retailer said sales plunged by almost 50 percent in the last quarter despite a surge in online sales.

  • Vacancies in Manhattan’s residential rental market have reached their highest level in 14 years after the virus pushed New Yorkers out of the city earlier this year when it was the center of the U.S. outbreak.

U.S. roundup

Credit...Anna Moneymaker for The New York Times

As the top health official in Tulsa, Okla., suggested that a surge in cases could be tied to the contentious indoor campaign rally held there last month, the top Republican in New Hampshire — where Mr. Trump is scheduled to hold a rally on Saturday — has already said he would skip the large gathering as a health precaution.

“I’m not going to put myself in the middle of a crowd of thousands of people,” Gov. Chris Sununu of New Hampshire, a Republican, said recently on CNN. He is up for re-election in November.

New Hampshire, a state narrowly won by Hillary Clinton in 2016, is one of just two states seeing declines in cases, and officials there want it to stay that way.

Mr. Trump’s campaign said it does not have a sense of the expected turnout for the event, which will be mostly outside at a Portsmouth airport hangar. Campaign officials are “strongly” encouraging attendees to wear face masks, with the hope that will ease concerns about catching the virus at the event, but are bracing themselves for a smaller turnout.

“It’s not what we need right now in terms of Covid,” said Tom Rath, a Republican former New Hampshire attorney general.

Last month, health officials in Tulsa raised concerns about an indoor Trump campaign rally becoming a “super spreader” event and advised people over 60 years old — who are at more risk of virus-related complications — not to attend. Tulsa is currently seeing record-high numbers of new cases.

“The past two days we’ve had almost 500 cases, and we know we had several large events a little over two weeks ago, which is about right,” Dr. Bruce Dart, director of the Tulsa Health Department, said at a news conference. “So I guess we just connect the dots.” Recent protests in the city were among the events.
In other news from around the United States:

  • Michael D. Cohen, Mr. Trump’s former lawyer and fixer, was taken back into federal custody on Thursday after being furloughed from prison in May, according to a person familiar with his legal status. He was returned to custody after tabloid photographs emerged in recent days that showed him at a Manhattan restaurant near his home. He had asked to be released over health concerns related to the virus.

  • The governor of Texas ordered hospitals in dozens of counties to suspend elective surgeries in order to free up hospital beds for Covid-19 patients. The state has had the fourth-highest caseload in the country, after New York, California and Florida. The governor had already issued such orders in several areas, including hard-hit Houston.

  • The Trump administration proposed barring migrants from obtaining asylum in the United States if they traveled through or came from a country struggling with the virus or other disease outbreaks. If enacted, the rule would lay a framework for the administration to continue to use a public health crisis to justify the sealing of the United States to nearly every person seeking protection at the southwestern border.

  • Antibody results from walk-in medical offices in New York City appear to present the starkest picture yet of how infection rates have diverged across the city. In Corona, a working-class Latino neighborhood in Queens that was among those hit hardest, 68 percent of people tested at a CityMD clinic had antibodies. But in a wealthier, whiter neighborhood a short distance away, only 13 percent of people tested positive.

Credit...Laetitia Vancon for The New York Times

Every morning, Marisa Lobato wakes up and checks the news to see if the travel restrictions have changed.

She lives in São Paulo, Brazil, and her fiancé, Horst Schlereth, is in Germany. Before everything was put on hold, Ms. Lobato had planned to go to Germany this spring to prepare for their wedding. Now their daily calls are filled with fretting over when they will reunite.

“We feel completely stuck in this situation,” she said. “I normally don’t cry in front of him, but I cry alone. It’s really a horrible feeling.”

The pair are among a number of separated, unmarried couples who have rallied on social media for changes to the European Union’s travel restrictions, using the hashtag #LoveIsNotTourism and #LoveIsEssential. Unlike most married people, they do not have a right to enter the European Union to be reunited with their partners.

Now, the European Commission, the bloc’s executive branch, is throwing its weight behind the cause, urging member states to exempt unmarried people with partners in Europe from the travel ban. But only Denmark and Sweden have adopted any of the recommendations and couples say even border guards in member states are confused about the regulations.

The European Union reopened travel last week to visitors from 15 countries, in an attempt to salvage the bloc’s peak tourism season. The United States, Brazil and Russia, among other countries, were notably excluded.

Without face-to-face contact and the ability to get acquainted with your colleagues in person, how can you settle into your new, remote workplace? Here are some tips to help.

Reporting was contributed by Maggie Astor, Peter Baker, Julia Calderone, Damien Cave, Patricia Cohen, Michael Cooper, Jill Cowan, Abdi Latif Dahir, Dana Goldstein, Joseph Goldstein, Erica L. Green, Maggie Haberman, Anemona Hartocollis, Mike Ives, Andrew Jacobs, Miriam Jordan, Zolan Kanno-Youngs, Patrick Kingsley, Apoorva Mandavilli, Raphael Minder, Richard C. Paddock, Elisabetta Povoledo, Mitch Smith, Megan Specia, Eileen Sullivan, Lucy Tompkins, Megan Twohey, Kim Velsey, David Waldstein, Noah Weiland, Billy Witz, Sameer Yasir, Elaine Yu and Karen Zraick.

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