Coronavirus Live Updates: Up to Half of All Patients Could Show No Symptoms, Says Fauci

Coronavirus Live Updates: Up to Half of All Patients Could Show No Symptoms, Says Fauci

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Credit…Anna Moneymaker/The New York Times

President Trump doubled down Sunday on his push for the use of an anti-malarial drug against the coronavirus, issuing medical advice that goes well beyond scant evidence of the drug’s effectiveness as well as the advice of doctors and public health experts.

Mr. Trump’s recommendation of hydroxychloroquine, for the second day in a row at a White House briefing, was a striking example of his brazen willingness to distort and outright defy expert opinion and scientific evidence when it does not suit his agenda.

Mr. Trump suggested he was speaking on gut instinct, and acknowledged he had no expertise on the subject.

“But what do I know? I’m not a doctor,” Mr. Trump said, after recommending the anti-malaria drug’s use for coronavirus patients as well as medical personnel at high risk of infection.

“If it does work, it would be a shame we did not do it early,” Mr. Trump said, noting again that the federal government has purchased and stockpiled 29 million doses of the drug.

“What do you have to lose?” Mr. Trump asked, for the second day in a row.

When a reporter asked Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, to weigh in on the question of using hydroxychloroquine, Mr. Trump stopped him from answering. As the reporter noted that Dr. Fauci was the president’s medical expert, Mr. Trump made it clear he did not want the doctor to answer.

“He’s answered the question 15 times,” the president said, stepping toward the lectern where Mr. Fauci was standing.

On Saturday, Dr. Fauci had privately challenged rising optimism about the drug’s efficacy during a meeting of the coronavirus task force in the White House’s Situation Room, according to two people familiar with the events. The argument was first reported by the website Axios.

Peter Navarro, the president’s trade adviser who is overseeing supply chain issues related to the coronavirus, plopped a sheaf of folders on the table and said he had seen several studies from various countries, as well as information culled from C.D.C. officials, showing the “clear” efficacy of chloroquines in treating the coronavirus.

Dr. Fauci pushed back, echoing remarks he has made in a series of interviews in the last week that rigorous study is still necessary. Mr. Navarro, an economist by training, shot back that the information he had collected was “science,” according to the people familiar with what took place.

The nation’s leading infectious disease specialist said Sunday night that as many as half the people infected with the virus may not have any symptoms, a much larger estimate than the director of the Centers for Disease Control and Prevention gave last week.

“It’s somewhere between 25 and 50 percent,” said the specialist, Dr. Anthony S. Fauci, during a briefing by President Trump and members of his coronavirus task force on Sunday. He cautioned, however, that it was only an estimate, adding that even the scientists helping lead the nation’s fight against the virus, “the friends that we are, we differ about that.”

In an interview with National Public Radio last week, Dr. Robert Redfield, the director of the C.D.C., said as many as 25 percent of people with the virus exhibit no symptoms. The large number of symptom-free cases — and scientists’ changing understanding of just how common such cases are — helps explain why the C.D.C. last week changed its guidance, recommending that all Americans wear a cloth face covering in public settings like grocery stores and pharmacies where they cannot ensure keeping a safe distance from others.

It also underscores the extraordinary challenge of controlling the virus’s spread. Dr. Fauci emphasized that for now his estimate was only a guess and that more testing was needed to figure out exactly how many Americans are carrying the virus without realizing it.

“Then we can answer the question in a scientifically sound way,” he said. “Right now, we’re just guessing.”

With new cases of the coronavirus rapidly increasing in Tokyo and other large cities in Japan, Prime Minister Shinzo Abe is moving toward declaring a state of emergency to help contain the epidemic, according to NHK, the public broadcaster.

Under an emergency law enacted last month, Mr. Abe can ask prefectural governors to close schools, request that residents refrain from going out or holding events, and order building owners to contribute their facilities for medical use. He cannot issue stay-at-home orders or force businesses to close, as other countries have done.

Nearly three months into its outbreak, Japan is continuing to record new daily highs in confirmed infections, with the health ministry announcing 383 on Monday. Japan’s total number of cases has more than doubled, to 3,654, in the last eight days.

Japan has so far not reported the sort of explosive rise in cases that other countries have experienced, even though it has not taken aggressive steps like restricting people’s movements or testing widely for the virus. Its leaders have said for weeks that they have managed to contain the outbreak by quickly identifying clusters and tracing close contacts to infected people, but experts fear that the limited testing has allowed the virus to spread.

In remarks to reporters, Yoshihide Suga, Mr. Abe’s chief cabinet secretary, said that “in urban areas, including Tokyo, the number of infections is rapidly increasing, and the number of infections that cannot be tracked is increasing.” He said that the government would “comprehensively judge whether the state of emergency should be declared” after consulting with epidemiological and public health experts.

In Tokyo on Sunday, the governor, Yuriko Koike, announced 143 new cases, a record high. Tokyo has now reported a total of 1,033 cases and 30 deaths. Citing the increasing number of cases, the American military, which has 50,000 active-duty members in Japan, declared a public health emergency for the Tokyo region.

The situation in Japan presents a contrast to the trajectory of the coronavirus outbreak in neighboring South Korea. That country, which has tested 466,804 people for the virus, more than 10 times the number in Japan, announced only 47 new cases on Monday, down from 78 a week earlier.

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Queen Elizabeth II rallied Britons in the midst of the coronavirus pandemic, which has infected at least 40,000 in the country. Her remarks were pre-recorded from Windsor Castle, where she is sequestering herself.CreditCredit…Paul Ellis/Agence France-Presse — Getty Images

Queen Elizabeth II, in a rare televised address on Sunday, tried to rally her fellow Britons to confront the coronavirus pandemic with the resolve and self-discipline that have seen the nation through its greatest trials.

“I am speaking to you at what I know is an increasingly challenging time,” the queen said in taped remarks from Windsor Castle. The virus has infected at least 40,000 people in Britain, including her eldest son and heir, Prince Charles, and Prime Minister Boris Johnson.

Mr. Johnson was admitted to the hospital for tests, the government said later on Sunday evening, underscoring how the virus has threatened the country’s political establishment.

A spokesman for Mr. Johnson, 55, said on Sunday that the prime minister was still dealing with symptoms of the virus and went to the hospital as a precautionary measure. Downing Street said Mr. Johnson, who was running a high temperature, remained at the helm of the government.

“On the advice of his doctor, the prime minister has tonight been admitted to hospital for tests,” a spokesman said Sunday. “This is a precautionary step, as the prime minister continues to have persistent symptoms of coronavirus 10 days after testing positive for the virus.”

The queen called it “a time of disruption in the life of our country: a disruption that has brought grief to some, financial difficulties to many, and enormous changes to the daily lives of us all.”

The appearance was only the fourth time in her 66-year reign that the queen has addressed the British people, apart from her annual Christmas greeting — and it carries a distinct echo of the celebrated radio address her father, George VI, delivered in September 1939, as Britain stood on the brink of war with Germany.

“I hope in the years to come, everyone will be able to take pride in how they responded to this challenge,” the queen said, “and those who come after us will say that the Britons of this generation were as strong as any. That the attributes of self-discipline, of quiet good-humored resolve and of fellow-feeling still characterize this country.”

Mr. Johnson had been in isolation in his residence next door to 10 Downing Street.

On Saturday, his 32-year-old girlfriend, Carrie Symonds, disclosed that she, too, is suffering symptoms. Ms. Symonds is pregnant.

The British foreign secretary, Dominic Raab, is expected to lead the daily cabinet meeting on the pandemic on Monday. Under the government’s succession plan, Mr. Raab would take up Mr. Johnson’s duties if he is incapacitated.

While the queen fully adopted social distancing early in the pandemic, the British government came late to the need for such measures, with Mr. Johnson initially balking at ordering pubs and restaurants to close. He is now an ardent convert and recorded a video from his quarantine urging people — without much success — not to flock to London parks during a sun-kissed spring weekend.

Britain’s response to the pandemic has improved since that shaky start. The government has vowed to conduct 100,000 virus tests a week by the end of April, a tenfold increase over the current rate.

If you are among the more than 6 million Americans applying for unemployment insurance this month, you are likely doing so for the first time. It’s important to understand how unemployment works and how it can help you in this time of need. Plus, tips for making a will and starting an emergency fund.

Indian health officials have identified what is believed to be the country’s first “superspreader” of the coronavirus, tracing more than a quarter of the country’s infections to gatherings held by a Muslim missionary group in New Delhi.

The cluster of infections, linked to events held last month at the Tablighi Jamaat Center in India’s capital, has set off frantic efforts to trace thousands of attendees around India, many of them foreigners visiting from Southeast Asia.

India has 4,067 confirmed cases and 109 deaths, with officials linking more than 1,000 of those cases to adherents of Tablighi Jamaat, an influential Islamist movement that urges Muslims to model their religious behavior and dress after the prophet, Muhammad.

In recent weeks, the group’s gatherings in Malaysia and in Pakistan have also played significant roles in spreading the virus globally.

As India’s 21-day nationwide lockdown nears its final week, the authorities have rushed to track more than 20,000 people who visited the Tablighi Jamaat Center in New Delhi, including preachers from Indonesia and the Philippines, several of whom have already died from the virus.

In the state of Uttarakhand, the police warned Tablighi Jamaat members that they could face attempt to murder charges if they did not report to health officials by Monday and were subsequently linked to an undisclosed case of the coronavirus.

A tiger at the Bronx zoo has been confirmed to be infected with Covid-19, in what is believed to be a case of what one official called “human-to-cat transmission.”

“This is the first instance of a tiger being infected with Covid-19,” according to the U.S. Department of Agriculture, which noted that although only one tiger was tested, the virus appeared to have infected other animals as well.

“Several lions and tigers at the zoo showed symptoms of respiratory illness,” according to a statement by the Agriculture Department.

Public health officials believe that the large cats caught the virus from a zoo employee. The tiger appeared visibly sick by March 27.

In a statement, the Agriculture Department suggested that those infected with the virus should, “out of an abundance of caution,” avoid contact with their pets and other animals.

The Centers for Disease Control and Prevention has said that it is “aware of a very small number of pets outside the United States reported to be infected,” but that it does not have evidence that pets can spread the coronavirus.

Texas set up checkpoints on its border with Louisiana on Sunday to screen people for the coronavirus, widening the scope of a mandatory quarantine order for visitors from one of the country’s emergent hot spots, the authorities said.

Photos of the checkpoints appeared on the Facebook page of the Louisiana State Police, which advised travelers to exercise caution and remain alert for traffic congestion in a post mentioning the enforcement measures.

The post said that commercial motor vehicle traffic would not be obstructed.

The screening measures came a week after Gov. Greg Abbott of Texas expanded a mandatory 14-day self-quarantine for travelers arriving from Louisiana, as well as air travelers from California, Washington State, Atlanta, Chicago, Detroit and Miami. The state had previously required air travelers from the New York metropolitan region and New Orleans to self-quarantine.

The steps taken by Texas authorities recalled an order last month by Gov. Gina Raimondo of Rhode Island, who ordered checkpoints in her state that singled out vehicles with New York license plates to enforce a similar quarantine.

China on Monday said it is arranging to charter flights for overseas students in the United States to get back home to China.

Chinese students who are under the age of 18 and without their parents in the United States are being asked to register online if they would like to return home, the Chinese Embassy in the United States said in a notice posted to its website.

Nearly all international flights into China have been canceled as the government tries to keep its coronavirus infection numbers down. It is worried that infected travelers who return would worsen the outbreak, but leaving these students hanging risks making Beijing look like it can’t protect its own citizens.

More than a million Chinese students have been left stranded around the world. The single largest group is in the United States, where there are more than 400,000, according to official figures.

Hospital officials, public health experts and medical examiners say that official tallies of Americans said to have died in the pandemic do not capture the overall number of virus-related deaths, leaving the public with a limited understanding of the outbreak’s true toll.

Limited resources and a patchwork of decision making from one state or county to the next have contributed to the undercount. With no uniform system for reporting coronavirus-related deaths in the United States, and a continuing shortage of tests, some states and counties have improvised, obfuscated and, at times, backtracked in counting the dead.

Adding to the complications, different jurisdictions are using distinct standards for attributing a death to the coronavirus and, in some cases, relying on techniques that would lower the overall count of fatalities.

A coroner in Indiana wanted to know if the coronavirus had killed a man in early March, but said that her health department denied a test. Paramedics in New York City say that many patients who died at home were never tested for the coronavirus, even if they showed telltale signs of infection.

In Virginia, a funeral director prepared the remains of three people after health workers cautioned her that they each had tested positive. But only one of the three had the virus noted on the death certificate.

Doctors now believe that some deaths in February and early March were likely misidentified as influenza or only described as pneumonia.

Even under typical circumstances, public health experts say that it takes months or years to compile data that is as accurate as possible on deaths in infectious outbreaks.

But they also say that an accurate count of deaths is an essential tool to understand a disease outbreak as it unfolds: The more deadly a disease, the more aggressively the authorities are willing to disrupt normal life. Precise death counts can also inform the federal government on how to target resources, like ventilators from the national stockpile, to the areas of the country with the most desperate need.

Reporting was contributed by Michael Crowley, Katie Thomas, Maggie Haberman, Roni Rabin, Mark Landler, Stephen Castle and Neil Vigdor.

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