Trump Stops U.S. Funding of W.H.O.; U.K. Coronavirus Deaths May Be Higher Than Official Toll: Live Coverage


Virus-related deaths in Britain may be 10 percent higher than the official toll.

Britain, with the fastest-growing outbreak in western Europe, has understated the human and economic cost of the coronavirus, according to new information released on Tuesday.

The government’s Office of National Statistics released figures indicating that deaths could be at least 10 percent higher than the official toll — 12,107 as of Tuesday — which does not take into account many people who die in nursing homes or at home.

More than 2,000 nursing homes, about 13 percent of the country’s total, have had coronavirus cases, said Dr. Chris Whitty, the government’s chief medical adviser. Workers in many of the homes have complained of an acute shortage of protective gear.

Care England, a charity representing independent care agencies, has estimated that nearly 1,000 Covid-19 deaths in nursing homes have gone uncounted. Two major home operators have reported 521 deaths in recent days, many of which are not yet included in official totals.

Critics say the government has focused on shoring up the National Health Service and its hospitals, neglecting the nursing home industry.

The financial outlook in Britain, which has almost 94,000 confirmed coronavirus cases, also darkened on Tuesday. The Office for Budget Responsibility, a fiscal watchdog group, said the country’s lockdown could shrink the economy by 35 percent in the second quarter, erasing 2 million jobs.

On Tuesday, the president said the organization “willingly took China’s assurances” and that it “defended the actions of the Chinese government, even praising its so-called transparency.”

Mr. Trump has been defensive about his decision to institute early travel restrictions on China, crediting himself with saving hundreds of thousands of lives while sustaining criticism for being xenophobic and racist.

But Mr. Trump has not addressed his administration’s inaction after that decision and the gap in the timeline of his response between the travel restrictions announced on Jan. 31 and the declaration of a national emergency on March 13.

In the debate about when to restart something resembling normal daily life, the cautionary tale at the moment is Singapore.

For weeks, public health officials have been enviously lauding its response to Covid-19: screening and quarantining travelers from outside the country; contact tracing; vigorously enforcing quarantines and isolation.

And yet, in the last week, officials have had to put the entire country on lockdown amid a new wave of infections. All migrant workers are confined to their compounds for at least two weeks.

Citizens may leave their homes, but only to buy food or medicine, or to exercise. Anyone who breaks the rules, including spending time with anyone not in their household, can be imprisoned, fined the equivalent of $7,000, or both.

Public health experts say Singapore’s experience illustrates how quickly the virus can rear its head again, and underscores that large-scale changes may have to stay in effect for many months. That goes for any country, they say, including the United States.

“There’s just no way that we’re going to be able to keep most of the country open through the year,” said Ezekiel Emanuel, vice provost of Global Initiatives at the University of Pennsylvania. “If Singapore can’t do it, I don’t imagine how we think we can. As I have said, this is going to be a roller coaster with multiple waves of opening and partial re-closings necessary.”

The stark forecast, issued on Tuesday in the fund’s World Economic Outlook, took into account the weeks of shuttered factories, quarantines and national lockdowns in response to the coronavirus pandemic that have caused economic output around the world to collapse.

This year’s fall in output would be far more severe than the last recession, when the world economy contracted by less than 1 percent between 2008 and 2009. A 3 percent decline in global output would be the worst since the Great Depression, the fund said.

“As countries implement necessary quarantines and social distancing practices to contain the pandemic, the world has been put in a Great Lockdown,” said Gita Gopinath, the fund’s chief economist. “The magnitude and speed of collapse in activity that has followed is unlike anything experienced in our lifetimes.”

The Trump administration has reached an agreement in principle with major airline companies over the terms of a $25 billion bailout to prop up an industry that has been hobbled by the pandemic.

“We welcome the news that a number of major airlines intend to participate in the Payroll Support Program,” Treasury Secretary Steven Mnuchin said in a statement.

The administration has been haggling with the airlines over the terms of the bailout, with Mr. Mnuchin pushing the airlines to agree to repay 30 percent of the money over a period of five years. The Treasury Department also has been seeking warrants to purchase stock in the companies that take money. Airlines have complained that Treasury was effectively turning the grants into loans by requiring repayment.

Also Tuesday, crude prices tumbled by as much as 10 percent in an early sign that the deal will not do to balance supply and demand, only two days after Saudi Arabia, Russia and other major oil producers agreed to the biggest production cut in history.

Doctors are questioning the care protocols for coronavirus patients, particularly the use of ventilators. That has led to a heated debate amid practitioners, with some warning that abandoning long-established policies could be dangerous.

In the video above, doctors at the center of the outbreak voice their fears about making the wrong decisions as the virus upends everything they thought they knew about treating patients in severe respiratory distress.

The pandemic has also presented challenges to the field of medical publishing, particularly for “preprint servers,” where medical researchers post early versions of their findings. They aim to improve communication between scientists, by allowing them to share promising information months before their research has gone through protracted peer review and official publication.

They’ve seen a huge surge in online traffic amid the outbreak — including many readers who lack the scientific expertise to understand them in their proper context. The same has happened with peer-reviewed journals.

“Science is a conversation,” said Dr. Ivan Oransky, a physician and co-founder of Retraction Watch, a blog that reports on retractions of scientific papers. “Unfortunately people in times of crisis forget that science is a proposition and a conversation and an argument. I know everybody’s desperate for absolute truth, but any scientist will say that’s not what we’re dealing with.”

Indonesia, a nation that had been widely criticized for lack of coronavirus testing and limited social distancing measures, has seen a rapid uptick in coronavirus deaths in recent days, with 60 new fatalities reported on Tuesday.

Health experts have warned for weeks that Indonesia could face a calamity on the scale of Iran or Italy and that its beleaguered health system was not prepared to handle a large number of critically ill patients.

Indonesia’s death toll of 459 is second only to China in East Asia. And the official death toll, while high, only accounts for some cases: Patients suspected of having Covid-19 who died before being tested are not taken into account.

Indonesia, the world’s fourth most populous country with 270 million people, has conducted minimal testing and has been slow to adopt social distancing measures.

Indonesia’s president, Joko Widodo, declared a national disaster on Monday, which could make the country eligible for international assistance. But he announced no new restrictions aimed at curbing the spread of the virus.

Nearly 10 percent of those reported dead have been medical personnel, including 22 doctors and six dentists, according to the Indonesian Medical Association, and 12 nurses according to the Indonesian Nurses Association.

Last week, the governor of Jakarta, the capital, imposed a partial shutdown, restricting transportation within the city and a banning religious, social and cultural gatherings. Other major cities in the metropolitan area imposed similar restrictions.

The announcement comes days after Africans in the Chinese city of Guangzhou said they had been subjected to forced evictions and arbitrary quarantines as Beijing ramped up efforts to fight against imported coronavirus cases. Anti-foreigner sentiment grew in the southern Chinese city after a recent cluster of cases was reportedly linked to its Nigerian community.

In a statement posted on Twitter, Mr. Wine said he had partnered with an American businessman to airlift Africans and African-Americans affected by the attacks “to a country in Africa that is willing to receive them.”

Together with Neil Nelson, chief executive of the Atlanta Black Star media firm, the two were also ready to evacuate to the United States those who hold American citizenship or permanent residency.

Videos and images of Guangzhou’s black residents facing harassment from police, sleeping in the streets and being refused service in stores and restaurants have surfaced online. On Monday, McDonald’s apologized after a video circulated online showing an employee at one of its restaurants in Guangzhou holding up a sign that read, “From now on, black people are not allowed to enter the restaurant.”

The incidents in China have drawn condemnation from leaders across the African continent, with nations including Nigeria and Uganda summoning their Chinese ambassadors. The authorities in China have said they have “zero tolerance for discrimination” and have promised to work to improve conditions.

The official Chinese news agency Xinhua said on Tuesday that 111 people from African countries had tested positive for the coronavirus in Guangzhou. More than 4,500 Africans there have been subject to nucleic acid testing since early April, the report said, citing the local authorities.

In Iraq, the fight against coronavirus means overcoming stigma.

The doctor paused before banging on the front gate, gesturing to his companions in hazmat suits and masks to stand back so they would not be the first thing the home’s occupants saw.

“This is very sensitive, very difficult,” said Dr. Wissam Cona of the provincial Health Department in Najaf, Iraq. The father at this home had begged him not to come with a retinue of health workers, saying he felt ashamed in front of his neighbors.

For Iraq, one of the biggest obstacles in fighting the coronavirus is the stigma associated with illness and quarantine. People avoid being tested, prevent family members from getting tests and delay seeking medical help until they are catastrophically ill.

That may help explain Iraq has relatively few confirmed coronavirus cases: 1,352 as of Monday. Iran, with roughly twice Iraq’s population, has more than 71,000.

“It is true we have cases that are hidden, and that is because people don’t want to come forward and they are afraid of the quarantine and isolation,” said Dr. Hazim al-Jumaili, a deputy health minister.

The stigma attached to illness and quarantine in Iraq and other Middle Eastern countries reflects cultural and religious beliefs, but also distrust of the government and bitter experience: Given the ragged state of Iraq’s health care system, some fear going to the hospital could be fatal.

“Some believe the virus means that God is displeased with them, or maybe it is a punishment for a sin so they don’t want others to see that they are sick,” said Dr. Emad Abdul Razzak, a consulting psychiatrist at Iraq’s Health Ministry.

A survey last month by the Ministry of Land, Infrastructure, Transport and Tourism found that fewer than 13 percent of workers were able to work from home. And those who have the option of teleworking fear harm to their careers.

Forced to balance the needs of the office and the risks to their own health, employees like Shuhei Aoyama, 26, say they are losing patience with the country’s work traditions. “It’s not so much our company’s culture as it is Japanese culture that’s causing the problems,” he said.

“Why do we have to put each other at risk just for something trivial like a hanko?” Yoshitaka Hibi, a professor of Japanese literature at Nagoya University, wrote in a Twitter post that was liked more than 28,000 times.

“This is our chance. For the love of god, someone please destroy this custom,” he added.

More than 100 million children could be at risk for measles because countries are suspending immunization programs to reduce the risk of coronavirus infection, international public health leaders warned on Monday.

So far, 24 low- and middle-income countries, including Mexico, Nigeria and Cambodia, have paused or postponed such programs, according to the Measles and Rubella Initiative, a consortium whose members include UNICEF, the American Red Cross, the World Health Organization, the United Nations Foundation and the Centers for Disease Control and Prevention.

Unlike wealthier countries, where parents typically make appointments to follow a vaccine schedule at clinics or private pediatric offices, these countries inoculate large numbers of infants and children in communal settings.

Dr. Robin Nandy, the chief of immunization for UNICEF, acknowledged that finding the balance between guarding against the spread of Covid-19, the illness caused by the coronavirus, and preventable diseases like measles was delicate and difficult.

Sports have gone dark everywhere in the Western Hemisphere. Except for one country.

Baseball and soccer leagues carry on in Nicaragua, whose public health officials report relatively few coronavirus cases. Many others have doubts.

All over the world, sports have shut down. Yet in one country, an alternate universe exists with a very full sports calendar.

Nearly two weeks ago, a national boxing tournament in Nicaragua began as planned. A couple weekends ago, a marathon was run in Managua, the country’s capital. Last week, after an important game in the country’s popular semiprofessional baseball league, fans participated in a caravan that ended with a rally in the town of Jinotepe’s main square. Nary a mask was in sight, nor was social distancing followed.

And the five scheduled matches last week in the country’s top professional soccer league were played, albeit in stadiums closed to the public. Despite protests by some players and teams, La Liga Primera the only professional soccer league still in action in the Western Hemisphere.

Reporting was contributed by Richard Pérez-Peña, Karen Zraick, Anton Troianovski, Oleg Matsnev, Sophia Kishkovsky, Monika Pronczuk, Wudan Yan, Patrick Kingsley, Aaron E. Carroll, Elisabetta Povoledo, Raphael Minder, Aurelien Breeden, Richard C. Paddock, Ceylan Yeginsu, Abdi Latif Dahir, Megan Specia, Melissa Eddy, Carlotta Gall, Ben Dooley, Makiko Inoue, Keith Bradsher, Edward Wong, Paul Mozur, Kai Schultz, Hari Kumar, Elaine Yu, Kate Taylor, Sebastian Modak, Alissa J. Rubin, William J. Broad, Miriam Jordan, Annie Correal, Ben Dooley, Makiko Inoue, James Wagner, Jose Maria Leon Cabrera, Anatoly Kurmanaev, Julie Bosman and Charlie Savage


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