With states beginning to allow varying degrees of economic reopening, large protests against police brutality being held in dozens of cities and warmer weather inviting people outside, forecasters tracking the Covid-19 pandemic in the United States are approaching a difficult juncture.
While the portrait of the country overall has improved significantly in recent weeks, epidemiologists have cautioned that different states are likely to experience very different challenges now in measuring and controlling the virus’s spread.
According to data compiled by The New York Times, more than a third of states are still seeing new infections increasing. But as many of them move ahead with reopening plans, their outcomes may depend on factors like how stressed their health care systems have been and how far they are along the curve.
In some relatively large states such as North Carolina and Arizona, increased testing suggests that infections are still climbing quickly and may spike further as more people venture out.
In another group are states that have achieved modest declines in new cases, but where the sheer number of people already infected remains the main source of concern. Even as states such as Maryland or Connecticut have seen small declines in new infections, both still have alarmingly high counts per capita, which have taxed health care systems for weeks.
The fear for states in the second category is that with scores of people already infected, recent declines could be quickly erased through increased social contact in the months ahead, threatening health care systems anew.
Some parts of the United States face financial ruin but few infections.
In Corpus Christi, the oil and gas and vacation town on the southeastern coast of Texas, it can be tough to find people who have experienced the coronavirus’s devastation, or even know someone who has. But people hit with job losses or business closures? They are everywhere.
Theresa Thompson has been furloughed from her position as a catering and events manager at a Holiday Inn. Richard Lomax has seen sales fall by more than 90 percent at the two restaurants his family owns. Brett Oetting, chief executive of the tourism office, has been working with countless businesses struggling to navigate the economic collapse.
None of them knows anyone local who has been sickened by the virus.
In corners of the United States facing financial ruin, but where the coronavirus hasn’t arrived in full, a New York Times analysis of economic and infection data helps explain why some see reopening as long overdue. The sharp disconnect between extreme economic pain and limited health impact presents local officials and businesses with difficult choices, even after Friday’s encouraging jobs report suggested more of the country was returning to work.
“In the first two weeks when they said this was coming, I was like, ‘Let’s all stay in, hunker down, and if we all do this, that can help while we figure out what is going on,’” said Stephanie Anderson, a real estate agent in Satellite Beach, Fla.
But since “places here aren’t producing mass death,” she said, “don’t tell me I can’t open my business in a responsible manner.”
Some business owners and workers in these communities have embraced reopening because of their firsthand experiences. Many are angry or confused. Others plead for caution. But most agree the virus has not posed the local public health threat that so many were expecting — even while acknowledging that things could get worse and the numbers would most likely already be higher with more testing.
Here are some other recent developments on the economic impact of the pandemic:
Brazil’s government on Friday removed comprehensive numbers on coronavirus cases and deaths from the Health Ministry’s website, claiming without offering evidence that state officials had been reporting inflated figures to secure more federal funding.
Carlos Wizard, a businessman recently appointed by President Jair Bolsonaro to a top job in the ministry, told the O Globo newspaper on Friday that the government suspects state officials have been including deaths from other causes in the coronavirus tallies they report to the federal government.
“Local officials, driven purely by a desire to get more funding for their cities, labeled everyone as Covid,” Wizard said. “We’re reviewing those deaths.”
The accusation outraged public health experts. Several noted that Brazil has a sophisticated health surveillance system and that there is a broad consensus among epidemiologists that a lack of testing worldwide has resulted in a gross undercount of deaths from Covid-19, the disease caused by the coronavirus.
Mr. Bolsonaro has come under withering criticism at home and abroad for his cavalier handling of the pandemic. He has sabotaged quarantine guidelines issued at the state level, calling them ruinous for economic growth. On Friday, he threatened to pull Brazil out of the World Health Organization, which has urged countries with increasing outbreaks to adopt social distancing guidelines.
As of Saturday, Brazil had more than 650,000 confirmed cases, second only to the United States, and more than 35,000 deaths. In recent days, Brazil has led the world in the number of new deaths reported each day.
The National Council of Health Secretaries, which represents municipal health officials, called Mr. Wizard’s accusation outrageous.
“This authoritarian, insensitive, inhumane and unethical attempt to erase people who have died from Covid-19 will fail,” the council said. “We are not mercenaries of death.”
As the country’s caseload exploded in recent weeks, Mr. Bolsonaro fired his health minister and replaced him with a doctor who lasted less than a month on the job.
Since mid-May, the health ministry has been led by an active duty general with no medical experience, and military officers have stepped into several top jobs as career health officials resigned.
Huge crowds turn out around the world to protest racism, and experts fear a coronavirus spike.
From London to Sydney, crowds of people around the world defied public health warnings and turned out in solidarity with U.S. protesters calling for justice in the death of an African-American man, George Floyd, killed in policy custody in Minneapolis. Health experts have warned that the demonstrations could accelerate the spread of the coronavirus, especially among people not wearing masks.
In Australia, huge crowds turned out in Sydney, Melbourne and many other communities in support of the Black Lives Matter movement calling for an end to systemic racism and Aboriginal deaths in police custody.
The health minister in Britain urged residents not to gather for demonstrations in London, Manchester and Birmingham. But large crowds appeared — despite the cold weather, the rain and warnings by the police that mass gatherings would violate the rule that only six people from different households could gather outside during the pandemic.
In Paris, the authorities barred people from gathering in front of the United States Embassy, but thousands protested there anyway in the late afternoon, as well as near the Eiffel Tower, echoing a protest earlier this week that drew nearly 20,000 people in memory of Adama Traoré, a Frenchman who died in police custody in 2016.
And in the German cities of Berlin and Cologne, thousands responded to social media calls to take to the streets to honor Mr. Floyd. The protests came after a week of demonstrations in cities like Hamburg and Frankfurt.
Fury against racism and police brutality has also brought crowds into the streets of Belgium, Canada, Sweden and Zimbabwe. In other parts of the world:
Art Basel, the centerpiece of the European art market calendar, is canceled. The 50th anniversary edition of the event in Basel, Switzerland, was to feature more than 250 international galleries and had already been postponed.
Saudi Arabia reimposed a curfew in the Red Sea city of Jeddah from 3 p.m. to 6 a.m. for two weeks starting on Saturday, halted prayers in the city’s mosques and suspended work in offices because of a rise in the spread of the coronavirus, the state news agency SPA reported.
Russia on Saturday reported 8,855 new cases of the coronavirus, pushing the total number of infections to 458,689, and 197 deaths in the past 24 hours. The nationwide death toll has reached 5,725.
The weekend ahead of New York City’s start of gradual reopening, Gov. Andrew M. Cuomo reported 35 new coronavirus deaths statewide, a drop of seven from the day before and the lowest daily total in the last two months.
“This is really, really good news compared to where we were,” Mr. Cuomo said Saturday during his daily briefing in Albany. “This is a big sigh of relief.”
Under Phase 1 of reopening, set to begin Monday, retail stores will be allowed to open for curbside or in-store pickup, and nonessential construction and manufacturing can resume, returning as many as 400,000 people to the work force.
“You want to talk about a turnaround — this one, my friends, is going to go in the history books,” Mr. Cuomo said. “There is no state in the United States that has gone from where we were to where we are.”
Mr. Cuomo also announced he was expanding the occupancy guidelines for houses of worship, which could now admit up to 25 percent of the building’s occupancy. It is unclear if the measure applies statewide or only in locations that have reached Phase 2. All regions of the state except New York City are in the first or second phase of reopening.
Across the Hudson River, Gov. Philip D. Murphy of New Jersey announced 60 new virus-related deaths Saturday via social media, bringing the state’s toll to 12,106. The figure was a drop from the 79 new deaths reported the previous day. He also reported 606 new confirmed positive cases, totaling 163,893 cases in the state.
While New York City’s shutdown has successfully flattened the number of infections, a study has found that the economic cost could have been reduced by a third or more by strategically choosing neighborhoods to close, calibrating the risk of infection for local residents and workers with the impact on local jobs.
When the coronavirus arrived in Japan, people did what they normally do: They put on masks.
Face coverings are nothing new there. During flu and hay fever seasons, trains are crowded with commuters half-hidden behind white surgical masks. Employees with colds, worried about the stigma of missing work, throw one on and soldier into the office.
Japan has reported more than 17,000 infections and just over 900 deaths, while the United States, with a population roughly two and a half times as large, has topped 1.9 million cases and is approaching 110,000 deaths.
“Japan, I think a lot of people agree, kind of did everything wrong, with poor social distancing, karaoke bars still open and public transit packed near the zone where the worst outbreaks were happening,” Jeremy Howard, a researcher at the University of San Francisco who has studied the use of masks, said of the country’s early response. “But the one thing that Japan did right was masks.”
During the pandemic, scientists have found a correlation between high levels of mask-wearing — whether as a matter of culture or policy — and success in containing the virus.
“I think there is definitely evidence coming out of Covid that Japan, as well as other countries which practice mask-wearing, tend to do much better in flattening the curve,” said Akiko Iwasaki, a professor of immunobiology at Yale.
How the coronavirus might affect pregnant women and newborns has been a major concern since the outbreaks began. A new report in the medical journal JAMA has both reassuring and worrisome findings, with caveats that there is limited data and still much unknown.
So far, compared to the general population, pregnant women do not seem to have an increased risk of severe illness if they contract the virus, the report said. Of 147 pregnant women with Covid-19 in China, 8 percent had severe disease and 1 percent had critical illness — rates that were actually lower than those in the rest of the population, where 14 percent had severe disease and 6 percent were critically ill. In New York City, a report on 43 pregnant women with Covid-19 found that their rates of severe disease were similar to those in other adults.
But whether the infection can cause birth defects, miscarriage, premature birth or stillbirth is not yet known. Newborns have become infected, but it’s not clear whether they contracted the virus before, during or after birth, or if breastfeeding can transmit the virus.
Even so, the report says that for women who are wondering whether this is a safe time to conceive, “based on limited data, there does not seem to be a compelling reason to recommend delaying pregnancy.”
President Jair Bolsonaro of Brazil has enabled increased razing of the Amazon rainforest. The coronavirus has accelerated that destruction.
Illegal loggers, miners and land grabbers have cleared vast areas of the Amazon with impunity in recent months as law enforcement efforts were hobbled by the pandemic.
The fallout from the pandemic has exacerbated the ecological degradation set in motion by government policies under Mr. Bolsonaro, who favors expanding commercial development in the Amazon and views environmental regulations as a hindrance to economic growth. But some career civil servants are still working to enforce environmental protections.
An estimated 464 square miles of Amazon tree cover was slashed from January to April, a 55 percent increase from the same period last year and an area roughly 20 times the size of Manhattan, according to Brazil’s National Institute for Space Research, a government agency that tracks deforestation with satellite images.
Already last year, deforestation in the Amazon had reached levels not seen since 2008.
At the same time, the coronavirus has killed more than 34,000 people in Brazil, which now has the highest daily number of deaths in the world.
For years, Gildo Negri visited schools to share his stories about blowing up bridges and cutting electrical wires to sabotage Nazis and fascists during World War II. In January, the 89-year-old made another visit, leaving his nursing home outside Milan to help students plant trees in honor of Italians deported to concentration camps.
But at the end of February, as Europe’s first outbreak of the coronavirus spread through Mr. Negri’s nursing home, it fatally infected him, too.
The virus, which is so lethal to the old, has hastened the departure of these last witnesses and forced the cancellation of commemorations. It has also created an opportunity for rising political forces who seek to recast the history of the last century in order to play a greater role in remaking the present one.
Throughout Europe, radical right-wing parties with histories of Holocaust denial, Mussolini infatuation and fascist motifs have gained traction in recent years.
Much of the attention to the toll Covid-19 has taken on older adults has rightly focused on long-term care facilities. Their residents and employees account for almost 40 percent of the nation’s deaths, according to an updated New York Times analysis.
But far more Americans — nearly six million, by one estimate — rely on paid home care than live-in nursing homes and assisted living combined. And both workers and clients have cause for worry.
Even more than nursing home employees, home care workers are poorly paid hourly workers and often lack health insurance; half rely on some form of public assistance. Not only do many home care workers serve several clients each week, but to piece together a living they may simultaneously work for several agencies or for nursing homes, or hold outside jobs.
Those conditions increase infection risks, and not only for their frail older clients. Almost a third of home care workers, a heavily female work force, are themselves over 55, and most are black or Hispanic, groups that have proved particularly vulnerable to Covid-19.
Personal protective equipment, or P.P.E., has proved hard to acquire, however. With hospitals and nursing homes scrambling for supplies, “this was the forgotten sector,” said Dr. Nathan Stall, a geriatrician at the University of Toronto.
“Home care workers are probably unknowingly involved in the transmission of Covid-19, especially when they’re not equipped with sufficient P.P.E.,” he added.
When the country was under lockdown, at least the rules were mostly clear. Essential workers ventured out; everyone else sheltered in.
Now states are lifting restrictions, but detailed guidance about navigating the minutiae of everyday life is still hard to come by — and anyway, there’s never going to be a ready solution to every problematic circumstance you may encounter.
As you tiptoe toward normalization — whatever that is, given these times — try to follow three precautions: avoid contact, confinement and crowds. And make realistic choices.
You need to continue with social distancing precautions. That means wearing masks, washing hands well and often, and keeping a six-foot distance from one another. No hugs, no handshakes.
Any 15-minute face-to-face conversation between people who are within six feet of one another constitutes close contact, said Dr. Muge Cevik, an expert on infectious diseases and virology at University of Saint Andrews School of Medicine in Scotland.
Indoor activities in confined enclosed spaces, even large ones, are more conducive to spreading the virus than events held outside, especially if the air inside the building is being recirculated or the windows don’t open.
Large groups are risky, even outdoors. They mean more people, more contacts — and more potential sources of infection.
People at high risk for developing severe disease if they become infected with the coronavirus — including those 65 and over, residents of nursing homes and long-term care facilities, people with compromised immune systems, chronic lung or kidney disease, heart conditions or severe obesity — will want to take the greatest of precautions.
But young healthy adults and children should also consider the protection of people around them, including family members, colleagues or friends who are vulnerable, said Dr. Barbara Taylor, an infectious disease specialist at The University of Texas Health Science Center at San Antonio.
Reporting was contributed by Andrea Salcedo, Zach Montague, Michael H. Keller, Steve Eder, Karl Russell, Denise Grady, Ernesto Londoño, Letícia Casado, Jason Horowitz, Damien Cave, Livia Albeck-Ripka, Iliana Magra, Ceylan Yeginsu, Elian Peltier, Yonette Joseph, Roni Rabin, Eduardo Porter, Patricia Cohen, Ernesto Londoño, Manuela Andreoni, Leticia Casado, Ben Casselman and Paula Span.