An inexpensive drug reduces virus deaths, scientists say.

Scientists at the University of Oxford said on Tuesday that they have identified what they called the first drug proven to reduce coronavirus-related deaths, after a 6,000-patient trial of the drug in Britain showed that a low-cost steroid could reduce deaths significantly for hospitalized patients.

The steroid, dexamethasone, reduced deaths by a third in patients receiving ventilation, and by a fifth in patients receiving only oxygen treatment, the scientists said. They found no benefit from the drug in patients who did not need respiratory support.

Matt Hancock, Britain’s health secretary, said National Health Service doctors would begin treating patients with the drug on Tuesday afternoon.

The government started stockpiling dexamethasone several months ago because it was hopeful about the potential of the drug, Mr. Hancock said, and now has 200,000 doses on hand.

“Dexamethasone is the first drug to be shown to improve survival in Covid-19,” said Peter Horby, professor of emerging infectious diseases at the University of Oxford, and one of the chief investigators for the trial, said in a statement. “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment.”

Professor Horby said that dexamethasone should now become the “standard of care in these patients,” noting that it is inexpensive, widely available and can be used immediately.

European health care workers, feted with daily applause from balconies in Milan, Paris and London during the pandemic, are taking to the streets to demand that the praise be matched by real improvements in their working conditions.

French doctors, nurses and other health workers demonstrated on Tuesday to put pressure on the government, which has promised to massively invest in the health care system.

In Paris, their protests were punctuated by a series of violent clashes with the police, who fired tear gas in response. Some at the protest, which included other groups outside the health care sector, set ablaze trash cans and threw stones at the police as throngs moved near the Eiffel Tower.

More than 200 other demonstrations were planned around the country. Unions representing the caregivers say they want pay raises, increased hiring, and a moratorium on plans to downsize or shut down hospitals.

One group of unions said in a statement on Tuesday that “the applause at 8 p.m.,” the government’s “assuaging speeches,” “the chocolate medals” and the promises of “hypothetical and random bonuses” were not enough.

In Italy, hundreds of nurses protested in more than 30 cities on Monday, demanding better pay and greater recognition for their professional skills in a country where they say they are not valued.

Ferdinando Iacuaniello, a Rimini-based nurse who edits the website Nurse24.it, said nurses were chronically underpaid. “During the emergency the government hailed nurses as heroes,” he said. Now, he added, “they felt abandoned.”

GLOBAL ROUND UP

Beijing raised its level of health alert to the second highest on Tuesday, ordering schools to close and urging people to work from home as the government presses to staunch a spike in virus infections.

The city announced the escalation in its health emergency footing late in the day, after earlier revealing that medical authorities had confirmed another 27 infections from the virus, creating a total of 106 cases since last week, all traced to the sprawling Xinfadi wholesale food market in the city’s south.

“Epidemic trends in Beijing are very grim,” Chen Bei, a deputy secretary-general of the Beijing government, said at a news conference.

City officials face intense pressure to extinguish the new outbreak. After the pandemic spread from central China from late last year, Xi Jinping, China’s top leader, made defending Beijing from mass infections a priority. China’s capital is a nerve center of Communist Party rule, and a crowded, restless metropolis with more than 21 million inhabitants.

“Make containing the outbreak the most important and urgent task for now,” Cai Qi, the Communist Party secretary of Beijing, and a protégé of Mr. Xi, said at a meeting of officials on Monday. “Adopt the most resolute, decisive and strictest measures.”

Even so, the decision to raise the level of alert and shut schools was a potentially embarrassing and disruptive reversal for the government. Beijing had lowered its alert level for public health threats just ten days earlier.

Elsewhere around the globe:

After declaring the pandemic eradicated last week, New Zealand authorities on Tuesday confirmed two new cases in travelers who had returned from Britain, ending the country’s 24-day streak without new infections.

Roughly 1.7 billion people worldwide — 22 percent of the global population — have at least one of the underlying health conditions that can worsen cases of the coronavirus, according to a new modeling study. The data could help officials focus on people vulnerable to the virus’s most dangerous effects and eventually prioritize them for vaccination.

Hong Kong will relax some social-distancing restrictions on Thursday, allowing wedding banquets and live music to resume and lifting the limit on public gatherings to 50 people from eight, the city’s secretary of health, Sophia Chan, said on Tuesday.

Canada and the United States will keep their border closed to nonessential travel until July 21, Prime Minister Justin Trudeau said Tuesday. A recent tweak to the border restrictions allowed married and common law couples who had found themselves unable to reunite if they weren’t both Canadian citizens to do so.

Trump’s rally on Saturday could cause a huge spike, Tulsa officials fear.

Officials in Tulsa, Okla., are warning that President Trump’s planned campaign rally on Saturday — his first in over three months — is likely to worsen an already troubling spike in infections and could become a disastrous “super spreader.”

They are pleading with the Trump campaign to cancel the event, slated for a 20,000-person indoor arena — or at least move it outdoors.

“It’s the perfect storm of potential over-the-top disease transmission,” said Bruce Dart, the executive director of the Tulsa health department. “It’s a perfect storm that we can’t afford to have.”

Tulsa County, which includes the city of Tulsa, tallied 89 new cases on Monday, its one-day high since the virus’s outbreak, according to local officials. The number of active cases climbed from 188 to 532 in a one-week period, a 182-percent increase; hospitalizations with Covid-19 almost doubled.

Mr. Trump on Monday said that criticism of the rally was the result of the news media “trying to Covid Shame us on our big Rallies.” Conservatives have claimed a double standard around large gatherings in recent weeks after millions of Americans attended protests, often inches from one another, over the death of George Floyd.

Reports of new virus cases continue to decrease across much of the Midwest and Northeast, leading officials there to forge ahead with reopening, even as other regions see troubling surges of the virus.

Outdoor sports and popular recreation sites are reopening in New Jersey and Chicago, areas of the country that had been overwhelmed by the spread of the virus. In Chicago, bars and breweries will also start to reopen, as well as the popular trail along Lake Michigan.

“We still have a long way to go before life fully returns to normal,” the Chicago mayor, Lori Lightfoot, said.

Kwame Raoul, the Illinois attorney general, said Tuesday that he had tested positive, and that his symptoms were mild. Reports of new cases have been trending downward in Illinois in recent weeks, but hundreds of additional infections are still being identified each day. Illinois has more cases per capita than any state not on the East Coast.

While officials are enthusiastic about moving forward, some states that were among the first to ease restrictions are now seeing spikes, including in Texas and Arizona.

Nearly half of the known cases in Maricopa County, Ariz., have been reported since the start of June. At least 300 new cases have been identified in Dallas County, Texas, on each of the last six days, and the Houston area has also seen a sharp increase. Here’s a look at over developments around the country.

In Miami-Dade County, Fla., more than 2,400 new cases have been announced over the past week, even as the state’s governor has dismissed the increase as a result of expanded testing.

In Nebraska, Gov. Pete Ricketts said restrictions on businesses would be eased next week, and officials have plans to safely reopen long-term care facilities, which have been hot zones for the spread of the virus across the country. The number of cases and hospitalizations has gone down in recent weeks across the state.

Representative Ilhan Omar, Democrat of Minnesota, said on Monday that her father, Nur Omar Mohamed, had died from complications of the virus.

When Dr. Nichole Quick, the health officer in Orange County, Calif., issued an order requiring all residents to wear masks when in public last month, the backlash was swift — and personal.

Angry speakers flooded a public meeting calling for her firing. Protesters defaced her photo, comparing her to Hitler. The situation got so heated, local officials said, that she was placed under police protection.

By last week, Dr. Quick had resigned as county health officer, and county officials had reversed the order, making face coverings optional in the county of 3 million, where new reported cases and hospitalizations have trended slightly upward. The county has a total of nearly 9,000 cases so far, the fourth most in the state, and new reported cases are also rising overall in California.

The abrupt turnaround is perhaps one of the most pronounced examples of the backlash facing officials who promote face mask requirements, as face masks increasingly become a flash point in the nation’s political and cultural wars. Support for face masks has often fallen along partisan lines, despite federal health recommendations and recent research that suggest that face masks could be critical to stopping the spread of the virus. Mr. Trump has largely declined to wear a mask in public.

Officials and business owners alike have faced pushback. In the Houston area, the county judge was sued over an order requiring face masks. Costco faced threats of boycotts over a similar requirement for its stores. And in Stillwater, Okla., north of Oklahoma City, an order requiring residents to wear face masks inside stores and restaurants was quickly rescinded last month, after an uprising among customers.

In a matter of hours on the first day of the order, store employees in the area were “threatened with physical violence and showered with verbal abuse,” the city manager, Norman McNickle, said in a strongly-worded statement lifting the order.

“We cannot, in clear conscience, put our local business community in harm’s way, nor can the police be everywhere,” he said. “It is unfortunate and distressing that those who refuse and threaten violence are so self-absorbed as to not follow what is a simple show of respect and kindness to others.”

Arts and Sports Roundup

The U.S. Open is on, Lyric Opera of Chicago cancels its fall season, and the Queen misses Royal Ascot.

The United States Open tennis tournament will proceed, but be closed to spectators. Lyric Opera of Chicago will remain closed until at least January. And in Britain, the normally glamorous Royal Ascot horse racing meeting got underway on Tuesday — but without the usual parade of royals in top hats and fascinators, and with jockeys wearing masks.

The outbreak continues to upend the worlds of sports and culture. Here is a look at the some of the latest developments:

Gov. Andrew M. Cuomo of New York announced Tuesday that the U.S. Open could go ahead as scheduled from Aug. 31 to Sept. 13 at the U.S.T.A. Billie Jean King National Tennis Center in Queens, but without fans. The lack of fans will be a financial hit for the U.S.T.A., but the organization still has the support of its primary sponsors and ESPN, which pays more than $70 million annually in rights fees mainly to televise the tournament. “We can watch it on TV and I’ll take that,” Mr. Cuomo said.

Royal Ascot, immortalized in “My Fair Lady” when Eliza Doolittle shocks a crowd of toffs by crudely urging on her horse, got underway Tuesday but was transformed. For the first time in her 68-year reign as sovereign, Queen Elizabeth, an enthusiastic racing fan, missed it. “I am sure,” she wrote in a statement, “it will remain one of Britain’s finest sporting occasions.” For the uninitiated, this dispatch from last year on Royal Ascot, its millinery and its social mores, provides a useful, or at least amusing, primer.

Lyric Opera of Chicago, one of the nation’s premier opera companies, announced Tuesday that it was canceling its fall season. It hopes to reopen in January with performances of “Blue,” a recent opera composed by Jeanine Tesori with a libretto by Tazewell Thompson about an African-American family whose son is killed by a police officer.

The classical music world is grappling not just with the threat that the virus poses to audiences, but also to orchestra musicians, who are often packed onto stages, sharing music stands and playing shoulder to shoulder. So critics from The New York Times have come up with a playlist of some favorite pieces requiring smaller forces, which might be playable by socially-distant orchestras. You can listen to their choices here.

Need one more thing worry about? A new study explores the danger that might lurk in bathrooms.

As cities around the world navigate reopening, more people will need to use public or shared restrooms — and new research raises concerns that flushing the toilet can generate a cloud of aerosol droplets.

Scientists have found that such clouds can rise nearly three feet. The droplets may linger in the air long enough to be inhaled by the toilet’s next user, or land on surfaces in the bathroom.

That isn’t just gross.

Simulations show that the plume can carry infectious particles that are already present in the surrounding air, or that were recently shed in stool. The research, published Tuesday in the journal Physics of Fluids, adds to growing evidence that the coronavirus can be passed not only through respiratory droplets but through feces, too.

While it remains unknown whether public toilets are a major point of transmission, the research highlights the need to rethink some of the common spaces people share.

Researchers have found viable virus particles in patients’ feces, as well as traces of viral RNA on toilet bowls and sinks in hospital isolation rooms, the material appears less likely to be infectious than virus that is coughed out.

A computer simulation of flushing showed that when water pours into the toilet, it generates a vortex and displaces air in the bowl. As the vortex rises, centrifugal force pushes out about 6,000 tiny droplets — and even tinier aerosol particles.

People can also block the plume with a simple piece of equipment: a toilet lid. If only so many public bathrooms didn’t lack them.

The S&P 500 rose more than 2 percent, in its third consecutive climb since stocks suffered a sharp decline last week.

The stock market rally, following global markets higher, came as national retail sales rebounded in May as thousands of stores and restaurants reopened after lockdowns were lifted and federal stimulus checks and tax refunds fueled a burst of spending. But there was also reason for caution: many of the stores and restaurants that welcomed back customers last month did so with fewer employees, an ominous sign for the economy as it struggles to recover.

Total sales, which include purchases in stores and online as well as money spent at bars and restaurants, rose 17.7 percent in May from the previous month, the Commerce Department said Tuesday.

The rise in May is the largest monthly surge on record — drawing a celebratory Twitter post from Mr. Trump — but the retail industry is nowhere near back to normal. Overall sales were still down 8 percent from February. Some categories, like clothing, were down as much as 63 percent from a year ago.

At least four members of Congress or their relatives received money under a stimulus loan program created to help small businesses keep paying their workers amid the pandemic, even as Congress intensifies pressure on the administration to release information about who has benefited from the program.

It is not illegal for members of Congress or their families to apply for or accept the loans under the newly created Paycheck Protection Program. But after approving about $2.8 trillion in economic relief to address the pandemic, lawmakers are facing additional scrutiny over whether they have tailored the rescue programs to benefit themselves.

Representative Susie Lee, Democrat of Nevada, helped lobby for casinos to be included in the Paycheck Protection Program, and shortly after the Small Business Administration and the Treasury Department began administering it, her husband’s casino company received millions of dollars from the program. A spokesperson told the Daily Beast, which first reported details of the loan, that the congresswoman had no involvement in the company’s decision to accept the loans.

Representative Vicky Harzler, Republican of Missouri, and her husband, who own a farm and other businesses, also received aid through the program, citing “the realities of this uncertainty” and the need “to ensure the continued ability to maintain the employment of all team members during this time.”

Fiesta Restaurant Group, the parent company of Pollo Tropical, a Miami restaurant chain where the husband of Representative Debbie Mucarsel-Powell, Democrat of Florida, is an executive, received $15 million in loans. The money was ultimately returned.

A car dealership owned by Representative Roger Williams, Republican of Texas and one of the wealthiest members of Congress, also received a loan, though it is unclear how much the loan was. A representative for the car dealership told the Dallas Morning News that the loan helped “keep over 100 employees on payroll and prevent their families from experiencing further hardships during this unprecedented pandemic.” Mr. Williams was singled out by Representative Katie Porter, Democrat of California, in a news release calling for transparency surrounding the funds.

The Trump administration has resisted calls for disclosure of how it is distributing the money and who is benefiting. House Democrats launched an investigation on Monday.

New contact-tracing apps set off debate about privacy rights across Europe.

When three people in the northern Italian region of Liguria tested positive for the coronavirus last week, they gave their doctors permission to punch into a national server anonymous codes generated by a new contact tracing application on their phones. Moments later, the phones of people who had also voluntarily downloaded the app and had come into contact with them buzzed with an alert.

Italy expanded that pilot program on Monday, to join the first European countries using national contact tracing apps. France has also activated its own app, Germany’s is available for downloading as of Tuesday morning, and Britain is testing one, too.

As they turn to unproven technology to avoid a second wave of infection, European nations are setting off widespread debate about how best to fight the virus while safeguarding privacy rights.

Such issues have not been limited to Europe, and have been addressed variably around the globe. In Asia, nations like South Korea have used cellphone data and credit card activity to successfully track and contain infections. India has required its citizens to download an app. The United States has tended to rely on human tracers in efforts that remain patchy and limited.

Italy has tried to finesse some of the thornier privacy concerns by making its app — called Immuni, or Immune — voluntary. What’s more, the app is built on a platform developed in a rare collaboration between Apple and Google, which sided with privacy advocates who raised concerns about how much data governments could collect through the apps and limited Immuni’s data-transmission capabilities.

Those restrictions and the voluntary approach may reduce the app’s effectiveness, but may also go some way toward assuaging public queasiness about state intrusion.

Kenya is investigating the attempted theft of medical equipment donated to fight the virus.

Kenya is investigating efforts to steal medical equipment donated to stop the virus, the latest graft case in a nation where corruption has for years remained commonplace.

The incident involved an attempted theft of personal protective equipment donated by the Chinese government, including masks, gowns, thermometers and protective suits. After the equipment arrived in Nairobi, fraudsters working with government officials and Chinese businessmen hatched an unsuccessful plot to steal the donations, the authorities said.

“These are thieves and I can’t speak for them, and I will assume that the law is going to take its course and they are going to be arrested,” said the Kenyan health minister Mutahi Kagwe. The attempt came as infections continued to rise in Kenya, which has reported more than 3,700 cases and 100 deaths, according to a Times database.

Kenya’s health ministry has been plagued by scandals, with tens of millions of dollars meant for health services, including free maternity care, diverted. In early May, Mr. Kagwe transferred at least 30 officers, mainly in the ministry’s procurement and finance departments, in a bid to bring down what he called “the cartels” operating from within.

In late March, German authorities said six million face masks that they had donated went missing at Kenya’s airport. After an investigation, the Kenya Airports Authority said “no cargo of this nature” had come through its terminals. Although officials insist that Kenya has enough protective equipment, the doctors’ union says that 81 of its members have contracted the virus, highlighting the need for adequate, high-quality gear to protect health workers.

NEW YORK ROUNDUP

As virus cases wane, New York hospitals can allow visitors again.

Three months after New York asked hospitals to suspend visits in an effort to halt the spread of the virus, the state will now allow them to resume, Gov. Andrew M. Cuomo said on Tuesday.

As hospitals filled to the brim, thousands of relatives of dying patients were forced to say their last goodbyes over the phone, via a tablet screen or not at all.

Hospitals will be required to limit the time of visits, and visitors will need to wear personal-protective equipment and be subject to temperature and symptom checks.

Group homes for people with developmental disabilities may also accept visitors, while restrictions on visitors to nursing homes have not been lifted.

Here are some other key developments from around New York.

After the governor warned that he might reimpose restrictions in New York City if officials did not control crowds outside Manhattan bars, Mayor Bill de Blasio said Tuesday that city agencies would continue to enforce social distancing. “If there’s enforcement needed, there’ll be enforcement,” he said.

The mayor said restrictions needed to remain after reports that locks had been broken on shuttered parks and playgrounds.

Mr. de Blasio said he expects the city to reach 50,000 tests per day by early July, up from over 20,000 daily tests now. Statewide, there were an additional 25 deaths, the governor said.

Though officials were preparing for the possibility of easing more restrictions in the city on Monday, two weeks after reopening began, the mayor said that no decisions had yet been made by city and state officials. (He has said repeatedly he did not expect the city to enter Phase 2 until early July.)

Two months after a sample of 3,000 antibody tests indicated that one of every five New York City residents tested positive for antibodies, a study in June of a larger sample of 12,000 tests showed similar results, Mr. Cuomo said.

Reporting was contributed by Livia Albeck-Ripka, Dan Bilefsky, Aurelien Breeden, Emma Bubola, Chris Buckley, Emily Cochrane, Michael Cooper, Michael Corkery, Abdi Latif Dahir, Thomas Erdbrink, Oskar Garcia, Rebecca Griesbach, Michael Gold, Christine Hauser, Jason Horowitz, Winnie Hu, Sapna Maheshwari, Jonathan Martin, Tiffany May, Sarah Mervosh, Benjamin Mueller, Elisabetta Povoledo, Katie Rogers, Adam Satariano, Christopher F. Schuetze, Nate Schweber, Libbie Seline, Knvul Sheikh, Mitch Smith, Kaly Soto, Eileen Sullivan, Anton Troianovski, Amber Wang, Timothy Williams, David Yaffe-Bellany, Noah Weiland and Karen Zraick.



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