U.S. officials don’t know what to do with 66 million doses of two malaria drugs in the federal stockpile.
The Food and Drug Administration’s abrupt decision this week to revoke an emergency waiver for two malaria drugs promoted by President Trump as potential “game changers” against the coronavirus has left 66 million doses stranded in the federal stockpile — and officials do not yet know what they will do with them.
The F.D.A.’s withdrawal on Monday of its “emergency use authorization” for chloroquine and hydroxychloroquine did not go over well at the White House, where top aides to Mr. Trump had rushed in March to fill the federal stockpile. That included accepting a donation from the pharmaceutical giant Bayer of three million tablets from a factory in Pakistan that had not been certified by the F.D.A. as safe.
Medical experts across the country — including those who are researching hydroxychloroquine — on Tuesday applauded the F.D.A.’s withdrawal of the waiver after it concluded the drugs’ potential benefits did not outweigh their risks.
An F.D.A. spokesman said the White House and Health and Human Services Secretary Alex M. Azar II were made aware of the decision before it was announced. But Peter Navarro, Mr. Trump’s trade adviser, said Monday night, “This is a Deep State blindside by bureaucrats who hate the administration they work for more than they’re concerned about saving American lives.”
His anger seemed to capture the futility of the administration’s headlong efforts to yield to the president’s wishes and rush the two drugs into use, yet another example of how politics and science have collided in Mr. Trump’s Washington.
In the end, none of the chloroquine was ever distributed from the stockpile; doctors preferred hydroxychloroquine, which is newer and has fewer side effects, they say. But its prospects as a treatment for Covid-19 also look dim.
As of Monday, the government had distributed 31 million tablets of hydroxychloroquine to state and local health departments, hospitals and research institutions; 63 million tablets remain, according to Carol Danko, a spokeswoman for the Department of Health and Human Services. Officials are working with the companies that donated the drugs to “determine the available options” for the products.
Mass flight cancellations. Abrupt farewells among students whose classes have been called off. Frustration about work and food in sealed-off neighborhoods. And unnerving uncertainty about plans for exams, work, vacation and travel.
With a fresh outbreak of coronavirus infections tied to a market — 137 cases after an additional 31 were reported on Wednesday — Beijing has started living through a milder, and so far limited, version of the disruptive restrictions that China enforced earlier this year to stifle its first tidal wave of infections. Residents in the capital have been sharply reminded that even in China — with its array of authoritarian powers — the coronavirus can leap back to life, triggering new rounds of limits on their lives.
The new outbreak in Beijing has brought embarrassment and a tough response from the Chinese Communist Party. Officials had been proud to the point of gloating in recent weeks about their success in stifling the pandemic in the country. Now the virus is back.
The Communist Party officials in charge of the city, including the party secretary, Cai Qi, sounded slightly penitent in a meeting on Tuesday.
“This group outbreak at the city’s Xinfadi market has already spread to multiple districts of the city and led to associated cases outside the city,” read an official summary of the meeting in The Beijing Daily. “The lessons run very deep, the situation for epidemic control is very grim, and this has sounded a warning to us.”
Most Beijing streets flowed with traffic on Wednesday, though less than usual. Restaurants were still open for business, though the government has ordered them to disinfect and to check employees.
But the flight cancellations from Beijing airports — about 60 percent, or more than 1,200 flights — and other signs of disruption have underscored how easily even a limited flare-up can ripple across society. The bulk of the flights in and out of the city were canceled, and so were many trains.
The flight cancellations were triggered by passengers pulling out of travel because of worry over infections or fear of being caught up in quarantine, Chinese news reports said.
Here are other developments from around the world:
The president of Honduras, Juan Orlando Hernández, announced on Tuesday that he, the first lady, Ana García, and two aides had tested positive for Covid-19. Mr. Hernández, who said he is well enough to continue working remotely, joins a small number of world leaders who have been infected, including Prime Minister Boris Johnson of Britain and Prime Minister Nikol Pashinyan of Armenia.
Prime Minister Jacinda Ardern of New Zealand said the military would now oversee quarantine facilities and strengthen border requirements after two new cases were confirmed on Tuesday in travelers who had returned from Britain. The cases ended the country’s 24-day streak without new infections, a development she called “unacceptable” after the nation declared the pandemic eradicated last week.
The United States and Mexico will keep restrictions on nonessential travel in place until at least July 21, the Embassy of Mexico announced Tuesday on Twitter. The rules were implemented March 21.
Premier League soccer returns on Wednesday in England, after a three-month hiatus. Two games will be played tonight, before a full slate of matches scheduled for this weekend.
Florida, Texas and Arizona all set records for the most cases they have reported in a single day.
The virus continues its steady spread across the Sun Belt, with state officials in Arizona, Florida and Texas all reporting their largest one-day increases on Tuesday in new cases yet.
Florida reported 2,783 new cases, Texas 2,622, and Arizona 2,392.
The new daily highs came as all three states have increased testing and moved swiftly to ease social distancing restrictions and allow more businesses to reopen. They were among 20 states that have seen the number of newly reported cases grow over the last two weeks, according to a New York Times database.
Gov. Ron DeSantis of Florida, a Republican, attributed the uptick to more widespread testing, noting at a news conference Tuesday that the state was not only testing far more people than it did earlier in the spring, but was also going into high-risk environments, testing farm workers and migrant workers, and finding new cases.
But epidemiologists have said that the numbers recorded in the state in recent days suggest increased transmissions, and the governor acknowledged that community transmission remained a factor.
“There’s been community spread the whole time,” Mr. DeSantis said at the news conference, saying that there were pockets of the state with higher rates, particularly lower-income areas.
He dismissed the idea that the recent infections stemmed from the reopening of businesses including bars and restaurants and said the state would not shutter activity again.
“We’re not shutting down,” he said. He added: “You have to have society function.”
Epidemiologists have said that even taking into account the increase in testing, the rise in confirmed cases in several Sun Belt states suggested increased transmissions, and they pointed to other measures, including the percentage of positive tests and hospitalizations. In Florida more than 4.5 percent of those who tested between May 31 and June 6 had the virus, compared with about 2.3 percent of people who sought tests in mid-May. Rates in Arizona and Texas have also risen in recent weeks.
Gov. Greg Abbott of Texas said that Tuesday’s new high reflected several anomalies, and that some counties may have reported a backlog of cases that were not reported in recent days. But he also put some of the blame for Texas’s increase in cases on people under 30, suggesting that they were being too casual about wearing masks and social distancing. He said that the Texas Alcoholic Beverage Commission had issued a warning this week to bars and restaurants that they face the suspension of their liquor licenses if they violate protocols.
Tension between the state and local governments over escalated again on Tuesday as nine Texas mayors, including those for the state’s largest cities, asked Mr. Abbott to give them the authority to mandate the use of face masks for their communities. The governor’s statewide policies do not require the wearing of face masks, although he strongly encourages them.
In Arizona, interest in the new one-day high was so great that the state’s health department’s website reported problems that it attributed to increased traffic. The state said that its daily increase of positive cases was 2,392, bringing its total to 39,097, and that another 25 people had died, bringing the state’s death toll to 1,219.
Global stock markets rose modestly on Wednesday, after several days of turbulence fueled by a cascade of news about the coronavirus and its impact on the global economy.
European stocks opened less than 1 percent lower, after a mostly positive trading day in the Asia-Pacific region. Japanese stocks were the exception, falling 0.6 percent after the release of data showing a sharp drop in exports in May.
Prices for U.S. Treasury bonds dropped, signaling improving investor sentiment. Oil prices also rose slightly in futures markets.
Futures that track American stock indexes were predicting a muted rise when Wall Street opens later in the day.
Markets went on a wild ride during the previous four trading days. Investors late last week grew alarmed as the number of infections grew in states like Florida and Arizona. A fresh outbreak in Beijing over the weekend also raised questions about China’s efforts to contain the outbreak.
After a drastic decline this spring, global greenhouse gas emissions are now rebounding sharply, scientists reported, as countries relax their lockdowns and traffic surges back onto roads.
In early April, daily fossil fuel emissions worldwide were roughly 17 percent lower than they were in 2019, as employees stopped driving to work, factories idled and airlines grounded their flights, according to a study published in May in Nature Climate Change.
But by mid-June, as countries eased their lockdowns, emissions had ticked up to just 5 percent below the 2019 average, the authors estimated in a recent update. Emissions in China, which accounts for one-quarter of the world’s carbon pollution, appear to have returned to pre-pandemic levels.
“We still have the same cars, the same power plants, the same industries that we had before the pandemic,” said Corinne Le Quéré, a climate scientist at the University of East Anglia in England and lead author of the analysis. “Without big structural changes, emissions are going to come back as the restrictions end.”
The researchers estimated that global fossil fuel emissions for all of 2020 are likely to be 4 percent to 7 percent lower than in 2019. That would be by far the largest one-year decline since World War II and several times larger than the drop seen in 2009 after the global financial crisis.
A laboratory in suburban Dallas has run some of the most expensive coronavirus tests in America.
Insurers have paid Gibson Diagnostic Labs as much as $2,315 for individual coronavirus tests. In a couple of cases, the price rose as high as $6,946 when the lab said it mistakenly charged patients three times the base rate.
The company has no special or different technology from, say, major diagnostic labs that charge $100. It is one of a small number of medical labs, hospitals and emergency rooms taking advantage of the way Congress has designed compensation for coronavirus tests and treatment.
“We’ve seen a small number of laboratories that are charging egregious prices for Covid-19 tests,” said Angie Meoli, a senior vice president at Aetna, one of the insurers required to cover testing costs.
How can a simple coronavirus test cost $100 in one lab and 2,200 percent more in another? It comes back to a fundamental fact about the American health care system: The government does not regulate health care prices.
This tends to have two major outcomes that health policy experts have seen before, and are seeing again with coronavirus testing: high prices over all, and huge price variation, as each doctor’s office and hospital sets its own charges.
Patients are, in the short run, somewhat protected from big virus testing bills. The federal government set aside $1 billion to pick up the tab for uninsured Americans who get tested. For the insured, federal laws require that health plans cover the full costs of coronavirus testing without applying a deductible or co-payment.
But American patients will eventually bear the costs of these expensive tests in the form of higher insurance premiums.
In a statement last week, Gibson said the $2,315 price was the result of “human error.” The company also said that it had recently reversed a few of its $2,315 charges and, after an inquiry from The New York Times, would reverse the rest of those bills within 24 hours.
Keep your hydroxychloroquine, President Trump. Vladimir V. Putin has found an even more unorthodox way to fight off the coronavirus: a “disinfectant tunnel.”
Visitors coming to see the Russian president at the country retreat where he is sheltering must first pass through the tunnel and be sprayed with a fine mist of a chemical agent intended to kill pathogens.
The Russian-made device had been installed at the home outside Moscow, Novo-Ogaryovo, RIA Novosti, a state-controlled news agency, reported. The news agency posted a video of a man in a suit walking through a demonstration model of the tunnel.
Mr. Putin’s spokesman, Dmitri Peskov, who recently returned to work after recovering from Covid-19, has said that anyone meeting the president in person is tested beforehand for the virus.
Like Mr. Trump, who says he has taken the antimalarial drug hydroxychloroquine to try to ward of infection, Mr. Putin has eschewed wearing a mask during what have become extremely rare public appearances. But he nonetheless seems spooked by the virus.
For the past two months, he has stayed away from the Kremlin in the center of Moscow, the epicenter of the pandemic in Russia. He has instead governed the country via videoconference from a drab and apparently windowless room — dubbed “the bunker” by Russian journalists — at his country residence.
Physically, the Russian president appears to be in good health. Politically, it is another matter: His approval ratings have slumped to 59 percent, the lowest since he came to power 20 years ago.
Coronavirus recovery wards are the new Covid-19 front lines.
With the peak of the coronavirus crisis in New York City in the past, hospitals and their medical staff are no longer straining under the number of critically ill patients — once so numerous that ventilators, dialysis machines and even sedatives ran dangerously low.
The front lines of the virus fight have shifted from intensive care units to recovery areas like 11 North, and similar units at other hospitals, like Rusk Rehabilitation at NYU Langone Orthopedic Hospital. Here, doctors are finding that for the most severe cases, recovery can be a long and arduous process.
Patients who survive lengthy I.C.U. stays during ordinary times — after heart attacks, car accidents, shootings, sepsis or respiratory failure — often face lengthy recoveries. Some patients report cognitive deficits, including difficulty concentrating. Many struggle to return to their jobs. About one-third have anxiety, depression or symptoms of post-traumatic stress disorder, said Dr. Lindsay Lief, a pulmonologist at Weill Cornell who works with post-I.C.U. patients.
“In the Covid era, I think this will be magnified,” Dr. Lief said.
She noted that the typical Covid-19 patient in an intensive care unit was generally there for an unusually long time — one study suggested at least two weeks. That means more muscle loss and increased risk of other problems as well.
Even those whose lungs are mostly healed may be quite debilitated after long immobilization in an intensive care unit, where they are administered high dosages of sedatives and sometimes paralytics. Some must relearn to swallow without choking. Others have crippling nerve pain. Others have cognitive deficits, including trouble with words.
Reporting was contributed by Keith Bradsher, Chris Buckley, Joseph Goldstein, Andrew Higgins, Sarah Kliff, Brad Plumer, Nadja Popovich, Frances Robles, Robert Simonson, Rory Smith, Kaly Soto, Sheryl Gay Stolberg and Daniel Victor.