The U.S. Hits the 9-Million Mark as Infections Keep Surging

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A drive-through testing site in El Paso this week. The virus has been surging there. 
Credit…Joel Angel Juarez for The New York Times

With daily reports of coronavirus cases in the United States surging to previously unseen heights, the country has crossed the threshold of nine million known infections since the pandemic began.

On Thursday, the U.S. set another record for new daily cases, more than 89,000, topping the record set last Friday when the country recorded 85,000. It’s the equivalent of more than one new case every second.

“There is no way to sugarcoat it: We are facing an urgent crisis, and there is an imminent risk to you, your family members, your friends, your neighbors,” said Gov. Tony Evers of Wisconsin.

Over the past week, new cases in the United States have averaged more than 75,000 a day, and eight states reported daily records on Thursday. More total cases have been identified in the U.S. than in any other country, though some nations have had more cases in proportion to their populations.

In Wisconsin, more than 200 coronavirus deaths have been announced over the last week, and as case numbers explode, hospitals have been under increasing strain.

Wisconsin, home to eight of the country’s 15 metro areas with the highest rates of recent cases, was among the first states to lose control of the virus this fall. But the surge that started in the Upper Midwest and rural West has now spread far beyond, sending infection levels soaring in places as disparate as El Paso, Chicago and Rexburg, Idaho.

Idaho’s governor, Brad Little, this week imposed new restrictions on businesses and gatherings. “Hospitals throughout the state are quickly filling up or are already full with Covid-19 patients and other patients, and way too many health care workers are out sick with Covid-19,” Mr. Little said.

Twenty-one states added more cases in the seven-day period ending Wednesday than in any other seven-day stretch of the pandemic against a backdrop of a bitter presidential contest.

President Trump, in the closing days of his campaign, has assured voters that the virus is vanishing, brushing aside the devastation it has wrought and even mocking people who take precautions — including measures his own health advisers recommend — to slow the spread of the disease.

Daily reports of deaths from the virus remain far below their spring peaks, averaging around 780 a day. But those, too, have started to tick upward.

There are not many hopeful signs in the recent data.

Reports of new cases are increasing in 42 states. Northeastern states, including New Jersey and Rhode Island, are seeing infection numbers rise after months of stability. And in North Dakota, where more than 5 percent of the population has now tested positive —  the biggest share of any state — reports of new cases continue to soar.

Former Vice President Joseph R. Biden Jr. putting on his mask after speaking in Wilmington, Del. Wednesday. 
Credit…Erin Schaff/The New York Times

As the nation heads into what some public health experts warn could be a “dark winter” of coronavirus illness and death, a growing cadre is coalescing around Joseph R. Biden Jr.’s call for a “national mask mandate,” even as they concede such an effort would require much more than the stroke of a presidential pen.

Over the past week, a string of prominent public health experts — notably Dr. Anthony S. Fauci, the government’s top infectious disease specialist, and Dr. Scott Gottlieb, a former commissioner of food and drugs under President Trump — have said it is time to seriously consider a national mandate to curb the spread of the virus.

Overseas, President Vladimir V. Putin of Russia this week became the latest foreign leader to impose a national mandate for citizens to wear masks. Mr. Trump is opposed to a mandate, and Mr. Biden has conceded that a presidential order for all Americans to wear masks would almost certainly face — and likely fall to — a legal challenge.

Mr. Biden, who echoed warnings of a “dark winter” during the final presidential debate, is already using his bully pulpit to promote and reinforce a culture of mask wearing. If he is elected, he will almost certainly do more.

Mr. Biden has already said that, as president, he would mandate masks on all federal property, an executive order that could have wide reach. He could use his authority under federal transit law to require masks on public transportation. He could also prod governors who are resisting mask mandates to at least require masks in public buildings in their states.

But that is delicate political terrain in the United States, where Mr. Trump has turned the act of wearing a mask — or not wearing one — into a political statement. Public health and legal experts say it would be far better for Mr. Biden — or Mr. Trump, for that matter — to use his powers of persuasion to convince Americans that covering one’s face to protect against disease is a patriotic or civic-minded action.

“Instead of making it about the president’s coercive authority under law it should be about whether the president can support a norm that supports public health, which is in people’s self interest,” said Harold Koh, a law professor at Yale University and an expert in national security and human rights.

Experts say the scientific evidence is growing that face masks can considerably reduce the transmission of respiratory viruses like the one that causes Covid-19. Even when mask wearing does not prevent infection, it can reduce the severity of disease by diminishing the intensity of a person’s exposure to the virus. Research also shows that states that have passed mask mandates have had lower growth rates of Covid-19, beginning on the day the mandate was passed.

Even so, any hint of a sweeping federal requirement would “go over like a lead balloon,” and “divide and harden areas of the country in opposition,” said Joel White, a Republican strategist with expertise in health policy. Mr. White said the Trump administration’s policy, of letting state and local leaders decide about masks, is “a far better way to go.”

But that has not produced the kind of compliance that public health experts say is necessary to reduce the spread of the virus. As of last week, 33 states and the District of Columbia required mask-wearing in public, according to a list compiled by AARP. But in certain parts of the country, especially heavily Republican states, resistance is deep — even when cases are soaring.

Health care workers at a hospital in the Czech Republic. Members of the National Guard have flown from the United States to the Czech Republic to help.
Credit…Petr David Josek/Associated Press

In Belgium, all nonessential hospital work has been postponed to deal with an influx of new Covid-19 patients, whose numbers have nearly doubled in the past week, matching levels seen in the first wave of the pandemic in the spring.

Croatia has asked former doctors to come out of retirement to help in hospitals, while National Guard troops have flown from the United States to the Czech Republic to assist overwhelmed health care professionals there.

In the Netherlands, new coronavirus patients have had to be transferred by helicopter to Germany to relieve Dutch intensive-care units.

Across Europe, hospitals are filling up at an alarming pace that harks back to the darkest hours of the first wave of the pandemic in the spring. The authorities are scrambling to slow the spread of a virus that threatens to bring ailing health care systems to the brink of collapse.

Worldwide, more than 500,000 cases were tallied on Wednesday, a record since the start of the pandemic. All 20 countries with the highest rates of new cases over the last week are in Europe. Britain, France, Italy and Spain were among the countries that recorded their highest death tolls in months.

In announcing a new nationwide lockdown in France on Wednesday, President Emmanuel Macron predicted that the second wave of the virus would be more deadly than the first.

In France, one million people are currently estimated to be infected with the coronavirus, and 2,000 new patients are hospitalized every day, according to government data, the highest numbers in the country since mid-April. Doctors have warned that hospitals won’t hold in the winter if the virus can’t be stemmed, and Mr. Macron bluntly said on Wednesday that if France couldn’t put the brakes on the pandemic, doctors would soon have to choose which Covid-19 patients to save.

In Germany, as hospitalizations have doubled in the past 10 days and nearly 1,500 patients are in intensive care, Chancellor Angela Merkel announced new lockdown measures on Wednesday as she vowed to avoid “situations that are extremely difficult.”

Exhausted health care workers and other epidemics, like the flu, that arrive in winter have led authorities to warn that the worst is yet to come. While in Western Europe, the fear of overwhelmed hospitals brought a feeling of déjà-vu from the first wave in the spring, countries in Central and Eastern Europe, which escaped the first wave relatively unscathed, have faced a frighteningly new situation.

Countries like the Czech Republic and Poland imposed tough restrictions in the spring and saw lower infections rates, but soaring cases this fall have laid bare a critical shortage of nurses, doctors, and intensive care beds. In Bulgaria, scores of health care professionals are falling ill with the virus, and an acclaimed doctor became the 19th medical professional there to die of the virus earlier this month. In the Czech Republic, where cases are rising at one of the fastest paces in Europe, Prime Minister Andrej Babis has warned that the country’s health care system could collapse before mid-November.

“What happened was somehow predicted but nobody expected its scope,” Mr. Babis said after declaring a second national lockdown.


Gov. Steve Bullock wore a mask as he spoke to reporters in late July. Some local officials in the state have defied his statewide mask-wearing order. 
Credit…Thom Bridge/Independent Record, via Associated Press

The virus is spreading at a swift pace across Montana, one of the Great Plains and Mountain West states that have been reporting major surges in new virus cases. The state ranks fourth in the country for the number of new cases relative to its population — about 70 cases per 100,000 residents — based on a seven-day average, compared to about 23 per 100,000 nationwide, according to a Times database.

Residents in some parts of Montana are defying a state mask mandate in the name of individual rights. And hospitalizations are up significantly, according to the Covid Tracking Project, which reports a nearly 100 percent increase between Oct. 3 and Oct. 28. With the spike in cases, health care officials across the state have been bracing for a strain on the system.

Montana is having a moment, but not the kind of #MontanaMoment that the state’s tourism bureau promoted in 2018. The state website for tourism and business promotion has a new slogan, “Montana Aware.”

In some ways, the state offers a snapshot of America less than a week from Election Day: divided along political lines and struggling to contain daily case counts that are running higher than at any time since the pandemic began.

Though the state is heavily Republican, it has competitive races this year for governor and for Senate. And President Trump, who won the state by 20 points in 2016, has seen his lead dwindle to single digits over his opponent, Joseph R. Biden Jr., in recent polls.

A Montana State University poll released earlier this month found that Democratic and independent voters are more concerned about health issues and support preventive measures like wearing masks in public.

“If you combine that with the dissatisfaction with the direction of the country, I would argue that this benefits Democratic candidates — especially in a higher turnout election environment,” said David C.W. Parker, one of the university professors who conducted the survey.

Gov. Steve Bullock, a Democrat now running for Senate, mandated that people wear face coverings in public spaces across the state to help slow the spread of the virus. But some local officials have defied the order, creating a patchwork of precautionary measures — sometimes varying within a single block.

Mike Cooney, the Democratic candidate for governor, is pro-mask mandate and is most often seen publicly wearing a mask, while the Republican candidate, Greg Gianforte, was recently criticized for hugging supporters without wearing a mask after he attended a concert that has since been linked to new virus cases.

A recent report prepared for the White House urged more precautions for the state, which the federal government has categorized in the “red zone” for cases.

“Given extent of transmission, Montana should limit bar and gym hours and urgently enforce face mask, occupancy restrictions, and social distancing policies in all counties,” said the report, which was dated Oct. 25.

Elsewhere in the United States:

  • Mayor Martin J. Walsh of Boston said on Thursday that city employees would get one paid hour off every two weeks, during normal work shifts, to get tested for the virus. The move is part of a new campaign, called “Get the Test Boston,” intended to encourage testing. The share of coronavirus tests coming back positive in Boston increased to 7.8 percent, from 6.2 percent a week earlier.

  • For a month beginning in November, United Airlines will test passengers over the age of 2 for the coronavirus before they board certain flights at Newark Liberty International Airport bound for Heathrow Airport in London. The trial program is intended to help persuade government officials that testing could be a crucial part of reopening international travel. Passengers will have to test negative to board the flights. Anyone who tests positive will be isolated and asked to get in touch with their health care provider, and the airline will help them rebook a flight for a later date.

A ninth-grade student who received a false negative result to a required coronavirus test triggered a super-spreading event that infected three-quarters of the 152 students, counselors and staff who attended a faith-based overnight summer school retreat in Wisconsin in July and August.

The illnesses were mild, and none required hospitalization, according to a description of the outbreak in a new report from the Centers for Disease Control and Prevention that was released on Thursday. The report did not identify the religious organization that sponsored the retreat, or say where in Wisconsin it took place.

The people who attended the boys’ retreat came from 21 states and territories and two foreign countries. They were required to provide either documentation of a positive test result for antibodies to the coronavirus that causes Covid-19, within the past three months, or proof of a negative result to a diagnostic test taken within a week of departing for the retreat. They were also asked to quarantine within their households for a week before the trip, and told to wear masks while traveling.

Once they were at the retreat, however, only the teachers observed social distancing and wore masks during classes. The students and counselors were not required to do so, and mixed freely.

Classes were held outside but students were seated less than six feet apart, and they slept in dormitories, four to six in a room, and in yurts, with up to eight in a room. Counselors also roomed together in dormitories and yurts. Only the teachers resided in separate housing units.

The ninth grader who was the index patient, and who had tested negative, developed a sore throat, cough and chills two days after arriving, and soon found out that a family member had just tested positive. Although he was quickly isolated and 11 of his close contacts were briefly quarantined, the virus spread. Ultimately at least 116 people at the retreat tested positive for the virus.

Among those who tested negative for the virus were 24 attendees who had previously been exposed to the virus and had antibodies before arriving at the retreat. The C.D.C. report notes that “evidence to date is insufficient to determine whether the presence of detectable antibodies indicates protective immunity, or how long such immunity might persist.”

The four staff members also tested negative, although one did develop symptoms of the illness and was classified as a probable case.

Health care workers performed C.P.R. on a Covid-19 patient at a hospital in Houston this summer.
Credit…Callaghan O’Hare/Reuters

In April, the coronavirus killed more than 10,000 people in New York City. By early May, nearly 50,000 nursing home residents and their caregivers across the United States had died.

But as the virus continued its rampage over the summer and fall, infecting nearly 8.5 million Americans, survival rates, even for seriously ill patients, appeared to be improving. At a New York hospital system where 30 percent of coronavirus patients died in March, the death rate had dropped to 3 percent by the end of June.

Doctors in England observed a similar trend. “In late March, four in 10 people in intensive care were dying.” said John M. Dennis, a University of Exeter Medical School researcher. “By the end of June, survival was over 80 percent.”

Though the virus has been changing slowly as it spreads, most scientists say there is no solid evidence that it has become either less virulent or more virulent.

As older people took greater precautions to avoid infection, however, more of the hospitalized patients were younger adults, who are generally healthier and more resilient. By the end of August, the average patient was under 40.

Were the lower death rates simply a function of the demographic changes, or a reflection of advances in treatment that blunted the impact of the new pathogen?

Researchers at NYU Langone Health zeroed in on this question, analyzing the outcomes of more than 5,000 patients hospitalized at the system’s three hospitals from March through August. They concluded the improvement was real, not just the result of a younger patient pool.

Even when they controlled for differences in the patients’ age, sex, race, underlying health problems and severity of Covid symptoms — like blood-oxygen levels at admission — they found that death rates had dropped significantly, to 7.6 percent in August from 25.6 percent in March.

A combination of factors contributed to the improved outcomes of hospital patients, experts said. As clinicians gained more experience with the disease, they became better able to manage it, incorporating the use of steroid drugs and non-drug interventions.

Researchers have also credited heightened community awareness. Patients are seeking care earlier in the course of their illness. And outcomes may also have improved as the load on hospitals lightened and there was less pressure on the medical staff.

“We don’t have a magic bullet cure, but we have a lot, a lot of little things, that add up,” said Dr. Leora Horwitz, director of NYU Langone’s Center for Healthcare Innovation & Delivery Science. “We understand better when people need to be on ventilators and when they don’t, and what complications to watch for, like blood clots and kidney failure.”

Once doctors became aware of the clotting risk, they began to quickly put patients on blood thinners when necessary.

Another problem in the spring was that as hospitals in hard-hit areas like New York City became overwhelmed, doctors who hadn’t worked in critical care for many years were being drafted to care for seriously ill patients. Nursing departments, meanwhile, were short-staffed, and equipment was in short supply.

Medical experts worry that the surges in cases around the country could roll back the improvements in mortality rates. The number of hospitalized Covid patients has increased by 40 percent over the last month, and more than 41,000 patients are now hospitalized in the United States.

Gilead Sciences, the manufacturer of remdesivir, has taken in more than $800 million from the drug so far this year.
Credit…Mike Blake/Reuters

The United States reached a milestone, of sorts, when last week the Food and Drug Administration approved the first treatment for Covid-19: Veklury, better known by its scientific name, remdesivir.

But the F.D.A.’s decision to grant the drug full approval — which means its manufacturer, Gilead Sciences, can begin marketing it broadly to doctors and patients — has puzzled several outside experts. They say that it may not deserve the agency’s stamp of approval because it is, at best, a mediocre treatment for the disease caused by the coronavirus.

One large, government-run trial found that the drug shortens patients’ recovery times, but the two other studies the F.D.A. used to justify its approval — sponsored by Gilead — did not compare the treatments with a placebo, the gold standard for evaluating a drug. No studies have shown that it significantly lowers death rates. And a large study sponsored by the World Health Organization found that remdesivir provided no benefit to hospitalized patients.

Experts have also questioned whether Gilead deserves to pocket potential billions from the drug when the government has played a significant role in its development. On Wednesday, the company said that remdesivir, which has been authorized for emergency use since the spring, had brought in $873 million in revenue so far this year.

“The F.D.A. doesn’t exist to give monetary prizes to drug companies,” said Dr. Peter B. Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center. “The F.D.A. exists to help inform doctors as to what drugs they should give patients in front of them today.”

Health officials say it is more important than ever to get a flu vaccine this year.
Credit…Cj Gunther/EPA, via Shutterstock

A health care worker in Solano County, Calif., is recovering after being simultaneously infected with both influenza and the coronavirus.

Citing patient confidentiality, health officials disclosed few details about the patient, including age or gender. They said the patient was between the ages of 20 and 65, works in the health care industry and has no other co-morbidities.

It is unclear whether this is the first case of influenza and coronavirus co-infection in the United States this flu season, but it may well not be the last, given the arrival of flu season in the midst of a raging pandemic. Health officials have warned that the nation might be confronted with what some call a “twindemic.”

Solano County, which sits roughly between Sacramento and the Bay Area, was also the site of the country’s first reported case of coronavirus transmitted through community infection. That occurs when someone is infected despite having had no known contact with anyone else who was infected or who had traveled overseas.

Dr. Bela T. Matyas, Solano County’s health officer, had been keeping in close contact with all health care and residential facilities in Solano County to spot possible outbreaks, and was able to quickly verify the community infection case when it happened in February. Then, in mid-October, Dr. Matyas directed that all people who show flulike symptoms in the county be tested for both influenza and the coronavirus.

“The very same people who are at risk of a bad outcome for Covid are also the ones at risk of a bad outcome from flu,” Dr. Matyas said in an interview. “And having them at the same time, or one right after the other, greatly increases the likelihood of a severe outcome.” ”

For Solano County, the case reported Thursday was not just the first known co-infection. It was also the first confirmed flu infection this season.

“The whole point of this is to remind our community that flu is now present and people really need to get vaccinated for flu as quickly as possible, especially those people who are 65 and over, or who have underlying health conditions,” Dr. Matyas said.

The patient became infected through contacts with friends and family members, not at work, according to Dr. Matyas. The patient began having symptoms last week, he said, tested positive over the weekend, and is now recovering in isolation.

“In our county, over the past four months, over 95 percent of the cases where we are able to identify a source have been exposed when they let their guard down during family and social gatherings,” Dr. Matyas said. “People wrongly assume that family and friends are safe, and so they don’t do social distancing with them, but that’s where most of the spread is occurring.”




Pelosi ‘Very Confident’ Biden Will Win

Speaker Nancy Pelosi said on Thursday that she had already made preparations for the Democratic nominee’s presidency.

I feel very confident that Joe Biden will be elected president on Tuesday, whatever the end count is. But on the election that occurs on Tuesday, he will be elected. On Jan. 20, he will be inaugurated president of the United States. So while we don’t want to be overconfident or assume anything, we have to be ready for how we are going to go down a different path. We’ve come to a fork in the road when it comes to the coronavirus. The president has taken us on a deadly path. The Heroes Act takes us on a scientific path to help save the lives, the livelihood and the lives of the American people. This weekend should be very interesting to see how many more people will vote in advance. I hope that people will not depend on the mail because they have done all they can to dismantle the postal system. But I salute our postal workers, our letter carriers and those who are making the best of the situation. But even the Postal Service is saying it’s too late now to mail. Well I want, I want a bill for two reasons. First and foremost, the American people need help, they need real help. And second of all, we have plenty work to do in the Joe Biden administration. We’re going to build the infrastructure of America in a green way.

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Speaker Nancy Pelosi said on Thursday that she had already made preparations for the Democratic nominee’s presidency.CreditCredit…Anna Moneymaker for The New York Times

Speaker Nancy Pelosi said on Thursday that she wanted to reach a deal on an economic relief bill during Congress’s lame-duck session after the election to clear the decks for a Joseph R. Biden Jr. presidency, expressing optimism that a deal could be done despite months of faltering negotiations.

“I want a bill for two reasons,” Ms. Pelosi, a California Democrat, said at her last news conference before the election on Tuesday. “First and foremost, the American people need help, they need real help. Second of all, we have plenty to do in a Joe Biden administration.”

Hours earlier, she had written to Treasury Secretary Steven Mnuchin, requesting a response to key differences in the stumbling relief talks as small businesses continue to struggle and millions of Americans remain out of work because of the coronavirus pandemic.

“Your responses are critical for our negotiations to continue,” Ms. Pelosi told Mr. Mnuchin.

On Thursday afternoon, Mr. Mnuchin shot back with a letter of his own to Ms. Pelosi, accusing her of a “political stunt.”

“I woke up this morning and read your letter to me in the press,” Mr. Mnuchin wrote. “Because you sent it to my office at midnight and simultaneously released it to the press, I can unfortunately conclude that it is a political stunt.”

Mr. Mnuchin noted that he had spoken to Ms. Pelosi almost daily for the last 45 days and accused her of mischaracterizing the status of their negotiations.

The list of unresolved issues include Democrats’ demand for aid to state and local governments, the amount of funding for schools and child care, and the terms of a national coronavirus testing plan that Ms. Pelosi has long sought.

Despite Ms. Pelosi’s wishes, lawmakers and the administration are unlikely to be able to reconcile their differences quickly, particularly given widespread concern among conservatives on Capitol Hill about the scope and size of the package.

Ms. Pelosi, however, has continued to insist that Mr. Mnuchin, the lead negotiator for the White House, agree to final language on a number of issues and respond to Democratic demands.

Ms. Pelosi said Mr. Mnuchin had yet to agree to final testing language, despite his declaration this month that “we’ll fundamentally agree with their testing language.”

In her letter, Ms. Pelosi said, “The president’s words that ‘after the election, we will get the best stimulus package you have ever seen’ only have meaning if he can get Mitch McConnell to take his hand off the pause button and get Senate Republican chairmen moving toward agreement with their House counterparts.”

She was referring to Senate Republicans’ public objections to the nearly $2 trillion framework. Mr. McConnell, the majority leader, has privately counseled the White House to hold off on agreeing to a deal until after the election.

Mr. Mnuchin said that the Trump administration had offered reasonable compromises on several fronts and that Ms. Pelosi had held up legislation that would allow the government to support airlines and small businesses and offer additional stimulus payments with unused funds from the last relief package.

“Your ALL OR NONE approach is hurting hardworking Americans who need help now,” Mr. Mnuchin wrote.

Officials say the hackers targeting American hospitals are affiliated with the same group that targeted a health network in a ransomware attack last month.
Credit…Raphael Satter/Reuters

Hundreds of American hospitals are being targeted in cyberattacks by the same Russian hackers who American officials and researchers fear could sow mayhem around next week’s election.

The attacks on American hospitals, clinics and medical complexes are intended to take those facilities offline and hold their data hostage in exchange for multimillion-dollar ransom payments, just as coronavirus cases spike across the United States.

“We expect panic,” one hacker involved in the attacks said in Russian during a private exchange on Monday that was captured by Hold Security, a security company that tracks online criminals.

Some hospitals in New York State and on the West Coast reported cyberattacks in recent days, though it was not clear whether they were part of the attacks, and hospital officials emphasized that critical patient care was not affected.

The Russian hackers, believed to be based in Moscow and St. Petersburg, have been trading a list of more than 400 hospitals they plan to target, according to Alex Holden, the founder of Hold Security, who shared the information with the F.B.I. Mr. Holden said the hackers claimed to have already infected more than 30 of them.

On Wednesday, three government agencies — the F.B.I., the Department of Health and Human Services and the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency — warned hospital administrators and security researchers about a “credible threat” of cyberattacks to American hospitals, according to a security executive who listened to the briefing.

Officials and researchers did not name the affected hospitals, but Sonoma Valley Hospital in California said it was still trying to restore its computer systems after an intrusion last week. St. Lawrence Health System in New York confirmed that two of its hospitals, Canton-Potsdam and Gouverneur, were hit by ransomware attacks Tuesday that caused them to shut down computer systems and divert ambulances. Sky Lakes Medical Center in Oregon was also crippled by a ransomware attack Tuesday that froze electronic medical records and delayed surgeries, a hospital representative said.

It was unclear whether those attacks were related to the hacking campaign underway. But the latest breaches were linked to the same Russian hackers who held Universal Health Services, a giant network of more than 400 hospitals, hostage with ransomware last month in what was then considered the largest medical cyberattack of its kind.

In Bellinzona, Switzerland, this week. The country has announced new coronavirus restrictions.
Credit…Alessandro Crinari/Keystone, via Associated Press

A day after France and Germany opted for severe coronavirus restrictions, Switzerland on Thursday took steps to try to control its own growing outbreak, imposing tighter controls on social gatherings, closing nightclubs and imposing an 11 p.m. closing time for bars.

For the moment, restaurants, shops and businesses will be allowed to remain open in a strategy that the home minister, Alain Berset, described as “a middle path” designed to limit the economic impact of the pandemic.

The new measures came as Switzerland recorded its highest number of daily cases since the start of the pandemic. The nation of eight million has reported an average of 6,271 new daily cases over the past week and has reported 1,985 total deaths.

The high rates of new cases in Switzerland led the authorities to reduce the number of countries from which arriving travelers must quarantine. The list, which includes countries with a higher per capita rate of infection than Switzerland’s, featured more than 60 countries earlier this month. The list released on Wednesday included only four European countries — Andorra, Armenia, Belgium, and the Czech Republic — and three regions of France, including Paris.

The Swiss authorities also limited public gatherings to 50 people, sports and cultural activities to 15 people, and private family gatherings to 10.

“If it’s not possible to get the virus under control, then other measures are possible,” Mr. Berset told a news conference in the capital, Bern.

In Greece, after a new spike in cases, Prime Minister Kyriakos Mitsotakis said on Thursday that he would announce a one-month action of “targeted restrictions” on Friday aimed at averting a second nationwide lockdown.

Three more regions will be locked down, Mr. Mitsotakis said: the country’s second-largest city of Thessaloniki as well as Rhodope, also in the north, and Larissa in central Greece. They will join four northern regions that have been locked down this month. Schools and retail stores will remain open, Mr. Mitsotakis said.

Greece initially did well in controlling the spread of the virus, but daily cases have been rising recently, entering four digits this week. By Wednesday, the country had recorded 34,299 cases and 603 deaths.

In Germany, Chancellor Angela Merkel on Thursday explained the necessity and details of the country’s monthlong partial lockdown. “The measures we are now taking are appropriate, necessary and proportionate,” she told lawmakers in a 25-minute speech that was repeatedly interrupted by heckling by members of the far-right party Alternative for Germany, or AfD.

“Lies and disinformation, conspiracy and hatred damage not only the democratic debate but also the fight against the virus,” she said.

The parliamentary head of the AfD called the new rules a “corona dictatorship” and said: “We consider the paralysis of the cultural sector, the gastronomy, and practically the entire leisure life of the citizens, as announced by Ms. Merkel, to be excessive and inappropriate.”

Germany has been averaging about 12,700 cases a day in the past week.

In Spain, ahead of a long holiday weekend, most regions announced travel restrictions that would prevent about 80 percent of the country’s 47 million residents from visiting other parts of the country.

Pope Francis greeting people at his weekly general audience at the Vatican on Wednesday. He will once again begin holding the sessions virtually, the Holy See announced on Thursday.
Credit…Yara Nardi/Reuters

In another sign that Europe is going back into crisis mode, Pope Francis will return to holding his weekly general audiences virtually from the library of his Apostolic Palace, the Holy See announced on Thursday.

The decision came after a participant in last week’s audience tested positive for the coronavirus, and was “aimed at avoiding any possible future risk for the health of the participants,” the statement read.

Worshipers only recently began participating in the audiences, which over the summer took place in a Vatican courtyard with a more limited number of attendants as compared to St. Peter’s Square, its traditional venue before the pandemic. But through the beginning of fall, the audiences were held indoors, in a large auditorium inside the Vatican.

The Vatican and its few residents were not spared during the first wave of the pandemic last spring, and the virus is circulating there again, like in the rest of Europe. Earlier this month, a person living in the Casa Santa Marta, the Pope’s residence, tested positive for the virus and left the guesthouse. Three other citizens of the Vatican had already been quarantined, as well as 13 Swiss Guards.

Italy hit a record number of daily cases on Wednesday: nearly 25,000, according to a Times database. Deaths are once again climbing after falling to low numbers over the summer, with 205 recorded on Wednesday.

The Los Angeles Unified School District, the country’s second-largest system, will probably not bring students back into classrooms until at least January, two members of the Board of Education said on Thursday.

The state requires a county to have no more than seven new daily cases per 100,000 people for two weeks before schools can fully reopen. In Los Angeles County, the daily case number is now about 18, and it has been climbing.

The president of the school board, Richard Vladovic, said that even if infections started declining soon, it would not make sense to reopen schools just as the holidays are about to begin. The news was first reported by The Los Angeles Times.

With the current county case numbers, Los Angeles schools are allowed to bring up to a quarter of students back onto campus, and can seek waivers to bring back all students in prekindergarten through second grade. But the district has not pursued those options.

Katie Braude, chief executive officer of Speak Up, a group that advocates for educational equity, said the district’s hands were tied because it had agreed with the teachers’ union that no teachers would be required to come back in person until schools were reopened for all students. The agreement expires on December 31.

Ms. Braude said the district, which has over 600,000 students, had done a lot of work to make the return to school safe, setting up an ambitious testing system for students and the staff and replacing ventilation systems.

“It’s just kind of ironic that the district has really gone out of its way on that front and they’re still not able to get kids back on campus who really need to be on campus,” she said, adding that “these kids are all losing out, and these are the kids who are already falling behind.”

The vice president of the Board of Education, Jackie Goldberg, said that even January was optimistic.

“It may be February or March,” she said.

And at that point, she said, the question may be whether it is worth starting in-person instruction if many children have to change teachers that late in the year.

The district has said that when it does reopen, it will use a hybrid model, in which students cycle between going to school buildings and learning at home.

Gross domestic product, adjusted

for inflation and seasonality, at

annual rates

Gross domestic product, adjusted for inflation

and seasonality, at annual rates

U.S. economic output grew at the fastest pace on record last quarter as businesses began to reopen and customers returned to stores. But the economy has climbed only partway out of its pandemic-induced hole, and progress is slowing.

Gross domestic product grew 7.4 percent in the third quarter, the Commerce Department said Thursday. The gain, the equivalent of 33.1 percent on an annualized basis, was by far the biggest since reliable statistics began after World War II; the previous record was a 3.9 percent quarterly increase in 1950.

Still, the economy in the third quarter remained 3.5 percent smaller than at the end of 2019, before the pandemic began. By comparison, G.D.P. shrank 4 percent over the entire year and a half of the Great Recession a decade ago.

The report was the last major piece of economic data before the presidential election on Tuesday. President Trump hailed the big gain as evidence that the economy had roared back to life after the spring’s pandemic-induced shutdowns.

But economists said the third-quarter figures revealed less about the strength of the recovery than about the severity of the collapse that preceded it. G.D.P. fell 1.3 percent in the first quarter and 9 percent in the second as the pandemic forced widespread business closures. A big rebound was inevitable once the economy began to reopen. The challenge is what comes next.

“The reason we had such a big bounce is that the economy went from closed to partially open,” said Michelle Meyer, head of U.S. economics at Bank of America. “The easy growth was exhausted, and now the hard work has to be done in terms of fully healing.”

Already, there are signs that the recovery is losing steam. Industrial production fell in September and job growth has cooled, even as a growing list of major corporations have announced new rounds of large-scale layoffs and furloughs. Most economists expect the slowdown to worsen in the final three months of the year as virus cases rise and federal aid to households and businesses fades.

“We’re having a record recovery, but it comes after an even more record collapse, and it looks like economic momentum is fading in the fourth quarter,” said Jim O’Sullivan, chief U.S. macro strategist for TD Securities.

In Amsterdam this month. Many people in the Netherlands had returned to bars, restaurants and beaches after a nationwide lockdown was lifted this summer.
<div><span> </span></div>
Credit…Ilvy Njiokiktjien for The New York Times

The Netherlands, one of Europe’s wealthiest countries, is renowned for its efficient and organized government in most circumstances — but not, apparently, in the pandemic.

As a second wave of the coronavirus surfaces across Europe, the Netherlands stands out with Belgium and the Czech Republic as among the hardest hit. It currently ranks sixth among European Union countries when it comes to the rate of new infections, with 56 cases per 100,000 inhabitants — its highest total ever.

The infection numbers keep rising, to a record 10,346 new cases on Monday in a country of 17 million people — one-19th the size of the United States, which is reporting in the neighborhood of 75,000 new cases a day. And it is hard to keep track of the true toll, with the country’s official data incomplete because of technical errors.

Last week, new coronavirus patients had to be transferred by helicopter to Germany to relieve Dutch intensive-care units.

After weeks of taking incremental steps to curb the spread of the virus, the government announced on Oct. 14 that, in addition to the new rules on face masks, all bars and restaurants would close for at least four weeks. With infections still rising, the authorities are considering establishing an evening curfew to keep people indoors, or even a two-week “circuit breaker” lockdown.

For the Dutch, who generally regard their country as one of the best run in the world — with at times an undertone of superiority — the level of institutional chaos has been a hard reckoning.

“It’s shocking really. I always thought we were one of the best countries in the world, best organized,” said Rob Elgersma, 18, an agriculture student. “But now, they have the ability to fix things but can’t get their act together. What happened to us?”

That’s a question a lot of Dutch people are asking right now.

Dignity GoHealth workers run&nbsp;Abbott ID Now rapid tests for United Airlines passengers in San Francisco. United is hoping expanded testing can help reopen international travel.
Credit…Jeff Chiu/Associated Press

For a month, beginning in November, United Airlines will test passengers over the age of 2 for the coronavirus on select flights from Newark Liberty International Airport to Heathrow Airport in London, in a trial intended to help convince government officials that testing could be a crucial part of reopening international travel.

United will administer the rapid molecular Abbott ID Now virus test to people flying between Nov. 11 and Dec. 11 on Flight 14, departing at 7:15 p.m. on Mondays, Wednesdays and Fridays from Newark. Everyone hoping to be on those flights will have to test negative for the coronavirus to board the plane. Those who test positive will be isolated and asked to get in touch with their health care provider, and the airline will help them book a flight for a later date. People who do not want to take the test will be moved to another flight.

“We believe the ability to provide fast, same-day Covid-19 testing will play a vital role in safely reopening travel around the world and navigating quarantines and travel restrictions, particularly to key international destinations like London,” said Toby Enqvist, chief customer officer for United. In September, international air arrivals to New York’s five regional airports were down 82 percent compared with September 2019, according to data from the Port Authority of New York and New Jersey.

People on the flights will have to make appointments to get tested, and the airline is advising them to plan to arrive at least three hours before a flight. The testing site at Newark will be in the United Club near Gate C93.

The pilot program is intended to make passengers feel comfortable traveling again, but it won’t replace practices like mask wearing, social distancing and protocols for boarding and deplaning that have become mandatory in recent months. Passengers will still have to follow quarantine rules when they arrive in London.

The test comes on the heels of United and other airlines offering coronavirus testing to people traveling from mainland states to Hawaii, where those with a negative test can skip the state’s 14-day quarantine. Travel industry experts believe that testing will make it possible for people to bypass quarantines and make it easier for international travel to begin again, and United’s leadership team hopes that the trial will lead to more testing at airports.

On Thursday in New York City, Mayor Bill de Blasio again cautioned residents against holiday travel, noting particular concern on Thursday about gatherings over the upcoming Halloween weekend. He reported that the citywide seven-day average rate of positive test results was 1.92 percent, “the first time that number has taken a meaningful jump.”

“That alone is not a number that would overwhelm us but the growth is what worries me,” the mayor said.

Dr. Jay Varma, a senior health adviser, also noted a “steady rise” in positive test results across the five boroughs. “The rise has been relatively slow but it hasn’t abated and that’s really what our concern is right now,” he said.


Migrant workers at a dormitory in Singapore in April.
Credit…Ore Huiying for The New York Times

Singapore is easing restrictions on hundreds of thousands of migrant workers who have largely been confined to their dormitories since last spring.

Under the new policy, which has been in trials for the past two months, workers who test negative for the coronavirus will be allowed to visit designated recreation centers on their days off starting Saturday. There must also be no active cases in their dorms.

The eight recreation centers across Singapore are central to the lives of the workers, who go there to buy groceries, get haircuts, wire money to their families back home and socialize with friends.

By means of a government smartphone app, workers who wish to leave their dorms will have to apply for permission and choose one of five three-hour slots between 8 a.m. and 11 p.m. There are a limited number of exit passes for each time slot.

The economy of Singapore, a country of almost six million people, is heavily dependent on more than 300,000 migrant workers, who hail largely from South Asian countries, including India and Bangladesh. They work in construction, shipbuilding, manufacturing and other sectors, earning about $400 or $500 a month. The pandemic has renewed longstanding questions in Singapore about inequality and how foreign workers are treated.

Early in the year, Singapore appeared to have largely brought the virus under control, thanks to extensive contact tracing and a partial national lockdown. But in April, after a surge in cases in the crowded dorms, the government imposed a much stricter lockdown that lasted until June 1. New infections began to be reported as separate tallies, one for foreign workers and one for “the local community.”

But even as stay-at-home orders were eased for Singapore’s other residents, migrant workers were barred from leaving their dorms and sometimes even their rooms except for work and essential errands. The confinement and the financial stress of job uncertainty have taken a heavy mental toll on the workers, with reports of suicides and attempted suicides. Government officials said keeping the dorms sealed off was necessary to reopen the economy.

All dorms were declared clear of the virus on Aug. 11, but new clusters emerged within weeks, delaying the easing of restrictions until now. Migrant workers account for about 95 percent of Singapore’s 58,000 total cases.

Kirsten Han, a Singaporean journalist and activist, said on Twitter in April that the country’s experience showed “that even if you do most things right, if you’re not considering or proactively looking out for the most vulnerable and marginalized in your society, you’re not going to effectively fight Covid-19.”

In other global developments:

  • After months of restrictions, international travelers from any country will be allowed into Costa Rica starting Nov. 1, as long as they are not displaying symptoms and have insurance to cover costs of any virus treatment or quarantine lodging during their stay. The move comes days after the country lifted a rule requiring a negative Covid-19 test for incoming air travelers. More than 15 percent of Costa Rica’s 160,000 coronavirus cases came from foreigners, according to its Department of Health. Initially, all Americans were blocked, and then only people from 23 states and the District of Columbia were allowed in.

  • Officials in India confirmed that the country had surpassed eight million cases of the coronavirus. The Ministry of Health reported 49,881 infections and 517 fatalities in the past 24 hours, raising the death toll to 120,527. India is the second country to break the eight-million mark after the United States.

  • Health officials in the Chinese region of Xinjiang on Thursday said 23 new cases of the coronavirus had been confirmed, which were all previously classified as asymptomatic cases. China does not include those who display no symptoms in its tally of confirmed infections, and this is the second consecutive day where all newly confirmed infections were linked to such known cases. The outbreak in Xinjiang began on Saturday, when a 17-year-old girl in a rural area outside Kashgar was found in regular testing to be an asymptomatic carrier, triggering widespread testing and travel restrictions.

  • The Marshall Islands reported its first coronavirus cases after two people who flew to a U.S. military base from Hawaii tested positive. The Pacific nation was among the last places in the world to have no reported cases.

  • Taiwan has gone 200 days without a locally transmitted case of the coronavirus, far longer than anywhere else in the world. The self-governing island of 23 million people last recorded a local case on April 12, with experts crediting tight border control, extensive contact tracing, strict quarantines and the widespread use of masks. Taiwan has had a total of 550 cases, the vast majority of them detected among people in quarantine after arriving from overseas, and seven deaths. A handful of countries, including New Zealand, Thailand and Vietnam, have come close to or surpassed 100 days without any local cases, only to experience new outbreaks.

Jennifer Jett and

Clemson quarterback Trevor Lawrence at a game against Syracuse last Saturday.
Credit…Pool photo by Ken Ruinard

Trevor Lawrence, the star quarterback at top-ranked Clemson and a leading contender for the Heisman Trophy, has tested positive for the coronavirus, his coach said Thursday night.

Tigers Coach Dabo Swinney said in a statement that Lawrence was “doing well with mild symptoms” but that he would miss Saturday’s home game against Boston College.

Perhaps more crucially for the race toward the College Football Playoff, Swinney did not say when Lawrence had tested positive or when he had developed symptoms — distinctions that could determine whether he would be eligible to play at No. 4 Notre Dame on Nov. 7.

Lawrence has been among the most electrifying signal callers in college football in recent years. He passed for more than 3,600 yards last season, when he steered Clemson back to the national championship game a year after it had won the title.

And just a few months ago, he was a leading figure in the #WeWantToPlay movement that urged college sports executives to mount a football season during the pandemic.

Last Friday, when Clemson’s athletic department most recently released data about its coronavirus testing, the university said seven of its student-athletes had tested positive over the previous week. That means that taking Lawrence’s infection into account, at least 138 Clemson student-athletes have tested positive since June 1.

The Lawrence announcement was just the latest development in a turbulent college football season marked by conferences’ shifting their decisions about whether to proceed and the postponement or cancellation of more than three dozen games involving Football Bowl Subdivision teams.

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