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As the science on masks’ effectiveness mounts, so does the U.S. debate on mandates.
As caseloads surge in many states, especially in the West and South, the debate over mask mandates continues, though evidence of their benefits has mounted substantially in recent months.
President Trump, who first wore a mask in public on July 11, said in a Fox News interview with Chris Wallace broadcast on Sunday that he was a “believer” in masks, but that he would not support a nationwide mask mandate: “I leave it up to the governors.”
The consistent message from the White House that virus restrictions be made at the local level has led to a patchwork of policies. More than half the states have issued mask requirements, but with many Americans feeling that mask orders impinge on individual freedom, some governors are holding out.
The issue dominated talk shows on Sunday.
Dr. Francis Collins, the director of the National Institutes for Health, called the politicization of face coverings “bizarre” in an interview on the NBC program “Meet the Press.” “Our best chance is for all of us to get together and do the right thing, and stop fighting so much about the divide between different political perspectives, which is just getting in the way,” Dr. Collins said.
Gov. Jared Polis of Colorado defended his decision to issue a statewide mask mandate that took effect Friday. New cases have been rising for a month, nearing the tallies during the peak of Colorado’s crisis in April, though deaths remain far lower. Mr. Polis, a Democrat, said on the ABC program “This Week” that it “was a really easy decision” after he saw data suggesting that local mask orders in his state were tied to lower case numbers.
Gov. Tate Reeves of Mississippi said that he would not issue a statewide mask order, even though cases and hospitalizations were soaring. “If I believed that was the best way to save lives in my state, I would have done it a long time ago,” Mr. Reeves, a Republican, said on the CNN program “State of the Union.” He said he preferred a “surgical approach,” with precautions varying county by county.
In Georgia, the Republican governor, Brian Kemp, has sued the Democratic mayor of Atlanta, Keisha Lance Bottoms, over virus policies in Atlanta that include a mask order. On the CBS program “Face the Nation,” she called the lawsuit “a blame game.”
On the ABC program “This Week,” Gov. Asa Hutchinson of Arkansas, a Republican, said he would not support a national mandate, though he issued a state ordinance on Thursday. He said he had waited because a mask mandate was “not popular” in his state. Arkansas has been averaging more than 660 cases daily, which is near the state’s peak level, according to a New York Times database.
Gov. Mike DeWine of Ohio, a Republican, said on “Meet the Press” that his state was heading in the “wrong direction” and that he would not rule out a mask order. While single-day tallies for new cases in Ohio averaged around 400 a month ago, they peaked on Friday, with 1,679 cases.
Representative Donna E. Shalala of Florida, a Democrat who was formerly the nation’s longest-serving Secretary of Health and Human Services, called on her state’s Republican governor, Ron DeSantis, to issue mask and stay-at-home orders. State health officials on Sunday reported more than 10,000 new cases for the fifth consecutive day. “We need to close down in Florida,” Ms. Shalala said on “This Week.” “We’ve asked the governor to do that. We’ve even asked him to do the simplest thing: That is to require masks for everyone.”
Frustrated by White House inaction, some Republican governors are beginning to go their own way.
Despairing over President Trump’s failure to contain the pandemic and his refusal to promote clear public-health guidelines, prominent figures in the Republican Party have broken with the White House in recent days on how to respond to the virus.
Some, concluding that the president may never play a constructive role in addressing the crisis, have decided that they must work around him, ignoring or even contradicting his pronouncements.
Republican leaders have split with Mr. Trump over issues like the value of wearing a mask in public and of heeding the advice of health experts like Dr. Anthony S. Fauci, whom the president and some aides have subjected to caustic personal criticism.
They appear to be spurred by several overlapping forces, including deteriorating conditions in their states, the president’s seeming indifference to the problem, and the approach of a presidential election in which Mr. Trump is badly lagging his presumed Democratic challenger, Joseph R. Biden Jr., in the polls.
Republican governors are now issuing orders that run counter to Mr. Trump’s demands. Some have been holding late-night phone calls among themselves to trade ideas and grievances; they have sought out partners in the administration, including Vice President Mike Pence, who, despite echoing Mr. Trump in public, is seen by governors as being far more attentive to the disaster.
“The president got bored with it,” David Carney, an adviser to the Texas governor, Greg Abbott, a Republican, said of the pandemic. His boss instead directs his requests to Mr. Pence, with whom he speaks two to three times a week, Mr. Carney said.
Europe thought it was ready. Pride was its downfall.
When European health ministers met in February to discuss the novel coronavirus emerging in China, they commended their own health systems and promised to send aid to poor and developing countries.
Barely a month later, the continent was overwhelmed. Officials once boastful about their preparedness were frantically trying to secure protective gear and materials for tests, as death rates soared in Britain, France, Spain, Italy and Belgium.
This was not supposed to happen. Many European leaders felt so secure after the last pandemic — the 2009 swine flu — that they scaled back stockpiles of equipment and faulted medical experts for overreacting.
But their pandemic plans were built on a litany of miscalculations. Though European leaders boasted of the superiority of their world-class health systems, they had weakened them with a decade of cutbacks.
When Covid-19 arrived, those systems were unable to test widely enough to see the peak coming. National stockpiles of medical supplies were revealed to exist mostly on paper, consisting in large part of “just in time” contracts with manufacturers in China. European planners overlooked the fact that a pandemic could disrupt those supply chains.
Britain most embodies Europe’s overconfidence. Prime Minister Boris Johnson was so certain of his country’s forecasts about the virus, records and testimony show, that he delayed locking down until two weeks after British emergency rooms began to buckle under the strain.
With the number of infections doubling every three days at the time, some scientists now say that locking down a week sooner might have saved 30,000 lives.
Government health workers sent out to care for Indigenous people in Brazil appear to have been spreading the virus among them instead.
More than 1,000 nurses and doctors with a health service known as Sesai, have tested positive for the virus as of early July. In at least six field offices, The New York Times found, the share of infected workers was above the Amazon region’s average of 8 percent.
The health workers were dispatched with neither adequate protective equipment nor access to enough tests. Their high infection rates suggests that “there were failures in the protection of health care workers at a critical moment, affecting teams that care for a highly vulnerable population,” said Felipe Tavares of the Federal Fluminense University.
More than 15,500 Indigenous Brazilians have been confirmed infected, including at least 10,889 living in protected territories, according to Instituto Socioambiental, a Brazilian nonprofit.
It is not possible to determine with certainty how many cases were introduced by health care workers. Some Indigenous people may have brought the virus into their communities after traveling to cities for supplies and emergency government aid. Illegal miners and loggers may also have exposed some communities.
In a statement, Sesai said reports that health workers had exposed Indigenous people to the virus were “inconclusive.” It said its employees were outfitted with protective equipment. “All this planning and early research led to timely and efficient care that was delivered in villages,” the statement said.
Several Sesai workers who spoke to The Times on condition of anonymity, fearing retaliation, described an exceptionally challenging mission marked by poor guidance, mistrust from many Indigenous communities and a scarcity of tests.
Enoque Taurepang, the coordinator of the Indigenous Council of Roraima, said doctors and nurses had been set up for failure. “You can’t blame health professionals, because they didn’t have the tools necessary to act,” he said.
The leader of Hong Kong, Carrie Lam, said Sunday that the city had recorded more than 100 new cases in the past 24 hours, the most since the pandemic took hold in late January. “The situation is very serious and there is no sign of it coming under control,” Ms. Lam said. Hong Kong suspended nonessential government services and told most civil servants to work from home from this week.
Turkey has suspended flights to Iran and Afghanistan in response to infections in those countries, its Transport Ministry said. President Hassan Rouhani of Iran said on Saturday that some 25 million Iranians may have been infected, and Iran reimposed restrictions in the capital and elsewhere. The figure, from a report Mr. Rouhani cited in a televised speech, was far higher than Saturday’s official figure for infections of 271,606.
Face coverings will be required in Melbourne, Australia’s second-largest city, whenever people leave home, officials there said on Sunday, citing a recent increase in cases. The requirement will take effect on Wednesday. Violations could result in a fine of 200 Australian dollars, or roughly $140.
Chinese officials are battling a growing outbreak in the far western Xinjiang region, the center of the country’s broad crackdown on predominantly Muslim ethnic minorities. Thirty confirmed infections have been reported in its capital, Urumqi, since Thursday, 13 of them on Sunday; there are an additional 41 asymptomatic infections.
European Union leaders held a third day of acrimonious negotiations on Sunday, but there was no sign that a deal was imminent on a stimulus package involving more than 750 billion euros, or $840 billion. Most E.U. countries are keen to see the plan move ahead, but some, mostly from the wealthier northern part of Europe, are loath to allow the money to make up for what they see as southern Europeans’ failure to adequately protect their economies.
With English hospitals operating at pandemic-reduced capacity, nearly four million people are on the National Health Service waiting list for routine hospital treatments that have been disrupted as hospitals have been forced to suspend services in favor of treating coronavirus cases. The waiting list could soar to 10 million people by the end of the year, according to the N.H.S. Confederation, which represents hospitals and other health care providers, though the service rejects that estimate.
The Bahamas, one of the places where Americans could still travel, will now bar commercial flights or vessels from the United States, the country’s prime minister announced on Sunday. The government-owned airline, Bahamasair, will also cease flights to the U.S. “effective immediately,” said the prime minister, Hubert Minnis. The ban does not include commercial flights to Canada, the United Kingdom, the European Union, or “private international flights,” he said.
Despite claiming to have no cases of Covid-19, North Korea says its scientists are developing a vaccine for the virus. In claims that cannot be verified, a propaganda website said that the vaccine’s safety had been verified through animal experiments and that it had entered a clinical trial. The reclusive nation’s public health system remains woefully underequipped, and international relief agencies have been providing test kits and other assistance to help the country fight the spread of the coronavirus.
Testing delays are complicating efforts to slow the spread of the virus.
As demand for coronavirus testing surges around the nation, laboratories that process samples have backlogs that have left anxious patients waiting days — and sometimes a week or more — for their results.
Dr. Francis Collins, the director of the National Institutes of Health, acknowledged the dangers associated with such delays in an interview on the NBC program “Meet the Press.”
“The average test delay is too long,” Dr. Collins said. “That really undercuts the value of the testing, because you do the testing to find out who’s carrying the virus, and then quickly get them isolated so they don’t spread it around. And it’s very hard to make that work when there’s a long delay built in.”
On the CBS program “Face the Nation,” Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said that “once testing is delayed more than 48 hours, it becomes not very useful.”
The longer it takes for people to determine whether they’ve been infected, Dr. Gottlieb said, the more difficult it will be to curb the spread of disease and drive new-case numbers down.
To speed turnaround times, Dr. Collins said, health officials are pushing for more point-of-care testing — “on the spot” assays designed to be done rapidly and easily without the need for specialized laboratory equipment or highly trained personnel.
Some of these tests could be completed in a doctor’s office, or perhaps even at home, in less than an hour. Simple, speedy tests could be a boon for institutions and communities that care for large numbers of vulnerable people, like nursing homes. A handful of point-of-care tests have been approved for emergency use by the F.D.A.
“We need to invest a lot of money, and the government is willing to do so, in scaling those up,” Dr. Collins said. “That’s the kind of thing that I personally, along with many others in other parts of the government, are working on night and day to try to do a better job of.”
Several Chinese companies are using Uighur labor to make masks, a Times visual investigation finds.
As companies across China rush to produce personal protective equipment amid the pandemic, a New York Times visual investigation has found that some of them are using Uighur labor through a contentious government-sponsored program that experts say often puts people to work against their will.
Uighurs are a largely Muslim ethnic minority primarily from the Xinjiang region of northwest China. The government promotes the labor transfer program, which sends Uighurs and other ethnic minorities into factory and service jobs, as a way to reduce poverty, but quotas on the number of workers put into the labor program and the penalties faced by those who refuse to cooperate mean that participation is often coerced.
Now, that labor is part of the P.P.E. supply chain.
According to China’s National Medical Products Administration, only four companies in Xinjiang produced medical grade protective equipment before the pandemic. As of June 30, that number was 51. After reviewing state media reports and public records, The Times found that at least 17 of those companies participate in the labor transfer program.
The companies produce equipment primarily for domestic use, but The Times identified several other companies outside Xinjiang that use Uighur labor and export globally. We traced a shipment of face masks to a medical supply company in the U.S. state of Georgia from a factory in China’s Hubei Province, where more than 100 Uighur workers had been sent. The workers are required to learn Mandarin and pledge their loyalty to China at weekly flag-raising ceremonies.
Watch the full visual investigation in the video above.
Mayor Eric Garcetti of Los Angeles said that the coronavirus was spreading in the city to the point where a new stay-at-home order would have to be issued.
“We’re on the brink of that,” he said on the CNN program “State of the Union” on Sunday.
He declined to be more specific about the timing or scope of a new order, except to say, “We have to be surgical, rather than a cleaver that would just shut everything down.”
He said he agreed that earlier restrictions had been relaxed too quickly. “Mayors often have no control over what reopens up and doesn’t,” he said. “That’s either at a state or county level.”
But he added, “It’s not just about what’s open and closed, but it’s also about what we do individually.”
Los Angeles County has recorded more than 153,000 cases so far, and the spread of the virus has been quickening across Southern California. “Cases have gone up, but we also have the most aggressive testing,” the mayor. “We were the first city to offer tests to people without symptoms.”
In other news around the country:
Congressional leaders are puzzling over how to safely and appropriately honor Representative John Lewis of Georgia, an icon of the civil rights movement who died on Friday. Congress has honored more than 40 people by allowing their remains to lie in state under the Capitol dome, and many believe that such an honor would be fitting for Mr. Lewis. But the Capitol is closed to tourists and those allowed inside are encouraged to stay six feet apart.
The Defense Department sent Navy teams to help support four medical centers in South and Southwest Texas as the virus surges there, Gov. Greg Abbott of Texas announced on Sunday. The teams were dispatched to Harlingen, Del Rio, Eagle Pass and Rio Grande City. The state has recorded 71,779 new cases in the last week, bringing its total case load to over 330,000, with nearly 4,000 deaths.
Officials in Louisiana reported 3,116 new cases on Sunday, exceeding the previous single-day record of 2,728 new cases, which were reported on April 2. The state did not provide any update on Saturday, which is a likely explanation for Sunday’s spike.
Despite the N.F.L. having outlined return dates for in-person training in a memo sent to teams last Friday, the N.F.L. Players Association still has not agreed with the league on key safety issues, prompting some of football’s biggest names to voice their concerns on social media. “If the NFL doesn’t do their part to keep players healthy there is no football in 2020,” Drew Brees, the New Orleans Saints quarterback, wrote on Twitter on Sunday. “It’s that simple. Get it done.”
The Canadian government said it would not allow the Toronto Blue Jays to stage home games. The team had hoped to play at Rogers Centre beginning on July 29, as part of Major League Baseball’s plan to use all 30 of its teams’ ballparks for a shortened 60-game season, with a number of precautions including having no fans in the stands. But on Saturday, Canada’s immigration minister said repeated cross-border travel by players and staff members posed a health risk. The team will play its regular-season home games in the United States instead, most likely at its AAA minor-league affiliate’s stadium in Buffalo.
Rising cases cut a painful path among the most vulnerable: Inside a Texas border town hospital.
As the virus spreads out across the United States, it is bearing down on places that are most vulnerable to its devastation — among them the southernmost wedge of Texas, on the border with Mexico, which is experiencing a punishing surge in infection.
In the Rio Grande Valley, more than a third of families live in poverty. Up to half of residents have no health insurance. More than 60 percent are diabetic or prediabetic. The rates of obesity and heart disease are among the nation’s highest. And more than 90 percent of the population is Latino, a group that is dying from the virus at higher rates than white Americans are.
“We knew that this was a time bomb,” said Dr. Adolfo Kaplan, a local critical care physician.
But in the early days of the pandemic, there were few infections in the valley. Many public health officials attributed that to lockdown orders. Then in May, Gov. Greg Abbott let them expire.
“We knew that if the hospital was hit, it was going to be a disaster,” said Dr. Kaplan, who works at DHR Health in Edinburg, Texas. “And that’s what we are living through.”
The three facilities the hospital is using to treat patients with Covid-19 have been filled to capacity since the first week of July. At times, a dozen or more ambulances have waited outside for beds to become available.
With 10,000 active infections in the region, public health officers estimate that hospitalizations could double within two weeks.
“Our curve is a straight up trajectory right now,” said Sherri Abendroth, the hospital’s safety and emergency management coordinator. “There’s no flattening. There’s no relief.”
Tennessee bar owners are fighting orders to close down again.
Coronavirus cases in Tennessee have been rising sharply since late June, especially in and around Memphis and Nashville, where county officials are reporting hundreds of new cases a day. Both cities have been trying to tamp down outbreaks by reintroducing some restrictions, but they have run into resistance from restaurant and bar owners in the bustling nightlife districts.
Across the country, crowded night spots have been cited as especially problematic settings in a pandemic, where masks just get in the way and social distancing is the opposite of what the patrons are there for. But owners have bridled at being singled out for shutdowns.
In Davidson County, which includes Nashville, four bars sued the city after bars were ordered to close through the end of July, while restaurants were allowed to stay open at 50 percent capacity.
Nashville’s mayor, John Cooper, acknowledged that the city’s restrictions would be difficult to enforce “in a population that probably does include disease deniers.” And he said there was only so much Nashville could do when surrounding counties had much laxer restrictions.
In Shelby County, which includes Memphis, bars and “limited service” restaurants were ordered to close earlier this month while others were allowed to stay open. That sparked a fight with owners who say the “limited service” distinction — applied to establishments that get less than 50 percent of their revenue from food — is arbitrary and pointless. A hearing in the case is set for Monday.
The plaintiffs say the closure rule simply pushes patrons from some restaurants to others without any appreciable public health benefit.
The lead plaintiff, Jeannette Comans, who owns the Blind Bear cocktail bar, said she had just rehired and trained enough employees to be almost fully staffed — including adding people at the door to check patrons’ temperatures and remind them about mask rules — when the new closure order was issued.
“They left me with no choice” but to sue, she said of health officials. “I still have to pay rent, I still have to pay business insurance. My poor employees daily are like, ‘What do we do?’ And I’m like, ‘I don’t know.’”
Trump calls Fauci ‘a little bit of an alarmist,’ the latest salvo of White House criticism.
President Trump called Dr. Anthony S. Fauci, the nation’s top infectious disease expert, an “alarmist” who provided faulty information in the early days of the coronavirus pandemic.
His remarks, in an interview with Fox News that aired Sunday, were the latest public criticism from a White House that appears to be mounting a coordinated effort to discredit Dr. Fauci, on the record and off, and in presidential tweets. Administration officials deny doing so.
“I don’t know that he’s a leaker,” Mr. Trump said during the interview with Chris Wallace “He’s a little bit of an alarmist. That’s OK. A little bit of an alarmist.”
Mr. Trump said that Dr. Fauci had been against his decision to close the borders to travelers from China in January. That is not true: While Dr. Fauci was initially opposed to the idea on the grounds that a ban would prevent medical professionals from traveling to hard-hit areas, he supported the decision by the time it was made.
Mr. Trump also said that Dr. Fauci had been against Americans wearing masks. Dr. Fauci has said that he does not regret urging Americans not to wear masks in the early days of the pandemic, referencing a severe shortage of protective gear for medical professionals.
Dr. Francis Collins, the director of the National Institutes of Health, was asked on the NBC program “Meet the Press” whether anyone at the White House had asked him to demote or fire Dr. Fauci, whose agency is under Dr. Collins’s supervision. “Nobody has asked me to do that and I find that concept unimaginable,” Dr. Collins said.
In the hourlong interview on Fox, Mr. Trump, whose administration made crucial missteps in handling the virus earlier this year, made several false claims on the government’s response to the pandemic.
Mr. Trump falsely claimed that the coronavirus rate in other countries was lower than in the United States because those nations did not engage in testing. When Mr. Wallace pointed out the lower case rate across the European Union, the president replied, “It’s possible that they don’t test.” When Mr. Wallace pointed out the increasing death rate in the United States, Mr. Trump replied, “It’s all too much. It shouldn’t be one case. It came from China. They should have never let it escape.”
Mr. Trump said that he doubted whether Dr. Robert R. Redfield, the director of the C.D.C., was correct in predicting that the pandemic would be worse this fall. “I don’t know,” Mr. Trump said. “And I don’t think he knows.”
He said that public health experts and the World Health Organization “got a lot wrong” in the early days of the pandemic, including a theory that the virus would abate as the weather warmed, and then reiterated his earlier claim, unsupported by science, that the virus would suddenly cease one day. “It’s going to disappear and I’ll be right,” Mr. Trump said. “Because I’ve been right probably more than anybody else.”
Mr. Trump threatened to pull federal funding from schools if they did not open soon. When Mr. Wallace pointed out that only a small portion of funding from the federal government goes to schools — and is mostly used to support disadvantaged and disabled children — the president replied, “Let the schools open.”
Mr. Biden, who has been critical of Mr. Trump’s handling of the outbreak, said in a statement on Sunday: “In the middle of a pandemic that continues to worsen on his watch, President Trump is trying to keep money away from the public health measures that we know will keep us and our families safe. He even went on to attack the value of testing again in the same interview, perpetuating a terrible monthslong streak.”
“Mr. President, your ignorance isn’t a virtue or a sign of your strength,” Mr. Biden said. “It’s undercutting our response to this unprecedented crisis at every turn and it’s costing Americans their jobs and their lives.”
How to have a better backyard.
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Reporting was contributed by Sarah Almukhtar, Manuela Andreoni, Ken Belson, Luke Broadwater, Alexander Burns, Letícia Casado, Choe Sang-Hun, Emily Cochrane, Melina Delkic, Maggie Haberman, Rebecca Halleck, Drew Jordan, Christoph Koettl, Ernesto Londoño, Jonathan Martin, Tiffany May, Raphael Minder, Elizabeth Preston, Roni Caryn Rabin, Natalie Reneau, Katie Rogers, Mitch Smith, Matina Stevis-Gridneff, Lucy Tompkins, Pranshu Verma, Haley Willis, Katherine Wu, Muyi Xiao, Ceylan Yeginsu and Karen Zraick.