Texas pauses its reopening and moves to free up room in hospitals as cases rise.

Texas paused its reopening process and moved to free up hospital space for coronavirus patients on Thursday amid growing concern over its rising tally of cases, Gov. Greg Abbott announced Thursday.

The state has recorded more than 130,000 cases and nearly 3,000 deaths. More than 4,300 people with the virus are hospitalized across the state, more than double the number at the beginning of June. To ensure that hospitals have enough capacity to care for virus patients, Mr. Abbott issued an executive order suspending elective procedures in hospitals in four counties: Bexar, Dallas, Travis and Harris, which includes hard-hit Houston.

Mayor Sylvester Turner of Houston told local lawmakers on Wednesday that the city’s intensive-care units were filled to 97 percent capacity, and that more than a quarter of those patients had tested positive for the virus.

Even as Texas health officials grappled with the surge, the state’s attorney general, Ken Paxton, asked the Supreme Court on Thursday to overturn the Affordable Care Act, which has extended health insurance to more than 1.1 million Texans while protecting state residents who have pre-existing medical conditions.

In legal briefs filed with the court on behalf of Texas and 19 other states, Mr. Paxton argued that when Congress rescinded the tax penalty that the law imposed on Americans who did not purchase insurance — known as the “individual mandate” — the entire law became invalid, a legal argument that has not changed with the pandemic.

“Congress deliberately designed the ACA and its goal of expanding health care coverage around the individual mandate,” Thursday’s brief said. Absent the mandate, it added, other provisions of the law “not only malfunction, but result in the opposite of what Congress intended.”

Although critics have blamed the reopening for contributing to the expanding pandemic, Mr. Abbott has said repeatedly that rolling it back would be a last resort, a stance he repeated on Thursday. Businesses that have already reopened can continue to operate, but any further reopening is halted, he said in a statement. (Bars now operate at 50 percent capacity, while restaurants operate at 75 percent capacity.)

“The last thing we want to do as a state is go backwards and close down businesses,” Mr. Abbott said. “This temporary pause will help our state corral the spread until we can safely enter the next phase of opening our state for business.”

Texas is one of 29 states where case numbers have been rising. The United States reported its largest one-day total since the start of the pandemic on Wednesday: 36,880 new cases, more than two months after the previous high. The resurgence is concentrated largely in the South and West; New York has imposed a quarantine on travelers from many hard-hit states that meet certain health metrics. Florida, Oklahoma, South Carolina and Texas reported their highest single-day totals on Wednesday.

The tally of new cases, based on a New York Times database, showed that the outbreak was stronger than ever. The elevated numbers are a result of worsening conditions across much of the country, as well as increased testing.

Gov. Ron DeSantis of Florida said Thursday that he did not intend to move to the next phase of reopening.

“We never anticipated necessarily doing anything different in terms of the next phase at this point anyways,” he said in Tampa. “We are where we are.”

Over the past two days, Florida has reported more than 10,000 new cases, bringing its total to more than 114,000. Orange County, home to Orlando, is averaging 353 new cases a day, compared with 73 two weeks ago. Across the state, long lines have returned at testing sites that just a few weeks ago were seeing limited demand.

Mr. DeSantis, a Republican, has pressed older people to keep staying home as much as possible. He has also pleaded with young people to be responsible, saying they account for the rising infections.

In spite of the accelerating contagion, a slew of recent local mask mandates have been met with stiff resistance in some communities, notably Palm Beach County. A public hearing in West Palm Beach this week drew a vocal anti-mask crowd, including one speaker who referred to the mask requirement as the “devil’s law.” The commission approved the mandate unanimously.

Some hospitals overwhelmed by Covid-19 patients have had to relocate people to other facilities with available beds. Among them was Homestead Hospital in South Florida, which serves one of the state’s hard-hit farmworker communities. Sarasota Memorial Hospital reinstated a no-visitors policy, citing the virus spread.

Miami-Dade County has reopened more slowly than the rest of the state, and it plans to keep it that way. For now, Mayor Carlos Giménez said, all plans to move forward are on pause.

Beaches, malls and hotels are open, as well as restaurants at 50 percent capacity, but concert halls, public pools, massage and tattoo parlors are not. People are required to wear masks indoors and outdoors when social distancing is not possible.

“We’re not opening up bars, we’re not opening up nightclubs,” Mr. Giménez said Wednesday. “That’s just asking for trouble.”

On Thursday, Apple said it planned to close 11 stores in Florida because of the state’s rising cases, adding to the 18 stores it had already shut down around the country over the past week. Stores in Arizona, North Carolina, South Carolina and Texas have been shut down after reopening briefly.

The Trump administration delivered more than a million stimulus payments worth about $1.4 billion to dead people in a rush to pump money into the economy this year, the Government Accountability Office said on Thursday.

The Treasury Department, working with the Internal Revenue Service, raced to deliver nearly $270 billion in economic impact payments to Americans this spring. But a chunk of the money ended up in the wrong places.

The improper payments reflect some of the wasteful government spending that occurred in the wake of the rapid economic stabilization effort that was undertaken after Congress passed a $2.6 trillion bailout package in March.

“The agencies faced difficulties delivering payments to some individuals, and faced additional risks related to making improper payments to ineligible individuals, such as decedents, and fraud,” the report said.

The report noted that while the I.R.S. typically uses death records maintained by the Social Security Administration to prevent improper payments, that did not happen with the first three batches of stimulus payments. The Treasury and the I.R.S. “did not use the death records to stop payments to deceased individuals for the first three batches of payments” because of a legal interpretation of the legislation authorizing the payments. I.R.S. lawyers “determined that I.R.S. did not have the legal authority to deny payments to those who filed a return for 2019, even if they were deceased at the time of payment,” the report found.

The G.A.O. recommended that the I.R.S. find ways to notify ineligible recipients of the payments how to return them, though it did not explain how that would work with regard to those who are deceased. It also suggested that Congress ensure that the Treasury and its Bureau of the Fiscal Service, which distributed the payments, gain full access to the Social Security Administration’s full set of death records to help prevent money from being paid to the deceased.

Treasury Secretary Steven Mnuchin said in April that the heirs of the deceased who received stimulus money should give the funds back.

In its report, the G.A.O. also warned that the $660 billion Paycheck Protection Program was vulnerable to fraud because the Small Business Administration is relying on borrower certifications to determine if the loans are needed and how they are being used.

The G.A.O. called on the S.B.A. to develop a system for identifying fraud associated with the program. It also expressed concern about potential overlap of people who were being paid unemployment insurance while also receiving proceeds from P.P.P. loans.

The report also criticized the C.D.C.’s counting of coronavirus tests, which combines tests for an active infection and those that detect antibodies. This practice inflates the percentage of Americans that appear to have been tested and gives an unreliable picture of the way the virus is spreading around the country, according to the new report.

After the C.D.C. was criticized last month for combining the two types of tests in its reports, the agency promised to separate them. But as of June 9, it had still not resolved the issue, the office reported.

Israel on Thursday announced a new partnership with the United Arab Emirates to battle the pandemic, a deal could open a door to closer ties with its Arab neighbors.

The partnership, announced by Prime Minister Benjamin Netanyahu at an air force base near Tel Aviv, appeared to represent a significant step toward normalization between two important U.S. allies in the Middle East.

But it fell well short of the establishment of formal diplomatic relations. And hours later, the Emirates issued a statement of its own, announcing what it described as an agreement between two private Emirati companies and two Israeli companies to develop technology to fight the virus.

The Emirati statement appeared to take the wind out of what Mr. Netanyahu was touting as a major diplomatic achievement.

The dueling announcements came at a time when Israel is drawing up plans to annex parts of the occupied West Bank, a move that Arab countries, including the Emirates, say would thwart warming relationships.

In recent years, Persian Gulf monarchies have shifted away from blanket condemnation of the Israelis over the Palestinian issue, in part because they view Israel as a valuable potential partner in trade, security and their rivalry with Iran.

The new partnership will include formal cooperation in research and development between the Israeli and Emirati health ministries on medical projects related to Covid-19 and other health issues in the Middle East, Mr. Netanyahu said.

New York City is on track to enter Phase 3 of the state’s reopening plan on July 6, Mayor Bill de Blasio said Thursday, which would allow indoor dining and personal-care services, like manicures, tattooing and waxing, to resume with social-distancing limits.

“Right now we are on track for Phase 3,” he said at a news briefing. “That’s exciting.”

The state has a four-stage reopening plan that gradually lifts shutdown restrictions imposed at the start of the outbreak. New York City is the only region left in the state that has yet to enter the third phase; five upstate regions will enter Phase 4 on Friday.

The city entered Phase 2 on Monday, allowing outdoor dining to resume and the reopening of offices, playgrounds, hair salons and barbershops.

When Phase 3 begins, the city will also reopen outdoor recreational spaces, including basketball courts, tennis courts and dog runs, the mayor said. (Separately, the city’s public beaches will open to swimming on July 1.)

Mr. de Blasio said he expected the change would come as a particular relief to children, who have been cooped up for months now, with limited access to school, friends and outdoor activities.

The mayor said that the city had continued to keep its infection rate down as it eased earlier restrictions. But as he has with each stage of the reopening, Mr. de Blasio cautioned that plans could change if the city’s infection rate surges.

“Am I 100 percent confident? Of course not,” he said.

For the first time since March 18, fewer than 1,000 people were hospitalized in the state with the virus, Gov. Andrew M. Cuomo said on Thursday. At the peak of the state’s outbreak, more than 18,000 were hospitalized; the number is now down to 996. Statewide, there were an additional 17 deaths, he said.

By mid-February, there were only 15 known cases in the United States, all with direct links to China.

The patients were isolated. Their contacts were monitored. Travel from China was restricted.

But none of that worked, as some 2,000 hidden infections were already spreading through major cities.

At every crucial moment, American officials were weeks or months behind the reality of the outbreak. Those delays likely cost tens of thousands of lives.

The Times has analyzed travel patterns, hidden infections and genetic data to show how the epidemic spun out of control in the United States.

In other news from around the country:

  • U.S. testing capacity has begun to strain as the pandemic spreads, with more than a dozen public laboratories saying they are “challenged” to meet the demand. The problem has become especially acute in Arizona.

  • North Carolina’s lieutenant governor, Dan Forest, announced on Thursday that he planned to sue Gov. Roy Cooper over his decision a day earlier to extend the state’s emergency orders and his mandate that state residents wear masks. Mr. Forest — a Republican who will face Mr. Cooper, a Democrat, in the November gubernatorial election — accused his opponent of overstepping his authority.

  • Former Vice President Joseph R. Biden Jr. on Thursday laced into President Trump, condemning him for saying he had ordered a slowdown of coronavirus testing. “He thinks that finding out that more Americans are sick will make him look bad,” Mr. Biden said, adding that without a capable leader in the White House, it will be up to the American people to care for themselves during the crisis. “Trump can’t wish it away,” he said. “There are no miracles coming.”

  • A federal whistle-blower who lost his job as chief of a Health and Human Services research agency has added a new charge to his complaint against the Trump administration: The president is orchestrating a “retaliatory media campaign” against him. Dr. Rick Bright was removed from his job as director of the Biomedical Advanced Research and Development Authority in late April, shortly before he filed a complaint with the Office of Special Counsel, the federal agency that protects whistle-blowers. In an amended complaint filed Thursday, he pointed specifically to a tweet in which Mr. Trump called him a “disgruntled employee, not liked or respected” shortly before Dr. Bright was to testify before Congress on May 14. “This message was a clear attempt by the president to unnerve and intimidate Dr. Bright,” the complaint said. Michael R. Caputo, an H.H.S. spokesman, dismissed the amendment as “more misleading claims from Rick Bright.”

  • Michigan’s governor, Gretchen Whitmer, a Democrat, signed an executive order on Thursday that allows professional sports to resume in the state without fans. The order stipulates that participants must stay six feet away from each other “to the extent compatible with the sport.”

  • The Democratic National Convention will move out of Milwaukee’s professional basketball arena, and state delegations are being urged not to travel to the city because of concerns about the pandemic, party officials said Wednesday.

  • Starting in August, travelers to Hawaii can avoid the state’s 14-day quarantine by showing a negative result from a valid test, the governor announced.

Europe sees a ‘significant resurgence’ of cases, a W.H.O. official warns.

The number of new cases in Europe increased last week for the first time in months, the World Health Organization said on Thursday.

In 11 countries in particular, “accelerated transmission has led to very significant resurgence,” said Dr. Hans Kluge, the W.H.O.’s regional director for Europe, warning that if left unchecked, the resurgence could “push health systems to the brink once again.”

Dr. Kluge did not name the countries, but he added that a total of 30 European countries had reported increases in the number of new cases over the previous two weeks.

His warning was the latest reminder of the risks of a resurgence in infections and deaths as countries around the world try to ease out of lockdowns.

“The pandemic continues to accelerate,” Dr. Kluge said, in a series of Twitter messages summarizing a briefing for the news media.

He noted that a record 183,020 new cases had been reported to the W.H.O. over the previous 24 hours. More than nine million cases and 400,000 deaths have been reported worldwide, he added.

The center of the pandemic has shifted from Europe to other continents, such as the Americas. But Europe continues to report 20,000 new cases and 700 deaths a day, Dr. Kluge said.

Hinting at a long struggle ahead, Dr. Kluge applauded Germany, Israel, Poland and Spain for “targeted interventions” that had controlled local outbreaks. He also commended the citizens of Europe for adopting behaviors like physical distancing and wearing face masks.

And with the United States threatening to end financial support to the W.H.O., Germany and France have pledged more than a half-billion dollars for the organization, while calling for reforms and accountability. The W.H.O.’s director-general said the organization is getting all the political and financial support it needs.

A C.D.C. study overlooks an important factor as it measures the effects of pregnancy on Covid-19 patients.

The increased risk for intensive care and mechanical ventilation worried experts. But the new study, by C.D.C. researchers, did not include one pivotal detail: whether pregnant women were hospitalized because of labor and delivery. That may have significantly inflated the numbers, so it is unclear whether the analysis reflects a true increase in the risk of hospitalization.

Admission for delivery represents 25 percent of all hospitalizations in the United States, said Dr. Neel Shah, an assistant professor of obstetrics and gynecology at Harvard University. Even at earlier stages of pregnancy, doctors err on the side of being overly cautious when treating pregnant women — whether they have the virus or not.

The analysis, the largest of its type so far, is based on data from women with confirmed infections as reported to the C.D.C. by 50 states, as well as New York City and Washington, from Jan. 22 to June 7.

Despite the ambiguities, some experts said that the new data suggested at the very least that pregnant women with the virus should be carefully monitored.

“I think the bottom line is this: These findings suggest that compared to nonpregnant women, pregnant women are more likely to have severe Covid,” said Dr. Denise Jamieson, a member of the Covid-19 task force for the American College of Obstetricians and Gynecologists. (An earlier version of this article misstated Dr. Jamieson’s title in the task force.)

When the pandemic first hit Egypt, the words “Stay Home” were projected in neon light across the Giza pyramids every night, a grand gesture fusing urgent health messaging with one of the world’s most famous monument.

But no more.

Starting Saturday, restaurants, cafes and mosques will gradually reopen after three months of lockdown that exacted a punishing economic toll on Egypt’s 100 million citizens. Restaurants will operate at 25 percent capacity and close by 10 p.m., and mosques and churches will stay shut for weekly prayers, the busiest time of the week.

In July, the Giza pyramids and ancient sites along the Nile will reopen, the tourism minister said on Wednesday, in an effort to tempt tourists.

But experts have questioned the wisdom of easing restrictions as the virus continues a steep upward trajectory in Egypt. Some desperate patients, unable to find treatment in overburdened hospitals, have resorted to social media to appeal for medical assistance. Medical unions say that chronic shortages of equipment and training has caused nearly 100 doctors to die and over 3,000 to become infected.

On Friday, Egypt reported 1,774 new cases, the highest number yet, for a total of nearly 60,000 cases and 2,450 deaths — the highest death toll of any Arab country.

The national carrier, EgyptAir, said Thursday it would resume flights to 24 destinations in early July when airports reopen.

President Abdel Fattah el-Sisi has been keen to show he is in control, even as several of his top generals died from the virus in March. But he has been hit with unusually strong criticism from the country’s main doctors’ union.

Although public protest and most strikes are outlawed in Egypt, doctors in several hospitals have walked out in protest over their working conditions. Prime Minister Mostafa Madbouly this week accused the doctors of fueling a rise in infections.

Elsewhere in the world:

  • The top U.N. relief official warned of a drastic worsening in the outbreak in war-ravaged Yemen, the Arab world’s poorest country, where he said that 25 percent of those infected die — about five times the global average.

  • In Honduras, the condition of President Juan Orlando Hernández, who was hospitalized last week after testing positive, was improving, his office said Wednesday.

  • In Guatemala, the number of members of the presidential staff who have tested positive has climbed to 158, President Alejandro Giammattei said Wednesday. He said he had been tested three times; the results were negative.

  • Portugal’s government announced a renewed lockdown in 19 districts on the outskirts of Lisbon starting July 1. Portugal had been hailed for early successes and began to lift restrictions in early May, but cases have risen significantly this month.

  • At least 22 police officers were injured in South London on Wednesday night as they tried to disperse hundreds gathered for an illegal outdoor party, the police said. Gatherings of more than six people from separate households are banned in England.

  • The French health minister told the newspaper Le Monde on Thursday that the authorities would introduce a “large-scale campaign” to test over a million people in the Paris region, “even if they don’t have symptoms,” in a bid to stave off more infections. The Eiffel Tower partially reopened.

  • In Bali, which was hoping to begin reopening hotels and tourist facilities as early as July, a recent gathering of about 60 foreigners at a spiritual center drew harsh criticism of the foreign community for violating Indonesia’s virus protocols. The center’s director will be deported to his native Syria for endangering the public health, officials said Thursday. Indonesia, the Southeast Asian country hit hardest, has seen its cases surge in recent weeks to 50,187, with 2,620 deaths.

  • The second-worst Ebola outbreak in history is over, the World Health Organization said on Thursday, after nearly two years and 2,280 deaths. The announcement, about an outbreak in eastern Congo, came as the country contends with the world’s largest measles epidemic, as well as the coronavirus.

More than 1 million people in the U.S. seek state jobless benefits for the 14th week in a row.

Nearly 1.5 million workers filed new claims for state unemployment insurance last week, the Labor Department reported Thursday. It was the 14th week in a row that the figure has topped one million.

An additional 728,000 filed for benefits from Pandemic Unemployment Assistance, a federally funded emergency program aimed at covering the self-employed, independent contractors and other workers who don’t qualify for traditional unemployment insurance.

The total number of people collecting state unemployment insurance is 19.5 million, down from about 25 million in early May.

Stocks drifted on Thursday, as growing outbreaks in parts of the United States added to concerns about the economic recovery. The S&P 500 and major European markets wavered between gains and losses.

Investors have worried for days about a rising number of new infections in the United States, a surge that raises questions about how quickly the world’s largest economy can get back up to speed.

The shaky economic outlook has both experts and workers worried about the looming expiration of the Federal Pandemic Unemployment Compensation program, which provides a supplement of $600 a week to those collecting state jobless benefits.

The Kentucky Derby planned for Sept. 5 will allow spectators to watch the race in person, track officials announced Thursday as they outlined health precautions including masks, fewer interactions throughout the venue and spaced out guest areas.

The plan, developed with the local health and labor departments, encourages guests to wash their hands frequently and remain socially distant. But it was not clear how many guests would be allowed at Churchill Downs Racetrack, the venue in Louisville, Ky., that has hosted the race since 1875 and welcomed more than 150,000 fans for the Derby last year.

It was also unclear how the protocols would be enforced, though officials said they would “severely” limit access throughout the facility. General admission tickets would be sold only for the track’s infield, and “guests will be consistently and frequently encouraged to wear a mask at all times unless seated in their reserved seat or venue,” the plan said.

Tickets purchased for the originally scheduled Derby in May are automatically valid, the announcement said.

“Both employees and guests are asked to take an active role in following all guidelines,” Kevin Flanery, the track’s president, said. “We must all do our part to ensure everyone has a safe and enjoyable experience.”

In other sports news:

  • The N.F.L. has canceled its annual Hall of Fame game — traditionally the first game of the preseason — as it tries to prepare for a football season in the midst of the pandemic. The game between the Dallas Cowboys and the Pittsburgh Steelers was scheduled to be played on Monday, Aug. 6, in Canton, Ohio, at the Pro Football Hall of Fame.

  • Billy Witz of The Times reported how Kansas State became the first school from a Power 5 conference to shut down football activities because of the virus.

Demand soars for a steroid that showed promise in treating severe cases, an analysis shows.

Scientists around the world last week cautiously hailed a report that an inexpensive and commonly available steroid had reduced deaths in patients with severe Covid-19. The drug, dexamethasone, is now in high demand, with orders among some U.S. hospitals rising by more than 600 percent in the week after the report, according to an analysis released on Thursday.

In a news conference on Monday, Tedros Adhanom Ghebreyesus, director general of the W.H.O., said interest in the drug had “surged” after announcements of its “clear benefit.” Dr. Tedros called for a sharp increase in production, while urging continued vigilance about recommended public health measures such as increased testing, contact tracing, physical distancing and hygiene.

The analysis by Vizient, an American health care services company, highlighted dexamethasone’s spike in popularity. Vizient serves more than 5,000 nonprofit health care system members and their affiliates.

Dexamethasone is frequently administered to patients with various conditions that involve excess inflammation, including arthritis, allergic reactions and certain gastrointestinal disorders. The drug, prized for its ability to tamp down certain aspects of the immune system, appears to ease the severity of some of the worst cases of Covid-19. For many infected, the most severe consequences arise when immune cells and molecules, roused to fight the virus, cannot be kept in check.

Experts caution that dexamethasone is not a cure-all. Patients with milder cases of Covid-19, particularly those not on respiratory support, did not benefit from the drug, the trial’s results showed. And if the steroid is administered too early in an infection, it might even quell the immune system to a degree that compromises a person’s ability to vanquish the virus.

China tells its citizens in Russia to stop faking test results.

China has warned its citizens to stop falsifying virus test results to board flights home from Russia.

The Chinese Embassy in Russia issued a statement this week in response to recent discoveries that Chinese travelers from Russia had fabricated negative results for the nucleic acid tests that are required before passengers can board their flights. The embassy announced that the counterfeiters had been placed under investigation and would be made to “bear the corresponding legal responsibilities.” It was the second time in three weeks that the embassy had issued such a warning.

Some passengers had “deliberately concealed their illnesses, caused adverse effects and consequences, caused great harm to the health and safety of other passengers and crew members on the same flight, and undermined China’s domestic epidemic prevention work,” the embassy said in a statement.

China requires passengers to produce a negative test that must be taken within the five days preceding their flight from Russia to China.

The Chinese government, fearful that incoming travelers would bring in the virus, has restricted international flights and banned foreigners, including those with resident permits.

Several Chinese cities along the China-Russia border have struggled with hundreds of infections. Russia on Wednesday reported 7,176 new cases over the previous 24 hours.

These are some of the challenges of maintaining distance.

With eased lockdowns in many places, keeping the recommended distance from others this summer has become more complicated. Here are ideas for handling conflicts over differing ideas of what is safe.

Reporting was contributed by Brooks Barnes, Ronen Bergman, Aurelien Breeden, Weiyi Cai, Benedict Carey, Choe Sang-Hun, Abdi Latif Dahir, Reid J. Epstein, Thomas Erdbrink, Jacey Fortin, Rick Gladstone, James Glanz, Michael Gold, Shane Goldmacher, Josh Holder, Ben Hubbard, David D. Kirkpatrick, Apoorva Mandavilli, Salman Masood, Raphael Minder, Dave Montgomery, Jack Nicas, Richard C. Paddock, Elian Peltier, Alan Rappeport, Dana Rubinstein, Christopher F. Schuetze, Nelson D. Schwartz, Kirk Semple, Dera Menra Sijabat, Mitch Smith, Chris Stanford, Sheryl Gay Stolberg, Carlos Tejada, Daniel Victor, Neil Vigdor, David Waldstein, Declan Walsh, Derek Watkins, Sui-Lee Wee, Jeremy White, Nic Wirtz, Katherine J. Wu and Karen Zraick.





Source link