The virus death toll in the U.S. surpasses 200,000.
The death toll in the United States from the coronavirus pandemic passed 200,000 on Tuesday as the first day of fall brought questions about what may be ahead.
More deaths have been announced in the United States than in any other country, and reports of new coronavirus cases have climbed in the U.S. and parts of Europe in recent days, suggesting an uncertain new phase in the crisis.
Some estimated in March that fewer than 500 would die over the course of the pandemic. “More like 60,000,” the leading U.S. authority on infectious disease predicted in April. “Anywhere from 75,000, 80,000 to 100,000 people,” President Trump said in May.
But even as the toll has gone from hazy estimates to cold realities, the sheer scale has remained hard to grasp. More than 200,000 dead is such an enormous loss — nearly two and a half times the number of U.S. service members to die in battle in the Vietnam and Korean Wars — obscuring the accretion of individual tragedies: a hard-working single mother, a Hall of Fame pitcher, a D-Day veteran, an inseparable couple and a picket line troubadour.
Now that 200,000 people have died — which the Centers for Disease Control and Prevention had discussed in March in internal documents as a low range for a worst-case scenario — infectious disease specialists are scrambling to determine how the pandemic could evolve in the months ahead.
Fewer new cases have been detected weekly since a summer surge in the South and West peaked in late July. But the nation’s caseload is again growing, especially in states in the middle of the country like Wisconsin, Montana and North Dakota. Early months of the pandemic had affected mainly urban, coastal areas. The virus is spreading more broadly now, through rural communities and college towns. The arrival of flu season and the prospect of cooler fall air — likely to send many people indoors — have added to fears about what the coming months may bring.
Trends can change quickly. Early in April, around 800 people were dying each day, but that soon climbed. For two weeks, from April 13 to April 27, daily deaths calculated as a seven-day average stayed at more than 2,000. Nearly 800 deaths are currently being reported in the country each day. Some epidemiologists say the death toll could climb to 300,000 by the end of the year in the United States.
The painful milestones have come quickly: 50,000 deaths in April, 100,000 by May, and now 200,000, even as some states, such as Arizona, have shown how quickly both cases and deaths can decline by embracing mitigation efforts.
The United States has the highest total number of deaths across the globe, though a handful of countries in Europe and Latin America have seen more deaths per capita.
Still, the persistently high death numbers in the United States stand in stark contrast to mortalities in other high-income countries. Italy, once the center of the pandemic, reported 17 deaths on Monday; Germany reported 10 deaths the same day. In the United States that day, 428 people were reported to have died of the virus.
In recent days, countries that saw fewer cases this summer have seen the virus surge once more. Around the world, at least 73 countries as of Sunday were seeing upticks in newly detected cases as scientists race to find a vaccine and new treatments.
The presidents of the United States and China squared off in their speeches to the annual General Assembly on Tuesday, punctuating a superpower rivalry that the leader of the 193-member organization, Secretary-General António Guterres, has called a great global risk.
On the coronavirus, global warming, human rights, international cooperation and a range of other issues, President Trump and his Chinese counterpart, Xi Jinping, laid out starkly differing views in their prerecorded remarks.
Mr. Trump blamed China for the coronavirus and demanded that the United Nations hold the country accountable. Mr. Xi, clearly anticipating Mr. Trump’s attacks, portrayed the virus as everyone’s challenge and described China’s response as scientific, generous and responsible.
“Any attempt at politicizing or stigmatizing this issue must be rejected,” Mr. Xi said.
Mr. Trump has been a longstanding critic of the United Nations and has challenged its multilateral diplomacy as an impediment to his “America First” policy — even as the United States remains the biggest single contributor to the United Nations budget.
But as Mr. Trump has withdrawn support for U.N. agencies such as the World Health Organization and Human Rights Council, China has been stepping in to fill the void as the No. 2 financial contributor to the United Nations. China has taken leadership in a number of U.N. agencies over the past few years.
The U.S.-China rivalry has emerged as a chief worry for Mr. Guterres, and he made that clear in his opening remarks to the annual gathering.
“We are moving in a very dangerous direction,” Mr. Guterres said. “Our world cannot afford a future where the two largest economies split the globe in a Great Fracture.”
The pandemic has many parents asking two questions. First, when can I get a vaccine? And second, when can my kids get it? The answers are not the same: Adults may be able to get a vaccine by next summer, but their children will have to wait longer. Perhaps a lot longer.
Thanks to the U.S. government’s Operation Warp Speed and other programs, a number of Covid-19 vaccines for adults are already in advanced clinical trials. But no trials have yet begun in the United States to determine whether these vaccines are safe and effective for children.
“Right now I’m pretty worried that we won’t have a vaccine available for kids by the start of next school year,” said Dr. Evan Anderson, a pediatrician at Children’s Healthcare of Atlanta and a professor at the Emory University School of Medicine.
Many vaccines — including ones for measles, polio and tetanus — were designed from the outset to be given to children. In such cases, vaccine developers would typically start with trials in adults to check for significant safety issues.
These trials come in three phases, going from small to large. Phase 1 and 2 trials let vaccine developers figure out which dose will likely be safest, while also delivering the best immune protection. Phase 3 trials, the last stage in vaccine testing, are carried out on thousands or tens of thousands of volunteers. It’s during these studies that scientists can get clear evidence that a vaccine protects people from a disease. They can also reveal side effects that were missed by smaller studies.
Only if researchers discovered no serious side effects would they start testing them in children, often beginning with teenagers, then working their way down to younger ages. Vaccine developers are keenly aware that children are not simply miniature adults. Their biology is different in ways that may affect the way vaccines work.
These trials allow vaccine developers to adjust the dose to achieve the best immune protection with the lowest risk of side effects. This process has proved safe and tremendously successful.
When the pandemic hit, some vaccine makers figured out how to combine phases, gathering more data in the same period of time. The result has been a swift march toward a vaccine. Just nine months into the pandemic, dozens of Covid-19 vaccines have reached clinical trials.
Dr. Anderson said that vaccine makers could have started running trials for children over the summer, as soon as they had gotten good Phase 2 results from adults. But that did not happen, and whenever those trials do start, it could take upward of a year to get vaccines ready for children.
A vote on vaccine rollout plans by a group that advises the C.D.C. has been delayed.
A committee that advises the Centers for Disease Control and Prevention has delayed a vote on plans to prioritize initial doses of a coronavirus vaccine, should one prove safe and effective.
The vote was initially planned for Tuesday, at a meeting of the Advisory Committee on Immunization Practices, or ACIP. The committee’s next meeting is planned for October, by which point more data will have likely emerged from several vaccines in late-stage clinical trials around the world.
The results of the vote, when it does occur, will help determine who receives the first doses of any coronavirus vaccine that shows promising results in late-stage clinical trials that test whether the product helps prevent severe cases of Covid-19 or perhaps even infection by the virus. Typically, the committee votes on these recommendations only after they have been greenlit by the Food and Drug Administration.
Two federal officials familiar with the C.D.C.’s vaccine committee said that it was a smart move to delay the vote until more data emerges from clinical trials and the F.D.A. has begun its vetting process. Some of the vaccines have very different logistical requirements and might perform better in certain subsets of the population, factors that will influence the details of the rollout plan.
The delay was first reported by the Wall Street Journal. It was confirmed by the C.D.C. senior public affairs officer Tom Skinner, as well as attendees of the ACIP’s Tuesday meeting.
President Trump has repeatedly claimed that a vaccine will be available for Americans by October, raising alarm that he is pressuring federal health agencies to rush their scientific and regulatory deliberations before the November elections.
Pfizer, a front-runner in the race for a coronavirus vaccine, has repeatedly said that its trials may produce data on vaccine effectiveness as early as October, at which point the company might apply for emergency approval for use in a subset of the population. But no vaccines have yet been approved for even limited use in the United States. And Pfizer, along with eight other drug companies, have pledged to “stand with science” and only release vaccines based on results from rigorous clinical trials.
Health care workers are expected to be among those prioritized in any forthcoming vaccine rollouts.
Prime Minister Boris Johnson of Britain on Tuesday announced new virus-related restrictions and said that the country had reached a “perilous turning point” in the pandemic.
“This is the moment when we must act,” Mr. Johnson said in a statement in Parliament, as he announced new measures designed to save “lives and livelihoods” that could stay in place for the next six months.
Greater penalties for breaking virus restrictions in England will be introduced, and Mr. Johnson promised mask-wearing rules would be more strongly enforced. He also announced new restrictions on nightlife and encouraged people to work from home, ramping up the country’s efforts to curb a rising tide of confirmed cases.
Pubs and restaurants will be restricted to offering table service only and must close at 10 p.m., beginning on Thursday, Downing Street revealed on Monday night; ordinarily, there is no mandatory closing time, though many close at 11 p.m. The new rules are the most stringent since restaurants, pubs and many other businesses were allowed to emerge from full lockdown in July.
After pushing hard for workers to return to the office over the summer, the British government is now encouraging people to work from home. For workers who cannot do their jobs from home, Mr. Johnson said rules on making workplaces “Covid-secure” would become a legal obligation.
Mr. Johnson also announced that fines for failing to wear a mask or for meeting more than six people would double to 200 pounds (about $260). Repeat offenders can currently be fined up to 3,200 pounds (not 10,000 pounds as an earlier version of this post said). Staff in retail and indoor hospitality, as well as passengers in taxis and for-hire vehicles, will also now be required to wear masks.
Wedding ceremonies and receptions will be downsized to a maximum of 15 people starting Monday, adult indoor sports teams will be restricted to six people, and a partial reopening of sports stadiums expected for the beginning of October was postponed.
The restrictions imposed by the central government apply only to England; Scotland, Wales and Northern Ireland set their own policies, which have followed a similar pattern.
Tighter restrictions are already in place in some parts of the country, and the virus alert rating was raised on Monday to Level 4, signifying that the virus is in general circulation, with transmission high or rising exponentially.
Britain’s opposition leader, Keir Starmer, took aim on Tuesday at Mr. Johnson’s handling of the crisis, denouncing him as “just not up to the job” and saying that a second national lockdown would be a “sign of government failure.”
Treasury Secretary Steven Mnuchin offered an upbeat view of the economic recovery on Tuesday, calling it the fastest rebound from any crisis in American history. Yet he acknowledged that more than half of the jobs that had been lost as a result of the pandemic had yet to be restored.
Mr. Mnuchin and Jerome H. Powell, the chair of the Federal Reserve, projected optimism as they testified Tuesday before the House Financial Services Committee. But Mr. Powell made clear that many of those gains were predicated on strong fiscal support, including additional jobless benefits and stimulus checks — economic support that has largely run out. Lawmakers show little indication of being able to agree on another package.
Mr. Powell told Congress that the economy had made meaningful progress but that the outlook was uncertain and policymakers will need to do more to help the millions of Americans who are out of work.
Mr. Mnuchin projected “tremendous” economic growth in the third quarter, noting increases in business activity, manufacturing and the housing market. He said that the 8.4 percent jobless rate was a “notable achievement” considering his own projections earlier this year that unemployment could hit 25 percent.
Nonetheless, Mr. Mnuchin said that more stimulus was needed and that he would continue working with Congress to strike a deal.
“The President and I remain committed to providing support for American workers and businesses,” Mr. Mnuchin said. “I believe a targeted package is still needed, and the administration is ready to reach a bipartisan agreement.”
Three N.F.L. head coaches have been fined for not wearing masks on the sidelines during games on Sunday, a league source, speaking on condition of anonymity, confirmed.
Pete Carroll of the Seattle Seahawks, Vic Fangio of the Denver Broncos and Kyle Shanahan of the San Francisco 49ers were each fined $100,000, with an additional $250,000 fine levied against their respective teams.
The league has mandated that coaches and other team staff members wear protective coverings over their mouths and noses at all times during games. Masks are not required for players.
During the Monday night game, the two head coaches, Jon Gruden of the Las Vegas Raiders and Sean Payton of the New Orleans Saints, wore masks around their necks but frequently did not have them over their noses or mouths.
Both have said they were already exposed to the virus, with Payton notably having been the first N.F.L. coach to publicly reveal in March that he had been infected with the virus.
“I’m doing my best,” Gruden told reporters after the game. “I’ll have to pay the fine, but I’m very sensitive about that and I apologize.”
In other news around the nation.
An Iowa school district that defied a reopening order moves toward a ‘hybrid’ model.
An Iowa school district that had openly defied the state’s Republican governor by teaching remotely decided on Monday to begin moving toward a hybrid of in-person and online learning, starting next month.
But the district has still not decided what level of coronavirus prevalence in the community would force it to send students home.
The dispute between the Des Moines Independent Community School District and Gov. Kim Reynolds is a stark example of tension between Republican state officials, who have followed President Trump’s lead on education policy, and local administrators, often in Democratic-leaning cities, who fear that in-person instruction is too much of a public health risk.
Ms. Reynolds has said she is prioritizing the needs of the most vulnerable students, and the state’s Education Department has threatened to require Des Moines to extend its school year — at a cost of about $1.5 million a day — if it does not comply with state regulations.
But the local school board has argued that the high caseload in Polk County, which includes Des Moines, makes it unsafe to hold in-person classes.
Of the more than 80,000 coronavirus cases in Iowa, Polk has more than 15,000, the most of any county in the state by far, according to a New York Times database.
The Des Moines school board on Monday voted 6 to 1 to start phasing in a “hybrid return to learn” plan. Preschool students will begin returning on Oct. 12, followed by elementary, middle and then high school students by Nov. 10, the Des Moines Register reported.
However, the board delayed setting an infection rate that would force the district to revert to remote learning, deciding instead to invite public health issues to provide guidance on the subject at a subsequent meeting. That means the planned return to class could still be delayed.
Iowa officials have said that 15 percent of a county’s coronavirus tests must be positive over a two-week period before its schools can close their doors — a threshold that is at least triple what many public health experts have recommended. The rules also say that districts in counties that remain below 15 percent must offer at least 50 percent of their classes in person.
In two weeks across late August and early September, Polk County had an average positivity rate of about 8 percent.
Mr. Trump minimized the dangers the coronavirus poses to young people, falsely telling supporters in Ohio on Monday night that the virus “affects virtually nobody,” just hours before the country reached the grim milestone of 200,000 recorded deaths linked to the pandemic, according to a New York Times database.
Mr. Trump, who has veered back and forth between claiming that he takes the crisis seriously and dismissing it as a transient problem that will disappear on its own, made his remarks during a rambling late-night rally at an airport hangar in Dayton.
“It affects elderly people, elderly people with heart problems, if they have other problems, that’s what it really affects, in some states thousands of people — nobody young — below the age of 18, like nobody — they have a strong immune system — who knows?” Mr. Trump said.
“It affects virtually nobody,” he added. “It’s an amazing thing — by the way, open your schools!”
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has rejected that argument. He told CNN on Tuesday that 25 to 30 percent or more of the population has an underlying condition, like obesity, that contributes to their risk of severe illness.
“It can be serious in young people,” he said.
According to the Centers for Disease Control and Prevention, as of Sept. 16, about 78 percent of the people in the country who have died from the virus were 65 years and older, a demographic that has historically favored Trump. About 20 percent of the people who have died from the virus were 64 and younger.
Teachers and school administrators around the country are struggling to address one of the most pressing challenges in the new school year: How to make sure students come to virtual class, and whether to punish them if they don’t.
Attendance data from last spring, while limited, suggests that the problem loomed large in many districts. In one survey of 5,659 educators around the country, 34 percent of respondents said that no more than one in four students were attending their remote classes, and a majority said fewer than half their students were attending.
More recent data indicates the problem persists, especially in poorer communities, including many urban school systems.
Data on why students disappear from virtual school is hard to come by, but there are some obvious explanations. Many students lack a computer or stable internet; others have to work or care for younger children; and some families were evicted and had to move.
It is also likely that some students found online learning so tedious or hard to keep up with that they just dropped out, especially since many schools stopped grading or taking attendance once they closed their doors.
Most states are pushing school districts to return to normal attendance and grading policies this fall, now that they have had some time to improve their distance learning programs. That is putting pressure on schools not only to keep students engaged, but also to keep tabs on their personal circumstances and emotional health.
Returning to normal attendance expectations has also sharpened a debate among education officials about how to approach truancy. Last spring, Massachusetts school officials reported dozens of families to the state’s Department of Children and Families because of issues related to their children’s participation in remote learning, The Boston Globe reported last month. Districts with large Black and Latino populations filed the most reports, the paper found.
But many districts have eased up on harsh truancy rules — which can involve fines and even jail for parents and, sometimes, students — during the pandemic out of concern that students had legitimate obstacles to attending class.
“I do think more schools are open to the notion that you need alternatives to legal action,” said Hedy Chang, the director of Attendance Works, a national group that promotes solutions to chronic absenteeism. “There’s a lot more empathy.”
Mexico announced on Tuesday that it would formally join the World Health Organization’s new vaccine-distribution initiative.
The program, known as COVAX, was announced on Monday, and will allow the 156 participating countries to pool their resources to clinch bulk deals with pharmaceutical companies while their vaccines are still in development, in an effort to ensure faster and more equitable distribution.
The W.H.O. on Monday urged more rich nations to support the project, which aims to deliver about two billion doses worldwide by the end of 2021. The W.H.O. needs the financial muscle of the rich nations to, in effect, subsidize the vaccines for the poorer members.
Three major economies — the United States, China and Russia — have not joined. All three are pursuing their own vaccine plans.
In a virtual appearance before the United Nations General Assembly on Tuesday, Russia’s president, Vladimir V. Putin, insisted that Russia’s vaccine was safe and effective, and offered free shots to U.N. staff. Russia’s approval of the vaccine, which came with much fanfare, occurred before it had been tested in late-stage trials.
More than 130 potential vaccines are estimated to be in development globally.
Mexico’s foreign minister, Marcelo Ebrard, said Tuesday that COVAX “represents the most secure means of access, because it includes vaccines from very different countries of the world.”
Mexico has seen one of the world’s worst coronavirus outbreaks, with over 700,000 recorded cases, or 555 per 100,000 people, and nearly 74,000 deaths, according to a Times database.
In other news around the world:
Prime Minister Jacinda Ardern of New Zealand has apologized after being photographed with supporters without social distancing or masks last week while on the campaign trail, drawing criticism from the public and opposition politicians.
The awards ceremony for this year’s Nobel Peace Prize has been canceled because of the pandemic, the Norwegian Nobel Institute announced on Tuesday. Instead of the usual ceremony at Oslo City Hall, a scaled-back event will be held at the city’s university with a limited number of guests on Dec. 10. The prize will be announced at a news conference on Oct. 9.
Russia has reported a sharp rise in the number of new cases, with Moscow the epicenter of a nationwide spike in infections. Official figures released on Tuesday showed 6,215 new cases over the previous 24 hours — a marked increase from the start of the month and the highest number of daily cases since mid-July. Of those, 980 were reported in Moscow.
South Korea on Tuesday suspended a plan to provide free flu shots for about 19 million people, amid reports of problems with storing some of the vaccines during transport. The number of newly confirmed cases in the country, which is battling a second wave of infections, has stayed below 100 for the past three days. But millions are set to travel domestically next week to celebrate a five-day holiday.
The German state of Bavaria announced new rules on Tuesday to try to stem an increasing number of virus cases, a day after the region’s capital, Munich, also set new lockdown rules. The new restrictions in Bavaria prohibit more than five people or two families from meeting and force pubs and restaurants to close at 11 p.m. in areas that registered more than 50 new infections per 100,000 citizens within seven days. They also make masks obligatory and forbid alcohol consumption in some public outdoor spaces. Bavaria, which is the largest and the most affected state in Germany, registered new 412 cases yesterday.
Sixteen more residential areas in Madrid exceeded the infection rate criteria to return to lockdown restrictions, government data showed Tuesday. Those areas are in addition to 37 areas that went back under lockdown on Monday, raising the prospect that restrictions on movement will soon spread further across Spain’s capital region. Ignacio Aguado, the deputy head of the Madrid region, said that health care services were struggling to control the spread of the virus, while Salvador Illa, Spain’s health minister, urged residents of Madrid to stay at home as much as possible.
NEW YORK ROUNDUP
‘A complete washout’: Some New York City hotels begin closing their doors for good.
Many of New York City’s biggest hotels closed their doors in March when the virus wiped out tourism and business travel. The shutdowns were supposed to be temporary, but six months later, with no potential influx of visitors in sight, a wave of permanent closures has begun.
In the past two weeks, the 478-room Hilton Times Square and two Courtyard by Marriott hotels in Manhattan said they would not reopen, joining several others that had already closed for good, including the 399-room Omni Berkshire Place in Midtown.
All told, more than 25,000 hotel employees have been out of work for more than six months, making the industry one of the hardest hit in the city and emblematic of the challenges New York faces as it tries to recover.
Financial experts say they expect the pace of hotel failures to accelerate as lenders lose patience half a year into the pandemic.
“The fall is really in New York the strongest season of the year for hotels,” said Douglas Hercher, the managing director of Robert Douglas, an investment banking firm that specializes in hotels. “It kicks off with the United Nations General Assembly, conventions, the holidays, the Rockettes. That whole season is basically going to be a wipeout.”
Vijay Dandapani, the president of the Hotel Association of New York City, which represents 300 of the city’s hotels, was equally glum about the industry’s prospects.
“The year’s a washout,” he said in an interview.
Mr. Dandapani said in late summer as few as 7 percent of the roughly 120,000 hotel rooms in the city were filled with traditional guests.
Elsewhere in the New York area:
In New York City, Mayor Bill de Blasio said Tuesday that an announcement on the status of outdoor dining beyond Oct. 31 could come very soon. While indoor dining in the city is set to resume at limited capacity on Sept. 30, Mr. de Blasio said that outdoor dining in colder months involved a different set of health and safety concerns than during the summer. “The last piece to fill in is those rules around the continuance of outdoor: What makes sense, what doesn’t make sense, how will that work?” he said.
Gov. Andrew M. Cuomo of New York said Tuesday that travelers from Arizona, Minnesota, Nevada, Rhode Island and Wyoming are now required to quarantine for 14 days, joining a list of those from dozens of other states as well as Guam and Puerto Rico.
Reporting was contributed by Livia Albeck-Ripka, Stephen Castle, Troy Closson, Rick Gladstone, Abby Goodnough, Andrew Higgins, Jan Hoffman, Mike Ives, Anatoly Kurmanaev, Apoorva Mandavilli, Victor Mather, Patrick McGeehan, Raphael Minder, Claire Moses, Campbell Robertson, Simon Romero, Dagny Salas, Anna Schaverien, Christopher F. Schuetze, Megan Specia, Sheryl Gay Stolberg, Eileen Sullivan, Katherine J. Wu, Carl Zimmer and Karen Zraick.