The Centers for Disease Control and Prevention has tacitly put guidelines on their website – and tacitly withdrawn on Monday – recognizing that the coronavirus is primarily airborne.
The rapid reversal is yet another reason for a number of confusing missteps by the agency regarding official guidance that it publishes on its website. The most recent debacle concerns the spread of the virus through aerosols, tiny particles that contain the virus that can stay in the air for long periods of time and move more than a meter.
Aerosol experts noted Sunday that the agency had updated its description of the virus's spread to say the pathogen is mainly airborne.
The virus spreads through "respiratory droplets or small particles, such as aerosols, which are produced when an infected person coughs, sneezes, sings, speaks or breathes," according to the C.D.C. said in his manual published on Friday. These particles can be inhaled and cause infection, the agency added, "This is believed to be the main spread of the virus."
But that language disappeared on Monday morning.
"A draft of the proposed changes to these recommendations was incorrectly posted on the agency's official website," the agency said. Once the final version is complete, the update language will be released.
The document was "prematurely" posted on the C.D.C. published and is still being revised, according to a federal official familiar with the matter.
More than 200 aerosol transmission experts appealed to the World Health Organization in July to review the evidence of aerosol transmission of the coronavirus. The WHO. acknowledged that this avenue appears to be contributing significantly to the spread of the pandemic, but health experts disagree on its importance compared to the heavier breath droplets sneezed or coughed by infected patients.
"It is becoming very clear in the scientific community that aerosols are very important," said Linsey Marr, an airborne virus expert at Virginia Tech. "I hope it comes back in some form that recognizes the importance of aerosols."
In another change to the guidelines on its website, the C.D.C. said in August that people who are in close contact with an infected person but have no symptoms do not need to be tested. But last week after the New York Times reported that the guidelines were being dictated by government officials rather than academics, the agency reversed its position, saying that all close contacts made by infected people should be tested regardless of symptoms.
Much of Europe is scrambling to avoid another round of economically devastating, widespread lockdowns as new spikes emerge in France, hospitals begin to fill Spain and UK officials warn that a six-month battle to contain the virus is imminent.
New targeted lockdown measures were put in place in Madrid on Monday, preventing nearly one million residents from traveling outside their neighborhood, except for essential activities such as work, school or emergency medical care.
The rules, which some residents protested over the weekend, have risen across the country in some cases, but are concentrated in Madrid, where virus-related hospital stays have tripled. The number of new cases in Spain rose to an average of more than 10,000 per day in the past week and exceeded the official number in the spring when Spain was one of the worst affected nations in Europe. Tests are more common now.
Although the nationwide deaths have not risen to this year's level, Madrid authorities said on Sunday that 37 people had died of Covid-19 in the past 24 hours and about 4,000 patients were hospitalized, including around 300 on the intensive care unit . The authorities there were preparing to reopen field hospitals if necessary.
In the UK, senior scientific and medical advisors warned on Monday that infections could hit 50,000 a day by next month and lead to a significant spike in deaths as Wales announced an extension of lockdown regulations, due to go into effect Tuesday.
"We literally went around the corner in the bad sense," said Chris Whitty, England's chief physician, in a rare television statement alongside Patrick Vallance, the chief scientific advisor.
They warned the UK of a six month battle to fight the virus. The UK has fined at least £ 1,000 [approximately $ 1,300] fines for those who fail to self-isolate after testing positive or exposure to the virus. Fines, which start on September 28th, can go up to a maximum of £ 10,000 for repeat offenders or for the most serious violations.
The UK government debates the introduction of additional restrictions as it faces what Prime Minister Boris Johnson has already described as a "second wave". Mr Johnson is expected to speak about the virus situation on Tuesday.
Although the UK has fewer cases or deaths than some European countries like France and Spain, there are fears that it will go down the same path, with cases increasing sharply as children return to school, students to colleges and workers to offices.
Italian Health Minister Roberto Speranza announced Monday that the country would mandate virus tests for people traveling from Paris and other parts of France where the virus is "widely spread". Other areas are Nouvelle Aquitaine, Occitanie and Provence-Cote d & # 39; Azur. Last week, the French health minister announced lockdowns in cities like Lyon and Nice.
As of August 12, tests are mandatory for all people arriving in Italy who have visited Greece, Croatia, Spain or Malta in the last two weeks. The policy will take effect on Tuesday.
It's an astonishing number, nearly 200,000 people who have died from the coronavirus in the United States and nearly a million people around the world.
And the pandemic, which has seen cases skyrocketing and trending down after lockdowns in many countries, has reached a precarious point. Will countries like the United States see the virus slow down further? Or is a new climb on the way?
"Nobody knows what's going to happen," said Catherine Troisi, an infectious disease epidemiologist at the University of Texas Health Science Center in Houston. "This virus has surprised us on many fronts and we may be surprised again."
Fewer new cases have been discovered week after week in the United States since the end of July, after outbreaks first hit the northeast, then the south and west.
But in the past few days, the number of new cases in the nation has been rising again on a daily basis, fueling concerns about a resurgence of the virus with universities and schools reopening and colder indoor weather.
Worldwide, at least 73 countries are seeing an increase in newly discovered cases.
More than 90,000 new cases are currently being discovered in India every day, bringing the total number of cases in the country to over five million.
In Europe, the virus is searing across the continent again after lockdowns helped stifle the spring crisis.
Israel, with nearly 1,200 deaths attributed to the virus, imposed a second lockdown last week, one of the few nations to have done so.
When the first wave of infections spread around the world, governments imposed extensive restrictions: more than four billion people were in some kind of home stay at one point in time. Now many countries are desperately trying to avoid such intensive measures.
"We have a very serious situation ahead of us," said Hans Kluge, Regional Director of the World Health Organization for Europe, last week. "The weekly cases have now exceeded the reported cases when the pandemic peaked in Europe for the first time in March."
Nearly 200,000 people died from the virus in the United States on Monday morning. Just four months ago, in late May, the nation's death list hit 100,000. According to analyzes, even the current balance sheet could represent a considerable undercounting of the toll.
Dr. Tom Inglesby, the director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, said it was conceivable that the death toll in the United States could reach 300,000 if the public lost their vigilance.
"There are many countries that we could consider our economic counterparts or that are far less developed in terms of economies or health systems and that have far less mortality rates," he said.
Early Monday morning, Tiyanna Jackson, who quit her job that spring to care for her 4-year-old daughter Zuri, was awash with relief when she arrived at a pre-K center in the South Bronx. Finally she said that when Zuri started school she could go back to work.
In East New York, Brooklyn, Balayet Hossain's day began in disappointment after taking his two daughters to school only to find the kids, a kindergarten teacher and first grader, wouldn't be able to return to school buildings until next week.
And in Corona, a district of Queens that was particularly badly affected by the coronavirus in the spring, Baryalay Khan said he dropped his daughter Fathma off at Pre-K and made him feel like the city is finally recovering.
"Schools are reopening, which is a good sign," he said.
The mixture of joy, confusion, and hope was felt across New York City on Monday, a first day of school that was unique for the largest school district in the country.
The vast majority of the city's 1.1 million students started the school year online on Monday and will have the opportunity to return to classrooms over the next several weeks. Up to 90,000 preschool children as well as students with advanced disabilities flocked to about 700 school buildings on Monday morning to begin personal lessons. The city's 1,400 school buildings were largely empty for six months after the city abruptly closed classrooms in mid-March to slow the spread of the coronavirus.
Although the reopening on Monday falls far short of what Mayor Bill de Blasio originally promised – all students have the option to return to classrooms – it is still a significant milestone in New York’s long journey towards fully reopening. It is one of the few cities in the country where some children are now back in the classroom.
Black doctors distrust the F.D.A. and form an expert panel on veterinary vaccines.
A black medical organization is forming a task force to review federal decisions about coronavirus vaccines and treatments. This is the latest sign of the medical community's dwindling trust in the Food and Drug Administration and Centers for Disease Control and Prevention under President Trump.
The panel is set up by the National Medical Association, which was founded in 1895 when black doctors were banned from other medical societies, STAT News reported Monday.
Non-white communities have suffered disproportionately from the virus as hospitalization and mortality rates have been higher, especially in black communities.
"There is a need to provide a trusted ambassador for verified information to the African American community," said Dr. Leon McDougle, president of the association, told STAT News.
Dr. McDougle cited the Trump administration's urge to approve the malaria drug hydroxychloroquine as a treatment for Covid-19. The F.D.A. gave the drug emergency approval in March but revoked it in June when studies found significant risks and no benefits for Covid-19 patients.
Many experts fear that the urge to give a vaccine in a short period of time will result in a vaccination that hasn't been rigorously reviewed and tested, said Dr. McDougle told STAT News, and which could lead to black people who have long been underrepresented in drug trials – believing that a government-approved vaccine may still not be safe.
The foundations of trust between Black Americans and the medical establishment have been shaken over the years by unequal and sometimes unethical treatment, particularly an infamous 40-year research study known as the Tuskegee Experiment involving black men infected with syphilis were intentionally left untreated while researchers observed disease progression. The experiment ended in 1972.
Cuba faces one of the worst food shortages in years after the pandemic devastated its tourist-dependent economy.
Cuba, a police state with a strong public health system, was able to control the coronavirus quickly even as the pandemic plunged wealthier nations into crisis. But its economy, already hurt by the crippling of US sanctions and mismanagement, was particularly vulnerable to the economic devastation that followed.
As nations closed airports and locked borders to fight the spread of the virus, tourist travel to Cuba collapsed and the island lost a major source of hard currency, plunging it into one of the worst food shortages in nearly 25 years.
Often times, what groceries are available can only be found in government-run stores that are stocked with imports and are priced in dollars. The strategy, which was also used in the 1990s during the economic crisis known as the "Special Period", is used by the government to collect hard currency from Cubans who have savings or who receive money from friends or relatives abroad.
Even these stores are in short supply and prices can be exorbitant: a buyer recently couldn't find chicken or cooking oil, but there was a £ 17 ham for $ 230 and a £ 7 block of Manchego cheese with a price from $ 149 label.
And reliance on dollar stores, a move designed to prop up the socialist revolution in a country that prides itself on egalitarianism, has exacerbated economic inequality, say some Cubans.
"This is a business that is billed in currency that Cubans don't deserve," said Lazaro Manuel Domínguez Hernández, 31, a doctor who receives cash from a friend in the US to buy in one of the 72 new dollar stores to spend. "It marks the difference in the classes because not everyone can buy here."
Cuba's economy struggled before the coronavirus. The Trump administration has worked hard to strengthen the decades-old trade embargo and track Cuba's currency sources. It also imposed sanctions on tanker companies delivering oil from Venezuela to Cuba and restricting commercial flights from the United States to the island.
Cuba faces "the triple threat of Trump, Venezuela and then Covid," said Ted A. Henken, professor at Baruch College and author of the book "Entrepreneurial Cuba". "Covid was the thing that pushed them over the edge."
In other international news developments:
The Taj Mahal, one of India's most famous landmarks and a major tourist attraction, reopened Monday after being closed for more than six months to contain the spread of the virus. The monument, which receives an average of 20,000 visitors a day, will limit entry to 5,000 people per day. The website reopened despite India having more than 5.4 million cases and more than 90,000 cases daily, the second highest case number behind the US.
The German city Munich will require masks in some of its open spaces starting Thursday, including busy streets and popular squares, the mayor said on Monday. Although masks are required when shopping, on public transport, or in other indoor spaces in most parts of Germany, outdoor public spaces have avoided the mask rules that apply in other European cities. The authorities in Munich, where more and more infections are occurring, also limited the gatherings to a maximum of five people or members of two households. The city had already canceled the traditional Oktoberfest.
Virus restrictions on travel and gatherings will be lifted in most cases New Zealand Prime Minister Jacinda Ardern said Monday from midnight. However, restrictions still exist in Auckland, the country's largest city, and will be eased but not completely lifted as of Wednesday. The city was the center of a mysterious outbreak in August. New Zealand, an island nation of five million people, has reported just over 1,800 cases of the coronavirus and 25 deaths, according to a Times database.
Bill Gates, one of the world's richest and most influential health donors, says it is "outrageous" that coronavirus test results are not returned within 24 hours for most people.
"We have to come to terms with the fact that we have not done a good job," said Gates, founder of Microsoft, on "Fox News Sunday". "You know, part of the reluctance, I think, to fix the test system now, is that no one wants to admit that it's still outrageous."
Turnaround time will depend in part on the type of test being used and the processing capacity in the laboratory. With the types most commonly used in the U.S., results can take up to two weeks to last, leaving people who might be infected thinking in the dark about whether they could put others at risk. Tests that give faster results, including 24-hour testing, come at a heavy cost, putting those who can afford them an advantage over those who cannot.
Mr Gates criticized the Trump administration's handling of the pandemic, including its failure to develop a national test plan. The president has blamed tests for the increase in virus cases the country and has allowed politics to shape politics against the advice of experts.
The Bill and Melinda Gates Foundation is currently funding research and development programs related to the virus, Gates said. At the beginning of the crisis, he supported a popular testing program in Seattle that included virus testing at home. But the Food and Drug Administration ordered the program to be terminated.
Students attending schools in California's Cajon Valley Union School District, which serves a largely low-income community in San Diego County, have taken in-person classes as part of a hybrid learning model – a rarity in the state where more than nine out of ten of the 6 , 3 million California public students are only distance learning.
And so far it works.
The district's 27 schools have seen no outbreaks, although the county has had nearly 2,000 new cases in the past seven days. In one case, a group of students had to be quarantined for 14 days after a parent tested positive for the virus. However, no cases of students or teachers have occurred.
Another factor that contributes to the district's early success is its policy of providing a laptop for every student and the extensive high-tech teacher training it has offered over the past seven years.
In other developments around the US:
Fox & Friends host Steve Doocy apologized on Monday on behalf of the network for a recent report on a local subsidiary operating the Nashville Mayor, a Democrat, had hidden virus data. The partner withdrew his story, but not before the allegations made the rounds in conservative media.
This mix of denial and defiance goes against the overwhelming evidence of the spread and spread of the virus and is at the center of Mr Trump's re-election efforts as early voting begins in Minnesota, Virginia and other states.
To some extent, this point of view reflects the resentment of Americans living in regions of the country like New York state and the upper reaches of Michigan that have been relatively untouched by the virus but have endured drastic business shutdown measures.
"The people in need of shelter should do this, but I don't think it should ruin the economy," said Karla Mueller, a Republican and church administrator who lives many small businesses in the Fond du Lac, Wisconsin People. I just don't think that's necessary. "
But it is also a direct result of the message the Trump administration has sent with increasing urgency, say pollsters and strategists, as the president faces a major challenge in re-electing Joseph R. Biden Jr. , his democratic opponent. Mr Trump on Twitter has urged people to "liberate" states, imposing stay-at-home instructions, withholding aid from Democratic governors and undercutting health professionals who warned of unproven medical treatments and early school openings.
The president's critics say his confrontational approach has prevented the country from reaching consensus on how to tackle the worst public health crisis in more than 100 years.
"The emotion, the passion – it's gotten out of hand," said Michigan Democrat Representative Debbie Dingell, who pointed to two violent episodes in her state that resulted from disagreements over mask wear. “People were shot. A security guard in a dollar store. There was another fight at Walmart. That's crazy."
Polls show that Republicans approve of how Mr Trump handled the response to the virus and, unlike much of the country, believe that the United States was too slow to reopen. A majority of them also support the wearing of masks, though not to the same extent as Democrats or the nation as a whole.
People in some of the world's most vulnerable communities are facing economic disaster as a result of measures taken to contain the spread of the virus, according to a new report.
Economies around the world have been decimated by the pandemic, but for the people of Afghanistan, Iraq, Kenya, Venezuela and ten other countries included in the Norwegian Refugee Council report, the financial crises have exacerbated challenges before which they already stood.
In countries where conflict and displacement are the order of the day, many suffer from hunger, homelessness and an educational crisis that is compounded by lost work, incomes and increased debt.
With businesses and markets closed and travel restricted, nearly 80 percent of people in already precarious situations have seen their incomes fall from job losses. Without the means to pay rent, many have been evicted or evicted from their homes, the report said. With so few resources, people said they were less likely to send their children to school and not be able to afford medical treatment or even the most basic groceries.
"The world's most vulnerable communities are in a dangerous downward spiral," warned Jan Egeland, Secretary General of the Norwegian Refugee Council.
Hunger is growing around the world, and the United Nations World Food Program estimates that the number of people in developing countries facing potentially life-threatening food insecurity will almost double this year to 265 million. Seventy percent of respondents said they had reduced the number of meals for their households since the pandemic began.
Women and girls in vulnerable communities are hardest hit by the economic crisis, the report said. Not only have they lost jobs and taken on the burden of unpaid care, but like many around the world, financial pressures have led to an increase in domestic violence.
"Without urgent action, this crisis will spiral out of control," said Egeland.
The reporting was written by Livia Albeck-Ripka, Jenny Anderson, Stephen Castle, Manny Fernandez and Apoorva Mandavilli. Raphael Minder, Adam Nagourney, Jeremy W. Peters, Simon Romero, Marc Santora, Anna Schaverien, Christopher F. Schütze, Eliza Shapiro, Eileen Sullivan, Sameer Yasir and Karen Zraick.