Mitch McConnell, the Republican Senate leader, said states should consider declaring bankruptcy. The discovery of an early death rewrote the timeline of the U.S. outbreak.

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Another 4.4 million people filed jobless claims in the U.S. last week, bringing the staggering five-week total to more than 26 million.

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A line outside an unemployment office in Fayetteville, Ark., in April.
Credit…September Dawn Bottoms for The New York Times

The relentless increase in the jobless has intensified the debate over when to lift restrictions that have helped halt the virus’s rapid spread but placed the economy in a stranglehold.

State agencies have scrambled to handle the overwhelming flood of filings as well as a set of federal eligibility rules instituted to deal with the crisis.

With government phones and websites clogged and drop-in centers closed, legal aid lawyers are fielding complaints from people who say they don’t know where else to turn.

“Our office has received thousands of calls,” said John Tirpak, a lawyer with the Unemployment Law Project, a nonprofit group in Washington.

Pain is everywhere, but it is widespread among the most vulnerable.

In a survey that the Pew Research Center released on Tuesday, 52 percent of low-income households — below $37,500 a year for a family of three — said someone in the household had lost a job because of the coronavirus, compared with 32 percent of upper-income families (with earnings over $112,600). Forty-two percent of families in the middle have been affected as well.

Those without a college education have taken a disproportionate hit, as have Hispanics and African-Americans, the survey also found.

House will vote on a $484 billion relief plan, and McConnell suggests states declare bankruptcy.

But it will not provide money for state governments, even as governors across the country have had to divert resources to fight the virus while watching their revenue streams fall off a cliff.

With commerce ground to a halt, sales taxes — the biggest source of money for most states — have plummeted. Personal income taxes, usually states’ second-biggest revenue source, started falling in March, when millions lost their paychecks and tax withholdings stopped.

When the Labor Department releases its weekly report Thursday morning, the figures are expected to show that millions more Americans have joined the ranks of the 22 million who have applied for unemployment benefits

April also usually brings a big slug of income-tax money, but this year, the filing deadlines have been postponed until July.

It has all added up to a huge challenge for nearly every state in the union.

Senator Mitch McConnell, Republican of Kentucky and the majority leader, said that states should consider declaring bankruptcy rather than looking to the federal government.

States do not now have the ability to declare bankruptcy to reduce their financial obligations, but Mr. McConnell raised the possibility of letting them do so.

“I would certainly be in favor of allowing states to use the bankruptcy route,” he said. “It saves some cities. And there’s no good reason for it not to be available.”

Governor Andrew M. Cuomo of New York accused Mr. McConnell of hyperpartisanship, criticizing him for distinguishing among states based on their political leanings, rather than “states where people are dying. Why don’t we think about that? Not red and blue. Red, white and blue. They’re just Americans dying.”

The coronavirus and seasonal flu could collide in the fall.

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‘We Will Have Coronavirus in the Fall,’ Fauci Says

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, emphasized the importance of containing the virus in the fall when influenza season is expected to complicate the outbreak.

“We will have coronavirus in the fall. I am convinced of that, because of the degree of transmissibility that it has, the global nature. What happens with that will depend on how we’re able to contain it when it occurs. And what we’re saying is that in the fall, we will be much, much better prepared to do the kind of containment compared to what happened to us this winter. Now, the complicating issue is that unlike the syndromic and influenza-like observances that we have that you could pick it up by clinically what’s happening, it’s going to get complicated by influenza season. And I believe that’s what Dr. Redfield was saying, that it is going to be complicated.” “So you would caution against people thinking that in the fall, there’s not going to be coronavirus anymore and we won’t have to worry about it?” “No.” “Or if it is, it’ll be spotty and it won’t be a big problem that we have to worry about?” “There will be coronavirus in the fall. If we do, which we won’t, but let’s take an imaginary period. We say, ‘OK, coronavirus, forget about it. We’re not going to do anything about it.’ It will take off. That’s what viruses do. But that’s not what’s going to happen. We are going to respond to it, to not allow it to do that.

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Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, emphasized the importance of containing the virus in the fall when influenza season is expected to complicate the outbreak.CreditCredit…Doug Mills/The New York Times

Could the United States face two epidemics — flu and the coronavirus — at the same time this fall?

That frightening idea was raised by Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, during an interview on Tuesday with The Washington Post. He suggested that a new surge in coronavirus cases could coincide with the next flu season, causing an even more difficult crisis than the one the nation is facing now.

“We’re going to have the flu epidemic and the coronavirus epidemic at the same time,” he said.

At the White House briefing on Wednesday, President Trump continued to broadcast his personal hopes for the virus and questioned its ability to last into flu season in the fall and winter.

He said that Dr. Redfield had been misquoted and would clarify his remarks.

Dr. Redfield then said that The Post had quoted him correctly, but tried to dial back the alarm his comments had provoked.

“I think it’s really important to emphasize what I didn’t say,” Dr. Redfield said at the briefing. “I didn’t say this was going to be worse, I said it was going to be more difficult and potentially complicated.”

He reiterated several times that if the situation became more difficult, that did not mean it became worse.

“The key to my comments and the reason I really wanted to stress them was to appeal to the American public to embrace the flu vaccine with confidence,” he said. “One of the greatest tools we have as we go through the fall-winter season is to get the American public to embrace the influenza vaccine and thereby minimize the impact of flu to be the other respiratory disease we confront.”

Mr. Trump, without citing evidence, presented a different theory,

“We may not even have corona coming back,” he said.

“If it comes back,” the president continued, “it won’t be coming back in the form that it was, it will be coming back in smaller doses that we can contain. What the doctor was saying, and I spoke to him at great length, he was saying if it should come back, you have the flu and the embers of corona, but in my opinion from everything I’ve seen, it can never be like anything like we witnessed right now. It’s nothing like — what we’ve just gone through, we will not go through.”

Epidemiologists and infectious disease experts interviewed before the Wednesday briefing doubted that the virus would go away, and did not rule out the prospect of a worse crisis in the fall if the two diseases strike at the same time.

“When flu season comes, there is the possibility that we will be dealing with two respiratory viruses at the same time — flu and Covid,” Dr. Thomas R. Frieden, the former head of the C.D.C. and the president of Resolve to Save Lives, a nonprofit focused on disease prevention, said in an email. “This could be a double challenge for our health care systems.”

Dr. Anthony S. Fauci, the head of the National Institute of Allergy and Infectious Diseases, also differed from the president’s optimistic forecast.

“We will have coronavirus in the fall,” he said. “I am convinced of that.”

The U.S. doctor in charge of developing a vaccine says he was ousted for his doubts on hydroxychloroquine.

The official who led the federal agency involved in developing a coronavirus vaccine said on Wednesday that he was removed from his post after he pressed for rigorous vetting of hydroxychloroquine, an anti-malaria drug embraced by President Trump as a coronavirus treatment, and that the administration had put “politics and cronyism ahead of science.”

As Michael D. Shear and Maggie Haberman reported, Rick Bright was abruptly dismissed this week as the director of the Department of Health and Human Services’ Biomedical Advanced Research and Development Authority, or BARDA, and removed as the deputy assistant secretary for preparedness and response. He was given a narrower job at the National Institutes of Health.

In a statement, Dr. Bright, who received a Ph.D. in immunology and molecular pathogenesis from Emory University, assailed the leadership at the health department, saying he was pressured to direct money toward hydroxychloroquine, one of several “potentially dangerous drugs promoted by those with political connections” and repeatedly described by the president as a potential “game changer” in the fight against the virus.

“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the Covid-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” he said in his statement. “I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way.”

Doubts about the use of hydroxychloroquine as a treatment for the coronavirus and the lack of evidence about the drug’s effectiveness — including some small studies that indicated patients could be harmed — appear to have dampened Mr. Trump’s enthusiasm for it.

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‘What Do You Have to Lose?’ How Trump Has Promoted Malaria Drug

President Trump has pushed a malaria drug, hydroxychloroquine, as a treatment for coronavirus patients. A recent study found that patients taking it had higher death rates compared with those who did not.

It is known as a malaria drug, and it’s been around for a long time. And it’s very powerful, but the nice part is it’s been around for a long time, so we know that if things don’t go as planned, it’s not going to kill anybody. And it’s shown very encouraging very, very encouraging early results. There’s a possibility — a possibility — and I say it: What do you have to lose? I’ll say it again, what do you have to lose? Take it. I really think they should take it. But it’s their choice, and it’s their doctor’s choice or the doctor’s and the hospital. But hydroxychloroquine, try it if you’d like. It will be, not a game changer because that’s not a nice enough term — it will be wonderful. It’ll be so beautiful. It’ll be a gift from heaven. If it works that would be great. If it doesn’t work, we know for many years — malaria, it’s incredible what it’s done for malaria. It’s incredible what it’s done for lupus. But it doesn’t kill people. But if it was somebody else other than President Trump that put it forward, if some other person put it forward that said, “Oh, let’s go with it, you know, what do you have to lose?”

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President Trump has pushed a malaria drug, hydroxychloroquine, as a treatment for coronavirus patients. A recent study found that patients taking it had higher death rates compared with those who did not.CreditCredit…Craig Lassig/Reuters

Startling discovery rewrites timeline of virus’s spread in the U.S.

Weeks before there was evidence that the coronavirus was spreading in U.S. communities, Patricia Dowd, a 57-year-old auditor at a Silicon Valley semiconductor manufacturer, developed flulike symptoms and abruptly died in her San Jose kitchen, prompting a search for what had killed her. Flu tests were negative. The coroner was baffled. It appeared that she had suffered a massive heart attack.

But tissue samples from Ms. Dowd, who died on Feb. 6, have now shown that she was infected with the coronavirus — a startling discovery that has rewritten the timeline of the virus’s early spread in the United States and suggested that the optimistic assumptions that drove federal policies over the early weeks of the outbreak were misplaced.

The unexpected new finding, as reported by Thomas Fuller, Mike Baker, Shawn Hubler and Sheri Fink, makes clear that the virus was circulating in the Bay Area of California as early as January, even before the federal government began restricting travel from China on Feb. 2. It also raises new questions about where else the virus might have been spreading undetected.

With little local testing throughout February — in part because of botched testing kits from the Centers for Disease Control and Prevention, along with strict guidelines that limited who could get tested — officials were not aware of the virus transmitting locally in the country until Feb. 26, in Solano County, Calif.

Previous cases had involved people who had traveled to China, where the outbreak began, or who had been exposed to someone who was sick. But the Feb. 26 case in Solano County was of unexplained origin. Similar cases of community transmission were quickly identified in nearby Santa Clara County, which includes San Jose, as well as in Washington State and Oregon.

The new test results made public late Tuesday show that even this timeline failed to reveal how long the virus had been circulating. Ms. Dowd had not recently traveled outside the country, the authorities said, and yet she died a full 20 days before the earliest recorded case of community transmission. Another previously unconnected death in Santa Clara County, on Feb. 17, has also now been linked to the coronavirus.

“Each one of those deaths is probably the tip of an iceberg of unknown size,” Dr. Sara Cody, Santa Clara County’s medical officer, said in an interview.

After Trump’s rebuke, Georgia governor signals he will stick with reopening plans.

President Trump on Wednesday criticized the decision of a political ally, Gov. Brian Kemp of Georgia, to allow many businesses to reopen this week, saying the move was premature given the number of virus cases in the state.

“I want him to do what he thinks is right, but I disagree with him on what he is doing,” Mr. Trump said at the White House. “I think it’s too soon.”

Mr. Kemp, a Republican, announced on Monday that he had cleared the way for what he described as a measured process meant to bolster the economy, as Georgia, like the rest of the nation, grapples with the devastation brought by the pandemic. The governor’s plan gives permission to gyms, hair and nail salons, bowling alleys and tattoo parlors to reopen on Friday. Then, on Monday, restaurants are allowed to resume dine-in service, and movie theaters and other entertainment venues can reopen.

Yet the decision was immediately assailed, as public health experts, the mayors of Georgia’s largest cities and others warned that it stood to have perilous consequences. Business owners who were otherwise eager to revive their livelihoods said they would hold off.

Mr. Kemp acknowledged speaking with Mr. Trump in a series of Twitter posts after the president’s briefing. And while he praised Mr. Trump for his “bold leadership and insight,” he gave no indication he was reconsidering his decision.

“Our next measured step is driven by data and guided by state public health officials,” he wrote.

States around the nation have been trying to balance combating a public health crisis with the need to ameliorate a growing economic crisis. In some states, small protests — with the support of some conservative groups — have urged governors to ease restrictions. But polls have found that Americans are more fearful of easing restrictions too early than too late, and some business leaders have cautioned against moving too quickly to reopen.

On Wednesday, Mayor Carolyn Goodman of Las Vegas called for the city’s casinos, restaurants and other businesses to immediately reopen but declined to provide any guidance on social distancing measures that might protect employees and customers.

“They better figure it out,” she said in an interview on CNN, during which she said she had offered the city “to be a control group” for relaxing restrictions.

The mayor, an independent, does not have the power to reopen the city’s economy, but Gov. Steve Sisolak of Nevada, a Democrat, and the largest union representing Las Vegas casino workers swiftly condemned her comments. “I will not allow the citizens of Nevada, our Nevadans, to be used as a control group,” Mr. Sisolak said.

During the weeks of legal wrangling that went all of the way to the Supreme Court, Texas had argued that abortion was like any other elective surgery, and should be delayed to preserve the personal protective equipment needed by medical workers exposed to the virus.

Lawyers for abortion clinics said the state was using the pandemic to advance its own political agenda, and took the state to court.

Abortion access in Texas swung wildly for a month, with clinics canceling dozens of appointments and rescheduling them days later, as the case bounced through the court system. Texas residents scrambled, with some traveling long distances to clinics in nearby states like Kansas and Colorado.

At least six other states — Alabama, Arkansas, Louisiana, Ohio, Oklahoma and Tennessee — have tried similar abortion restrictions, often through emergency orders by their governors.

But hospitals around the country have been under financial strain after postponing often lucrative elective surgical procedures to make way for coronavirus patients, and last week, Gov. Greg Abbott of Texas eased the restrictions on some surgical procedures. A court filing in a federal court in Texas late Wednesday confirmed that abortions were included in the relaxing of the rules.

“Finally, women in Texas can get the time-sensitive abortion care that they are constitutionally guaranteed,” said Nancy Northup, president and chief executive of the Center for Reproductive Rights, which represents some of the clinics. “Women never should have had to go to court to get essential health care.”

Dyana Limon-Mercado, the executive director of Planned Parenthood Texas Votes, said, “The past month has been an unthinkable nightmare for Texans who have been forced to travel out of state just to access essential health care.”

Islam’s call to prayer will play on loudspeaker in Minneapolis to aid social distancing during Ramadan.

Islam’s call to prayer will play throughout a Minneapolis neighborhood during Ramadan as the authorities urge people to stay apart during the holy month.

The call, known as Adhan, will be played over a loudspeaker in the Cedar-Riverside area of the city five times a day until Ramadan’s conclusion next month.

“At a time when physical distancing requires we pray apart, it’s incumbent on leaders to create a sense of togetherness where we can,” Mayor Jacob Frey, who helped arrange a noise permit, said in a statement.

“Adhan provides solidarity and comfort — both of which are essential during a time of crisis,” he said. “As our Muslim community prepares for Ramadan, we hope the broadcast will offer a measure of stability and reassure our entire city that we are all very much in this together.”

The call will come from a loudspeaker positioned outside the Dar Al-Hijrah Mosque, near downtown and the University of Minnesota, and will be played “at volumes consistent with city regulations.”

Local officials said they expected thousands of people would be able to hear it.

Jaylani Hussein, the executive director of the Minnesota chapter of the Council on American-Islamic Relations, said the playing of the call would be “welcomed by the Muslim community and all those who value diversity and mutual understanding.”

Ramadan, which begins Thursday and concludes May 23, is among the holiest periods for Muslims, who fast during the day throughout the month.

In tight-knit company towns across the Midwest, rising cases and growing fears.

As some big cities on the coasts of the United States are starting to see coronavirus cases level off, a staggering number of small Midwestern towns anchored by meatpacking plants and other factories are finding themselves as the new hot spots.

The new cases are worrying because they come as many governors and city officials are contemplating reopening the nation’s businesses. But the outbreaks also raise the prospect of new spread in less populous communities in the middle of the country, complicating those company towns’ debates over when to restart public life.

Tyson Foods closed a pork processing plant in Columbus Junction, Iowa, this month, and announced on Wednesday that it was closing a plant in Logansport, Ind., as well as another large pork processing plant in Iowa, where public officials had called to shutter the facility amid a growing outbreak. A Smithfield meatpacking plant in Sioux Falls, S.D., has been linked to nearly 1,000 cases, and a JBS pork plant in Worthington, Minn.; a Hormel food processing facility in Rochelle, Ill.; and a ConAgra food processing plant in Marshall, Mo., are among others that have reported significant outbreaks.

“I’ve lived in this community all my life,” said Cindy Johnston, who lives near the Tyson plant on the edge of Columbus Junction, a small community along the Iowa River, “and I’ve never seen it so scared.”

Tips on tending to your budget.

You may be wondering how to cut some expenses right now. One way is to figure out who owes you money from the many services you pay for but aren’t in business right now. Think day camps, gyms and airlines. But when is it fair to ask for your money back? Here are some guidelines to help.

Global food crisis could double the number of people facing acute hunger to 265 million.

The coronavirus has sometimes been called an equalizer because it has sickened both rich and poor, but when it comes to food, the commonality ends. It is poor people, including large segments of poorer nations, who are now going hungry and facing the prospect of starving.

“The coronavirus has been anything but a great equalizer,” said Asha Jaffar, a volunteer who has taken food to families in the slum of Kibera, in the Kenyan capital, Nairobi. “It’s been the great revealer, pulling the curtain back on the class divide and exposing how deeply unequal this country is.”

Already, 135 million people had been facing acute food shortages, but with the pandemic, 130 million more could go hungry in 2020, said Arif Husain, chief economist at the World Food Program, a United Nations agency. Altogether, an estimated 265 million people could be pushed to the brink of starvation by year’s end.

Reporting for The New York Times from Kenya, Abdi Latif Dahir writes that the impact can already be seen around the world.

In the largest slum in Kenya’s capital, people desperate to eat set off a stampede during a recent giveaway of flour and cooking oil, leaving scores injured and two people dead.

In India, thousands of workers are lining up twice a day for bread and fried vegetables to keep hunger at bay.

And across Colombia, poor households are hanging red clothing and flags from their windows and balconies as a sign that they are hungry.

“We don’t have any money, and now we need to survive,” said Pauline Karushi, who lost her job at a jewelry business in Nairobi, and lives in two rooms with her child and four other relatives. “That means not eating much.”

What’s happening around the world.

Our team of international correspondents is tracking developments in the coronavirus pandemic.

Reporting was contributed by Eileen Sullivan, Alan Blinder, Patricia Cohen, Carl Hulse, Sheri Fink, Mike Baker, Thomas Fuller, Shawn Hubler, Peter Baker, Karen Barrow, Lara Jakes, Zoltan Kanno-Youngs, Rick Rojas, Katie Rogers, Marc Santora, Dionne Searcey, Sabrina Tavernise and Neil Vigdor.

  • Updated April 11, 2020
    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • How can I help?

      The Times Neediest Cases Fund has started a special campaign to help those who have been affected, which accepts donations here. Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


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