Fauci cautions the virus could disrupt life in the U.S. until ‘maybe even towards the end of 2021.’
The United States should not expect a return to normal until “well into 2021, maybe even towards the end of 2021,” Dr. Anthony S. Fauci, the nation’s top infectious diseases expert, said on Friday.
In an interview with “Andrea Mitchell Reports” on MSNBC, Dr. Fauci addressed when people would most likely be able to do things again that they had done before the pandemic, such as going to an indoor movie theater “with impunity.” While a vaccine may be available by the end of the year, he said, “by the time you mobilize the distribution of the vaccinations, and you get the majority or more of the population vaccinated and protected, that’s likely not going to happen till the mid or end of 2021.”
Dr. Fauci was also asked about comments he had made on Thursday in a panel discussion at Harvard Medical School, where he said “we need to hunker down and get through this fall and winter because it’s not going to be easy.” Ms. Mitchell pointed out that this conflicted with what President Trump had said at the White House on the same day, that the country had “rounded the final turn” on the virus.
“I have to disagree,” Dr. Fauci said of Mr. Trump’s optimistic read on the situation.
“We’re plateauing at around 40,000 cases a day and the deaths are around 1,000.” He raised concerns that Labor Day could make that number rise again, as Memorial Day and the Fourth of July had done before.
But in any case, he said “what we don’t want to see is going into the fall season when people will be spending more time indoors — and that’s not good for a respiratory borne virus — you don’t want to start off already with a baseline that’s so high.”
As of Thursday, there had been an average of 35,629 cases per day over the previous week, a decrease of 16 percent from the average two weeks earlier, according to a Times database. Case numbers remain persistently high across much of the country, though reports of new cases have dropped considerably since late July, when the country averaged well over 60,000 per day.
But even as many of the country’s most populous states saw vast improvement — and as the Northeast kept case reports low — new infections were rising by late summer across parts of the Midwest and South.
Deaths, though still well below their peak levels in the spring, averaged around 700 per day in mid-September, more than were reported in early July.
From Asia to Africa, China promotes its vaccine candidates to win friends.
China is still most likely months away from mass producing a vaccine that is safe for public use. But the country is using the prospect of the drug’s discovery in a charm offensive aimed at repairing damaged ties and bringing friends closer in regions China deems vital to its interests.
Latin American and Caribbean nations will receive loans to buy the medicine, and Bangladesh will get over 100,000 free doses from a Chinese company.
In the Philippines, where China is competing with the United States for influence, President Rodrigo Duterte told lawmakers in July that he had “made a plea” to China’s leader, Xi Jinping, for help with vaccines. He also said he would not confront China over its claims to the South China Sea.
A day later, Wang Wenbin, a spokesman for China’s Foreign Ministry, said China was willing to give the Philippines priority access to a vaccine.
China’s vaccine pledges, on top of earlier shipments of masks and ventilators around the world, help it project itself as a responsible player and could also help it push back against accusations that the ruling Communist Party should be held accountable for its initial missteps when the coronavirus first emerged in China in December.
The Trump administration has roundly attacked Beijing over its handling of the virus crisis, as well as over accusations that Chinese-directed hackers have tried to steal vaccine research to gain an edge. The Justice Department indicted two Chinese suspects accused of targeting pharmaceutical companies in July.
China is a leader in the global race for a Covid-19 vaccine, and four out of the eight late phase clinical trials are for Chinese vaccines. The country began testing experimental vaccines on soldiers and employees of state-owned companies in July, and the testing has quietly expanded to include health care and aviation workers. Chinese vaccine makers have built factories that can produce hundreds of thousands of doses.
The United States has three vaccine candidates in late-stage trials, with Pfizer saying it could apply for emergency approval as early as October and Moderna saying it hopes to have a vaccine by the end of the year. AstraZeneca, a British-Swedish company that received U.S. government funding to develop its vaccine, paused its late-stage global trials this week because of a serious suspected adverse reaction in a participant.
But Chinese vaccine companies that have gone abroad to conduct clinical trials have also generated controversy amid fears that local residents are being treated like guinea pigs. And some political experts worry about the leverage that China could wield over countries that accept vaccines.
“Should we be suspicious, or should we be grateful?” asked Muhammad Zulfikar Rakhmat, an academic at Universitas Islam Indonesia, who researches China’s foreign policy in Indonesia.
The other way the virus will kill: hunger.
Long before the coronavirus swept into her village in the rugged southeast of Afghanistan, Halima Bibi knew the gnawing fear of hunger. It was a relentless source of anxiety as she struggled to nourish her four children.
Her husband earned about $5 a day, hauling produce by wheelbarrow from a local market to surrounding homes. Most days, he brought home a loaf of bread, potatoes and beans for an evening meal.
But when the virus arrived in March, taking the lives of her neighbors and shutting down the market, her husband’s earnings plunged to about $1 a day. Most evenings, he brought home only bread. Some nights, he returned with nothing.
“We hear our children screaming in hunger, but there is nothing that we can do,” said Ms. Bibi, speaking by telephone from a hospital in Kabul, where her 6-year-old daughter was being treated for severe malnutrition. “That is not just our situation, but the reality for most of the families where we live.”
As the global economy absorbs the most punishing reversal of fortunes since the Great Depression, hunger is on the rise. Those confronting potentially life-threatening levels of so-called food insecurity in the developing world are expected to nearly double this year to 265 million, according to the United Nations World Food Program.
The largest numbers of vulnerable communities are concentrated in South Asia and Africa, especially in countries that are already confronting trouble, including military conflict, extreme poverty and climate-related afflictions like drought, flooding and soil erosion.
How China brought nearly 200 million students back to school.
Under bright blue skies, nearly 2,000 students gathered this month for the start of school at Hanyang No. 1 High School in Wuhan, the Chinese city where the coronavirus first emerged.
Medical workers stood guard at school entrances, taking temperatures. Administrative officials reviewed the students’ travel histories and coronavirus test results. Local Communist Party cadres kept watch, making sure teachers followed detailed instructions on hygiene and showed an “anti-epidemic spirit.”
“I’m not worried,” a music teacher at the school, Yang Meng, said in an interview. “Wuhan is now the safest place.”
As countries around the world struggle to safely reopen schools this fall, China’s Communist Party is harnessing the power of its authoritarian system to offer in-person learning for about 195 million students in kindergarten through 12th grade at public schools.
It has mobilized battalions of local officials and party cadres to inspect classrooms, deployed apps and other technology to monitor students and staff, and restricted their movements. It has even told parents to stay away for fear of spreading germs.
China’s leader, Xi Jinping, said in a speech on Tuesday that the country’s progress in fighting the virus, including the opening of schools, had “fully demonstrated the clear superiority of Communist Party leadership and our socialist system.”
In many ways, China is applying the same heavy-handed model to reopen schools that it has used to bring the virus under control. To stop the epidemic, the authorities imposed harsh lockdowns and deployed invasive technologies to track residents, raising public anger in some places and concerns about the erosion of privacy and civil liberties.
With schools, the government’s effort has in some places been met with similar frustrations. Teachers, who are at times doubling as medical workers, checking for fevers and isolating sick students, say they are exhausted by the new protocols. Students have complained that some policies, such as lockdowns on university campuses, are excessive.
“The Chinese system moves by itself,” said Yong Zhao, a scholar at the University of Kansas who has studied education in China. “The system is run like a military: it just goes for it, no matter what anyone thinks.”
A C.D.C. study investigates a possible link between dining out and exposure to the virus.
A new study suggests that restaurant dining may have increased the risk of exposure to the virus for some patrons, but several researchers said that the links between contracting the virus and eating out should be viewed with caution, because the study did not distinguish between patrons who dined at indoor or outdoor facilities, and didn’t rely on contact tracing.
The study, released by the Centers for Disease Control and Prevention, analyzed 314 patients and found that those who tested positive for the virus were twice as likely to have eaten at a restaurant in the previous two weeks as those who tested negative.
“We want people to understand as society opens back up where the risks are for Covid-19,” said Dr. Wesley Self, a doctor and researcher at Vanderbilt University and an author of the study.
Dr. Self said he believed in retrospect that the researchers should have made the distinction between indoor and outdoor dining.
Gov. Andrew M. Cuomo announced on Wednesday that New York City would lift its prohibition on indoor dining on Sept. 30, allowing restaurants to operate at one-quarter indoor capacity. In July, the governor and Mayor Bill de Blasio halted a plan to resume indoor dining, citing concerns about a resurgence of the virus. (The conditions of outdoor dining are considered less risky.)
Last month, data from a number of states and cities showed that community outbreaks had centered on restaurants and bars. Contact tracers in Maryland found that 12 percent of new cases in July were traced to restaurants, and in Colorado, 9 percent of outbreaks were traced to bars and restaurants. The patients in the new study were treated at 11 hospitals in California, Colorado, Maryland, Massachusetts, Minnesota, North Carolina, Ohio, Tennessee, Utah and Washington.
Some researchers have urged caution in interpreting the findings of the new C.D.C. study.
“The way folks have interpreted this study is that going to a restaurant causes Covid,” said Zack Cooper, an associate professor of public health at the Yale School of Public Health. “That isn’t what this type of study is designed to show. What this shows is people who have Covid were more likely to have been in restaurants.”
Dr. Cooper said dining in restaurants was probably associated with increased risk because it puts people in proximity with others who are not exercising caution in limiting their exposure to the virus. He said researchers needed to be careful in studying the risks of common activities, given the challenges for the general public in interpreting statistical findings.
In an interview with CNN on Friday, Dr. Fauci was asked what the study’s findings meant for people who wanted to dine out. He said that he would not completely rule out going to a restaurant.
“But,” he said, “restaurant owners should be aware that, particularly if you’re in a zone where you have a significant degree of infection, you either do outdoor dining or if it’s indoor, you don’t do it at 100 percent capacity.”
Canada reports zero Covid-19 deaths in a 24-hour period.
Canada reported zero deaths linked to Covid-19 in a 24-hour period on Friday night, according to government data, even as the number of new cases in the country has ticked slowly upward as restrictions ease and schools reopen for in-person classes.
There have been at least 135,600 confirmed coronavirus cases in Canada as of Friday evening, according to the government. The number of new cases being reported daily has fallen significantly from an early May peak of nearly 3,000 cases, and now averages a few hundred a day. But as of Thursday, the average number of new daily cases was up by nearly 50 percent compared with a few weeks earlier.
Four Canadian provinces — Alberta, British Columbia, Ontario and Quebec — account for more than 4,000 of the 4,439 cases that the country has reported over the past week. Those provinces also accounted for all of the 23 deaths related to Covid-19 that were reported over the same period. This week, Ontario, Canada’s most populous province, said that it will take a four-week “pause” before it considers loosening restrictions or allowing further economic reopening.
Over all, at least 9,163 deaths in the country have been linked to Covid-19. Quebec accounts for more than half of them, with 5,774, followed by Ontario, with 2,813.
Canada has previously reported zero Covid-19 deaths in 24-hour periods, although measuring that can be imprecise because of delays in reporting. The average number of daily reported deaths over the past week is three.
By contrast, as of Thursday the average number of daily reported deaths over the past week in the United States was 702.
Colleges are now hot spots, as nursing homes and meatpacking plants were earlier in the pandemic.
It began as a trickle of coronavirus infections as college students arrived for the fall semester. Soon that trickle became a stream, with campuses reporting dozens, and sometimes hundreds of new cases each day.
Now the stream feels like a flood. In just the past week, a New York Times survey has found, American colleges have recorded more than 36,000 additional infections, bringing the total of 88,000 cases since the pandemic began.
Not all those cases are new, and the increase is partly the result of more schools beginning to report the results of more testing. But The Times survey of 1,600 colleges also shows how widely the contagion has spread, with schools of every type and size, and in every state reporting infections.
Only about 60 of the campus cases have resulted in death — mostly of college staff members — and only a small number have resulted in hospitalizations. But public health experts say the rising number also underscores an emerging reality: Colleges and universities have, as a category, become hot spots for virus transmission, much as hospitals, nursing homes and meat packing plants were earlier.
Hoping to salvage some sense of normalcy — along with lost revenue from housing fees and out-of-state tuition — many schools invested heavily in health measures to bring at least some students back to campus.
But outbreaks have forced course correction after correction.
The State University of New York at Oneonta sent students home after the virus spun out of control in less than two weeks, with more than 500 cases. And the University of Illinois at Urbana-Champaign mounted one of the most comprehensive safety plans, requiring more than 40,000 students to be tested for the virus twice a week, and barring them from campus buildings without app verification that the latest test was negative. But, some students continued partying after they received a positive test result, and hundreds were infected.
A lockdown brought the number of new cases at the university down again. But its surge pushed its metro regions toward the top of the list of U.S. areas with most cases per capita, as did spikes at universities in Oxford, Miss., and Athens, Ga.
Officials in Oregon’s state corrections system this week began moving hundreds of inmates out of the path of the wildfires creeping toward some of their prisons. But the introduction of large groups of prisoners into different facilities may be exposing them to another risk — contracting the virus.
Juan Chavez, a lawyer with the Oregon Justice Resource Center, a nonprofit legal advocacy group, said that relocated inmates were sleeping on mattresses crammed close together, but it’s “picking your poison” between the virus and the fires. He added that he fears the relocated inmates could contribute to a superspreader event for the virus in the prisons.
But few other options exist for the Oregon Department of Corrections, which has evacuated four prisons so far.
Inmates will be “housed with others from their home institution whenever possible,” and officials are aware of the potential virus spread, said Jennifer Black, a spokeswoman for the prison system.
The virus has already ravaged the state prison population. In June, the governor commuted the sentences of 57 inmates who were vulnerable to the virus. There have been 829 confirmed cases in prison system facilities, including staff members and inmates, according to the department’s records. Six people have died.
At the Oregon State Penitentiary, 36 staff members and 143 inmates have tested positive.
Helene Cooper, a Pentagon correspondent with The New York Times, was selected to participate in a vaccine trial for Moderna, a biotech company based in Massachusetts. Ms. Cooper, who covered the Ebola outbreak for The Times in 2014, shared her experience in a personal essay. Following are some excerpts.
“I signed up for a Covid vaccine trial,” I texted a group of friends, all reporters with smart mouths on them. But one response gave me pause.
“I admire your dedication to the cause,” my friend Mark Mazzetti told me. But he was clear in his text: “You gotta be really careful given your underlying condition. You could be given a placebo and sent to hang out in hot spots.”
I hadn’t thought of the placebo part of the vaccine trial when I signed up. I am a Type 1 diabetic — a chronic autoimmune disorder I have had since I was 15, with asthma to boot, so I am firmly in the high-risk category. That had been made clear to me by Dr. Fauci himself in early March when I ran into him in the green room for NBC’s “Meet the Press.”
“What happens if I get Covid?” I had asked him.
“I’m not saying you’re a dead duck,” he replied, “but I cannot stress enough that you really need to not get it.”
So last Wednesday, I arrived at George Washington University Hospital at the appointed time in all my triple-risk glory: Black woman, Type 1 diabetic, asthmatic. I hadn’t slept the night before.
France is facing a worrying surge in cases, the government said on Friday, warning that the new cases were rapidly increasing and that hospitals were seeing an uptick in admissions.
Many expected new restrictions, especially after the government’s scientific council said earlier this week that the authorities would have to take “difficult measures.”
But the authorities did not announce new rules, vowing instead to improve the country’s immense testing program — which has been plagued by delays in recent weeks — and urging the French to continue social distancing measures.
The country registered about 54,000 new cases over the past 7 days — less than Spain, but far more than other neighboring countries like Italy or Germany. Nearly 31,000 people in France have died of the virus.
On Thursday, there were nearly 10,000 new confirmed cases, a record since the beginning of the epidemic. The surge is due partly to widespread testing, but the positivity rate for those tests has also increased — it was at 5.4 percent this week, up from 1.5 in late July — meaning that the virus is picking up speed.
Jean Castex, the French prime minister, said in a televised address on Friday that authorities were particularly worried about a renewed increase in the number of hospitalizations, especially of elderly people.
“This shows there is no Maginot line,” said Mr. Castex, referring to national fortifications built in the 1930s. Even if the virus is still mostly spreading among younger people, he said, it “inevitably” ends up reaching more vulnerable segments of the population.
In other developments around the world:
Myanmar has locked down half of its largest city, Yangon, and halted travel between regions in an effort to halt the spread of the virus. Myanmar’s leader, Daw Aung San Suu Kyi, urged the public to follow health protocols in a nationally televised address on Thursday. The number of confirmed cases has gone up fivefold in less than three weeks, reaching 2,422 on Friday, with 14 deaths, according to a Times database.
India again broke a record for daily new cases, reporting 97,750 on Saturday, according to a Times database. The previous record, set Friday, was 96,551.
North Korea has deployed crack troops along its border with a shoot-to-kill order to prevent smugglers from introducing the coronavirus into its isolated and malnourished population, the United States’ top general in South Korea, Gen. Robert B. Abrams, said on Thursday. North Korea insists that it has not confirmed a single case of Covid-19. But outside experts are skeptical, citing the country’s decrepit public health capabilities and the long border it shares with China, where the epidemic first erupted.
New studies underscore the gravity of Britain’s surge.
A series of studies released on Friday offered the strongest evidence yet that the coronavirus is surging again in Britain, suggesting that the country may be following other European nations in seeing significant new spikes of the virus.
Scientists from Imperial College London said that the prevalence of coronavirus infections doubled every eight days from late August to early September in England, a significant quickening of the spread.
The scientists tested a random sample of 150,000 people and estimated that the so-called reproduction number — a measure of how many people on average a single patient will infect — was 1.7, indicating a growing outbreak. An R number below 1 would indicate a dwindling outbreak.
The government’s own scientific advisory group offered a more conservative estimate of the virus’s spread — it said the R number was between 1 and 1.2 in Britain — but still said that “the epidemic is growing.”
The British government reported 3,539 new daily cases on Friday, lifting its seven-day average well over 2,500, a level last seen in May. Its total caseload has surpassed 361,000, with more than 41,600 deaths.
Heeding the surge, Prime Minister Boris Johnson announced this week that the government would ban gatherings of more than six people. But with students now returning to school and Britons socializing inside more as the weather cools, scientists said that might not be enough.
“This is a massive blow to the government’s strategy to contain the spread of Covid-19,” Simon Clarke, an associate professor at the University of Reading, said of the Imperial College London study.
Mr. Johnson has been encouraging people to go back to work, eat out at restaurants, patronize pubs and send children back to school. Many Britons have also remained resistant to wearing face masks in crowded places.
Britain’s new contact-tracing app will be introduced in England and Wales on Sept. 24, Mr. Johnson’s government announced on Friday. The government had previously been criticized over the long delay; earlier versions were scrapped months ago.
Florida will reopen bars on Monday, and people in Puerto Rico can go back to the beach.
Halsey Beshears, Florida’s secretary for the Department of Business and Professional Regulation, announced on Twitter on Thursday that the state would allow bars to operate at half capacity starting Monday. He rescinded an executive order from June that had banned drinking at bars as the state experienced a surge.
Gov. Ron DeSantis, a Republican, had hinted earlier on Thursday that his administration would not only soon allow the reopening of bars and restaurants but also forbid future closures.
“I think that we probably need to just have it that everyone knows they’ll be able to operate,” he said. “The closures are just totally off the table, because it’s hard to plan if you think you have the sword of Damocles hanging over your head.”
On Friday, Mr. DeSantis announced that the state’s two biggest counties, Miami-Dade and Broward, would move to the second phase of reopening on Monday, paving the way for schools to bring students back into classrooms sooner than expected.
The mayor of Miami-Dade County, Carlos Gimenez, and the county’s schools superintendent, Alberto Carvalho, appeared with the governor at the news conference on Friday. Mr. Carvalho said he expects to make an announcement about physically opening schools before the end of the month; he had previously established a timeline to bring students back by Oct. 5.
About 51 percent of parents of public school students have told the district they want to send their children back, he said, adding that “six feet of distance is probably not going to be possible in many schools.”
Mr. Gimenez, whose county was hit hardest in the state, said that his administration would begin to look at businesses that could now reopen under certain restrictions, including movie theaters and bowling alleys, though he reiterated it would not include bars and nightclubs. On Wednesday, he said he did not foresee reopening them “until we get a vaccine.”
“We’re still not out of the woods yet, but we’re getting close,” he said Friday.
In Puerto Rico, Gov. Wanda Vázquez eased some of the island’s tight restrictions on Thursday, citing a recent drop in cases. Ms. Vázquez lifted a lockdown that had forced people to stay home on Sundays, and reopened beaches to everyone. She also authorized the reopening of gyms, movie theaters and casinos at 25 percent capacity.
Bars and nightclubs remain closed, and a nightly curfew will remain in effect.
The U.S. commemorates Sept. 11 at another time of harrowing loss.
The outbreak also altered a moment to honor the dead. Though the names of the victims resounded across the plaza, and bells tolled across New York as they have in years past, there was no stage in front of those who came to mourn.
Some of America’s most notable politicians attended, including Vice President Mike Pence and Joseph R. Biden Jr., the Democratic nominee for president, but all of them wore masks in addition to their customary memorial ribbons and lapel pins. They exchanged elbow bumps, then distanced themselves six feet apart as they stood for the national anthem.
It has been 19 years since passenger jets hijacked by terrorists slammed into the World Trade Center and the Pentagon and crashed into a field in Shanksville, Pa. Nearly 3,000 lives were lost, some 2,700 of them in New York, in the deadliest attack in the country’s history.
The United States’ death toll from the pandemic has far exceeded that of Sept. 11, 2001. In New York City alone, more than 23,000 people have died of the virus.
F.D.A. regulators defend their integrity and allude to potential interference.
In an opinion column published in USA Today on Thursday, eight top regulators at the Food and Drug Administration promised to uphold the scientific integrity of their work and defend the agency’s independence. The column warned that “if the agency’s credibility is lost because of real or perceived interference, people will not rely on the agency’s safety warnings.”
The pledge by career scientists in the federal government came amid mounting concerns over the role the White House has played in emergency approvals for coronavirus therapies, including convalescent plasma and the malaria drug hydroxychloroquine, which the agency later revoked.
The specter of political arm-twisting has grown as several drugmakers entered large late-stage vaccine trials this summer. President Trump told reporters on Monday that “we’re going to have a vaccine very soon, maybe even before a very special date.”
That timeline, framed around Election Day, has been widely challenged by the administration’s top health officials, who have said that a vaccine approval by early November was improbable.
The statement in USA Today was written in large part because of fears over political influence on the F.D.A., including from the White House, according to senior administration officials familiar with the effort.
A new stimulus plan before Election Day is looking even more unlikely.
Prospects for any additional stimulus to address the coronavirus pandemic’s devastating toll before the election darkened considerably on Thursday, when a whittled-down Republican plan failed in the Senate on a partisan vote.
Democrats voted unanimously to block the proposal from advancing, calling it inadequate to meet the mounting needs for federal aid, in the latest indication of a lack of political will to reach an agreement, even as critical federal aid for individuals and businesses has run dry.
It was a nearly party-line vote whose outcome was never in doubt. The proposal amounted to a fraction of the $1 trillion plan Republicans had offered in negotiations with Democrats, who in turn are demanding more than twice as much.
A failure to compromise would leave millions of jobless Americans in potentially dire straits, as they exhaust jobless benefits and states run out of additional funds that Mr. Trump steered to the unemployed by executive order last month. It would also strand a wide swath of small business owners who have endured steep drops in revenue, with little prospect of a return to normal levels for months to come.
“Along with a pandemic of Covid-19, we have a pandemic of politics,” Senator Pat Roberts, Republican of Kansas, said. “Looking to the House — and for that matter, our colleagues across the aisle — it’s a sort of a dead-end street.”
He spoke after the measure failed on a 52-to-47 vote, falling short of the 60 it would have needed to advance.
After a long delay, Britain will introduce a contact-tracing app this month.
The new application will allow people to scan QR codes when they visit hospitality venues and will use Apple and Google’s technology for detecting other smartphones in the vicinity.
Matt Hancock, Britain’s health secretary, said in a statement on Friday that the app would be a vital tool for containing the spread of the coronavirus.
“We need to use every tool at our disposal to control the spread of the virus including cutting-edge technology,” he said. “The launch of the app later this month across England and Wales is a defining moment and will aid our ability to contain the virus at a critical time.”
How can countries’ responses be compared? Think of the virus like a marathon.
What’s the fairest expectation of how bad the pandemic should have been in the United States?
In his Morning newsletter, David Leonhardt spoke with Donald McNeil, the New York Times reporter who has frequently appeared on “The Daily” podcast to talk about the coronavirus.
Mr. Leonhardt writes:
Donald makes a fascinating point: Don’t look only at snapshots, like a country’s per capita death toll. “It’s not fair to pick one point in time and say, ‘How are we doing?’” he writes. “You can only judge how well countries are doing when you add in the time factor” — that is, when the virus first exploded in a given place and what has happened since.
The pandemic, he adds, is like a marathon with staggered start times.
The virus began spreading widely in Europe earlier than in North America. Much of Europe failed to contain it at first and suffered terrible death tolls. The per capita toll in a few countries, like Britain, Italy and Spain, remains somewhat higher than in the U.S. But those countries managed to get the virus under control by the late spring. Their caseloads plummeted.
In the U.S., the virus erupted later — yet caseloads never plummeted. Almost every day for the past six months, at least 20,000 Americans have been diagnosed with the virus. “Europe learned the hard lesson and applied remedies,” as Donald says. “We did not, even though we had more warning.”
This chart makes the point:
When the pandemic hit, Americans vastly scaled back on preventive health, and there is little sign that this deferred care will be made up.
Vaccinations dropped by nearly 60 percent in April, and almost no one was getting a colonoscopy, according to new data from the nonprofit Health Care Cost Institute.
The data, drawn from millions of health insurance claims, shows a consistent pattern, whether it was prostate screenings or contraceptives: Preventive care declined drastically this spring and, as of late June, had not yet recovered to normal levels. Many types of such care were still down by a third at the start of this summer, the most recent data available shows, as Americans remained wary of visiting hospitals and medical offices.
Americans continued seeking care they couldn’t avoid — hospital admissions for childbirth, for example, held steady — but avoided care they could put off. More invasive preventive procedures, such as mammograms and colonoscopies, showed the greatest decline.
Colonoscopies, which are generally used to screen for colon cancer, declined by 88 percent in mid-April and were still 33 percent lower than normal at the end of June. Mammograms, which fell 77 percent at the height of the pandemic, are still down 23 percent.
Critical childhood vaccinations for hepatitis, measles, whooping cough and other diseases also declined significantly, a trend that had already begun to worry pediatricians earlier in the pandemic. Of particular concern, measles vaccinations fell 73 percent in mid-April and were still down 36 percent at the end of June.
But one preventive service stayed relatively steady through the pandemic: pregnancy-related ultrasounds. Those declined slightly in March and April but never fell more than 20 percent below 2019 levels. Insertions of IUDs, one of the most effective birth control methods, declined like other preventive care — raising the possibility of an increase in pregnancies in coming months.
Reporting was contributed by Sarah Almukhtar, Aurelien Breeden, Kenneth Chang, Choe Sang-Hun, Emily Cochrane, Abdi Latif Dahir, Marie Fazio, Emma G. Fitzsimmons, Michael Gold, Emma Goldberg, Peter S. Goodman, Sophie Hardach, Javier C. Hernández, Jonathan Huang, Mike Ives, Sarah Kliff, David Leonhardt, Dan Levin, Patricia Mazzei, Benjamin Mueller, Saw Nang, Richard C. Paddock, Roni Caryn Rabin, Campbell Robertson, Dana Rubinstein, Karan Deep Singh, Megan Specia, Jim Tankersley, Kate Taylor, Sui-Lee Wee and Noah Weiland.
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