With the first coronavirus vaccines in the final stages of testing, the National Governors Association has some pressing questions for the Trump administration: Who is going to pay for the administration of vaccines? And how will scarce supplies be allocated among the states?
The association, a bipartisan group headed by Gov. Andrew M. Cuomo of New York, posted its questions on Twitter.
“Will there be additional funding allocated to states to assist with distribution of the vaccine and other vaccine efforts?” the group asked.
And what, they asked, is the national plan to deal with vaccine shortages?
There were also questions about the mundane supplies needed to immunize people — needles, syringes, alcohol pads, adhesive bandages, dry ice. How will they be managed, the governors ask.
The need for a vaccine is so large and so urgent that there will almost certainly not be enough to go around, at least at first. And it is not clear how the vaccine supplies will be doled out. Will they be allocated to each state based on total population, or according to the number of people at the highest risk of infection, or by some other rubric?
The question of who should be vaccinated once the states receive supplies has been studied intensively by several groups, including the National Academies of Science and Medicine, which proposed dividing the population into groups based on risk and need.
The first group to be offered a vaccine would be emergency, public safety and health care workers, including those employed in nursing homes. Next would be people with medical conditions that place them at high risk for severe infections, and older people living in group homes or crowded neighborhoods.
From there the lists move on to less and less vulnerable groups, ending with healthy children and young adults. Lastly, anyone not included in one of the specified groups would then be offered a vaccine.
A federal Centers for Disease Control and Preventions committee said it favored the National Academies’ approach, but would hold an emergency meeting to vote on a final plan once a vaccine was ready and approved by the Food and Drug Administration. From there, it would be up to the C.D.C. to adopt a plan.
As the coronavirus continued to surge in many parts of the United States, officials and experts offered starkly different outlooks on Sunday about what was to come and when the situation might improve.
Alex Azar, the secretary of Health and Human Services, noting that many have grown tired of pandemic precautions, tried to paint an optimistic picture of how much longer they would be needed.
“Hang in there with us,” he said on Sunday on the NBC program “Meet the Press.” “We’re so close. We’re weeks away from monoclonal antibodies for you, for safe and effective vaccines. We need a bridge to that day.”
“Please,” Mr. Azar said, “give us a bit more time of your individual, responsible behavior,” referring to hand washing, wearing masks and maintaining social distance.
But any notion that life in America might be returning to normal within weeks, or even a few months, is too hopeful, other officials and experts said. The public health measures with which the public is fatigued will be needed for some time to come, even after new drugs and vaccines can be approved, they said.
And in the big picture, the numbers are headed the wrong way.
On Friday, more than 70,450 new coronavirus cases were reported in the United States, the highest figure since July 24, according to a New York Times database, and more than 900 new deaths were recorded. Case counts are rising in 41 of the 50 states, with much of the worst news in the Great Lakes and Great Plains regions.
Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the public did not know what to believe about how soon a vaccine would be available. And communicating clearly and credibly with the public is just as important as the science, he said, because slowing the spread of the virus depends on individuals taking the right precautions.
“The next six to 12 weeks are going to be the darkest of the entire pandemic,” Dr. Osterholm said on “Meet the Press.”
A similar warning was sounded by Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, who said on the CBS program “Face the Nation” that the country was headed into “probably the most difficult phase of this epidemic.”
“I think the next three months are going to be very challenging,” Dr. Gottlieb said.
As most of the world still struggles with the pandemic, China is showing once again that a fast economic rebound is possible when the virus is brought under control.
The Chinese economy surged 4.9 percent in the July-to-September quarter compared with the same months last year, the country’s National Bureau of Statistics announced on Monday. That brings China almost back up to the roughly 6 percent pace of growth that it was reporting before the pandemic.
Many of the world’s major economies have climbed quickly out of the depths of a contraction last spring, when shutdowns caused output to fall steeply. But China is the first to report growth that significantly surpasses where it was at this time last year.
The vigorous expansion of the Chinese economy means that it is set to dominate global growth — accounting for at least 30 percent of the world’s economic growth this year and in the years to come, Justin Lin Yifu, a cabinet adviser and honorary dean of the National School of Development at Peking University, said at a recent government news conference in Beijing.
Chinese companies are making up a greater share of the world’s exports, manufacturing consumer electronics, personal protection equipment and other goods in high demand during the pandemic. At the same time, China is now buying more iron ore from Brazil, more corn and pork from the United States, and more palm oil from Malaysia. That has partly softened the impact of the pandemic on some industries.
Twitter removed a tweet denouncing masks from its service that was posted on Saturday by Dr. Scott Atlas, a neuroradiologist who serves on President Trump’s coronavirus task force.
In the tweet, Dr. Atlas wrote, “masks work? NO” and falsely claimed that the World Health Organization and the Centers for Disease Control did not support their use, and that they cause “many harms.”
Most health authorities are unanimous on the efficacy of wearing masks to curtail the spread of the virus. The C.D.C. recommends wearing masks “in public settings when around people not living in your household and particularly where other social distancing measures are difficult to maintain.” The federal agency adds that masks “may slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.”
The W.H.O. says “masks are a key measure to suppress transmission and save lives.”
Dr. Atlas’s tweet, a Twitter spokeswoman wrote in an email, violated its policy against misleading information about the coronavirus pandemic. That policy, the spokeswoman added, applies to tweets that “could lead to harm,” in particular “statements or assertions that have been confirmed to be false or misleading by subject-matter experts, such as public health authorities.”
Dr. Atlas’s stances on the pandemic have clashed with those of other members of the White House Task Force, including Dr. Deborah L. Birx and Dr. Anthony S. Fauci.
Although President Trump has disdained the wearing of masks, Chris Christie, the former New Jersey governor who helped the president prepare for his presidential debates, said he “was wrong” not to wear one. Mr. Christie was hospitalized with a coronavirus infection around the same time as Mr. Trump.
In a statement last week, Mr. Christie wrote, “I believed when I entered the White House grounds, that I had entered a safe zone, due to the testing that I and many others underwent every day.” But, he said, “I was wrong.”
“I hope that my experience shows my fellow citizens that you should follow C.D.C. guidelines in public no matter where you are and wear a mask to protect yourself and others,” he said.
Mayor Brandon Whipple of Wichita, Kan. is the latest Democratic government official to be threatened over coronavirus mandates.
The Wichita Police Department said in a news release Friday that a 59-year-old man, Meredith Dowty, had been arrested on a charge of criminal threat in connection with statements directed at the mayor.
The messages, reported to the police Friday, laid out a “very descriptive plan of execution,” Mr. Whipple said. It included locating him, slitting his throat, hanging him and then turning him to fertilizer, the mayor said Saturday.
It was the latest in a series of threats made against government officials by people angry about lockdown and social-distancing rules.
On Oct. 8, the F.B.I. said an anti-government group in Michigan had plotted in detail to kidnap the Gov. Gretchen Whitmer, a Democrat. And on Thursday, the F.B.I. said the governor of Virginia, Ralph Northam, another Democrat, was also discussed as a target by the same group.
Ms. Whitmer became a focal point of anti-government anger over her efforts to fight the spread of the virus.
“Until I’m voted out or until they’re successful in assassinating me, I’m hoping to do what’s right for the people of Wichita,” the mayor said.
A wedding with up 10,000 guests? In Brooklyn, near a coronavirus hot spot?
No, New York state officials said.
The officials have taken extraordinary steps to shut down the ultra-Orthodox wedding planned for Monday, with the state health commissioner personally intervening to have sheriff’s deputies deliver an order to the Hasidic synagogue where it would take place.
The order, delivered on Friday, warned that the synagogue must follow health protocols, including limiting gatherings to fewer than 50 people.
On Sunday, the synagogue, the Congregation Yetev Lev D’Satmar, accused state officials of “unwarranted attacks” on the wedding, at which a grandson of Zalman Leib Teitelbaum, the synagogue’s rabbi, is to be married. The congregation said that the ceremony and meal would have been restricted to “close family members,” and that members of the public would have been invited to participate only “for a short period of time.”
The wedding will continue, the synagogue said, but will be limited to a smaller group of family members.
“It’s sad that nobody verified our plans before attacking us,” Chaim Jacobowitz, the congregation’s secretary, said in a statement.
The episode highlighted the brewing tensions between state and local officials the Hasidic community as state health officials try to control surging coronavirus cases in some neighborhoods in Brooklyn and Queens and in counties north of New York City.
Governor Andrew M. Cuomo said Sunday that a large wedding was too risky and could have resulted in a so-called superspreader event. State officials said that they determined the wedding, scheduled to take place in Williamsburg, could have had up to 10,000 people in attendance.
“My suggestion: Have a small wedding this year,” Mr. Cuomo said at a news conference on Sunday. “Next year, have a big wedding. Invite me, and I’ll come.”
Congressional Democrats and the White House remain at an impasse over a fresh package of coronavirus economic relief, as time runs out to get a bill passed before the election, Speaker Nancy Pelosi said on Sunday.
Ms. Pelosi said on the ABC program “This Week” that she was still in negotiations with the Treasury secretary, Steven Mnuchin, but that “we don’t have agreement on the language yet.” She said a deal would have to be struck within 48 hours in order for a package to be enacted by Election Day.
But even if she and Mr. Mnuchin reach a deal, Senate Republicans are not expected to accept it. The Senate majority leader, Mitch McConnell, Republican of Kentucky, has said he does not believe he can sell a package of more than $1 trillion to conservative Senate Republicans, which is less than half the size of the bill House Democrats have proposed. The Democrats have proposed a $2.4 trillion package, named the Heroes Act, that would provide aid to families, schools, restaurants, businesses and airline workers; it includes about $500 billion for state and local governments. Mr. Mnuchin, negotiating on behalf of President Trump, has countered with a number of proposed alterations to scale back the package.
On Sunday, Mr. Trump said he remained optimistic.
“We’re talking about it. I think Nancy Pelosi maybe is coming along, we’ll find out,” he said. “I want to do it at a bigger number than she wants. That doesn’t mean all the Republicans agree with me but I think they will in the end if she would go along.”
The White House has proposed changes to the Democrats’ proposal, and in a letter to colleagues Sunday afternoon, Ms. Pelosi detailed her objections.
“The White House has removed 55 percent of the Heroes Act’s language for testing, tracing, and treatment,” Ms. Pelosi wrote. “Especially disappointing was the elimination of measures to address the virus’s disproportionate and deadly impact on communities of color. The White House does not appreciate the need to direct resources to culturally competent contact tracing.”
She added: “The Administration continues to fail to meet the well-documented need for funds to protect frontline workers in health care, first responders, sanitation, transportation, food workers, teachers and others, and to prevent service cuts to struggling communities.”
Nevertheless, she said, she hoped to find common ground. “I am optimistic that we can reach agreement before the election,” she wrote.
Mr. McConnell, who has not been negotiating with Ms. Pelosi, is expected to put forward a $500 billion package this week.
Mr. McConnell also said on Saturday that he planned to hold votes on a stand-alone bill to revive the Paycheck Protection Program, a federal loan program for small businesses created in the spring. Some of the $500 billion in his relief proposal would be used to finance the loan program.
Mr. McConnell has faced pressure from moderate members of his conference to act on relief legislation. President Trump’s decision to abruptly end talks, and then to reverse course, prompted concerns among Republicans that he had in effect guaranteed that Republicans would be blamed for a failure to provide further federal aid.
Without congressional action and a new round of federal relief, the country’s economic recovery has continued to shudder, and millions of Americans have slipped back into poverty.
Key Data of the Day
In both Europe and the United States, coronavirus cases are mounting sharply for a third time in the pandemic, but reported deaths are not rising proportionately.
Part of the reason may be more widespread testing. Jon Zelner, an epidemiologist at the University of Michigan, said that many of the additional cases are probably being found among younger people who have no symptoms or mild illness — cases that might have gone undetected before. That is what is happening in Michigan, he said in an interview.
But he said that it also may just be a matter of time.“Deaths are a very laggy indicator of transmission,” he said, and the deaths occurring now are largely among people who became ill 30 to 40 days ago. Dr. Zelner said he expected the current surge in cases to be reflected in an increase in deaths in November.
Single-day and weekly records for new cases are growing more common both in European countries and in individual American states.
In the U.S., average daily reported cases have increased by 28 percent over the last 14 days, and hospitalizations are rising, while deaths have increased 1 percent.
Ohio, Indiana, North Dakota, Illinois, New Mexico, Wyoming, Colorado, South Dakota, Kentucky, West Virginia and Idaho each reported more cases this week than in any previous seven-day period. So did Minnesota, even though the state reported no new cases on Saturday because of computer updates.
Only one of those states — North Dakota — was among the eight reporting the highest number of deaths relative to their populations.
In France, which reported 115,897 cases and 619 deaths in the last week, according to a Times database, curfews were imposed in Paris and other cities. Italy reported a record of 10,925 new infections on Saturday, almost three times the number it was averaging 14 days ago, and a slight increase of 47 deaths. The government is expected to announce further restrictions on Sunday.
The European region registered its highest weekly incidence of cases since the pandemic’s beginning, the World Health Organization said on Thursday. “Daily numbers of cases are up, hospital admissions are up, Covid-19 is now the fifth leading cause of death and the bar of 1,000 deaths per day has now been reached,” said a statement by Dr. Hans Kluge, the organization’s regional director for Europe. Still, deaths were still five times fewer than the April peak.
New York State continued its incremental path to recovery from the pandemic on Sunday, with Gov. Andrew M. Cuomo announcing that ski resorts would be allowed to open at 50 percent indoor capacity starting on Nov. 6.
Across the United States, the coming winter brings a significant risk of stoking outbreaks of the virus, with the colder weather forcing people to gather indoors. But Mr. Cuomo noted on Sunday that “once we start talking about the winter, skiing comes up,” and encouraged New Yorkers to ski in the state instead of traveling to other parts of the country.
“You don’t have to quarantine when you come back,” he said.
Public health experts have linked skiing to significant coronavirus outbreaks in other countries, underscoring the dangers of travel and tourism while the pandemic still rages. An outbreak at an Austrian ski resort, Ischgl, and its surrounding villages led to the infection of thousands of skiers who traveled to the area from around the world.
The skiers then carried the coronavirus to more than 40 countries on five continents, including some of the first known cases in Iceland.
Many ski resorts in North America shut down earlier this year, fearing the spread of the virus among visitors as well as in surrounding communities that service them, which often have limited medical resources.
Mr. Cuomo said that skiers would still have to socially distance at the resorts, especially in bars, restaurants and aboard shuttles to and from ski mountains. Other restrictions include limiting ski lessons to 10 people or less, requiring masks unless people are eating, drinking or skiing and reducing outdoor capacity on the slopes by 25 percent on peak days.
He said that the state has aggressively attacked new clusters of the virus to keep the overall infection rate in the state relatively stable, even as the northeast has seen the virus’s resurgence in recent days.
Former Vice President Joseph R. Biden Jr. is flipping the script on President Trump, who has tried to frame the election as a choice between keeping the economy open or returning to coronavirus lockdowns under Democrats.
In Michigan, Mr. Trump has clashed with Gov. Gretchen Whitmer, a Democrat, over restrictions, with the president telling tens of millions of Twitter followers earlier this year that they should liberate the state.
Earlier this month, the F.B.I. announced terrorism, conspiracy and weapons charges against 13 men for their part in a plot to try to overthrow the government in Michigan. At least six of the people arrested, law enforcement officials said, had hatched a detailed plan to kidnap Ms. Whitmer.
Saeb Erekat, a senior Palestinian official who tested positive for the coronavirus earlier this month, was transferred from his home in the West Bank to an Israeli hospital on Sunday, following a deterioration in his health.
His wife, Neamh Erekat, is also infected, but her condition is improving, Palestinian officials said.
Mr. Erekat, 65, a veteran negotiator and secretary general of the Palestine Liberation Organization’s Executive Committee, received a lung transplant in 2017 and is considered to be at high risk of suffering severe Covid-19.
An Israeli ambulance transported him from his home in Jericho to the Hadassah Ein Kerem hospital in Jerusalem, Israel’s Magen David Adom emergency medical service said.
In a statement, the hospital said that Mr. Erekat had received supplemental oxygen in a Covid-19 intensive care unit, describing his condition as “serious but stable.”
Mr. Erekat, who has long supported nonviolence and the two-state solution, has been intimately involved in Palestinian politics and Israeli-Palestinian negotiations for decades. He was a central member of the Palestinian delegation to the Madrid peace conference in 1991 and has served as a close aide to Mahmoud Abbas, thepresident of the Palestinian Authority.
Mr. Erekat has also been one of the loudest Palestinian voices rejecting the Trump administration’s policies on the Israeli-Palestinian conflict.
In other global news:
New Zealand has broken a three-week streak without a locally acquired coronavirus case after a maritime worker tested positive on Saturday. Authorities said on Sunday that the case was caught early and the risk of community transmission has been contained. The man developed symptoms on Friday and sought a test on the same day. Health officials believe the most likely source of the infection was a ship the man worked on that is now bound for Brisbane, Australia. The last confirmed locally acquired coronavirus case in New Zealand was on September 25. The country has since removed almost all domestic social distancing restrictions after a three-week lockdown of Auckland, its largest city, to contain a second outbreak.
Officials in Melbourne, Australia, announced some easing of one of the world’s strictest lockdowns, allowing residents to travel up to 25 kilometers from their homes and up to 10 people from two households to socialize outdoors. Dan Andrews, premier of the state of Victoria, drew a contrast between the situation there and in Britain, where there have been fewer restrictions despite a surge in cases. “Back in August and at our peak, we reported 725 daily cases. At the same time, the U.K. recorded 891,” he said in a statement. “Today, as Victoria records two new cases, the U.K. hit 16,171. And as we continue easing our restrictions, they are being forced to increase theirs.”
Giuseppe Conte, the prime minister of Italy, announced new measures to curb the spread of the virus on Sunday night, and “avoid a second general lockdown that would jeopardize the country’s economy.” The government did not introduce a curfew like other European countries. Mayors will have the power to close streets or squares where people tend to gather after 9 p.m., while restaurants, bars and pubs will be allowed to serve seated customers — up to six per table — until midnight. Drinking outside of restaurants or bars will be permitted only until 6 p.m. Gaming and betting halls will close at 9 p.m. Italy has so far fared better than its European counterparts, but infections have been rising in recent weeks, witha record 11,705 new cases reported on Sunday.
Prime Minister Jacinda Ardern of New Zealand said on Sunday that her landslide election victory was an endorsement of the government’s efforts to stamp out the coronavirus and reboot the economy. Ms. Ardern’s liberal Labour Party got 49 percent of the vote, crushing the conservative National Party, which got 27 percent, The Associated Press reported. With a population of five million, the country has tallied only 25 coronavirus deaths. However, on Sunday it reported its first community transmission in more than three weeks.
Wallis and Futuna, a French territory in the South Pacific, reported its first coronavirus case on Friday. Officials said the infected individual, who is asymptomatic and in isolation, arrived on Oct. 3 and tested positive while in a compulsory 14-day quarantine. Almost all of the handful of nations believed to still be virus-free are in the Pacific, including Kiribati, the Marshall Islands, Micronesia, Nauru, Palau, Samoa, Tonga, Tuvalu and Vanuatu.
Ireland will reimpose tighter restrictions across the country on Monday, a cabinet minister said in a televised interview. Reuters reported that Simon Harris, who was health minister in the spring and now heads the higher education ministry, said the current level of precaution in most of the country “has not worked” and that varying it by region had been ineffective. Mr. Simon suggested that many nonessential businesses would have to close, but that the new restrictions would be short of a total lockdown. The country has set new daily case records four times in the last week.
A protest in Prague against the Czech Republic’s new coronavirus restrictions turned violent on Sunday, as the police used tear gas and water cannons to disperse an unruly crowd about four times larger than currently allowed.
Some 2,000 protesters in the city’s historic center, many of them unmasked, were objecting to measures imposed on Wednesday, including a ban on sporting events.
When representatives of the city’s Town Hall tried to end the event after an hour, the crowd became unruly, and when the police began to try to break the protest up, some in the crowd began throwing bottles, trash bins and flares. The police responded with greater force.
The Czech prime minister, Andrej Babis, tweeted: “I am shocked how inconsiderate and selfish some citizens are, they do not follow the government restrictions and put both themselves and others in harm’s way. I am for a strict recourse.”
The Czech Republic is currently seeing the fastest rise in Covid-19 cases per capita in Europe, according to a New York Times database. On Friday, the health ministry reported the country’s highest number of new daily cases, adding 11,105.
Starting on Wednesday, when the government barred all sporting events, it also closed all schools, with the exception of kindergartens. Restaurants, bars and cafes were also closed, and public gatherings of more than six people were banned, though demonstrations of up to 500 masked people were allowed if they broke into groups of 20.
In a televised speech last week, the health minister, Roman Prymula, said that a steep rise of patients with serious illness was expected and that the death toll was almost certain to rise, too.
“We have three truly complicated and joyless weeks ahead of us,” said the minister.
Many scientists say the likelihood of catching the virus from packaged frozen food is very low, arguing that when the virus crosses international borders, it is almost certainly transmitted by people, rather than the products they transport.
So what should we make of a finding reported by the Chinese Centers for Disease Control and Prevention that coronavirus that survived on packages of imported frozen cod fueled an outbreak in Qingdao, in eastern China?
In a statement on its website on Saturday,the Chinese C.D.C. said it had isolated live virus samples from frozen-food packaging in Qingdao. It is known that viruses can survive cold and freezing.
But to prove that a dangerous, viable, virus persists on food or packaging, researchers would need to isolate the microbe and show in a lab that it can still replicate and that it is present in sufficient quantities to fuel an outbreak, a complicated process it is not clear the Chinese researchers managed.
And to show the virus that was isolated actually infected people, researchers would need to demonstrate that the genetic signature of the virus on food matched that in patients.
China, which acknowledges that the virus’s main route to infection is through respiratory droplets, is alone in pointing to frozen foods as the potential cause of outbreaks. The U.S. Centers for Disease Control and Prevention maintain that “there is no evidence to suggest that handling food or consuming food is associated with Covid-19.”
In the Qingdao outbreak, Chinese authorities saida dozen people tested positive for the virus last weekend, the country’s first locally transmitted casesin almost two months. Officials said the cases appeared to be linked to the Qingdao Chest Hospital, which had been treating people who tested positive after arriving in China from abroad.
The Chinese C.D.C. said that employees handling the frozen foods were at risk of infection and that it would step up monitoring and disinfection. The agency stressed that it had found no evidence that consumers had been infected by handling frozen foods and that the risk of infection to them was “extremely low.”
An Indonesian former airline pilot who was convicted in the 2004 midair poisoning death of a prominent human rights activist has died of Covid-19, an attorney for the pilot’s family said on Sunday.
The use of poison to kill a political target, a method more recently employed by Russia and North Korea, eliminated the activist, Munir Said Thalib, who had been one of the Indonesian military’s most vocal critics. And the murder, carried out on a commercial flight of the state carrier, Garuda Indonesia, by one of its pilots, shocked the newly democratic nation.
The pilot, Pollycarpus Budihari Priyanto, 59, was sentenced to 20 years in prison for his role in the murder. He ended up serving eight years and was released in 2014. Human rights activists accused him of working for Indonesia’s intelligence agency and have long called for a thorough investigation.
Andreas Harsono of Human Rights Watch said, “The death of secret agent Pollycarpus is a stark reminder that the masterminds behind the Munir killing have evaded justice.”
An attorney for Mr. Pollycarpus’s family, Wirawan Adnan, said that Mr. Pollycarpus died of Covid-19 on Saturday, 16 days after he was hospitalized at a hospital in Jakarta.
Activists called for an investigation to determine the cause of death.
“His death needs to be properly investigated by the competent authorities,” said Usman Hamid, executive director of Amnesty International Indonesia. “As a person who was convicted of being a field actor, Pollycarpus certainly had a lot of information regarding the Munir murder case, especially information about his superiors and the people who ordered him.”
Mr. Munir, 38, sought justice for victims of human rights abuses under the dictator, Suharto, who stepped down in 1998.
At the time of his death, he was traveling to Amsterdam to begin a study program. Mr. Pollycarpus, who was off duty, traveled on the same Garuda flight from Jakarta.
Prosecutors said that Mr. Pollycarpus had upgraded Mr. Munir’s seat to business class, where it would be easier to administer the poison, and slipped arsenic into a glass of orange juice.
Mr. Pollycarpus always maintained his innocence. Mr. Wirawan, the attorney, said that his client had been convicted because of pressure from human rights groups but that the real killer had never been caught.
“I believe that Munir was murdered,” Mr. Wirawan said. “But I don’t believe that Pollycarpus was the murderer.”
Early results of a few small studies offer a glimmer of hope that, in at least some cases, patients with lung damage caused by Covid-19 showed signs of recovery, especially with intensive aftercare and exercise.
Lingering shortness of breath and diminished stamina have dogged many Covid-19 patients, and doctors have worried that the lung damage might be irreversible.
Even after rehabilitation, many were still coughing and short of breath as they went home, equipped with exercise instructions and breathing devices — small, inexpensive plastic tubes that require one to breathe in and out with force.
But as they came back for checkups weeks later, their CT scans showed improvement, doctors said. Fluids were clearing from their lungs, and the white-glass lesions often seen in Covid pneumonia were lessening, sometimes disappearing entirely and sometimes noticeable only as thin white bands.
“There are some signs of reversible damage,” said Dr. Thomas Sonnweber, a co-author of the study. At the time the patients were discharged from the hospital, 88 percent had lung damage, but 12 weeks later, only 56 percent did.
Their symptoms also improved. They coughed less, breathed and walked more easily, in some cases with markedly improved endurance.
Longer range studies still have to be conducted to assess the potential for permanent effects.
More than 70,450 new coronavirus cases were reported in the United States on Friday, the highest figure since July 24, according to a New York Times database. More than 900 new deaths were recorded.
At least nine states set single-day case records on Friday: Wyoming, Minnesota, Wisconsin, West Virginia, North Dakota, Indiana, New Mexico, Utah and Colorado. And as of midday Saturday, Indiana and Ohio had set records.
The virus has also been surging globally: a record 415,000-plus cases on Friday, a record.
Epidemiologists warn that nearly half of the states in the U.S. are seeing surges unlike anything they experienced earlier in the pandemic. Eighteen states and Guam added more cases this week than in any other week. The nationwide seven-day average has increased by nearly 8,000 daily new cases since last Friday.
The virus has been pummeling some of the least populous states in the country, but their relatively low population numbers can make the total number of known cases deceptive. The surges in rural areas, when calculated by infections per person, have been just as severe as the spikes in densely populated cities in the Sun Belt over the summer.
Uncontrolled outbreaks in the Midwest and Mountain West are driving the surge, according to The Times database. Some states with the fastest growth had relatively few cases until recently, and now rural hospitals are strained.
Per capita, North Dakota and South Dakota are adding more new cases than any states have since the start of the pandemic. Wisconsin — which reported more than 4,160 new cases on Friday, a single-day record for the state — has seven of the 10 metropolitan areas in the United States with the highest rates of recent cases.
Other states with large rural areas — including Wyoming, Idaho, West Virginia, Nebraska, Iowa, Utah, Alaska and Oklahoma — have recently recorded more cases in a seven-day stretch than in any other week of the pandemic.
In the more populous states where case increases are being seen, including Wisconsin and Illinois, the worst numbers are coming not from the largest population centers but from rural counties.