Trump Returns to a Capital in Chaos as Covid-19 Outbreak Spreads

Trump Returns to a Capital in Chaos as Covid-19 Outbreak Spreads

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Credit…Michael A. McCoy for The New York Times

As the coronavirus upended the top echelons of the U.S. government on Tuesday — leaving President Trump convalescing in the White House, the Capitol eerily empty after lawmakers tested positive and most of the Joint Chiefs of Staff in quarantine — the president abruptly ended talks on a stimulus bill intended to shore up the nation’s pandemic-stricken economy.

Mr. Trump’s announcement Tuesday that he was ending talks with Democrats on the bill, which aimed to send more aid to Americans grappling with high unemployment and to help state and local governments stay afloat as tax collections plummet, sent the stock market sliding. It came after Jerome H. Powell, the chairman of the Federal Reserve, warned that failing to inject more federal help into the economy would risk weakening the tenuous recovery.

In multiple tweets later Tuesday night, Mr. Trump appeared to backtrack on his assertion that an agreement would wait until after Nov. 3, at one point urging both chambers to “IMMEDIATELY Approve” reviving a lapsed loan program for small businesses, funds to prevent airlines from furloughing or laying off workers and another round of stimulus checks. It remained unclear if his tweets, which came after stocks plummeted, reflected a willingness to restart negotiations with House Speaker Nancy Pelosi. Both provisions have bipartisan support, but several lawmakers have pushed for them to be included in a broader package.

Taken together, the drumbeat of events showed the extent to which the coronavirus is continuing to dominate life in America with less than a month to go before the next presidential election. The outbreak at the White House has raised concerns in the city that surrounds it. New cases are surging in the upper Midwest. The average of new reported infections across the country is creeping up again, after a late-summer decline.

In New York, which was the center of the pandemic early on but has since seen a marked decline in cases, several worrisome outbreaks led Gov. Andrew M. Cuomo to temporarily close nonessential businesses and schools in some parts of New York City and its northern suburbs.

And Mr. Trump, who left the hospital to convalesce at a White House that has become a virus hot spot, announced on Twitter that he wants to face off against his opponent, Joseph R. Biden Jr., in person next week — when he could still be contagious.

Mr. Trump said he planned to attend next week’s debate in Miami, which is scheduled for Oct. 15. It was unclear if the debate commission would permit the debate to go ahead, given his illness, or whether Mr. Biden would agree to share the stage with him. And as both campaigns prepared for a vice-presidential debate on Wednesday, aides to Vice President Mike Pence raised objections to plans to put plexiglass dividers between him and his opponent, Senator Kamala Harris of California.

Mr. Biden, in a speech in Gettysburg, Pa., where a Civil War battlefield serves as a symbol of a country divided against itself, called for national unity and said that what “we’re experiencing today is neither good nor normal.”

Facebook removed a post from Mr. Trump on Tuesday that violated its policy against sharing misinformation about the virus, one of the few times that the social network has taken down one of his posts. In Mr. Trump’s message, he falsely suggested that the flu was deadlier than the coronavirus.

And hopes that a new vaccine could be authorized by Election Day — which Mr. Trump has relentlessly pushed for — faded after the Food and Drug Administration released updated, stricter guidelines for vaccine developers. The stricter guidelines had been blocked by White House officials, including Mark Meadows, the chief of staff.

In pulling the plug until after the November election on talks for a new bill to send aid to needy Americans, Mr. Trump accused Ms. Pelosi in a tweet of “not negotiating in good faith” and urged Senate Republicans to focus solely on confirming his nominee to the Supreme Court in the coming weeks. Mr. Trump said that he had instructed Steven Mnuchin, the Treasury secretary, to stop negotiating, sending the S&P 500 down as much as 1 percent in the immediate aftermath of his tweet. It had been up more than half a percent in the moments before. The index closed down 1.40 percent for the day.

“Our Economy is doing very well,” Mr. Trump tweeted as the market fell. “The Stock Market is at record levels, JOBS and unemployment also coming back in record numbers. We are leading the World in Economic Recovery, and THE BEST IS YET TO COME!” Mr. Biden countered on Twitter that “the President has turned his back on you.”

Mr. Trump was recovering in the White House residence, as a number of advisers and other officials stayed home, because they either had contracted the coronavirus or had been near people who had.

Credit…Anna Moneymaker for The New York Times

On Tuesday evening, senior administration officials confirmed that Stephen Miller, Mr. Trump’s top speechwriter and policy adviser, had tested positive for the virus.

The Capitol, normally a beehive of a workplace for 535 legislators and thousands of staff members, was eerily empty on Tuesday after Senate leaders agreed to adjourn for two weeks beginning Monday, even as Republicans are trying to fast-track Judge Amy Coney Barrett’s nomination to the Supreme Court. More than 40 senators, along with more than a dozen congressional aides and reporters, have been tested for the coronavirus since late last week, officials said on Tuesday. Three Republican senators — Mike Lee of Utah, Thom Tillis of North Carolina and Ron Johnson of Wisconsin — have tested positive in recent days.

At the highest level of the military, Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, along with several of the Pentagon’s most senior uniformed leaders, was quarantining after being exposed to the coronavirus, a Defense Department official said Tuesday. The official said that almost the entirety of the Joint Chiefs of Staff, including Gen. James C. McConville, the Army chief of staff, was quarantining after Adm. Charles Ray, the vice commandant of the Coast Guard, tested positive for the virus.

Credit…Jonathan Ernst/Reuters

In a memo titled “Precautions and POTUS Interactions” sent around the White House this week, staff members were warned about what to do when interacting with the president, including acquiring personal protective equipment from an “Isolation Cart.”

Staff members are only to go to the Oval Office or the residence on the second floor, where the first family lives, if they’re requested to go and expected to be there. If staff members are not in close contact with the president, meaning they’re more than six feet away from him, only a “surgical mask” and hand sanitizer are required, according to the memo from the White House Management Office, which was reviewed by a Times reporter.

But within six feet, people must use sanitizer and “remove any outer garments,” the memo said. “Ensure you are wearing the following Personal Protective Equipment (PPE). PPE is provided in the Isolation Cart” that’s located “in the foyer area of the second floor residence and the outer Oval Office,” the memo stated.

The memo listed the types of equipment, including, “Yellow gown,” “Surgical mask,” “Protective eye wear” and “Gloves.”

Upon exiting, people are instructed to remove gowns and gloves and put them in a trash receptacle next to the cart, clean the eye shields with wipes that are provided and save them for future use, and then wash hands or use sanitizer after leaving.

Credit…Ken Cedeno/Reuters

President Trump on Tuesday abruptly ended talks with Democrats on an economic stimulus bill, sending the stock market sliding and dealing a final blow to an intensive set of on-again-off-again negotiations to deliver additional pandemic aid to struggling Americans before the November elections.

Mr. Trump announced that he was pulling the plug on the effort in a series of afternoon tweets in which he accused Speaker Nancy Pelosi of California of “not negotiating in good faith” and urged Senate Republicans to focus solely on confirming his nominee to the Supreme Court in the coming weeks.

Instead, Mr. Trump said that he had instructed Steven Mnuchin, the Treasury secretary, to stop negotiating, sending the S&P 500 down as much as 1 percent in the immediate aftermath of his tweet. It had been up more than half a percent in the moments before. The index closed down 1.40 percent for the day.

“Our Economy is doing very well,” Mr. Trump tweeted as the market fell. “The Stock Market is at record levels, JOBS and unemployment also coming back in record numbers. We are leading the World in Economic Recovery, and THE BEST IS YET TO COME!”

Ms. Pelosi and Mr. Mnuchin, who had previously been scheduled to speak later Tuesday afternoon, briefly spoke after Mr. Trump’s tweet, with Mr. Mnuchin confirming that the president had discontinued talks and Ms. Pelosi expressing disappointment “in the President’s decision to abandon the economic & health needs of the American people,” Drew Hammill, a spokesman for Ms. Pelosi, said on Twitter.

Speaker Pelosi & Secretary Mnuchin spoke briefly at 3:30 p.m. by phone. The Secretary confirmed that the President has walked away from COVID talks. The Speaker expressed her disappointment in the President’s decision to abandon the economic & health needs of the American people.

— Drew Hammill (@Drew_Hammill) October 6, 2020

The president’s move came not long after Jerome H. Powell, the chairman of the Federal Reserve, had made his latest urgent plea for additional stimulus, warning that a failure by Congress to inject more federal help into the economy would risk weakening the recovery.

The announcement came after the president had spoken by phone with Mr. Mnuchin, Senator Mitch McConnell of Kentucky, the majority leader, and Representative Kevin McCarthy of California, the minority leader, according to two people briefed on the conversation.

Ms. Pelosi had told lawmakers on a private caucus call moments before Mr. Trump’s tweets that Democrats were “waiting for them to approve our language to crush the virus and how we put money in the pockets of the American people,” according to a Democratic aide on the call, who disclosed her remarks on condition of anonymity.

In a statement after the president’s tweets, Ms. Pelosi accused him of showing “his contempt for science, his disdain for our heroes — in health care, first responders, sanitation, transportation, food workers, teachers, teachers, teachers and others.”

Mr. Trump, in tweets later Tuesday night, appeared to backtrack on his assertion that an agreement would wait until after Nov. 3. at one point urging both chambers to “IMMEDIATELY Approve” reviving a lapsed loan program for small businesses, funds to prevent airlines from furloughing or laying off workers and another round of stimulus checks.

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‘Far From Complete,’ Powell Says of Fiscal Expansion

Federal Reserve Chair Jerome H. Powell spoke about the role of the federal response to the economic decline caused by the coronavirus pandemic.

The fiscal response was truly extraordinary. The unanimous passage of the CARES Act, and three other bills passed with broad support in March and April, established wide-ranging programs that are expected to provide roughly $3 trillion in economic support overall — by far the largest and most innovative fiscal response to an economic crisis since the Great Depression. The expansion is still far from complete. At this early stage, I would argue that the risks of policy intervention are still asymmetric — too little support would lead to a weak recovery creating unnecessary hardship for households and businesses. Over time, household insolvencies and business bankruptcies would rise, harming the productive capacity of the economy and holding back wage growth. By contrast, the risks of overdoing it seem for now to be smaller, even if policy actions ultimately prove to be greater than needed. They will not go to waste. The recovery will be stronger and move faster if monetary policy and fiscal policy continue to work side by side to provide support to the economy until it is clearly out of the woods. Since it appears that many will undergo extended periods of unemployment, there is likely to be a need for further support. Second, aid to firms, in particular, the Paycheck Protection Program, and the general boost to aggregate demand have, so far, partly forestalled an expected wave of bankruptcies and lessened permanent layoffs. Business investment appears to be on a renewed upward trajectory, and new business formation similarly appears to be rebounding, pointing to some confidence in the path ahead.

Video player loadingFederal Reserve Chair Jerome H. Powell spoke about the role of the federal response to the economic decline caused by the coronavirus pandemic.CreditCredit…Pool photo by Caroline BrehmanCredit…Olivier Maire/EPA, via Shutterstock

The Food and Drug Administration released updated, stricter guidelines on Tuesday for coronavirus vaccine developers — a step that was blocked for two weeks by top White House officials. The guidelines make it highly unlikely that a vaccine could be authorized by Election Day.

The move, which was cleared by the Office of Management and Budget, appeared to be an abrupt reversal a day after The New York Times reported that White House officials, including Mark Meadows, the chief of staff, were blocking the guidelines.

The new recommendations, which do not carry the force of law, call for gathering comprehensive safety data in the final stage of clinical trials before an emergency authorization can be granted.

On Tuesday evening, President Trump showed his displeasure at the action of his own White House, and charged that the new guidelines were a conspiracy against his reelection prospects.

“New F.D.A. Rules make it more difficult for them to speed up vaccines for approval before Election Day. Just another political hit job!” he tweeted, tagging Dr. Stephen M. Hahn, the F.D.A. commissioner.

Since the start of the coronavirus pandemic, the F.D.A. has said that it has been seeking ways to accelerate the development of vaccines without sacrificing safety. In June, the agency released an initial set of guidelines to give vaccine developers a better idea of how the F.D.A. would decide if a vaccine were acceptable, either for an emergency use authorization or for a full license.

Four vaccines have reached the final stage of testing, known as a Phase 3 trial, in the United States. A fifth is expected to start this month. President Trump has repeatedly suggested that a vaccine would be ready by Election Day, if not before.

But with public confidence declining in opinion polls about what could be a rushed coronavirus vaccine, the F.D.A. submitted a new set of guidelines to the White House for approval on Sept. 21.

Among the recommendations, the agency advised vaccine makers to follow volunteers for a median of two months after the final dose. The F.D.A. also expected vaccine makers to document five cases of severe infection in people who received the placebo instead of the vaccine.

The F.D.A. submitted the guidelines to the Office of Management and Budget for approval more than two weeks ago, but they stalled in part because of Mr. Meadows’s involvement, according to a senior administration official and others familiar with the situation.

The White House objected that the guidelines would add more time before a vaccine could be authorized. In a conversation with Dr. Hahn days after the guidelines were submitted, Mr. Meadows said the recommendations amounted to changing the rules on drugmakers in the throes of clinical trials, according to one senior administration official. He also suggested that Dr. Hahn was overly influenced by career scientists, who had drafted the document, the official said.

Trump administration officials have the authority to intervene with such nonbinding documents, partly because of a 2019 executive order that tightened restrictions over their issuance.

The F.D.A., however, continued to share parts of this guidance with vaccine developers in response to questions they submitted to the agency.

“We’ve made it clear that we want to see a median of about two months of follow-up for any of the vaccines that comes in,” Dr. Peter Marks, the F.D.A.’s top regulator for vaccines, said in an interview on YouTube on Friday.

On Tuesday, the F.D.A. published the guidelines at the end of a document the F.D.A. prepared for the meeting on Oct. 22 of the Vaccines and Related Biological Products Advisory Committee. The committee will be discussing the development, authorization and licensing of Covid vaccines.

In a statement Tuesday, the drug industry’s largest trade group, the Pharmaceutical Research and Manufacturers of America, said it supported “any efforts by F.D.A. to provide clarifying guidance.”

“We have engaged with the agency to support bringing greater transparency to the review process for COVID-19 vaccines,” the statement said. “We welcome the agency’s efforts to instill confidence in the rigorous safety of these potential vaccines.”

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Cuomo Imposes New Restrictions to Curb Coronavirus Clusters

Gov. Andrew M. Cuomo announced tighter restrictions on Tuesday aimed at curbing the surge in coronavirus clusters in parts of New York City and some suburbs.

The virus spreads in mass gatherings. We know this from our own experience, from what we’ve seen and from what every expert tells us, right? The outbreaks, which is when the virus is spreading out of control, it starts with a mass gathering and then it expands from there, especially indoors. So it’s to be taken very seriously. A mass gathering causes infections, infections cause a cluster, a cluster causes community spread. That is the natural evolution of things unless we intervene and we stop the cycle. What’s our strategy? Crush the cluster and stop the spread. And we’re announcing a special initiative to do just that — Cluster Action Initiative. Catchy name. Step 1, you take the most dramatic action within the cluster itself, where you have the highest density of cases. Understanding that the people in that cluster interface with the surrounding communities, take additional action in the communities surrounding the cluster. And then on a precautionary measure, take action in the communities that are outlying that area, right? So three steps.

Video player loadingGov. Andrew M. Cuomo announced tighter restrictions on Tuesday aimed at curbing the surge in coronavirus clusters in parts of New York City and some suburbs.CreditCredit…Mike Segar/Reuters

In a bid to contain coronavirus clusters in parts of New York City and its northern suburbs, Gov. Andrew M. Cuomo on Tuesday announced new restrictions in those areas, including temporarily closing nonessential businesses and schools.

Starting as soon as Wednesday and no later than Friday, many stores, gyms, salons and other businesses will close in the hardest-hit places, where the rate of new cases has remained stubbornly high in the past week. Restaurants and bars would again be restricted to takeout and delivery only, as they were at the start of the pandemic.

Mass gatherings would be barred except at houses of worship, which would be limited to 25 percent capacity, with a 10-person maximum. And Mr. Cuomo, who on Monday closed schools in the city’s hot spots, said that schools in parts of Rockland and Orange Counties would also close.

In geographic areas around the clusters, less severe restrictions would be in place, including prohibiting indoor dining and closing businesses deemed “high-risk,” including gyms and personal care business.

The exact boundaries of all the new cluster zones began to emerge late Tuesday, with Mr. Cuomo posting on Twitter a map of the Brooklyn cluster zone, which appeared to include the neighborhoods of Bay Ridge, Borough Park, Midwood, Sheepshead Bay and Sunset Park, and maps for the other cluster zones. The restrictions will be in place for at least two weeks.

Today we establish clear limits for areas where we see high positivity: The Cluster Action Initiative.

Locations will be categorized either Red, Orange, or Yellow, based on proximity to the cluster.

The severity of the problem will determine the response. pic.twitter.com/707FYGHB0g

— Andrew Cuomo (@NYGovCuomo) October 6, 2020

The new measures marked a staggering setback in New York, once the center of the pandemic, where officials had seen months of declining or flat rates of positive test results after a devastating and deadly spring.

Officials have warned recently about clusters where the virus appeared to be spreading rapidly, including at colleges and universities.

In an effort to address hot spots in Brooklyn and Queens, Mr. Cuomo had already ordered all public and private schools in nine of the city’s ZIP codes to close as of Tuesday morning.

On Tuesday, Mr. de Blasio said that during testing at 35 schools in the nine ZIP codes, just two of 1,351 tests returned positive results between Sept. 25 and Oct. 5. But recent estimates of the spread of infections in city schools suggested that the city’s ambitious testing plans may be insufficient to catch outbreaks before they spread beyond a handful of students.

Officials in Orange County already closed all schools in Kiryas Joel, a predominantly ultra-Orthodox Jewish village located in a ZIP code seeing some of the highest seven-day average positivity rates in the state in recent days. Schools in other parts of that ZIP code were not ordered to close.

On Tuesday, the governor said 705 virus patients were hospitalized statewide, up from 636 the day before.

Mr. Cuomo also said that travelers from New Mexico are now required to quarantine for 14 days upon arrival, joining a long list of other states and territories.

Travelers to Connecticut and New Jersey are also now subject to a 14-day quarantine if they are coming from those same places, though compliance is voluntary in New Jersey and there is a testing alternative in Connecticut.

Credit…Doug Mills/The New York Times

The White House physician, Dr. Sean P. Conley, said on Tuesday that President Trump was experiencing no symptoms of Covid-19 and doing “extremely well” on his first full day at home since a three-night stay in the hospital.

But outside doctors and medical experts in Covid-19 and lung disease said they were struggling to piece together an accurate picture of Mr. Trump’s health. Far from having vanquished Covid-19, the outside experts said, Mr. Trump is most likely still struggling with it, and possibly entering a pivotal phase in which he could take a turn for the worse.

Dr. Conley said on Monday that Mr. Trump had been prescribed dexamethasone, which some experts saw as a sign that the president could be dealing with pulmonary issues since it is recommended only for Covid-19 patients who have severe or critical forms of the disease.

“Does he have lung involvement? My guess is yes, because they did give him a lot of medications that they would only give to someone who did,” said Dr. Mangala Narasimhan, a pulmonologist and director of critical care services at Northwell Health in New York.

In a televised event on Monday that some of the president’s Republican allies tried to frame as a quick recovery from the virus, Mr. Trump was flown from Walter Reed National Military Medical Center to the White House. After leaving his helicopter, he crossed the lawn, walked up a set of stairs and removed his mask.

“As a pulmonologist, he did two things for me: He did a walk test, and he did a stair-climbing test,” said Dr. Talmadge E. King Jr., a specialist in pulmonary critical care and the dean of the UCSF School of Medicine. He added that lung doctors still rely on tests like these “to just get a picture of how the patient’s doing.”

He and others said that at the top of the stairs, Mr. Trump used his neck muscles to help him breathe — a classic sign that someone’s lungs are not taking in enough oxygen.

Dr. Ilan Schwartz, an infectious disease doctor and assistant professor at the University of Alberta, agreed. “As a physician, I would refrain from commenting on somebody whom I haven’t examined,” he said. “But in this case, the clinical signs are so obvious that it can be seen from a distance, even on a short two- or three-second clip.”

Credit…Anna Moneymaker for The New York Times

On Tuesday evening, senior administration officials confirmed that Stephen Miller, Mr. Trump’s top speechwriter and a policy adviser, had tested positive for the coronavirus, joining a growing list of Mr. Trump’s close aides who have the virus.

“Over the last five days I have been working remotely and self-isolating, testing negative every day through yesterday,” Mr. Miller said in a statement. “Today, I tested positive for Covid-19 and am in quarantine.”

Mr. Miller is married to Katie Miller, Vice President Mike Pence’s communications director. A senior administration official said Ms. Miller, who contracted the virus this spring and returned to work in May, was tested Tuesday morning and was negative for any new infection.

On Tuesday, many White House offices were empty as officials stayed home to wait out the infectious period from an outbreak of the coronavirus within the building and among people who had been there.

President Trump was in the White House residence, convalescing, as a number of advisers and other officials stayed home, either because they had contracted the coronavirus or had been near people who did.

The White House communications and press shops were bereft of people. The White House press secretary, Kayleigh McEnany, announced on Monday that she had tested positive. Two other press office aides have also contracted the virus, and two more aides on Tuesday were said to have tested positive, people familiar with the results said.

The outbreak in the White House, which has extended to some lawmakers on Capitol Hill, has raised concerns in the city that surrounds it. Washington, D.C., which has managed to bring infection rates down in recent weeks through preventive laws and high rates of compliance, has almost no control over the federal government.

The city reported 105 new coronavirus cases on Tuesday, the highest number since June 3.

The gathering at the Rose Garden would have violated the city’s mandates limiting the size of gatherings and requiring masks. But because the White House is on federal property, it is exempt from such rules.

City officials said they would be closely monitoring infection trends for several days to see if the Capitol and White House cases affected the city’s overall infection rate.

U.S. ROUNDUP

Credit…Kerem Yucel/Agence France-Presse — Getty Images

With the coronavirus raging out of control in Wisconsin, Gov. Tony Evers announced tight new limits on Tuesday on the size of public indoor gatherings in the state. But the order exempts some of the settings that have been of greatest concern for spreading the virus: schools and colleges, houses of worship, polling places and political rallies.

Wisconsin, a pivotal, sharply divided battleground state in the presidential election, has seen coronavirus cases explode. Three of the four metro areas in the United States with the most cases per capita last week were in northeast Wisconsin, and hospitals in the state are becoming overwhelmed. The state has recently been reporting about 2,400 new cases a day on average, according to a New York Times database.

The order by the state’s Department of Health Services limits public indoor gatherings to 25 percent of capacity; indoor spaces without an official occupancy limit will be restricted to 10 people. The order takes effect on Friday and is set to continue through Nov. 6.

“We’re in a crisis right now, and need to immediately change our behavior to save lives,” Governor Evers, a Democrat, said in a statement.

The governor’s previous efforts to fight the pandemic with statewide restrictions have repeatedly met stiff resistance from Republicans. A stay-at-home order he issued in March was struck down in May by the conservative-leaning state Supreme Court, and a court ruling is expected soon on a lawsuit challenging the governor’s mask mandate.

In other U.S. news:

  • Gov. Tom Wolf of Pennsylvania moved in the opposite direction on Tuesday, easing restrictions somewhat on gatherings in his state. Starting Friday, facilities with normal capacities of up to 2,000 people will be allowed to operate at 20 percent of capacity if indoors and 25 percent if outdoors. Larger facilities will have incrementally lower percentage limits. Until now, gatherings in Pennsylvania have been limited to 25 people indoors and 250 outdoors, regardless of capacity. Case counts in the state have been climbing gradually since late August and have lately averaged about 1,000 a day.

In what is believed to be one of the first cases of its kind in New York State, prosecutors have filed negligent homicide charges over a fatal confrontation in suburban Buffalo over someone who was not wearing a face mask.

Rocco Sapienza, 80, died five days after being pushed to the ground by Donald Lewinski, 65, a fellow bar patron, prosecutors say.

Mr. Lewinski plans to plead not guilty, according to his lawyer, Barry Covert. He is expected to enter the plea in an Erie County courtroom Tuesday. If convicted, Lewinski could face four years in prison.

In New York State, customers at bars and restaurants are required to wear face coverings when they are not seated, and according to John J. Flynn, the Erie County district attorney, surveillance video showed Lewinski walking around Pamp’s Red Zone Bar & Grill in West Seneca, N.Y., multiple times without wearing a mask. Flynn said the video shows Lewinski shoving Sapienza to the ground with both hands after Sapienza confronted him over his refusal to wear a face mask as required.

As he fell, Mr. Sapienza’s left arm knocked over a nearby stool and his head hit the floor, apparently causing him to lose consciousness. Flynn said preliminary autopsy results showed that Mr. Sapienza, who underwent brain surgery after the confrontation, died from blunt force trauma to the head.

“It’s beyond sad,” Mr. Flynn said. “These kinds of situations have continued to escalate, and this should cause everyone to pause and think twice now about how we as a society want to conduct ourselves during this pandemic.”

Credit…Greg Nash/Getty Images

A senior vaccine scientist at the Department of Health and Human Services resigned from government service following a long battle with White House appointees over their interference in his efforts to fight the coronavirus pandemic.

Rick Bright served as chief of the department’s Biomedical Advanced Research and Development Authority until six months ago, when he was abruptly reassigned to a narrower job at the National Health Institute after raising concerns about “cronyism” and political interference in science.

Dr. Bright, who filed a whistle-blower complaint in May, filed a new addendum saying that officials at the N.I.H., where he worked after his demotion, rejected his idea for a national coronavirus testing strategy “because of political considerations.” He also accused them of ignoring his request to join the $10 billion effort to fast-track a coronavirus vaccine, known as Operation Warp Speed, and of sidelining him to the point where he had no work to do.

The addendum said Dr. Bright “remains very concerned” about the failure of the Trump administration to put forth a national plan to combat the pandemic and is troubled by the growing influence of Stanford’s Hoover Institution of Dr. Scott W. Atlas, a neuroradiologist without training in epidemiology or infectious diseases. Dr. Atlas’s aversion to mask wearing and his belief that “herd immunity” could stop Covid-19 have made him a favorite of President Trump.

“Dr. Bright was forced to leave his position at N.I.H. because he can no longer sit idly by and work for an administration that ignores scientific expertise, overrules public health guidance and disrespects career scientists, resulting in the sickness and death of hundreds of thousands of Americans,” Dr. Bright’s lawyers, Debra Katz and Lisa Banks, said in a statement.

Credit…Al Drago for The New York Times

After months of crowded events and often maskless encounters, a growing number of top government officials, including President Trump, and their close contacts have tested positive for the coronavirus.

The fault for the outbreak lies in no small part with an ill-conceived disease-prevention strategy at the White House, health experts said: From the early days of the pandemic, federal officials have relied too heavily on one company’s rapid tests, with little or no mechanism to identify and contain cases that fell through the diagnostic cracks.

“It seems the White House put all their eggs in one basket: testing,” said Dr. Megan Ranney, an emergency medicine physician at Brown University. “But there is no single strategy, no single thing we can do to be safe. It has to be multimodal.”

Other health experts noted that the tests deployed by the White House, manufactured by Abbott Laboratories, were given emergency clearance by the Food and Drug Administration only for people “within the first seven days of the onset of symptoms.” But they were used incorrectly, to screen people who were not showing any signs of illness. Such off-label use, experts said, further compromised a strategy that presumably was designed to keep leading officials safe from a pandemic that so far has killed more than 210,000 Americans.

“It’s not being used for the intended purpose,” said Syra Madad, an infectious disease epidemiologist based in New York. “So there will be potentially a lot of false negatives and false positives.”

Dr. Scott Gottlieb, the former commissioner of the F.D.A., described these procedures as a misguided attempt at a “zero-fail testing protocol” in an interview on CBS’ “Face the Nation” on Sunday, saying that officials “weren’t taking any precautions beyond testing people who are going to be in contact with the president.”

Although Abbott’s products are not cleared for asymptomatic testing, the company has told experts that it thinks such use is likely to pan out.

On Saturday evening, Andrea Wainer, Abbott’s executive vice president of rapid and molecular diagnostics, emailed a document to several public health experts containing preliminary results outlining the test’s performance in people without symptoms. Among an unspecified number of individuals, the test picked up about 88 percent of the infections found by laboratory P.C.R. tests, the company statement said.

“By studying the test in the asymptomatic people, Abbott knows it works in that population,” the document said. “It can’t say that for itself, because the test isn’t approved for that, but that data has been shared with others and the F.D.A. too.”

Credit…Pool photo by Alexander Astafyev

European countries that have again restricted residents’ movement in an effort to contain a second wave of the coronavirus are confronting a lack of adherence to the new rules that the World Health Organization attributed to “pandemic fatigue.”

“Citizens have made huge sacrifices to contain Covid-19,” Dr. Hans Henri P. Kluge, the W.H.O.’s regional director for Europe, said in a statement to the news media on Tuesday. “It has come at an extraordinary cost, which has exhausted all of us, regardless of where we live, or what we do. In such circumstances it is easy and natural to feel apathetic and demotivated.”

Many have expressed their opposition to their countries’ restrictions through demonstrations. In Spain, where the capital Madrid has become the epicenter of a strong second wave, an initial selective lockdown brought out protesters and underscored the divisions between rich and poor.

In Germany, where cases are surging, thousands of people filled the streets over the weekend to protest the measures that have come into force.

Recognizing the apathy and backlash against some restrictions, Dr. Kluge recommended closer consultation with communities to understand their frustrations and said countries should be working with their citizens to form policies that will have their backing.

To combat the fatigue as the holiday season approaches, the W.H.O. advised balancing science, social and political needs and placing empathy at the heart of their approach.

Credit…Timothy D. Easley/Associated Press

All 21 employees of the public works department of Richmond, Ky., have been quarantined after one tested positive for Covid-19 on Sept. 29, the office of the city manager said.

Employees will return to work on Oct. 13, Rob Minerich, the city manager, told local news outlet WBON-TV.

“We ask the citizens of Richmond to be patient with us,” Mr. Minerich said. The Public Works Department’s duties include helping clean streets, clearing out tree limbs and repairing potholes. Richmond is located about 100 miles southeast of Louisville and has a population of just under 38,000.

Additional city departments will be covering some of these functions, and some street pavings have been delayed as a result of the quarantine, Mr. Minerich said.

The virus has been surging in Kentucky, where the governor, Andy Beshear, said Tuesday that he had extended a mask mandate for another 30 days and promised stricter enforcement as the state struggles with surging numbers of coronavirus cases, The Associated Press reported.

On Monday, 701 new coronavirus cases were reported in Kentucky. In the past week, the state has recorded an average of 826 cases each day, a 22 percent increase over two weeks earlier.

Credit…T.J. Kirkpatrick for The New York Times

Gen. Mark A. Milley, the chairman of the Joint Chiefs of Staff, and several of the Pentagon’s most senior uniformed leaders are quarantining after being exposed to the coronavirus, a Defense Department official said on Tuesday.

The official said almost the entirety of the Joint Chiefs of Staff, including Gen. James C. McConville, the Army chief of staff, are quarantining after Adm. Charles Ray, the vice commandant of the Coast Guard, tested positive for coronavirus.

“We are aware that Vice Commandant Ray has tested positive for Covid-19 and that he was at the Pentagon last week for meetings with other senior military leaders,” Jonathan Hoffman, the Pentagon spokesman, said in a statement released by his office.

“Out of an abundance of caution, all potential close contacts from these meetings are self-quarantining and have been tested this morning,” he added. “No Pentagon contacts have exhibited symptoms and we have no additional positive tests to report at this time.”

The announcement represents an alarming development — as the virus extends its reach from the highest levels of civilian government to the operational heart of the country’s national security apparatus.

A military official noted that General Milley and the other senior officers have full operational capability from where they are working — most at home — and said that there is no degradation to the country’s national defense.

Admiral Ray was in the Pentagon last week, attending meetings in the secure “Tank” with General Milley and the senior Pentagon uniformed leadership. Defense Department officials said the decision to quarantine complied with Defense Department guidelines established by the Centers for Disease Control.

General Milley, 62, and a number of senior Defense Department officials have also been getting tested frequently since Sept. 27, when many of the Pentagon’s senior leadership attended a White House reception for “Gold Star” families of fallen troops.

Both Mr. Trump and Melania Trump, the first lady, were at that event. Admiral Ray also was at the White House Gold Star gathering, a Defense Department official said.

The reaction at the Pentagon to the possible exposure of senior military leaders to coronavirus stands in contrast to the White House, where Mr. Trump has flouted the same guidelines established by the C.D.C. that the Pentagon is following.

White House officials, citing national security concerns, last weekend told Defense Department officials that they should no longer inform the public or the news media about the coronavirus status of senior Pentagon leaders. But Defense Department officials have questioned the directive.

Credit…John Minchillo/Associated Press

Reported crime of nearly every kind has declined this year amid the pandemic. The exception to that has been stark and puzzling: Shootings and homicides are up in cities around the United States, perplexing experts who normally expect these patterns to trend together.

The president and others have blamed protests and unrest, the changing tactics of police officers, and even the partisan politics of mayors. But at least part of the puzzle may lie in sources that are harder to see (and politicize): The pandemic has frayed all kinds of institutions and infrastructure that hold communities together, that watch over streets, that mediate conflicts, that simply give young people something to do.

Schools, libraries, recreation centers and public pools have closed. Nonprofits, churches and sports leagues have scaled back. Mentors, social workers and counselors have been hampered by social distancing.

And programs devised to reduce gun violence — and that have proved effective in studies — have been upended by the pandemic. Summer job programs were cut this year. Violence intervention workers were barred from hospitals. Group behavioral therapy programs meant to be intimate and in-person have moved, often haltingly, online.

“This work is a pat on the shoulder, a touch on the hand, a handshake,” said Del McFadden, the director of the office of neighborhood safety and engagement for the District of Columbia. “All of those things are different now.”

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Horace Mann, one of New York City’s most prominent private schools, has temporarily ended in-person learning, following several cases of coronavirus.

The closing was ordered after the school discovered three infections while tracing people who had come in contact with the school’s first case, according to Thomas M. Kelly, Horace Mann’s head of school. The news was first reported by The Riverdale Press.

“Two of the three new cases involve Middle and Upper Division physical education teachers/coaches, and the third involves a member of our college counseling department,” Mr. Kelly wrote in an email to parents and staff members that he shared with The Times. He said the school only became aware of the third case Monday night.

Dr. Kelly said that Horace Mann’s nursery and lower divisions, which are housed elsewhere, would continue in-person education.

The rapidity of Dr. Kelly’s decision — announcing the school’s Tuesday closure on Monday night — mirrors the tumult surrounding Mayor Bill de Blasio’s decision to close public and private schools this week in nine ZIP codes that have seen an alarming rise in the prevalence of coronavirus.

Horace Mann’s middle and high schools, near Van Cortlandt Park in the Bronx, have about 1,200 students. Following a quarantine, in-person classes for those students are scheduled to resume Oct. 19. The additional three cases of “do have overlap with students and employees at a level that makes me uncomfortable moving forward with in-person instruction,” Dr. Kelly wrote.

Credit…Eve Edelheit for The New York Times

Facebook removed a post from President Trump on Tuesday that violated its policy against sharing misinformation about the virus, one of the few times that the social network has taken down one of his posts.

In Mr. Trump’s message, he falsely claimed that the flu was responsible for more deaths than the coronavirus. More than one million people have died from the coronavirus, with more than 35.5 million cases reported around the world. Mr. Trump’s post is no longer available on Facebook.

“Many people every year, sometimes over 100,000, and despite the Vaccine, die from the flu,” Mr. Trump wrote in the post. “We have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!”

The president’s comments and actions over the past few days — including his Twitter message on late Monday telling Americans: “Don’t be afraid of Covid. Don’t let it dominate your life” — have drawn outrage from scientists, ethicists and doctors, as well as from some people whose relatives and friends have died.

“I am struggling for words — this is crazy,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania. “It is just utterly irresponsible.”

Facebook had previously removed ads and posts by Mr. Trump’s re-election campaign for spreading coronavirus misinformation or for violating policies about hate symbols, and it took down a video Mr. Trump posted in August in which he claimed children were “virtually immune” to the coronavirus. While the Silicon Valley giant has been under intense pressure to deal with Mr. Trump’s spreading of falsehoods on its site, its chief executive, Mark Zuckerberg, has said that he is a proponent of free speech.

This year, Facebook introduced new policies to remove misinformation related to Covid-19 “that could contribute to imminent physical harm.” The company has applied the policy to remove posts that “make false claims about cures, treatments, the availability of essential services or the location and severity of the outbreak.”

“We remove incorrect information about the severity of Covid-19, and have now removed this post,” Facebook said in a statement.

Mr. Trump also tweeted the same message falsely claiming that the flu was responsible for more deaths than the coronavirus. The company added a label to the tweet that hides the message, saying that the post violated its policies by spreading misleading information about Covid-19.

A Twitter spokeswoman said that the label would mean “engagements with the tweet will be significantly limited.”

Credit…Joe Raedle/Getty Images

President Trump’s comparisons of Covid-19 to the flu stand in sharp contrast with months of data gathered by experts, who have repeatedly said that the coronavirus poses a far more serious threat than influenza viruses.

The president tweeted on Tuesday morning:

“Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu. Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!”

Based on data gathered thus far, most flu viruses are less deadly and less contagious than the coronavirus. And while flu vaccines and federally approved treatments for the flu exist, no such products have been fully cleared by governing bodies for use against the coronavirus.

According to the Centers for Disease Control and Prevention, between 24,000 and 62,000 flu-related deaths occur in the United States each year — substantially fewer than Mr. Trump claimed. In February, Mr. Trump stuck closer to the facts at a White House news conference. “The flu, in our country, kills from 25,000 people to 69,000 people a year. That was shocking to me,” he said at the time. On average, seasonal flu strains kill about 0.1 percent of the people they infect.

The coronavirus, on the other hand, has killed more than 210,000 people in the United States, and more than one million worldwide, since the start of 2020. The virus’s true mortality rate remains unclear, as it is difficult to gather such data while the pandemic rages on. Inadequate testing has also made it hard to pinpoint how many people have been stricken by the virus, which can spread silently from people who never show symptoms.

Still, estimates from experts tend to put the coronavirus’s death rate higher than the flu’s. The virus’s death toll was especially high in late winter and spring, when hospitals were overwhelmed, clinically tested treatments were scarce and masking and distancing were even more intermittent than they are now.

Frequent encounters with past flu strains, in combination with effective vaccines, can also bolster the body’s defenses against new flu viruses. The coronavirus, however, has swept through a defenseless population of unprepared hosts at a dizzying rate.

And deaths also don’t reveal the entire picture. Researchers still don’t fully understand the long-term consequences of coronavirus infections, which have saddled a growing number of people, called long-haulers, with serious and debilitating symptoms that can linger weeks or months.

Twitter appended a note to Mr. Trump’s tweet, saying that it violated the company’s rules about spreading false or misleading information about the virus, and Facebook removed the post for violating its similar policy.

Credit…Hilary Swift for The New York Times

President Trump announced on Tuesday that he was planning to attend next week’s debate in Miami against former Vice President Joseph R. Biden Jr. despite his continued struggle with the coronavirus and unresolved questions about the event’s rules.

“I am looking forward to the debate on the evening of Thursday, October 15th in Miami. It will be great!” the president tweeted early Tuesday, the morning after he returned to the White House from Walter Reed National Military Medical Center.

“FEELING GREAT!” he added in a separate tweet, hours before his physician reported that he was feeling well.

Asked later on Tuesday if he would feel safe debating Mr. Trump next week, Mr. Biden said, “Well, I think if he still has Covid, we shouldn’t have a debate.”

Physicians who specialize in infectious diseases quickly warned that Mr. Trump’s optimism might be premature, and could reflect a false sense of security about his condition, reinforced by temporary improvements that could be reversed once he is removed from medications.

People with mild to moderate cases of the illness are likely to “remain infectious no longer than 10 days after symptom onset,” according to guidelines from the Centers for Disease Control and Prevention. But that period could be doubled in cases of more serious illness.

That means Mr. Trump could still be contagious, depending on the severity of his case and when his symptoms began, during the next debate, according to Dr. Krutika Kuppalli, an infectious-disease physician in South Carolina.

“We don’t even know what’s going to happen tomorrow, let alone in a few days,” she said.

Medical details that Mr. Trump’s doctors disclosed over the weekend — including his fluctuating oxygen levels and a decision to begin treatment with a steroid drug — suggested to many infectious-disease experts that he had a more severe case of Covid-19 than the physicians acknowledged.

He has been taking a steroid called dexamethasone — a drug known to buoy feelings of well-being, said Dr. Taison Bell, an emergency medicine physician at the University of Virginia, and patients typically need to demonstrate they can function without medication before being allowed to resume normal activities.

Should Mr. Trump’s condition continue to improve and should he be definitively cleared by physicians to participate in next week’s debate, Dr. Bell added, masking and distancing would remain crucial. “They need to stick with the rules they’ve set,” he said.

If Mr. Trump is able to follow through on his promise, he faces a campaign transformed by an infection that has spread to his top aides, and stakes that have been heightened by a disruptive performance in the first debate that prompted the Commission on Presidential Debates to consider revising its procedures.

Mr. Trump had previously questioned whether he would participate if new rules, including the possibility that his microphone would be muted to discourage interruptions, were enacted. But his illness has upended those calculations, and Republican officials said that he now needed to show that is physically capable of carrying on his campaign.

Debate planners are also trying to keep their events from exacerbating the pandemic. On Monday, the commission decided to install a sheet of plexiglass between Kamala Harris and Mike Pence at the vice-presidential debate on Wednesday amid concerns about transmission during their back-and-forth.

After first objecting to the barriers as unnecessary, aides to Mr. Pence reversed course on Tuesday, saying that if the plexiglass barriers were important to Ms. Harris, then they would accept them for the vice president, according to Frank J. Fahrenkopf Jr., a co-chair of the Commission on Presidential Debates.

It is not clear if the commission will do the same at the town-hall-style presidential debate in Miami, but Democratic officials have pressed for rigorous safety measures, including the expulsion of attendees who refuse to wear masks or decline to observe social distancing protocols.

Credit…Kevin Lamarque/Reuters

Dr. William Foege, a legendary figure in public health circles who served both Democratic and Republican presidents, has written an extraordinary private letter to the director of the Centers for Disease Control and Prevention calling on him to expose the Trump administration’s mishandling of the coronavirus pandemic — even if it means getting fired.

In the Sept. 23 letter, obtained and published Tuesday evening by USA Today, Dr. Foege, who served as director of the C.D.C. under former Presidents Jimmy Carter and Ronald Reagan, called on the current director, Dr. Robert R. Redfield, to admit to the administration’s failures or risk presiding over the ruin of the public health agency’s reputation, and his own.

“Dear Bob, I start each day thinking about the terrible burden you bear,” he began, making clear that this was not the first conversation the two men have had about the administration’s response and Dr. Redfield’s role in it.

“As I have indicated to you before, resigning is a one-day story and you will be replaced,” Dr. Foege wrote, adding that if Dr. Redfield remained silent, the White House would simply “blame you for the disaster” and move on.

He suggested another course: “You could, upfront, acknowledge the tragedy of responding poorly, apologize for what has happened and your role in acquiescing, set a course for how C.D.C. would now lead the country if there was no political interference.”

“Don’t shy away from the fact this has been an unacceptable toll on our country,” he added. “It is a slaughter and not just a political dispute.”

Dr. Foege, 84, has worked in the field for more than half a century. He is credited with devising the strategy that led to the successful eradication of smallpox in the 1970s, and played a key role in improving immunization rates in developing countries in the 1980s. He told Dr. Redfield he needed to lift morale at the C.D.C. and restore the agency’s reputation.

“When they fire you,” he concluded, “this will be a multi-week story and you can hold your head high. That will take exceptional courage on your part. I can’t tell you what to do except to revisit your religious beliefs and ask yourself what is right.”

GLOBAL ROUNDUP

Credit…Andrew Medichini/Associated Press

Italy’s government is considering making face masks mandatory outdoors all over the country to curb a steady increase in coronavirus cases, the country’s health minister, Roberto Speranza, told the Senate on Tuesday.

“Together with Germany, we are the country that is better withstanding the second wave,” Mr. Speranza said. “But we should not be misled. It would be deeply wrong to think that we are out of it.”

The Lazio region, which includes Rome, made face masks mandatory outdoors last week.

Mr. Speranza said cases had been growing for nine consecutive weeks across the country, and were not limited to one area as they were early in the pandemic, when Italy became the first European country to lock down in the face of a strong first wave in the northern regions. “Today, no region can feel not at risk,” he said.

For the moment, intensive care units are seeing a manageable number of Covid-19 cases. Patients are on average in their 40s, not their 70s, like in the spring.

In the southern region of Campania, mostly spared by the first wave, cases have been growing so rapidly in recent weeks that the regional president has limited business hours for bars and restaurants, which must close by 11 p.m. Other regions may consider similar measures.

The government is drafting “measures of prudence” for the next month, Mr. Speranza said. Soldiers and policemen will patrol the streets to prevent gatherings of people outdoors, while dance halls and nightclubs remain closed in Italy. The government is also considering limiting the number of guests allowed to attend private parties or ceremonies.

In other news from around the world:

  • A top World Health Organization official said Monday that about 10 percent of the world’s population may have already contracted the coronavirus. That estimate — which works out to about 760 million people — far exceeds the confirmed global caseload of about 35 million. “This varies depending on country, it varies from urban to rural, it varies between different groups,” the official, Dr. Mike Ryan, said at a special session of the agency’s executive board in Geneva. “But what it does mean is that the vast majority of the world remains at risk.” Another agency official said Monday that the 10 percent estimate had been calculated based on an average of antibody studies from around the world.

  • The leader of Scotland’s government, Nicola Sturgeon, said the country was facing “the most difficult decision point yet” as cases rise, but she ruled out another national lockdown on Tuesday. As Cabinet discussions continue over what new measures to implement, Ms. Sturgeon said the government must strike a balance between the public health toll and the wider costs of a lockdown to the economy and people’s lives. Scotland has recorded 5,108 cases over the last seven days, which works out to 94 cases per 100,000.

  • There’s a shortage of remdesivir, the anti-viral drug that is being used to treat the virus, in the Netherlands. On Monday, the government said that the Dutch National Institute for Public Health and the Environment had run out of the drug, which meant hospitals could not request doses. A new shipment was expected on Tuesday, the Dutch broadcaster NOS said, but it was unclear how much of the medicine was being delivered. Case numbers continue to climb in the Netherlands, with more than 25,000 cases in the last seven days, a rate of 149 cases per 100,000 people, according to a Times database.

  • Spain is heading for a deeper recession than initially predicted, the government said on Tuesday. Nadia Calviño, the Spanish economics minister, told a news conference on Tuesday that the government anticipated that the economy would shrink by 11.2 percentage points this year. But Ms. Calviño also forecast a sharp rebound of 7.2 percent for 2021, followed by growth of as much as 9.8 percent in 2022, by which point the country would significantly benefit from about 140 billion euros allocated as part of a European Union recovery fund.

Credit…Zohra Bensemra/Reuters

Huge throngs of people traveled in recent days to Touba, 120 miles west of Senegal’s capital of Dakar, for West Africa’s largest religious gathering — the Magal — which commemorates the exile of a Muslim spiritual leader. Many people wore masks. Many did not.

It is expected to be one of the biggest events to be held anywhere in the world since the start of the coronavirus pandemic. In a typical year, as many as four or five million attend the Magal, though no estimates were yet available this year. The event is officially taking place on Tuesday but lasts about a week.

The leader of the Mourides, the Muslim sect that organizes the event, issued the annual call for pilgrims to come, despite the pandemic. The government of Senegal, which has been heaped with praise for its handling of the outbreak, did not try to ban it. And the levels of traffic suggested that most people were going ahead, despite the risks. Magal pilgrims do not book hotel rooms: Touba’s residents open up their homes and travelers bed down, many to each room. Lunch and dinner, in the Senegalese tradition, are usually eaten off a communal plate.

It has already been well documented that Magal pilgrims are particularly susceptible to viruses, because of the event’s inherent lack of social distancing. A study released last year showed that the prevalence of respiratory tract infection symptoms among pilgrims increased fivefold following the pilgrimage.

On a trip to Touba last Thursday, Senegal’s health minister told local journalists that he would be deploying 5,000 health ministry officials to Touba to monitor it and respond if necessary. He did not respond to calls or text messages requesting an interview, or answer questions about why the Magal had not been canceled and why many ministers were attending.

Ousmane Balde contributed reporting from Dakar.

Credit…Doug Mills/The New York Times

As a buoyant President Trump emerged from Walter Reed National Military Medical Center this week, appeared on a balcony at the White House, and proclaimed on Twitter that the public should have no fear of the coronavirus, many Americans saw few parallels between Mr. Trump’s experience with the virus and their own.

A woman in Brooklyn was reminded of the $4,000 she was charged for medication for her father, who eventually died from the coronavirus.

One man in Texas said he understood why the president of the United States would have top-flight doctors, but could not help comparing the place where Mr. Trump was treated with the facility where his 87-year-old mother became sick and died.

Nothing about the medical care that presidents receive is ever typical, and the coronavirus is no different: Mr. Trump so far seems to have benefited not only from power, money and access to first-class medical treatment, but also from the timing of his illness. He caught the virus seven months into the pandemic, after the country built up supplies and doctors honed their understanding of the disease.

One of his treatments, the steroid dexamethasone, was not used widely to treat patients at the beginning of the pandemic and was not adopted by some hospital officials in the United States until this summer.

Prudencio Matias Mendoza’s brother, Mariano, died from the coronavirus in late July, and in the past week, Mr. Matias Mendoza, 38, has been following Mr. Trump’s bout with the virus.

He supports some of the president’s policies. But he could not help but feel angry to see Mr. Trump and other officials ignoring social distancing and mask-wearing mandates.

“The president is not a god,” Mr. Matias Mendoza said. “Everyone has to do their part. This is a virus that comes to kill.”

Credit…Roslan Rahman/Agence France-Presse — Getty Images

Singapore has been trying for years to bolster its low birthrate by offering new parents a “baby bonus” of more than $6,000 for each child. Now the country of 5.7 million people says it plans to further sweeten the incentive with a one-time payment to help couples “have more babies” during the pandemic.

“We have received feedback that Covid-19 has caused some aspiring parents to postpone their parenthood plans,” Deputy Prime Minister Heng Swee Keat said in a statement on Monday. “This is fully understandable, especially when they face uncertainty with their income.”

The amount of the newly introduced payment had not been announced as of Tuesday evening.

Singapore had initial success against the coronavirus, but its caseload soared in April, fueled by an outbreak among migrant workers. It has reported 27 deaths and at least 57,000 infections since the start of the pandemic, including 104 new cases over the past week.

Singapore’s economy posted its worst-ever performance in the second quarter and is expected to contract by 6 percent this year.

Over the years, Singapore’s government has organized speed dating and other matchmaking services in a mostly futile attempt to encourage procreation. It also provides dollar-for-dollar matching services for savings accounts that are set up for newborns.

But the city-state’s fertility rate has continued to fall anyway over the past four decades — from 1.82 to 1.14 births per woman. That does not include modest fertility spikes that coincide with the lunar Year of the Dragon, which comes every 12 years and is widely thought to be auspicious.

Singapore’s birthrate of 8.6 per 1,000 people ranked 214th in the world in 2017. Of the 12 countries that scored lower, three were in Asia: Japan, South Korea and Taiwan. Monaco scored last.

Credit…Jackie Molloy for The New York Times

The pandemic has laid bare gender inequities across the country, and women in academia have not been spared. The outbreak erupted during universities’ spring terms, hastily forcing classes online and researchers out of their laboratories.

Faculty with young or school-aged children — especially women — had to juggle teaching their students with overseeing their children’s distance learning from home.

Many universities struggled to put meaningful policies in place to help faculty, especially caretakers and women. During the summer break ahead of this fall semester, administrators at some institutions began to reassess and develop strategies that experts say are a palatable start to stymieing crises stemming from the pandemic.

But the issues that women in academia are facing are not new. Instead, they are more severe versions of longstanding gender gaps that already cause universities to hemorrhage female faculty, particularly women of color, and will require measures that go beyond institutional responses to the pandemic.

Multiple studies have already shown that women have written significantly fewer papers than their male counterparts during the pandemic. Reports showed that at least one-third of working women in two-parent households exclusively provided child care after schools and day cares closed and babysitters quit or were let go.

Years of research have proven that female faculty struggle to balance work and family, often causing them to exit academia — or what experts refer to as “leaking from the academic pipeline.” For those who stay, anecdotal reports and Twitter outcries during the pandemic indicate that female faculty are suffering reduced productivity, which could affect their ability to get tenure.

Some women faced harsher student evaluations during the outbreaks, too. Research shows that gender bias is rampant in end-of-term evaluations, with women and people of color more likely than men to get comments related to “their appearance or the tone of their voice — things that are less closely related to the ability to successfully teach,” said Jenna Stearns, an economist at the University of California, Davis.

Credit…Wilfredo Lee/Associated Press

Miami-Dade Public Schools welcomed its youngest students back to classrooms on Monday, beginning a phased process that by the end of the week will make it the largest district in the country to reopen for five-day-a-week in-person instruction for all students who want it.

District officials said the first day of school for about 22,000 pre-kindergartners, kindergartners, first graders and students with special needs at about 300 schools went smoothly. Just over half of the district’s roughly 345,000 students signed up to attend school in-person this fall, with the rest continuing to learn remotely.

Last week, New York City, the nation’s largest district, began hybrid schooling for about half of its 1.1 million students. But unlike in Miami, the nation’s fourth largest district, students in New York receive a mixture of in-person and remote instruction.

Gov. Ron DeSantis of Florida, a Republican and a Trump supporter, mandated that all of the state’s schools reopen fully this fall, despite a surge in coronavirus cases over the summer that has only partially abated, leaving the state with a lingering high volume of cases. The state allowed only the three largest counties — Miami-Dade, Broward, and Palm Beach — to continue offering fully remote instruction past Aug. 31.

The Miami-Dade school board originally planned to begin a phased reopening on Oct. 14, but moved up its opening date under pressure from the state, despite concerns from some board members and the teachers union that schools were not fully prepared.

Credit…Doug Mills/The New York Times

For more than a century, Secret Service agents have lived by a straightforward ethos: They will take the president where he wants to go, even if it means putting their bodies in front of a bullet.

But that guiding principle has been tested in recent days by President Trump’s desire to get back to work, play or campaigning, despite an active coronavirus infection that could pose a serious threat to those around him.

The problem came into focus on Sunday, when a masked Mr. Trump climbed into a hermetically sealed, armored Chevy Suburban with at least two Secret Service agents so the president could wave to supporters outside Walter Reed National Military Medical Center in Bethesda, Md., where he was hospitalized from Friday to Monday.

Medical experts said the move put agents at risk. Secret Service personnel have privately questioned whether additional precautions will be put in place to protect the detail from the man they have pledged to protect.

“It’s on everybody’s mind,” said W. Ralph Basham, a former director of the Secret Service and the commissioner of U.S. Customs and Border Protection in the George W. Bush administration. “The ones no longer there are happy they’re not there. These are tough decisions to have to make.”

Central to the job of Secret Service agents is a willingness to say yes to the president no matter what he asks. Now, that means subjecting an agent’s health to Mr. Trump’s whims.

Critics say the president is not repaying his protectors’ dedication with anything like care or consideration. While agents have volunteered to sacrifice themselves for those they protect, they do so knowing that there is a low chance they will need to step in between a gunman and the president.

If they’re on the protection detail, they’ll take a bullet for their protectee,” said Janet Napolitano, President Barack Obama’s first homeland security secretary. “There’s a difference between that and being unnecessarily exposed to risk,” she added, one that extends to their families.

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Trump Leaves Hospital, but Doctor Says He Isn’t ‘Out of the Woods’

President Trump left the Walter Reed medical center after spending three nights there being treated for Covid-19. His physician, Dr. Sean P. Conley, said earlier in the day that the president was not “out of the woods yet.”

(camera shutters) (from off-camera) “Mr. President, how many staff are sick?” “How many of your staff are sick?” (President Trump) “Thank you very much. Thank you.” (from off-camera) “Do you think you might be a superspreader, Mr. President?” (camera shutters)

Video player loadingPresident Trump left the Walter Reed medical center after spending three nights there being treated for Covid-19. His physician, Dr. Sean P. Conley, said earlier in the day that the president was not “out of the woods yet.”CreditCredit…Anna Moneymaker for The New York Times

President Trump returned to the White House on Monday night, staging a defiant, made-for-television moment in which he ripped off his face mask and then urged the nation to put aside the risks of the deadly coronavirus that has swept through his own staff and sent him to the hospital for three days.

Just hours after his press secretary and two more aides tested positive, making the White House the leading coronavirus hot spot in the nation’s capital, Mr. Trump again dismissed the pandemic that has killed more than 210,000 people in the United States, telling Americans “don’t be afraid of it” and saying that he felt “better than 20 years ago.”

The words and visuals were only the latest ways Mr. Trump has undermined public health experts trying to persuade Americans to take the pandemic seriously. Even afflicted by the disease himself, the president who has wrongly predicted that it would simply disappear appeared unchastened as he pressed America to reopen and made no effort to promote precautions.

“We’re going back to work. We’re going to be out front,” Mr. Trump said in a video shot immediately after his return and then posted online. “As your leader, I had to do that. I knew there’s danger to it, but I had to do it. I stood out front. I led. Nobody that’s a leader would not do what I did. And I know there’s a risk, there’s a danger, but that’s OK. And now I’m better and maybe I’m immune, I don’t know. But don’t let it dominate your lives.”

Mr. Trump’s statement was meant to cast his illness as an act of courage rather than the predictable outcome of recklessness. He took no responsibility for repeatedly ignoring public health guidelines by holding campaign rallies and White House events without masks or social distancing, like the ceremony for the new Supreme Court nominee last month that may have infected a wide array of his aides and allies.

The regret-nothing approach demonstrated that the president intended no pivot in his handling of the pandemic despite his own medical crisis and the growing number of infections among his inner circle. The White House press secretary, Kayleigh McEnany, and two of her deputies were the latest to test positive.

Mr. Trump’s message, in effect, was that Americans should live their lives and not worry about catching the virus because “we have the best medicines in the world,” never mind that he has had access to experimental treatment and high-quality health care not available to most people.

The president’s dismissal of a virus that in recent weeks has been killing another 700 people each day in the United States set off alarm bells among health specialists who worried that it would send the wrong message to the public.

Kristin Urquiza, who addressed the Democratic National Convention in August after her father died of the coronavirus, responded on Twitter to the president’s admonishment to Americans not to be afraid of Covid-19, the disease caused by the coronavirus. “At this point the only thing we should be afraid of is you,” she wrote.

Critics also noted the president’s bravado is bolstered by care that isn’t available to most people, including an experimental antibody treatment that is still being tested in clinical trials and has been given to only a few hundred people. The manufacturer, Regeneron, has said that most of those who have gotten the cocktail have done so as participants in the trials, although in a handful of cases they have received it outside of the studies, as Mr. Trump did.

Mr. Trump pressured his doctors to release him from Walter Reed National Military Medical Center in suburban Maryland, but it did not indicate that he had escaped jeopardy, only that he could be treated at the White House, where he has 24-hour medical care. Dr. Sean P. Conley, the White House physician, acknowledged that the president “may not entirely be out of the woods yet,” adding that it would be another week until doctors could feel confident that he had passed the danger point.

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Credit…Abedin Taherkenareh/EPA, via Shutterstock

Iran’s coronavirus crisis worsened on Monday, with a record numbers of deaths and new infections, as the capital, Tehran, went into partial shutdown for a week.

The restrictions in Tehran, which went into effect on Saturday, include fines for anyone not wearing a mask in public. The government ordered the shutdown of schools, gyms, cafes, cinemas, beauty salons, museums and mosques, even for Friday prayers.

The health ministry on Monday reported 235 deaths from the virus, the highest daily count in Iran since the disease was first reported there in February. Masoud Mardani, a member of the government’s coronavirus committee, told the newspaper Etemad that the true death toll was several times higher than the official tally.

The ministry reported 3,902 new infections on Monday — another record — and 2,000 people hospitalized. Doctors warned on state TV that hospitals across the nation had reached full capacity and there were no more empty beds in intensive care units in Tehran.

President Hassan Rouhani announced the new restrictions as his government came under fire for taking a relatively passive stance on the crisis, referred to as the “inshallah” approach, from the Arabic expression meaning “God willing” or “if God wills.”

“Unfortunately, Tehran in terms of enforcing health regulation is like a city with nobody in charge,” said Hossein Kermanpour, the spokesman for the country’s regulatory body for health care.

In other global developments:

  • A top World Health Organization official said Monday that about 10 percent of the world’s population may have already contracted the coronavirus. That estimate — which works out to about 760 million people — far exceeds the confirmed global caseload of about 35 million. “This varies depending on country, it varies from urban to rural, it varies between different groups,” the official, Dr. Mike Ryan, said at a special session of the agency’s executive board in Geneva. “But what it does mean is that the vast majority of the world remains at risk.” Another agency official said Monday that the 10 percent estimate had been calculated based on an average of antibody studies from around the world.

  • Nicolas Maduro, the leader of Venezuela, has said his son and sister plan to take part in clinical trials of a coronavirus vaccine developed in Russia. The vaccine, called Sputnik V, has not been tested in late-stage clinical trials that show whether a vaccine is effective and can find rare side effects. Russia is now conducting those trials inside Russia and in Belarus and Venezuela. Russia also plans to test the vaccine in Brazil, India and the United Arab Emirates. Mr. Maduro said he planned to take the Russian vaccine once the trial is completed.

  • Ireland will enact more restrictive coronavirus measures starting at midnight on Tuesday, but will not impose the full lockdown recommended by some of its public health officials. The implications of a strict lockdown are “severe and very different to those we faced earlier this year,” said Prime Minister Micheal Martin on Monday, adding that it put “hundreds of thousands” of jobs at risk. Instead, the rest of the country will join the city of Dublin and the county of Donegal in a move to Level 3 restrictions for three weeks. Those rules ban social gatherings and indoor events. Bars and restaurants will remain open, with restrictions. The country has reported a spike in infections not seen since earlier in the pandemic, with at least 3,100 new cases in the past week.

  • The first minister of Scotland, Nicola Sturgeon, is considering implementing a “circuit breaker” lockdown as she warned that infection levels were increasing in “pretty much every part of the country.” On Monday, Scotland reported 697 new cases of the virus. The country’s cabinet will meet on Tuesday to decide on tighter restrictions. Government advisers have advocated for a two-week lockdown to stop the spread of the virus and help buy time ahead of winter. Ms. Sturgeon said on Monday that the term “circuit breaker” could mean a number of things and she would give as much notice as possible before any new restrictions go into effect.

  • Germany’s Parliament, the Bundestag, required masks to be worn inside its building starting Tuesday, as the number of virus cases continues to rise. Although social-distancing rules were introduced in the Bundestag early in the pandemic, wearing masks was only encouraged until now. While most lawmakers wore masks when not speaking, some, especially those from the far-right Alternative for Germany party, did not. The new rule will be in effect until at least Jan. 17. Four districts in Berlin, including the one where the Bundestag is located, have now surpassed the level of 50 infections per 100,000 people in a week, making them hot spots.

Credit…Federica Narancio/Associated Press

Top White House officials are blocking strict new federal guidelines for the emergency release of a coronavirus vaccine, objecting to a provision that would almost certainly guarantee that no vaccine could be authorized before the election on Nov. 3, according to people familiar with the approval process.

Facing a White House blockade, the Food and Drug Administration is seeking other avenues to ensure that vaccines meet the guidelines. That includes sharing the standards with an outside advisory committee of experts — perhaps as soon as this week — that is supposed to meet publicly before any vaccine is authorized for emergency use. The hope is that the committee will enforce the guidelines, regardless of the White House’s reaction.

The struggle over the guidelines is part of a monthslong tug of war between the White House and federal agencies on the front lines of the pandemic response. White House officials have repeatedly intervened to shape decisions and public announcements in ways that paint the administration’s response to the pandemic in a positive light.

That pattern has dismayed a growing number of career officials and political appointees involved in the administration’s fight against a virus that has killed more than 210,000 people in the United States.

The vaccine guidelines carry special significance: By refusing to allow the F.D.A. to release them, the White House is undercutting the government’s effort to reassure the public that any vaccine will be safe and effective, health experts fear.

“The public must have full faith in the scientific process and the rigor of F.D.A.’s regulatory oversight if we are to end the pandemic,” the biotech industry’s trade association pleaded on Thursday, in a letter to President Trump’s health secretary, Alex M. Azar II, asking for release of the guidelines.

Credit…Al Drago for The New York Times

Despite almost daily disclosures of new coronavirus infections among President Trump’s close associates, the White House is making little effort to investigate the scope and source of its outbreak.

According to a White House official familiar with the plans, the administration has decided not to trace the contacts of guests and staff members at the Sept. 26 Rose Garden celebration for Judge Amy Coney Barrett, Mr. Trump’s Supreme Court nominee. At least 11 people who attended the event, including the president and the first lady, have since tested positive.

Instead, it has limited its efforts to notifying people who came in close contact with Mr. Trump in the two days before his Covid diagnosis on Thursday evening. The White House official, who declined to be identified because he was not authorized to speak about the matter, said that the administration was following guidelines from the C.D.C.

The contact tracing efforts have consisted mostly of emails notifying people of potential exposure, rather than the detailed phone conversations necessary to trace all contacts of people who have been exposed. These efforts, typically conducted by the C.D.C., are being run by the White House Medical Unit, a group of about 30 doctors, nurses and physician assistants, headed by Dr. Sean Conley, the White House physician.

“This is a total abdication of responsibility by the Trump administration,” said Dr. Joshua Barocas, a public health expert at Boston University, who has advised the city of Boston on contact tracing. “The idea that we’re not involving the C.D.C. to do contact tracing at this point seems like a massive public health threat.”

Credit…Abedin Taherkenareh/EPA, via Shutterstock

Iran’s coronavirus crisis worsened on Monday, with a record numbers of deaths and new infections, as the capital, Tehran, went into partial shutdown for a week.

The restrictions in Tehran, which went into effect on Saturday, include fines for anyone not wearing a mask in public. The government ordered the shutdown of schools, gyms, cafes, cinemas, beauty salons, museums and mosques, even for Friday prayers.

The health ministry on Monday reported 235 deaths from the virus, the highest daily count in Iran since the disease was first reported there in February. Masoud Mardani, a member of the government’s coronavirus committee, told the newspaper Etemad that the true death toll was several times higher than the official tally.

The ministry reported 3,902 new infections on Monday — another record — and 2,000 people hospitalized. Doctors warned on state TV that hospitals across the nation had reached full capacity and there were no more empty beds in intensive care units in Tehran.

President Hassan Rouhani announced the new restrictions as his government came under fire for taking a relatively passive stance on the crisis, referred to as the “inshallah” approach, from the Arabic expression meaning “God willing” or “if God wills.”

“Unfortunately, Tehran in terms of enforcing health regulation is like a city with nobody in charge,” said Hossein Kermanpour, the spokesman for the country’s regulatory body for health care.

The government said that all of Iran’s 31 provinces are considered hot spots, but Tehran is the worst.

Mr. Rouhani said on Saturday that only 53 percent of Iranians were following health protocols such as social distancing and wearing masks. He said “regulations and oversight” would increase, and he authorized local coronavirus committees in each province to enforce one-week shutdowns.

Global Roundup

Credit…Cesar Manso/Agence France-Presse — Getty Images

Two midsize Spanish cities, León and Palencia, were ordered on Monday by the regional authorities to apply lockdown restrictions similar to those that came into force in Madrid last weekend, underlining the extent to which a second wave of coronavirus infections is spreading beyond Spain’s capital region.

The new restrictions mean that residents of León and Palencia, which are in the northwestern region of Castile and León, will not be able to leave their cities as of Tuesday. Both have reached an infection rate of more than 500 cases per 100,000 residents.

Over the last seven days, Spain has reported 73,451 new cases, which works out to 157 cases per 100,000 residents, according to a Times database. As of Monday, almost 11,000 people were being treated in hospitals across the country for Covid-19, the disease caused by the virus, including 1,580 people in intensive care units.

In other global developments:

  • Bars in Paris will close for two weeks starting on Tuesday, the authorities there announced on Monday, as France tries to stem a surge of coronavirus cases in its capital. The measure will also affect most cafes, which in many cases serve alcohol, but little or no food. Restaurants will be able to remain open if they follow a strict health protocol. Local health officials said the capital had been above the thresholds for the top alert level — more than 250 coronavirus cases per 100,000 people generally, more than 100 per 100,000 among the elderly, and more than one-third of intensive care beds used for Covid-19 patients — since last Thursday.

  • Nicolas Maduro, the leader of Venezuela, has said his son and sister plan to take part in clinical trials of a coronavirus vaccine developed in Russia. Russian health officials in August said they were the first in the world to register a vaccine for emergency use outside of clinical trials, but no other countries have followed their lead with the Russian vaccine. The vaccine, called Sputnik V, has not been tested in late-stage clinical trials that show whether a vaccine is effective and whether it has side effects. Those trials are underway in Russia, Belarus and Venezuela. Russia also plans to test the vaccine in Brazil, India and the United Arab Emirates. In the trial, Mr. Maduro’s family members will receive either a placebo or the vaccine. Mr. Maduro said he planned to take the Russian vaccine once the trial is completed.

  • New Zealand will lift restrictions on Auckland, its most populous city, from midnight on Wednesday, joining the rest of the nation. Restrictions had been reinstated after a cluster of infections emerged, but after the city reported no new infections for 10 consecutive days, Prime Minister Jacinda Ardern said on Monday that a second wave there had almost certainly been “eliminated.”