As the nation heads into what some public health experts warn could be a “dark winter” of coronavirus illness and death, a growing cadre is coalescing around Joseph R. Biden Jr.’s call for a “national mask mandate,” even as they concede such an effort would require much more than the stroke of a presidential pen.
Over the past week, a string of prominent public health experts — notably Dr. Anthony S. Fauci, the government’s top infectious disease specialist, and Dr. Scott Gottlieb, a former commissioner of food and drugs under President Trump — have said it is time to seriously consider a national mandate to curb the spread of the virus.
Overseas, President Vladimir V. Putin of Russia this week became the latest foreign leader to impose a national mandate for citizens to wear masks. Mr. Trump is opposed to a mandate, and Mr. Biden has conceded that a presidential order for all Americans to wear masks would almost certainly face — and likely fall to — a legal challenge.
Mr. Biden, who echoed warnings of a “dark winter” during the final presidential debate, is already using his bully pulpit to promote and reinforce a culture of mask wearing. If he is elected, he will almost certainly do more.
Mr. Biden has already said that, as president, he would mandate masks on all federal property, an executive order that could have wide reach. He could use his authority under federal transit law to require masks on public transportation. He could also prod governors who are resisting mask mandates to at least require masks in public buildings in their states.
But that is delicate political terrain in the United States, where Mr. Trump has turned the act of wearing a mask — or not wearing one — into a political statement. Public health and legal experts say it would be far better for Mr. Biden — or Mr. Trump, for that matter — to use his powers of persuasion to convince Americans that covering one’s face to protect against disease is a patriotic or civic-minded action.
“Instead of making it about the president’s coercive authority under law it should be about whether the president can support a norm that supports public health, which is in people’s self interest,” said Harold Koh, a law professor at Yale University and an expert in national security and human rights.
Experts say the scientific evidence is growing that face masks can considerably reduce the transmission of respiratory viruses like the one that causes Covid-19. Even when mask wearing does not prevent infection, it can reduce the severity of disease by diminishing the intensity of a person’s exposure to the virus. Research also shows that states that have passed mask mandates have had lower growth rates of Covid-19, beginning on the day the mandate was passed.
Even so, any hint of a sweeping federal requirement would “go over like a lead balloon,” and “divide and harden areas of the country in opposition,” said Joel White, a Republican strategist with expertise in health policy. Mr. White said the Trump administration’s policy, of letting state and local leaders decide about masks, is “a far better way to go.”
But that has not produced the kind of compliance that public health experts say is necessary to reduce the spread of the virus. As of last week, 33 states and the District of Columbia required mask-wearing in public, according to a list compiled by AARP. But in certain parts of the country, especially heavily Republican states, resistance is deep — even when cases are soaring.
In Belgium, all nonessential hospital work has been postponed to deal with an influx of new Covid-19 patients, whose numbers have nearly doubled in the past week, matching levels seen in the first wave of the pandemic in the spring.
Croatia has asked former doctors to come out of retirement to help in hospitals, while National Guard troops have flown from the United States to the Czech Republic to assist overwhelmed health care professionals there.
In the Netherlands, new coronavirus patients have had to be transferred by helicopter to Germany to relieve Dutch intensive-care units.
Across Europe, hospitals are filling up at an alarming pace that harks back to the darkest hours of the first wave of the pandemic in the spring. The authorities are scrambling to slow the spread of a virus that threatens to bring ailing health care systems to the brink of collapse.
Worldwide, more than 500,000 cases were tallied on Wednesday, a record since the start of the pandemic. All 20 countries with the highest rates of new cases over the last week are in Europe. Britain, France, Italy and Spain were among the countries that recorded their highest death tolls in months.
In announcing a new nationwide lockdown in France on Wednesday, President Emmanuel Macron predicted that the second wave of the virus would be more deadly than the first.
In France, one million people are currently estimated to be infected with the coronavirus, and 2,000 new patients are hospitalized every day, according to government data, the highest numbers in the country since mid-April. Doctors have warned that hospitals won’t hold in the winter if the virus can’t be stemmed, and Mr. Macron bluntly said on Wednesday that if France couldn’t put the brakes on the pandemic, doctors would soon have to choose which Covid-19 patients to save.
In Germany, as hospitalizations have doubled in the past 10 days and nearly 1,500 patients are in intensive care, Chancellor Angela Merkel announced new lockdown measures on Wednesday as she vowed to avoid “situations that are extremely difficult.”
Exhausted health care workers and other epidemics, like the flu, that arrive in winter have led authorities to warn that the worst is yet to come. While in Western Europe, the fear of overwhelmed hospitals brought a feeling of déjà-vu from the first wave in the spring, countries in Central and Eastern Europe, which escaped the first wave relatively unscathed, have faced a frighteningly new situation.
Countries like the Czech Republic and Poland imposed tough restrictions in the spring and saw lower infections rates, but soaring cases this fall have laid bare a critical shortage of nurses, doctors, and intensive care beds. In Bulgaria, scores of health care professionals are falling ill with the virus, and an acclaimed doctor became the 19th medical professional there to die of the virus earlier this month. In the Czech Republic, where cases are rising at one of the fastest paces in Europe, Prime Minister Andrej Babis has warned that the country’s health care system could collapse before mid-November.
“What happened was somehow predicted but nobody expected its scope,” Mr. Babis said after declaring a second national lockdown.
Daily reports of coronavirus cases in the United States have surged to previously unseen heights, averaging more than 75,000 a day over the last week, and the country is rapidly closing in on nine million known infections over the course of the pandemic — a threshold it will probably cross on Thursday.
More total cases have been identified in the United States than in any other country, though some nations have had more cases in proportion to their populations.
“There is no way to sugar-coat it: We are facing an urgent crisis, and there is an imminent risk to you, your family members, your friends, your neighbors,” said Gov. Tony Evers of Wisconsin. Hospitals in his state have been strained, case numbers have exploded, and more than 200 coronavirus deaths have been announced over the last week.
Wisconsin, home to eight of the country’s 15 metro areas with the highest rates of recent cases, was among the first states to lose any control of the virus this fall. But a national uptick that started in the Upper Midwest and rural West has now spread far beyond, sending infection levels soaring in places as disparate as El Paso, Chicago and Rexburg, Idaho.
In Idaho, “hospitals throughout the state are quickly filling up or are already full with Covid-19 patients and other patients, and way too many health care workers are out sick with Covid-19,” Gov. Brad Little said this week as he imposed new restrictions on businesses and gatherings.
Twenty-one states added more cases in the seven-day period ending Wednesday than in any other seven-day stretch of the pandemic. And yet President Trump is closing his re-election bid by continuing to declare that the virus is vanishing, brushing aside the devastation it has wrought and making fun of people who take precautions — including measures his own health advisers recommend — to slow the spread of the disease.
Daily reports of deaths from the virus remain far below their spring peaks, averaging around 780 a day. But those, too, have started to tick upward.
There are not many hopeful signs in the recent data. Reports of new cases are increasing in 42 states. Northeastern states, including New Jersey and Rhode Island, are seeing infection numbers rise after months of stability. And in North Dakota, where more than 5 percent of the population has now tested positive — the biggest share of any state — as reports of new cases continue to soar.
The virus is spreading at a swift pace across Montana, one of the Great Plains and Mountain West states that have been reporting major surges in new virus cases. The state ranks fourth in the country for the number of new cases relative to its population — about 70 cases per 100,000 residents — based on a seven-day average, compared to about 23 per 100,000 nationwide, according to a Times database.
Residents in some parts of Montana are defying a state mask mandate in the name of individual rights. And hospitalizations are up significantly, according to the Covid Tracking Project, which reports a nearly 100 percent increase between Oct. 3 and Oct. 28. With the spike in cases, health care officials across the state have been bracing for a strain on the system.
Montana is having a moment, but not the kind of #MontanaMoment that the state’s tourism bureau promoted in 2018. The state website for tourism and business promotion has a new slogan, “Montana Aware.”
In some ways, the state offers a snapshot of America less than a week from Election Day: divided along political lines and struggling to contain daily case counts that are running higher than at any time since the pandemic began.
Though the state is heavily Republican, it has competitive races this year for governor and for Senate. And President Trump, who won the state by 20 points in 2016, has seen his lead dwindle to single digits over his opponent, Joseph R. Biden Jr., in recent polls.
A Montana State University poll released earlier this month found that Democratic and independent voters are more concerned about health issues and support preventive measures like wearing masks in public.
“If you combine that with the dissatisfaction with the direction of the country, I would argue that this benefits Democratic candidates — especially in a higher turnout election environment,” said David C.W. Parker, one of the university professors who conducted the survey.
Gov. Steve Bullock, a Democrat now running for Senate, mandated that people wear face coverings in public spaces across the state to help slow the spread of the virus. But some local officials have defied the order, creating a patchwork of precautionary measures — sometimes varying within a single block.
Mike Cooney, the Democratic candidate for governor, is pro-mask mandate and is most often seen publicly wearing a mask, while the Republican candidate, Greg Gianforte, was recently criticized for hugging supporters without wearing a mask after he attended a concert that has since been linked to new virus cases.
A recent report prepared for the White House urged more precautions for the state, which the federal government has categorized in the “red zone” for cases.
“Given extent of transmission, Montana should limit bar and gym hours and urgently enforce face mask, occupancy restrictions, and social distancing policies in all counties,” said the report, which was dated Oct. 25.
Elsewhere in the United States:
Mayor Martin J. Walsh of Boston said on Thursday that city employees would get one paid hour off every two weeks, during normal work shifts, to get tested for the virus. The move is part of a new campaign, called “Get the Test Boston,” intended to encourage testing. The share of coronavirus tests coming back positive in Boston increased to 7.8 percent, from 6.2 percent a week earlier.
For a month beginning in November, United Airlines will test passengers over the age of 2 for the coronavirus before they board certain flights at Newark Liberty International Airport bound for Heathrow Airport in London. The trial program is intended to help persuade government officials that testing could be a crucial part of reopening international travel. Passengers will have to test negative to board the flights. Anyone who tests positive will be isolated and asked to get in touch with their health care provider, and the airline will help them rebook a flight for a later date.
Speaker Nancy Pelosi of California said on Thursday that she wanted to reach a deal on an economic relief bill during Congress’s lame duck session after the election in order to clear the decks for a Joseph R. Biden Jr. presidency, expressing optimism despite months of faltering negotiations.
“I want a bill for two reasons,” Ms. Pelosi said at her last news conference before the election. “First and foremost, the American people need help, they need real help. Second of all, we have plenty to do in a Joe Biden administration.”
The comments came hours after she wrote to Steven Mnuchin, the Treasury secretary, requesting a response to key differences in the stumbling talks as small businesses continue to struggle and millions of Americans remain out of work.
“Your responses are critical for our negotiations to continue,” Ms. Pelosi warned Mr. Mnuchin.
Hampering the deal are a list of outstanding issues, including Democrats’ demand for aid to state and local governments, the amount of funding for schools and child care and the terms of a national testing plan that Ms. Pelosi has long sought.
Despite Ms. Pelosi’s wishes, it remains unlikely that lawmakers and the administration will be able to quickly reconcile their differences, particularly given widespread conservative concern on Capitol Hill over the scope and size of the package.
Ms. Pelosi, however, continued to demand responses to a number of issues, insisting that Mr. Mnuchin, the lead negotiator for the White House, agree to final language and respond to a number of Democratic demands.
Ms. Pelosi said that Mr. Mnuchin had yet to agree to final testing language, despite the Treasury secretary declaring earlier this month that “we’ll fundamentally agree with their testing language.”
“The president’s words that ‘after the election, we will get the best stimulus package you have ever seen’ only have meaning if he can get Mitch McConnell to take his hand off the pause button and get Senate Republican chairmen moving toward agreement with their House counterparts,” Ms. Pelosi wrote, referring to Senate Republicans’ public objections to the nearly $2 trillion framework. Mr. McConnell, the majority leader, has privately counseled the White House to hold off agreeing to a deal until after the general election.
A ninth-grade student who received a false negative result to a required coronavirus test triggered a super-spreading event that infected three-quarters of the 152 students, counselors and staff who attended a faith-based overnight summer school retreat in Wisconsin in July and August.
The illnesses were mild, and none required hospitalization, according to a description of the outbreak in a new report from the Centers for Disease Control and Prevention that was released on Thursday. The report did not identify the religious organization that sponsored the retreat, or say where in Wisconsin it took place.
The people who attended the boys’ retreat came from 21 states and territories and two foreign countries. They were required to provide either documentation of a positive test result for antibodies to the coronavirus that causes Covid-19, within the past three months, or proof of a negative result to a diagnostic test taken within a week of departing for the retreat. They were also asked to quarantine within their households for a week before the trip, and told to wear masks while traveling.
Once they were at the retreat, however, only the teachers observed social distancing and wore masks during classes. The students and counselors were not required to do so, and mixed freely.
Classes were held outside but students were seated less than six feet apart, and they slept in dormitories, four to six in a room, and in yurts, with up to eight in a room. Counselors also roomed together in dormitories and yurts. Only the teachers resided in separate housing units.
The ninth grader who was the index patient, and who had tested negative, developed a sore throat, cough and chills two days after arriving, and soon found out that a family member had just tested positive. Although he was quickly isolated and 11 of his close contacts were briefly quarantined, the virus spread. Ultimately at least 116 people at the retreat tested positive for the virus.
Among those who tested negative for the virus were 24 attendees who had previously been exposed to the virus and had antibodies before arriving at the retreat. The C.D.C. report notes that “evidence to date is insufficient to determine whether the presence of detectable antibodies indicates protective immunity, or how long such immunity might persist.”
The four staff members also tested negative, although one did develop symptoms of the illness and was classified as a probable case.
In April, the coronavirus killed more than 10,000 people in New York City. By early May, nearly 50,000 nursing home residents and their caregivers across the United States had died.
But as the virus continued its rampage over the summer and fall, infecting nearly 8.5 million Americans, survival rates, even for seriously ill patients, appeared to be improving. At a New York hospital system where 30 percent of coronavirus patients died in March, the death rate had dropped to 3 percent by the end of June.
Doctors in England observed a similar trend. “In late March, four in 10 people in intensive care were dying.” said John M. Dennis, a University of Exeter Medical School researcher. “By the end of June, survival was over 80 percent.”
Though the virus has been changing slowly as it spreads, most scientists say there is no solid evidence that it has become either less virulent or more virulent.
As older people took greater precautions to avoid infection, however, more of the hospitalized patients were younger adults, who are generally healthier and more resilient. By the end of August, the average patient was under 40.
Were the lower death rates simply a function of the demographic changes, or a reflection of advances in treatment that blunted the impact of the new pathogen?
Researchers at NYU Langone Health zeroed in on this question, analyzing the outcomes of more than 5,000 patients hospitalized at the system’s three hospitals from March through August. They concluded the improvement was real, not just the result of a younger patient pool.
Even when they controlled for differences in the patients’ age, sex, race, underlying health problems and severity of Covid symptoms — like blood-oxygen levels at admission — they found that death rates had dropped significantly, to 7.6 percent in August from 25.6 percent in March.
A combination of factors contributed to the improved outcomes of hospital patients, experts said. As clinicians gained more experience with the disease, they became better able to manage it, incorporating the use of steroid drugs and non-drug interventions.
Researchers have also credited heightened community awareness. Patients are seeking care earlier in the course of their illness. And outcomes may also have improved as the load on hospitals lightened and there was less pressure on the medical staff.
“We don’t have a magic bullet cure, but we have a lot, a lot of little things, that add up,” said Dr. Leora Horwitz, director of NYU Langone’s Center for Healthcare Innovation & Delivery Science. “We understand better when people need to be on ventilators and when they don’t, and what complications to watch for, like blood clots and kidney failure.”
Once doctors became aware of the clotting risk, they began to quickly put patients on blood thinners when necessary.
Another problem in the spring was that as hospitals in hard-hit areas like New York City became overwhelmed, doctors who hadn’t worked in critical care for many years were being drafted to care for seriously ill patients. Nursing departments, meanwhile, were short-staffed, and equipment was in short supply.
Medical experts worry that the surges in cases around the country could roll back the improvements in mortality rates. The number of hospitalized Covid patients has increased by 40 percent over the last month, and more than 41,000 patients are now hospitalized in the United States.
The attacks on American hospitals, clinics and medical complexes are intended to take those facilities offline and hold their data hostage in exchange for multimillion-dollar ransom payments, just as coronavirus cases spike across the United States.
“We expect panic,” one hacker involved in the attacks said in Russian during a private exchange on Monday that was captured by Hold Security, a security company that tracks online criminals.
Some hospitals in New York State and on the West Coast reported cyberattacks in recent days, though it was not clear whether they were part of the attacks, and hospital officials emphasized that critical patient care was not affected.
The Russian hackers, believed to be based in Moscow and St. Petersburg, have been trading a list of more than 400 hospitals they plan to target, according to Alex Holden, the founder of Hold Security, who shared the information with the F.B.I. Mr. Holden said the hackers claimed to have already infected more than 30 of them.
On Wednesday, three government agencies — the F.B.I., the Department of Health and Human Services and the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency — warned hospital administrators and security researchers about a “credible threat” of cyberattacks to American hospitals, according to a security executive who listened to the briefing.
Officials and researchers did not name the affected hospitals, but Sonoma Valley Hospital in California said it was still trying to restore its computer systems after an intrusion last week. St. Lawrence Health System in New York confirmed that two of its hospitals, Canton-Potsdam and Gouverneur, were hit by ransomware attacks Tuesday that caused them to shut down computer systems and divert ambulances. Sky Lakes Medical Center in Oregon was also crippled by a ransomware attack Tuesday that froze electronic medical records and delayed surgeries, a hospital representative said.
It was unclear whether those attacks were related to the hacking campaign underway. But the latest breaches were linked to the same Russian hackers who held Universal Health Services, a giant network of more than 400 hospitals, hostage with ransomware last month in what was then considered the largest medical cyberattack of its kind.
A day after France and Germany opted for severe coronavirus restrictions, Switzerland on Thursday took steps to try to control its own growing outbreak, imposing tighter controls on social gatherings, closing nightclubs and imposing an 11 p.m. closing time for bars.
For the moment, restaurants, shops and businesses will be allowed to remain open in a strategy that the home minister, Alain Berset, described as “a middle path” designed to limit the economic impact of the pandemic.
The new measures came as Switzerland recorded its highest number of daily cases since the start of the pandemic. The nation of eight million has reported an average of 6,271 new daily cases over the past week and has reported 1,985 total deaths.
The high rates of new cases in Switzerland led the authorities to reduce the number of countries from which arriving travelers must quarantine. The list, which includes countries with a higher per capita rate of infection than Switzerland’s, featured more than 60 countries earlier this month. The list released on Wednesday included only four European countries — Andorra, Armenia, Belgium, and the Czech Republic — and three regions of France, including Paris.
The Swiss authorities also limited public gatherings to 50 people, sports and cultural activities to 15 people, and private family gatherings to 10.
“If it’s not possible to get the virus under control, then other measures are possible,” Mr. Berset told a news conference in the capital, Bern.
In Greece, after a new spike in cases, Prime Minister Kyriakos Mitsotakis said on Thursday that he would announce a one-month action of “targeted restrictions” on Friday aimed at averting a second nationwide lockdown.
Three more regions will be locked down, Mr. Mitsotakis said: the country’s second-largest city of Thessaloniki as well as Rhodope, also in the north, and Larissa in central Greece. They will join four northern regions that have been locked down this month. Schools and retail stores will remain open, Mr. Mitsotakis said.
Greece initially did well in controlling the spread of the virus, but daily cases have been rising recently, entering four digits this week. By Wednesday, the country had recorded 34,299 cases and 603 deaths.
In Germany, Chancellor Angela Merkel on Thursday explained the necessity and details of the country’s monthlong partial lockdown. “The measures we are now taking are appropriate, necessary and proportionate,” she told lawmakers in a 25-minute speech that was repeatedly interrupted by heckling by members of the far-right party Alternative for Germany, or AfD.
“Lies and disinformation, conspiracy and hatred damage not only the democratic debate but also the fight against the virus,” she said.
The parliamentary head of the AfD called the new rules a “corona dictatorship” and said: “We consider the paralysis of the cultural sector, the gastronomy, and practically the entire leisure life of the citizens, as announced by Ms. Merkel, to be excessive and inappropriate.”
Germany has been averaging about 12,700 cases a day in the past week.
In Spain, ahead of a long holiday weekend, most regions announced travel restrictions that would prevent about 80 percent of the country’s 47 million residents from visiting other parts of the country.
In another sign that Europe is going back into crisis mode, Pope Francis will return to holding his weekly general audiences virtually from the library of his Apostolic Palace, the Holy See announced on Thursday.
The decision came after a participant in last week’s audience tested positive for the coronavirus, and was “aimed at avoiding any possible future risk for the health of the participants,” the statement read.
Worshipers only recently began participating in the audiences, which over the summer took place in a Vatican courtyard with a more limited number of attendants as compared to St. Peter’s Square, its traditional venue before the pandemic. But through the beginning of fall, the audiences were held indoors, in a large auditorium inside the Vatican.
The Vatican and its few residents were not spared during the first wave of the pandemic last spring, and the virus is circulating there again, like in the rest of Europe. Earlier this month, a person living in the Casa Santa Marta, the Pope’s residence, tested positive for the virus and left the guesthouse. Three other citizens of the Vatican had already been quarantined, as well as 13 Swiss Guards.
Italy hit a record number of daily cases on Wednesday: nearly 25,000, according to a Times database. Deaths are once again climbing after falling to low numbers over the summer, with 205 recorded on Wednesday.
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U.S. economic output grew at the fastest pace on record last quarter as businesses began to reopen and customers returned to stores. But the economy has climbed only partway out of its pandemic-induced hole, and progress is slowing.
Gross domestic product grew 7.4 percent in the third quarter, the Commerce Department said Thursday. The gain, the equivalent of 33.1 percent on an annualized basis, was by far the biggest since reliable statistics began after World War II; the previous record was a 3.9 percent quarterly increase in 1950.
Still, the economy in the third quarter remained 3.5 percent smaller than at the end of 2019, before the pandemic began. By comparison, G.D.P. shrank 4 percent over the entire year and a half of the Great Recession a decade ago.
The report was the last major piece of economic data before the presidential election on Tuesday. President Trump hailed the big gain as evidence that the economy had roared back to life after the spring’s pandemic-induced shutdowns.
But economists said the third-quarter figures revealed less about the strength of the recovery than about the severity of the collapse that preceded it. G.D.P. fell 1.3 percent in the first quarter and 9 percent in the second as the pandemic forced widespread business closures. A big rebound was inevitable once the economy began to reopen. The challenge is what comes next.
“The reason we had such a big bounce is that the economy went from closed to partially open,” said Michelle Meyer, head of U.S. economics at Bank of America. “The easy growth was exhausted, and now the hard work has to be done in terms of fully healing.”
Already, there are signs that the recovery is losing steam. Industrial production fell in September and job growth has cooled, even as a growing list of major corporations have announced new rounds of large-scale layoffs and furloughs. Most economists expect the slowdown to worsen in the final three months of the year as virus cases rise and federal aid to households and businesses fades.
“We’re having a record recovery, but it comes after an even more record collapse, and it looks like economic momentum is fading in the fourth quarter,” said Jim O’Sullivan, chief U.S. macro strategist for TD Securities.
The Netherlands, one of Europe’s wealthiest countries, is renowned for its efficient and organized government in most circumstances — but not, apparently, in the pandemic.
As a second wave of the coronavirus surfaces across Europe, the Netherlands stands out with Belgium and the Czech Republic as among the hardest hit. It currently ranks sixth among European Union countries when it comes to the rate of new infections, with 56 cases per 100,000 inhabitants — its highest total ever.
The infection numbers keep rising, to a record 10,346 new cases on Monday in a country of 17 million people — one-19th the size of the United States, which is reporting in the neighborhood of 75,000 new cases a day. And it is hard to keep track of the true toll, with the country’s official data incomplete because of technical errors.
After weeks of taking incremental steps to curb the spread of the virus, the government announced on Oct. 14 that, in addition to the new rules on face masks, all bars and restaurants would close for at least four weeks. With infections still rising, the authorities are considering establishing an evening curfew to keep people indoors, or even a two-week “circuit breaker” lockdown.
For the Dutch, who generally regard their country as one of the best run in the world — with at times an undertone of superiority — the level of institutional chaos has been a hard reckoning.
“It’s shocking really. I always thought we were one of the best countries in the world, best organized,” said Rob Elgersma, 18, an agriculture student. “But now, they have the ability to fix things but can’t get their act together. What happened to us?”
That’s a question a lot of Dutch people are asking right now.
Singapore is easing restrictions on hundreds of thousands of migrant workers who have largely been confined to their dormitories since last spring.
Under the new policy, which has been in trials for the past two months, workers who test negative for the coronavirus will be allowed to visit designated recreation centers on their days off starting Saturday. There must also be no active cases in their dorms.
The eight recreation centers across Singapore are central to the lives of the workers, who go there to buy groceries, get haircuts, wire money to their families back home and socialize with friends.
By means of a government smartphone app, workers who wish to leave their dorms will have to apply for permission and choose one of five three-hour slots between 8 a.m. and 11 p.m. There are a limited number of exit passes for each time slot.
The economy of Singapore, a country of almost six million people, is heavily dependent on more than 300,000 migrant workers, who hail largely from South Asian countries, including India and Bangladesh. They work in construction, shipbuilding, manufacturing and other sectors, earning about $400 or $500 a month. The pandemic has renewed longstanding questions in Singapore about inequality and how foreign workers are treated.
Early in the year, Singapore appeared to have largely brought the virus under control, thanks to extensive contact tracing and a partial national lockdown. But in April, after a surge in cases in the crowded dorms, the government imposed a much stricter lockdown that lasted until June 1. New infections began to be reported as separate tallies, one for foreign workers and one for “the local community.”
But even as stay-at-home orders were eased for Singapore’s other residents, migrant workers were barred from leaving their dorms and sometimes even their rooms except for work and essential errands. The confinement and the financial stress of job uncertainty have taken a heavy mental toll on the workers, with reports of suicides and attempted suicides. Government officials said keeping the dorms sealed off was necessary to reopen the economy.
All dorms were declared clear of the virus on Aug. 11, but new clusters emerged within weeks, delaying the easing of restrictions until now. Migrant workers account for about 95 percent of Singapore’s 58,000 total cases.
Kirsten Han, a Singaporean journalist and activist, said on Twitter in April that the country’s experience showed “that even if you do most things right, if you’re not considering or proactively looking out for the most vulnerable and marginalized in your society, you’re not going to effectively fight Covid-19.”
In other global developments:
After months of restrictions, international travelers from any country will be allowed into Costa Rica starting Nov. 1, as long as they are not displaying symptoms and have insurance to cover costs of any virus treatment or quarantine lodging during their stay. The move comes days after the country lifted a rule requiring a negative Covid-19 test for incoming air travelers. More than 15 percent of Costa Rica’s 160,000 coronavirus cases came from foreigners, according to its Department of Health. Initially, all Americans were blocked, and then only people from 23 states and the District of Columbia were allowed in.
Officials in India confirmed that the country had surpassed eight million cases of the coronavirus. The Ministry of Health reported 49,881 infections and 517 fatalities in the past 24 hours, raising the death toll to 120,527. India is the second country to break the eight-million mark after the United States.
Health officials in the Chinese region of Xinjiang on Thursday said 23 new cases of the coronavirus had been confirmed, which were all previously classified as asymptomatic cases. China does not include those who display no symptoms in its tally of confirmed infections, and this is the second consecutive day where all newly confirmed infections were linked to such known cases. The outbreak in Xinjiang began on Saturday, when a 17-year-old girl in a rural area outside Kashgar was found in regular testing to be an asymptomatic carrier, triggering widespread testing and travel restrictions.
The Marshall Islands reported its first coronavirus cases after two people who flew to a U.S. military base from Hawaii tested positive. The Pacific nation was among the last places in the world to have no reported cases.
Taiwan has gone 200 days without a locally transmitted case of the coronavirus, far longer than anywhere else in the world. The self-governing island of 23 million people last recorded a local case on April 12, with experts crediting tight border control, extensive contact tracing, strict quarantines and the widespread use of masks. Taiwan has had a total of 550 cases, the vast majority of them detected among people in quarantine after arriving from overseas, and seven deaths. A handful of countries, including New Zealand, Thailand and Vietnam, have come close to or surpassed 100 days without any local cases, only to experience new outbreaks.
— Jennifer Jett and