Tag Archives: Coronavirus

U.S. officials to urge ‘aggressive’ local steps against coronavirus

Reuters
By Susan Heavey

WASHINGTON (Reuters) – The Trump administration on Wednesday plans to urge U.S. states and localities to take stronger steps to fight the coronavirus, Health Secretary Alex Azar said, as the governor of at least one state criticized the federal government’s handling of the outbreak.

“You’re going to hear from CDC today and the White House that we’re going to be making recommendations to those local communities about aggressive steps that we think they should be taking,” Azar told Fox News in an interview.

He did not detail what the recommendations would be. U.S. Vice President Mike Pence had told reporters on Tuesday that recommendations by the Centers for Disease Control and Prevention would be aimed at communities that have already seen spread of the disease.

Azar said federal leaders were working with local officials in the hardest hit states so far, including Washington, California, New York, Massachusetts, and Florida, saying “strong mitigation steps” could help buy valuable time.

The governor of New York, however, said federal officials had left states scrambling to act on their own, including ramping up testing for the highly contagious – and sometimes fatal – respiratory illness.

“We can’t wait for the federal government because it’s not going to happen,” said Andrew Cuomo, who has deployed the National Guard to help contain an outbreak in the suburbs of New York City.

“The federal government has just fallen down on the job,” Cuomo, a Democrat, told MSNBC in an interview, adding that he had told other state governors, “you’re on you own.”

The number of U.S. coronavirus cases has risen steadily and has affected almost three-quarters of the states. More than 1,025 cases and 28 deaths have been reported, according to a count by Johns Hopkins University.

State and local officials have said a delayed U.S. response over testing capabilities has hampered their ability to manage the outbreak, even as U.S. President Donald Trump has offered assurances that anyone who wanted a test could get one.

Police wearing riot gear broke up a protest by hundreds of students at the University of Dayton in Ohio after the school announced the temporary suspension of classes and on-campus housing on Tuesday, the Dayton Daily News reported.

Washington Governor Jay Inslee is expected on Wednesday to restrict large gatherings in three counties at the center of the coronavirus outbreak in the state, according to the Seattle Times. The move will be aimed at sports, concerts and other cultural events and will not affect retail stores, the newspaper reported.

Pence, tasked by Trump to lead the nation’s coronavirus response, met with a number of U.S. governors at the White House on Monday.

Maryland’s governor, Republican Larry Hogan, afterward praised Pence but criticized the mixed message coming from Trump, telling the Washington Post after the meeting that the Republican president “at times just says whatever comes to mind or tweets.”

New York’s Cuomo said his state was moving aggressively on its own to expand testing, including the implementation of mobile testing seen in other countries.

“It’s either massive testing or massive quarantine, and we don’t want to quarantine, so we’re going to have to do the testing,” he told MSNBC.

(Reporting by Susan Heavey in Washington and Maria Caspani in New York; Writing by Alistair Bell; Editing by Steve Orlofsky and Rosalba O’Brien)

EU privacy rules no obstacle to coronavirus fight; smartphone tracking a no-no

By Douglas Busvine

BERLIN (Reuters) – Europe’s privacy rulebook does not create obstacles to taking action to curb the coronavirus epidemic but mass tracking of people’s movements and contacts using smartphone location data would represent a clear violation.

Technophiles support the use of such data to reconstruct the movements of people exposed to the flu-like virus and identify others at risk of infection. Privacy advocates counter that this approach, used in China, subjects people to the kind of digital surveillance that has no place in a Western democracy.

The General Data Protection Regulation (GDPR), which took effect in the European Union in mid-2018, states that people’s data is their own and requires anyone seeking to process it to obtain their consent.

WHAT DO EMPLOYERS HAVE TO DO?

Companies should take action to minimise both the risk of infection and violations of privacy. They can obtain information on whether an employee has travelled to a region with confirmed coronavirus cases, according to law firm CMS https://cms.law/en/nld/publication/coronavirus-employer-measures-and-policies.

Some systemic data collection may also be required, such as through workplace questionnaires or requiring staff to report their travel plans.

This is covered under Articles 6 and 9 of the GDPR, which cover workplace health and safety, and using preventive or occupational medicine to address serious cross-border health threats.

WHAT CAN’T THEY DO?

Employers are not allowed to take mandatory readings of the temperature of employees or visitors, nor can they require them to fill out compulsory medical questionnaires, according to French data protection office CNIL.

In practical terms that means a receptionist may only take the temperature of a visitor under certain conditions, as this may require processing of health data that can only be done by a doctor, said Holger Lutz, partner at law firm Baker & McKenzie.

CAN NATIONAL GOVERNMENTS OVERRIDE THE GDPR?

Italy, the European country hardest hit by coronavirus, has passed emergency legislation requiring anyone who has recently stayed in an at-risk area to notify health authorities either directly or through their doctor.

Germany, meanwhile, recently inserted wording into its GDPR enabling legislation that specifically allows for the processing of personal data in the event of an epidemic, or natural and man-made catastrophes, said Lutz.

COULD SMARTPHONE TRACKING HELP?

The head of the Robert Koch Institute, Germany’s main public health body, caused a stir last week by suggesting that smartphone location data could be used to track people as a tool for curbing the spread of the coronavirus.

The technology exists – Google Maps for example uses smartphone GPS location data to estimate traffic congestion and calculate journey times.

A Hamburg geotracking startup called Ubilabs is working with the Hannover School of Medicine on a data analysis platform that could track people who have tested positive for the coronavirus and their contacts, Der Tagesspiegel reported on Tuesday.

HOW COULD TRACKING COMPLY WITH THE GDPR?

Such smartphone tracking would in all probability require people’s consent to have a valid legal basis, Federal Data Protection Officer Ulrich Kelber told Reuters.

Any tracking-based system would need to undergo detailed analysis to ensure an acceptable level of data protection, Kelber said. It should also be proportionate, both in terms of whether the accuracy of the location data gathered serves the intended purpose and whether a less intrusive method is available.

WHAT ARE OTHER COUNTRIES DOING?

China, the source of the coronavirus epidemic, has introduced a mandatory traffic-light system https://www.nytimes.com/2020/03/01/business/china-coronavirus-surveillance.html that uses smartphone software to determine whether people can move about or meet.

Individuals rated red or yellow on the Alipay Health Code app are not allowed to travel or visit public places such as restaurants or shopping malls for 14 or 7 days respectively.

In Taiwan, visitors are required https://jamanetwork.com/journals/jama/fullarticle/2762689 on arrival to download a questionnaire using a QR code and report the airport they came from, their 14-day travel history and health symptoms.

Those assessed to have low risk receive a text message telling them that they are free to travel. Those deemed to pose a risk are required to self-isolate for 14 days, with their compliance monitored using location data from their smartphones.

(This story has been refiled to clarify comment from legal expert, paragraph 8)

(Additional reporting by Foo Yun Chee; Editing by Nick Macfie)

Homeless shelters, programs ill-equipped for coronavirus, U.S. cities warned

By Carey L. Biron

WASHINGTON (Thomson Reuters Foundation) – Homeless people in the United States are at particular risk of contracting coronavirus, and the systems that care for them are poorly equipped to handle a major outbreak, according to public health experts.

The United States had more than 750 confirmed cases of the respiratory virus – which emerged in China’s Hubei province late last year – as of Tuesday morning and 26 related deaths, as estimated by a national tally kept by Johns Hopkins University.

The count could rise sharply as testing increases this week. More than 110,000 people have been infected globally and about 4,000 people have died, according to a Reuters tally of government announcements.

Fears have been raised that the U.S. homeless population – nearly 600,000 people in 2019 – could be particularly vulnerable to the disease, which spreads primarily through tiny droplets coughed or sneezed from an infected person and inhaled by another.

“For the general public that contracts this virus, they’re told to quarantine, rest and recuperate at home,” said Barbara DiPietro, senior director of policy at the National Health Care for the Homeless Council (NHCHC), a nonprofit.

“What does that mean if you don’t have a home or a service provider who can accommodate them 24/7?,” she said.

Vigilant hygiene can prevent transmission, health experts say, in what could be a challenge for people living without homes.

Los Angeles lawmakers are considering setting up washing facilities in encampments, while county officials in Seattle have purchased a motel and set up modular housing, in part to quarantine homeless individuals who contract the disease.

There have been no reports of coronavirus among U.S. homeless populations.

The U.S. shelter system is ill-equipped to deal with a major outbreak, with most housing open only at night for sleeping and little room for quarantines, DiPietro said.

“We don’t have a homeless services infrastructure that is equipped, funded or staffed to be able to respond to a pandemic public health emergency,” she added.

Concerns about the potential for homeless populations to spread coronavirus have cropped up on social media and among conservative commentators who see homeless encampments ripe for spreading the disease.

But G. Robert Watts, an epidemiologist and head of the NHCHC, downplayed the concerns as “fearmongering”.

Because they often have weakened immune systems, “people experiencing homelessness are at greater risk of contracting this disease than of passing it on,” he told the Thomson Reuters Foundation.

Several of the U.S. coronavirus cases have been in the states of Washington and California, which have among the highest homeless populations in the country.

Last week the U.S. Department of Housing and Urban Development released extensive new guidance on dealing with infectious disease outbreaks in shelters, encampments and among homeless populations in general.

Also, President Donald Trump on Friday signed an $8.3 billion emergency bill to fight the virus, with $100 million for community health centers that NHCHC said could include homeless services.

Looking ahead to potential dangers, cities and homeless services providers are adopting a spectrum of new strategies for dealing with the outbreak.

“We are developing special protocols such as phone screening for patients calling into our primary care sites, education to prevent the spread of illness and support for our staff,” said Rachel Solotaroff, head of Central City Concern, a nonprofit in Portland, Oregon.

Some shelters are starting to assign people to sleep in the same beds every night to limit the potential for exposure, said Watts.

But homeless people get help from a host of service providers from shelters to food pantries, day centers and outreach teams, all of which are often pressed for resources and left out of response plans, DiPietro said.

A lack of resources could lead any of those to turn away anyone with potential symptoms that are not necessarily coronavirus, triggering a “vast increase” in homeless people with nowhere to go, she said.

(Reporting by Carey L. Biron @clbtea, Editing by Ellen Wulfhorst and Zoe Tabary. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

Top U.S. public health official expects coronavirus outbreak to worsen

By Susan Heavey and Lisa Lambert

WASHINGTON (Reuters) – The U.S. coronavirus outbreak is likely to get worse, the country’s top public health official said on Tuesday, and Americans should assess their personal circumstances when deciding whether to cancel travel plans or avoid public gatherings.

The virus, which can cause a sometimes fatal flu-like respiratory illness, has steadily spread in the United States this week, disrupting life and spooking investors who worry that a contraction in economic activity could trigger a recession.

“Not every community has an outbreak going on right now, but people should know that this is likely to get worse before it gets better,” U.S. Surgeon General Jerome Adams said in an interview on ABC’s “Good Morning America” program.

A total of 755 confirmed cases of the coronavirus were confirmed nationwide as of Tuesday morning, according to a tally by Johns Hopkins University. There have been 26 coronavirus-related deaths in the country, most of them in Washington state.

The Trump administration has been criticized for a slow response to the public health crisis and is under growing pressure to do more to help workers and companies hurt by the outbreak and to boost investors’ confidence in the economy.

After U.S. stock indexes recorded their biggest one-day selloff since 2008 on Monday, President Donald Trump said his administration would take “major” steps to gird the economy and discuss a possible payroll tax cut with congressional Republicans on Tuesday.

He did not provide details but said a news briefing would be held on Tuesday.

A payroll tax cut could encourage consumer spending and help households that might otherwise struggle to make rent and mortgage payments on time or pay medical bills if family members’ work hours are reduced during the coronavirus outbreak.

U.S. stock indexes opened higher on Tuesday.

VIRTUAL CLASSES

More than 113,000 people have contracted the coronavirus around the world and nearly 4,000 have died since it surfaced in China late last year. More than 100 nations have reported cases, with Italy bearing the brunt of the outbreak in Europe.

Italy’s government on Monday took its most drastic steps yet to contain the outbreak, ordering the country’s 60 million people not to move around other than for work or emergencies, banning public gatherings and suspending sporting events.

In the United States, 34 of the 50 states and the District of Columbia have reported infections of COVID-19, the illness caused by the virus, to the U.S. Centers for Disease Control and Prevention (CDC).

Washington state has been the hardest hit, with a nursing home in the Seattle suburb of Kirkland accounting for the bulk of the state’s 22 confirmed deaths.

In California, the Grand Princess cruise ship docked at the Port of Oakland on Monday and had begun offloading its 2,400 passengers. The vessel was barred from returning to San Francisco last week due to a coronavirus outbreak on board.

Most of the passengers will be quarantined at military bases in the United States, with those requiring immediate medical attention heading to hospitals. The crew of 1,100 will be quarantined and treated aboard the ship, unless they are in need of acute care off the vessel.

California and New York each have more than 140 confirmed coronavirus cases.

As the outbreak spreads, daily life in United States has been increasingly disrupted, with concerts and conferences canceled, and universities urging students to stay home and take classes online.

U.S. health officials have urged older people, especially those with chronic medical concerns, to avoid big social gatherings, cruise ships and airline flights.

The public is advised to wash hands frequently and practice “social distancing” – minimizing unnecessary contact with others in public settings. Several U.S. lawmakers have gone into self-quarantine after being in contact with a person at a conference who later tested positive for coronavirus.

Harvard University asked its students on Tuesday not to return to campus after the spring break this month, and said it would begin moving to virtual instruction for graduate and undergraduate classes.

(Reporting by Susan Heavey and Lisa Lambert in Washington and Shubham Kalia in Bengaluru; Editing by Paul Simao and Bernadette Baum)

Streets deserted as Italy imposes unprecedented coronavirus lockdown

By Angelo Amante and Giselda Vagnoni

ROME (Reuters) – Italy faced an unprecedented lockdown on Tuesday that left streets in the capital Rome and other cities deserted after the government extended a clampdown across the entire country in a bid to slow Europe’s worst outbreak of the coronavirus.

The measures, announced late on Monday by Prime Minister Giuseppe Conte, widen steps already taken in the rich northern region of Lombardy and parts of neighboring provinces, restricting movement and banning public gatherings.

“The future of Italy is in our hands. Let us all do our part, by giving up something for our collective good,” Conte said in a tweet, encouraging people to take personal responsibility.

The latest steps came after data showed the coronavirus outbreak continuing to spread, with 9,172 positive cases recorded as of Monday and 463 deaths, heavily concentrated in the prosperous northern regions of Lombardy, Emilia Romagna and Veneto.

An empty restaurant in a virtually deserted St. Mark’s Square after a decree orders for the whole of Italy to be on lockdown in an unprecedented clampdown aimed at beating the coronavirus, in Venice, Italy, March 10, 2020. REUTERS/Manuel Silvestri

In Rome, cars circulated freely under a clear blue sky in the normally traffic-clogged center and commuters could find seats in the usually packed underground system during rush hour.

Rome landmarks including the Trevi Fountain, the Pantheon, the Spanish Steps and St Peter’s Square in the Vatican were closed or empty, with police telling tourists to return to their hotels.

For at least the next three weeks, people have been told to stay at home if possible, moving only for reasons of work, health needs or emergencies. Anyone traveling will have to carry a document declaring their reasons and schools and universities will remain closed.

Outdoor events, including sports fixtures, have been suspended, while bars and restaurants will have to close from 6 p.m. Shops are allowed to remain open as long as customers maintain a minimum distance of a meter between each other.

“The whole of Italy is closed now,” was the headline in Corriere della Sera, the country’s largest circulation daily.

In the wake of the clampdown, neighboring Austria said it would deny entry to people arriving from Italy, while British Airways canceled all flights to and from the country.

SEVERE CONTROLS

The measures are some of the most severe controls imposed on a Western country since the Second World War and already there have been questions about how effectively they can be enforced across a country of 60 million people.

Shortly after Conte announced them, shoppers in Rome rushed to late-night supermarkets to stock up on food and basic necessities, prompting the government to declare that supplies would be guaranteed and urging people not to panic buy.

“You’ve also got the worry that the supermarkets will be emptied out of fear. If people keep over-buying there won’t be any water left,” said building superintendent Gianni, who like many Italians drinks bottled water.

“They should make people do it with an identity card, with one case per family,” he said, refusing to give his surname.

In the financial capital Milan, already under stricter controls, the situation was similar, with many shops and businesses open but far fewer people than normal on the streets.

The World Health Organization has praised Italy’s “aggressive” response to the crisis, since the first cases emerged near Milan almost three weeks ago, saying it could help contain the spread of the disease from its northern epicenter.

But the economic cost has been huge, with sectors from manufacturing to tourism reporting a collapse in orders that will impact for months to come.

On Monday, the Milan stock exchange dropped over 11% and Italy’s borrowing costs shot up, reviving fears that an economy already on the brink of recession and struggling under the euro zone’s second-heaviest debt pile could be plunged into crisis.

The market recovered some ground on Tuesday, with the all-share index up almost 3% in early trade.

Conte has already promised “massive shock therapy” to help deal with the immediate economic impact of the crisis and on Tuesday, Industry Minister Stefano Patuanelli said the government would approve measures worth around 10 billion euros.

As well as pressing the European Union to relax its strict borrowing rules, he said the government was also working on temporarily suspending payments of bills, taxes and mortgages to ease pressure on small firms and households.

(Additional reporting by Cristiano Corvino, Guglielmo Mangiapane; Writing by James Mackenzie; Editing by Gavin Jones and Alison Williams)

Seven dead as coronavirus measures trigger prison riots across Italy

By Angelo Amante and Stephen Jewkes

ROME (Reuters) – Seven prisoners have died as riots spread through crowded jails across Italy over measures imposed to contain the coronavirus.

Inmates, many angered by restrictions on family visits, went on the rampage and started fires from Sunday into Monday, authorities said. In one prison, inmates took guards hostage and in another some escaped.

By Monday afternoon, violence that started at the heart of the coronavirus outbreak in northern Italy had spread south, hitting more than 25 penitentiaries nationwide.

Justice Minister Alfonso Bonafede said the government was open to discussing prison conditions but the rebellions had to stop.

In a sign of the political pressures piling onto his coalition government, the leader of the far-right opposition League, Matteo Salvini, called for an “iron fist” response.

Italy – the worst-hit country in Europe – has reported 463 deaths linked to the virus.

The biggest rebellion began on Sunday in a prison in the northern town of Modena.

Three prisoners died there, and another four in prisons where they were moved after the violence started, a prison administration official at the justice ministry, said.

Some died from overdoses of drugs they had stolen from prison clinics, a justice ministry source said, without giving details on what had caused the other fatalities.

Police and fire trucks massed outside the prison as black smoke swirled into the sky on Sunday. A justice ministry spokesman said the situation there was under control by Monday, and officials were assessing the damage.

Two guards were taken hostage in a prison in the northern town of Pavia on Sunday night, and then freed in a police raid hours later, the prison police group UILPA said.

Inmates revolted in Milan’s San Vittore prison, taking to the roof and unfurling a banner demanding a general pardon.

Further south, prisoners in the Tuscan city of Prato set fire to mattresses.

On Sicily, inmates rebelled at Palermo’s Ucciardone prison, which houses some Mafia convicts, but guards managed to regain control, officials said.

Italian media said about 50 inmates managed to escape from a jail in the southern city Foggia. The majority were rapidly captured, but by nightfall nine prisoners were still missing.

Italy’s prisons are among the most over-crowded in Europe. “The spread of the virus is a real concern,” said Andrea Oleandri of the Italian prison rights group Antigone.

(Reporting by Angelo Amante in Rome and Stephen Jewkes in Bologna, writing by Philip Pullella; Editing by Andrew Heavens and Crispian Balmer)

U.S. church group heads back from Holy Land after virus scare: Palestinian mayor

By Mustafa Abu Ganeyeh

BEIT JALA, West Bank (Reuters) – Thirteen Americans were heading home from the Holy Land on Monday after they were cleared in a coronavirus scare, the mayor of the Palestinian town where they were quarantined said.

The group, from the 3Circle Church in Fairhope, Alabama, was placed in quarantine at the Angel Hotel in Beit Jala on Wednesday after several hotel staff there tested positive.

Beit Jala is in the Israeli-occupied West Bank, near the biblical city of Bethlehem.

The Americans’ quarantine ended after they tested negative for coronavirus on Sunday.

Beit Jala Mayor Nicola Khamis told Reuters they left on Monday for Israel’s Ben Gurion Airport, outside Tel Aviv, to fly on to the United States. A Reuters witness saw the group, at least one of them wearing a surgical mask, boarding a van in Beit Jala.

Twenty-five Palestinians in the West Bank have been confirmed as infected with coronavirus, 24 of them in the Bethlehem area.

Under a 30-day state of emergency declared by the Palestinian Authority, foreigners have been turned back at checkpoints and schools, colleges, kindergartens and national parks ordered closed.

(Writing by Dan Williams; Editing by Andrew Heavens)

No hugs, handshakes as U.S. churches take new precautions against coronavirus

By Rich McKay

ATLANTA (Reuters) – With a wide smile and arms outstretched, but quickly dropped into double elbow bumps, James Harper warmly greets fellow congregants at Our Lady of Lourdes Catholic Church on Sunday in Atlanta’s Old Fourth Ward neighborhood.

“We’re all tight here,” said Harper, 51, a salesman. “Normally it’s nothing but deep hugs. But it’s a different day now.”

Churches across the United States are advising parishioners to avoid direct contact with fellow members as an oft-reiterated warning against spreading the coronavirus, which emerged in China last year and causes the sometimes deadly respiratory illness COVID-19.

At least 19 people have died out of about 450 reported cases in the United States. The outbreak has killed more than 3,600 worldwide.

Reverend Jeffery Ott, pastor of Our Lady of Lourdes, said that the biggest change on Sunday was omitting the ceremonial sharing of wine in the common cup, or chalice, during the Holy Communion service, as well as receiving the wafer or bread in the hand only, not the mouth.

“Traditionalist may want the service, but this is not just the flu,” he said. “We are all responsible to stop the spread.”

The instructions, now widespread across archdioceses across the nation, involve changes to relatively new ceremonies, such as the exchange of peace, which was introduced in the 1960s, as well as age-old traditions such as Holy Communion that are at the core of Catholic ritual.

Thomas Groome, a professor of theology at Boston College and a former priest, said the new measures show how seriously the church is taking the risks of coronavirus.

“All of these things are traditions that many are sentimental about,” he said. “But none of these symbols are essentials to the church.”

Traditionally Catholics embrace or shake hands during the so-called “exchange of peace” while repeating the greeting “peace be with you.”

But the Roman Catholic Archdiocese of Atlanta is one of many that have told parishes to discourage physical contact during the ritual, which is designed to remind worshippers they are members of a community. Some dioceses want the “peace” ceremony eliminated all together until the coronavirus outbreak abates.

As an alternative to touching, the Archdiocese of New York is encouraging worshippers to wave at fellow parishioners during the greeting, said Joseph Zwilling, a spokesman for the archdiocese.

Groome said that at his church in Boston, the congregation nods or trades fist-bumps.

“This is the responsible thing to do,” he said.

In the Archdiocese of Miami, churches have been urged to empty the holy water fonts at the church doors as a precaution. When entering a church, many Catholics dip their fingers in the fonts and make the sign of the cross with the water which a priest had blessed. Experts say it is an obvious conduit for infection.

Keeping people healthy is more important than tradition, Reverend Ott said.

“Some of our older members might not like the changes but we have to be responsible,” he said.

(Reporting by Rich McKay in Atlanta; Editing by Daniel Wallis)

Italy locks down millions as its coronavirus deaths jump

By James Mackenzie and Crispian Balmer

MILAN (Reuters) – Italy ordered a virtual lockdown across much of its wealthy north, including the financial capital Milan, in a drastic new attempt to try to contain a outbreak of coronavirus that saw the number of deaths leap again sharply on Sunday.

The unprecedented restrictions, which aim to limit gatherings and curb movement, will impact some 16 million people and stay in force until April 3. They were signed into law overnight by Prime Minister Giuseppe Conte.

The new measures say people should not enter or leave Lombardy, Italy’s richest region, as well as 14 provinces in four other regions, including the cities of Venice, Modena, Parma, Piacenza, Reggio Emilia and Rimini.

Only people with proven, work-related reasons, or health problems will be able to move in and out of the exclusion zones. Leave has been canceled for health workers.

A woman wears a protective face mask at Roma Termini railway station, after the Italian government imposed a virtual lockdown on the north of the country, in Rome, Italy, March 8, 2020. REUTERS/Yara Nardi

“We are facing a national emergency. We chose from the beginning to take the line of truth and transparency and now we’re moving with lucidity and courage, with firmness and determination,” said Conte.

“We have to limit the spread of the virus and prevent our hospitals from being overwhelmed,” he told a news conference called in the early hours of Sunday.

Italy has been hit harder by the crisis than anywhere else in Europe so far and Sunday’s latest figures showed that starkly.

The number of coronavirus cases jumped 25% in a 24-hour period to 7,375, while deaths climbed 57% to 366 deaths. It was the largest daily increase for both readings since the contagion came to light on Feb. 21.

Antonio Pesenti, head of the Lombardy regional crisis response unit, told the Corriere della Sera newspaper the health system in Lombardy was “a step away from collapse” as intensive care facilities came under growing strain from the new cases.

“We’re now being forced to set up intensive care treatment in corridors, in operating theaters, in recovery rooms. We’ve emptied entire hospital sections to make space for seriously sick people,” he said.

The Milan stock exchange, whose all-share index has plunged 17% since the crisis broke, was scheduled to open normally on Monday but one trader said he expected “a violent sell-off” as markets digested the lockdown of Italy’s economic heartland.

The World Health Organization said it fully supported the actions taken by Italy, which were in line with its guidelines for containing the spread of the virus.

But with the Italian economy already on the edge of recession, some local politicians pushed back against the measures, which leaked out before the regions were consulted.

The head of Veneto, Luca Zaia, complained he had not been properly consulted and was unhappy that three provinces in his region, including Venice, had been included in the clampdown.

“We do not understand the rationale of a measure that appears scientifically disproportionate to the epidemiological trend,” he wrote on Facebook.

CHURCHES, MUSEUMS, SPORTS EVENTS CLOSED

On Saturday, health officials had expressed alarm at the apparent lack of concern in the general public, as fine weekend weather attracted large crowds to the ski slopes outside Milan. But streets were notably quieter than normal as northern cities woke up to the news on Sunday.

“What is happening in my city is worrying me and it is also saddening, because Milan is a lively city and to see it like this today is almost a defeat for me,” said resident Lucia Navone. “I never would have thought this would happen.”

Public transport services were operating and train stations were still running as people caught away from home when the measures came into force were allowed to return.

But national carrier Alitalia said it would suspend international and domestic services from Milan’s main Malpensa airport from Monday and operate only domestic flights from the smaller Linate airport.

There was some confusion about what controls there would be from Monday on shops, offices and factories. Assolombarda, a business association that represents employers in Lombardy, said it understood the measures would not stop businesses from working or block deliveries of supplies of goods provided appropriate protective measures were adopted.

However, all museums, gyms, cultural centers, ski resorts and swimming pools in the targeted zones will have to close.

Top flight Serie A soccer matches were played behind closed doors despite a call from the country’s sports minister to stop the championship. The Italian Soccer Federation said it would meet on Tuesday to discuss the situation.

Restaurants and bars will be allowed to open from 6:00 a.m. to 6:00 p.m. (0500-1700 GMT) and only if they can guarantee that customers are at least one meter (yard) apart.

FIPE, a body representing restaurants and catering businesses, said the sector faced devastation and criticized measures that it called “incoherent and difficult to apply”.

Church services on Sunday were also canceled in the region.

Pope Francis delivered his Sunday blessing over the internet from inside the Vatican instead of from a window to stop crowds gathering in St Peter’s Square to see him.

On Sunday, the head of Piedmont region said he had tested positive for the virus despite having no symptoms — the second regional chief to be infected in 24 hours — while Army Chief of Staff General Salvatore Farina also contracted the illness.

As the alarm spread, Czech Prime Minister Andrej Babis said Italy should ban all its citizens from traveling to Europe. Austrian Chancellor Sebastian Kurz said it was only a matter of time until more European countries adopt the kind of aggressive steps that Italy is taking to combat the spread of the virus.

(Crispian Balmer reported for this story in Rome. Additional reporting by Silvia Aloisi, Eliza Anzolin, Francesca Landini, Valentina Za, Elvira Pollina, Giulio Piovaccari, Emilio Parodi, Gianluca Semeraro in Milan, and Angelo Amante and Gavin Jones in Rome; Editing by Frances Kerry)

Confirmed coronavirus may force Americans to avoid crowds and cancel cruises; U.S. cases near 550

By Susan Cornwell and Nathan Layne

WASHINGTON/NEW YORK (Reuters) – Older Americans, especially those with chronic medical concerns, should probably avoid big social gatherings and airline flights, given the rapid spread of coronavirus, a top U.S. health official said on Sunday, as investors braced for another volatile week in financial markets.

Anthony Fauci, the head of the infectious diseases unit at the National Institutes of Health, also said on NBC’s “Meet the Press” that after initial missteps distributing diagnostic tests, there should be 400,000 more kits available by Monday and 4 million by the end of the week.

The number of confirmed U.S. cases of coronavirus reached nearly 550 on Sunday, including 22 deaths, according to state public health authorities and a running national tally kept by the Johns Hopkins University center tracking the outbreak.

More than half of the 50 U.S. states have reported infections, including the first cases in Virginia, Connecticut and Iowa, as well as the U.S. island territory of Puerto Rico, documented on Sunday.

Warnings from Fauci and others about the need for greater “social distancing” – the practice of minimizing unnecessary contact in public settings – came amid the disclosure of a high-profile example of the risks now inherent in large gatherings.

U.S. Senator Ted Cruz said on Sunday he would self-quarantine after coming in contact at last month’s annual Conservative Political Action Conference with an attendee who had since tested positive for coronavirus.

The Texas Republican and 2016 presidential candidate said he had “briefly interacted” with the infected person at the CPAC meeting in Maryland 10 days ago, but was not experiencing any symptoms and felt “fine and healthy.”

The coronavirus originated in China last year and causes the sometimes deadly respiratory illness COVID-19. The outbreak has killed more than 3,600 globally.

Life Care Center of Kirkland public liaison Tim Killian speaks during a press conference outside the long-term care facility linked to several confirmed coronavirus cases, in Kirkland, Washington, U.S. March 8, 2020. REUTERS/Lindsey Wasson

As the outbreak spreads, daily life has been increasingly disrupted, with concerts and conferences canceled and universities telling students to stay home and take classes online.

To contain the outbreak in China, the government quarantined millions of people for weeks. Italy has announced similar measures, locking down 16 million people in the north of the country.

As recently as Saturday, President Donald Trump said he would continue to hold political rallies, which sometimes draw up to 20,000 people. The Democrats competing to challenge him in the Nov. 3 presidential election, Senator Bernie Sanders and former Vice President Joe Biden, have not canceled any campaign events so far.

Germany, which has nearly 1,000 cases, on Sunday urged the cancellation of all events with more than 1,000 people.

‘THINK TWICE’

Fauci said authorities in the United States may also need to consider steps to keep people out of crowded places if the virus continued to spread.

Still, he downplayed the likelihood of the type of large-scale mandatory quarantines imposed in China and Italy, while saying nothing could be ruled out.

“I don’t imagine that the degree of the draconian nature of what the Chinese did would ever be either feasible, applicable, doable or whatever you want to call it in the United States,” he said in an interview on CBS’ “60 Minutes.” “But the idea of social distancing, I mean, obviously, that’s something that will be seriously considered.”

He urged those most at risk to limit travel.

“If you’re a person with an underlying condition and you are particularly an elderly person with an underlying condition, you need to think twice about getting on a plane, on a long trip, and not only think twice, just don’t get on a cruise ship,” Fauci said on “Meet the Press.”

U.S. Surgeon General Jerome Adams told CNN that case numbers would rise, adding that the average age of death for people with the virus was 80, and the average age of those needing medical attention was 60.

“Unfortunately, you are going to see more deaths, but that doesn’t mean that we should panic,” he said. Communities need to “prepare for more cases so we can prevent more deaths,” Adams said.

In financial markets, talk about recessions and bear markets was growing as investors try to assess how badly the outbreak will damage global growth. Many strategists have turned more pessimistic in recent days and are anticipating further market drops and a possible end to the longest economic expansion in U.S. history.

CRUISE SHIP CRISIS

The hardest-hit place in the United States has been a nursing home in the Seattle suburb of Kirkland, and Washington state is considering mandatory measures such as banning large gatherings but not necessarily imposing massive quarantines, the governor said.

The Life Care Center nursing facility has accounted for 13 of the 18 confirmed coronavirus-related deaths in Washington state, which has reported a total of 136 cases overall to date, the most of any state.

In California, officials said on Sunday that the cruise ship Grand Princess, barred from returning to San Francisco last week due to a coronavirus outbreak on board, would send most of its 2,400 passengers to quarantine centers set up at four military bases across the country. Those requiring immediate medical attention will go to hospitals. The crew of 1,100 will be quarantined and treated aboard the ship, unless they are in need of acute care off the vessel.

The ship was ordered to remain at sea last week after a group of passengers and crew developed flu-like symptoms, and health officials learned that some passengers from an earlier cruise aboard the same vessel had later contracted coronavirus. One has died.

Twenty-one people aboard the Grand Princess tested positive for COVID-19 on Friday, and the ship has been redirected to a specially secured terminal across San Francisco Bay at the port of Oakland for a brief stop on Monday to let passengers off the ship.

As of Sunday, California’s tally of confirmed cases had risen to 114 statewide, including the two passengers aboard the Grand Princess who tested positive two days earlier, the state Public Health Department.

New York Governor Andrew Cuomo said the number of cases in New York was now 105 and he expects that to rise as testing expands.

“What we are really trying to do here is avoid the massive disruption of closing everything down for two weeks the way China did, the way Italy is doing,” he said.

Cuomo said a lawyer from Westchester County who is believed to be at the center of the outbreak there had attended a number of large gatherings, contributing to the roughly 70 people in Westchester who have tested positive.

“It’s these large gatherings where you can expose a number of people in a very short period of time and then it’s like dominoes, right, then the tree continues to expand with branches.”

In New York state, the Scarsdale public school district said it was closing all its campuses for more than a week starting on Monday after a middle-school teacher tested positive.

Columbia University in New York City said it was suspending classes on Monday and Tuesday because someone on the campus was under quarantine from exposure to the virus.

(Reporting by Susan Cornwell in Washington and Nathan Layne in New York; Additional reporting by Barbara Goldberg in New York; Writing by Lisa Shumaker; Editing by Sonya Hepinstall, Daniel Wallis and Peter Cooney)