Covid-19 Live Updates: White House Doctor Says Trump Is No Longer Infectious

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Credit…Anna Moneymaker for The New York Times

President Trump’s doctor said in a memo released Saturday night that he was “no longer considered a transmission risk to others,” as the president prepared to resume campaign activities this week.

The memo from Dr. Sean P. Conley, the White House physician, said he was releasing information with Mr. Trump’s permission. But the amount of information he provided was limited, in keeping with restrictive presentations to the public that Dr. Conley has made throughout Mr. Trump’s battle with symptoms of the coronavirus since officials made his diagnosis public early on Oct. 2. Dr. Conley last released an update on the president’s condition on Thursday.

Experts have repeatedly called into question the true severity of Mr. Trump’s illness. According to guidelines released by the Centers for Disease Control and Prevention, people with severe Covid-19, the disease caused by the coronavirus, may need to isolate for up to 20 days. And the president’s health could still deteriorate in the next few days.

“I don’t think he’s out of the woods for certain,” said Dr. Krutika Kuppalli, an infectious disease physician based in South Carolina. Men of Mr. Trump’s age, 74, and weight are at higher risk for severe cases of Covid-19. His recent course of steroids, which suppress certain parts of the immune system, could also make him vulnerable to other infections, Dr. Kuppalli added. “I would still be careful with someone like him.”

The start date of Mr. Trump’s symptoms has also remained unclear. By Dr. Conley’s assessment, Mr. Trump would have needed to show signs of his illness on Wednesday, Sept. 30, for Saturday to qualify as 10 days after the onset of symptoms. Most people stop being infectious by the 10th day after they start feeling ill, according to the C.D.C.

“This evening I am happy to report that in addition to the president meeting C.D.C. criteria for the safe discontinuation of isolation, this morning’s Covid P.C.R. sample demonstrates, by currently recognized standards, he is no longer considered a transmission risk to others,” Dr. Conley wrote. “Now at day 10 from symptoms onset, fever-free for well over 24 hours and all symptoms improved, the assortment of advanced diagnostic tests obtained reveal there is no longer evidence of actively replicating virus. In addition, sequential testing throughout his illness has demonstrated decreasing viral loads that correlate with increasing cycle threshold times, as well as decreasing and now undetectable subgenomic mRNA.”

Several experts expressed skepticism at the wording describing Mr. Trump’s diagnostic tests, which did not explicitly categorize the president as “negative” for the coronavirus. P.C.R., a laboratory technique that detects the virus’s genetic material, can give researchers a rough sense of how much virus remains within a person’s body, or the viral load. Dr. Conley’s note suggested Mr. Trump’s viral load was dropping, but appeared to still be detectable.

The subgenomic mRNA mentioned by Dr. Conley is a part of the virus that can be detected by laboratory techniques, and that suggests the presence of actively replicating virus, said Susan Butler-Wu, a clinical microbiologist at the University of Southern California. But “there are zero cleared tests that look at subgenomic mRNA” from the coronavirus, she added, which means the procedure is “experimental at this point.”

Another, more traditional, approach to determine whether Mr. Trump still harbored actively replicating virus in his body might be to take a sample from the president’s airway and see if the coronavirus could be grown from the sample in a lab. But this technique was not mentioned in Dr. Conley’s memo.

There is also no test that can definitively show if a person at the end of a coronavirus infection is still contagious and poses a risk to others, said Melissa Miller, a clinical microbiologist at the University of North Carolina School of Medicine.

Dr. Conley said he would continue to monitor the president in the coming days.

Mr. Trump is to speak at a campaign event on Monday.

Mr. Trump’s voice has grown stronger since he was released from Walter Reed National Military Medical Center on Monday. But other than on his trips to and from the hospital, he had not been seen in public before Saturday, when he appeared on a balcony for nearly 20 minutes before a crowd of a few hundred people gathered on the South Lawn of the White House.

Credit…Noah Seelam/Agence France-Presse — Getty Images

The world recorded more than one million new cases of the coronavirus in the last three days, as one-day records for new infections were set in France, Russia, Nepal and several U.S. states, and as India surpassed seven million total cases.

The number of new cases is growing faster than ever. Deaths and hospitalizations in some countries are also beginning to rise. The pandemic has sickened more than 37 million people and more than one million people have died globally, according to a New York Times database.

A hot spot has emerged in Britain, which has suffered the highest number of virus-related deaths in Europe. Spain and France, which set a record on Friday with 20,339 new cases and then again on Saturday with 26,896, are experiencing a second wave of infections. Russia on Saturday also set a one-day record of 12,673 new cases. Argentina, which has seen more than 90,000 new cases in the past seven days, is a problem zone in South America, as are Brazil and Colombia.

However, the United States is one of the largest contributors to the surging global tally. On Saturday, the country recorded more than 590 new deaths and more than 51,000 new cases. That tally included single-day case records in five states: Alaska, Indiana, Minnesota, Missouri and Oklahoma. All of those states except Oklahoma announced more cases this week than in any other seven-day stretch of the pandemic, as did Colorado, Idaho, Montana, New Mexico, North Dakota, South Dakota and Utah.

Uncontrolled outbreaks continue to spread in the Upper Midwest and Rocky Mountains, and the Northeast is seeing early signs of a resurgence. In Wisconsin, a long-dormant field hospital is being readied for patients. In New York, officials fear clusters in some neighborhoods and suburbs could spread.

Still, the number of new cases nationally remains below the levels seen in late July, when the country averaged more than 66,000 per day. Deaths, though still well below their peak spring levels, have averaged around 700 per day in October. That is far more than the toll in early July.

The new highs in the United States come one week after President Trump himself tested positive for the virus and was hospitalized. Though he has returned to the White House and said repeatedly that he feels “great,” he has continued to play down the effectiveness of masks and routinely sidelined his own public health experts.

Globally, the United States has led the ranking of nations with the highest number of coronavirus infections since late May. However, the spread of the virus in India — which has roughly four times the population of the United States — has put the country on course to overtake the United States. On Sunday, India reported 74,383 new infections, taking its total past seven million, while the United States has more than 7.7 million cases.

Global Roundup

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Nepal, a country of 30 million people sandwiched between India and China, is enmeshed in a public health crisis.

Coronavirus infections have surpassed 100,000, about a third of which are currently active. That is a modest caseload compared with the United States and neighboring India, which lead the world in total infections, but more than the 94,000 cases reported in Nepal’s other neighbor of more than a billion people, China, where the virus first emerged late last year.

Cases in Nepal are increasing sharply, with a record 5,008 new infections recorded on Saturday. The Health Ministry counts fewer than 400 patients in intensive care, but even that has left I.C.U.s overflowing. Frontline doctors have also been infected, raising fears that health institutions’ staffing will be hollowed out.

To avoid system collapse, the government has asked Covid-19 patients to stay in home isolation — with the possibility of imprisonment if they venture outside — and to go to hospitals only if their condition turns critical. Almost 16,000 infected patients are in home isolation, according to the Health Ministry, and more than 11,000 others are in institutional isolation or hospitals.

But by the time infected people become seriously ill, it may be too late. Dr. Rabindra Pandey, a public health expert, said that some patients had died in ambulances while searching for I.C.U. beds, others in home isolation, and still others while waiting for I.C.U. beds in isolation wards. More than 600 people have died in Nepal since the pandemic began, a relatively low death rate but one that is likely to rise since the explosion in cases was so recent.

“We are already in critical condition in terms of controlling coronavirus,” Dr. Pandey said. “But darker days are yet to come.”

On Sunday, health experts warned that if the virus continued to spread in the countryside it would be impossible for the health care system to handle the influx of cases. Most facilities are in Kathmandu, the capital, which is the center of the country’s outbreak.

The situation has raised alarm about two major approaching festivals. During Dashain, a 15-day Hindu and Buddhist festival that takes place later this month, Nepalis living abroad and the country’s urbanites normally travel to villages in the mountains and plains to see relatives. Similar celebrations take place during Tihar, a five-day Hindu festival that is akin to the Diwali festival of lights in India and that falls next month.

The Health Ministry has urged Nepalis not to go out for Dashain shopping and to keep their distance from older people, even if it means canceling holiday plans.

In other global developments:

  • South Korea said on Sunday that it was easing social-distancing restrictions, lifting a ban on gatherings of more than 50 people indoors and more than 100 outdoors. Under the new guidelines, which take effect on Monday, high-risk facilities like nightclubs, bars, karaoke parlors and buffet restaurants can open for business and spectators will be allowed into sports stadiums. South Korea tightened restrictions in August amid a second wave of infections but appears to have brought the outbreak under control, with daily new cases mostly down to double digits in the past two weeks.

  • A curfew in Berlin closed bars and restaurants at 11 p.m. on Saturday, curbing the German capital’s renowned nightlife. Berlin was following in the footsteps of Frankfurt, where a curfew had already been imposed, but starting an hour earlier.

Credit…James Estrin/The New York Times

Obese Americans are more likely to become dangerously ill if they are infected with the new coronavirus. Now public health officials are warning that a much broader segment of the population also may be at risk: Even moderately excess weight may increase the odds of severe disease.

The warning, reported by the Centers for Disease Control and Prevention last week, may have serious implications for Americans. About 40 percent of U.S. adults are obese, and another 32 percent are simply overweight — rates that are among the highest in the world.

By the new calculus, nearly three-quarters of Americans may be at increased risk of severe Covid-19 if infected with the coronavirus.

“It’s important to make sure the public and individuals are aware of this potential risk,” said Dr. Brook Belay, a medical officer at the C.D.C.

Other medical conditions for which there is limited or mixed evidence of increased Covid-19 severity include asthma, cerebrovascular disease and cystic fibrosis, the C.D.C. said. Medical conditions clearly shown to increase the risk of Covid-19 include cancer, chronic kidney disease, heart disease and sickle cell disease, among others.

“This greatly expands the risk to a pretty big chunk of the U.S. population,” Barry M. Popkin, a professor of nutrition at the University of North Carolina at Chapel Hill, said of the C.D.C.’s new advice.

Doctors observed early on in the pandemic that excess weight appeared to pose an extra risk to patients. But since obesity is often accompanied by other medical problems, it took some time for researchers to learn whether excess fat, in and of itself, was the culprit. Many studies now indicate that it may be, at least in some patients.

Credit…Ian Langsdon/EPA, via Shutterstock

In a sports year wildly disrupted by the pandemic, an upended Grand Slam season will conclude on Sunday with one of the most predictable sights in tennis, if not all of sports: Rafael Nadal in the men’s singles final of the French Open.

Never mind that the tournament will finish in October instead of June. Or that it began weeks after the United States Open, which is supposed to be the final Slam, and that it will end as the N.B.A. plays its 2019-20 championship series in the same month it was supposed to begin the 2020-21 season.

Few things are as reliable as Nadal’s sovereignty on the red-clay courts of Roland Garros, the tennis complex on the fringe of the Bois de Boulogne in Paris. This will be his 13th trip to the French Open final, where he has never lost. In the tournament over all, Nadal has compiled a 99-2 record since making his smash-hit debut as a 19-year-old in clam-diggers and a sleeveless shirt in 2005.

The women’s singles title was won on Saturday by an unseeded 19-year-old, Iga Swiatek, who became the first Grand Slam singles champion from Poland.

On Sunday, Nadal, 34, will face Novak Djokovic, 33, with a shot at equaling Roger Federer’s record of 20 Grand Slam men’s singles titles. If Djokovic knocks off the king of Roland Garros, he will move into closer range of the record, with 18.

Nadal, though, has already captured the spirit of this often-gloomy edition of the French Open.

Much of the time, the weather was cold and gray, the grounds ghostly quiet. The players were all stuck in a hotel meant to cocoon them from the virus, and some doubted whether it was worthwhile.

“I’m going to be honest here,” Ons Jabeur of Tunisia, the 35th-ranked woman in the world, said in the tournament’s early days. “I was like, ‘Why are we playing?’”

And then a voice — the voice of this tournament — rang out on Philippe Chatrier Court.

“The feeling is more sad than usual,” Nadal said during an interview after his first-round victory. “Maybe that’s what it needs to feel like. It needs to be sad. Many people in the world are suffering.”

His words resonated with Jabeur. “If he’s a champion and he doesn’t complain,” she said, “I mean, who I am to complain about it right now?”

Credit…Melissa Golden for The New York Times

Without in-person company meetings during the pandemic, many chief executives have become regulars at a new type of meeting: the family dinner. For some of the busiest people in the world, the new normal has reshaped life at home.

John Foley, the chief executive and founder of Peloton, and his wife, Jill, a vice president at Peloton, used to leave the house each morning by 7:45 a.m. and not come home until 7:30 p.m. By then, their nanny had already fed and readied their two children — an 8-year-old daughter and a 12-year-old son — for bed.

In March, everything changed. Not only were the Foleys having dinner together every night, they were together all of the time.

Mr. Foley said he credited family dinners for helping his daughter become more mature. “Her personality has blossomed,” he said, “and that’s partly because we’re together as a family, learning from each other.”

Homayoun Hatami, a managing partner at McKinsey & Company in Paris, surveyed chief executives for a report on leadership during the pandemic and found that many, like Mr. Foley, had begun to set aside time for family dinners.

Decades of research have shown the benefits of regular family meals for children across the socioeconomic spectrum. Children who eat with their parents have bigger vocabularies, receive higher grades and have lower rates of obesity.

Sara Blakely, the chief executive and founder of Spanx, which sells sculpting bodysuits and pants, said her family of six now eats dinner together every night, up from three to four nights a week before the pandemic. Spending more time at home has given her children new insights into who she is not only as their mother, but also as the creator of a business empire, she said.

She realized recently that her children had not known she was an inventor, with several patents in her name.

“They were like, ‘Well, what do you mean you’re an inventor?’ They think of an inventor as only a man — as being Einstein or Edison,” she said.

Credit…Heather Ainsworth for The New York Times

Even as rising coronavirus cases forced other colleges to halt in-person classes or send students home, Syracuse University managed to keep the virus at bay, with only a handful of students testing positive since classes began in the fall.

That was, campus officials say, until someone traveled to a nearby city and brought the virus back to campus, where it spread rapidly at parties. Syracuse, a big private college in Central New York, now has more than 75 active cases, including 68 people who tested positive in the last four days.

The sudden rise highlights how quickly the virus can spread in a college environment, even as many students take pains to protect themselves and their classmates.

It’s not how Ava Notkin was expecting her last semester to play out. The senior said on Saturday that she was exhausted from the health anxiety that pervaded the campus, making it hard to focus on homework, exams and other aspects of college life that would, under normal circumstances, constitute the bulk of a student’s stress.

“I feel like I’m teetering on the edge,” said Ms. Notkin, 21, a marketing management major from Pittsburgh. “We’re always in this risky gray area.”

Ms. Notkin and other students have expressed frustration with students holding parties that officials say are leading to new infections.

“Everyone just needs to realize that this is not our normal college experience anymore,” she said.

Still, students and campus administrators say they recognize the desire to socialize, particularly for those who are just getting to know their peers or are spending their last year in the same city. The campus has organized a series of virtual lectures, events — “Zumba Party at Home,” anyone? — and other programming for the campus. Ms. Notkin said she had safely enjoyed the region through outdoor activities like kayaking and hiking with friends.

Back in August, a gathering of students alarmed university officials enough that they issued a scolding letter warning the campus could be shut down before the semester even began.

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