Surging Coronavirus Cases Push Latin America ‘to the Limit’

The U.S. caseload, already the world’s highest, is approaching two million. A book about the fall of France in 1940 has become a hit during the pandemic.

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ImageA Covid-19 field hospital on the outskirts of Sao Paulo, Brazil, on Tuesday.
Credit...Andre Penner/Associated Press

The outbreak is spreading rapidly in Latin America and the Caribbean, prompting Dr. Carissa F. Etienne, the director of the Pan American Health Organization, to warn on Tuesday that the unfolding crisis had “pushed our region to the limit.”

Cases are surging in countries that took early isolation measures — like Peru, which is just behind Italy in its case count — and in those that ignored recommendations, like Brazil, which has the second-highest tally worldwide, behind only the United States, according to a New York Times database.

Forced to choose between watching citizens die of the virus or of hunger, governments are loosening lockdowns, even as they watch infections climb.

“We go to bed without eating, giving nothing to our children,” said María Camila Salazar, 22, a mother of two in Medellín, Colombia, who collects cardboard, glass and plastic for a living. The country’s caseload — nearly 41,000 as of Tuesday night — has soared since President Iván Duque of Colombia relaxed lockdown rules.

And in Brazil, the crisis has grown so intense that some of the country’s most powerful military figures are warning of instability — an ominous sign for a country that shook off military rule in the 1980s and built a thriving democracy in its wake.

Far from denouncing the idea, President Jair Bolsonaro’s inner circle seems to be clamoring for the military to step into the fray. One of his sons, a congressman who has praised the former military dictatorship, has even warned of a looming “rupture” in the country’s democratic system.

Credit...Audra Melton for The New York Times

Georgia election officials, poll workers and voters reported major trouble with voting in Atlanta and elsewhere in the primaries on Tuesday, a test of the state’s preparations to hold elections during the pandemic.

Elections have emerged as a major point of contention since the outbreak began, with many states moving to embrace voting by mail even as President Trump has objected strenuously with false charges that such voting is riddled with fraud or that it favors Democrats.

In Georgia, there was a meltdown of new voting systems put in place after widespread claims of voter suppression during the state’s 2018 governor’s election, with scores of new voting machines reported missing or malfunctioning. Hourslong lines formed at polling places across the state, and some people gave up and left before casting ballots.

The office of Brad Raffensperger, Georgia’s secretary of state, blamed the problems on a variety of factors, including a shortage of experienced poll workers because of virus fears and a learning curve in using the new machines.

More than one million Georgia voters had already cast ballots before Tuesday, most of them by mail, after Mr. Raffensperger sent absentee ballot applications to all active voters.

But those who had voted in person before Tuesday at early-voting sites had already reported long waits — in some cases up to seven hours. New rules for social distancing and disinfecting voting machines had caused many of those delays.

Clarice Kimp, who arrived at her polling place in DeKalb County on Tuesday morning before 7, waited until 9:15 a.m. to vote. “There were supposed to be 12 people working there, and there were only four,” she said. “They could not get the voting machines to register voting cards, and they said they could not reach the technicians.”

Finally, the poll workers handed out provisional ballots, Ms. Kimp said. But those were also in short supply.

By midafternoon, several counties had begun extending voting hours to account for time lost because of the new machines.

U.S. roundup

Credit...Anna Moneymaker/The New York Times

The top U.S. infectious disease expert, Dr. Anthony S. Fauci, delivered a grim assessment of the devastation wrought around the world by the coronavirus, describing Covid-19 on Tuesday as his “worst nightmare” — a new, highly contagious respiratory infection that causes a significant rate of illness and death.

“In a period of four months, it has devastated the whole world,” Dr. Fauci told biotech executives during a conference held by the Biotechnology Innovation Organization. “And it isn’t over yet.”

His discussion with a moderator was conducted remotely and videotaped for conference participants. Although Dr. Fauci said he had known that an outbreak like this could occur, one aspect surprised him: “how rapidly it just took over the planet.”

An efficiently transmitted disease can spread worldwide in six months or a year, but “this took about a month,” Dr. Fauci said. He attributed the rapid spread to the contagiousness of the virus and extensive world travel by infected people.

Vaccines are widely regarded as the best hope of stopping or at least slowing the pandemic, and Dr. Fauci said he was “almost certain” that more than one would be successful. Several are already being tested in people, and at least one is expected to move into large, Phase 3 trials in July.

But much is still unknown about the disease and how it attacks the body, research that Dr. Fauci described as “a work in progress.” Another looming question, he said, was whether survivors who were seriously ill would fully recover.

As the U.S. caseload approaches two million, here’s a look at other important developments around the country:

  • Gov. Philip D. Murphy of New Jersey — one of the hardest-hit states in the U.S. — said on Tuesday that he was lifting the stay-at-home order that he issued in March and increasing the limits on how many people can gather indoors and outdoors.

  • Harvard University said that it would dip into its endowment, the largest university endowment in the world, to avoid furloughing or laying off employees and to cover other costs during the pandemic, which is projected to cost more than $1 billion in revenue.

  • Senators are debating whether to extend a substantial package of unemployment benefits enacted as part of the stimulus bill to help Americans weather the pandemic, after the latest jobs report showed an unexpected rebound in hiring.

  • In Virginia, Gov. Ralph Northam moved on Tuesday to ease some restrictions in the northern part of the state. Beginning Friday, he said, restaurants in Northern Virginia could offer indoor dining at half capacity, gyms could reopen at 30 percent capacity, and social gatherings of up to 50 people would be allowed. .

  • Regular testing of nursing home employees is seen as one of the most important ways to contain outbreaks, and a debate has emerged over who should pay for it. Nursing homes, which have received nearly $5 billion in federal stimulus funding to cover virus expenses — including testing — have asked for more help. Insurers have also said they should not be required to pay.

  • Connecticut’s top health official on Tuesday ordered hospitals that were barring visitors because of the coronavirus to make exceptions for patients with disabilities.

  • The U.S. Defense Department on Monday started lifting travel restrictions. Thirty-nine states and five host nations — Bahrain, Belgium, Britain, Germany, Japan — were part of the first wave of openings, allowing personnel to travel on business farther than the 100-mile restriction that had been in place if conditions at bases there met specific benchmarks.

  • In a sign of the economic pressure on local newspapers, The Miami Herald announced it would move out of its Doral, Fla., headquarters in August, ending its lease and directing its employees to continue working from home until year’s end.

Global Roundup

Credit...Bae Byung-Soo/Newsis, via Associated Press

South Korea on Wednesday began requiring gyms, nightclubs, karaoke bars and concert halls to register visitors through smartphone QR codes, in the country’s latest effort to fight a new wave of coronavirus infections linked to entertainment venues.

Until now, these facilities have mostly asked their customers to write down their identities and contact information in rosters before entering. But when the authorities tried to track down customers after the new infections began cropping up last month, they found that much of the information was fake.

Under the new system, nightclubs and other facilities must install QR scanners, and customers must download a QR code that contains their basic personal information. Any QR codes that the government collects are to be automatically destroyed after four weeks.

South Korea’s project is just the latest effort worldwide to harness common consumer technology to track new cases. But privacy concerns have made the approach slower to catch on in the United States and Britain. And in China, the government’s virus-tracking software has prompted fears that it will randomly collect citizens’ information in the name of disease prevention.

There has not yet been a significant public debate over South Korea’s new QR code tracking system, although that may come as the government rolls it out.

Since last month, South Korea has eased its social-distancing restrictions, saying it was confident in its virus-containment strategy. But it has also urged the people to stick to preventive measures, and acknowledged that its goal is to keep the daily caseload below 50 until a vaccine is available.

South Korea’s daily caseload has fluctuated between 38 and 57 over the past week, and the country reported 50 new cases on Wednesday.

In other news from around the world:

  • As India continued to ease its lockdown on Wednesday, officials reported almost 10,000 new cases over the past 24 hours. Nearly 8,000 people in the country have died, and the total number of infections is approaching 300,000.

  • In Russia, where the number of cases is approaching 500,000, Moscow’s tough lockdown ended abruptly on Tuesday as a nationwide vote on extending President Vladimir V. Putin’s rule loomed. The Russian capital continues to report more than 1,000 new virus cases a day.

  • Malaysia, citing virus fears, has said it will ask Bangladesh to take back 269 Rohingya refugees who arrived by boat after months at sea.

  • The U.S. Agency for International Development issued regulations on Tuesday that broadly restrict its workers from using federal funding to buy surgical masks, gloves and other protective medical gear to confront the virus overseas, in order to keep that equipment available for health providers in the United States.

  • Britain on Tuesday abandoned plans to bring back all primary school students before the summer holidays. The Department of Education had aimed for the pupils to spend four weeks in classes, but many schools have said they are already full and cannot safely accommodate more.

  • Residents of Spain will have to continue to wear face masks even after the country officially lifts its state of emergency on June 21, the health minister, Salvador Illa, announced on Tuesday as the government presented its “new normalcy” plan.

  • In France, where the virus has killed over 29,000 people, the Paris prosecutor has opened an investigation into dozens of complaints over the authorities’ response to the epidemic.

Credit...Christopher Black/Agence France-Presse — Getty Images

Officials at the World Health Organization on Tuesday walked back an earlier claim by one of their colleagues that transmission of the virus by people without symptoms is “very rare.”

The officials called it a “misunderstanding,” but it’s not the first time the W.H.O.’s assessment has seemed to lag behind scientific opinion.

Even as agency leads the worldwide response to the pandemic, several scientists warned on Tuesday, it is failing to take stock of rapidly evolving research findings and to communicate clearly about them.

Another example: The agency delayed endorsing masks for the general public until Friday, claiming there was too little evidence that they prevented transmission of the virus. Virtually all scientists and governments have been recommending masks for months.

The W.H.O. has also said repeatedly that small airborne droplets, or aerosols, are not a significant factor in the pandemic’s spread, although a growing body of evidence suggests that they may be.

These scientific disagreements have wide policy implications. Many countries, including the United States, adopted lockdown strategies because they recognized that isolating only people who were sick might not be enough to contain the epidemic.

“On the one hand, I do want to cut the W.H.O. some slack, because it is hard to do this in an evolving pandemic,” said Dr. Ashish Jha, director of the Harvard Global Health Institute. “At the same time, we do rely on the W.H.O. to give us the best scientific data and evidence.”

Credit...James Hill for The New York Times

It became the indispensable book of the pandemic, its French author revealing how society’s weaknesses and human frailties gave way to disaster.

As the coronavirus tore through France, intellectuals, historians and journalists cracked open their old copies in search of eternal truths in an unsettling time.

It was not Albert Camus’s “The Plague.’’ “Strange Defeat’’ by Marc Bloch, a scholarly dissection of the fall of France in 1940, has become the reference point to understand the underpinnings of what went wrong this time.

Why did France record one of the world’s highest Covid-19 death tolls and mortality rates? Why is it expected to suffer a catastrophic drop of 11 percent in its gross domestic product?

“Strange Defeat’’ described a country that, in 1940, believed it had the best army in the world but that was trounced by Hitler’s forces in six short weeks.

Bloch, a historian and army officer, wrote that an ossified bureaucracy and an out-of-touch elite had left his country without the proper defenses and without the critical capacity to adapt to a rapidly changing situation on the ground.

To some readers, the parallels to 2020 cannot be ignored.

In the early months of this year, as the virus ravaged China and then found a European foothold in Italy, France watched with confidence, seemingly secure behind a health care system that it has long believed to be one of the world’s best.

Once again, as in 1940, France’s historical rival, Germany, has come out ahead. Though Germany has recorded nearly 9,000 deaths, France’s death toll is more than 29,000.

Credit...Malaysia Maritime Enforcement Agency/EPA, via Shutterstock

The Malaysian government, citing fears over the spread of the coronavirus, has said it will ask Bangladesh to take back 269 Rohingya refugees who arrived by boat after months at sea.

The refugees, who escaped genocide and persecution in Myanmar, were detained Monday in Malaysia after their dilapidated boat neared the island of Langkawi.

Malaysia has a history of turning back Rohingya refugee boats and can now cite the tightening of border controls over the virus as another reason to refuse them entry.

“The Rohingya should know, if they come here, they cannot stay,” Malaysia’s defense minister, Ismail Sabri Yaakob, told reporters on Tuesday.

About 730,000 Rohingya fled Myanmar in 2017 as the military waged a genocidal campaign of murder and rape. Others fled earlier, and now about a million Rohingya live in squalid camps in Bangladesh.

Leaving by boat, often at the mercy of human traffickers, is one of the few ways they can escape from the camps.

The boat that reached Malaysia is believed to have departed from Bangladesh in February with many hundreds of passengers aboard, but only 269 reached Malaysia. The fate of the others remained unclear as of Wednesday afternoon.

It also appeared unlikely that the refugees pose a coronavirus threat to Malaysia, which has reported just over 8,000 cases. The first report of the virus reaching the Bangladesh camps was not until mid-May.

Health experts fear that the spread of the virus in the crowded camps could be catastrophic.

Human rights advocates urged Malaysia to recognize the refugees’ rights under international law.

“The Rohingya who were on that boat are not criminals, but asylum seekers in need of safety and protection,” said Kasit Piromya, a former Thai foreign minister and a board member of Asean Parliamentarians for Human Rights.

Credit...Ruth Fremson/The New York Times

After months of being embattled over its response to the coronavirus, Amazon is working to convince the public that its workplaces — specifically, the warehouses where it stores everything from toys to hand sanitizer — are safe during the pandemic.

The company is spreading its safety message after a period that Jeff Bezos, the chief executive, has called “the hardest time we’ve ever faced.” Amazon struggled to balance a surge of orders with the health concerns of the one million workers and contractors at its warehouses and delivery operations.

Workers at hundreds of its facilities became ill with Covid-19, and many blamed the company. At the height of the crisis, one executive said he quit over the firings of workers who had raised questions about workplace safety during the pandemic.

While Amazon has rolled out safety changes, many workers and officials said the measures were unevenly deployed and came too late.

The New York Times agreed to tour a warehouse in Kent, Wash., to see the changes that Amazon and many of its workers around the country had described.

The most significant transformation is the building’s entryway. When workers arrive, they are channeled past thermal cameras to take their temperatures. At a small stand enclosed in plexiglass, a worker hands out masks using tongs.

Workers then enter a makeshift testing center and are handed, via forceps, a self-service test kit for the virus. After administering the test, they seal the kit and place it into a green bin.

Credit...U.S. Navy, via Reuters

The agonizing tale of the coronavirus outbreak on the carrier Theodore Roosevelt starting in March led to the infection of hundreds of crew members, an emergency stop in Guam, the removal of the ship’s captain and the resignation of the acting Navy secretary.

But while the Navy and civic leaders in Guam struggled to quell the spread of the virus, naval officials and researchers at the Centers for Disease Control and Prevention began a medical investigation into the outbreak, the results of which were released on Tuesday.

The study found that, among a few hundred service members who volunteered to be tested and questioned about their experiences onboard and while in Guam, more than a third had enough functioning antibodies to Covid-19 to indicate they could have some protection against the virus, at least for a limited time.

Some were still showing the presence of neutralizing antibodies, which block the virus from binding to cells, three months after the onset of symptoms.

“This is a promising indicator of immunity,” said Daniel C. Payne, an epidemiologist and one of the lead authors of the study, which was undertaken in conjunction with the Navy. “We don’t know how long-lasting, for sure, but it is promising.”

In late April, after the outbreak began, naval medical officers began testing the volunteers. Blood samples were sent overnight from Guam to Georgia, where they were tested at the C.D.C. labs, using their own antibody tests.

The first testing found the presence of coronavirus antibodies in 228 (59.7 percent) of the volunteers. Of those, 135 (59.2 percent) had antibodies powerful enough to neutralize the virus and thwart infection.

Credit...Atul Loke for The New York Times

Before the pandemic, India’s women were already dropping out of the labor force. Virus restrictions — and one of the worst economic slumps in decades — now threaten even more losses for them.

One national employment study conducted in May found that a higher proportion of women reported losing their jobs than men. Among Indians who remained employed, women were more likely to report anxiety about their futures.

The global slowdown could have especially stark consequences in developing economies, where about 70 percent of working women are employed in the informal economy, with few protections.

Although India recently lifted most of its lockdown measures in an effort to ease pressure on the economy, many women fear that even a limited degree of freedom will be difficult to regain.

Seema Munda, 21, kept refusing her parents’ pleas to get married. She slipped out of her conservative village in northern India and found work stitching shirts at a factory in Bengaluru, 1,000 miles to the south.

“This job liberated me,” she said.

But when the pandemic hit, Ms. Munda’s life of independence shattered as she became one of the 120 million Indians left jobless. After first being forced to take shelter in a school after losing her hostel room, Ms. Munda made a wrenching decision and boarded a train home.

Credit...Joan Wong

Since the virus began spreading in the United States, there has been an uptick in acts of violence and prejudice toward Asian-Americans. For many, these episodes represent a compounded bigotry: They are wrongly blamed for the pandemic, and they are lumped together as a single group.

The term “Asian-American” masks profound national and cultural differences in the name of representation. The Times asked 11 illustrators of Asian descent to create a self-portrait, reflecting on their heritage, their stories of immigration and how they identify as Asian-American.

“In the last couple of years we have become more visible and more heard,” writes Joan Wong, above, an American artist born to parents from Hong Kong. “It has made me feel less alone and injected me with more pride.”

Credit...Oli Scarff/Agence France-Presse — Getty Images

The British government on Tuesday abandoned plans to bring back all primary school students before the summer holidays amid growing concerns that filling up classrooms could lead to new infections.

The Department of Education had aimed for all primary schoolchildren to spend four weeks in school before the summer holidays, but many schools have said they are already full and cannot accommodate more children safely.

The education secretary, Gavin Williamson, said on Wednesday that the department’s plans were no longer feasible and that schools would be asked to take in as many children as possible while implementing social-distancing measures and a maximum class size of 15 students.

“The safety of our children, young people and staff remains my priority,” Mr. Williamson said addressing Parliament on Tuesday. “We are not able to welcome all primary school children back before the summer for a full month.”

“We all know how important it is for children and young people to be in education and childcare and it is vital that we get them back there as soon as the scientific advice indicates that we can,” he added.

Nursery school and three primary school year groups have been eligible to return to school since June. 1, but many students have stayed home because of safety concerns and capacity issues.

Credit...Bryan Anselm for The New York Times

Gov. Philip D. Murphy of New Jersey said on Tuesday that he was lifting the stay-at-home order that he issued in March and increasing the limits on how many people can gather indoors and outdoors.

“With more and more of our businesses reopening, we are no longer requiring you to stay at home, but we are asking you to continue to be responsible and safe,” he said.

The moves are a major milestone for the state, which was among the hardest hit, with more than 164,000 cases and more than 12,000 deaths. After peaking in April with more than 4,000 new daily cases, the number declined gradually and has remained below 1,000 in June. It dipped below 500 for the last three days.

The governor said indoor gatherings could involve 50 people, up from 10, or 25 percent of a building’s capacity, with face coverings required. That extends to religious institutions but does not include indoor dining or performance venues.

Mr. Murphy also raised the limit on outdoor gatherings from 25 people to 100. The easing of restrictions does not apply to spectators at sporting events.

The limit on the size of outdoor gatherings will be raised to 250 people by June 22 and to 500 by July 3. Because graduation ceremonies will be permitted on July 6, schools may plan to have as many as 500 people. Gatherings like political protests of “any persuasion” and outdoor religious services will not be limited in size.

But Mr. Murphy said state officials might reverse permission for bigger gatherings “should we see any troubling signs in the data indicating a spike in cases.” The governor said state officials needed more data to assess the spread and urged residents to get tested, especially recent demonstrators.

Harvard said that it would dip into its endowment, the largest university endowment in the world, to avoid furloughing or laying off employees and to cover other costs during the pandemic, which is projected to cost more than $1 billion in revenue.

The university’s governing body voted for a one-time special expenditure from the endowment — valued at $41 billion before the outbreak — to cover immediate virus costs, including room and board rebates to students for the spring semester and their moving costs. The money will also cover an increase in financial aid, enhancements in remote learning and public health improvements on campus, officials said.

Harvard said it had lost $415 million since the spring because of the pandemic and estimated that it would lose another $750 million in the fiscal year that begins in July.

A Harvard spokesman declined to put a dollar amount on extra funds that the university would draw from its endowment or to disclose how much the endowment had shrunk as the pandemic upended the market.

In April, Harvard turned down $8.6 million in taxpayer money from a $14 billion federal emergency relief package for higher education after President Trump attacked the university for receiving federal funds despite its large endowment. “Harvard’s going to pay back the money,” Mr. Trump said.

But Harvard said there was nothing to pay back because it had never applied for or received the money, even though it was included in the federal formula.

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A 7 p.m. ritual outside Brooklyn Hospital Center in Fort Greene, where crowds have gathered to cheer hospital workers during the virus crisis, ended Monday with a farewell party. Video footage from Kara Baker.

With all of New York State now reopened in some capacity, officials on Tuesday preached caution, warning that as hundreds of thousands of people returned to work, the risk of spreading the virus remained.

“We’re in a new phase,” Gov. Andrew M. Cuomo said. “Reopening resets the whole game.”

The governor unveiled a new online dashboard that he said would show the percentage of positive cases by region and county. The information would signal “tremors of a spike” in infections if one were on the horizon, he said.

In New York City, which began reopening this week, Mayor Bill de Blasio offered a similar message. Based on the timeline outlined by the state, it is technically possible that the city could move into Phase 2 on June 22. But the mayor has targeted early July for that next step, and on Tuesday he continued to emphasize patience.

Any missteps, he added, could lead to a resurgence of the virus that would put the city under “fuller restrictions or worse.” “I do not want to unduly raise expectations,” the mayor said. “We are not like the other regions of state.”

Arts and sports roundup

Credit...Nidarosdomens Guttekor

Group singing has gone from being something life-affirming to a potential source of disease, even death. Outbreaks have been linked to choir rehearsals and church services around the world.

Some countries have banned group singing as a result, and scientists are studying the risks. But with conflicting messages from the authorities worldwide, for now singers are left with little but anxiety.

The most obvious reason singing is a risk for transmission is that droplets of saliva containing the virus can spray from someone’s mouth. But a potentially bigger issue comes from tiny particles, called aerosols, that are so light that they travel on air currents. There is uncertainty over whether aerosols spread the virus, but some scientists say that outbreaks among choir groups suggest they played a role, especially when singers said they had followed social-distancing rules. In May, the Centers for Disease Control and Prevention issued guidance that churches should ensure that choirs follow social distancing. Its previous advice that was to “consider suspending or at least decreasing” singing.

Lucinda Halstead, the president-elect of the Performing Arts Medical Association, said if “it’s a small group and it’s outside and the wind is not at your back,” the risk of catching the virus while singing would be reduced.

But she said that choirs probably cannot return to their past ways without a vaccine or rapid testing. “This is only temporary.” she said. “God understands you can’t sing right now.”

Here are other arts- and sports-related developments:

  • The Salzburg Festival announced on Tuesday that it would go forward in August, but in modified form. The original plan — more than 200 performances over 44 days — will become 90 performances over 30 days. Audiences of up to 1,000, about half the capacity of its main theater, will sit in staggered formation.

  • The first women’s golf major championship of this year, the Evian Championship, was canceled on Tuesday because of travel restrictions and quarantine requirements related to the pandemic. The L.P.G.A. Tour has canceled or postponed nearly two dozen tournaments and has not held an event since the Women’s Australian Open in February.

  • Chicago canceled all arts performances and festivals in parks through Labor Day, including Lollapalooza, Chicago SummerDance and the Chicago Jazz Festival.

  • The N.F.L. has detailed the steps that teams must take before players can return to training facilities, the latest effort by the league to return to business as usual in an off-season that has largely been conducted virtually.

  • A North Carolina auto racing track was ordered to close after it staged two events with packed stands last month. Ace Speedway held its season opener on May 23, with a near-capacity crowd at the 5,000-seat facility, in defiance of Gov. Roy Cooper’s order banning outdoor public gatherings of more than 25 people. The speedway held another night of racing on May 30.

  • Visitors can once again enter the Pantheon in Rome after the monument joined a growing list of sites that reopened their doors after weeks of lockdown. In Milan, the building housing Leonardo’s “Last Supper” also reopened Tuesday, as did the Capodimonte Museum in Naples.

  • While the in-person art world in New York City remains mostly shuttered, some galleries are opening spaces in the Hamptons.

Credit...Diego Ibarra Sanchez for The New York Times

Relief workers are broadly restricted from using federal funding to buy surgical masks, gloves and other protective medical gear to confront the virus overseas, in order to keep that equipment available for health providers in the United States, according to regulations issued Tuesday by the U.S. Agency for International Development.

The new rules did grant an exception: The money can be used to buy equipment if it is produced in the part of the world where it would be used, a key provision that helps local economies that also are struggling because of the virus.

Humanitarian aid groups have waited for months for the guidance, a topic of intense debate within the Trump administration, as masks, gloves, ventilators and respirators were desperately needed by American health workers to care for U.S. patients.

As they waited, the groups received only a fraction of nearly $1.6 billion that Congress approved in March to send to aid workers in foreign countries.

The new guidance, a copy of which was obtained by The Times, requires that humanitarian aid groups that are distributing support to some of the poorest or most unstable countries seek written approval before using federal funding to buy N95 respirators or other surgical face masks, medical gloves, ventilators, certain air purifiers and filters and American-made testing kits.

The limits on the protective medical gear will remain in place until there is a surplus of supplies in the United States.

Credit...Anna Moneymaker/The New York Times

The chairman of the Senate health committee, hoping to pass legislation this year to address future pandemics, on Tuesday released a set of proposals for beefing up the U.S. ability to respond to a public health crisis — and is crowdsourcing suggestions from the public.

In a white paper entitled “Preparing for the Next Pandemic,” Senator Lamar Alexander, Republican of Tennessee, identified five priorities: accelerating research and development of tests, treatments, and vaccines; expanding disease surveillance capability; rebuilding the Strategic National Stockpile; beefing up state and local public health departments; and improving coordination of federal agencies during a public health emergency.

“In this internet age, attention spans are short,” Mr. Alexander said in a statement. “Even with an event as significant as Covid-19, memories fade, and attention moves quickly to the next crisis. That makes it imperative that Congress act on needed changes this year in order to better prepare for the next pandemic.”

Public health experts have been warning of a deadly pandemic for decades. In 2015, Susan Rice, the national security adviser to President Barack Obama, created a “global health security and biodefense unit” inside the White House. But President Trump disbanded the team.

Mr. Alexander’s white paper steered clear of laying blame for the lack of preparedness. But he said the federal government must play a critical role in preparedness., noting, for example, that “only the federal government can fund research at the scale necessary to create tests, treatments, and vaccines” and “coordinate the distribution of supplies and information at the national level.”

Mr. Alexander, who has held his Senate seat since 2003 and will retire when his term expires early next year, said he hoped that the paper would lead to discussion among lawmakers and the public. Anyone with ideas may submit them, no later than June 26, to

Connecticut on Tuesday ordered hospitals that were barring visitors because of the pandemic to make exceptions for patients with disabilities. They must be allowed to have a family member or a care provider accompany them when they need support.

The order assures “vital safeguards for individuals with special needs to ensure proper and safe care is being provided and received in a hospital setting,” Gov. Ned Lamont said in a statement released by the federal health department’s Office of Civil Rights.

The order resolved complaints that disability rights groups had filed with the federal agency.

Roger Severino, who directs the health department’s Office of Civil Rights, said in an interview that Connecticut’s order should be a model for other states trying to balance safety with civil rights during the pandemic.

“People should not be left to fend for themselves when they can be reasonably accommodated,” he said. “The safety of patients with disabilities shouldn’t be pitted, as if it’s a zero-sum game, against the safety of others. Both can be protected.”

Credit...Kyodo News, via Getty Images

Moscow’s tough lockdown ended abruptly on Tuesday as a nationwide vote on extending President Vladimir V. Putin’s rule loomed. The Russian capital continues to report more than 1,000 new virus cases a day.

Barbershops, beauty parlors, veterinary clinics and photography studios were allowed to reopen on Tuesday, and the city’s intricate system of digital permits for leaving one’s house stopped operating. A day earlier, Mayor Sergei S. Sobyanin said the spread of the virus in the capital had slowed to the point that the city’s shelter-in-place measures, some of the world’s most stringent outside of China, could be lifted.

Libraries and agencies including real estate, advertising and consulting will be allowed to reopen next Tuesday, Jun,Mr. Sobyanin said, along with museums and zoos as long as they sell tickets online. Sporting events will reopen to spectators at 10 percent capacity, and restaurants and cafes will be able to serve customers seated outdoors. Gyms, pools and kindergartens will fully open on June 23.

“The battle is not yet over,” Mr. Sobyanin told Muscovites on his website. “Nevertheless, I would like to congratulate you with our latest joint victory and with a major step toward returning to full-fledged life.”

But critics said Mr. Sobyanin was declaring victory far too soon and pointed to possible pressure from the Kremlin. Last month, Mr. Putin postponed the military parade celebrating the 75th anniversary of Soviet victory in World War II; it will be held June 24. And Mr. Putin rescheduled to July 1 a constitutional referendum that would allow him to stay in office until 2036.

A grand parade coupled with a renewed sense of optimism thanks to relaxed lockdown measures could help Mr. Putin drum up much-needed enthusiasm for the July 1 vote, analysts said. It wasn’t clear what metrics Mr. Sobyanin was using to suddenly end the lockdown in Moscow, which has reported a total of 198,590 cases and 3,029 deaths. The number of daily new reported cases had hovered around 2,000 for two weeks before falling to 1,572 on Tuesday.

Credit...Natalie Keyssar for The New York Times

Reports of child abuse cases in New York City cases have dropped 51 percent compared with the same time period a year ago, a concerning trend among child welfare advocates who worry an unseen epidemic of abuse is spreading behind locked doors.

When the virus shuttered New York City, the fragile system of safeguards designed to protect children has fallen apart and left them confined at home, the most dangerous place they can be, Times correspondent Nikita Stewart reports. In the first eight weeks of spring 2019, New York City’s child welfare agency received an average of 1,374 cases of abuse or neglect to investigate each week. In the same period this year, that number fell to 672, a decline of 51 percent.

Teachers, pediatricians, social workers and camp counselors, for example, are typically the first to discover bruises or signs of hunger or mistreatment of children. But the virus has transitioned those interactions to virtual ones.

The tensions resulting from stay-at-home orders and social distancing — isolation, unemployment and even alcohol abuse — can easily erupt into violence, child welfare experts said. Sexual predators now have all-day access to children who would normally be in school; in the Bronx, for example, sexual abuse is the most common type of child abuse arrest since the start of the pandemic, according to the borough’s District Attorney’s Office.

Other parts of the country are seeing a similar trend since measures were put in place to keep people at home with the goal of stopping the spread of the virus.

The virus has also had a similar impact on domestic violence cases across the country.

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Antarctica is the only continent that has not reported any cases of the virus. In an effort to keep it that way, Antarctica New Zealand, the government agency responsible for carrying out New Zealand’s activities on the continent, will cut back on research trips.

The institute will support only “long-term science monitoring, essential operational activity and planned maintenance this season in Antarctica,” it said in a statement on Tuesday. The reduction will minimize the number of visitors to the continent.

Antarctica is not a country and is governed by the Antarctic Treaty system, which came into force in 1961. New Zealand is among the countries that operates a base there.

Antarctica New Zealand and other government agencies, the statement said, are preparing a “managed isolation plan” for the continent, which is largely isolated anyway, to make sure it remains free of the virus.

“We acknowledge the impact this Covid-19 response will have on research this season, but these are unprecedented times,” Simon Trotter, the general manager of Antarctic operations for the institute, said on Tuesday.

Reporting was contributed by Ian Austen, Ken Belson, Ronen Bergman, Aurelien Breeden, Choe Sang-Hun, Emily Cochrane, Michael Cooper, Maria Cramer, Abdi Latif Dahir, Reid J. Epstein, Jack Ewing, Richard Fausset, Sheri Fink, Jerry Garrett, Denise Grady, Anemona Hartocollis, Mike Ives, Lara Jakes, David D. Kirkpatrick, Aaron Krolik, John Leland, Antonio de Luca, Iliana Magra, Apoorva Mandavilli, Alex Marshall, Patricia Mazzei, Jesse McKinley, Raphael Minder, Paul Mozur, Norimitsu Onishi, Aimee Ortiz, Richard C. Paddock, Bill Pennington, Elisabetta Povoledo, Suhasini Raj, Scott Reyburn, Jaspal Riyait, Rick Rojas, Kai Schultz, Jeanna Smialek, Kaly Soto, Matt Stevens, Alexandra Stevenson, Nikita Stewart, Katie Thomas, Anton Troianovski, Julie Turkewitz, David Waldstein, Karen Weise, Edward Wong, Jin Wu, Sameer Yasir, Ceylan Yeginsu, Raymond Zhong and Karen Zraick.