President Trump suggested at a rally early Monday morning that he might fire Dr. Anthony S. Fauci after Election Day, further escalating the tension between his administration and the nation’s top infectious disease expert as the number of new coronavirus cases in the United States reaches record highs.
Mr. Trump spoke well past midnight at the Miami-Opa Locka Executive Airport in Florida at his fifth and final rally of the day. At one point, he began reciting a familiar complaint about the news media’s continued coverage of the virus.
His grousing led the crowd to chant, “Fire Fauci! Fire Fauci!” Mr. Trump listened in silence for a few moments before remarking: “Don’t tell anybody, but let me wait until a little bit after the election. I appreciate the advice.”
The president’s aside came toward the end of what was a whirlwind day of campaigning across five states — Michigan, Iowa, North Carolina, Georgia and Florida — and he spoke even as a local curfew aimed at curbing the spread of the coronavirus took effect at midnight. On Friday, more than 99,000 cases were reported across the country, a single-day record. Nonetheless, Mr. Trump has maintained without citing evidence that the United States has “turned the corner” in fighting the virus, a point he reiterated at the rally early Monday.
That assertion is strongly disputed by Dr. Fauci, who told the The Washington Post in an interview published on Saturday that the United States “could not possibly be positioned more poorly” as it heads into the winter. A White House spokesman later called Dr. Fauci’s comments “unacceptable.”
Former Vice President Joseph R. Biden Jr., the Democratic nominee, has said repeatedly that if he were to win the presidency, he is hopeful Dr. Fauci would remain in his role and serve in his administration.
In his interview with The Post, Dr. Fauci offered praise for the Biden campaign, saying it was taking the coronavirus “seriously from a public health perspective.”
Ordinarily circumspect, Dr. Fauci also took the opportunity to unload on another Trump pandemic adviser, Dr. Scott W. Atlas, who has won the president’s favor by questioning mask use and espousing a number of other contrarian views.
“I have real problems with that guy,” Dr. Fauci said, suggesting that Dr. Atlas, a neuroradiologist with no background in infectious disease, is out of his depth.
Dr. Atlas, on Saturday, appeared on RT, a Russian state-sponsored television network that has helped Moscow spread false health information about the pandemic. American intelligence agencies consider RT a propaganda arm for Russia, and it is registered in the United States as a foreign agent.
“The lockdowns will go down as an epic failure of public policy by people who refuse to accept they were wrong,” Dr. Atlas said in the interview. “The argument is undeniable, the lockdowns are killing people.”
The interview with RT was not approved by the White House press office, an administration official said, and Dr. Atlas apologized for giving it.
“I regret doing the interview and apologize for allowing myself to be taken advantage of,” he said in a tweet. “I especially apologize to the national security community who is working hard to defend us.”
The White House has had no public criticism of Dr. Atlas, though it did for Dr. Fauci.
In a statement to The Post, a White House spokesman, Judd Deere, said it was “unacceptable and breaking with all norms” for Dr. Fauci to “play politics” three days before the election. Dr. Fauci, he said, had made “his political leanings known by praising the president’s opponent, exactly what the American people have come to expect from the swamp.”
On a cold weekend in mid-February, when the world still harbored hope that the coronavirus could be contained, a World Health Organization team arrived in Beijing to study the outbreak and investigate a critical question: How did the virus jump from animals to humans?
At that point, there were only three confirmed deaths from Covid-19 outside China, and scientists hoped that finding an animal source for the virus would unlock clues about how to stop it, treat it and prevent similar outbreaks.
“If we don’t know the source, then we’re equally vulnerable in the future to a similar outbreak,” Dr. Michael Ryan, the emergency director of the W.H.O., had said that week.
What the team members did not know was that they would not be allowed to investigate the source at all. Despite Dr. Ryan’s pronouncements, and against the advice of its emergency committee, the organization’s leadership had quietly negotiated terms that sidelined its own experts. They would not question China’s initial response or even visit the live-animal market in the city of Wuhan where the outbreak seemed to have originated.
Nine months and more than 1.1 million deaths later, there is still no transparent, independent investigation into the source of the virus. China has impeded the effort, while leaders of the W.H.O., if privately frustrated, have largely ceded control, even as the Trump administration has fumed.
From the earliest days of the outbreak, the W.H.O. — the only public health body with a global remit — has been both indispensable and impotent. The Geneva-based agency has delivered key information about testing, treatment and vaccine science. When the Trump administration decided to develop its own test kits, rather than rely on the W.H.O. blueprint, the botched result led to delays.
At the same time, the health organization pushed misleading and contradictory information about the risk of spread from symptomless carriers. Its experts were slow to accept that the virus could be airborne. Top health officials encouraged travel as usual, advice that was based on politics and economics, not science.
The W.H.O.’s staunchest defenders note that, by the nature of its constitution, it is beholden to the countries that finance it. And it is hardly the only international body bending to China’s might.
Now, as a new Covid-19 wave engulfs Europe and the United States, the organization is in the middle of a geopolitical standoff between the world’s two greatest powers, the United States and China.
China’s authoritarian leaders want to constrain the organization; President Trump, who formally withdrew the United States from the body in July, seems intent on destroying it; and European leaders are scrambling to reform and empower it.
As rapid coronavirus tests are becoming more widely available, delivering results in minutes, officials warn of a significant undercount, blurring the virus’s spread in the United States and in communities where such tests are more commonly used.
Public health officials say that antigen tests, which are faster than polymerase chain reaction (P.C.R.) tests but less able to detect low levels of the virus, are an important tool for limiting the spread of the virus. But they caution that with inconsistent public reporting, the case undercount may worsen as more “point-of-care” antigen tests, as well as D.I.Y. and home test kits, come on the market.
“We want to be sure that we’re not now saying, ‘there’s no disease,’ when there is lots of disease. All that’s happened is that the science with which we identify it has evolved,” said Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists, the group that helps the Centers for Disease Control and Prevention define cases of the coronavirus.
Despite C.D.C. guidance to report cases based on P.C.R. and antigen testing, Washington, D.C., and seven states don’t publicly share case counts for those with antigen positive tests, including California, New Jersey and Texas.
Another six states keep these tallies separate from their total counts, and most of these report them less frequently.
The differences among states are in part because of each state’s comfort level with the rapid tests, which aren’t “confirmatory” like P.C.R. tests because they can miss low levels of the virus. Yet most states treat antigen positive cases or “probable” cases the same as “confirmed” cases, by following up with interviews and contact tracing.
And a growing number of states, including New Mexico, Oregon and Utah, include individuals with positive antigen tests in their total confirmed case counts.
Scientists who follow the development of coronavirus tests say that rapid testing capacity — most of it antigen-based — could reach 200 million tests a month by early next year, and help the country reach recommended testing levels.
Europe surpassed 10 million confirmed coronavirus cases and 268,000 Covid-19 deaths on Sunday, staggering tolls for a region that seemed to have a semblance of control over the pandemic after the lockdowns of spring and early summer.
In response to the spread of the virus, several countries, including Britain, France and Germany have taken the strongest lockdown measures since the spring. Germany’s new rules — restricting mixing between households and closing restaurants, bars, gyms and more — went into effect Monday. France began a national lockdown on Saturday, and Britain is set to enter a second national lockdown on Thursday.
In July, when the devastating first wave subsided, Europe was averaging fewer than 15,000 new infections a day, but that figure reached about 253,000 in the past week, according to figures compiled by The New York Times, and many nations have returned to lockdowns as the virus has spiraled out of control.
The continent’s death rate, which had dropped to about 300 a day in midsummer, is approaching 2,500 a day. That is still lower than at the peak in April, when medical treatment was less effective, but the figure is climbing fast and hospitals in some regions are once again at risk of being inundated.
The United States has the world’s highest totals of confirmed coronavirus infections, more than 9.2 million, and Covid-19 deaths, more than 230,000. In late summer and early autumn, the United States had far more cases and fatalities than Europe, which has more than twice as many people.
But in recent days, Europe overtook the United States in both deaths and infections. The number of infections in Europe reached more than 10.1 million on Sunday, doubling in just 32 days, and it is growing three times as fast as the American caseload.
The figures, reported by country, are a bit imprecise; they include the non-European part of Russia, but exclude the European part of Turkey. And experts say the true numbers are invariably higher than the official tallies, because some cases go undiscovered.
Globally, there have been about 46.4 million cases and 1.2 million deaths. Europe, with about 10 percent of the world’s population, has had about 22 percent of the infections and fatalities.
The Czech Republic, Belgium and Andorra have Europe’s highest infection rates, both currently and since the start of the pandemic, and some of the highest death rates. Overall, Russia has reported more cases than any other European country, over 1.6 million, but it also has the largest population; several other countries have had higher rates. Britain has reported the most deaths, almost 47,000.
President Trump’s illness from a coronavirus infection last month was the most significant health crisis for a sitting president in nearly 40 years. Yet little remains known about how the virus arrived at the White House and how it spread.
The administration did not take basic steps to track the outbreak, limiting contact tracing, keeping cases a secret and cutting out the Centers for Disease Control and Prevention.
One standard public health technique may still shed some light: tracking the cluster’s genetic fingerprints.
To better understand the outbreak, The New York Times worked with geneticists to determine the genetic sequence of viruses that infected two Times journalists believed to have been exposed as part of their work covering the White House.
The study reveals, for the first time, the genetic sequence of the virus that may have infected Mr. Trump and dozens of others, researchers said. That genome is a crucial clue that may allow researchers to identify where the outbreak originated and whether it went on to infect others across the country.
Additional sequencing could help establish the path of the virus through the White House, the role of a possible super-spreading event for Judge Amy Coney Barrett and the origin of an outbreak among the staff of Vice President Mike Pence.
The journalists, Michael D. Shear and Al Drago, both had significant, separate exposure to White House officials in late September, several days before they developed symptoms. They did not spend any time near each other in the weeks before their positive tests.
The viral genomes of the two journalists shared the same distinct pattern of mutations, the research found. The findings suggest that they were infected as part of the broader White House outbreak, said Trevor Bedford, a geneticist at the Fred Hutchinson Cancer Research Center and the University of Washington who led the research team.
The study, which has been posted online but not yet peer reviewed or published in a science journal, followed academic protocols that require genetic samples to be anonymous. Mr. Shear and Mr. Drago chose to disclose their identities for this article.
Last year, Nepal attracted so many mountain climbers that a traffic jam of hundreds of hikers snarled a trail to the top of Mount Everest.
It was unmistakable proof of a tourism industry that had grown incredibly fast — too fast, some would say — and that had become a lifeline for the country. Last year the industry brought in more than $2 billion to Nepal, one of Asia’s poorest countries, and employed a million people, from porters to pilots.
The trails snaking through the Himalayas are deserted, including those leading up to Everest Base Camp. Fewer than 150 climbers have arrived this fall season, immigration officials said, down from thousands last year.
Countless Sherpas and mountain guides have been put out of work, leaving many to plant barley or graze yaks across the empty slopes to survive.
Many Nepalis fear that the combined effect of the coronavirus and the hammer blow to the economy could set their nation back for years.
“I often think I will die of hunger before corona kills me,” said Upendra Lama, an out-of-work mountain porter who now relies on food handouts to provide for himself and his children. “How long will this go on?”
Although the whole world is asking similar questions, Nepal has few resources to help people cope. Covid-19 cases are steadily rising, and with around 1,000 intensive-care beds for a population of 30 million, the authorities have instructed people who get sick to stay home unless they slip into critical condition. An unknown number may die undetected.
The economic wreckage is easier to see. Hotels and the teahouses clinging to the sides of mountains are boarded up. Restaurants, gear shops and even some of the most popular watering holes in the capital, Kathmandu, have closed for the foreseeable future.
Amid a record spike of coronavirus cases, President Trump and his administration have expressed increasing helplessness at containing the virus, focusing instead on improvements in survivability and trying to hold the economy together.
While it is a theme welcomed by many of the president’s supporters, it is alarming to health officials, including some who say they are encountering rising resistance to their calls for unity in combating a pandemic that has already led to the deaths of at least 230,000 Americans.
Governors around the country, particularly Republican ones, are following the president’s lead in resisting new restrictions.
Gov. Kristi Noem of South Dakota wrote that “there is no way to stop the virus,” while Gov. Doug Burgum of North Dakota said that when it comes to saving lives, “it’s not a job for government, this is a job for everybody.” In Tennessee, Gov. Bill Lee told residents that “at the end of the day, personal responsibility is the only way.” Gov. Mike Dunleavy of Alaska said in an interview that rising case numbers this fall should not cause people to go into hiding.
With the weather cooling and people moving their lives back indoors, the virus has begun an autumn rampage. On Friday, the nation set a record of more than 98,000 infections in a single day. Deaths have also started to rise again.
Hospital and government officials have seen signs of pandemic fatigue, with child sports leagues looking to restart activities, friends celebrating birthdays and families making plans to gather. Gallup has tracked social-distancing habits of Americans and seen sliding numbers of people practicing them, from 92 percent in April to 72 percent in September.
In Idaho, where many residents cherish self-reliance, resistance to mandates surfaced early in the pandemic. In recent weeks, hot spots have developed all over the state, which is now averaging about 900 new cases each day, more than triple the numbers seen just six weeks ago.
Australia reported its first day of no new coronavirus cases in nearly five months, paving the way for further easing of restrictions.
In the 24 hours between 8 p.m. Friday and 8 p.m. Saturday the country reported no locally transmitted cases — the first 24-hour period since June 9 without a new case. Late Saturday, the state of New South Wales reported one new case.
The lack of new cases comes less than a week after Melbourne, Australia’s second-largest city, emerged from an 111-day lockdown imposed during a second wave that at its peak in August saw over 700 new cases a day. Residents can now sit in cafes, restaurants and pubs for the first time since July. More restrictions are set to be eased this coming weekend.
Greg Hunt, the country’s health minister, told local media that Australia was on track for restrictions on travel between states to be removed by Christmas. Residents of New South Wales and Victoria are barred from visiting some states and must quarantine for 14 days when entering other states.
On Monday, the state of Victoria recorded a third straight day with no new cases.
In other news around the world:
Portugal is set to reintroduce a partial lockdown that will affect about 70 percent of its population of 10 million, including inhabitants of Lisbon and Porto, the two largest cities. As of Wednesday, residents of the worst-hit areas will be allowed to leave their home only to go to work, school or shop.
Tedros Adhanom Ghebreyesus, the leader of the World Health Organization, said late Sunday on Twitter that he was quarantining after a contact tested positive. “I am well and without symptoms but will self-quarantine over the coming days, in line with @WHO protocols, and work from home,” he said.
Cambodia on Monday announced that schools could reopen for the first time since March if they meet certain safety standards. Like some of its regional neighbors, the Southeast Asian nation has avoided a large outbreak of the coronavirus. “We are also worried that the reopening will be risky,” Hang Chuon Naron, the minister of education, said on Monday. The education ministry said that the number of students in each classroom would be limited but did not specify whether students had to wear masks. A poor country with underfunded schools, Cambodia has few resources to combat a major virus outbreak.
Prince William contracted Covid-19 in England in April but kept his diagnosis a secret, the BBC and The Sun, England’s largest paper, have reported, citing information from sources within Kensington Palace.
The Duke of Cambridge is likely to have contracted the virus around the same time as his father, Prince Charles, but did not reveal the information for fear of alarming the public, according to British news media. He was treated by palace doctors while isolating at his family home Anmer Hall, in Norfolk, and carried out more than a dozen business calls during this time, The Sun reported.
Kensington Palace could not be immediately reached for comment.
The coronavirus swept its way through the British halls of power in April, sickening the prime minister, Boris Johnson, as well as Prince Charles, the eldest son of Queen Elizabeth II and the heir to the British throne. Cases in England recently surpassed one million, and the country is set to enter a second nationwide lockdown, with pubs, restaurants, gyms and nonessential shops closing for four weeks beginning on Thursday.
“Now is the time to take action because there is no alternative,” Mr. Johnson said at a news conference on Sunday. “We must act now to contain this autumn surge,” he said.
The pandemic has spared almost no business in New York City. Some have thrived, like liquor stores. But no industry has been clobbered like restaurants and bars, a multibillion-dollar lifeblood that gives the city vibrancy and diversity, employs hundreds of thousands of people, including many immigrants, and attracts millions of tourists every year.
From Michelin-starred fine dining to hole-in-the-wall restaurants, the industry brings in about $46 billion annually in sales and pays out about $10 billion in wages to employees, according to the state.
To understand the pandemic’s impact on restaurants, The New York Times took a close look at Gertie, which opened in February 2019 and was finalizing a makeover when the virus hit. (Gertie’s landlord has cut its base rent by 50 percent, down to $5,000 a month, and offered to extend the discount, which included a separate increase in rent payments based on Gertie’s percentage of sales, for another 16 months.)
“Every restaurant has become a shell of a restaurant, like nothing is noticeable inside,” said Nate Adler, an owner Gertie. “Nothing is being used the way that it’s supposed to be used or the way that it was initially intended, and that’s just a hard pill to swallow.”
As a third wave of infections has begun to take off across much of the United States, San Francisco has been a bright spot. The city has tamped down infections to near their lowest levels since the pandemic began. Restaurants, movie theaters, and museums are open at 25 percent of capacity.
One crucial part of the city, however, remains closed: the public schools.
Even as private and parochial schools have begun to reopen, the school district has not set a timeline for resuming in-person instruction.
The district’s decision to stay closed this fall, even as other urban districts — including New York City, Miami, Philadelphia and Washington, D.C. — have opened or set dates for partly reopening, has angered many parents, local health experts and the mayor, London Breed, who does not control the school system.
It has also touched off a sharp debate about how best to safely educate low-income and minority students during the pandemic — and over who speaks for the Asian, Latino and Black families.
That debate is underway in other cities where schools have been slow to reopen. In some places, like Los Angeles and Chicago, school buildings remain closed partly because virus cases remain high. In others, like Oakland, teachers’ unions have said that their members do not want to return to classrooms until there is essentially no local transmission.
urgent calls from doctors to the county department of health began in mid-October, shortly after skyrocketing coronavirus cases had brought a state-imposed lockdown to the community north of New York City.
“Some patients are refusing testing because they do not want D.O.H. bothering them,” a doctor said in a message for the county health commissioner on Oct. 13.
A day later, a caller to a state complaint hotline said in a message, “I would also like to report that there is a widespread effort from the community’s leadership to discourage Covid testing.”
Two weeks after a flurry of similar messages, the positivity rate in Kiryas Joel, an ultra-Orthodox Jewish village in Orange County, plummeted from 34 percent — the highest in the state — to just 2 percent. Last week, citing “dramatic progress” on the rate, the governor eased restrictions in the zone.
The course of events in Orange County has raised deep suspicions among some health experts about the reliability of the data, reflecting broader concerns about whether top officials in New York and around the country are tracking the outbreak in ways that may not accurately capture how much the virus is spreading.
Epidemiologists suggest that officials should rely on many factors when making decisions about reopening, including interviews with health care providers, hospital admission rates and contact tracing, as well as the positivity rate, which is the percent of people who have tested positive over a particular time period.
In New York, senior officials say they use all that data, and refer to the positivity rates as merely a lead measure and shorthand.
The concern over misleading positivity rates has come to a head in regards to Kiryas Joel, also called the Town of Palm Tree, a densely populated Hasidic village of 26,000 people that is about 50 miles north of New York City, and among the poorest communities in the state.
In Orange County, the local health commissioner, Dr. Irina Gelman, said she was concerned about easing restrictions because she had serious doubts about whether the suggested decline in virus cases was real.
“This is an alarming trend,” Dr. Gelman said. “Refusing tests, clearly, makes it very difficult as far as gauging the infection prevalence rate within the community.”