An ambitious new study of nearly 85,000 coronavirus cases in India and nearly 600,000 of their contacts, published Wednesday in the journal Science, offers important insights not just for India, but for other low- and middle-income countries.
India now has more than six million cases, second only to the United States.
Among the findings of the study: The median hospital stay before death from Covid-19, the illness caused by the coronavirus, was five days in India, compared with two weeks in the United States, possibly because of limited access to quality care. And the trend in increasing deaths with age seemed to drop off after age 65 — perhaps because Indians who live past that age tend to be relatively wealthy and have access to good health care.
The contact tracing study also found that children of all ages can become infected with the coronavirus and spread it to others — offering compelling evidence on one of the most divisive questions about the virus.
“The claims that children have no role in the infection process are certainly not correct,” said Dr. Joseph Lewnard, an epidemiologist at the University of California, Berkeley, who led the study. “There’s, granted, not an enormous number of kids in the contact tracing data, but those who are in it are certainly transmitting.”
And the report confirmed, as other studies have, that a small number of people are responsible for seeding a vast majority of new infections.
Though its overall total of cases is huge, the per capita number of cases reported daily in India — and in many other low-income countries, including in Africa — is lower than in Spain, France or even the United States. And its number of deaths has not yet topped 100,000 — which has surprised some scientists.
The study focused on two southern Indian states, Andhra Pradesh and Tamil Nadu, which together have a population of about 128 million, and represent two of the five Indian states with the most cases. They also have among the most sophisticated health care systems in the country.
Contact tracers reached more than three million contacts of the 435,539 cases in these two states, although this still did not represent the full set of contacts. The researchers analyzed data for the 575,071 contacts for whom test information was available.
The data revealed that the people infected first — known as index cases — were more likely to be male and older than their contacts. That may be because men are more likely to be out in situations where they might be infected, more likely to become symptomatic and get tested if they do become infected, or perhaps more likely to respond to contact tracers’ calls for information, said Dr. Lewnard. They also found that infected people tend to spread the virus to those of similar ages.
In media appearances and talks with investors, Pfizer’s chief executive nearly always mentions a word that most of his competitors shy away from: October. “Right now, our model — our best case — predicts that we will have an answer by the end of October,” Dr. Albert Bourla told the “Today” show this month.
His statements have put his company squarely in the sights of President Trump, who has made no secret of his desire for positive vaccine news to boost his chances on Election Day.
By repeating a date that flies in the face of most scientific predictions, Dr. Bourla is making a high-stakes gamble. If Pfizer puts out a vaccine before it has been thoroughly tested — something the company has pledged it will not do — it could pose a major threat to public safety. But if Americans see the vaccine as having been rushed in order to placate Mr. Trump, many may refuse to get the shot.
But “an answer by the end of October” is not the same as having a vaccine then.
When Dr. Bourla referred to a “conclusive readout” next month, a company spokeswoman said, he meant that it’s possible the outside board of experts monitoring the trial would have by that date found promising signs that the vaccine works.
In public interviews, government health officials have refuted the October date. Both Dr. Moncef Slaoui, the chief scientific adviser to Operation Warp Speed, the federal effort that has awarded billions of dollars to vaccine makers, and Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, have said October was unlikely.
Pfizer’s leading competitors in the vaccine race, Moderna and AstraZeneca, have been more vague about timing, saying they expect something before the end of the year. In a recent interview, Moderna’s chief executive, Stéphane Bancel, said: “October is possible, because very few things in life are impossible.” The better word, he said, is “unlikely.”
More than 60 percent of households with children in the United States reported serious financial problems — including struggles to afford medical care, depletion of household savings and difficulty paying credit card and other debts — during the coronavirus pandemic, according to a new poll.
Black and Latino households with children bear the brunt of the hardships. Of the Latino households who responded, 86 percent reported these difficulties; in Black households, 66 percent reported them. In white households, the number hovers around 50 percent.
The immense differences were surprising, as they came after federal and state governments invested heavily in programs for communities disproportionately affected by the pandemic, said Robert Blendon, a director of the study behind the report and a professor at the Harvard School of Public Health.
“So much money was spent to put a cushion under households,” Dr. Blendon said, adding that because of this, “the expenditures should have lowered for everybody.” But, he said, “the numbers of people in trouble, that is the shock.”
The poll, conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, surveyed more than 3,400 adults, 1,000 of whom were living with children under the age of 18, between July 1 and Aug. 3.
Now that some government measures to support households financially during the pandemic are waning, experts are concerned that the financial devastation could be worse than what the survey shows, said Julie Morita, the executive vice president of the Robert Wood Johnson Foundation. Now, Dr. Morita said, “households are probably suffering just as much if not more,” leaving Black and Latino communities especially “unprotected.”
The survey highlights other challenges faced by households with children during the pandemic. Over a third of them reported “serious problems” keeping children’s education going. Six in 10 said that an adult in the home lost their job, was furloughed or had wages or hours cut. And in nine out of 10 households where someone was diagnosed with Covid-19, they faced “serious financial problems” in addition to difficulty caring for their children.
These responses, Dr. Blendon said, show that a high number of households — particularly Black and Latino ones — will face substantial long-term financial effects from the pandemic.
“It’s a very large number of people who can’t pay the basics,” Dr. Blendon said. “You have unbelievably vulnerable people over the next six months.”
Treasury Secretary Steven Mnuchin said Wednesday he would make Speaker Nancy Pelosi a counteroffer to Democrats’ new $2.2 trillion stimulus plan, as part of a last-ditch effort to break a stalemate on another round of coronavirus relief before lawmakers leave Washington to campaign.
After a 50-minute phone call with Ms. Pelosi on Tuesday, Mr. Mnuchin said he was giving talks “one more serious try.” But in an interview on CNBC, Mr. Mnuchin suggested that the measure he was prepared to offer would be around $1.5 trillion, similar to a bipartisan framework a group of lawmakers presented earlier this month — one Ms. Pelosi and her top lieutenants rejected as inadequate.
He said it would include liability protections for schools and businesses, more economic impact payments, support for airlines and relief money for emergency workers in states.
“More fiscal response will help the economy,” Mr. Mnuchin said.
Signaling their pessimism, House Democrats prepared to approve their $2.2 trillion measure — which was all but guaranteed to die in the Republican-led Senate — as early as Wednesday in the absence of a bipartisan agreement. Representative Steny H. Hoyer of Maryland, the majority leader, privately told House Democrats in a conference call that he intended to hold a vote on the bill if the call between Ms. Pelosi and Mr. Mnuchin did not go well.
Democratic leaders appeared disinclined to make many concessions. Ms. Pelosi, in the private call, counseled Democrats that “we’re closer to the inauguration of Joe Biden right now, so we will have our moment,” according to two people familiar with her remarks who disclosed them on condition of anonymity.
“As soon as we get through this we’ll start writing the next bill,” she added.
Economists and top officials have warned that to bolster the economic recovery from the pandemic, Congress needs to approve additional aid for American families and businesses. Airlines and other large companies have warned that tens of thousands of workers will be either furloughed or laid off in the coming days because of the toll of the pandemic and the limitations imposed to slow the spread of the coronavirus.
Republicans have already called the Democrats’ $2.2 trillion recovery bill unacceptable. Representative Steve Scalise of Louisiana, the second-ranking Republican in the House, said on Wednesday that the measure is “not a bipartisan bill. That only sets us back further.”
SEOUL, South Korea — North Korea has discovered “faults” in its anti-epidemic measures, its state news media reported on Wednesday, days after the country apologized for killing a South Korean official found adrift near the disputed western sea border with South Korea.
North Korea’s leader, Kim Jong-un, convened the politburo of his ruling Workers’ Party on Tuesday to review its fight against the coronavirus. In its report on the meeting, the North’s official Korean Central News Agency did not mention the killing of the South Korean official, but said that the North’s officials had discussed some faults in the country’s antivirus efforts, such as “self-complacency, carelessness, irresponsibility and slackness.”
This is not the first time that North Korea has admitted to falling short in its antivirus campaign. In late August, Mr. Kim convened the party’s politburo and its Executive Policy Council to discuss “shortcomings” and “defects” in its battle against Covid-19.
Both the United States military and South Korean officials said that North Korea had given its soldiers “shoot to kill” orders to prevent smugglers and others illegally crossing its borders in order to prevent the spread of the coronavirus. The South’s National Intelligence Agency told lawmakers that the North issued such orders in August.
On Sept. 21, an official from a South Korean government ship monitoring fishing near the disputed western sea border went missing. He was found adrift in North Korean waters a day later and shot and killed by the crew on a North Korean patrol ship that considered him an “illegal intruder,” according to a message North Korea sent to the South on Friday.
South Korea accused the North of killing its official despite his expressing a desire to defect and burning his body for fear of Covid-19. But the North said the official did not express any such intentions. It said that it had burned only his flotation device and that his body had been lost at sea.
Early clinical trials have been completed on a second Russian vaccine, a health official said Wednesday, moving it closer to registration under the Russian approach of approving vaccines for emergency use before beginning late-stage trials to determine whether they are effective.
Early trials provide information about safety, though rare side effects may go undetected until much larger late-stage trials are conducted. The later trials, known as Phase 3, are the only means of determining whether a vaccine actually protects against the coronavirus.
Russia registered its first Covid-19 vaccine — one based on common cold viruses — in August, and is now offering a small number of doses outside of trials to people at elevated risk of infection, like health care workers. Western vaccine experts criticized the Russian approach as potentially dangerous.
Anna Papova, the head of Rospotrebnadzor, a Russian agency regulating health care, said on Wednesday that researchers had completed early clinical trials of a different vaccine, based on proteins that mimic those in the coronavirus.
Ms. Papova defended the Russian regulatory approach, saying that it drew on a long history of Soviet vaccine development. “The Russian vaccines deserve absolutely no criticism,” she said.
Her agency said earlier this month that it planned to register the second vaccine, made by Vektor, a Siberian laboratory that studied biological weapons during the Cold War, by Oct. 15. A third Russian vaccine, made by the Chumakov Institute in Moscow and based on inactivated coronavirus, is now in early-stage trials.
In other developments around the world:
South Korea said on Wednesday that it would impose a fine of up to $85 on anyone caught without a mask in high-risk areas like outdoor gatherings and public transportation, starting on Oct. 13. As people in the country began on Wednesday to celebrate Chuseok, a major holiday that runs through the weekend, health officials reported 113 new cases, the highest daily tally in five days. Tens of millions of South Koreans are traveling for Chuseok and officials fear that holiday gatherings could create new vectors of infection.
Finland on Tuesday ordered bars and restaurants to close at 1 a.m. and to stop alcohol sales at midnight starting Oct. 8 to help contain the spread of the virus. Finland’s virus numbers have remained among the lowest in Europe for months but its public health authority said 149 new coronavirus cases had been reported on Tuesday, among the country’s highest daily numbers for several months. Finland has recorded nearly 10,000 cases of the virus and 345 deaths, according to a New York Times database.
Belgium has recorded more than 10,000 deaths from the coronavirus, one of the highest death tolls in Europe. In a country where paramedics and hospitals sometimes denied care to older people, more than half of the deaths in Belgium have been residents of nursing homes.
Chancellor Angela Merkel of Germany warned citizens that infections will probably rise and called for vigilance. “I appeal to you all, follow the rules that will be in effect in the next while,” she said in a prepared speech during a budget debate. “We have a difficult time ahead of us with autumn and winter approaching.” Ms. Merkel and state governors agreed on Tuesday to lower ceilings on group gatherings and to fine bar and restaurant owners and other businesses who are lax about verifying patrons’ contact information. The country reported 1,798 new infections on Tuesday, more than its recent average of more than 1,600 a day. According to a New York Times Database, Germany has had a total of 289,219 reported cases and 9,488 deaths since the pandemic began.
The first presidential debate between President Trump and Joseph R. Biden Jr. unraveled into an ugly melee Tuesday, as Mr. Trump hectored and interrupted Mr. Biden nearly every time he spoke and the former vice president denounced the president as a “clown” and told him to “shut up.”
During the chaotic, 90-minute event in Cleveland, Mr. Trump defended his administration’s response to the coronavirus pandemic and deflected blame, referring to the virus as the “China plague.”
“It’s China’s fault,” he said of the crisis. “It should have never happened.”
In Beijing on Wednesday, a spokesman for China’s foreign ministry said the accusations leveled against the country during the debate were “groundless and untenable.”
Mr. Trump also voiced impatience with a range of public-health restrictions, while Mr. Biden criticized the president for being dismissive of measures like mask wearing and social distancing.
“He said, ‘It is what it is,’” Mr. Biden said, referring to Mr. Trump’s reaction when the country’s death toll from the virus surpassed 100,000 in May (the number is now over 200,000). “It is what it is, because you are who you are,” Mr. Biden said.
When Mr. Trump was asked about his statements regarding the availability of a vaccine before the election — which directly contradict his own health experts who say it will most likely not be publicly available before next summer — the president said they were wrong: “I’ve spoken to the companies and we can have it a lot sooner.”
Mr. Biden said, “We’re for a vaccine, but I don’t trust him at all and nor do you, I know you don’t. We trust the scientists.”
A 19-year-old student at Appalachian State University — a basketball player “in tremendous shape,” according to his family — died Monday night, apparently of neurological complications related to Covid-19, his family and the university said.
Chad Dorrill, a sophomore at the school in Boone, N.C., had been living off campus and taking classes online when he became ill with flu-like symptoms, Appalachian State’s chancellor, Sheri Everts, wrote on Tuesday in a statement to students.
Mr. Dorrill tested positive for the coronavirus on Sept. 7 and quarantined for 10 days with his family in Wallburg, N.C., before returning to Boone, according to an uncle, David Dorrill. He said after his nephew returned to college, he almost immediately began experiencing dramatic neurological problems.
“When he tried to get out of bed,” Mr. Dorrill said, “his legs were not working, and my brother had to carry him to the car and take him to the emergency room. The doctor said it was a one-in-a-million case — that they’d never seen something progress the way it did. It was a Covid complication that rather than attacking his respiratory system attacked his brain.”
Although colleges and universities have become hot spots in the pandemic, young, healthy people generally have been at lower risk for developing severe forms of Covid-19. Only a handful of deaths among American college students has been linked to the virus, including a football player at California University of Pennsylvania.
A New York Times database tracking the virus on college campuses has recorded at least 130,000 confirmed cases since the start of the pandemic, mostly this fall, but only about 70 confirmed deaths, mostly in the spring among college employees.
David Dorrill said an autopsy was being conducted. Dr. Colin McDonald, chair of neurology at Forsythe Medical Center in Winston Salem, N.C., where Chad’s parents removed him from life support at 8 p.m. on Monday, said that the hospital and staff who cared for him were “devastated.”
“We are doing everything we can to figure out why this happened,” Dr. McDonald said.
For six months, Disney has kept tens of thousands of theme park workers on furlough with full health care benefits in hopes that a light at the end of the pandemic tunnel would appear. On Tuesday, Disney conceded that none was coming.
The company said it would eliminate 28,000 theme park jobs in the United States, or about 25 percent of its domestic resort work force.
“As heartbreaking as it is to take this action, this is the only feasible option we have in light of the prolonged impact of Covid-19 on our business, including limited capacity due to physical distancing requirements and the continued uncertainty regarding the duration of the pandemic,” Josh D’Amaro, chairman of Disney Parks, Experiences and Products, said in an email to “cast members,” which is how Disney refers to theme park workers.
About 67 percent of the layoffs will involve part-time jobs that pay by the hour. However, executives and salaried workers will be among those laid off. Disney’s theme parks in California and Florida employed roughly 110,000 before the pandemic. The job cuts, which will come from both resorts, will reduce that number to about 82,000.
Disneyland in California has remained closed because Governor Gavin Newsom has refused to allow theme parks in the state to restart operations. About 31,000 people work at the Disneyland complex and the majority are unionized and have been furloughed.
Walt Disney World in Florida reopened on a limited basis in mid-July. But attendance has been weaker than Disney expected, with concern about coronavirus safety a major factor.
A former president and opposition politician in Ukraine, Petro O. Poroshenko, announced on Wednesday that he had tested positive for the coronavirus amid a flurry of virus-related disruptions to Ukrainian politics.
The Parliament said on Wednesday that it had canceled plenary sessions until Oct. 20 because of rising infections. The speaker, Dmytro Razumkov, said at least 10 members of Parliament tested positive before the shutdown.
Cases ticked up in Ukraine during summer holiday travel, because of lax observance of mask-wearing and social-distancing rules, and after schools opened last month.
Mr. Poroshenko, who assumed the presidency after a pro-Western popular uprising in 2014, has diabetes, a risk factor for complications. The diagnosis will remove him from campaigning ahead of local elections next month. Mr. Poroshenko said in a statement posted on social media that the positive test was “very untimely” because of the campaign and that he would self-isolate at home.
After a strict lockdown in Ukraine ended in June, the country switched to what authorities called “adaptive measures,” closing some businesses and encouraging social distancing and wearing masks.
Mr. Poroshenko, who now leads an opposition party, had criticized the government’s decision to ease lockdowns in June, for fear that it would lead to a second wave of the virus.
Before catching the virus over the summer, Yulia Tymoshenko, a populist former prime minister, had last spring criticized government lockdowns from the opposite perspective, saying they went too far and infringed on personal freedoms.
Ukraine has reported an average of 3,488 new cases daily over the past seven days.
As Spain struggles to cope with a second wave of the virus, its capital, Madrid, the epicenter of the latest outbreak, has locked down about 1 million people in 45 neighborhoods.
But those areas, where registered cases per 100,000 inhabitants have exceed 1,000, are for the most part poorer areas of Madrid, outside the city center. The renewed lockdown measures include the closure of public spaces like parks and restricted hours for bars and restaurants, leaving empty streets and struggling businesses.
By contrast in the city center, life goes on as normal as it can in a pandemic, with masked shoppers on the streets and customers keeping social distance as they eat and drink at tapas bars and restaurants until late at night.
The sharp difference between the two Madrids underlines how the coronavirus is hitting the most economically vulnerable districts of the capital disproportionately hard.
The one million people living in the neighborhoods that are now locked down are increasingly chafing at the restrictions, especially since they can see that residents of affluent areas are free to travel most places they like.
“This health crisis has nothing to do with a way of life, but a lot to do with people’s living conditions,” said Patricia Estevan, a doctor. “If you share a tiny apartment, and travel across the city on public transport every day to work as a supermarket cashier or cleaner, that is not a choice of life but an economic necessity.”
On Wednesday, the central government was hoping to push through new nationwide lockdown rules and force Madrid to drop its strategy of localized restrictions.